1 Patient Selection IOL Power Calculation Verisyse™ and VeriFlex™ Iris Claw Technology for Correcting Refractive Errors in Phakic and Aphakic Eyes ESCRS 2011 Intructional Course 61 Patient Selection IOL Power Calculation Verisyse™ and VeriFlex™ Iris Claw Technology for Correcting Refractive Errors in Phakic and Aphakic Eyes ESCRS 2011 Intructional Course 61 Josef Ruckhofer Josef Ruckhofer Josef Ruckhofer Josef Ruckhofer University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010 Verisyse™ and VeriFlex™ Verisyse™ and VeriFlex™ Patient Selection Refraction History General Ocular Social Exclusion Criteria Preop Examination ACD Pupil Size Planning Surgery Biometry IOL-Power calculation using Vericalc 2.0 Patient Selection Refraction History General Ocular Social Exclusion Criteria Preop Examination ACD Pupil Size Planning Surgery Biometry IOL-Power calculation using Vericalc 2.0 University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010 Patient Selection for Verisyse/Veriflex Patient Selection for Verisyse/Veriflex Refraction stable ± 0.5 D within 2 years Myopia - 1.0 up to - 23.5 D (5 mm optic) - 1.0 up to - 15.5 D (6 mm optic) - 2.0 up to - 14.5 D (Veriflex) Hyperopia + 1.0 to +12.0 D Astigmatism 1 to 7.5 D Refraction stable ± 0.5 D within 2 years Myopia - 1.0 up to - 23.5 D (5 mm optic) - 1.0 up to - 15.5 D (6 mm optic) - 2.0 up to - 14.5 D (Veriflex) Hyperopia + 1.0 to +12.0 D Astigmatism 1 to 7.5 D University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010 Patient Selection for Verisyse/Veriflex Patient Selection for Verisyse/Veriflex AC-Depth > 3.0 mm (FDA 3.2 mm) Scotopic (Low Mesopic) Pupil Size 5 to 6 mm Endothelial Cell Count according to age >2.000 No other major systemic or ocular disorders AC-Depth > 3.0 mm (FDA 3.2 mm) Scotopic (Low Mesopic) Pupil Size 5 to 6 mm Endothelial Cell Count according to age >2.000 No other major systemic or ocular disorders Abib, JCRS 2001 University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010 General History General History pregnancy collagen-vascular dis. (rheumatism) diabetes mellitus thyroid dis. hyperplastic scars heart problems blood pressure pregnancy collagen-vascular dis. (rheumatism) diabetes mellitus thyroid dis. hyperplastic scars heart problems blood pressure asthma epilepsy kidney dis. liver dis. medication asthma epilepsy kidney dis. liver dis. medication University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010 Ocular History Ocular History Known ocular disorders (e.g.: Keratoconjunctivitis sicca or optic neuritis) Ocular trauma Squint Previous surgeries Family Hx of ocular disease Amblyopia Known ocular disorders (e.g.: Keratoconjunctivitis sicca or optic neuritis) Ocular trauma Squint Previous surgeries Family Hx of ocular disease Amblyopia
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Patient Selection Refraction IOL Power Calculation...Biometry IOL-Power calculation using Vericalc 2.0 Refraction Exclusion Criteria Preop Examination IOL-Power calculation using University
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Patient SelectionIOL Power Calculation
Verisyse™ and VeriFlex™ Iris Claw
Technology for Correcting Refractive Errors in Phakic and Aphakic Eyes
ESCRS 2011 Intructional Course 61
Patient SelectionIOL Power Calculation
Verisyse™ and VeriFlex™ Iris Claw
Technology for Correcting Refractive Errors in Phakic and Aphakic Eyes
ESCRS 2011 Intructional Course 61
Josef RuckhoferJosef RuckhoferJosef RuckhoferJosef Ruckhofer
University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
Verisyse™ and VeriFlex™Verisyse™ and VeriFlex™
� Patient Selection� Refraction
� History
� General
� Ocular
� Social
� Exclusion Criteria
� Preop Examination
� ACD
� Pupil Size
� Planning Surgery
� Biometry� IOL-Power calculation using
Vericalc 2.0
� Patient Selection� Refraction
� History
� General
� Ocular
� Social
� Exclusion Criteria
� Preop Examination
� ACD
� Pupil Size
� Planning Surgery
� Biometry� IOL-Power calculation using
Vericalc 2.0
University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
Patient Selection for Verisyse/VeriflexPatient Selection for Verisyse/Veriflex
� Refraction� stable ± 0.5 D within 2 years
� Myopia
� - 1.0 up to - 23.5 D (5 mm optic)
� - 1.0 up to - 15.5 D (6 mm optic)
� - 2.0 up to - 14.5 D (Veriflex)
� Hyperopia
� + 1.0 to +12.0 D
� Astigmatism
� 1 to 7.5 D
