Can you explain why there is a trend among cataract surgeons who have invested tens of thousands of dollars in femtosecond laser machines, to abandon their use and now prefer small incision (manual) surgery over laser surgery?
Where are you seeing this "trend"? There are more laser cataract surgery procedures done than ever. The technology is better than ever. There may be a few surgeons who have decided it doesn't suit their practice... but these seem like the exception.
Is there a particular brand of laser that all these doctors are talking about? Is it the femtosecond laser? Is there more than one brand of laser available? If so, are all laser brands considered equal?
Hi @peggyribaudo4361, All of the lasers used for cataract surgery are "femtosecond lasers". The word "femtosecond" refers to the extremely short pulse duration of the laser. There are several different laser manufacturers in the United States, including Alcon, Lensar, and Johnson & Johnson. Different surgeons may have preferences for one company's laser over others. In general, they all perform the same steps during cataract surgery: imaging of the eye, astigmatism correction, bladeless incisions, capsulotomy, and cataract fragmentation.
It’s all about $$$ and paying off expensive equipment and marketing - read large independent retrospective studies to see no difference in patient outcomes yet more expansive and takes longer
I don’t get it. Laser is better but we need to pay out of pocket? Someone explain it to me. No where else can you do this. I can’t tell my photography clients they have to pay more if they want me to use the best equipment.
Hi Bill, Good question. Unfortunately, this has to do with the way medical insurance plans are set up in the United States. We assume that you don't accept "photography insurance"... If you did, you might find yourself in a similar situation in which insurance plans decide to cover certain things, but not others. Do you decide to offer these better services to your clients at an additional fee? Or only offer the basic covered services that the insurance plan covers? Medical insurance plans often (sadly) drag their feet on adopting new technologies. This allows them to save money. In the United States, medical practices are allowed to offer these "noncovered services" to patients; however, the patient must pay on their own (i.e. "out-of-pocket") for them. I hope that clarifies a little bit. Medical insurance can be quite a confusing subject. Also, every plan is different... and there are many, many different plans.
@@bestcataractsurgeons I get all that but I can’t tell my clients I just bought new gear and they have to pay more. I just bought a $6099 camera and now you need to pay more? Even without I insurance they would still do the same thing. Again why do we need to pay more for a machine you decided to buy? Also there is no way a lens could cost $3500. I know for a fact the markup on those is insane. I bet those lenses cost $10 to make I could be wrong but I would bet I’m not
@@billrhea You ask good questions. I believe the difference is that the laser corrects for astigmatism, which is not covered by medical insurance. In terms of cost of things like lenses, you are right in that the marginal cost of producing one lens might be fairly low, but as with all products, consumers pay for everything involved in the production, including research and development, capital expenditures, operating costs, etc.
Unfortunately that's how it is. Im in the same situation, insurance pays only for the basic procedure and the basic lens. Anything extra, such a laser surgery, it's additional.
This is confusing, because I came here after watching Shannon Wong's video, where he explains why he has virtually eliminated femtosecond laser assisted surgery from his practice. His "final answer" is that he considers manual cataract surgery to be preferable for several reasons. Granted, that video was three years old. Now I see this video, with the opposite conclusion/opinion. --Whatever.
There may have been a debate 15-20 years ago when the first laser cataract systems were developed... but that debate is over. No surgeon can perform the delicate steps that the last performs as precisely and consistently as modern laser cataract systems.
@@bestcataractsurgeons Ok, but it does appear that you and SW disagree. For the record, I'm scheduled for CS in Jan. 2025, with laser assist , which is more expensive. Then I see SW's video, followed by yours. Differing opinions, for sure.
So happy with my laser cataract surgery
Happy to hear I am going to have surgery and I am fade
Can you explain why there is a trend among cataract surgeons who have invested tens of thousands of dollars in femtosecond laser machines, to abandon their use and now prefer small incision (manual) surgery over laser surgery?
Where are you seeing this "trend"? There are more laser cataract surgery procedures done than ever. The technology is better than ever. There may be a few surgeons who have decided it doesn't suit their practice... but these seem like the exception.
Is there a particular brand of laser that all these doctors are talking about? Is it the femtosecond laser? Is there more than one brand of laser available? If so, are all laser brands considered equal?
Hi @peggyribaudo4361,
All of the lasers used for cataract surgery are "femtosecond lasers". The word "femtosecond" refers to the extremely short pulse duration of the laser.
There are several different laser manufacturers in the United States, including Alcon, Lensar, and Johnson & Johnson.
Different surgeons may have preferences for one company's laser over others. In general, they all perform the same steps during cataract surgery: imaging of the eye, astigmatism correction, bladeless incisions, capsulotomy, and cataract fragmentation.
It’s all about $$$ and paying off expensive equipment and marketing - read large independent retrospective studies to see no difference in patient outcomes yet more expansive and takes longer
I don’t get it. Laser is better but we need to pay out of pocket? Someone explain it to me. No where else can you do this. I can’t tell my photography clients they have to pay more if they want me to use the best equipment.
Hi Bill,
Good question. Unfortunately, this has to do with the way medical insurance plans are set up in the United States.
We assume that you don't accept "photography insurance"... If you did, you might find yourself in a similar situation in which insurance plans decide to cover certain things, but not others. Do you decide to offer these better services to your clients at an additional fee? Or only offer the basic covered services that the insurance plan covers?
Medical insurance plans often (sadly) drag their feet on adopting new technologies. This allows them to save money. In the United States, medical practices are allowed to offer these "noncovered services" to patients; however, the patient must pay on their own (i.e. "out-of-pocket") for them.
I hope that clarifies a little bit. Medical insurance can be quite a confusing subject. Also, every plan is different... and there are many, many different plans.
@@bestcataractsurgeons I get all that but I can’t tell my clients I just bought new gear and they have to pay more. I just bought a $6099 camera and now you need to pay more? Even without I insurance they would still do the same thing. Again why do we need to pay more for a machine you decided to buy? Also there is no way a lens could cost $3500. I know for a fact the markup on those is insane. I bet those lenses cost $10 to make I could be wrong but I would bet I’m not
@@billrhea You ask good questions. I believe the difference is that the laser corrects for astigmatism, which is not covered by medical insurance. In terms of cost of things like lenses, you are right in that the marginal cost of producing one lens might be fairly low, but as with all products, consumers pay for everything involved in the production, including research and development, capital expenditures, operating costs, etc.
Unfortunately that's how it is. Im in the same situation, insurance pays only for the basic procedure and the basic lens. Anything extra, such a laser surgery, it's additional.
This is confusing, because I came here after watching Shannon Wong's video, where he explains why he has virtually eliminated femtosecond laser assisted surgery from his practice. His "final answer" is that he considers manual cataract surgery to be preferable for several reasons. Granted, that video was three years old. Now I see this video, with the opposite conclusion/opinion. --Whatever.
There may have been a debate 15-20 years ago when the first laser cataract systems were developed... but that debate is over. No surgeon can perform the delicate steps that the last performs as precisely and consistently as modern laser cataract systems.
@@bestcataractsurgeons Ok, but it does appear that you and SW disagree. For the record, I'm scheduled for CS in Jan. 2025, with laser assist , which is more expensive. Then I see SW's video, followed by yours. Differing opinions, for sure.