Rethinking the Drop with iDose TR: Practice Implementation

UNITYtime Podcast is back. Join Drs. Lori Provencher* and Arjun Hura* as they take an unscripted look at the science behind UNITY® 4D Phaco and volumetric ultrasound. Drawing on independent research and real surgical cases, they explore how improved efficiency, followability, and fluidics may help surgeons approach both routine and complex cataract procedures with greater confidence. *Paid Consultants of Alcon 4:25 - Compared to CENTURION and CONSTELLATION Vision Systems. Based on bench data. 8:09 - Based on bench data. Trademarks are the property of their respective owners. Based on N=10 HPs, Artificial cataract lens IOP 55mmhg vacuum of 450 mmHg 9:50 - For posterior segment surgeries/posterior cassette pack; approximately 1.7 minutes faster. For posterior segment surgeries/posterior cassette pack; approximately 1.4 minutes faster. For posterior segment surgeries/posterior cassette pack; approximately 0.35 minutes (21 seconds) faster. 10:00 – Based on bench data. 66 cadaver porcine eyes (33 Tors, 33 4D) and 64 artificial lenses (32 Tors, 32 4D); p<0.001. 13:41 - 66 cadaver porcine eyes (33 Tors, 33 4D) and 64 artificial lenses (32 Tors, 32 4D); p<0.001. 15:18 - Based on an adjusted multivariable regression analysis which resulted in a mean difference of -1.71 percent-seconds for CDE with the UNITY VCS/CS ® (n=139) console compared to CENTURION™ Vision System with AS (n=160). Most patients in the real-world study had non-dense cataracts (≤2+ nuclear density measurement; 64.8% for UNITY VCS/CS® and 72.0% for CENTURION™ Vision System with AS) and received FLACS (FLACS only, FLACS + there devices; 35.9%, 24.6% for UNITY VCS/CS® and 34.2%, 23.6%for CENTURION™ Vision System with AS). Performance may also be impacted by the surgeon's machine settings. 35:07 - Based on bench data. Reduction in surge is correlated to less change in anterior chamber depth. 36:58 - 66 cadaver porcine eyes (33 Tors, 33 4D) and 64 artificial lenses (32 Tors, 32 4D); p<0.001. 51:30 - Mean fluctuation at flow vs. setpoint of 2.36 ± 2.13, 4.19 ± 1.97, 1.84 ± 2.82, and 2.13 ± 2.86 mmHg during phacoemulsification, irrigation/aspiration (IA), vitrectomy, and extrusion/fragmentation, respectively. 52:58 - Clinical evidence of physiologic IOP was established using CENTURION with Active Sentry; UNITY VCS/CS utilizes advanced Intelligent IOP designed with the same physiologic principles. 55:29 - Based on bench data. Trademarks are the property of their respective owners. Based on N=10 HPs, Artificial cataract lens IOP 55mmhg vacuum of 450 mmHg 56:11 - Based on bench data.

How should eye care providers approach patients with concurrent glaucoma and catracts? And when does cataract surgery alone fall short? In this episode of CRST: The Podcast, Anupam Laul, OD, FAAO, and Sahar Bedrood, MD, PhD, work through 3 real-world cases covering ocular hypertension with visually significant cataracts, primary open-angle glaucoma with rapid RNFL progression, and acute angle closure with a large crystalline lens. The discussion covers SLT timing, MIGS selection, sustained-release drug delivery, IOL choice in glaucoma patients, and when trabeculectomy remains the right call.

In this episode of Best Practices in Keratoconus Management, Bradon D. Ayres, MD is joined Parag Majmudar, MD, and Neel S. Vaidya, MD, MPH, to discuss their early experiences with Epioxa now that it is available for the treatment of progressive keratoconus. Discover how they are incorporating Epioxa into their practices, their initial treatment successes, and what they have learned from their initial wave of patients. They also explore how this new treatment option may influence their approach to crosslinking and help them take a more proactive approach to keratoconus management. [Test Your Knowledge HERE]

Neda Nikpoor, MD, and Neda Shamie, MD, are joined by Radhika Rampat, MBBS, BSc(Hons), FRCOphth, for an exploration of sustainability in ophthalmology. They discuss the AECOS Green Working Group, waste reduction, and how to champion sustainability locally. 

What does it take to make every surgical consultation feel individualized amid increasing pressure for efficiency? George O. Waring IV, MD, speaks with Alexandra Dean, Director of Practice Development at Waring Vision Institute, about building a counseling continuum that starts before the patient arrives and uses intake forms, previsit outreach, and cohesive handoffs to connect clinical recommendations with individual goals. Dean also shares practical guidance on training nonclinical counselors, using technology without losing the human touch, and creating an experience patients remember for how it made them feel. Related article: “Individualization at Every Touchpoint,” in Cataract & Refractive Surgery Today, June 2026

The conversation continues as Sonny Goel, MD; and Robert T. Lin, MD, discuss strategies to help surgeons new to SMILE (Carl Zeiss Meditec) prevent and manage intraoperative complications. The panel shares practical pearls for avoiding common pitfalls, building confidence, and navigating challenging cases

Listen as John F. Doane, MD, FACS; Sonny Goel, MD; and Robert T. Lin, MD, discuss the evidence-based keratorefractive lenticule extraction (KLEx) guidelines and how they align with real-world SMILE (Carl Zeiss Meditec) practice. At each step, the panel shares practical pearls to sharpen clinical judgment, refine surgical technique, and optimize SMILE outcomes.

Listen as host Savak Teymoorian, MD, speaks with Courtney Bovee, MD, and David Stephens, MD, about their experiences with iDose TR (Glaukos), a procedural pharmaceutical. They specifically address patient education with iDose TR and the role it plays in their glaucoma journey.

In this podcast episode, Christine Funke, MD, is joined by Zarmeena Vendal, MD, and Lisa Feulner, MD, PhD, to discuss how surgeons can operationalize the use of iDose TR (Glaukos) and integrate this procedural pharmaceutical into their glaucoma treatment armamentarium. The discussion covers the barriers to implementation and next steps for integrating interventional glaucoma in practice.

Ashley Brissette, MD, MSc, FRCSC; and Matthew Rauen, MD Join Dr. Ashley Brissette and Dr. Matthew Rauen for the first episode of the UNITYtime Podcast—a new series focused on the real impact of extraordinary experiences with UNITY® VCS |CS. In this inaugural episode, they share early impressions of UNITY® VCS | CS, including insights on workflow, team experience, and considerations when transitioning from established platforms. Through a candid, peer-to-peer conversation, they offer practical perspectives on adopting new technology into everyday clinical practice. Whether you're evaluating new surgical platforms or looking to learn from your peers, this episode provides a thoughtful, real-world look at the UNITY® VCS| CS experience.