Ocular Innovation Summit ASCRS San Diego 2019 - Oliver Klaproth Senior Product Manager Biometry 2018-08-14 - Ophthalmology Innovation Summit
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Ocular Innovation Summit
ASCRS San Diego 2019
Oliver Klaproth
Senior Product Manager Biometry
2018-08-14
Not all concepts shown in this presentations are currently available for sale in- or outside the USA.
Wouldn’t you like to
never worry about IOL power calculation again?
Carl Zeiss Meditec AG, Oliver Klaproth
Subjective visual perception can be described objectively
Applied Physiological Optics
© Brian Barsky PSF
Carl Zeiss Meditec AG, Oliver Klaproth Not all concepts shown in this presentations are currently available for sale in- or outside the USA.
Optical properties can be translated to visual perception
Reconstruction of Retinal Images with Fast Fourier Transformation
Object Wavefront Image
Diffraction
Included!!
PSF = FFT of Pupil Function
FFT FFT-1
FFT
Carl Zeiss Meditec AG, Oliver Klaproth Not all concepts shown in this presentations are currently available for sale in- or outside the USA.
SWEPT Source Biometry® enables assessment of individual optical properties
ZEISS IOLMaster 700 and ZEISS IOL
3 Zone
Patented cornea-to-retina SWEPT Source OCT scan with Fixation
telecentric Patented cornea-to-retina SWEPT Source OCT scan
segmential refractive index AL check
keratometry
Telecentric Individual iterative power optimization
PLP Prediction, Tilt Compensation Retinal Image
Central Corneal based on
and IOL Design Quality
Power Maps neuronal weightened retinal image metric
Carl Zeiss Meditec AG, Oliver Klaproth The concepts presented in this presentation are not currently marketed in- or outside the Not
USA.all concepts shown in this presentations are currently available for sale in- or outside the USA.
Iterative Calculation of Retinal Image Quality
Changing the SPHERE
SPHERE increasing
CYL increasing
IOL selection based on
predicted VA and
neuronal weighted
retinal image quality
metrics
Carl Zeiss Meditec AG, Oliver Klaproth Not all concepts shown in this presentations are currently available for sale in- or outside the USA.
When to Choose a Toric IOL
Case Example, Hirnschall et al, JCRS 2019
3,87 3,87 23,57
4,38 4,00 24,70
Ast: 2,05D 4° Ast: 2,35D 173°
AT Asphina 409MP: SE 15,50 PVA: 42% AT Asphina 409MP: SE 22,50 PVA: 57%
14,00 14,50 15,00 15,50 16,00 16,50 17,00 21,00 21,50 22,00 22,50 23,00 23,50 24,00
SE SE
AT Torbi 709MP: SE +15,50 Cyl +3.00 A 95° PVA: 162% AT Torbi 709MP: SE +22,50 Cyl +2.00 A 72° PVA: 59%
SE SE 21,50 22,00 22,50 23,00 23,50
14,50 15,00 15,50 16,00 16,50
Cyl Cyl
2.00 1.50
2,50 2,00
Hirnschall et al, Pilot
3,00 2,50
evaluation of refractive
prediction errors
associated with a new
3,50 3,00
method for ray-tracing –
based intraocular lens
4,00
power calculation JCRS
3,50
2019
Carl Zeiss Meditec AG, Oliver Klaproth Not all concepts shown in this presentations are currently available for sale in- or outside the USA.
A glance at first clinical results
Hirnschall et al, JCRS 2019, in press
Study Design • Calculation of refractive spherical equivalent
absolute error of the ray-tracing method, based on
• Monofocal aspheric plate haptic IOL (CT
Asphina 409M/MP) implantation • individualized eye model data,
• a physical lens position predictor,
• 40 cataract eyes
• retinal image quality metrics criteria for IOL
• 1 month postoperatively manifest refraction and power selection,
optical coherence tomography–based biometry • and exact IOL design information
(IOLMaster 700)
Comparison to outcomes with
• Barrett Universal II,
• Hill-RBF,
• SRK/T, and
• Haigis formulas.
Hirnschall et al, Pilot evaluation of refractive prediction errors associated with a new method for ray-tracing – based intraocular lens power calculation JCRS 2019
Carl Zeiss Meditec AG, Oliver KlaprothA glance at first clinical results
Hirnschall et al, JCRS 2019
Cumulative percentage of eyes within the stated amount of Box plots of absolute prediction errors of the different formulae and
absolute prediction error in the raytracing group and for the raytracing based IOL power calculation.
different IOL calculation formulae.
Hirnschall et al, Pilot evaluation of refractive prediction errors associated with a new method for ray-tracing – based intraocular lens power calculation JCRS 2019
Carl Zeiss Meditec AG, Oliver Klaproth Not all concepts shown in this presentations are currently available for sale in- or outside the USA.Translating precise calculation to the OR: Intra-operative Toric IOL Alignment
ZEISS CALLISTO eye
• Matches the reference biometry image with the real-time
view from the microscope
• Continuosly tracks the live image to provide assistance
overlays for toric IOL alignment, incisions and rhexis
• Records intraop snapshots and videos in HD quality
Carl Zeiss Meditec AG, Oliver KlaprothProven Clinical Performance
More Precise Alignment and Shorter Overall Surgery Time
• Prospective comparative study of 57 eyes of 29 patients
using manual and ZEISS markerless workflow
• Toric IOL misalignment from intended target axis is
significantly better with markerless: 2.0° vs. 3.4° with
manual marking
• Overall surgery process time was significantly reduced by >
6 minutes (35% reduction) with markerless
“I align toric IOLs 40% more precisely and save 6 minutes in
surgery workflow per patient compared to manual marking.”
Wolfgang Mayer, MD, Center for Refractive Therapy, LMU Munich, Germany
W. Mayer (2017). “Comparison of visual outcomes, alignment accuracy, and surgical time between
2 methods of corneal marking for toric intraocular lens implantation”.
JCRS, October 2017
Carl Zeiss Meditec AG, Oliver KlaprothProven Clinical Performance
Better Toric Outcomes Compared to ORA
• Randomized, prospective and contralateral eye study of 104
eyes of 52 patients
• More than double the number of patients within ±0.25D post-
op cylinder compared with ORA
• Residual refractive astigmatism was significantly better as
well:
• 0.28±0.24 D with CALLISTO and
• 0.48±0.28 D with ORA (P =0.0003)
“I achieve 40% better outcomes compared to using ORA
intraoperative aberrometry system.”
Jonathan Solomon, MD, Bowie Vision Institute, Bowie, USA
Solomon JD, Ladas J.
Toric outcomes: Computer-assisted registration versus intraoperative aberrometry.
J Cataract Refract Surg 2017;43(4):498–504.
Carl Zeiss Meditec AG, Oliver KlaprothAre we on the right track? Carl Zeiss Meditec AG, Oliver Klaproth
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