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Cover Focus | Jul 2015

Highlights of the AL-Scan in Clinical Practice

For the past 2 years, we have used the AL-Scan at one of our practices and the OPD-Scan III (both by Nidek) at all three locations. The AL-Scan is quick and easy to use, with little training needed. What makes the device so easy to use is the 3-D auto-tracking and auto-shot features, which essentially take over once an eye is sensed, enabling alignment and focusing along the x, y, and z axes. Once the eye is aligned, image and data acquisition are performed automatically.

Image data include pupil positioning (for those who feel this is important for multifocal IOL positioning) and a Scheimpflug cross-section that can demonstrate cataract density. Eight built-in formulas aid in lens calculation, and IOL constants can be optimized by entering postoperative refractive data. The AL-Scan accurately determines the steepest axis and can produce an image with the steepest meridian over an image of the eye, so that the relationship to a vessel or landmark can be determined. This visual guide can then be used in the operating room.

Figure 1. The IOL Station predicts visual performance on a variety of IOLs, assisting the surgeon in using the best lens optic to match the patient's cornea.

Data from the AL-Scan can be integrated with data from the OPD-Scan III through a peripheral desktop program called the IOL Station. This is a clever innovation, as it is peripheral software that does not require the doctor to physically go to and interrogate the instrument, potentially disturbing technicians and their workflow. Additionally, changes in software can be achieved with a simple upgrade to the desktop without any need for an engineer to make an office visit to change software on the device.

The IOL Station software predicts visual performance for a variety of IOLs, assisting the surgeon in choosing the best lens optic to match the patient's cornea (Figure 1). I must confess I do not use this feature much, as more than 90% of my patients undergo surgery with trifocal IOL implants; however, for those patients with abnormal corneas, and for the surgeon not well versed in corneal topography, the IOL Station software is a valuable tool.

Sheraz M. Daya, MD, FACP, FACS, FRCS(Ed), FRCOphth
• Director and Consultant Surgeon, Centre for Sight, East Grinstead, United Kingdom
• Chief Medical Editor, CRST Europe
• Financial disclosure: Consultant (Nidek)