Author: cvanassche

Marco’s EPIC-5100: Technology Worth Fighting Over

As a solo, private practice surgeon for the past 25 years, I’ve performed more than 25,000 cataract surgery procedures and more than 30,000 laser vision correction (LASIK, PRK) procedures in my career. After performing some 25 to 30 of these procedures each week, I can tell you that Marco’s EPIC-5100 workstation is an absolute must-have piece of equipment in my practice.

Indeed, we conduct all of our cataract evaluations using the EPIC-5100, which comprises Marco’s OPD-Scan III (a combination autorefractor, topographer, pupillometer, and wavefront aberrometer) as well as Marco’s TRS-5100 digital refractor, autolensometer, and an electronic chart.

Using the powerful EPIC-5100, we can gather all of the information we need, including refractive data, angle alpha, angle kappa, pupillometry (mesopic and photopic), and corneal topography (corneal versus lenticular astigmatism) when considering IOL selection — all of which helps us to make the proper IOL selection for our patients. As a result, we are achieving better outcomes.

We all know that not every patient is a candidate for advanced IOL technology. Patients need to meet certain criteria, including angle alpha/kappa, corneal coma, and pupil sizes. The OPD-Scan III captures the data needed to qualify patients for multifocal, toric, and monofocal IOLs based on their individual visual needs. In addition, the OPD-Scan III gathers all of the information needed to assess aberrations in a patient’s visual system. Dry eye, for example, will induce corneal coma, and being able to show the difference drops can make helps patients better understand this preexisting condition. Pterygia can be monitored and measured over time to know when they are creating aberrations and need to be removed.

Improving Efficiency and Patient Throughput
As an “all-in-one” device, the EPIC-5100 helps improve patient flow and data gathering. Not having to move patients from device to device saves time and provides more accurate data, specifically by reducing the risk of tear film dehydration resulting from the use of multiple diagnostic machines. The EPIC-5100 enables one technician to work up at least 30 patients per day. And with its small footprint, much less space is needed for the EPIC-5100 than an actual exam lane.

We only have one EPIC-5100 workstation because my office space can’t accommodate additional EPIC-5100 workstations. But we plan to purchase two more when we move into our new office next year. We see roughly 50 to 70 patients a day, so two more EPIC-5100 workstations will be incredibly helpful. Other devices also can be added to the EPIC-5100 workstation for further testing, such as for tear osmolarity, increasing its efficiency that much more.

Another advantage of the OPD-Scan III is that it doesn’t require repositioning the patient’s head, as some other products do. When a patient’s head is turned, and he or she is looking at a target, this can induce excyclotorsion, which could lead to erroneous imaging, such as induced astigmatism. The OPD-Scan III measures patients in their natural seated position.

I’m only slightly exaggerating when I tell you the EPIC-5100 station is fought over by all six of my technicians. They will be happy when we add those additional two stations, as this machine truly is the most efficient way to evaluate patients.

Patients Approve
Like our staff, patients enjoy the advanced approach to our workups using the EPIC-5100. In fact, most say they’ve never had such advanced diagnostic testing in past eye exams. Furthermore, our patient education and IOL recommendations are improved because the OPD-Scan III enables us to gather the data so easily, and we are able to show patients their measurements right there in the exam lane using the system’s viewing software. For example, we can highlight areas on the ocular surface where they have dry eye, show them their corneal topography, or display a retro illumination of the eye that shows their cataract. They really get a kick out of that!

Practice Growth
By increasing the number of patients we can see in a day, our practice has realized at least a three-to-five fold increase in profitability, measured in time and patient conversions to surgery with appropriate surgical approaches selected based on our use of the EPIC-5100 technology.

I would be remiss if I failed to mention that Marco has been an excellent company to work with throughout the last 20 years. The representatives are extremely knowledgeable on the technology, and Marco’s training capabilities make the transition and integration quite easy for my technicians — especially when a new staff member joins our practice.

The bottom line: I have found that the EPIC-5100 results in better efficiency, happier technicians, and more advanced decision-making capabilities. Not only does this make for a happier doctor, it has led to better outcomes and happier patients. What’s not to love about that?

– Mitchell A. Jackson, MD, is the founder and CEO of JacksonEye in Lake Villa, Ill.

