Accutome a-scan plus User manual

A-Scan Plus
User’s Guide
24-4016 Rev B

Federal law restricts this device to sale by or on
the order of a physician.
FEDERAL COMMUNICATIONS COMMISSION (FCC)
UNINTENTIONAL EMITTER PER FCC PART 15
This device has been tested and found to comply with the limits for a
Class B digital device, pursuant to Part 15 of the FCC rules. These
limits are designed to provide reasonable protection against harmful
interference in an office installation. This equipment generates,
uses, and can radiate radio frequency energy and, if not installed and
used in accordance with the instructions in the user manual, may
cause harmful interference to radio or television reception. However,
there is no guarantee that interference will not occur in a particular
installation. If this equipment does cause interference to radio and
television reception, which can be determined by turning the
equipment off and on, the user is encouraged to try to correct the
interference by one or more of the following measures:
Reorient or relocate the receiving antenna
Increase the separation between the equipment and
receiver
Connect the equipment to an outlet on a different circuit
from that to which the receiver is connected
Consult Accutome Ultrasound, Inc or an experienced
radio/TV technician for help.
This device complies with Part 15 of the FCC Rules. Operation of
this product is subject to the following two conditions: (1) this device
may not cause harmful interference, and (2) this device must accept
any interference received, including interference that may cause
undesired operation.
CAUTION:
Changes or modifications not expressly approved by Accutome
Ultrasound, Inc. could void the FCC compliance and negate your
authority to operate the product.
Authorized Representative in Europe (for regulatory affairs only):
Emergo Europe
P.O. Box 18510
2502 EM The Hague
The Netherlands
Tel: [phone]
Fax: [phone]
0086

i
Contents
Introduction - - - - - - - - - - - - - - - - - 1
Accutome A-Scan Plus Overview - - - - - - - - - - 1
Features - - - - - - - - - - - - - - - - - - - - 2
Measurements - - - - - - - - - - - - - - - - 2
IOL Calculations - - - - - - - - - - - - - - - - 3
Components - - - - - - - - - - - - - - - - - 4
Optional Components - - - - - - - - - - - - 4
About This Manual - - - - - - - - - - - - - - - - 5
Safety - - - - - - - - - - - - - - - - - - - - 7
Safety Information - - - - - - - - - - - - - - - - 7
Safety Issues to Consider When Using the Accutome A-
Scan Plus - - - - - - - - - - - - - - - - - - 7
Indications for use- - - - - - - - - - - - - - - 7
Symbol Definitions for the Accutome - - - - - - - - 8
Safety Precautions - - - - - - - - - - - - - - - - 9
Sterilization- - - - - - - - - - - - - - - - - - 9
Disinfection and Cleaning - - - - - - - - - - - - 10
Electrical Hazard and Safety - - - - - - - - - 12
Avoiding Equipment Damage - - - - - - - - - 12
Getting Started - - - - - - - - - - - - - - - 13
Assembling the Accutome A-Scan Plus - - - - - - 13
What you need - - - - - - - - - - - - - - - - 13
Probe - - - - - - - - - - - - - - - - - - - 14
Printer - - - - - - - - - - - - - - - - - - - 14
Serial Link Port - - - - - - - - - - - - - - - 15
Foot Switch - - - - - - - - - - - - - - - - - 15
Keyboard - - - - - - - - - - - - - - - - - - 15
Power Supply - - - - - - - - - - - - - - - - 15

ii
Accutome A-Scan Plus User’s Guide
Placing the Accutome A-Scan Plus - - - - - - - - 16
Quick-Close Kickstand - - - - - - - - - - - - 16
Mounting - - - - - - - - - - - - - - - - - - 18
Connecting the Components - - - - - - - - - - 18
Connecting the Printer - - - - - - - - - - - - 19
Connecting the Footswitch - - - - - - - - - - 19
Connecting the Keyboard - - - - - - - - - - - 20
Connecting the Serial Link - - - - - - - - - - 21
Connecting the Power - - - - - - - - - - - - 22
Connecting the Probe - - - - - - - - - - - - 23
Probe Setup - - - - - - - - - - - - - - - - - - 25
Accutome Probe with an Immersion Shell - - - - - 26
Accutome Probe with Goldman Tonometer Adapter- 27
Accutome Probe with Handle Extension - - - - - - 28
Basic Operation - - - - - - - - - - - - - - - - 30
How to Power On the Accutome A-Scan Plus - - - 30
How to Adjust the Contrast - - - - - - - - - - - 32
Using the Test Block - - - - - - - - - - - - - - 33
How to Start a New Patient - - - - - - - - - - - 34
How to Enter Text without a Keyboard - - - - - 38
Screen Keyboard Features - - - - - - - - - - - 39
Entering a Patient with the Screen Keyboard - - 40
How to Take a Measurement - - - - - - - - - - 41
How to Perform a Calculation - - - - - - - - - - 43
How to Print a Record - - - - - - - - - - - - - 47
How to Save Patient Records - - - - - - - - - - 48
How to Use the Buttons and Screens - - - - 51
Overview - - - - - - - - - - - - - - - - - - - 51
Accutome A-Scan Plus Buttons - - - - - - - - - - 52
Dedicated Buttons - - - - - - - - - - - - - - - 52
Measure Button - - - - - - - - - - - - - - - 53
Patient Record Button - - - - - - - - - - - - 53
Calculate - - - - - - - - - - - - - - - - - - 53
Preferences - - - - - - - - - - - - - - - - - 53
Print - - - - - - - - - - - - - - - - - - - - 54
Check or Affirmative (9) - - - - - - - - - - - 54
Negative or Delete (X) - - - - - - - - - - - - 54

