TECNIS® Toric Calculator System Online Operation Manual Welcome to the AMO TECNIS Toric Calculator System. The TECNIS Toric Calculator System has been specifically designed to make calculating the TECNIS Toric IOL simple, intuitive, and easy.
DRAFT With the TECNIS Toric Calculator System you can: •
Input prompted data in order to determine the TECNIS Toric IOL model that gives the optimized surgical outcome.
•
Get calculated TECNIS Toric IOL results for your surgical needs easily and rapidly.
•
Generate a print-out which includes all the data you need for ordering the calculated TECNIS Toric IOL model.
•
Have access to the calculation for the required TECNIS Toric IOL lens 24 hours a day, seven days a week.
•
System performs in the following browser environments: Internet Explorer® (8.0 TM or higher), Firefox® (3.5 or higher), Safari® (3.0 or higher), Google Chrome (3.0 or higher)
TECNIS Toric Calculator System Overview Abbott Medical Optics has developed the TECNIS® Toric Intra Ocular Lens (IOL) with patients undergoing cataract surgery in mind. The goal is to deliver a lens which will reduce the residual refractive cylinder based on a personalized level of data entry. The TECNIS Toric IOL on-line calculator considers the preoperative corneal astigmatism, as well as any anticipated surgically induced astigmatism in determining the resultant postoperative corneal astigmatism correction. The best practice which will afford the most appropriate results requires that accurate keratometry measurements are implemented to determine the preoperative corneal astigmatism. While the desired surgical procedure strives towards astigmatic neutrality, even minor incisions during cataract surgery can induce corneal astigmatism. This may affect the amount of postoperative corneal astigmatism as well as the respective axis. As a result, Abbott Medical Optics recommends that based upon individual surgical technique and past results, surgeons customize their surgically induced corneal astigmatism value.
Prerequisites To use the Abbott Medical Optics TECNIS ® Toric Calculator, you need: • • • • •
An Apple® computer (Mac OS® X 10.5 or higher)or PC (Windows® XP operating system or higher) A working Internet connection Internet Explorer® (8.0 or higher), Firefox® (3.5 or higher), Safari® (3.0 or higher), or Google Chrome™ (3.0 or higher) Adobe® Flash® Platform (Download it here.) Adobe Reader® (Download it here.)
DRAFT
The TECNIS Toric IOL calculator is a user-friendly tool, designed to help further integrate Toric lenses into your practice. The TECNIS Toric calculator generally eliminates the need for hand-written or the multiple use of manual or on-line calculators. It is a single use software application that helps you select the most appropriate TECNIS Toric IOL for your patient. The TECNIS Toric IOL calculator allows the input for personalized surgically induced astigmatism and / or IOL A-constants. Finally, if based on the resulting residual refraction, you prefer a different target refraction, you can directly modify the IOL power input and perform the calculation without initiating a new calculation scenario. This allows you to see the original calculation as well as the alternative calculation based on your modification.
Although the tool has been tested to a large range of possible situations, it is the user’s responsibility to decide the usefulness of the calculated information.
Simply go to www.TecnisToricCalc.com and start entering your data.
Before You Begin Read this important information if this is your first time using the AMO TECNIS Toric Calculator system.
Overview:
Preoperative Calculator Screen:
This section includes important instructions. It explains how to access and navigate through the system. Calculator Access: 1.
Click the TORIC folder tab web-link at the top of the AMO Calculator Platform Welcome page.
2.
R e v i e w t h e T E C N I S Toric Calculator License Agreement, Terms of Use, and Privacy Policy page and Accept or Decline the Terms of Use.
DRAFT
(Note: To work in the calculator, you must Agree to the Terms of Use). 3.
Once on the TECNIS Toric Online Calculator site, you will see the Preoperative Calculator Screen prompting data input for preoperative patient information to be used in the calculation.
4.
Data input fields are indicated by boxes located on the screen. A schematicdiagram of an eye with respective facial orientation (i.e., OD or OS) and orientation axis markings is located on the Graphical Output Area of the screen.
5.
Graphical Output Area is the area of the screen which indicates:
5.1
Pictorially and through abbreviation (i.e., OD: right or OS: left), the subject eye for current calculation input / output.
5.2
The Graphical output of the input incision @axis, calculated lens orientation / rotation.
AMO User 11/8/10 10:18 AM
Deleted:
Support Options There are three support options to assist you during your use of the AMO TECNIS Toric Calculator system: 1.
Click the Section Header links to display definition and data input range information for each section. These informative text boxes will be displayed in the Graphical Output area of the Calculator Screen,
2.
Click the Tutorial link at the top of the calculation page to download a copy of this training guide,
3.
Click on Terminology, FAQ, and Support link at the top of the calculation page to view details a glossary of Terms used in the calculator, Frequently Asked Questions, or to contact an AMO Customer Service representative.
