What is the pragmatic impact of top-class, reliable devices and equipment in a busy ophthalmic practice? We asked Jonathan Myers, Chief of Glaucoma Service, and Douglas Wisner, Director of Cataract and Primary Eye Care Service, at Wills Eye Hospital, Philadelphia, PA, USA to share their experience with Haag-Streit’s “gold-standard” ophthalmic devices.
Jonathan Myers, Douglas M. Wisner |
sponsored by Haag-Streit Group
What Haag-Streit devices and equipment do you use?
Myers: I’ve been using Haag-Streit slit lamps from the very beginning of my training, and was using one of the first visual field devices in the US, the Octopus 201. In addition, I presently also use Reliance chairs and Lenstar biometry devices. In our glaucoma practice, all the perimetry devices, slit lamps, microscope stands, and chairs are from Haag-Streit.
Wisner: I use Haag-Streit slit lamps daily however, I rely on other Haag-Streit devices throughout my practice, such as microscopes in the operating room, and medical simulators and surgical stools in the training laboratory.
And how do these devices affect patient care?
Myers: Haag-Streit products are really solid. Their optics are among the best in the business; they’re dependable, offer excellent visibility, and they are remarkably low in maintenance. We’ve been using our Octopus perimeter with the EyeSuite software since 2009, and there has hardly been any downtime. Another example are their Reliance chairs. I don’t need to think about the chair, and the patient doesn’t complain about it. And a chair that suits all is quite an achievement – after all, patients come in all shapes, sizes, and ages!
Haag-Streit devices just work – and when devices work really well, you hardly notice them because they don’t interfere with patient care.
We’re especially delighted with the performance of the Octopus perimeters – it’s made a big difference to what we do in our practice. Octopus’ networking system is robust, its easy-to-use progression algorithm eliminates data variability and allows me to assess a patient in mere seconds. Its cluster trend analysis feature helps highlight visual field concerns. In brief, Octopus gives my team a deeper understanding of patient data, and it plays a central role in our practice.
The Lenstar is another great addition to the practice; this plug-and-play biometry device has my favorite formula, the Barrett IOL, directly built in and automatically collects all measurements, thereby reducing error. It is a tried and proven technology that gives reliable results quickly, so patients and technicians alike are completely satisfied.
Wisner: Haag-Streit optics are excellent; I can always see what I need to see. Simplicity is also a key advantage of the Haag-Streit range; device operation quickly becomes second nature.
The importance of ergonomics
Ergonomics is a hot topic among physicians; what details can you share about the profile of Haag-Streit devices?
Myers: This is an important point – many ophthalmologists have required neck surgery, or even become disabled, because of work-related postural issues. Fortunately, Haag-Streit instruments allow us to work hard without harming our own health.
Wisner: Haag-Streit continually works with physicians to identify the best ergonomic practices, modify the equipment we use. The equipment and devices have been very useful to our trainees – they have to be comfortable while learning so that they can develop good ergonomic habits for when they are operating on their patients.
Haag-Streit technology for teaching: how to build an ophthalmic surgical training laboratory
Wills Eye Institute designed an entire surgical skill center around the portfolio of Haag-Streit devices – and Douglas Wisner explains the hospital’s decision.
Ophthalmic surgery is increasingly complicated – and subject to constantly rising high standards of excellence and patient safety. Consequently, educators must squeeze a higher number of more demanding skills into the training period – gone are the days when residents could train on a few pig eyes, and then move on to humans! How should we meet this challenge? At Wills, we decided the answer was to develop a training lab that was compatible with both animal and artificial tissue, and with advanced capabilities, such as virtual reality (VR) medical simulators.
We chose Haag-Streit to help construct this training lab for two main reasons – the quality of the microscopes and the company’s collaborative approach. The latter was critical; the Haag-Streit team ensured they understood our space restraints and worked with us to develop an entire lab system, including everything from floor planning to selection of microscopes, audio-visual resources, and other surgical equipment. Throughout, Haag-Streit paid attention to the important details – they even developed an adjustable table that mimics the OR stretcher, and is height adjustable to promote best-in- class ergonomics for surgeons of different physical builds. This attribute is very useful in the training lab – people must be comfortable when they are learning. In addition, making the stations mobile – to retain flexibility of use and assist maintenance – was very helpful during the pandemic, with the need to practice social distancing. Our access to a well- designed lab, at this difficult time, allowed our training program to continue without significant disruption – it all worked well!
We’ve found the Haag-Streit Eyesi Surgical medical simulators within a VR environment to be an especially valuable resource. They allow residents to practice a range of techniques – from basic to very complex surgery – in a standardized environment, supporting objective performance measurement. In brief, they fill an important gap in early training. And that’s why our residents love the lab; they are more confident going into the OR with the high level of virtual training they’ve received. Even our fellows find the medical simulators useful – whenever I look in the lab, someone is always in there practicing!
Furthermore, we now host industry-led programs to train surgeons in the use of innovative ophthalmic devices. Our new lab is ideal for these purposes, because many people can participate simultaneously. We are open to all companies for such collaborations; as an educational institution, we continually want to expose our faculty to the best available technology and help develop and expand it further.
In conclusion, the training lab is a great success, and we’ve been extremely fortunate to have Haag-Streit partner with us on this project.