Cataract is one of the leading causes of vision impairment in the world and, due to the ageing population, the number of people requiring cataract surgery is on the rise. Cataract surgery is ever evolving and there is a need now, more than ever, for new technology to allow for efficiency and accurate surgical outcomes.
Ophthalmologists were recently invited to attend an evening in Perth, hosted by Zeiss, to learn about emerging equipment and technology in the cataract space.
I’m able to perform high volumes of surgery efficiently and safely, and produce high quality results with many happy patients
EQ Workplace
Dr Amir Hamid, renowned cataract and refractive surgeon based in London, commenced the evening by introducing Zeiss’ EQ Workplace. EQ Workplace is a software based on Zeiss Forum that allows for streamlined cataract workflow and offers protection against never events.
Biometry data is automatically transferred from the Zeiss IOLMaster to EQ Workplace, and intraocular lens (IOL) calculation and selection is auto populated. When ordering lenses, the chosen IOL information directly copies into the supplier order.
Zeiss claims that this not only saves time, but also reduces the risk of human error that can occur when manually inputting data at each step of the process.
For Dr Hamid, this had a big impact in both of his practices, which have a focus on refractive lens exchange and premium cataract surgery.
He felt EQ Workplace helped him to achieve his goal of improving the safety and accuracy of cataract surgery for his patients.
“I have used EQ Workplace for more than three years now. I’m able to perform high volumes of surgery efficiently and safely, and produce high quality results with many happy patients,” he told the audience.
EQ Workplace connects to the EQ Mobile app and the Zeiss Callisto eye, allowing for automatic transfer of IOL parameters and other surgical assistance data, again saving valuable time. For Zeiss IOLs, the EQ Mobile app is easily able to confirm the chosen IOL by scanning the barcode. Rather than making manual markings on the eye, the scleral reference image can be sent from the IOLMaster to the Callisto eye, then transferred to the correct eyepiece of the microscope. This ensures the markings are accurately aligned and cannot be washed away during the procedure.
Dr Hamid said the streamlined and efficient interface has made a “huge difference” for all members of the practice and noted, “as a result of EQ Workplace, I am much more relaxed and so is my surgical team”.
Quatera Phacoemulsification System
Associate Professor Angus Turner, Director of Lions Outback Vision, and Dr Andrea Ang, corneal and refractive specialist, shared their experience with the Zeiss Quatera 700, and showcased several videos from their cataract procedures.
The Quatera is a phacoemulsification system with a range of features, in particular, the Zeiss-patented Quattro Pump. It is unique in that it both measures and controls aspiration and infusion volumes in real time. The pump maintains an extremely stable anterior chamber by actively compensating for incision leakage volume. As a result, there can be recovery of IOP post occlusion in around 200 milliseconds, regardless of aspiration settings.
“The Quatera 700 is a closed system where what is happening in the eye is directly connected to the machine,” said Assoc Prof Turner. With the stability of the anterior chamber maintained so well, he described the entire cataract surgery process with the Quatera as “more relaxing for the ophthalmologist”. He shared a video of the new Lions Outback Vision clinic in Broome, where a patient spoke about the successful cataract surgery he had, and how regaining vision had allowed him to continue to create Indigenous artwork.
For Dr Ang, the Quatera has been useful for both soft lenses in the case of refractive lens exchange, as well as dense cataracts. She also highlighted the anterior chamber stability and noted that other key features she has enjoyed included the efficient followability, light phaco hand piece, and minimal learning curve. Dr Ang has also used the Quatera in surgery for patients with Fuch’s endothelial dystrophy with great success.
Lucia 621 Intraocular Lens
Dr Tun Kuan Yeo, Senior Consultant and Deputy Head of Cataract, Implant and Anterior Segment at Tan Tock Seng Hospital in Singapore, spoke about the Zeiss CT Lucia 621, a preloaded new generation modified aspheric IOL that he described as offering unique spherical aberration correction, excellent centration, and stability.
The lens provides high contrast due to negative spherical aberration in the central optic zone and is designed to balance out the positive spherical aberration of the cornea. The peripheral zone changes gradually from negative to positive spherical aberration, providing tolerance to tilt and decentration. As a result, the patient enjoys better vision.
The CT Lucia 621P/PY comes in a fully preloaded injector, making it easy to use. Compared to other hydrophobic acrylic monofocual IOLs, it has longer haptics and a large angle of contact (AoC), which improves lens stability and centration.1 Dr Yeo referenced a study by Dr Antonino Cuttitta, which measured the pseudophakic anterior chamber depth of 60 patients at one week and one month after surgery, and found that the CT Lucia 621P/PY maintained the same position at both time points, indicating its good stability within the capsular bag.2
Dr Yeo further shared his clinical results with the CT Lucia 621P. The refractive predictability of the IOL was excellent, especially with modern IOL formulas such as Barrett Universal II, EVO 2.0, and Kane, achieving 89.5% to 94.7% within 0.5D.
References
1. Borkenstein A.F., Borkenstein E.M., Geometry of acrylic, hydrophobic IOLs and changes in haptic-capsular bag relationship according to compression and different well diameters: A bench study using computed tomography. Ophthalmol Ther. 2022 Apr;11(2):711-727. doi: 10.1007/s40123-022-00469-z. Epub 2022 Feb 5. PMID: 35122227; PMCID: PMC8927568.
2. Cuttitta A., Examining stability of aspheric IOL in cataract patients. Ophthalmology Times. Volume 46. Issue 8, May 2021.
