As consultants to ophthalmic surgery centers, it is imperative to keep current on the latest technologies and products available to the specialty. At the American Society of Cataract and Refractive Surgery's annual meeting, these products are under one roof. About 300 vendors lined the exhibit hall in San Francisco in April. Here are some of the new products that were on display.

WaveTec Vision's ORange Intraoperative Wavefront Aberrometer
WaveTec Vision generated a lot of buzz on the show floor, and even in some of the clinical presentations we attended, with its ORange Intraoperative Wavefront Aberrometer. The device, which connects to your ophthalmic microscope, translates wavefront data into refractions during cataract surgery to supply your surgeons with real-time measurements of the patient's eye and its degree of astigmatism. Immediate access to that kind of feedback, as opposed to taking pre-operative measurements and referring back to the notes during a case, can help to verify the surgeon's limbal relaxing incisions, the corrections made to the shape of the cornea and the power and placement of the IOL. All of which potentially adds up to achieving better clinical outcomes and meeting increased patient expectations. WaveTec's ORange lists for $60,000.

Alcon's Constellation Vision System
Encouraged by increased reimbursement and improved technology, more and more cataract surgery practices are considering adding retina to their case mixes. As a standard vitrectomy platform with a lot of useful features built right in, Alcon's Constella-tion Vision System seems to be catering to those facilities. Introduced to replace the Accurus Surgical System, the Constellation includes a high-performance Ultravit probe that lets surgeons work closer to the retina with less traction; a Web-like user interface that puts function selection and physician customization at nurses' fingertips; RFID-equipped handpieces that enable plug-and-play set-ups; and a bar-code reader for easy tracking of disposables. An attractive feature of this device is that everything is in a single unit. Setting up 1 piece of equipment instead of 10 will lead to quicker turnover times — a critical consideration, since efficiency is the key to profitable retina cases. The Constellation lists for $150,000 with an integrated Purepoint laser and $115,000 without.

Dutch Ophthalmic USA's MembraneBlue 0.15%
For cataract surgery centers entering the field of retina procedures, a new product from Dutch Ophthalmic USA has shown great promise. MembraneBlue 0.15% (trypan blue ophthalmic solution) was approved by the FDA earlier this year for staining epiretinal membranes — and creating a clear contrast against the retina beneath it — in vitrectomies. The end result is better visualization for tissue removal and a lessened risk of incomplete removal. The product is non-compounded, pre-mixed, pre-loaded and ready to use for physician convenience, with a 2-year shelf life. A box of 5 sterile, single-use glass 0.5mL syringes lists for $495.

Carl Zeiss Meditec's Wireless Foot Control Panel
Carl Zeiss Meditec promoted new additions to its OPMI Lumera i surgical microscope, including a touchscreen for user settings and an automatic reset function. However, their truly impressive offering this year was the Wireless Foot Control Panel, which is available for purchase with new scopes or as an upgrade for existing models. It's lightweight, waterproof and runs for months on 3 C batteries. The clear benefit of this product is in turnover time, since it's easier to reposition between cases, and it also means one less cable to step over in a crowded, equipment-cluttered OR. Purchased with a new scope, it costs $1,500 more than a wired foot pedal does. As an upgrade to an existing scope, it lists at $5,000.

Leica Microsystems' Rotatable Beamsplitter
Leica Microsystems also introduced an accessory intended to speed equipment setups and room turnovers. Its Rotatable Beamsplitter, available as an option on its M620 and M820 ophthalmic microscopes, lets you quickly and easily reposition the assistant's binocular optics. Compared to the alternative of having to disassemble and reassemble your scope's components between cases when the assistant needs to stand on the other side of the table, the swiveling optics save you several minutes and the possibility of costly damage if parts are dropped during the process.

