Summary of a-scan plus

  • Page 3: Table of Contents

    Table of contents chapter 1: introduction .................................................................1 accutome a-scan plus overview .............................................................1 features ............................................................................................

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    Connecting the usb keyboard and usb disk...................................................17 connecting the rs232 connector.......................................................................17 connecting the probe.....................................................................................

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    Types of information...................................................................... ....................48 soft menus..........................................................................................................48 tips..................................................................

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    Setup screen soft menu.....................................................................................75 how to set the printer.........................................................................................76 how to set the print title.....................................................

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    Capture modes .............................................................................................144 auto mode........................................................................................................144 manual mode................................................................

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    Vc.....................................................................................................................166 how to customize an eye type .............................................................167 overview..............................................................................

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    Chapter 10: personalizing lens constants .....................200 overview...........................................................................................................200 personalizing lens constants...........................................................................200 how to p...

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    Chapter 13: maintenance ..............................................................226 general maintenance........................................................................................226 safety inspections....................................................................................

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    Chapter 15: warranty and repairs .........................................245 warranty............................................................................................................245 product returns .........................................................................................

  • Page 12: List of Figures

    List of figures figure 1-1 accutome a-scan plus........................................................................1 figure 3-1 accutome a-scan plus components.................................................12 figure 3-2 closed kickstand.............................................................

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    Figure 5-7 selecting the eye type name cell...................................................64 figure 5-8 adding the new eye type name ....................................................64 figure 5-9 activating the area to select new lens material............................65 figure 5-10 lens ma...

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    Figure 5-50 default id added...........................................................................106 figure 5-51 default gain field selected...........................................................107 figure 5-52 default gain field changed........................................................

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    Figure 6-14 gain selected ...............................................................................159 figure 6-15 gain field changed.......................................................................160 figure 6-16 zoom selected................................................................

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    All accutome a-scan units are manufactured by accutome ultrasound at: 3222 phoenixville pike malvern, pa 19355 usa.

  • Page 17: Introduction

    Introduction 1 1 introduction the accutome a-scan plus pictured below has all the features that make it easy to obtain extreme accuracy and improved patient outcomes. Accutome a-scan plus overview figure 1-1 accutome a-scan plus.

  • Page 18: Features

    Accutome a-scan plus user’s guide 2 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 ...

  • Page 19

    Introduction 3 • predefined eye types and velocities handle most situations such as phakic, dense cataract, three pseudo-phakic, aphakic, and even silicone oil filled eyes. All velocities are fully adjustable. • custom eye types and material velocities can be created to handle individual preferences...

  • Page 20: About This Manual

    Accutome a-scan plus user’s guide 4 optional components there are also several optional components which further simplify the use of the accutome a-scan: • external printer • immersion shell • mounting options about this manual section 2 section 3 section 4 section 5 section 6 section 7 safety getti...

  • Page 21

    Introduction 5 section 8 section 9 section 10 section 11 section 12 section 13 section 14 section 15 section 16 section 17 performing calculations setting up iol groups personalizing lens constants storing and recalling patient records maintenance specifications warranty and repairs printing a-scan ...

  • Page 22: Safety

    6 accutome a-scan plus user’s guide 2 safety safety information the section lists: • safety precautions associated with the accutome a-scan plus • safety precautions of a general nature federal law restricts this device to sale by or on the order of a physician. Safety issues to consider when using ...

  • Page 23

    7 safety symbols definitions for the accutome statements, graphics and symbols listed below are used on components of the accutome a-scan plus. Descriptions and meanings are listed to the right of the symbols. “attention! Consult instruction manual.” single phase alternating current when pressed tur...

  • Page 24: Safety Precautions

    8 accutome a-scan plus user’s guide power connector disposal of product within eu safety precautions there are several areas in the use of the accutome a-scan that require special attention, as they may pose a safety threat. Sterilization sterilization issues are confined to the a-scan probe that co...

  • Page 25

    9 safety this instrument has no user operated controls or settings that affect the acoustic output. When using this instrument, the alara (as low as reasonably achievable) principle should be followed. This principle is used to reduce unnecessary, potentially hazardous exposure to individuals, by ke...

  • Page 26

    10 accutome a-scan plus user’s guide electrical hazard and safety the instrument, footswitch and probe of the accutome a-scan plus are electrical/electronic devices. Reasonable care should be taken when making electrical connection and handling electrically powered devices. Avoid use of damaged elec...

  • Page 27

    11 safety safety precautions avoiding electromagnetic and other interference alara principle do not use a cellular telephone and other devices not complying with emc class b requirements, as its signals may cause the equipment to malfunction. The effect of radio signals on medical devices is depende...

  • Page 28: Getting Started

    12 accutome a-scan plus user’s guide 3 getting started assembling the accutome a-scan plus the accutome a-scan plus is designed to be used in multiple environments and can be rested on a surface, mounted on a wall, or mounted on a pedestal, or camera mount. The instrument requires little assembly. A...

  • Page 29

    13 getting started probe the probe provided with the accutome a-scan is an essential component. No other probes should be used with the instrument. Footswitch the footswitch can be used to capture, review and delete measurements. Battery specification and installation in addition to the external pow...

  • Page 30

    14 accutome a-scan plus user’s guide placing the accutome a-scan plus the instrument is designed to be placed almost anywhere; it is equipped with a quick-close kickstand and several options for mounting. It can be placed on a surface, such as a counter or a desk, using the quick-close kickstand pro...

  • Page 31

    15 getting started assembling the accutome a-scan plus figure 3-3 open kickstand mounting the accutome a-scan plus is designed to be mounted with many types of hardware. The back of the accutome has five threaded holes. Four of the holes are amps-nec compatible and will accept any compatible mountin...

  • Page 32

    16 accutome a-scan plus user’s guide connecting the footswitch to connect the footswitch: 1. Locate the footswitch connector, on the side, at the left of the instrument (see figure 3-5). 2. Insert the connector of footswitch cable into the footswitch connector. Connecting the power there are two com...

  • Page 33

    17 getting started assembling the accutome a-scan plus connecting the ethernet connection connecting the usb keyboard and usb disk connecting the rs232 connector locate a regular ethernet cable (not provided with the unit) with rj45 connectors. Plug one end of the ethernet connector and the other en...

  • Page 34

    18 accutome a-scan plus user’s guide connecting the probe the accutome a-scan plus probe connector is located on the right side of the instrument (facing the instrument). To connect the probe: 1. Locate the probe connector, on the side, at the right of the instrument, facing the screen (see figure 3...

  • Page 35: Probe Setup

    19 getting started assembling the accutome a-scan plus figure 3-6 probe connected probe setup the accutome a-scan plus probe is an integral component. There are several options available for probe use. The accutome a-scan plus probe can be used: 1. With an immersion shell 2. Mounted into a goldman t...

  • Page 36

    20 accutome a-scan plus user’s guide figure 3-7 accutome ultrasonic probe kit (pn 24-4001) accutome ultrasonic probe kit (pn 24-4001) the accutome probe is designed to be used with an immersion shell. When using an immersion shell ensure that there is a distance of 5 - 14.5 mm between the bottom of ...

  • Page 37

    21 getting started probe setup accutome probe with goldman tonometer adapter the accutome probe is designed to be used with a goldman tonometer adapter. When using the tonometer adapter: 1. Slide the adapter over the end of the probe as shown in figure 3-10 below. 2. Mount the probe by inserting the...

  • Page 38

    22 accutome a-scan plus user’s guide accutome probe with handle extension the accutome probe is designed to be used with an handle extension to increase the length of the probe. When using the probe handle extension: 1. Insert the probe into the handle extension as shown in figure 3-11 below. 2. Sli...

  • Page 39

    23 getting started probe setup figure 3-12 probe with handle extension and insertion tool figure 3-13 probe with handle extension.

  • Page 40: Basic Operation

    24 accutome a-scan plus user’s guide basic operation the basic operation of the accutome a-scan plus consists of the following steps: 1. Power on the instrument. 2. Adjust the lcd display contrast. 3. Take five measurements per eye. 4. Calculate the iol power for desired result. 5. Print or save the...