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One Machine… Endless Possibilities

As a veteran ophthalmologist who is still relatively new to running my own private practice, there’s probably not much advice I can offer to my more experienced colleagues. But to my younger peers, I can speak from experience: Go with Marco’s OPD-Scan III as you venture forth to open your own private practice. You’ll be glad you did.

After earning my medical degree from the University of South Florida College of Medicine in 2000, I completed an ophthalmology residency at the University of Florida and my corneal surgery/refractive surgery/uveitis fellowship at the University of California, Davis, where I used the OPD-Scan I and OPD-Scan II for pre-LASIK screening and surgical planning. I also used the two devices for surgical evaluation and planning of corneal-transplant patients. After completing my fellowship, I wenton to practice with a large multispecialty group in Southwest Florida, where I had access to many types of anterior segment diagnostic devices.

In October 2015, I decided to leave that group and start my own practice. To do so, I needed my own accurate and reliable diagnostic equipment. I looked closely at many machines, and test drove several. Ultimately, based on my previous experience with older versions of the OPD and Marco’s unparalleled track record, I selected the OPD-Scan III to accompany me on my new endeavor in private practice.

Fast, Reliable Data
Don’t let the singular name fool you. Like your favorite smartphone, the OPD-Scan III actually consists of five powerful “apps” — an autorefractor, a keratometer, a pupillometer, a corneal topographer with 11,880 data points, and that aforementioned integrated wavefront aberrometer with 2,520 light vector data points.

Moreover, this single device completes 20 diagnostic metrics in less than 10 seconds per eye (including angle kappa and angle alpha, HOAs, average pupil power, RMS value, and point spread function, among others). Wavefront data are gathered from available zones up to a 9.5-mm area, adding the capability to provide for calculation of mesopic refractions. Blue light, 33 ring, placido disc topography is gathered in just 1 second.

Although it’s true that other units in the marketplace can obtain similar images and information,they’re not nearly as simple to use. The OPD-Scan III makes it incredibly easy to create new templates, showing only the information you want to see at any given time for any patient.

As a corneal specialist who actively performs corneal surgeries, such as penetrating keratoplasty and a high percentage of premium IOL and refractive surgeries, I can get all the information I need from the OPD-Scan III for everything from the simplest exams to the most complicated decision-making processes for corneal transplant patients.

With respect to my preoperative cataract surgery patients, for example, I frequently turn to the multifocal IOL (mfIOL) algorithm to assist in IOL selection. This powerful tool provides me with a “decision tree” to confirm in an algorithmic way which specific IOL would be best for a given patient. The algorithm provides me with accurate corneal astigmatism, angle kappa, corneal coma, and pupillary size — all of which play an important role in selecting the proper mfIOL. Indeed, I believe my accuracy and patient satisfaction have increased significantly since I began using this algorithm.

For toric IOL selection, the algorithm gives me another precise measurement that I can compare to other diagnostics, including manual keratometry and my Lenstar biometer. I feel most comfortable when I can compare all of these data, but I would also be comfortable using the OPD-Scan III alone.

Less Space, More Patients
It helps our practice immensely that all of these capabilities fit into an 11″ x 18″ footprint. Since its inception less than 2 years ago, our practice has grown from two employees to seven across two offices in Naples and Fort Myers, FL, and an affiliate office in Miami.

As a relatively new practice in a small office space here in Naples, we have been tasked with seeing patients efficiently and without the luxury of an extra room. The OPD-Scan III allows us to achieve this goal. We see about 100 patients per week at Naples and Fort Myers. In addition, I perform about 30 surgical procedures per week for all three offices. All of the information I need about a patient’s vision can be obtained with this single machine. The unit is definitely space and time efficient.

Impact on Staff
My staff also loves working with the OPD-Scan III. Frankly, they were a little concerned with learning what appeared at the outset to be a complex machine, but after surprisingly short training sessions with Marco representatives, we all were up and running in no time. The same was true with the in-house, hands-on training for our second technician, who required very little ramp-up time (24/7 online training tutorials are also available). For its part, Marco has far exceeded my expectations for customer and technical service. Issues are always resolved quickly. On the few occasions it became necessary, Marco provided a loaner device on short notice, so our workflow wouldn’t be disturbed. Indeed, the loaner backup is a big selling point to me when evaluating other diagnostics and providers.

