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REVIEW
Technology Update
Edited by Michael Colvard, MD, and Steven Charles, MD
The Integrated
Cataract Surgical Suite
By linking diagnostic instruments with surgical ones, companies
hope to improve surgical safety and effi cacy.
Walter Bethke, Managing Editor
The drive to integrate and connect
a practice’s equipment is extending
into the cataract suite, as well,
with the recent release of integrated
systems from both Alcon and Carl
Zeiss Meditec. Users say the benefits
can run from simply having all the patient
data transferred to the operating
microscope to having the microscope
display digital overlays to aid in the
positioning of toric lenses. Here’s a
look at the two new systems and the
features they bring to the practice.
Alcon’s Applied Integration
Alcon’s Cataract Refractive Suite
connects an imaging/measurement
device called the Verion with the Centurion
phaco machine, the LenSx femtosecond
cataract laser and the Luxor
operating microscope.
“The goal is to have all of the surgeon’s
in-office data acquisition easily
transferable to the OR suite,’” says
Richard J. Mackool Jr., MD, of Astoria,
N.Y., who uses the system. “In the
past, we would do the testing, obtaining
the IOL power and astigmatism
results on paper, and then make decisions
about our lens choice in the
Richard Mackool, MD
OR based on those measurements.
With the Verion, the data is stored
digitally on a USB memory stick that
is taken to the OR and inserted into
the system. The microscope retrieves
the data, giving you a digital overlay
that’s visible in the microscope oculars
and indicates the correct axis at which
to implant the toric IOL. Before this,
we’d mark the eye with a pen with the
patient sitting up to indicate the principal
meridians, then use a toric axis
marker to locate the desired meridian.
With the Verion, these steps are
eliminated. Instead, you have a digital,
real-time overlay as a direct indicator
of the preop data.”
The Alcon Verion can provide an axis guide
in the microscope to aid in the placement
of a toric intraocular lens.
The Verion system captures the
globe image and maps out landmarks
such as iris features and blood vessels,
explains Dr. Mackool. “That’s how
it orients the eye in space,” he says.
“When you’re in the OR, you capture
another image and the system overlays
the original reference image and the
new image, so that the patient’s eye
under the operating microscope is oriented
in space in the exact position the
machine expects.” Additionally, the
Verion gives the surgeon the option of
aligning any IOL, toric or multifocal,
on the pupillary axis, the visual axis or
the geometric center of the cornea. A
capsulorhexis guide, which can also be
centered where the surgeon chooses,
is also available as an overlay, to help
guide the surgeon as he creates it.
For lens selection, the Verion has
such formulas as the Holladay, Holladay
II, SRK/T and the Hoffer Q.
“More important, after you’ve done
a number of cases and entered the
results into the system, the Verion will
optimize your case results in the future
by retrospectively analyzing the
data so you can tailor the program
you choose to the cases you perform.
For instance, everyone has a differ-
18 | Review of Ophthalmology | February 2014
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