  • Page 41

    25 getting started probe setup 1. 2. The first screen you see will be the measure screen. Scanning mode preferences are maintained while the instrument is powered off. How to adjust the contrast when you turn on the accutome a-scan plus you may have to adjust the contrast of the display. The display...

  • Page 42

    26 accutome a-scan plus user’s guide using the test block the accutome a-scan plus is equipped with a test block, located at the top, right side (facing the display) of the instrument. Refer to the figure below for location. The test block is provided as a way to test the basic operation of the inst...

  • Page 43

    27 getting started probe setup how to start a new patient preparation of patient for examination preparing a patient for an a-scan exam consists of the following steps: 1. Anesthetizing the patient’s eye with a topical anesthetic such as proparacaine. Please refer to the manufacturer’s instructions ...

  • Page 44

    28 accutome a-scan plus user’s guide 1. Press the button under the “start new patient” selection on the measure, calculate iol or patient records screens. Refer to figure 3-18 below. When you start a new patient the accutome a-scan plus will clear all fields on the measure screen as follows: • gain ...

  • Page 45

    29 getting started basic operation the patient’s last name will be highlighted, using the keyboard type in the last name. 4. Figure 3-20 enter patient’s last name press the enter button, the knob or the check mark to activate the patient information field. Figure 3-19 patient information field opene...

  • Page 46

    30 accutome a-scan plus user’s guide press the tab key saves the entry and advances to the next entry in one step. 5. Figure 3-21 enter patient information type in the patient’s first name 6. Pressing the tab key saves the entry and advances to the next entry in one step. 7. Continue entering patien...

  • Page 47

    31 getting started basic operation how to enter text without a keyboard the keyboard is optional with the accutome a-scan plus. The keyboard makes entering text very easy. When a field is active requiring text, and you have a keyboard, you simply have to enter the text. The accutome a-scan plus also...

  • Page 48

    32 accutome a-scan plus user’s guide screen keyboard features the screen keyboard is displayed at the bottom of the screen and is divided into a row of selectable alphanumeric characters and soft menu selections. The background of the selectable characters is white and has a border drawn around it t...

  • Page 49

    33 getting started basic operation entering a patient with the screen keyboard to enter the patient name with the screen keyboard: 1. Select the patient field by rotating the knob. 2. Press the knob or the √ button, to open the patient information screen field. 3. Using the knob, select the patient ...

  • Page 50

    34 accutome a-scan plus user’s guide figure 3-23 measurement fields selected how to take a measurement after you have entered all the patient information you should set the measurement selections to your liking. The selections you can change are: • automatic/manual - which method are you using to ta...

  • Page 51

    35 getting started basic operation to take a patient measurement: 1. Change the necessary measurement settings by pressing the buttons beneath the measurement selections. Each of the measurement selections toggle between one and the other. 2. Set the appropriate eye type (the field under od or os) f...

  • Page 52

    36 accutome a-scan plus user’s guide how to perform a calculation after you have completed a patient’s scans you can calculate the power of the iol for the patient. You can perform the calculation from the calculate iol screen. To calculate a lens: 1. Press the calculate button, located at the right...

  • Page 53

    37 getting started basic operation 2. The accutome will display the calculate iol screen as shown in figure 3-25 below note: for more information on calculating iols refer to the “performing calculations” section of this manual. Select the iol group, if necessary, by pressing the button beneath the ...

  • Page 54

    38 accutome a-scan plus user’s guide select the formula, if necessary, by pressing the button beneath the selection “select formula” until the appropriate formula is displayed. If using the haigis formula, and the acd value needs to be changed, rotate the knob to select the acd field and press the k...

  • Page 55

    39 getting started basic operation enter the k1 value in the designated area as shown in figure 3-27 below. Rotate the knob to select the k1 field and press the knob or the √ button to activate the field. When the field is active enter the k1 values in diopters or mm. Enter k2 value in the same mann...

  • Page 56

    40 accutome a-scan plus user’s guide after entering the k1 and k2 values, the emmetropic power is calculated and displayed for each iol. Enter the ametropoic target value in the designated area as shown in figure 3-28 below. Rotate the knob to select the target field and press the knob or the √ butt...

  • Page 57

    41 getting started basic operation how to save patient records the accutome a-scan plus allows you to save patient records at any time to either internal memory, usb stick or network drive.You can save the record after you have taken all the desired measurements or, after you have taken the measurem...

  • Page 58

    42 accutome a-scan plus user’s guide figure 3-29 patient record storage press the button below “save to list”. The accutome a-scan plus will store the patient record. The “not saved” prompt patient id will be changed to “saved” and a new entry will appear in the patient list. 2. Figure 3-30 patient ...

  • Page 59: How to Use The

    43 button and screens 4 how to use the buttons and screens overview the accutome a-scan plus consists of a screen display with buttons located beneath the screen and buttons located to the right of the screen. The a-scan allows you to control every feature for capturing waveforms and calculating iol...

  • Page 60

    44 accutome a-scan plus user’s guide figure 4-1 accutome a-scan plus buttons accutome a-scan plus buttons there are two types of buttons available on the accutome a-scan plus front panel, dedicated buttons and soft menu buttons. Dedicated buttons the dedicated buttons, located at the side of the fro...

  • Page 61

    45 button and screens note: two of the dedicated buttons, calculate and preferences, can be pressed multiple times to scroll through lower level linked screens. Measure button the measure button displays the measure screen where the user can acquire patient waveforms and adjust waveform parameters. ...

  • Page 62

    46 accutome a-scan plus user’s guide print check or affirmative ( √ ) negative or delete (x) soft menu buttons the affirmative button acts like pressing the knob. Whenever you have selected a field and press the affirmative button the field becomes active. If you press the affirmative button a secon...

  • Page 63: Screens

    47 button and screens accutome a-scan plus buttons buttons that toggle between two selections buttons that display other screens or soft menus accutome a-scan plus knob how the knob works screens soft menu buttons that toggle cause the accutome to switch between one state and another; e.G. On the me...

  • Page 64

    48 accutome a-scan plus user’s guide it is in the various screens that you perform all operations; measuring patients, calculating lens replacements, setting up the accutome a-scan plus, setting up iol groups, personalizing lens constants, etc. The name of each screen is displayed in the top right c...

  • Page 65

    49 button and screens screens error messages moving between screens a high continuous tone indicates valid measurements. No tone is emitted if the waveform cannot be measured. A quick double beep is emitted when the waveform is automatically captured. When you have completed capturing five waveforms...

  • Page 66

    50 accutome a-scan plus user’s guide high level screen buttons figure 4-2 accutome a-scan plus screen hierarchy top level screens the top level screens are: • measure - for performing measurements • calculate - for calculating iol power • patient records - for saving, retrieving, deleting and batch ...

  • Page 67

    51 button and screens screens from the patient records screen there is are four lower level screens available from the patient records screen. They include save/recall, print, delete and transfer. From the preferences screen from the top level of the preferences screen, which is eye types, you can a...

  • Page 68

    52 accutome a-scan plus user’s guide active area the active area on any screen is surrounded by a dashed border. Text entry certain screens require text entry. The accutome a-scan plus will automatically provide you with a new soft menu of alphanumeric characters. You select the various characters b...

  • Page 69: Keyboard Shortcuts

    53 button and screens screens 1. Select the field by rotating the knob. 2. Activate the field by pressing the knob or the affirmative button. 3. When the field is active, rotate the knob to select one of the pre-entered values. Fields requiring information there are several fields that require the i...

  • Page 70: Table 4-1 Keyboard Shortcuts

    54 accutome a-scan plus user’s guide action f1 - f6 correlate to the soft menu keys, functions change according to selected screen f7 same as print key f8 operates like the footswitch, will display the measure screen from other screens, can be used to capture, select and recapture waveforms f9 same ...

  • Page 71: Using The Footswitch

    55 button and screens keyboard shortcuts the footswitch can be used to select a waveform on the measure screen. If you want to scroll through the list of (up to) five waveforms, step on the footswitch. If you would like to recapture that waveform, step on the footswitch and keep pressing, for approx...

  • Page 72: Preferences

    56 accutome a-scan plus user’s guide 5 preferences setting up the accutome a-scan plus the accutome a-scan plus is equipped with personal preference options, and provides the flexibility necessary to customize your machine. You can not only add eye types and lens materials, but you can also set many...

