My approach to premium laser cataract surgery is to, up front, explain what the technology provides for patients.

Rather than offering options that start with a “basic” package, I ensure that patients understand the range of vision that they can achieve and how that benefits their lifestyle.

Laser technology — now we have the Catalys cOS 6.0 (Johnson & Johnson Vision) upgrade with enhanced astigmatism management — and lens technology have reached a level that truly elevates cataract surgery. Keep in mind, of course, that not every patient is a candidate for a presbyopia-correcting IOL.

Jared Younger, MD

The astigmatism talk

When it comes to discussing astigmatism with my cataract patients, I find it is most simple to transition from explaining what a cataract is to describing astigmatism and then telling patients what amount they have based on the measurements I have taken at the visit. I describe that I normally correct the astigmatism during surgery with the laser. This is a powerful way to illustrate the technology’s capabilities that makes sense to patients.

At that point, I have not yet discussed the range of vision possible, just that astigmatism affects their vision and how it can be treated. I ask if they would like to see at all distances, glasses free, and ask about important activities. If the premium options are not appropriate, I reassure the patient that manual cataract surgery with a monofocal lens is still a very good surgery.

Price vs. value

In terms of pricing, my philosophy has always been that a midrange upgrade that includes additional testing, such as topography, and the correction of astigmatism in the operating room makes sense. The method of correction, of course, has transitioned from a manual approach to laser. When aberrometry became available, I included that in the package. It is up to the surgeon to select the right tools to get the patient the vision they want.

To successfully implement laser cataract surgery into practice requires a good plan and comfort with a range of advanced technology. It is well accepted how important refractive cataract surgery is for patients today, and we can increasingly correct smaller amounts of astigmatism than ever before.

As we adjust to the COVID-19 era for our practices, changing the flow and scheduling, it is likely that volume will be affected. That is why having a seamless option for correcting astigmatism makes more sense than ever before. With the soon-to-be available Catalys software upgrade, for example, outcomes can be even more accurate. Patients, no matter what, still want the best vision they can achieve, even if they may not be able to opt for a presbyopia-correcting lens.

I see laser cataract surgery with premium technology as a default option. I educate, and patients largely select the option because it makes sense to them. Offering patients optimal outcomes with the most up-to-date technology will continue to drive practices’ financial health. Having access to laser technology and taking the time to hone one’s skills and overall approach are well worth the effort.

Maintaining overall practice efficiency in the face of spaced-out appointments and lower volumes can be greatly enhanced by utilizing advanced technology. Relying on pre-education and maximizing the time spent with patients — clustering testing for convenience, for example — will also ensure practices stay strong in the new environment. Now more than ever, convenience for patients combined with excellent outcomes is paramount for success.

Conclusion

This is no time for surgeons to return to “business as usual.” The current environment requires us to rethink every aspect of our cataract practices to ensure our wallets’ health, but more importantly, so that we keep doing the right thing for our patients.