Our multispecialty practice in the Finger Lakes region of Upstate New York offers retinal, oculoplastic, corneal, and comprehensive eye care. We serve a diverse patient population across multiple counties. We perform a high volume of cataract surgeries locally, which ensures accessible care for our rural demographic. Partnering with iOR Partners to launch our office-based surgery (OBS) center, we were confident in the quality and efficiency of care we would deliver. In just the second year at our OBS, we performed more than 2,000 cataract surgeries. This article offers insights from our experience, particularly regarding our transition to OBS and integration of innovative technology such as the miCor 700 (Carl Zeiss Meditec).
TRANSITIONING TO OBS
Historically, we collaborated with several small community hospitals, but the COVID-19 pandemic and resulting disruptions to health care—particularly nursing and anesthesia shortages in Upstate New York—made securing OR time difficult. Challenges such as staffing issues, high turnover rates, and inadequate training further complicated this process. Opening an OBS center allowed us to create and manage our own dedicated team, which significantly improved our operational experience and efficiency. Building a cohesive, well-trained team is essential for any high-volume practice because it directly affects both the efficiency of operations and patient outcomes.
IMPLEMENTING INNOVATIVE TECHNOLOGY
Our practice has always been committed to adopting new technologies that improve patient outcomes. The miCor system represents a novel approach to lens extraction, an area with relatively few innovations in recent decades. Embracing innovation is essential for improving patient outcomes, enhancing surgical skills, and adapting to new techniques. Our willingness to evolve ultimately benefits patients and helps us maintain a competitive edge in the field
Following our transition to an OBS setting, we integrated the miCor 700 into our practice owing to its potential to expand and improve our surgical offerings. The benefits of the miCor system are noteworthy. It does not induce cavitation, and it operates with low levels of irrigation. The reduction in energy emission in and around the eye may decrease endothelial trauma, minimize tissue swelling, reduce trauma to wound edges, improve tissue reapproximation, and facilitate faster visual recovery. Ongoing studies are being conducted to explore these benefits further.1
The technology’s straightforward design simplifies its assembly and use, allowing for easy integration and promotion by our OBS staff.
COST AND OPERATIONAL CONSIDERATIONS
Portability and Flexibility
The device’s portability allows it to be used at multiple locations, providing flexibility. Additionally, it does not require the substantial capital investment typically associated with new phaco machines and other equipment, making it a highly cost-effective option for providers considering a transition to OBS.
Efficiency Gains
Our OBS center is designed for high efficiency. The adoption of miCor has hastened setup and reduced sterilization time compared to traditional phaco equipment, saving us several minutes per case. The time saved can be used for additional surgeries or other essential tasks, ultimately improving overall productivity.
PATIENT RECEPTION
Patient education is key when introducing new technologies. We have found that, when patients understand the potential benefits of innovative technology, they are more likely to embrace it. To date, none of our patients has declined the use of the miCor system after being informed about it. Patients report a comfortable experience and are pleased with the excellent vision they achieve postoperatively. Additionally, the single-use apparatus helps alleviate concerns about contamination or infection.
FUTURE PLANS AND GROWTH
We are considering dedicating one room specifically to procedures using miCor. The easier setup and cleanup could allow us to open a second room with our existing staff, which would increase our operational capacity without necessarily increasing our overhead.
CONCLUSION
The transition to an OBS center and the integration of the miCor 700 have had a positive impact on our practice. By addressing pandemic-related challenges and adopting innovative technology, we have improved patient outcomes and our center’s operational efficiency. Incorporating new technologies and approaches has allowed our practice to remain efficient and adapt to unforeseen challenges.
Embracing innovation is not just about adopting the latest tools. It is also about continuously seeking ways to improve processes, optimize the patient experience, and ensure long-term success in a competitive environment. As we continue to refine our approach, we remain optimistic about the potential of miCor and other novel technologies.
1. Ianchulev TA, Yeu E, Hu EH, Singh IP, Tyson FC. Comparative efficiency of microinterventional and femto laser pretreatment during subsonic miCor fragmentation lensectomy in 557 surgeries. Presented at: ASCRS 2024; May 5, 2024; Boston, MA.