  • Page 73: How To Access Preferences

    57 preferences accutome a-scan plus user’s guide how to access preferences to access the accutome a-scan plus preferences, press the preferences button, located on the right side of the front panel (see figure 5-1 below). Preferences button figure 5-1 preferences button note: if you press the prefer...

  • Page 74

    58 accutome a-scan plus user’s guide top level of preferences when you press the preferences button the accutome a-scan plus will display the eye types screen (see figure 5-2 below). In the eye types screen you can add a new eye type, new lens material, new anterior/vitreous material and assign velo...

  • Page 75: How To Add A New Eye Type

    59 preferences accutome a-scan plus user’s guide how to add a new eye type the accutome a-scan plus provides the ability to customize the current patient eye type for unique or rare eye types using the customize eye type screen. When you add a new eye type, you will add the eye type to the eye types...

  • Page 76

    60 accutome a-scan plus user’s guide adding a new lens material before using a material in the definition of an eye type, the lens material must exist in the lens material table. To add a new lens material: 1. Rotate the knob and select the lens material table. The table is selected when it is surro...

  • Page 77

    61 preferences accutome a-scan plus user’s guide how to add a new eye type press the knob to activate the lens material table. The table is activated when it is surrounded by a dashed border as shown in figure 5-4 below. When the table is activated rotate the knob until an empty cell in the material...

  • Page 78

    62 accutome a-scan plus user’s guide figure 5-5 entering the name for new lens material assigning a velocity to the new lens material the accutome a-scan plus is set up at the factory with default sonic velocities for the most common types of lens materials. The accutome a-scan plus knows which velo...

  • Page 79

    63 preferences accutome a-scan plus user’s guide how to add a new eye type figure 5-6 adding new material velocity adding the new eye type information 1. Rotate the knob and select the eye types table. 2. Press the knob or the √ button, to activate the eye types table. 3. Within the eye types table,...

  • Page 80

    64 accutome a-scan plus user’s guide figure 5-7 selecting the eye type name cell enter the name of the new eye type. Press the knob or the √ button, to save the eye type name and to deactivate the cell. 4. 5. Figure 5-8 adding the new eye type name.

  • Page 81

    65 preferences accutome a-scan plus user’s guide how to add a new eye type within the eye types table, rotate the knob to select the lens cell associated with the eye type name you just entered. Press the knob or the √ button, to activate the cell, indicated by the dashed border. 6. 7. Figure 5-9 ac...

  • Page 82

    66 accutome a-scan plus user’s guide figure 5-10 lens material selected within the eye types table, rotate the knob to select the lens thickness cell associated with the current eye type name, and lens. Press the knob or the √ button, to activate the cell, indicated by the dashed border. If the lens...

  • Page 83

    67 preferences accutome a-scan plus user’s guide how to add a new eye type figure 5-11 lens thickness entered within the eye types table, rotate the knob to select the ac cell associated with the current eye type name, and lens. Press the knob or the √ button, to activate the cell, indicated by the ...

  • Page 84

    68 accutome a-scan plus user’s guide figure 5-12 anterior chamber material selected within the eye types table, rotate the knob to select the vc cell associated with the current eye type name, lens, and anterior chamber. Press the knob or the √ button, to activate the cell, indicated by the dashed b...

  • Page 85

    69 preferences accutome a-scan plus user’s guide how to add a new eye type figure 5-13 vitreous chamber material selected eye type screen menu selections there are three menu selections available for execution at the bottom of the eye types screen. Two of the selections, “reset field to factory” and...

  • Page 86

    70 accutome a-scan plus user’s guide if you have already changed, or are editing a pre-entered field on the eye type screen, and you would like to reset it: 1. Rotate the knob until the field you would like to reset is selected with a solid black border as shown in figure 5-14 below. Figure 5-14 non...

  • Page 87

    71 preferences accutome a-scan plus user’s guide how to add a new eye type figure 5-15 restore selected field prompt the accutome a-scan plus will reset the selected field to its factory default as shown in figure 5-16 on the next page. 5..

  • Page 88

    72 accutome a-scan plus user’s guide figure 5-16 selected field restored reset all to factory the reset all to factory selection provides you with the ability to return all pre-entered fields on the eye types screen to their default factory values. If you have already changed several pre-entered fie...

  • Page 89

    73 preferences accutome a-scan plus user’s guide eye type screen menu selections figure 5-17 non-factory fields displayed the accutome a-scan plus will prompt you with the message “are you sure?” as shown in figure 5-18 on the next page. You must either cancel or continue. Press the button beneath t...

  • Page 90: More Settings

    74 accutome a-scan plus user’s guide figure 5-18 restore all fields prompt note: at this point, if you would like to continue with the setting preferences, press the button beneath the selection “more settings...” or press the dedicated preferences button a second time. More settings from the high l...

  • Page 91

    75 preferences accutome a-scan plus user’s guide • default k index • iol step for iol calculation power table • network folder • date • time • auto mode setup screen soft menu the setup screen has the following soft menu selections activated by the buttons beneath the selection: • sound on/sound off...

  • Page 92

    76 accutome a-scan plus user’s guide how to set the printer in order to obtain the best print out possible from the accutome a-scan plus, it is recommended that all records be printed to a hp, or hp compatible printer. The accutome a-scan plus has over 200 hp drivers included in the software. We sup...

  • Page 93

    77 preferences accutome a-scan plus user’s guide more settings press the knob or the √ button, to activate the field, indicated by the dashed border as shown in 5-21. 2. Figure 5-21 printer field open.

  • Page 94

    78 accutome a-scan plus user’s guide within the printer field, rotate the knob to select one of the pre-entered options as shown in 5-22. 3. Figure 5-22 selecting the printer.

  • Page 95

    79 preferences accutome a-scan plus user’s guide more settings press the knob or the √ button, to save the selected printer and to deactivate the field as shown in figure 5-23. 4. Figure 5-23 printer selected the accutome a-scan has the ability to update the printer driver as new releases become ava...

  • Page 96

    80 accutome a-scan plus user’s guide within the setup screen, rotate the knob and select printer, indicated by the solid black border as shown in figure 5-24. 2. Figure 5-24 select printer.

  • Page 97

    81 preferences accutome a-scan plus user’s guide more settings press the knob or the check mark, to activate the printer field, indicated by the dashed border as shown in firgure 5-25. 3. Figure 5-25 activate the printer field.

  • Page 98

    82 accutome a-scan plus user’s guide rotate the knob until “none” is selected as shown in figure 5-26. 4. Figure 5-26 printer selection “none”.

  • Page 99

    83 preferences accutome a-scan plus user’s guide more settings press the knob or the check mark to confirm selection of none as shown in firgure 5-27. 5. Figure 5-27 new patient selected.

  • Page 100

    84 accutome a-scan plus user’s guide within the setup screen, rotate the knob to select “update...” field, indicated by a solid black border. 6. Figure 5-28 update selected.

  • Page 101

    85 preferences accutome a-scan plus user’s guide more settings press the knob or the check mark button, to activate the field, indicated by the dashed border as shown in figure 5-29. 7. Figure 5-29 are you sure? The screen will prompt: “are you sure? Update custom printer drivers from usb disk?” pre...

  • Page 102

    86 accutome a-scan plus user’s guide upon completion of the updating of the files, the system will prompt you, “driver update complete.” press ok as shown in figure 5-30. 10. Figure 5-30 driver update complete.

  • Page 103

    87 preferences accutome a-scan plus user’s guide more settings within the set up screen, rotate the knob and select printer, indicated by the solid black border as shown in figure 5-31. 11. Figure 5-31 select printer field.

  • Page 104

    88 accutome a-scan plus user’s guide press the knob or the check mark, to activate the printer field, indicated by the dashed border as shown in figure 5-32. 12. Figure 5-32 selecting custom print drives rotate the knob until “custom” is selected. 13..

  • Page 105

    89 preferences accutome a-scan plus user’s guide more settings press the knob or the check mark to confirm selection of custom as shown in figure 5-33. 14. Figure 5-33 custom print drivers selected how to set the print title the accutome a-scan plus provides you with the ability to have a title appe...

