As we noted with our introduction of the IOL Master 700 in our Birmingham office, technology will play a huge role in our path toward excellence in cataract surgery refractive outcomes. In addition to the IOL Master 700, we are also excited to be able to offer intraoperative aberrometry with the ORA System. Historically, one of the primary challenges with cataract surgeries is that surgeons have not been able to determine the quality of the refractive outcome during the procedure. Often times, a patient would have to wait weeks after the surgery to determine the accuracy of the surgical results. The ORA System, which stands for Optiwave Refractive Analysis, is a relatively new technology that allows the surgeon to achieve better results and confirm the optimal outcome for the patient during the procedure. VisionAmerica's Dr. Karen Shelton has significant experience with ORA and has utilized the system over the last few years during cataract surgeries. We sat down with Dr. Shelton to learn more about the ORA System and get her thoughts on the technology. What are the benefits of using the ORA System? As you know, determining the correct IOL power is the most important part of achieving excellent refractive outcomes after cataract surgery. Historically, we used ultrasound-based axial lengths and keratometry readings and then advanced to optical biometry and most recently swept source OCT measurements with the IOL Master 700. Each of these technological advances, along with improved formulas, have helped improve outcomes. However, even with this technology, you are still implanting the lens and hoping that all of the measurements and calculations are correct. The ORA system uses intraoperative aberrometry to validate the lens power and toric IOL alignment. ORA technology allows the surgeon to more accurately determine the correct lens power after the cataract is removed in the operating room, instead of having to wait weeks after the surgery. This becomes especially important when patients have chosen premium lenses due to their higher expectations. Are there additional charges to the patient when using the ORA System? There is an additional charge to the patient when having ORA technology and there is additional time required by the surgeon to utilize it. But my experience has shown that having the ability to use ORA in the operating room helps to ensure proper IOL lens selection with better predictable outcomes. None of the technologies available are absolutely perfect, but together they all help to give better surgical outcomes. "None of the technologies available are absolutely perfect, but together they all help to give better surgical outcomes." What is your overall assessment of the ORA System? I first had the opportunity to use this technology in my practice prior to joining VisoinAmerica. This was a high volume cataract practice that had used ORA for quite some time. As I looked at the outcomes, I was impressed by the percentage of post cataract surgical eyes that had predictive uncorrected visual acuities of 20/20 or very close. I felt this was in large part due to the ORA system. We felt so strongly about the technology that we bundled the cost of the procedure with premium lenses to make sure we were achieving the optimal refractive outcomes that these patients expect. In addition to the premium lenses, I have also found this system very beneficial for post corneal refractive surgery eyes which can always be challenging. I am excited to continue offering this technology here at VisionAmerica. If you would like to read more about the ORA system, Alcon has a great educational page that goes into additional detail. You can view that here. If you have any questions, please don't hesitate to give us a call.
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August 2019
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