Dr. King:
We’re back.
Dr. Strange:
And, so King’s like the the Jay Leno. Yeah.
Dr. King:
I don’t know, I never know what I’m going to say till it comes out. I really don’t.
Dr. Cha:
Know what to say. Robot assist. It does.
Dr. King:
I do.
Dr. Strange:
I’m going to his. I know. Oh, sweet.
Dr. King:
Well, okay. I already started that. Hi, and welcome to Days of Our Eyes. We’re back. I’m Doctor King.
Dr. Cha:
And I’m Doctor Cha.
Dr. King:
And today we’re joined by Doctor Taylor Strange. He’s our founder and chief surgeon at Alliance Vision Institute. So today we’re going to be talking about AI and robotic assisted cataract surgeries. What is it? Why would you want it? And how can I get it? Stay tuned. We’ll tell you.
Dr. King:
Doctor Strange. What is robotic assisted cataract surgery?
Dr. Strange:
So, robotic assisted cataract surgery has, revolutionized how we do modern cataract surgery. In the past, we would do the whole surgical case manually, meaning we would just use blades to do the whole procedure with our phaco emulsification instrument to break up the cataract and take it out. Now we have the new ally laser assisted robotic cataract surgery machine.
Dr. Strange:
So it’s really cool. It’s like a robot that ducks onto the patient’s eye and it uses A.I. Artificial intelligence, overlay over the patient’s eye and lines up their eye during the cataract surgery to perfectly correct the astigmatism to their eye, which is the shape of the cornea. And it also breaks up the cataract into, detail with laser guidance, which allows for patients to have faster visual recovery.
Dr. Strange:
And it’s safer, and it’s extremely accurate as far as correcting the astigmatism. And we do that here at Alliance Vision Institute for all of our premium packages, because we want to get that perfect outcome to eliminate the patient’s, need for prescription glasses after cataract surgery, depending on what package level we go to, there’s different levels where we’re maybe just correcting the distance, where the patient will still need readers for intermediate and year range.
Dr. Strange:
Or we have kind of a good intermediate package where the distance to intermediate range is corrected, and then the full range of vision package. There’s two options with the new, Johnson and Johnson Odyssey multifocal lens, which will correct patients for all full range of vision, and the new light adjustable lens technology, which can also get patients glasses independence.
Dr. Strange:
And that’s one that, we adjust it, but we’re talking about robotics. That’s what we’re allowed to do now, overlaying with those premium options for patients to give them to the best visual outcome, possible.
Dr. King:
Yeah. I think, you know, we see the patients afterwards, you and I can notice how much quicker their vision’s coming back and how much quicker the recovery is. And when we’re going after astigmatism and whatnot with that, that eye overlay, it’s much more precise. So they’re healing faster and enjoying sharper vision. With, you know, just by allowing us to be more accurate in lens placement, it’s been pretty amazing just seeing the evolution over our careers.
Dr. Strange:
And one more feature I left off, I want to mention it. It does perfect situation of the IOL.
Dr. Cha:
That’s what I say.
Dr. Strange:
Which is, you know, is very important, especially when you have a multifocal lens or a toric lens, you want it lined up just perfectly inside the eye, and it just doesn’t get better than with the robot doing it. A lot of surgeons are really good with manual.
Dr. Cha:
Like yourself honestly. Okay.
Dr. Strange:
Thank you. But I can still not beat the robot when it comes to lens placement. It takes it down to the finest micron detail. Yeah. So.
Dr. King:
And what I like about it is it’s actually it’s able to focus on the visual axis versus center of the pupil. Well, people don’t understand that the center of the pupil is not necessarily exactly the visual axis, but by using the technologies we use today in pre pre cataract surgery and then the, the the lens, our system talking to our measurements, they can read our measurements and we actually can get right on the visual axis.
Dr. King:
And that’s where we get this when we talk about improved accuracy and improved visual outcomes. Right. Because we’re just more precise right.
Dr. Strange:
Correct. Yeah. And that diagnostic equipment we do in the lane. The nice thing is it talks to the robot via the cloud. So all the imaging is set from the clinics. Pre-operative examination sent to the robotic laser. And then when the patient lays down under it, it perfectly lines up the patient under the machine. Yeah. So I don’t have to mark the patient for operatively.
Dr. Strange:
I used to have to do that when we were doing things just manual. Right, right. And so it’s a time saving thing. It’s a better experience for the patient when they’re at the surgery center.