DRAFT
Quick Steps: Data Entry – Section 1 Surgeon and Patient Information
Quick Steps: Data Entry – Surgeon and Patient Information Section Input data into the following fields:
Preoperative Data Input Screen:
Surgeon and Patient Information 1.
Surgeon Name – enter the surgeon name; this field is optional and serves as reference only
2.
Patient Information – enter any related patient information (e.g. ID, Case, etc.); this field is optional and serves as reference only.
4.
Eye Selection – select the operative eye, either OD (Right) or OS (Left).
5.
K Notation – select the K notation, either diopter (D) or millimeter (mm).
DRAFT
You can move through the data input fields by either pressing the “Enter” button on your keyboard, or by tabbing through the data input fields. Data Entry continues with Keratometry Section
Quick Steps: Data Entry – Keratometry Section Keratometry
Preoperative Data Input Screen:
1.
Surgically Induced Astigmatism (SIA) – enter the amount of surgically induced corneal astigmatism in diopters (D). The system will accept values between 0.00 and +2.00D.
2.
Incision @ axis – enter the incision location in degrees (°). The system will accept values between 0 and 360°.
3.
Flat K - enter the keratometry measurement of the flattest corneal power in diopters (D) or millimeters (mm). The system will accept values between 33.00 and 52.00D or 6.49 and 10.23mm.
DRAFT
Note: When displayed in Diopters, the value of the Flat K1 must be less than or equal to the Steep K2. When displayed in mm, the value of the Flat K1 must be greater than or equal to the Steep K2.
4.
Flat K1 @ Axis – enter the axis of the flattest corneal power in degrees (°). The system will accept values between 0 and 180°.
Quick Steps: Data Entry – Keratometry Section (continued) Keratometry 5.
Preoperative Data Input Screen:
(continued)
Steep K – enter the keratometry measurement of steepest corneal power in diopters (D) or millimeters (mm). The system will accept values between and including 33.00 and 52.00D or 6.49 and 10.23mm. Note: When displayed in Diopters, the value of the Steep K2 must be greater than or equal to the Flat K1. When displayed in mm, the value of the Steep K2 must be less than or equal to the Flat K1
DRAFT
6.
Steep K2 @ Axis – the axis of the steepest corneal power will be automatically calculated, based on the Flat K1 @ axis value, and displayed in degrees (°).
7.
Preoperative Corneal Astigmatism – the preoperative corneal astigmatism will be automatically calculated and displayed in diopters (D).
Data Entry continues with Biometry Section
Quick Steps: Data Entry – Biometry Information Section Preoperative Data Input Screen:
Biometry Section 1.
Axial Length – enter the axial length measurement in millimeters (mm). The system will accept values between 19.0 and 35.0 mm.
2.
Method – Choose from the drop-down menu, the Biometry measurement method used,
2.1
Optical (method using light waves to measure distance, often called “PCI”), e.g. IOLMaster
2.2
Ultrasound (method using sound waves to measure distance, often called “AScan”.
2.3
Personalized
2.3.1
2.4 2.4.1
DRAFT
Choosing “Personalized” allows you to input either the Surgeon Factor, Anterior Chamber Depth (ACD) value, or A-constant IOL A-Constant – This field will be populated as follows
If in the Method field you chose “Optical,” the system will populate the IOL A-constant field with the Aconstant value: 119.1
Quick Steps: Data Entry – Biometry Information Section (continued) Biometry Section
(continued)
2.4.2
If in the Method field you choose “Ultrasound,” the system will populate the IOL A-constant field with the A-constant value: 118.8
2.4.3
If in the Method field you choose to “Personalize,” your input, the system displays additional optional user entries of either: “Personalized Surgeon Factor”, “Personalized A-Constant”, or “Measured Anterior Chamber Depth” (ACD).
DRAFT
2.4.3.1
If you choose “Personalized Surgeon Factor,” and enter a value into the Surgeon Factor field, the system will accept a Surgeon Factor between -3.31 and 2.92
2.4.3.2
If you choose “Personalized AConstant,” and enter a value into the A-Constant field, the system will accept an A-Constant between 110 and 121
2.4.3.3
If you choose “Measured ACD,” and enter a value into the ACD field, the system will accept an Anterior Chamber Depth between 0.3 and 6.72mm
Data Entry continues with Calculation Preferences Section
Preoperative Data Input Screen:
Quick Steps: Data Entry – Calculation Preferences Section Calculation Preferences
Preoperative Data Input Screen:
1. Target Refraction - enter the target refraction desired for surgical outcome in diopters (D). The system will accept values between and including -3.00 and 3.00D. 2. K-index - from the drop-down menu, clickchoose the K-index related to the keratometer used for corneal power measurements. Available (typical) values include: •
DRAFT
1.3375, 1.336, 1.332, and 1.3315
3. Cyl Convention display - Click on the radio button of which Cylinder Convention you would like displayed in the Final Calculated Results. You may choose from either the Plus Cylinder or Minus Cylinder display.
