Dr. Richard Mauer is an ophthalmologist emphasizing cataract and refractive eye surgery and retinal disease. For 30 years he ran a successful private practice in Waterloo, Iowa. In 2020 he moved to Florida where he continues to practice.
When Dr. Mauer started operating in Florida, the surgery center had Stellaris Elite. Prior, he had always operated using a widely used flow-based phacodynamic machine.
Before his first procedure with Stellaris Elite, Dr. Mauer consulted with his Bausch + Lomb rep. He described his surgical style, goals for cataract surgery, and the settings he used on his old machine. Based on his goals and style he created 3 unique customized settings to use on the Stellaris Elite machine. He currently uses these same settings.
First Surgical Experience with Stellaris Elite
The first day Dr. Mauer operated using Stellaris Elite, he performed cataract surgery on 12 patients. Some of the patients had very dense cataracts. He commented, “I was AMAZED with the ability of Stellaris Elite for cutting through a dense cataract and for holding the piece on the tip.” He didn’t need to chase the pieces because they came to the tip via the vacuum-based properties of the system.
Modified Technique with Stellaris Elite
Dr. Mauer “was able to adjust my technique and felt safer.” He did this by holding the tip in the center of the anterior chamber and using his second hand to occasionally feed pieces of cataract into the tip. He would chop the pieces against the phaco tip. With the flow-based system he had used in the past, he was unable to get a good enough purchase with his phaco hand to hold the piece in a secure location and chop it. With Stellaris Elite, he was able to anchor on the piece of cataract and use it as a fulcrum. Therefore, he chopped towards the phaco tip through the nucleus, splitting it on the phaco tip in the mid-iris plane.
Stellaris Elite advanced his technique for cataract surgeries. Dr. Mauer noted that “Stellaris Elite changed how I approach the nucleus. Stellaris Elite was an impressive upgrade from what I had used for many years.”
Misperceptions about Vacuum-based Phaco Machines
One of the concerns Dr. Mauer had regarding using his new system was the development of post-occlusion surges. Stellaris Elite uses Adaptive Fluidics™, which reduces post-occlusion surges.1* With Stellaris Elite, post-occlusion surges are extremely rare and surgeons don’t need to focus on this issue.1 The Adaptive Fluidics proactively increases pressurization as the surgeon increases commanded vacuum.1 Increased pressure only occurs when the surgeon is requesting higher vacuum.
“Seeing how the machine behaves and how the fluidics were handled, I was pretty impressed. I did not see any shallowing of the chamber. I didn’t see the bag trampolining. I was impressed. The anterior chamber was very stable and solid.”
– Dr. Richard Mauer
Benefits of Vacuum-based Phaco
With the Stellaris Elite vacuum-based phaco machine, the surgeon does not need to chase pieces of the cataract nucleus. The vacuum draws pieces towards the phaco tip. Even pieces that are behind the iris or in another crevice are pulled to the tip by the vacuum. Dr. Mauer found that instead of holding the phaco handpiece firmly like a pencil, he rests it in the crease between his thumb and forefinger thereby reducing pressure on the wound and allowing pieces of nucleus to move towards the phaco tip. With the vacuum pump machine, the flow is controlled by adjusting vacuum settings so the surgeon can command higher vacuum when needed.1 Conversely, with a flow pump, the surgeon presets the vacuum target level and the flow rate, with vacuum dependent on several variables. The followability with vacuum-based phaco machines holds onto fragments of cataract in a more consistent manner.
Other benefits of Stellaris Elite that Dr. Mauer has realized include fewer post-occlusion surges, improved cutting ability, improved chamber stability, and reduced number of people in the operating room by one due to the simplicity of the machine.
To learn more about the Stellaris Elite System, please go to www.bauschsurgical.com. Connect with a representative today, if you would like to hear more about how to demo the system in your OR.
Dr. Richard Mauer is an experienced general opthalmologist with an emphasis on cataract and refractive eye surgery and retinal disease. He practices in a state-of-the-art ophthalmic office, and retail optical center.
Financial disclosure: consultant to Bausch + Lomb