Introduction

SWEPT Source OCT Technology

The IOLMaster 700 is the first biometer with SWEPT Source Biometry® from ZEISS. One major advantage of this technology is its ability to provide an OCT scan through the entire length of the eye, from the cornea to the fovea (Figure 1). The full-length B-scan allows fast and reliable boundary checks in phakic, aphakic and pseudophakic eyes. The scan has a 44 mm depth and a 6 mm width on the cornea. A multi-touch screen facilitates use; it can be operated in much the same way as a smartphone or tablet. The new features of the IOLMaster 700 are designed to help users reduce the risk of refractive surprises and optimize refractive outcomes.

Figure 1. Full length B-Scan of the entire eye obtained with the IOLMaster 700.

Unique Telecentric Keratometry

The IOLMaster 700 is able to provide extended, robust and reproducible measurements of the corneal surface by means of the unique telecentric keratometry system. Telecentric keratometry ensures a constant spot distance on the cornea irrespective of the device-to-eye distance. The standard deviation (SD) of measurements taken with this system shows high repeatability (SD ±0.07 D).

Fixation Check

The device incorporates a unique Fixation Check scan with an approximately 1 mm width of the retina, which allows the operator to verify proper patient fixation during the measurement. If the foveal pit can be seen in the image, the user can assume that the patient fixated properly during the measurement; if not, the measurement needs to be repeated and the patient needs to be instructed to fixate better on the target light (Figure 2). This is especially important in cases with difficulties fixating for example due to macular pathologies or very dense cataracts. The Fixation Check reduces the risk of refractive surprises as a consequence of undetected, poor fixation. Besides this primary usage, the Fixation Check allows users to get indications for macular pathologies.12, As the ZEISS IOLMaster 700 is clearly not intended to be used for diagnostics, findings need to be verified and pathologies diagnosed with a dedicated retina OCT. Nevertheless, in high-volume practices the ability to detect these eyes preoperatively can be invaluable.16

Figure 2. Centered fixation, foveal pit visible (left); decentered fixation, foveal pit not visible (middle)

Source: Image courtesy of Prof. M Blum, HELIOS Klinikum Erfurt, Germany

Figure 3. Macular hole: Fixation Check scan (A) and the SD-OCT scan in inverted color (B)*

Source: Hirnschall et al.; Macular disease detection with a swept-source optical coherence tomography-based biometry device in patients scheduled for cataract surgery; J Cataract Refract Surg VOL 42, April 2016

In a prospective study with 120 patients, Oliver Findl, MD, had two retinal specialists analyze all IOLMaster 700 macula scans in a randomized order. The scans were re-analyzed 3 weeks later and confirmed by an SD-OCT analysis. The IOLMaster 700 showed high levels of specificity (89.1%) and sensitivity (67.7%) for the detection of macular diseases.1 The IOLMaster 700 demonstrated a good ability in the detection of cystoid macular edema (CME) and macular holes.

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© Carl Zeiss Meditec AG, 2016 EN_32_173_0002I

 

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Introduction

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