iii
Contents
Soft Menu Buttons - - - - - - - - - - - - - - - 55
Buttons that Toggle between Two Selections - - 55
Buttons that Display Other Screens or Soft Menus 55
Accutome A-Scan Plus Knob - - - - - - - - - - 55
How the Knob Works - - - - - - - - - - - - - 55
Screens - - - - - - - - - - - - - - - - - - - - 56
What the Screen Displays - - - - - - - - - - - 56
Types of Information - - - - - - - - - - - - - 56
Soft Menus - - - - - - - - - - - - - - - - - 57
Tips - - - - - - - - - - - - - - - - - - - - 57
Sounds- - - - - - - - - - - - - - - - - - - 57
Error Messages - - - - - - - - - - - - - - - 57
Moving between Screens - - - - - - - - - - - - 57
Screen Hierarchy - - - - - - - - - - - - - - - 58
Top Level Screens - - - - - - - - - - - - - - - 59
Associated Sub-Level Screens - - - - - - - - - 59
From the Measure Screen - - - - - - - - - - - - 59
From the Calculate Screen - - - - - - - - - - - 59
From the Patient Records Screen- - - - - - - - - 59
From the Preferences Screen - - - - - - - - - - 59
How Buttons, Screens and Knob Work Together - - 60
Changing Fields and Table Cells - - - - - - - - - 60
Active Area - - - - - - - - - - - - - - - - - 60
Text Entry - - - - - - - - - - - - - - - - - 60
Selecting a New Active Area - - - - - - - - - - 61
Changing Fields in the Active Area - - - - - - - 61
Pre-entered Fields - - - - - - - - - - - - - - - 61
Fields Requiring Information - - - - - - - - - - 61
Numeric Fields - - - - - - - - - - - - - - - - 62
Keyboard Shortcuts - - - - - - - - - - - - - - 63
Using the Footswitch - - - - - - - - - - - - - - 64
Preferences - - - - - - - - - - - - - - - - 65
Setting Up the Accutomre A-Scan Plus - - - - - - 65
How to Access Preferences - - - - - - - - - - - 66
Top Level of Preferences - - - - - - - - - - - - 67
How to Add a New Eye Type - - - - - - - - - - - 68
Adding a New Lens Material - - - - - - - - - - - 69

iv
Accutome A-Scan Plus User’s Guide
Assigning a Velocity to the New Lens Material - - 72
Adding the New Eye Type Information - - - - - 73
Eye Type Screen Menu Selections - - - - - - - - 80
Reset Field to Factory - - - - - - - - - - - - - 80
Reset All to Factory - - - - - - - - - - - - - - 83
More Settings - - - - - - - - - - - - - - - - - 85
Setup Screen Fields - - - - - - - - - - - - - - 85
Setup Screen Soft Menu - - - - - - - - - - - - 85
How to Set the Print Title - - - - - - - - - - - - 87
How to Set the Printer - - - - - - - - - - - - - 91
How to Set the Serial Link - - - - - - - - - - - 96
Text with Data Driver - - - - - - - - - - - - 96
How to Set the Serial Baud - - - - - - - - - - 102
How to Set Delete Confirm - - - - - - - - - - 106
How to Adjust the Contrast - - - - - - - - - - 110
How to Set the Default Patient Eye Type - - - - 114
How to Set the Default ID - - - - - - - - - - 118
How to Set the Default Gain - - - - - - - - - 122
How to Set the Target Refraction - - - - - - - 124
How to Set the K Index - - - - - - - - - - - 128
How to Set the IOL Step - - - - - - - - - - - 133
How to Adjust the Date and Time - - - - - - - 137
How to Set the Auto Mode - - - - - - - - - - 141
Sound On/Sound Off - - - - - - - - - - - - - 148
Restart On/Restart Off - - - - - - - - - - - - 148
Scr Save On/Scr Save Off - - - - - - - - - - 148
Save and Restore Factory Default Gates
and Threshold - - - - - - - - - - - - - - - 149
About This Unit - - - - - - - - - - - - - - - 150
Performing Measurements - - - - - - - - 151
Overview - - - - - - - - - - - - - - - - - - -151
Measure Screen - - - - - - - - - - - - - - - -152
Information Displayed on the Measure Screen - - 153
Soft Menu Selections - - - - - - - - - - - - 153
Starting a New Patient - - - - - - - - - - - - 154
How to Set the Eye Type - - - - - - - - - - - -155
Eye Types - - - - - - - - - - - - - - - - - 155

