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of the fragmented pieces and implantation of the new lens — turns rapid 6-
minute procedures into 22-minute marathons (by cataract surgery standards).
That extra time adds up and turned 1 surgical day into 2 for Dr. Newsom, who
would routinely use the laser on 20 to 30 premium eye patients a day.
"That's when we said, Wait a minute, taking all this time, opening up the
OR on an additional day, is it really worth it?" he says. "That's when we cut
back on using the laser and took a long look at if it was worth it financially for
patients and for us as a business."
Future promise?
Dr. Miller says there are very few things he's done in his career that cost patients a
lot of money, but that produce no direct benefit other than the perception of better
care.
Perception, as they say, is reality. Some of Dr. Newsom's patients demand
laser-assisted surgery, because they feel they're receiving suboptimal care if the
laser isn't used. Many patients want to undergo surgery with the latest and
hottest tool, which Dr. Newsom believes is one of the technology's strengths.
He also believes it levels the playing field for novice surgeons who might not
be as skilled with the blade in making the capsulorhexis.
Mr. Dawes says the femto laser is almost a must-have for surgeons who want to
run a true refractive practice. Surgeons who are doing only basic cataract surgery
have learned that they can get by without a laser by offering some level of astig-
matism correction with limbal-relaxing incisions or a multifocal or accommodat-
ing lens package, according to Mr. Dawes. "But they're competing as cataract sur-
geons," he adds, "not as refractive surgeons."
Dr. Miller believes laser cataract surgery is around for the long haul. He's seen
the story play out before when phacoemulsification hit the market in the early
1990s. "People were touting the technology, but couldn't show that it provided
any major benefit," he says. "Sure it let you remove the cataract through a small