Dr. King:
Right. And that was those purple remarks. Right.
Dr. Cha:
Yeah. The the ink that would that you would put on like the the AI to help make sure.
Dr. Strange:
We’re.
Dr. Cha:
On the same page, like going with what we’re planning.
Dr. King:
So who do you think I think is a good cat candidate for this type of surgery.
Dr. Cha:
Yeah. Well, you know, like Doctor Strange said, this is modern cataract. This is the modern version of cataract surgery. Really? We recommend it for everybody. I don’t, and correct me if I’m wrong, I don’t think anybody’s disqualified from the laser option. It is because it is our preferred method of cataract surgery.
Dr. Strange:
It’s true. Yeah. Even if we’re just targeting just distance vision, it’s better to have that laser guidance there to correct the astigmatism. The patient has. And also especially some of these dense lenses that we see. It’s good to have the laser robotic fragment that for us, basically break it up by lasers and so, everyone is a candidate, with very rare exceptions.
Dr. Strange:
Right?
Dr. King:
Right, right. Yeah. When we talk about breaking up the camera, you know, the lens is is dense. And the older way of doing it is we actually used a little machine. It phaco emulsified it like that. Yeah. Yeah. Like a jacket that creates more, more energy inside the eye with using the laser to break it up. We’re we’re not getting as much energy dispersed through the eye, which makes the eye get less angry.
Dr. King:
We’re already in there messing with it. We don’t want to make it any more mad than we have to. So the laser is actually a little gentler on the eye, in my opinion. When I see the post ops than when we use have to use the Phaco machine.
Dr. Strange:
Yeah, that’s I was gonna ask you guys. I mean, you see the cornea is manual versus the laser. And, what’s been your experience over the years?
Dr. King:
Oh, much quicker. I remember when we switched to the laser, I walked in the first day and I looked at you and I said, I can’t believe these corneas. Yeah, they’re so much clearer now. So patients are just. They all get there. It’s not like you’re not going to get clear the other way. But the patients were enjoying their vision, you know, the day after surgery versus having to wait a few days for a lot of that swelling to clear, especially on the more dense cataracts.
Dr. Cha:
Right. Yeah. I usually tell my patients, you know, after characters, especially at the traditional route. Right. Expect your vision to be very blurry. I mean, if you can’t count your fingers afterward, that’s normal because that’s how much work that needs to, you know, but how much elbow grease needs to go in to do it by hand, so to speak.
Dr. Cha:
But with the laser, with the precision of the laser and with the algorithms and the robotics that help, guide Doctor Strange to be able to be as precise as possible, or that translates to more immediate visual recovery and also long term visual precision. I believe as well. Right. Yeah. But you know a question, doctor Strange like so we do like this whole hour long workup to get all these calculations.
Dr. Cha:
You say you put it into this, you know, this, computer that does it. Do you just press a button and walk away and does it for you, or, like, how does it.
Dr. Strange:
Actually, what are our technicians does that. Oh, yeah. Sure.
Dr. Cha:
But so, like, do you just, there’s a patient laying on the table, and you’re not even in the room with them. How can you how comes in, like, how do you implement it into your actual surgery?
Dr. Strange:
Yeah, that’s a great question. So the scans go to via cloud to the actual, robotic laser in the surgery center. And then one of our technicians pulls up the patient’s file. And what’s really cool is you can see the pin cam, iris and cornea imaging. The laser robotic laser takes that image, and when the patient is docked underneath the laser, it knows the different iris landmarks on the patient and where the steep and flat axis of their stigmatism is to correct it.
Dr. Strange:
And it it it’ll even adjust to any kind of micro movements or what we call cyclo torsion. Basically, when you lie down in your eye, moves one way or the other, which is pretty common actually. The laser knows that via the iris landmarks that it needs to shift, which keeps it on the perfect axis and orders tickets that get that, neutral outcome for their vision for the prescription.
Dr. Strange:
Right. So it’s all done. The technician pulls it up. I doc the patient, that the robot knows that patient’s iris based on the image and it lines it up perfectly. Yeah. And then I just fire away.
Dr. Cha:
Gotcha. So, yeah. No, Doctor Strange is not, you know, delegating the procedure to, like,
Dr. King:
Not pressing a button and leaving the room.
Dr. Cha:
There’s a robot walking in the room.
Dr. Strange:
And maybe in a few years.
Dr. King:
Yeah.