Endure Medical's Illumin-i
Over time, the strength of your surgical microscope's light source declines. Endure Medical says its Illumin-i can make an old scope's light as good as new, at a fraction of the cost that would be required to replace the scope. The illumination module, which is compatible with most Leica and Zeiss optics, retrofits to the scope to upgrade its red reflex visualization for improved clarity and perception. The module is integrated as a feature in Endure's Reflex scope, but can be purchased for upgrade at $12,000.

Accutome's Donnenfeld Irrigating Positioner
The precise placement of toric IOLs is critical in attaining optimal refractive outcomes and astigmatism treatment. Accutome's Donnenfeld Irrigating Positioner (which lists at $250) was designed with toric IOL placement in mind. Unlike conventional positioning devices, which have irrigation ports directly opposite each other, the Donnenfeld's ports are angled. The company says this helps to open the capsular bag, create a larger chamber and make lens rotation and positioning easier, without having to remove the viscoelastic. The tip also includes a hook for grabbing and positioning the lens by the haptics.

Feather Safety Razor Co.'s Safeshield Scalpels
Japan's Feather Safety Razor Co. isn't new to the surgical blade game, but its Safeshield Scalpels are its first line of ophthalmic safety scalpels. The stainless steel blades, available in 4 blade types, are mounted in plastic handles. The safety mechanism involves a textured barrel around the blade end of the scalpel, which rotates to unlock, slides back to expose the blade, and rotates again to lock in place. These actions are reversed to shield the blade. Since sharps safety is a big issue for nurses and scrub techs, and since open sharps increase the risk of injuries, a simply designed protective guard seems like a useful idea. Distributed in the United States by Oasis Medical, the knives are sterile-packed, 5 to a box. The 15 ? incision and 30 ? incision knives are $40 per box; the 2.8mm slit knives, $110.50 per box and the 3.0mm round tunnel knives, $131.25 per box.

MST's Barrett V2 I/A Tip
Over the past decade, phaco technology, techniques and fluidics have seen improvements, but the design of coaxial irrigation and aspiration tips has not. With its new Barrett V2 I/A Tip, MST is changing that. It is designed with a narrower lumen diameter, allowing for smaller incisions, and the tip irrigates from the side while aspirating up the center. By taking competing forces out of the equation, users have better control and more stable chambers for safety, plus more irrigation flow for better efficiency. MST says the tip is compatible with Alcon's, AMO's and Bausch & Lomb's phaco platforms and lists at $190.

Oasis Medical's Soft Shield Collagen Scleral Shields
Small-incision eye surgeries don't typically require sutures for recovery. There may be occasions, however, when patients may benefit from a little extra post-operative support. Oasis Medical's Soft Shield Collagen Scleral Shields are thin, purified discs that conform to a patient's eye to offer protection, comfort and lubrication after pars plana incisions or intravitreal injections without blurring the patient's vision. They can even be soaked in an antibiotic solution before they're applied. And they dissolve over time: Shields are available for "quick," 12-hour, 24-hour and 72-hour dissolution. At 19.5mm in diameter — 5mm larger than the company's Soft Shield Collagen Corneal Shields — they're intended to cover a portion of the sclera as well as the cornea. Sold in boxes of 10, the Quick Shield lists for $237.23 per box, the 12-hour for $269.07, the 24-hour for $313.24 and the 72-hour for $355.34.

Akorn's Akten 3.5%
Previously, the only product available to ophthalmologists for local anesthesia during cataract surgery was the off-label use of lidocaine jelly. Now Akorn offers an alternative: preservative-free, FDA-approved Akten (lidocaine HCl ophthalmic gel) 3.5% for extended localized contact in eye procedures. It's a viscous, topical, ocular anesthetic gel that eliminates the need for intracameral injections, often a source of patient discomfort. Akten takes effect in 20 to 60 seconds, much more quickly than injected blocks do. At $15 per sterile 5mL vial, it is also less expensive than injectable lidocaine. Since the formulation is effective for 5 to 30 minutes, 1 to 2 drops administered pre-operatively should be sufficient for an entire cataract procedure. If it is used to anesthetize patients for longer surgeries, periodic reapplication may be necessary.