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    Phaco technology evolves over time

    Manufacturers of cataract surgery platforms mark five decades of innovation, with a look to the future


    Bausch + Lomb

    The first system introduced by Storz—which later became part of Bausch + Lomb—was the DAISY (Digital Aspiration Irrigation System) in 1986.

    “It had a lot of firsts for the industry,” said Tom Moore, director of surgical equipment research and development at the company.

    One such first was vacuum-based aspiration. Though this concept was similar to flow-based systems, Moore sees it as a key distinction.

    The other new feature on the DAISY was an ultrasound handpiece that ran at a frequency of 28 kHz versus the higher frequencies used by other units. Yet, one more feature was a patented user interface inspired by automated teller machines.

    The Premiere system that came next had a similar look and user interface, but through rigorous design methods was more reliable and could be used at altitudes above 5,000 feet.

    The year 1997 brought along the Millennium phaco system, which was modular in design.

    “That wasn’t necessarily of great interest to surgeons at the time, but it allowed us to introduce a platform that could be continually upgraded,” Moore explained.

    Surgery facilities could expedite repairs as needed by swapping modules and keep the unit state-of-the-art with the addition of new surgical modules as they became available. The Millennium also was the first Bausch + Lomb system that used Windows software.

    Stellaris, the fourth-generation system, was introduced in 2007 and incorporated all previous technology and surgical features. Moore describes it as more aesthetically pleasing than its predecessors. New features included a wireless foot control and the ability to operate using only electricity without the need for compressed gas. This made it more attractive for smaller institutions and global markets.

    Stellaris Elite, the current iteration that was introduced at this year’s meeting of the American Society of Cataract and Refractive Surgery in Los Angeles, has integrated new features like adaptive fluidics. It also has capabilities for both cataract and retina surgery, said Chuck Hess, vice president and manager of U.S. surgical at Bausch + Lomb.

    Going forward, the company plans to continue its focus on streamlining surgical efficiency—part of the idea of having cataract and retina capabilities in one machine—and also will focus in smart use of big data and cloud-based management of information, he said.

    A team of cataract and retina surgeons is currently working with the company to help pinpoint how data collection would be most useful for the surgeon.

    “It’ll be an evolutionary process, much like the iPhone,” Hess said. “We continue to believe that data will be critical, including how we can use information from our surgical systems to enhance efficiency and effectiveness.”

    Johnson & Johnson Vision

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