v
Contents
Eye Type Materials and Velocities - - - - - - - 156
Setting the Eye Type- - - - - - - - - - - - - 157
Probe Application Methods - - - - - - - - - - - -160
Immersion - - - - - - - - - - - - - - - - - 160
Contact - - - - - - - - - - - - - - - - - - 160
Capture Modes - - - - - - - - - - - - - - - -161
Auto Mode - - - - - - - - - - - - - - - - - 161
Manual Mode - - - - - - - - - - - - - - - - 162
How to Capture a Waveform - - - - - - - - - - -163
Using the Foot Switch - - - - - - - - - - - - 163
Using the Running/Frozen Button - - - - - - - 163
Using the Measure Button - - - - - - - - - - 163
How to Select a Measurement - - - - - - - - - -164
Selecting a Measurement with the Knob - - - - 164
Selecting a Measurement Using Waveform
Review Menu - - - - - - - - - - - - - - - - 165
Selecting a Measurement with the Foot Switch - 166
How to Delete a Measurement - - - - - - - - - -167
Deleting a Measurement with X Button
or Keyboard - - - - - - - - - - - - - - - - 167
Deleting a Measurement with the Foot Switch - - 167
How to Adjust Gates/Threshold - - - - - - - - -168
Available Gates/Threshold - - - - - - - - - - 169
Selecting Gates/Threshold - - - - - - - - - - 170
Waveform Review Menu - - - - - - - - - - 171
How to Adjust the Cornea Gate - - - - - - - - 172
How to Adjust the Anterior Lens Gate - - - - - 173
How to Adjust the Posterior Lens Gate - - - - - 175
How to Adjust the Retina Gate - - - - - - - - 177
How to Adjust the Threshold - - - - - - - - - 178
How to Apply Gate Adjustments to All Waveforms 179
How to Adjust the Gain - - - - - - - - - - - - -180
How to Use Zoom - - - - - - - - - - - - - - -182
How to Scroll - - - - - - - - - - - - - - - - -184
Switching Eyes - - - - - - - - - - - - - - - -186
Customize Eye Type - - - - - - - - - - - - - -186

vi
Accutome A-Scan Plus User’s Guide
Customizing Eye Types - - - - - - - - - - 187
Overview - - - - - - - - - - - - - - - - - - -187
Patient Customization - - - - - - - - - - - - 187
Customize Eye Type Screen - - - - - - - - - - -188
Customize Fields and Menu Selections - - - - - 188
OD - - - - - - - - - - - - - - - - - - - 188
OS - - - - - - - - - - - - - - - - - - - 188
Eye Type Table - - - - - - - - - - - - - - 188
AC - - - - - - - - - - - - - - - - - - - - - - 188
Lens - - - - - - - - - - - - - - - - - - - - - 188
VC - - - - - - - - - - - - - - - - - - - - - - 189
How to Customize an Eye Type - - - - - - - - -190
Performing Calculations - - - - - - - - - 197
Overview - - - - - - - - - - - - - - - - - - -197
Calculating the Lens - - - - - - - - - - - - - -197
Calculation after Corneal Refractive Surgery- - 197
Calculate IOL Screen - - - - - - - - - - - - - -199
Selecting an IOL Group- - - - - - - - - - - - 200
Selecting a Formula - - - - - - - - - - - - - 200
Entering an ACD Value with the Haigis Formula 200
Changing the AXL Value - - - - - - - - - - - 201
Selecting a Measurement - - - - - - - - - - 201
Entering an AXL Value - - - - - - - - - - - 202
Entering the K1, K2 Values - - - - - - - - - - 202
Entering the Target Value - - - - - - - - - - 204
Calculation Results - - - - - - - - - - - - - 204
Formula Compare Feature - - - - - - - - - - 206
Switching Between OD/OS - - - - - - - - - - 206
Calculating IOL Power After Corneal
Refractive Surgery - - - - - - - - - - - - - - -207
Double K Method - - - - - - - - - - - - - - 207
Determining Corneal Power after
Refractive Surgery
(Post Rx Surg) - - - - - - - - - - - - - - - 208
Post Rx Surg IOL Calculation Steps - - - - - - 208
Selecting a K Post Calculation Method - - - - 208
Changing Rx Surg Field to Yes - - - - - - - - -210