  • Page 106

    90 accutome a-scan plus user’s guide to set a print title: 1. Within the setup screen, rotate the knob to select the print title field, indicated by a solid black border as shown in figure 5-34. Figure 5-34 print title field selected.

  • Page 107

    91 preferences accutome a-scan plus user’s guide more settings press the knob or the √ button, to activate the field, indicated by the dashed border as shown in figure 5-35. 2. Figure 5-35 print title field activated.

  • Page 108

    92 accutome a-scan plus user’s guide within the print title field, enter the title you would like printed on every record as shown in figure 3-36. 3. Figure 5-36 entering the print title.

  • Page 109

    93 preferences accutome a-scan plus user’s guide more settings press the knob or the √ button, to save the entered print title and to deactivate the field as shown in figure 5-37. 4. Figure 5-37 print title added how to select automatic or manual network address the network address allows you to rec...

  • Page 110

    94 accutome a-scan plus user’s guide figure 5-38 selecting automatic network address press the knob or check mark to confirm the selection. 4..

  • Page 111

    95 preferences accutome a-scan plus user’s guide more settings when set to manual, please refer to the site’s network manager for the following information: static ip address, subnet mask, and gateway address. The following steps will guide you through entering data in “manual” mode: press “ enter ”...

  • Page 112

    96 accutome a-scan plus user’s guide how to adjust the contrast you may need to adjust the contrast because the optimal contrast setting varies with viewing angle and temperature. The contrast feature in the setup screen allows you to adjust the contrast of the instrument’s display screen. Note: the...

  • Page 113

    97 preferences accutome a-scan plus user’s guide more settings figure 5-39 contrast field selected press the knob or the √ button, to activate the field, indicated by the dashed border as shown in figure 5-40. 2..

  • Page 114

    98 accutome a-scan plus user’s guide figure 5-40 contrast field activated.

  • Page 115

    99 preferences accutome a-scan plus user’s guide more settings with the contrast field active, rotate the knob to adjust the white/grey contrast of the screen. The amount of grey vs. White is indicated in the contrast field by a solid grey bar, that increases or decreases as you adjust the contrast ...

  • Page 116

    100 accutome a-scan plus user’s guide figure 5-42 contrast adjusted how to set the default patient eye type the accutome a-scan plus has a default eye type setting so that every time you start a new patient you do not have to select an eye type. When you start a new patient the eye type displayed on...

  • Page 117

    101 preferences accutome a-scan plus user’s guide more settings figure 5-43 default eye type field selected press the knob or the √ button, to activate the field, indicated by the dashed border as shown in figure 5-44. 2. Figure 5-44 default eye type field activated.

  • Page 118

    102 accutome a-scan plus user’s guide within the default eye type field, rotate the knob to select one of the pre-entered eye types as shown in figure 5-45 below 3. Figure 5-45 new default eye type selected press the knob or the √ button, to save the selected default eye type and to deactivate the f...

  • Page 119

    103 preferences accutome a-scan plus user’s guide more settings figure 5-46 default eye type changed how to set the default id the accutome a-scan plus provides you with the ability to have a default id appear whenever you start a new patient. For example, you may want to have a doctor’s name, or a ...

  • Page 120

    104 accutome a-scan plus user’s guide figure 5-47 default id field selected press the knob or the √ button, to activate the field, indicated by the dashed border as shown in figure 5-48. 2..

  • Page 121

    105 preferences accutome a-scan plus user’s guide more settings figure 5-48 default id field activated within the default id field, enter the default id as shown in figure 5-49. 3. Figure 5-49 entering the default id.

  • Page 122

    106 accutome a-scan plus user’s guide press the knob or the √ button, to save the entered default id and to deactivate the field as shown in figure 5-50. 4. Figure 5-50 default id added how to set the default gain the default gain parameter allows you to adjust the new patient ultrasound gain. You c...

  • Page 123

    107 preferences accutome a-scan plus user’s guide more settings figure 5-51 default gain field selected rotate the knob to select one of the pre-entered gain values, or manually enter the new value. The gain is adjustable in increments of 1 db from 0- 23 db. When the gain is at the appropriate level...

  • Page 124

    108 accutome a-scan plus user’s guide figure 5-52 default gain field changed how to set the target refraction when you are calculating iols, one of the values you need to enter is the desired target refraction. The accutome a-scan plus allows you to specify the default target refraction that is most...

  • Page 125

    109 preferences accutome a-scan plus user’s guide more settings figure 5-53 target field selected press the knob or the √ button, to activate the field, indicated by the dashed border as shown in figure 5-54. 2. Figure 5-54 target field activated.

  • Page 126

    110 accutome a-scan plus user’s guide with the target field active, rotate the knob until you reach the appropriate value or enter the target number on the keyboard as shown in figure 5-55. 3. Figure 5-55 adjusting the target press the knob or the √ button, to save the entered default id and to deac...

  • Page 127

    111 preferences accutome a-scan plus user’s guide more settings figure 5-56 target adjusted how to set the k index the keratometer index of refraction, used to convert corneal radius to diopter power is not the same for all keratometers. In north america, most units have an index of refraction of 1....

  • Page 128

    112 accutome a-scan plus user’s guide to set the k index: 1. Within the setup screen, rotate the knob to select the k index field, indicated by a solid black border as shown in figure 5-57. Figure 5-57 k index field selected press the knob or the √ button, to activate the field, indicated by the das...

  • Page 129

    113 preferences accutome a-scan plus user’s guide more settings figure 5-58 k index field activated rotate the knob to adjust the k index , or manually enter the new value. The maximum value is 1.5000 and the minimum is 1.2500 as shown in figure 5-59. 3. Figure 5-59 adjusting the k index.

  • Page 130

    114 accutome a-scan plus user’s guide press the knob or the √ button, to save the entered default id and to deactivate the field as shown in figure 5-60. 4. Figure 5-60 k index field adjusted how to set the iol step the accutome a-scan plus allows you to modify the diopter step used when calculating...

  • Page 131

    115 preferences accutome a-scan plus user’s guide more settings figure 5-61 iol step field selected press the knob or the √ button, to activate the field, indicated by the dashed border as shown in figure 5-62. 2. Figure 5-62 iol step field activated.

  • Page 132

    116 accutome a-scan plus user’s guide rotate the knob to select one of the pre-entered step values, or manually enter the new value. The iol power step is adjustable in increments of 0.05 d from 0.05 - 5.00 d as shown in figure 5-63. 3. Figure 5-63 adjusting the iol step when the iol step is at the ...

  • Page 133

    117 preferences accutome a-scan plus user’s guide more settings figure 5-64 iol step adjusted.

  • Page 134

    118 accutome a-scan plus user’s guide how to activate the network folder within the set up screen, rotate the knob to select the network folder on/ off field, indicated by a solid black border as shown in figure 5-65. 1. Figure 5-65 selecting network folder on/off press the knob or the check mark, t...

  • Page 135

    119 preferences accutome a-scan plus user’s guide more settings configure network folder: move the selection to the “ network folder ” section. The first entry is the “ on/off ” toggle. The default is “ on ”. In case networking is not available or users do not intend to use the networking features, ...

  • Page 136

    120 accutome a-scan plus user’s guide 2. 3. Set up an account and share a folder from a windows pc and collect the follwoing information. The following are required fields: • computer name ( host ). • shared folder name ( folder ). • user name of an account on the pc ( user ). • password of the acco...

  • Page 137

    121 preferences accutome a-scan plus user’s guide more settings 3. 4. 5. 6. 7. Type in the computer name and press “ enter ” when fin - ished. The border of the box will turn to a dashed line when you start typing and turn back to solid after you press “ enter ”. Press “ tab ” key to move to the “ f...

  • Page 138

    122 accutome a-scan plus user’s guide note: the password will turn back to “*****” characters after you press “enter”. 9. 10. Press “ enter ” again to turn the border of the entire box to solid and you can move to anther section. If we need to make any changes or found any errors in data, press “ en...

  • Page 139

    123 preferences accutome a-scan plus user’s guide more settings testing network connection on the a-scan plus after we configure the network folder connection on the a-scan plus, we can start testing the connection. Make sure the network and the pc are up and run - ning before we can start testing t...

