IOLMaster with Software Version V 3.0

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1 IOLMaster with Software Version V 3.0 The aim of this little paper is to provide you with a condensed summary of everything you need to know about the IOLMaster and the new software version V 3.0 and higher. This information is intended as a guide for your work with the IOLMaster. The software version V 3.0 is the consistent enhancement of the IOLMaster, offering added convenience, increased safety and an extended field of application in refractive surgery. You can quickly utilize the benefits offered by the system. Please send any ideas you may have to me by (bissmann@zeiss.de). Sincerely, W. Bissmann Product Management Carl Zeiss Jena GmbH Phone: Ophthalmology Fax: ophthalmo@zeiss.de internet: 1

2 IOLMaster with Version V 3.0 News The most important additions to Version V 2.02 at a glance: White-to-white determination (Option A) WTW is the horizontal iris width and is used for two applications. In the 1 st application, the Holladay 2 formula requires WTW as a measuring parameter in order to calculate the power of the intraocular lens. The also required input parameter Lens thickness (LT) cannot be measured with the IOLMaster, but is easy to calculate from the patient s age (A) using the formula LT= 4+ A/100). The 2 nd application is sulcus-supported intraocular lenses (especially for refractive surgery). As the sulcus diameter (SD) is not accessible (except by using ultrasound microscopy), the formula SD=WTW+1mm is often used here to find the suitable outer diameter of the IOL. The position of the visual axis relative to the iris is still displayed. It is advisable to know the position of the visual axis, e.g. prior to refractive corneal surgery, in order to avoid any refractive surprises. White-to-white measurement IOL calculation after refractive corneal surgery (Option A) An increasing number of patients are undergoing an IOL implantation after RK/PRK/Lasik/Lasek/LTK, etc. The refracting power of the cornea is required for the IOL calculation. Measurement of this power after refractive corneal surgery is not currently possible. Therefore, two main methods which make use of refractive data are utilized for this purpose. The clinical history method requires the refraction data prior and subsequent to refractive corneal surgery. This method is currently the most reliable, but the data before corneal surgery, which usually took place years before, is often unknown. In this case, the use of the contact lens method (contact lens overrefraction) is the only option. For this method, the refraction data with and without a hard, plane contact lens and the refractive values of the contact lens are required. The refraction data cannot be obtained with the IOLMaster; data acquired with commercial refractors, or even better subjective refraction data, should be used. Refracting power after refractive corneal surgery Keratometer with fewer measuring errors In some isolated cases in the past, errors occurred in patients with drooping eyelids or eyelashes (partially concealed measuring marks) or due to multiple reflections caused by a poor tear film or bad focusing. An enhanced algorithm in the image evaluation largely rules out the possibility of measuring errors. The faulty measuring points are displayed. An animation requests the patient to close his/her lid before the measurement. A good tear film is a must if optimum results are to be obtained. 2 + and cylinders All data can be displayed or entered in + or cylinders. For the keratometer display, the setting made under Options -> Setup -> Program settings is decisive.

3 Change in the tolerance of the Evaluation error display in axial length measurement The display appears if a difference larger than 100 µm (previously 200 µm) exists between the minimum and maximum axial length values. This reduction was made in order to decrease measuring uncertainties resulting from multipeaks caused by different retinal layers. Backup and restore To increase data safety, especially for subsequent IOL constant optimizations, all patient data required for the optimization and the IOL constants can be stored on disk. After a crash, the user manager can use the Restore function to restore his data to the status present at the time of the backup. Correction of patient data The correction of first name, last name, date of birth and ID number is also possible after completion of the measurement/lens calculation. Deletion of patient data Deletion of individual patients from the name register is possible. This erases all associated data. Import The import function can be used to simply transfer IOL constants from disk to the IOLMaster if the data is available in a suitable form. The file with the IOL constants ( can be downloaded. This function therefore simplifies installation/handing over of the system to the customer, as the lens data as per the ULIB table can be easily transferred to the system for use by any operator. Data transfer to disk (Option A) Particularly users who wish to compile their own scientific papers or lectures using their clinical results need to use the patient data (measured values, but without graphs) for their own evaluations. The function for data export to a disk is now available precisely for this purpose. Extended data export via serial interface (Option A) Until now, the serial interface could only be used to export both the patient data and the individual measured values, including the graphs and one selected calculated IOL, to an office management system. In the V 3.0 an additional mode (setting via Setup) is available which allows the transfer of all calculated lenses for the two eyes for all 5 biometry formulas. This makes it possible to forgo printout on the IOLMaster in favor of data transfer to the office management system, permitting paperless work. Data export to a PC (Option B) Optionally, a standard PC with a WIN95/98/2000/NT/ME operating system can be connected instead of an office management system. For the PC, we supply software (CD, Option B) which files the stored data in a database. From there, it is possible to transfer data to Excel or to export the graphs in the JPG format. Demo software Demo software is available for Option A, but deletes itself automatically after 4 weeks and can subsequently no longer be installed on this system. Installation note The installation of Option A requires the previous installation of the software V 3.0 or higher. The corresponding update disks are an integral part of the equipment. 3