vii
Contents
Clinical History Method - - - - - - - - - - - - 211
Clinical History Fields - - - - - - - - - - - 211
Contact Lens Method - - - - - - - - - - - - 212
Shammas Clinical Method- - - - - - - - - - 213
Calculation Results - - - - - - - - - - - - - 214
Switching Between OD/OS - - - - - - - - - - 214
Setting Up IOL Groups - - - - - - - - - - 215
How are IOL Groups Used - - - - - - - - - - - -215
How to Set Up an IOL Group - - - - - - - - - - -216
Accessing the IOL Groups Screen - - - - - - - 216
IOL Calculation Groups Screen - - - - - - - - 217
Entering IOL Group Names - - - - - - - - - - 218
Entering the Group’s Lenses - - - - - - - - - 219
Personalizing Lens Constants - - - - - - - 225
Overview - - - - - - - - - - - - - - - - - - -225
Personalizing Lens Constants - - - - - - - - - 225
How to Personalize Constants - - - - - - - - - -226
Accessing the Personalize IOLs Screen - - - - - 226
Personalize IOLs Screen - - - - - - - - - - - 228
Personalize IOLs Screen Soft Menus - - - - - 228
Selecting an IOL Group and Lens - - - - - - - 229
Next IOL/Group - - - - - - - - - - - - - - 229
Selecting IOL Group with the Knob - - - - - -230
Entering Postoperative Results - - - - - - - - 231
Pasting Patient Information - - - - - - - - - -232
Manually Entering Patient Information - - - - 233
Entering Remaining Postoperative Results- - - 234
Deleting Postoperative Results - - - - - - - - 234
Deleting Current Postoperative Result - - - - 234
Deleting All Postoperative Results - - - - - - 235
How to View Individual Results for a Formula - - 235
How to Sort Postoperative Results - - - - - - - 235
How to Update IOL Constants - - - - - - - - - 236
Update IOL Constants Screen - - - - - - - - 237
Selecting an IOL Group and Lens - - - - - - - 238

viii
Accutome A-Scan Plus User’s Guide
Storing and Recalling Records - - - - - - - 241
Overview - - - - - - - - - - - - - - - - - - -241
How to Store a Record - - - - - - - - - - - - -242
How to Recall a Record - - - - - - - - - - - - -244
How to Adjust Parameters on Saved Records - - 246
How to Update Calculations - - - - - - - - - - 246
How to Sort Patient Records - - - - - - - - - - -247
Printing Records - - - - - - - - - - - - - 249
How to Print a Record - - - - - - - - - - - - -249
Screen Printout Formats - - - - - - - - - - - 249
How to Select the Right Printout Format - - - 250
Sample Printouts - - - - - - - - - - - - - 250
How to Batch Print- - - - - - - - - - - - - - 254
Required Printer - - - - - - - - - - - - - - - -256
Maintenance - - - - - - - - - - - - - - - 257
General Maintenance - - - - - - - - - - - - - -257
Specifications - - - - - - - - - - - - - - 259
Overview - - - - - - - - - - - - - - - - - - -259
Physical Specifications - - - - - - - - - - - - -259
Environmental Specifications - - - - - - - - - -262
Measurement Accuracy - - - - - - - - - - - - -263
Operating Modes - - - - - - - - - - - - - - - -264
Formula References - - - - - - - - - - - - - -265
Storage/Range Specifications - - - - - - - - - -266
Acoustic Output - - - - - - - - - - - - - - - -268
Warranty & Repairs - - - - - - - - - - - 271
Warranty - - - - - - - - - - - - - - - - - - -271
Product Returns - - - - - - - - - - - - - - - -272
Service and Repair - - - - - - - - - - - - - 272
All Other Returns - - - - - - - - - - - - - - 272
Non-Returnable Merchandise - - - - - - - - - 272
Replacement Parts - - - - - - - - - - - - - - -273
Documentation - - - - - - - - - - - - - - - -273