Note: Alternate IOL Power data entry is a PostCalculation preference field only 4. Alternate IOL Power: Following the initial calculation, you have the opportunity to input an Alternative IOL Power value if you would like to run scenarios without clearing all fields. This color-shaded field will appear only after the initial calculation has been performed. The system will accept IOL Power values of between and including 15.00 and 28.00D in 0.50 diopters increments. Data Entry Complete!
Quick Steps: Final Results and Model Recommendation - Calculation Section
Calculation – Final Results and Model Recommendation
Preoperative Data Input Screen:
(Displayed per Cylinder Convention Request)
General: The postoperative corneal astigmatism (orange / red: steep axis) and incision location (blue) are displayed on the schematic diagram of the eye located in the graphical area on the right side of the screen, as well as the recommended IOL orientation. Identification of Temporal and Nasal are displayed in this graphical area, relative to the choice of eye (OD or OS).
DRAFT
After clicking the “Calculate Results” button at the bottom of the data-input screen, you should: 1.
Review / Verify data entries if the “Required data is missing or incorrect. Please check fields in red” message is displayed or if the eye figure does not look correct for your planned procedure.
2.
If required, correct any data entries and select “Calculate Results” to update the schematic eye diagram.
Quick Steps: Final Results and Model Recommendation - Calculation Section (continued)
Calculation – Final Results and Model Recommendation (continued)
Calculation Results Screen:
(Displayed per Cylinder Convention Request)
3.
Final Results (Cylinder Convention) will be displayed. Final Results include:
3.1
Recommended IOL Model based on calculated results and range evaluation
3.2
Residual Refraction - Calculator will return the following values
DRAFT
3.2.1
Sphere: The spherical portion of a lens prescription written in Spherocylinder notation, e.g., 0.02 + 0.01 x 90
3.2.2
Cylinder: The cylinder portion of a lens prescription written in Spherocylinder notation, e.g., 0.02 + 0.01 x 90
3.2.3
Axis: The orientation of the cylinder axis of a lens prescription written in Spherocylinder notation, e.g., 0.02 + 0.01 x 90
3.2.4
SEQ: Also written as “SE,” abbreviation for “Spherical Equivalent,” the mean power of a spherocylindrical lens.
Quick Steps: Final Results and Model Recommendation - Calculation Section (continued)
Calculation – Final Results and Model Recommendation (continued)
Calculation Results Screen:
(Displayed per Cylinder Convention Request)
3.3
You will also notice that there is now a color-shaded data input entry box within the “Calculation Preferences” Section. You may input an alternate IOL Power value into this field (from drop-down selection).
3.3.1
This is available in case you would like to perform some scenario comparisons with various alternate IOL powers.
3.3.2
In all cases, when you modify the IOL Power, the original results from the original data input set is retained and shown in white to allow direct comparison and choice of IOL model without the need to re-calculate the original input basis.
DRAFT
Quick Steps: Printing Calculation Output and Ordering Lens Printing Calculation Output and Ordering Lens General: Preoperative Information from the Data Input Screen is retained on the screen for reference and record maintenance. Once you move away, or closes out the TECNIS Toric Online Calculator session, all inputted data is deleted and is not available for future access. Prior to printing and ordering the lens, there is a pop-up box which queries whether the you have reviewed and verified your data input. Upon clicking on “ok” the system will make the printout or the order-form screen available. 1.
2.
2.1
Calculation Results Screen: Print and Order Functionality
DRAFT
Print Results: In order to keep a record of the TECNIS Toric On-line Calculator output, select “Print Results” at the bottom of the screen. This will print results and specifications for inclusion in the patient’s file and for surgeon reference during the procedure. Order Lens: You click-choose the lens you would like to order from the options listed in the “Final Results” Section. This activates the “Order Lens” button. You may then order the selected lens as follows: “Order Lens” button is clicked and the printable order-form screen is launched.
Quick Steps: Printing Calculation Output and Ordering Lens Printing Calculation Output and Ordering Lens (continued) 2.2
The Lens Order form may be modified online and then printed for using the data for the local order process. You can fill out any or all of the form which will best address the various processes. The only fields that may not be modified are the fields which are pre-populated from the TECNIS Toric On-line Calculator. These include:
DRAFT
2.2.1
Surgeon Name (for reference)
2.2.2
Patient Information (for reference)
2.2.3
Material Number
2.2.4
Model Number (diopter and ZCT-model)
2.2.5
Description (TECNIS Toric 1-PIECE 6.0mm Diopter and CYLvalue)
Quick Steps:
Order Form: Print and then FAX
Quick Steps: Clearing Calculation Output and Data Input Clearing Calculation Output and Data Input
Clearing Calculation and Data Input
General: If you would like to initiate a new calculation, or equivalent, the “Clear Results” button is clicked and the previously data inputted is cleared and the cursor returns to the initial data field, “Surgeon Name,” in the Surgeon and Patient Information section.
DRAFT
DRAFT