  • Page 140

    124 accutome a-scan plus user’s guide how to adjust the date and time the measure screen displays the date and time that a waveform is captured. When you first set up the accutome a-scan plus you can adjust the date and time as appropriate for your time zone. Both the date and time are divided into ...

  • Page 141

    125 preferences accutome a-scan plus user’s guide press the knob or the √ button, to activate the field, indicated by the dashed border as shown in figure 5-68. 2. Figure 5-68 day field activated more settings.

  • Page 142

    126 accutome a-scan plus user’s guide with the day field active, rotate the knob until you reach the appropriate day number or enter the number with the keyboard as shown in figure 5-69. 3. Figure 5-69 adjusting the day press the knob or the √ button, to save the adjusted day and to deactivate the f...

  • Page 143

    127 preferences accutome a-scan plus user’s guide more settings figure 5-70 day adjusted if necessary, adjust the month (m) and day (d) fields of the date in the same manner. If necessary, adjust the hour (h), minute (m), and seconds (s) fields of the time in the same manner. 5. 6. How to set the au...

  • Page 144

    128 accutome a-scan plus user’s guide the auto mode setting is displayed in the soft menu on the measure screen as ‘auto (srs), where (srs) means sclera, retina, stable. If the feature is on, the first letter appears in its place, otherwise a placeholder ‘_’ is displayed. The default is ’sclera’, di...

  • Page 145

    129 preferences accutome a-scan plus user’s guide more settings figure 5-71 auto mode sclera selected press the knob or the √ button, to activate the field, indicated by the dashed border as shown in figure 5-72. 2. Figure 5-72 auto mode sclera field activated.

  • Page 146

    130 accutome a-scan plus user’s guide with the sclera field active, rotate the knob until you the word “on” is displayed. Automatic mode will no longer be triggered by sclera detection as shown in figure 5-73. 3. Figure 5-73 changing the auto mode - turning on sclera press the knob or the √ button, ...

  • Page 147

    131 preferences accutome a-scan plus user’s guide more settings figure 5-74 auto mode - “sclera” on 1. If you would like to define the auto mode by retina signal quality, rotate the knob to select the “retina” field. 2. Press the knob or the √ button, to activate the field, indicated by the dashed b...

  • Page 148

    132 accutome a-scan plus user’s guide figure 5-75 auto mode - “stable” selected press the knob or the √ button, to save stable as on and to deactivate the field. 9. Figure 5-76 auto mode defined by “stable” measurement.

  • Page 149

    133 preferences accutome a-scan plus user’s guide more settings select and turn on or off all the auto mode criteria until you have accurately defined how a measurement will be automatically captured. 10. Sound on/sound off restart on/restart off scr save on/scr save off the sound on/sound off selec...

  • Page 150

    134 accutome a-scan plus user’s guide save and restore factory default gates and threshold you may find, after using the accutome a-scan plus for a while, that you frequently have to adjust one or several gates and threshold. If you continually make the same adjustments to gates/threshold, you may w...

  • Page 151

    135 preferences accutome a-scan plus user’s guide more settings figure 5-77 about this unit screen note: if setup is complete, press the button beneath the selection “done” and you will return to the eye types screen..

  • Page 152: Performing

    136 accutome a-scan plus user’s guide 6 performing measurements overview the accutome a-scan plus is very simple to operate, and has advanced features to help you obtain the best possible measurements. The accutome a-scan plus takes measurements by sending a signal through the eye through the ultras...

  • Page 153: Measure Screen

    137 performing measurements accutome a-scan plus user’s guide measure screen when you power on the accutome a-scan plus the measure screen is displayed as shown in figure 6-1 below. You can get to the measure screen at any time by pressing the measure button located at the right side of the front pa...

  • Page 154

    138 accutome a-scan plus user’s guide information displayed on the measure screen the measure screen provides the continuous display of axial length, acd, lens thickness, and vitreous dimensions for the active patient. The top, left side of the screen displays the active patient waveform. Within the...

  • Page 155: How to Set The Eye Type

    139 performing measurements accutome a-scan plus user’s guide measure screen • start new patient - clears the current patient information and measurements and resets gain, gate, and id to default values. • customize eye type... - displays the customize eye type screen where you can customize the eye...

  • Page 156

    140 accutome a-scan plus user’s guide note: all eye types, including aphakic, have an assumed cornea of 0.55 mm at a velocity of 1641 m/sec. This assumption is included in the acd measurement. Eye type materials and velocities the tables below list the preset eye types and define the materials and v...

  • Page 157

    141 performing measurements accutome a-scan plus user’s guide setting the eye type the patient’s od or os eye type may not match the default provided by the accutome a-scan plus default preferences. To set the eye type: 1. Within the measurement screen, rotate the knob to select the eye type located...

  • Page 158

    142 accutome a-scan plus user’s guide press the knob or the √ button, to activate the field, indicated by the dashed border. (see figure 6-3 below.). 2. Figure 6-3 eye type active within the eye type field, rotate the knob to scroll through the list of eye types. Select the appropriate eye type. Pre...

  • Page 159: Probe Application Methods

    143 performing measurements accutome a-scan plus user’s guide how to set the eye type figure 6-4 eye type changed probe application methods the accutome a-scan plus supports two different methods of applying the probe to the cornea, contact and immersion. Select the method you will be using by press...

  • Page 160: Capture Modes

    144 accutome a-scan plus user’s guide contact the contact method allows you to apply the probe directly to the anesthetized cornea. Caution: when using the contact method, care should be taken to minimize corneal compression. Corneal compression will result in a shorter axial length measurement and ...

  • Page 161: How to Capture A Waveform

    145 performing measurements accutome a-scan plus user’s guide ’retina’, displayed as ‘auto (_r_)’, must begin at the base line, have no data greater than 10% of the threshold in front of it (for 1.5 mm), and be steeply rising. “stable’, displayed as ‘auto (__s)’, means the measurement needs to be wi...

  • Page 162: How to Select A Measurement

    146 accutome a-scan plus user’s guide using the measure button when you want to capture a waveform, press the measure button at the top right corner. The accutome a-scan plus will switch from running to frozen. How to select a measurement after you have taken measurements you may want to go back and...

  • Page 163

    147 performing measurements accutome a-scan plus user’s guide figure 6-5 measurement selected selecting a measurement using waveform review menu the waveform review menu will be displayed at the bottom of the measure screen when the waveform area is active. To select a measurement using the waveform...

  • Page 164

    148 accutome a-scan plus user’s guide figure 6-6 measurement activated with waveform review menu press the button beneath the “view” selection. The measurement outlined with white text against a black background in the measurement table is the active measurement. The view button will scroll through ...

  • Page 165: How to Delete A Measurement

    149 performing measurements accutome a-scan plus user’s guide how to delete a measurement to select a measurement with the footswitch: 1. Within the measure screen, press and release the footswitch to select a measurement. The footswitch will scroll through the table of measurements each time you pr...

  • Page 166

    150 accutome a-scan plus user’s guide the events the accutome a-scan plus seeks when scanning are: • cornea • anterior lens (if eye is not aphakic) • posterior lens (if lens thickness is measurable) • retina there is also unnecessary information captured in a waveform. There is a threshold for echoe...

  • Page 167

    151 performing measurements accutome a-scan plus user’s guide selecting gates/threshold all gates/threshold are visible in the current waveform. Each gate should be situated to the left of the event it is indicating. To select a gate: 1. Within the measure screen, rotate the knob to select the curre...

  • Page 168

    152 accutome a-scan plus user’s guide waveform review menu the waveform review menu has selections for adjusting gates/threshold, gain, zoom, scrolling, selecting a waveform and for exiting the menu. To select an item from the menu for adjustment, press the button beneath the selection and then rota...

  • Page 169

    153 performing measurements accutome a-scan plus user’s guide how to adjust gates/threshold tip: you can use c to select the cornea gate directly from the keyboard, or hold to select cornea gates for all measurements. Rotate the knob to move the cornea gate close to the cornea echo. When the gate is...

  • Page 170

    154 accutome a-scan plus user’s guide to adjust the anterior lens gate: 1. Press the button beneath the gate selections until the “gate ant lens” is visible. Tip: you can use a to select the anterior lens gate directly from the keyboard, or hold to select anterior lens gates for all measurements. Ro...