ix
List of Figures
Figure 1 Accutome A-Scan Plus - - - - - - - - - - - - - - - - - - - - - - - 1
Figure 2 Accutome A-Scan Plus Components - - - - - - - - - - - - 14
Figure 3 Closed Kickstand - - - - - - - - - - - - - - - - - - - - - - - - - - 16
Figure 4 Open Kickstand - - - - - - - - - - - - - - - - - - - - - - - - - - - 17
Figure 5 Accutome A-Scan Plus Mounted on a Pedestal - - - - 18
Figure 6 Component Connectors (Left Side of Instrument) - - - 22
Figure 7 Probe Connector (Right Side of Instrument) - - - - - - - 23
Figure 8 Probe Connected - - - - - - - - - - - - - - - - - - - - - - - - - - 24
Figure 9 Accutome Ultrasonic Probe Kit (PN 24-4001) - - - - - - 25
Figure 10 Accutome Probe - - - - - - - - - - - - - - - - - - - - - - - - - - 26
Figure 11 Probe Setup with Immersion Shell - - - - - - - - - - - - - - 26
Figure 12 Probe with Goldman Tonometer Adapter - - - - - - - - - 27
Figure 13 Inserting the Probe into the Handle Extension - - - - - 28
Figure 14 Probe with Handle Extension and Insertion Tool - - - - 29
Figure 15 Probe with Handle Extension - - - - - - - - - - - - - - - - - 29
Figure 16 Turning on the Accutome A-Scan Plus - - - - - - - - - - - 30
Figure 17 Measure Screen Displayed - - - - - - - - - - - - - - - - - - - 31
Figure 18 Accutome A- Scan Plus Test Block (Top of Instrument) -
33
Figure 19 Measure Screen Starting New Patient - - - - - - - - - - - 34
Figure 20 Patient Field Activated - - - - - - - - - - - - - - - - - - - - - - 35
Figure 21 Entering New Patient Information - - - - - - - - - - - - - - 36
Figure 22 New Patient Information Entered - - - - - - - - - - - - - - - 37
Figure 23 Screen Keyboard - - - - - - - - - - - - - - - - - - - - - - - - - - 38
Figure 24 Measurement Fields Selected - - - - - - - - - - - - - - - - - 41
Figure 25 Calculate IOL Screen - - - - - - - - - - - - - - - - - - - - - - - 43
Figure 26 ACD Field Selected - - - - - - - - - - - - - - - - - - - - - - - - 44
Figure 27 K1, K2 Values Entered - - - - - - - - - - - - - - - - - - - - - - 45
Figure 28 Calculation Completed - - - - - - - - - - - - - - - - - - - - - - 46
Figure 29 Patient Record Screen - - - - - - - - - - - - - - - - - - - - - - 48
Figure 30 Patient Record Stored - - - - - - - - - - - - - - - - - - - - - - 49
Figure 31 Accutome A-Scan Plus Buttons - - - - - - - - - - - - - - - - 52