High Impact on Patients — and Satisfaction
Our patients notice when they sit down in front of one small machine, only to be told a very short time later that we’ve obtained all the information needed for the exam. I can’t tell you how often I’m asked by a surprised patient, “You really got everything you need from just that one exam?” I also believe patient satisfaction comes in the form of successful visual outcomes, especially with premium IOL patients. I know it has helped with our ability to successfully prescribe appropriate IOLs for each patient. Thanks, in no small part, to the OPD-Scan III, we have had a high percentage of premium IOL patients and a very high success rate.

Heed My Advice
As I mentioned at the outset, to those ophthalmologists coming up behind me to start their own practices, I can definitely offer a word to the wise: Go with the OPD-Scan III as you embark on practice ownership. This accurate, state-ofthe-art, all-in-one, time- and space-efficient unit does it all. It eliminates the need for multiple diagnostic machines, and it can be used for corneal and refractive surgeries and evaluations, as well as pre- and post-op planning and evaluations. But don’t just take my word for it — go and see for yourself. You will understand what I mean.

– Dr. Ginsberg is owner and operator of Ginsberg Ophthalmology in Naples, FL.

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Speed and Precision: Marco Helps Bring Both to Your Practice

I first had the opportunity to use Marco autorefractors in the 1990s while serving in the U.S. Army at Fort Jackson, SC. There, I witnessed firsthand how Marco’s technology helped us swiftly and efficiently process the eyecare needs of 100 or more troops on any given day. I also appreciated the ability to transmit data directly to the lab with no need for data entry or writing out prescriptions. Having experienced the benefits of this technology, I knew that I would want the same technology in my own practice one day.

Technology I Can Trust
After completing my 3-year commitment to the Army, I moved to San Antonio and began looking for practice opportunities. I purchased my practice, Stone Oak Vision Source, in 2004 and began outfitting it with Marco’s automated technology as quickly as I could.

I started Stone Oak with one associate; we now have three associates and a staff of 20. We expect to gross more than $3 million this year. To this day, we still run an ARK-1 autorefractor and LM-1200 lensometer in our primary prescreening room, and an AR-510A autorefractor and an LM-1000 lensometer in our secondary prescreening room. Exam rooms 1, 2, and 3 each have an older generation RT-900 autorefractor, while exam room 4 has an RT-2100 autorefractor and exam room 5 has the latest TRS-5100 digital autorefractor that we acquired when we moved into our new building in 2016. Marco technology is clearly a part of the fabric of this practice.

Quick and Accurate
Today, just as when I was in the Army, one of the things I appreciate most about Marco’s technology is how easy it is to quickly and accurately transfer autorefraction and lensometry data. Indeed, I have no doubt this reduces prescription mistakes and remakes. The autorefractors and the lensometers seamlessly network into our phoropters and ExamWRITER software. We use the new manifest-to-old-Rx toggle feature at the end of the refraction to show our patients the difference between their new prescription and their old one. This allows them to more accurately appreciate the change they will see in ways they can understand.

In addition, the ability to transmit data with the touch of a button is a huge time-saver. Anything that can help improve accuracy and efficiency in our clinic is a win for us. In fact, spending less time on data entry and the refraction process as a whole gives us more time to discuss each patient’s condition and the solutions we can offer. For example, it’s easier to get patients on board with multiple pairs of eyeglasses when our doctors have enough time to discuss how each one will meet specific needs, and when patients are able to quickly assess the Rx differences themselves.

The “Wow” Factor
The technology is also a “wow” factor for our patients; they appreciate that our office doesn’t have the same old equipment they’ve seen for decades in other offices. We offer high-tech lenses and diagnostic options throughout our clinic. Performing examinations with anything less than state-of-the-art equipment simply wouldn’t correspond with our mission to deliver high-tech, cutting-edge service.

As fond as I am of our older RT-900s, I am looking to upgrade them to TRS-5100 digital refractors this year. They have served us well these past 14 years, so it almost pains me to let them go. Still, I know exactly where to turn to receive the same high-quality technology that I’ve come to trust for so many years.

– Monica Allison, OD, MBA, FIAO

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Technology That Patients — and Doctors — Love

Epic Refraction Workstation From Marco Ophthalmic

Our five-location optometric practice, Nittany Eye Associates, located in State College, PA, employs 12 optometrists and a staff of 55. We provide full-scope optometric care, on-site consulting for LASIK surgery and other ophthalmology services, and see approximately 800 patients per week.

