IBRA Professional. Leading Technology for Refractive Outcome Analysis. Brochure 2015

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1 IBRA Professional Leading Technology for Refractive Outcome Analysis Brochure 2015

2 Introduction IBRA is the leading all-in-one system for refractive laser and lens surgery outcomes, allowing eye surgeons to access their data and outcomes over encrypted Internet connections, independent to the location and computer operating system. IBRA is a fast, comprehensive and easy-to-use solution that offers an extensive range of tools to comprehensively work with refractive and visual data after LASIK, PRK, clear lens extraction, cataract surgery, corneal cross linking and corneal ring segment implantation. IBRA is more than just software. IBRA is part of a unique concept to review the results and benefits from the performance analysis from ophthalmic surgery of individuals, centers or trusts with different sites. Even co-managing of patients is possible, reaching out to the referral base and integrating data into IBRA created by others. The outcome concept follows a 4-step cycle. The first step is to analyse and report on the treatments. This is commonly used for audits and quality controlling (clinical governance). 'Enterprise features' are included. The second step is to compare the results of a surgeon or center with another surgeon, with another center or with a global reference. This enables 'quality positioning' and provides a better treatment awareness. The third step is to use the results from analysis and comparison to better understand differences and performance profiles. This happens via the means of nomograms. The fourth step shall provide an outcome and prediction model allowing for realistic outcome expectations. IBRA's 4-step outcome concept is paired with competent support and training from IT and ophthalmic specialists.

3 Overview of the IBRA System

4 Key features for LASIK / PRK Laser Performance IBRA allows unique access to a large global reference database using polynomial best fit algorithm to produce accurate performance profiles of a range of excimer lasers (Alcon WaveLight, VISX, Technolas, Schwind) for LASIK and PRK treatments. Surgeons can produce surgeon-specific performance analyses, or use center data. Laser Performance Graph Two scattergrams present the relation between programmed (or attempted) and achieved refractive correction for the spherical equivalent and the cylinder value at a defined follow-up time. Simple linear regression analysis is used to describe slope and intercept. Standard Outcomes IBRA produces 14 of the most commonly used outcome graphs (incl. Waring types) and offers a complex filter section to separate or group data for analysis. Charts can be created in high resolution (for presentations) or printed together as a single page summary report (pdf). Demographic data is calculated for the data selection and a cohort of data (subgroup) can be marked for the use in other IBRA modules or for data export. IOL Power Calculation after LASIK IBRA can be used to calculate the IOL power for eyes that previously underwent refractive laser surgery (LASIK/PRK).

5 Key features for lens surgery IOL Performance The personal, optimal (ULIB) and nominal a-constant of the user's lens treatments is calculated and presented in a table. Many parameters can be used to specify the data used for calculation (e.g. optical or ultrasound biometry, AL, Ks). IBRA can present the refractive error versus axial length of the eye in a scattergram. Astigmatism Calculation The incision induced astigmatism is calculated for each treatment and presented as a mean value or histogram. Several filters can be applied, e.g. different incision sizes (2.2mm versus 2.75mm) or position of the incision (on the cylinder axis, temporal). Arcuate keratotomies from Femto Phaco surgery can be analysed. Toric IOL Module This module allows a comprehensive overview of the outcomes of toric lens surgery. Several analyses are possible, including rotational stability, change and distribution of manifest and keratometric astigmatism. A table shows a summary of important results for each case, including incision induced astigmatism,. Multifocal IOL Module IBRA allows the graphical presentation of monocular and binocular, unaided and corrected near and distance visual acuity. The results can be presented in a line chart over time (preoperative to 12 months) or as a bar chart for a range of achieved visual acuity levels (e.g. percentage of eyes achieving 20/20).