� Refraction� stable ± 0.5 D within 2 years
� Myopia
� - 1.0 up to - 23.5 D (5 mm optic)
� - 1.0 up to - 15.5 D (6 mm optic)
� - 2.0 up to - 14.5 D (Veriflex)
� Hyperopia
� + 1.0 to +12.0 D
� Astigmatism
� 1 to 7.5 D
University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
Patient Selection for Verisyse/VeriflexPatient Selection for Verisyse/Veriflex
� AC-Depth� > 3.0 mm (FDA 3.2 mm)
� Scotopic (Low Mesopic) Pupil Size � 5 to 6 mm
� Endothelial Cell Count� according to age
� >2.000
� No other major systemic or ocular disorders
� AC-Depth� > 3.0 mm (FDA 3.2 mm)
� Scotopic (Low Mesopic) Pupil Size � 5 to 6 mm
� Endothelial Cell Count� according to age
� >2.000
� No other major systemic or ocular disorders
Abib, JCRS 2001
University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
General HistoryGeneral History
� pregnancy
� collagen-vascular dis. (rheumatism)
� diabetes mellitus
� thyroid dis.
� hyperplastic scars
� heart problems
� blood pressure
� pregnancy
� collagen-vascular dis. (rheumatism)
� diabetes mellitus
� thyroid dis.
� hyperplastic scars
� heart problems
� blood pressure
� asthma
� epilepsy
� kidney dis.
� liver dis.
� medication
� asthma
� epilepsy
� kidney dis.
� liver dis.
� medication
University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
Ocular HistoryOcular History
� Known ocular disorders � (e.g.: Keratoconjunctivitis sicca or optic neuritis)
� Ocular trauma
� Squint
� Previous surgeries
� Family Hx of ocular disease
� Amblyopia
� Known ocular disorders � (e.g.: Keratoconjunctivitis sicca or optic neuritis)
� Ocular trauma
� Squint
� Previous surgeries
� Family Hx of ocular disease
� Amblyopia
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University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
Pupil SizePupil Size
� Large pupil diameter can be a contraindication forVerisyse™or VeriFlex™ phakic IOL, especially for patientswith relevant professions like Taxi drivers!
� Horizontal pupil diameter may be reduced by ~1 mm postop� Bootsma SJ et al. Evaluation of pupil dynamics after implantation of artisan phakic intraocular
lenses. J Refract Surg. 2006 Apr;22(4):367-71
� Dick HB et al. Change in pupil size after implantation of an iris-fixated toric phakic intraocular lens. J Cataract Refract Surg. 2005 Feb;31(2):302-7.
� In any case discuss the risks of glare and halos with the patient
� Large pupil diameter can be a contraindication forVerisyse™or VeriFlex™ phakic IOL, especially for patientswith relevant professions like Taxi drivers!
� Horizontal pupil diameter may be reduced by ~1 mm postop� Bootsma SJ et al. Evaluation of pupil dynamics after implantation of artisan phakic intraocular
lenses. J Refract Surg. 2006 Apr;22(4):367-71
� Dick HB et al. Change in pupil size after implantation of an iris-fixated toric phakic intraocular lens. J Cataract Refract Surg. 2005 Feb;31(2):302-7.
� In any case discuss the risks of glare and halos with the patient
University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
Planning SurgeryPlanning Surgery
� Pentacam (Oculus)� Pentacam (Oculus)
University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
Patient Data
University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
Patient Data
University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
Patient Data
University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
Patient Data
University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
Calculation
University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
Calculation
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University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
Calculation
University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
Calculation
University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
Calculation
University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
PrintoutPrintout
� The final choice of the power for Verisyse™ and VeriFlex™ Phakic IOL depends on various factors and is the responsibility of the physician implanting the lens
� The final choice of the power for Verisyse™ and VeriFlex™ Phakic IOL depends on various factors and is the responsibility of the physician implanting the lens
University Eye Clinic Salzburg, Austria Verisyse and Veriflex Iris Claw Technology ESCRS 2010
Thank you for your attention !Thank you for your attention !