If your practice is a candidate for a YAG laser and on the hunt for glaucoma patients, you’ve already got most of an argument in favor of a combo platform. Here’s why more practices are doing it.
Any seasoned clinician will have had this conversation in their practice. When someone suggests SLT capability, the first thing I ask is whether it needs its own platform. You already have a YAG. You’re doing capsulotomies regularly. With a second laser comes the need for a second capital investment, second service contract and another piece of equipment competing for real estate in your laser room.
So the glaucoma procedures continued to be neglected. Patients get referred. The revenue follows them.
The combo laser argument is not one you haven’t heard before, but it’s becoming increasingly hard to dismiss. So what does this look like in the booth when both procedures live in one platform, literally, and what about that Meridian MR Q YAG/SLT Combo you may want to scrutinize if you’re looking at your laser?
The 2 Most Common Laser Treatments in the Office
Let’s reflect on what your laser room primarily manages. In a large cohort of your post-cataract patients, the posterior capsule becomes opacified. YAG capsulotomy gets it solved fast, in office, with the least disturbance to the patient’s day. Your Nd:YAG laser earns back its footprint if you are doing any cataract surgery volume at all.
Now consider your patients both with glaucoma and those who are suspect. Selective laser trabeculoplasty has moved from a stopgap to a viable first line treatment in newly diagnosed open-angle glaucoma. The case for that was made most explicitly by the LiGHT trial, and clinical dialogue has followed suit. Patients are arriving with more knowledge than ever before. The guidelines you use are saying the same. And if you are not delivering it internally, you are moving those patients away.
Capsulotomy and SLT really encompass most of what a busy ophthalmology practice would need for laser procedures. They’re just different wavelengths they need. Gaming profit is less glamorous; the Meridian MR Q handles both.
One footprint, a service contract, one training workflow. The economics of a combination laser platform are cleaner than many practices realize until they run the number for themselves.
What The MR Q Actually Gives You
The MR Q itself is based on real engineering roots. The MR Q continues the lineage from Meridian’s first commercial Nd:YAG laser that they built with Dr. Fankhauser back in 1982. A manufacturer with over four decades of experience designing the same category device is going to approach design decisions based on years of clinical experience rather than spec-sheet optimization.
The pair of lasers comprise a 1064 nm Nd:YAG component for capsulotomy and iridotomy with a 532 nm SLT photoregenerator within the device to treat open-angle glaucoma. Both modalities are passed through the same slit lamp system, which has a 7-inch touch display for the laser parameters and easy-to-read, and clear-mode changes.
It is important to understand one or two specifics before you write off the safety details as marketing talk.
The MR Qoffset is reset to 200 μm posterior each time you turn it on. It’s not something you need to memorize or check off with your team. It happens by default. This offsets the risk of lens pitting from a wrong-offset shot that would otherwise make it through the original startup sequence. This is important if you’ve ever inherited a laser where the previous user left no record of how the settings were set.
To change from YAG to SLT mode or vice versa requires you to double confirm the command on the same touch panel. The screen changes color too as a visual cue to you always knowing what mode you’re in, the small things. But it is the type of little tools to help prevent wrong-mode errors on a busy clinic day.
The V-split mirror tower is optional to provide coaxial YAG delivery and red reflex retro-illumination of the capsule for your premium IOL patients requiring capsulotomy. More visualize for the places where it helps most.
There are chuckleworthy design flourishes such as the twin-column table and peculiar chinrest, and the ergonomics are not neglected on either side. Patients are in a relaxed position, not confined and uncomfortable, and the way you set up the table means that it’s workable without moving everything around even for a wheelchair-bound patient.
Again, its housing is made of aluminium monobloc. Not a cost-cut plastic chassis. The sort of construction that allows electronics are shrouded in dust as well as provides the unit a super sturdy experience, even after years of ordinary use.
The Hidden Cost of Referring Out
Once you refer out a glaucoma patient for SLT, that is revenue on the procedure side lost. That part is obvious. However, the blind price is that it hampers relationships. Now they had an experience in another place — and it was a good one. They got treated at someone else’s practice which is not your clinic! Sometimes they come back. Sometimes they don’t. And you may not know till the attrition hits your recall numbers months down the line which it is.
An Exercise in the Actual Numbers on SLT Referrals For example, the revenue going out the door on laser referrals adds up more quickly than it looks for anyone not running a practice with meaningful volumes of glaucoma suspects and newly diagnosed open-angle glaucoma patients.
Having two separate laser platforms equates to purchasing 2 investments, 2 service contracts, occupying two spots in your laser room as well as putting double the burden of training on your staff. One step purchase, one contract, one training workflow and both procedures in-house with a combo unit like the MR Q. The math is not complicated.
The MR Q makes the most sense for you if you’re already doing YAG caps on a regular basis and are not offering SLT at all or referring it out. It’s an apt description for much of the comprehensive ophthalmology landscape—a growing number of therapeutically incentivized optometrists who have incorporated laser procedures into their armamentarium.
The same is true when you are building out a glaucoma management program and want the patient to have access to a first-line laser option starting on day one after diagnosis, rather than going down the drop therapy pathway. That conversation is easier to have when the equipment is in your clinic.
This is very real if you are in Texas or elsewhere in the Southwest, on the demand side of this. Patient perception of SLT as a glaucoma therapy is becoming more common, and practices that can do it in-house are viewing SLT as a true competitive differentiator. When patients are trying to decide where to go, the difference between being the practice that handles it as opposed to the one that refers it out is a big one.
Why Meridian, and Why EyeCare Technologies
Meridian is a Swiss manufacturer. They aren’t the noisiest player in ophthalmic laser, but they have an impressive engineering record. Four decades of Nd:YAG platform building, a consideration for sourcing components from European suppliers and housing derived from high-grade aluminum instead of cheap materials. These are decisions for a company that isn’t only worrying about how a device scores at the trade show demo, but how it will wear over time — eight years down the line.
EyeCare Technologies is an approved Meridian Medical distributor who works with Texas Eye care practices and beyond. It means you are purchasing the MR Q via a channel that harbours direct support from the manufacturer, adequate onboarding and service backup that is actually there when you need it.
That is precisely the conversation we are configured to have if you are wondering if a combo laser platform makes sense for your unique practice volume and patient mix.
