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How the Eyestar 900 Can Improve Workflow

Clinical experience in a busy practice.

Individualized patient care and optimized workflow are crucial factors for the success of any practice. One way that I have been able to achieve both is by incorporating the Eyestar 900 (Haag-Streit; Figure), a fully automated swept-source OCT device that has diagnostic applications for both cataract and refractive surgery. As a surgeon who works in a busy practice, I need a versatile diagnostic tool that produces results both quickly and accurately to improve my workflow.


I have used the Eyestar 900 for approximately 1 year. Several advantages aid in improved workflow.

Speed. The device provides precise measurements and imaging data of the whole eye, from the cornea to the retina. In addition to cornea-to-retina biometry, the Eyestar 900 delivers topographic assessment of the anterior and posterior corneal surfaces and visualization of the anterior chamber, including the lens. The entire measurement process, including topography, keratometry, and axial length, takes only about 40 seconds for both eyes.

Ease of use. Measurements with the Eyestar 900 can be easily delegated to a technician and performed just after autorefraction and endothelial cell measurements. Another nice thing is that most technicians do not require additional training to operate the device because it is intuitive to use.

Data can be displayed in multiple ways. All the basic measurements for both eyes can be displayed on the same screen in one view, and more detailed measurements can be displayed as separate reports. It’s easy and intuitive to adapt view on the Eyestar 900 to display the proper measurements. For instance, I can switch to cataract mode to interpret the A- and B-scans.

Updated functionality. The latest software uses dual-zone reflective keratometry to provide precise keratometry and astigmatism measurements that are compatible with existing IOL formulas. It also integrates the asymmetry of the astigmatism into keratometry measurements and provides all the different maps that I need to analyze keratometry readings, allowing me to fully document the status of the entire eye and quickly and reliably diagnose diseases.

The updated software of the Eyestar 900 also incorporates Zernike polynomials, which is a great feature and something I use with every cataract patient. (Editor’s note: For more on Zernike polynomials, see the article by Warren E. Hill, MD, on pg 2.) The aberration coefficients may be reviewed as groups (lower- and higher-order) or independently and the pupil size adjusted, which are great tools to use when explaining to patients how they could benefit from different IOLs. The root-mean-square of the higher-order aberrations, usually in a 4-mm pupil, can be used to evaluate if patients would be suitable for a premium lens.

Figure. The Eyestar 900 has diagnostic applications for both cataract and refractive surgery.

The Eyestar 900 also can be used to assess lens tilt, which is another helpful tool for determining patients’ candidacy for premium IOLs.

Small footprint. One thing that I really like about the Eyestar 900 is its small footprint. It can fit on the table next to an endothelial camera or autorefractometer.

A better patient experience. Because of the device’s small footprint and intuitive software, patients have a better preoperative experience. The patient can sit in one spot rather than moving around to different devices, and they don’t even have to switch from one eye to the other. Everything is operated by a touchscreen. Additionally, the software provides audible feedback when the measurement is completed successfully or if a repeat measurement is required. I have to say, however, that there is little to no need for repeat measurements with the Eyestar 900 because it is that accurate.


The fast acquisition time of the Eyestar 900 combined with its intuitive software helps improve workflow efficiency. I can delegate the measurements to my technicians and be assured that the data are accurate and precise. This device is a huge benefit in my busy practice.

Pascal Imesch, MD
  • Founder and director, Eyeparc, Bern, Koniz, and Muri-Gümligen, Switzerland
  • pascal@imesch.com
  • Financial disclosure: None acknowledged