Our practice has always been dedicated to providing the best clinical care, while also providing an outstanding experience for our patients. This commitment to excellence in care and customer service has allowed us to weather the storm that stems from the increasing pressures of managed care as well as commercial and online competition. Although our practice has grown, we have remained committed to reinvesting in our practice to fulfill our mission of providing excellent diagnostic care.

EPIC-5100 = Effortless Refractions
Due to limited space and a need to increase efficiency and improve outcomes, we acquired three EPIC-5100 refraction workstations and began delegating refractions to our technicians. This decision was not taken lightly, and we had some concerns. For example, would delegating refractions increase the number of remakes and decrease our patient’s clinical results? Would the investment pay dividends — experientially for the patient and financially for our practice? Well, it’s been more than a year and half since we began this process, and I’m pleased to report that none of our concerns materialized and the investment was, in fact, a wise one.

The EPIC-5100 combines the OPD-Scan III wavefront aberrometer and corneal analyzer, and the TRS-5100 digital refractor. The two technologies can be used together to evaluate the entire visual system in a fraction of the time it takes traditional manual systems. The OPD-Scan III takes more than 20 measurements in less than 10 seconds, while assessing all aberrations in the optical pathway and establishing refraction start points. The TRS-5100 then steps in to complete all refractions with unprecedented accuracy, also in just seconds per eye.

Patient Preferred
Indeed, our patients overwhelmingly prefer the automated experience of the EPIC-5100 over the previous manual experience. The dual-prism technology of the EPIC-5100 allows the patient to see two cross-cylinder images simultaneously and, as a result, the process induces less anxiety as patients make their lens choices with confidence. In addition, patients perceive the refractive process as more comfortable and more advanced than the traditional manual refraction. Every day, we receive positive feedback from our patients about their experience with the technology. As a result, our patients view our practice as far more advanced and cutting-edge, which helps differentiate our practice from that of our competitors.

Not only is the patient experience better, but we’ve also found that the EPIC-5100 provides a better experience for our doctors and staff. The EPIC-5100 delivers consistent, accurate refractive data results. Our remake percentage for eyeglasses has dropped by more than half — from 12.8 to 6.3 percent.

Increasing the Bottom Line
Finally, our investment in the EPIC-5100 has paid dividends. By allowing us to quickly and easily show patients the difference between their current and new prescription, the EPIC-5100 helps us demonstrate how much better we can help them see. This also gives us more time to talk to patients about how to improve their visual performance and, in turn, their quality of life. The data automatically provided by the EPIC-5100 and the time provided to discuss options have resulted in an average increase of $69 per lens sale.

A Win-Win Situation
This single technology has helped us not only to increase our efficiency, but also to improve our patients’ experiences and our practice’s own financial performance. We could not be happier with the EPIC-5100.

– Mike Talone, OD is a managing partner at Nittany Eye Associates, State College, PA.

 

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Succeed in Health Care Reform with Technology

Health care reform is an issue that affects every optometry practice. Tim Petito, OD, FAAO discusses how technology enables optometrists to provide better patient care.

“For us in the practitioner world, we tend to think health care reform as a problem because it makes things more expensive for us, it makes things more difficult for us, and sometimes it takes away time from our patient care or our relationship with our patients. However, there are some are very good points to health care reform and we point those out; it helps us become more efficient, it’s a reality that we have to see more people, make less mistakes, and with more collaborative care going forward. That’s good for the patients, that’s good for the system, that’s good for our practices. We use difficult cases to point out how the technology that we incorporated under the health care reform mandate really solved those patients’ problems and allowed us to take care of patients.”

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Visit Marco at Vision Expo West, Sept. 18-21, 2019

Join us at VisionExpo! Visit Marco at Booth #MS8031!

Click here to Register for a Free Exhibit Hall Pass as our Guest

Vision Expo West is the complete event for ophthalmic professionals, where eyecare meets eyewear and education, fashion and innovation mingle.

  • Educate yourself and your staff with more than 300+ hours of education and 23 specialty tracks to deliver improved patient care and grow your business.
  • Shop more than 5000 fashion and luxury brands for an unforgettable buying experience.
  • Experience the latest industry advances in contact lenses, solutions, therapeutics and leading edge medical and diagnostic equipment.
  • Engage in essential learning and networking that extends past the classroom onto the show floor and beyond.
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