x
List of Figures
Figure 32 Accutome A-Scan Plus Screen Hierarchy - - - - - - - - - 58
Figure 33 Preferences Button - - - - - - - - - - - - - - - - - - - - - - - - 66
Figure 34 Eye Types Screen - - - - - - - - - - - - - - - - - - - - - - - - - 67
Figure 35 Selecting the Lens Materials Table - - - - - - - - - - - - - 69
Figure 36 Selecting a Cell to Enter New Lens Material - - - - - - - 70
Figure 37 Entering the Name for New Lens Material - - - - - - - - 71
Figure 38 Adding New Material Velocity - - - - - - - - - - - - - - - - - 72
Figure 39 Selecting the Eye Type Name Cell - - - - - - - - - - - - - 73
Figure 40 Adding the New Eye Type Name - - - - - - - - - - - - - - - 74
Figure 41 Activating the Area to Select New Lens Material - - - - 75
Figure 42 Lens Material Selected - - - - - - - - - - - - - - - - - - - - - - 76
Figure 43 Lens Thickness Entered - - - - - - - - - - - - - - - - - - - - - 77
Figure 44 Anterior Chamber Material Selected - - - - - - - - - - - - 78
Figure 45 Vitreous Chamber Material Selected - - - - - - - - - - - - 79
Figure 46 Non-Factory Field - - - - - - - - - - - - - - - - - - - - - - - - - 80
Figure 47 Restore Selected Field Prompt - - - - - - - - - - - - - - - - 81
Figure 48 Selected Field Restored - - - - - - - - - - - - - - - - - - - - - 82
Figure 49 Non-Factory Fields Displayed - - - - - - - - - - - - - - - - - 83
Figure 50 Restore All Fields Prompt - - - - - - - - - - - - - - - - - - - - 84
Figure 51 More Settings - Setup Screen - - - - - - - - - - - - - - - - - 86
Figure 52 Print Title Field Selected - - - - - - - - - - - - - - - - - - - - - 87
Figure 53 Print Title Field Activated - - - - - - - - - - - - - - - - - - - - 88
Figure 54 Entering the Print Title - - - - - - - - - - - - - - - - - - - - - - 89
Figure 55 Print Title Added - - - - - - - - - - - - - - - - - - - - - - - - - - 90
Figure 56 Printer Field Selected - - - - - - - - - - - - - - - - - - - - - - - 92
Figure 57 Printer Field Activated - - - - - - - - - - - - - - - - - - - - - - 93
Figure 58 Selecting the Printer - - - - - - - - - - - - - - - - - - - - - - - - 94
Figure 59 New Printer Selected - - - - - - - - - - - - - - - - - - - - - - - 95
Figure 60 Serial Data Printout - - - - - - - - - - - - - - - - - - - - - - - - 97
Figure 61 Serial Link Field Selected - - - - - - - - - - - - - - - - - - - - 98
Figure 62 Serial Link Field Activated - - - - - - - - - - - - - - - - - - - - 99
Figure 63 Selecting the Serial Link - - - - - - - - - - - - - - - - - - - - 100
Figure 64 New Serial Link Selected - - - - - - - - - - - - - - - - - - - 101
Figure 65 Serial Baud Field Selected - - - - - - - - - - - - - - - - - - 102
Figure 66 Serial Baud Field Activated - - - - - - - - - - - - - - - - - - 103
Figure 67 Selecting the Serial Baud - - - - - - - - - - - - - - - - - - - 104
Figure 68 New Serial Baud Selected - - - - - - - - - - - - - - - - - - 105
Figure 69 Delete Confirm Field Selected - - - - - - - - - - - - - - - - 106
Figure 70 Delete Confirm Field Activated - - - - - - - - - - - - - - - 107

xi
Accutome A-Scan Plus User’s Guide
Figure 71 Selecting the Delete Confirm Value - - - - - - - - - - - - 108
Figure 72 New Delete Confirm Entered - - - - - - - - - - - - - - - - - 109
Figure 73 Contrast Field Selected - - - - - - - - - - - - - - - - - - - - 110
Figure 74 Contrast Field Activated - - - - - - - - - - - - - - - - - - - - 111
Figure 75 Adjusting the Contrast - - - - - - - - - - - - - - - - - - - - - 112
Figure 76 Contrast Adjusted - - - - - - - - - - - - - - - - - - - - - - - - 113
Figure 77 Default Eye Type Field Selected - - - - - - - - - - - - - - 114
Figure 78 Default Eye Type Field Selected - - - - - - - - - - - - - - 115
Figure 79 New Default Eye Type Selected - - - - - - - - - - - - - - 116
Figure 80 Default Eye Type Changed - - - - - - - - - - - - - - - - - - 117
Figure 81 Default ID Field Selected - - - - - - - - - - - - - - - - - - - 118
Figure 82 Default ID Field Activated - - - - - - - - - - - - - - - - - - - 119
Figure 83 Entering the Default ID - - - - - - - - - - - - - - - - - - - - - 120
Figure 84 Default ID Added - - - - - - - - - - - - - - - - - - - - - - - - - 121
Figure 85 Default Gain Field Selected - - - - - - - - - - - - - - - - - 122
Figure 86 Default Gain Field Changed - - - - - - - - - - - - - - - - - 123
Figure 87 Target Field Selected - - - - - - - - - - - - - - - - - - - - - - 124
Figure 88 Target Field Activated - - - - - - - - - - - - - - - - - - - - - 125
Figure 89 Adjusting the Target - - - - - - - - - - - - - - - - - - - - - - - 126
Figure 90 Target Adjusted - - - - - - - - - - - - - - - - - - - - - - - - - - 127
Figure 91 K Index Field Selected - - - - - - - - - - - - - - - - - - - - - 129
Figure 92 K Index Field Activated - - - - - - - - - - - - - - - - - - - - - 130
Figure 93 Adjusting the K Index - - - - - - - - - - - - - - - - - - - - - - 131
Figure 94 K Index Field Adjusted - - - - - - - - - - - - - - - - - - - - - 132
Figure 95 IOL Step Field Selected - - - - - - - - - - - - - - - - - - - - 133
Figure 96 IOL Step Field Activated - - - - - - - - - - - - - - - - - - - - 134
Figure 97 Adjusting the IOL Step - - - - - - - - - - - - - - - - - - - - - 135
Figure 98 IOL Step Adjusted - - - - - - - - - - - - - - - - - - - - - - - - 136
Figure 99 Day Field Selected - - - - - - - - - - - - - - - - - - - - - - - - 137
Figure 100 Day Field Activated - - - - - - - - - - - - - - - - - - - - - - - 138
Figure 101 Adjusting the Day - - - - - - - - - - - - - - - - - - - - - - - - - 139
Figure 102 Day Adjusted - - - - - - - - - - - - - - - - - - - - - - - - - - - - 140
Figure 103 Auto Mode Sclera Selected - - - - - - - - - - - - - - - - - - 142
Figure 104 Auto Mode Sclera Field Activated - - - - - - - - - - - - - 143
Figure 105 Changing the Auto Mode - Turning Off Sclera - - - - - 144
Figure 106 Auto Mode - "Sclera" Off - - - - - - - - - - - - - - - - - - - - 145
Figure 107 Auto Mode - "Stable" Selected - - - - - - - - - - - - - - - 146
Figure 108 Auto Mode Defined by "Stable" Measurement - - - - 147
Figure 109 About This Unit Screen - - - - - - - - - - - - - - - - - - - - - 150