  • Page 171

    155 performing measurements accutome a-scan plus user’s guide how to adjust gates/threshold how to adjust the posterior lens gate the posterior lens gate should be located before the start of the last lens echo. Note: the posterior lens gate is visible only if the eye type requires the lens thicknes...

  • Page 172

    156 accutome a-scan plus user’s guide figure 6-11 posterior lens gate selected how to adjust the retina gate the retina gate should be located before the start of the retina echo. To adjust the retina gate: 1. Press the button beneath the gate selections until the “gate retina” is visible. Tip: you ...

  • Page 173

    157 performing measurements accutome a-scan plus user’s guide how to adjust gates/threshold figure 6-12 retina gate selected the threshold gate should be located at the minimum echo height or amplitude. To adjust the threshold gate: 1. Press the button beneath the gate selections until the “gate thr...

  • Page 174

    158 accutome a-scan plus user’s guide rotate the knob to move the threshold below the minimum height of the echo. When the gate is in the proper position, either press the button beneath the gate selections to select another gate for adjustment or press the button beneath “done”, the knob or the √ b...

  • Page 175: How To Adjust The Gain

    159 performing measurements accutome a-scan plus user’s guide move the gate to the desired location. The gate is moved in all waveforms for the current eye. For each movement, each waveform is re-evaluated and new measurements are updated in the measurement table. 2. How to adjust the gain the gain ...

  • Page 176

    160 accutome a-scan plus user’s guide rotate the knob to select one of the pre-entered gain values. 2. Note: to return the gain to the new patient default value, press and hold the gain button for approximately 2 second. Tip: you can use g to increase the gain 1db directly from the keyboard, or hold...

  • Page 177

    161 performing measurements accutome a-scan plus user’s guide how to use zoom the zoom feature allows you to zoom in on a selected waveform. The height of the waveform remains the same, only the width changes. Zoom expands the distance scale. The waveform must be selected and active to display the w...

  • Page 178: How to Scroll

    162 accutome a-scan plus user’s guide tip: you can use ctrl+z to increase the zoom with wrap directly from the keyboard, or hold to set the zoom to the default 1.6x. Figure 6-17 zoom changed how to scroll the scroll feature moves the active waveform from left to right and from right to left. Scroll ...

  • Page 179

    163 performing measurements accutome a-scan plus user’s guide how to scroll figure 6-18 scroll selected rotate the knob to move the waveform. 2. Tip: you can use ctrl+ s to scroll the waveform increasing 1mm directly from the keyboard, or hold to set the scroll to 0. When the waveform is in the corr...

  • Page 180: Switching Eyes

    164 accutome a-scan plus user’s guide figure 6-19 measurement scrolling changed switching eyes it is very simple to switch between eyes using the accutome a-scan plus. To switch from od to os, or from os to od press the button beneath the selection od/os. The waveforms and eye type for the selected ...

  • Page 181: Customizing Eye Types

    7 customizing eye types overview the accutome a-scan plus not only allows you to create and store custom eye types, you can also customize eye types on-the-fly for an individual patient. Patient customization if you have a patient with a unique situation, you can specify the eye type, materials, and...

  • Page 182: Customize Eye Type Screen

    Accutome a-scan plus user’s guide 166 customize eye type screen the accutome a-scan plus provides access to the customize eye type screen through the measure screen. When you power on the instrument it starts up at the measure screen. When you press the button beneath the selection “customize eye ty...

  • Page 183

    167 customizing eye types accutome a-scan plus user’s guide customize eye type screen • edit text - allows you to enter your own field names; you don’t have to select pre-entered values. • done... - exits the customize eye type screen and returns you to the measure screen. Note: if there is an * (as...

  • Page 184

    168 accutome a-scan plus user’s guide within the custom eye type screen, rotate the knob to select the material/velocity table, indicated by a solid black border. There are two material/velocity tables on the screen. You should select the one to the right of the patient’s eye that you are customizin...

  • Page 185

    169 customizing eye types accutome a-scan plus user’s guide customize eye type screen figure 7-3 os materials table activated within the vc material cell, rotate the knob to select one of the pre-entered materials as shown in figure 7-4 on the next page. You can also press the button beneath the sel...

  • Page 186

    170 accutome a-scan plus user’s guide figure 7-4 changing vc material press the knob or the √ button, to save the selected vc material and to deactivate the field. Notice that they eye type name in figure 7-5 on the next page is now followed by an * indicating that is a custom eye type. 7..

  • Page 187

    171 customizing eye types accutome a-scan plus user’s guide how customize an eye type figure 7-5 vc material cell changed within the os material/velocity table, rotate the knob to select the vc velocity cell. The velocity may need to be changed to correlate to the change in material. Within the vc v...

  • Page 188

    172 accutome a-scan plus user’s guide figure 7-6 changing velocity field all the custom changes to the patient eye type will be followed by an asterisk (*), as shown in figure 7-7 on the next page. Adjust any other eye type fields following the same procedures. When you have completed customizing th...

  • Page 189

    173 customizing eye types accutome a-scan plus user’s guide how customize an eye type figure 7-7 os eye type customized.

  • Page 190: Performing Calculations

    174 accutome a-scan plus user’s guide 8 performing calculations overview performing iol calculations with the accutome a-scan plus can be as simple as pressing the calculate button. There are numerous features available to enhance the calculation process. The accutome a-scan plus instantly calculate...

  • Page 191

    175 performing calculations accutome a-scan plus user’s guide figure 8-1 calculate button calculate button calculate iol screen.

  • Page 192: Calculate Iol Screen

    176 accutome a-scan plus user’s guide calculate iol screen the calculate iol screen shown in figure 8-2 below displays the average of the five measurements for the selected eye (if there are five measurements available), the calculation for the currently selected formula and the three lenses of the ...

  • Page 193

    177 performing calculations accutome a-scan plus user’s guide calculate iol screen selecting an iol group you may want to select lenses from a different group. To access one of the available iol groups, press the button beneath the “select iol group” selection. You can then scroll through the list o...

  • Page 194

    178 accutome a-scan plus user’s guide note: the acd field is only active if you are using the haigis formula. If you have selected another calculation formula, the field will not appear. Entered acd should be a phakic acd measurement. The acd can be estimated by entering “0”. Changing the axl value ...

  • Page 195

    179 performing calculations accutome a-scan plus user’s guide calculate iol screen entering an axl value you may not be satisfied with the average measurement of any of the five acquired measurements, or you may want to enter the axial length from a previous measurement. The accutome a-scan plus all...

  • Page 196

    180 accutome a-scan plus user’s guide keratometer data can be entered in mm as well as diopters. The ranges for these two units are mutually exclusive. Values less than 20 are assumed to be mm. Values 20 or greater as assumed to be diopters. Units are displayed with all entries. Diopter entries have...

  • Page 197

    181 performing calculations accutome a-scan plus user’s guide calculate iol screen entering the k1, k2 values to enter the target value: 1. Within the calculate iol screen, rotate the knob to select the “target” field, located in the middle right side of the screen. Selection is indicated by a solid...

  • Page 198

    182 accutome a-scan plus user’s guide figure 8-3 calculate iol screen - all fields entered formula compare feature the formula compare feature allows the comparison of all formulas for each calculation. When compare is on, it displays the closest matching iol power that will achieve the target refra...

  • Page 199

    183 performing calculations accutome a-scan plus user’s guide calculate iol screen figure 8-4 compare on selected switching between od/os to perform a calculation for the current patient’s other eye, press on the button beneath “od/os”. This button toggles between the two eyes and will display the r...

  • Page 200

    184 accutome a-scan plus user’s guide calculating iol power after corneal refractive surgery the accutome a-scan plus also provides the ability to calculate iols for patients who have had corneal refractive surgery. Corneal refractive surgery alters the characteristics and power of the cornea. Note:...

  • Page 201

    185 performing calculations accutome a-scan plus user’s guide calculate iol screen determining corneal power after refractive surgery the k value (corneal power or corneal curvature) for patients that have had corneal refractive surgery cannot be determined using common methods. Four k post formulas...