Dr. Cha:
Doctor Strange’s expertise and skill is still very intimately part of the procedure. But we are utilizing technology at its highest degree that it’s, you know, that is safe and soothing. Yes.
Dr. Strange:
It’s assisting me and other surgeons that use this technology throughout that surgery, cataract surgery case or, lens exchange cases. Right. Sensor. Yeah. It’s assisted.
Dr. King:
So when do we all think we should start? Patients should start considering cataract surgery for themselves or their loved ones and.
Dr. Strange:
Yeah.
Dr. Cha:
Yeah, what I usually tell patients, they always ask me is, is my cataract ready? Right. And, you know, I think my colleagues would agree it’s $1 million question. You know, you can’t time it for anyone. It really is patient dependent. And, you know, usually there is a wide range of when you’re ready for a procedure, one, you know, you want to make sure that you are getting seen by a professional who knows what options are available and hopefully can provide a breadth of options, not just, one size fits all, like hammer, so to speak.
Dr. Cha:
And then once you understand your options, let’s say a lens exchange procedure or, you know, maybe to the point of cataract procedure is, necessary or recommended. Well, you know, if you’re looking for a refractive or, you know, visual correction outcome and the lens exchange procedure is recommend it. I mean, that’s the way to go, right? Usually, our patients that are cataract age, so to speak, you know, into their sixth or so decade, you know, that’s the prime age.
Dr. Cha:
And most that’s when most patients get it. I believe you told me, statistic. Right. Usually by the seventh decade, most Americans have already had cataract surgery. Is that right?
Dr. Strange:
Yes. Over 80%. Yeah.
Dr. Cha:
It’s the vast majority. So if your grandparents or whatever haven’t gotten and you had told them to get on the, you know, get with the times and let them know that we have a great option that they they might be afraid of, like what their grandparents got stuck with the Coke bottle glasses. You know, that’s just not what modern cataract surgery is anymore.
Dr. King:
No. And the thing that, you know, it sneaks up on cataracts slowly develops. So a lot of people kind of adapt to the changes in their vision. So if you have loved ones who are kind of giving up some of their activities that, oh, we’re not we can’t come over, it’s going to be dark before we come home.
Dr. King:
And I don’t like to drive in the dark. That’s not normal. You may want, you know, that may be a red flag or they’ve got every light in the house on to read. You know, it’s you need more light constantly. Right. That’s can be a sign that there’s something going on.
Dr. Strange:
Yeah. And when I see most too is driving seems to be the number one complaint for patients that typically bring them in for a cataract evaluation. It’s that night driving oncoming traffic, the star bursting off the light. The car lights is pretty much up there on number 1 or 2. As far as visual complaints for patients with visually significant cataracts, a lot of patient patients, you know, we all start cataracts typically, maybe in their late 40s, 50s.
Dr. Strange:
It’s a very slow, gradual process from most people over a couple of decades. Then when you start getting more into your 60s, mid to late 60s, then you kind of cross that threshold where typically night vision and the activities that you guys have mentioned, start to get to patients where they were, they fall off a cliff basically with their vision.
Dr. Strange:
And then that’s what what brings them typically into cataract surgery at that time, for sure.
Dr. King:
Where can patients find more information about, AI and robotics assisted cataract surgery.
Dr. Strange:
Yeah. Great question. I mean, you can go to our website. It’s Alliance eyes.com and you can also Google us at Alliance Vision Institute as well. Finds that way, you can book online. We have a portal that you can go in your own cell phone and click the book online button, and you can select whether that’s a Lasik eval, cataract eval and, other options there for you and see our scheduling.
Dr. Strange:
And you can also call the office, the phone numbers are easy. It’s 8174422020.
Dr. Strange:
It’s so good. Who would’ve thought, right? No.
Dr. Cha:
Hey, you know the other guy.
Dr. King:
That doesn’t have 20? So if you’re interested in finding out more about what you heard, click on the link that’s found in our in the description. And just FYI, I’ve actually had robot assisted cataract surgery on my own eyes. And let me tell you, it made it a breeze and you just see some pretty colors. It’s not easy.
Dr. King:
So we’re glad to be back. Welcome back to Days of Our Eyes. If you like what you heard today, please click on the subscribe button down below and we’re looking forward to seeing you next time. In the meantime, I’m Doctor King and Literature.
Dr. Strange:
Doctor strange.
Dr. King:
Have a great day.