6 Data comparison and other features 2 Group comparison with statistics The system can compare the visual acuity or refractive outcomes of two treatments (e.g. LASIK versus PRK, lens versus laser surgery, Laser A versus Laser B, 2012 / 2013 results, surgeon versus Center results). IBRA automatically calculates a p- value to determine the statistical significance of the difference between the data of the two treatments. The results are also presented in a boxplot. Comparison with a global reference IBRA allows the surgeon to compare the individual outcomes with outcomes of a global reference. Ten main measures are offered for comparison, including percentage of eyes achieving 20/20 or eyes with loss of more than 1 Snellen line. Jackson Cross Cylinder Analysis IBRA calculates mean J0, J45, B and M, and presents the results in a table, in a series of scattergrams and a bar chart. The pre- and postoperative cylinders can be presented in an interactive, rotatable 3D plot. Patient Satisfaction This module allows the analysis of patient satisfaction scores of different treatments or separated by surgeon, center or date. A set of real-time outcomes can be placed on a 'Public Dashboard', accessible to visitors of the surgeons own website.

7 Data collection and other features Quick data entry pages & Verification These pages are designed to allow rapid and relevant data collection for 6 areas of refractive laser, lens and corneal surgery. The data content of each field is validated for correct format and range at the time of data entry. Customization of data entry IBRA allows users to customize the data entry pages and fields. Users can choose from a total of 210 fields/parameters available for each treatment. A wide selection of IOLs, lasers and other medical devices can be allocated to the user profile via the device settings. EMR Interface (data import) Several EMR software manufacturer have created specific interfaces to allow export of recorded data from their EMR system into IBRA for advanced outcome analysis. Zubisoft also supports interfacing with bespoke EMR systems. Data export and many more features. IBRA is designed to run on any operating system (Win, Mac) and on any browser. The user interface has been optimized to allow use of smartphones or tablet computers (ipad, Surface). The IBRA system provides multi-screen capability, uses high secure 256 bit encryption and operates from a redundant and scalable hosting platform in Switzerland. The system has large data capability (e.g. working with 50,000 or more cases). The data can be exported by the user at any time directly into an EXCEL spreadsheet.

8 Testimonials from IBRA Users IBRA is used in more than 25 countries. Below, and on the next page, we present some testimonials made by international refractive, cataract and corneal experts. All of the named surgeons formally allowed us to present their name and photo on our website. Although surgeons are mentioned on our websites, the relation created by this shall not constitute a partnership. Neither party is an agent of the other. Privacy is a key element of our services and we guarantee not to publish customers' details without prior consent.

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10 Customer Services "...excellent support and competence. "...very keen to help wherever possible and very approachable. "...they promptly helped me to solve the problem. The team of IBRA is specialised on refractive and visual outcome analysis. We offer independent consulting and work in a variety of ways depending on the scale and complexity of the project. We provide advice and support and deliver detailed reports on outcome and quality controlling. We support implementation of new techniques that can lead to outcome changes. Our customer services may include interactive online support and teaching. All meetings, webinars and training sessions are completely private and secure and feature Secure Sockets Layer and 128-bit Advanced Encryption Standard. Our solutions use HTTP outbound connections to transparently enable screen-sharing sessions even with corporate firewalls in place. IBRA customers have access to the online Learning Center with trainings videos, Question & Answer section and training courses.

11 10 Reasons - why you should use IBRA

12 Contact Zubisoft GmbH Zubisoft GmbH is a Swiss company specialised in the development of high-end software systems for medical and business purposes. Behind Zubisoft is a well coordinated team of IT and medical specialists who is working with web-based technologies since their first releases. Zubisoft implements current and upcoming standards into easy-to-use applications that can be run on client computers, over the Internet and on mobile devices, such as iphone or ipad. Company Milestones 1988 Zubisoft company formation 1989 Launch of the first version of the business office software 'PRISMA' Web design and web application developments First ophthalmic surgery outcome software released, called Proexcimer, after two years of development and research IBRA System introduced as the successor of Proexcimer Reorganization of the operating sectors and focus on the two main products: IBRA (Medical) and PRISMA (Business) Year Anniversary of ophthalmic surgery outcome software. Headquarters (German): Zubisoft GmbH Birchstrasse 151 CH-8156 Oberhasli Switzerland Phone: International Contact (English): Phone: Internet:

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