  • Page 202

    186 accutome a-scan plus user’s guide the kpost calculation methods are listed in order of preference, with the clinical history method widely accepted as the most accurate. The clinical history method is the default for new patients. For the refractions entered, the vertex of the refraction is stor...

  • Page 203

    187 performing calculations accutome a-scan plus user’s guide calculate iol screen when the rx surg field is set to yes, the k1/k2 fields are replaced with kpre and kpost and the kpost methods and associated fields appear in the middle, bottom of the screen. Please note: the kpre field is an average...

  • Page 204

    188 accutome a-scan plus user’s guide contact lens method the contact lens method requires you to enter the following fields: • kpre-the average k value before refractive surgery • current refraction in sphere and cylinder. • refraction with contact lens on in sphere and cylinder. • base curve (of t...

  • Page 205

    189 performing calculations accutome a-scan plus user’s guide calculate iol screen shammas clinical method the shammas clinical method requires you to enter the following fields: • kpre-the average k value before refractive surgery • k1 (measured)* • k2 (measured)* *measured - using a manual keratom...

  • Page 206

    190 accutome a-scan plus user’s guide calculation results after all fields have been entered, the calculate iol screen will display the power of the iol, for each lens with bold, large, black numbers. These values are the optimal powers for the specified target refraction, and do not necessarily exi...

  • Page 207: Setting Up Iol Groups

    191 setting up iol groups accutome a-scan plus user’s guide 9 setting up iol groups how are iol groups used iols can be grouped by type, manufacturer, physician, location, patient pathology, or other criteria. Iols are organized in groups of three. Each group can be given a custom name to distinguis...

  • Page 208

    192 accutome a-scan plus user’s guide figure 9-1 select iol groups iol calculation groups screen the iol groups screen as shown in figure 9-2 on the next page, displays a listing of all the iol groups and their associated lenses. The accutome a-scan plus has a capacity to store 15 groups. The left s...

  • Page 209

    193 setting up iol groups accutome a-scan plus user’s guide how to set up an iol group figure 9-2 iol groups screen entering iol group names to enter an iol group name: 1. In the iol groups screen, rotate the knob to select an empty group field (selection is indicated by a solid black border). You c...

  • Page 210

    194 accutome a-scan plus user’s guide figure 9-3 entering the iol group name entering the group’s lenses to enter an iol group’s lenses: 1. Select the lens table located to the right of the group field (selection is indicated by a solid black border). 2. Press the knob to activate the table, indicat...

  • Page 211

    195 setting up iol groups accutome a-scan plus user’s guide how to set up an iol group figure 9-4 entering the iol description note: this procedure uses the a-constant as the iol constant. You can enter the acd or sf as the first constant entered also. When entering a lens constant, the three consta...

  • Page 212

    196 accutome a-scan plus user’s guide figure 9-5 selecting the a-constant field enter the a-constant for the first lens you are entering. 7..

  • Page 213

    197 setting up iol groups accutome a-scan plus user’s guide how to set up an iol group figure 9-6 entering the iol constant press the knob to save the value and to deactivate the field. The accutome a-scan plus will then determine the corresponding iol constant for each formula and automatically fil...

  • Page 214

    198 accutome a-scan plus user’s guide figure 9-7 first lens entered for group 1 continue to enter all lens information for the iol group in the same manner. When you have completed the table, press the knob or the √ button once to save the last cell entered and then again to deactivate the table. If...

  • Page 215

    199 setting up iol groups accutome a-scan plus user’s guide how to set up an iol group figure 9-8 first iol group complete.

  • Page 216: Personalizing Lens

    200 accutome a-scan plus user’s guide 10 personalizing lens constants overview one of the great features of the accutome a-scan plus is the ability to personalize the lens constants used in calculating lens power. This ability to fine tune lens constants results in even greater success for patient o...

  • Page 217: How to Personalize Constants

    201 personalizing lens accutome a-scan plus user’s guide the process of personalizing iols consists of: • selecting iol groups and lenses • entering postoperative results • updating the iol constants how to personalize constants all personalization of iol constants takes place at the personalize iol...

  • Page 218

    202 accutome a-scan plus user’s guide in the iol groups screen press the button beneath the selection “personalize iols...”. The personalize iols screen will be displayed. 2. Figure 10-2 personalize iols screen personalize iols screen the personalize iols screen displays a group field at the top lef...

  • Page 219

    203 personalizing lens accutome a-scan plus user’s guide how to personalize constants personalize iols screen soft menus at the bottom of the personalize iols screen are the following soft menu selections: • next iol/group - selects the next iol in the current group and then scrolls through iol grou...

  • Page 220

    204 accutome a-scan plus user’s guide selecting iol group with the knob to select an iol group and iol: 1. In the personalize iols screen, rotate the knob to select the iol group field, indicated by a solid black border. You can also press the button beneath the selection ’next iol/group’ to select ...

  • Page 221

    205 personalizing lens accutome a-scan plus user’s guide how to personalize constants there are two ways to enter patient information: you can select and activate the postoperative results table, then select and activate each patient field and manually enter the information or you can use the soft m...

  • Page 222

    206 accutome a-scan plus user’s guide manually entering patient information 1. Rotate the knob to select the postoperative results table, indicated by a solid black border. 2. Press the knob or the √ button, to activate the postoperative results table. 3. Rotate the knob and select the patient field...

  • Page 223

    207 personalizing lens accutome a-scan plus user’s guide how to personalize constants entering remaining postoperative results after all patient calculation information has been either pasted or manually entered, select activate and enter the following fields. • power - power of iol implanted in dio...

  • Page 224

    208 accutome a-scan plus user’s guide deleting all postoperative results to delete all postoperative results for the current iol: 1. Press the button beneath the selection “delete all results”. 2. The accutome a-scan plus will then query you “are you sure?”. Press the button beneath the selection “y...

  • Page 225

    209 personalizing lens accutome a-scan plus user’s guide how to personalize constants to sort postoperative results by a field: within the personalize iols screen, rotate the knob to select a sort field, indicated by a solid black border. The a-scan will only select the current sort field. To select...

  • Page 226

    210 accutome a-scan plus user’s guide update iol constants screen figure 10-3 update iol constants screen the update iol constants screen (see figure 10-3 below) displays an iol group field in the upper left corner. Located to the right of the group field is a table displaying the selected iol group...

  • Page 227

    211 personalizing lens accutome a-scan plus user’s guide how to personalize constants selecting an iol group and lens just like on the personalize iols screen, there are two ways to select an iol group and lens in the update iol constants screen: you can use the knob and first select and activate th...

  • Page 228

    212 accutome a-scan plus user’s guide the update iols screen will display the formulas requiring constants to be updated, as soft menu selections in black text against a gray background. “update hol sf” in black text indicates that the surgeon factor (sf) for the holladay formula needs to be updated...

  • Page 229: Storing and

    213 storing and recalling records accutome a-scan plus user’s guide 11 storing and recalling records overview you can save a patient record at any time for later review or calculation. If you are away from your printer, you can save the current patient measurements and print the patient’s record at ...

  • Page 230

    214 accutome a-scan plus user’s guide figure 11-1 patient record screen press the button below “save to list”. The accutome a-scan plus will store the patient record and indicate record storage by changing the text beside the patient id that the record was stored. There will also be a line added to ...

  • Page 231

    215 storing and recalling records accutome a-scan plus user’s guide how to store a record figure 11-2 patient record stored how to recall a record you may need to recall a patient record at a later date to review a measurement, or execute a calculation. To recall a patient’s record: 1. Press the “pa...

  • Page 232

    216 accutome a-scan plus user’s guide figure 11-3 recalling a patient record press the measure or calculate button, located at the right side of the front panel. The a-scan will display the recalled patient record. 5. Note: the network must be activated in order to allow retrieval of a record from a...

  • Page 233

    217 storing and recalling records accutome a-scan plus user’s guide how to store a record figure 11-4 recalled patient record how to adjust parameters on saved records you can adjust any of the waveform parameters on a saved record in exactly the same manner as you would on an active waveform. To ad...

  • Page 234: How to Sort Patient Records

    218 accutome a-scan plus user’s guide how to sort patient records the accutome a-scan plus provides the ability to sort patient records by several fields: • patient • id or date of birth • date saved the sort fields are located above the patient records. To sort patient records by a field: 1. Within...