xii
List of Figures
Figure 110 Measure Screen Displaying Current Settings - - - - - 152
Figure 111 Eye Type Selected - - - - - - - - - - - - - - - - - - - - - - - - 157
Figure 112 Eye Type Active - - - - - - - - - - - - - - - - - - - - - - - - - - 158
Figure 113 Eye Type Changed - - - - - - - - - - - - - - - - - - - - - - - 159
Figure 114 Measurement Selected - - - - - - - - - - - - - - - - - - - - - 164
Figure 115 Measurement Activated with Waveform Review Menu - -
165
Figure 116 Current Measurement Waveform Selected - - - - - - - 170
Figure 117 Waveform Review Menu Activated - - - - - - - - - - - - 171
Figure 118 Cornea Gate Selected - - - - - - - - - - - - - - - - - - - - - 172
Figure 119 Anterior Lens Gate Selected - - - - - - - - - - - - - - - - - 174
Figure 120 Posterior Lens Gate Selected - - - - - - - - - - - - - - - - 176
Figure 121 Retina Gate Selected - - - - - - - - - - - - - - - - - - - - - - 177
Figure 122 Threshold Gate Selected - - - - - - - - - - - - - - - - - - - 178
Figure 123 Gain Selected - - - - - - - - - - - - - - - - - - - - - - - - - - - 180
Figure 124 Gain Field Changed - - - - - - - - - - - - - - - - - - - - - - - 181
Figure 125 Zoom Selected - - - - - - - - - - - - - - - - - - - - - - - - - - 182
Figure 126 Zoom Changed - - - - - - - - - - - - - - - - - - - - - - - - - - 183
Figure 127 Scroll Selected - - - - - - - - - - - - - - - - - - - - - - - - - - 184
Figure 128 Measurement Scrolling Changed - - - - - - - - - - - - - 185
Figure 129 Customize Eye Type Screen - - - - - - - - - - - - - - - - - 190
Figure 130 OS Materials Table Selected - - - - - - - - - - - - - - - - - 191
Figure 131 OS Materials Table Activated - - - - - - - - - - - - - - - - 192
Figure 132 Changing VC Material - - - - - - - - - - - - - - - - - - - - - 193
Figure 133 VC Material Cell Changed - - - - - - - - - - - - - - - - - - 194
Figure 134 Changing Velocity Field - - - - - - - - - - - - - - - - - - - - 195
Figure 135 OS Eye Type Customized - - - - - - - - - - - - - - - - - - - 196
Figure 136 Calculate Button - - - - - - - - - - - - - - - - - - - - - - - - - 198
Figure 137 Calculation Fields - - - - - - - - - - - - - - - - - - - - - - - - 199
Figure 138 Calculate IOL Screen - All Fields Entered - - - - - - - - 205
Figure 139 Compare On Selected - - - - - - - - - - - - - - - - - - - - - 206
Figure 140 Post Rx Surgery Field (Rx Surg) Selected - - - - - - - 210
Figure 141 Post Rx Surgery Calculation Activated - Clinical History
211
Figure 142 Post Rx Surgery Calculation with Contact Lens Method -
212
Figure 143 Post Rx Surgery Calculation with Shammas Clinical Meth-
od 213
Figure 144 Select IOL Groups - - - - - - - - - - - - - - - - - - - - - - - - 216

