Eyeworld

SEPTEMBER 2021 | EYEWORLD | 47 C Contact Hoffer: khoffermd@startmail.com Loh: jenniferlohmd@gmail.com Shammas: hshammas@aol.com When it comes to considering a new biom- eter, Dr. Loh offered this additional advice: She said the device should show anterior chamber depth and data on the keratometry reading. "Reliability on K readings is critical, and make sure axial length and core measurements are accurate. Also, getting through a dense cata- ract is important," she said. Dr. Shammas also said he thinks physi- cians should consider SS-OCT biometers when they're seeking out new equipment, but perhaps consider one that is also a Scheimpflug tomog- rapher. "As cataract surgeons, we are always looking for ways to streamline our process and improve our results. The most important objective is to optimize patients' outcomes and satisfaction after surgery. We need to have a keen eye on every step of the patient's clinical journey, from our preoperative assessment to our surgical procedure and postoperative recov- ery. The trend now is to streamline the process by bringing important clinical enhancements to the operating room," he said, explaining that improved integration of the biometry reading with intraoperative aberrometry eliminates the need for manual data entry, reducing tran- scription errors, and can be paired with digital marking systems for precise and integrated IOL planning and execution. ultrasound A-scans, which she said was not ideal for patients who wanted premium lenses. It was not only less accurate, but her technicians weren't as familiar using the ultrasound biome- ter. It was more time consuming. In addition to the type of technology, Dr. Hoffer said one reason to consider a new biom- eter, and a factor to consider when selecting a biometer, is IOL power calculations. While you can find the formulas online and perform them manually, newer biometers do the calculation and provide a printout. Dr. Hoffer said the Hoffer Q, SRK/T, and Holladay 1 are the stand- by formulas that have been used for a long time, but some instruments have different and newer formulas. The formulas Dr. Hoffer recommended using—either online or via the biometer, when available—are the Kane formula, the Barrett Universal II, and the new Hoffer QST, all with printouts for the chart. "You can stick with the old formulas, but why [would you] when the new formulas are proven to provide better [outcomes]," he said. Dr. Loh said with her older biometer, she was having to go online and manually recalcu- late all of her IOLs. "I wanted to be accurate and meticulous so I would go online and type in the information. This was very time consuming, but there is also the risk for transcription errors. That's what took me so long; I was triple checking. Here I was getting busier … and errors would have been devastating," she said, explaining that a newer biometer with this capability would be accurate, convenient, and easy to use. Dr. Loh said she chose ARGOS because it had great data showing accuracy and reliability but also significant support, with the company training her and her staff. When she spoke to EyeWorld, she was 2 months into using the new technology and said she and her staff were im- pressed with how fast it was. "I don't think since we've had it that I've had to do an A-scan, which is a huge relief," she said. She also said the technology was easy to learn. She hired two new staff members with no prior ophthalmology experience and found they were able to easily learn how to use the machine. Modern biometers Aladdin (Topcon) AL-Scan (Nidek) Anterion (Heidelberg, not approved in the U.S.) ARGOS Biometer with Image Guidance (Alcon) Galilei G-6 (Ziemer) IOLMaster 700 (Carl Zeiss Meditec) LENSTAR LS-900 (Haag-Streit) OA-2000 (Tomey, not approved in the U.S.) Pentacam AXL (Oculus) REVO NX (Optopol, not approved in the U.S.)

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