  • Page 235: Printing Records

    219 printing records accutome a-scan plus user’s guide 12 printing records how to print a record the accutome a-scan plus makes printing accessible and easy. Whenever you want to print a patient record, or patient measurements, you simply press the print button. The accutome a-scan plus will provide...

  • Page 236

    220 accutome a-scan plus user’s guide how to select the right printout format you should choose the print format according to your needs. For example, if you need to view each of the waveforms for an irregularity, you should print the measurement printout. If you need only the calculation informatio...

  • Page 237

    221 printing records accutome a-scan plus user’s guide how to print a record figure 12-2 calculation printout and patient record screen.

  • Page 238

    222 accutome a-scan plus user’s guide how to batch print the accutome a-scan plus also provides a batch print capability. During a batch print you can print multiple selected patient records using the iol calculation screen print format. As with direct printing, if the print to network link is enabl...

  • Page 239

    223 printing records accutome a-scan plus user’s guide using the button, located below “select location”, select the appropriate date storage location. This is done by pressing the select location button until the appropriate data storage location is selected. The locations are a-scan memory, usb di...

  • Page 240

    224 accutome a-scan plus user’s guide 6. 7. 8. 9. If you would like to select all patients, press the “select all” button for one second. Conversely, if you would like deselect patients already selected for batch print, hold the “select for batch print” button for one second. Continue to select all ...

  • Page 241

    225 printing records accutome a-scan plus user’s guide required printer the accutome a-scan plus will print to most hp printers currently manufactured. The system has over 200 of the most popular hp drives installed, including the popular desk jet pcl3, laser jet pc5, office jet and photo smart. If ...

  • Page 242: Maintenance

    Accutome a-scan plus user’s guide 13 maintenance general maintenance maintenance that should be performed on the accutome a-scan plus consists of activities such as keeping surfaces free of dust and dirt and storing in a dry and cool place so as to not adversely effect electronic parts. Care must be...

  • Page 243: Battery Disposal

    227 maintenance calibration of accutome a-scan plus the accutome a-scan plus unit is self calibrating and therefore requires no adjusting or further calibration by the user. Battery disposal follow the procedure outlined below for proper disposal of lithium batteries. Instructions for disposal 1. Gu...

  • Page 244

    Accutome a-scan plus user’s guide for further information on disposal of this product, please contact your local dealer or the manufacturer or its legal successor company. Please read the latest internet information provided by the manufacturer. Where the product or its components are resold, the se...

  • Page 245

    229 maintenance battery disposal following is a suggestion for battery recycler and collector in the us: toxco inc. 3200e frontera, anaheim, california 92806 contact person- david miller email- dmiller320@aol.Com tel- (714) 879 2076 fax (714) 441 0857 www.Toxco.Com.

  • Page 246: Specifications

    230 accutome a-scan plus user’s guide 14 specifications overview this section provides the physical and operational specifications of the accutome a-scan plus. Physical specifications table 14-1 below lists the physical specifications of the instrument and associated peripherals. Table 14-1 accutome...

  • Page 247

    231 specifications accutome a-scan plus user’s guide table 14-2 accutome a-scan plus physical specifications dc power 2.5mm dc coaxial probe (use only accutome pn 24-4001) frequency 10 mhz dimensions 4.32 cm (1.7”) long, 0.63 cm (0.25”) diameter cable length 1.5m (5 feet) accessories tonometer adapt...

  • Page 248

    232 accutome a-scan plus user’s guide table 14-3 environmental specifications temperature operating +10° c to +40° c storage -20° c to +60° c relative humidity operating 20% to 80% (non-condensing) storage 15% to 90% (non-condensing) atmospheric pressure operating 700 - 1060 hpa storage 500 - 1060 h...

  • Page 249: Operating Modes

    233 specifications accutome a-scan plus user’s guide environmental specification operating modes the following table summarizes the mode/application possibilities for each system/transducer combination: clinical application a b m ped cwd cd combined (specify) other (specify) ophthalmic fetal imaging...

  • Page 250: Formula References

    234 accutome a-scan plus user’s guide formula references table 14-6 below lists the references for the calculation formulas used in the accutome a-scan plus. Table 14-6 formula references hoffer q hoffer q formulas are implemented as defined in “the hoffer q formula: a comparison of theoretic and re...

  • Page 251: Storage/range Specifications

    235 specifications accutome a-scan plus user’s guide storage/range specifications table 14-7 below lists the data storage and range specifications of the accutome a-scan plus. Table 14-7 data specifications stored data capacity waveforms / patient 10 stored patients 100 iols 45 total; 15 groups of 3...

  • Page 252

    236 accutome a-scan plus user’s guide table 14-8 data specifications calculation field ranges target refraction range -20 to 20 d entered axl range 15 to 40 mm entered iol a-constant range 110.5 to 122.5 entered iol acd range 0.10 to 6.50 mm entered iol sf range -3.5 to 3.5 mm entered acd range 0.01...

  • Page 253: Acoustic Output

    237 specifications accutome a-scan plus user’s guide acoustic output acoustic output table 14-9 below provides the acoustic output reporting for the following: transducer model: accutome a-scan plus operating mode: a-scan application(s): ophthalmic table 14-9 acoustic output reporting table for trac...

  • Page 254: Emc Compliance Information

    238 accutome a-scan plus user’s guide table 14-10 acoustic output reporting table for track 1 non-autoscanning mode operating control conditions control 1 control 2 control 3 control 4 control 5 these values are based on measurements of production units. The “derated” intensity calculations are base...

  • Page 255

    239 specifications accutome a-scan plus user’s guide warning!! The use of accessories, transducers and cables other than those specified by the manufacturer may result in increased emissions or decreased immunity of the a-scan plus. Warning!! The a-scan plus should not be used adjacent to or stacked...

  • Page 256

    240 accutome a-scan plus user’s guide the a scan plus is intended for use in the electromagnetic environment specified below. The customer or the user of the a-scan plus should assure that it is used in such an environment. Emissions test compliance electromagnetic environment - guidance rf emission...

  • Page 257

    241 specifications accutome a-scan plus user’s guide emc compliance information electrostatic dis-charge (esd)iec 61000-4-2 +/- 6kv contact +/- 8kv air +/- 6kv contact +/- 8kv air floors should be wood, con-crete or ceramic tile. If floors are covered with synthetic material, the relative humidity s...

  • Page 258

    242 accutome a-scan plus user’s guide table 14-13 guidance and manufacturer’s declaration - electromagnetic immunity the a scan plus is intended for use in the electromagnetic environment specified below. The customer or the user of the a-scan plus should assure that it is used in such an environmen...

  • Page 259

    243 specifications accutome a-scan plus user’s guide emc compliance information note 2: these guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects and people. *field strengths from fixed transmitters, such as base s...

  • Page 260

    244 accutome a-scan plus user’s guide table 14-14 recommended separation distances between portable and mobile rf communications equipment and the a-scan plus the a-scan plus is intended for use in an electromagnetic environment in which radiated rf disturbances are controlled. The customer or the u...

  • Page 261: Warranty and Repairs

    245 warranty and repair 15 warranty and repairs warranty accutome, inc. Warrants its new equipment to be free from defects in workmanship or materials. Any product that is proven to be defective will be repaired or replaced at our discretion, free of charge, up to one year from the date of purchase ...

  • Page 262: Product Returns

    246 accutome a-scan plus product returns follow the instructions given below to return products to accutome inc. Service and repair before returning instruments for service or repair, contact the accutome technical service group for a return goods authorization (rga) number. Toll free (in usa): 1-80...

  • Page 263: Replacement Parts

    247 warranty and repair replacement parts replacement parts table 15-1 below lists items that are available from accutome, inc. Or from your local sales representative. Please be sure to use the accutome part number for the item when placing an order. Table 15-1 accutome replacement parts descriptio...

  • Page 264

    248 accutome a-scan plus network addendum replacement parts the accutome a-scan plus has an active ethernet port that can be turned on to allow the system to connect to a shared folder within a secure class-c network domain. This shared folder must be located within the operating system. We support ...