xiii
Accutome A-Scan Plus User’s Guide
Figure 145 IOL Groups Screen - - - - - - - - - - - - - - - - - - - - - - - 217
Figure 146 Entering the IOL Group Name - - - - - - - - - - - - - - - - 218
Figure 147 Entering the IOL Description - - - - - - - - - - - - - - - - - 219
Figure 148 Selecting the A-Constant Field - - - - - - - - - - - - - - - 221
Figure 149 Entering the IOL Constant - - - - - - - - - - - - - - - - - - 222
Figure 150 First Lens Entered for Group 1 - - - - - - - - - - - - - - - 223
Figure 151 First IOL Group Complete - - - - - - - - - - - - - - - - - - - 224
Figure 152 Calculate IOL Screen - IOL Groups Selection - - - - - 226
Figure 153 Personalize IOLs Screen - - - - - - - - - - - - - - - - - - - 227
Figure 154 Update IOL Constants Screen - - - - - - - - - - - - - - - - 237
Figure 155 Patient Record Screen - - - - - - - - - - - - - - - - - - - - - 242
Figure 156 Patient Record Stored - - - - - - - - - - - - - - - - - - - - - 243
Figure 157 Recalling a Patient Record - - - - - - - - - - - - - - - - - - 244
Figure 158 Recalled Patient Record - - - - - - - - - - - - - - - - - - - - 245
Figure 159 Measurement Printout - - - - - - - - - - - - - - - - - - - - - 251
Figure 160 Calculation Printout - - - - - - - - - - - - - - - - - - - - - - - 252
Figure 161 Waveform Text Printout - - - - - - - - - - - - - - - - - - - - 253
Figure 162 Saved Patient Record Screen - - - - - - - - - - - - - - - - 254
Figure 163 Saved Patient Record - Select for Batch Print - - - - - 255

xiv
List of Figures

xv
List of Tables
Table 1 Keyboard Shortcuts - - - - - - - - - - - - - - - - - - - - - - - - 63
Table 2 Eye Types - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 156
Table 3 Lens Materials and Velocities- - - - - - - - - - - - - - - - - 156
Table 4 Anterior/Vitreous Materials and Velocities - - - - - - - - 156
Table 5 Accutome A-Scan Plus Physical Specifications - - - - 259
Table 6 Environmental Specifications - - - - - - - - - - - - - - - - - 262
Table 7 Measurement Accuracy- - - - - - - - - - - - - - - - - - - - - 263
Table 8 Operating Mode(s) - - - - - - - - - - - - - - - - - - - - - - - - 264
Table 9 Formula References - - - - - - - - - - - - - - - - - - - - - - - 265
Table 10 Data Specifications - - - - - - - - - - - - - - - - - - - - - - - - 266
Table 11 Acoustic Output Reporting Table for Track 1
Non-Autoscanning Mode - - - - - - - - - - - - - - - - - - - - 268
Table 12 Accutome Replacement Parts - - - - - - - - - - - - - - - - 273

xvi
List of Tables

1
Introduction
Accutome
A-Scan Plus
Overview
The Accutome A-Scan Plus pictured below has all the
features that make it easy to obtain extreme accuracy
and improved patient outcomes.
Figure 1 Accutome A-Scan Plus

2
Accutome A-Scan Plus User’s Guide
Features The Accutome A-scan Plus is designed for easy access
to all screens and functions.
The advanced User Input Knob provides unsurpassed
ease of use and the straightforward Graphical User
Interface guides you through every operation.
What you can’t see on the surface is also important.
Industry-leading signal acquisition and processing helps
you assure accurate measurements. Reliable design
and efficient manufacturing provide fiscal value.
Upgradeable software protects your investment. The
Accutome A-Scan Pluslets you accomplish even the
complex simply.
The A-Scan provides the following general features:
Large 7.5 inch high resolution LCD screen with
intuitive User Interface
Rotary User Input knob and dedicated tactile
buttons
External, universal input, worldwide power
supply
Desktop, slit lamp, or wall mountable
Provides a variety of printouts
1.9" thick, portable
Measurements
The accuracy of the Accutome A-Scan Plus
measurement is provided by the following:
High-resolution, real-time waveform display
with up to 8X zoom pinpoints tissue
boundaries
High-speed digitalization acquires over 4000
points per waveform
Continuous display of Axial Length, ACD, Lens
Thickness, and Vitreous dimensions
Audible feedback of contact, signal quality, and
capture
Immersion mode yields improved accuracy -
Contact mode also supported
Automatically or Manually capture up to 5
waveforms for each eye