4 Possibilities for Data Transfer Various possibilities are available for data transfer: Transfer to office management systems to V 2.02 The transfer of patient data, measured values, graphs and data of one selected IOL from the IOLMaster to the office management system, and of patient data from the management system to the IOLMaster are possible. Product Management can provide a description of the interface as a basis for manufacturers of software for office management systems to allow them to structure their customization program accordingly. Transfer to office management systems from V 3.0 Transfer as in V 2.02, transfer setting via setup or extensive data transfer from V 3.0 are possible. Patient data, measured values, graphs and data of all calculated IOLs for all biometry formulas are transferred from the IOLMaster to the office management system, and the patient data from the management system to the IOLMaster. Systems already connected under V 2.02 or lower to a management system must either be converted to the old transfer protocol via Setup, or the supplier of the management system must extend his interface for the new data. Product Management can provide a description of the interface as a basis for manufacturers of software for office management systems to allow them to structure their customization program accordingly. Data transfer via a disk (Option A) The selected patient data and individual measurements (without graphs) are copied onto disk. This means that the data is available for further evaluation on a separate computer. IOL data are not written onto disks. Data transfer to a PC (Option B) The serial interface permits data transfer to a PC with the WIN 95/98/2000/NT/ME operating system. Patient data, measured values and IOL data are transferred in much the same way as to an office management system. The data is stored in a database, from which it is available for further processing. The graph can be exported in the JPG format. An installation routine is part of the software in order to allow users to install the software themselves. Backup This function backs up all data of the user manager (patient data, mean measured values, users with their IOLs and constants, eyes already allocated to an IOL for optimization, postop refraction, implanted IOL power...) in a compressed form on disk. For data protection, this function should be used at regular intervals. The underlying access database can also be used for the archival of IOL constants used at the time in question. Data transfer to a PC Restore This function imports the file of the user manager on a disk (in the same format as the backup) into the IOLMaster and hence allows the restoration of the user manager s data subsequent to a computer crash. Import of IOL Constants During the initial startup of an IOLMaster system, IOL constants must be entered in the user manager for optical biometry. Customers do not generally have these constants in their possession. The use of the clinical data of the User Group for Laser Interference Biometry (ULIB) has proved to be a favorable solution here. If an appropriate database is available on disk, this data can be imported into the system during the initial installation and allocated to each user. Needless to say, individual IOLs can also be subsequently added in this way. 4

5 The following brochures are currently available: Brochure IOLMaster German English French Spanish Poster IOLMaster German English Special Prints Warren Hill, MD, FACS, East Valley Ophthalmology, Mesa, Arizona, USA, Vergleichende Analyse der optischen Biometrie unter Verwendung des Zeiss IOLMaster und der Ultraschallbiometrie German Warren Hill, MD, FACS, East Valley Ophthalmology, Mesa, Arizona, USA, Comparative Analysis Between Optical Coherence Biometry Using the Zeiss IOLMaster and Ultrasonic Biometry English Wolfgang Haigis, et al.,university Eye Clinic Wuerzburg, Germany, Comparison of Immersion Ultrasound Biometry and Partial Coherence Interferometry for Intraocular Lens Power Calculation According to Haigis English no SNR B.A.M.Lege, W. Haigis, Universitäts-Augenklinik, Würzburg, Deutschland, Laserinterferenzbiometrie und konventionelle Ultraschallbiometrie in staphylomatösen Augen B.A.M.Lege, W. Haigis, University Eye Clinic Wuerzburg, Germany, Laser Interference Biometry and Conventional Acoustic Biometry on Staphylomatous Eyes A. Vogel, H.B. Dick, et.al. Universitäts-Augenklinik, Mainz, Deutschland, Reproduzierbarkeit bei optischer Biometrie: Intra- und Interuntersucher-Variabilität A. Vogel, H.B. Dick, et.al. University Eye Clinic, Mainz, Germany, Reproducibility of Measurement Results in Optical Biometry: Intraobserver and Interobserver Variability Haigis, B.A.M.Lege, Universitäts-Augenklinik, Würzburg, Deutschland, Optische Biometrie als Alternative zur Ultraschallbiometrie W. Haigs, B.A.M. Lege, University Eye Clinic Wuerzburg, Germany, Optical Biometry as Alternative to Acoustical Biometry German English German English German German J. Retzlaff MD, T. Linville, Intraocular Lens Implant Power Calculation with the Zeiss IOLMaster A Preliminary Report English no SNR 5