Enhancing the Patient Journey: Solutions for Confident Refractive Planning and Follow-up
Refractive surgery encompasses a range of surgical procedures designed to correct common vision problems, reducing or eliminating the need for glasses or contact lenses. Each procedure has its unique advantages, limitations, and suitability criteria, requiring refractive surgeons to tailor a solution for each individual patient’s specific vision needs and lifestyle.
The Heidelberg Engineering Ecosystem supports you in this selection process by providing you with precise, accurate, and comprehensive diagnostic data and monitoring capabilities, efficient data management, and outstanding image quality. These tools empower you to deliver the highest quality care to your patients on their refractive journey. Find out how refractive experts worldwide are leveraging these advanced tools and technologies to enhance the1 patient experience, increase diagnostic confidence, and improve patient outcomes.
Dynamic Visualization of all Parameters
The electronic medical record, HEYEX EMR enhances refractive workflows by managing and presenting all ophthalmic patient records in a flexible, intuitive interface. You can access medical records across multiple locations, streamline planning and documentation, and review comprehensive patient summaries at a glance. This high-quality, structured data supports limitless analytical possibilities, improving diagnostic accuracy and facilitating seamless clinical communication.
Dr. Hackl from Hanusch Hospital in Vienna highlights HEYEX EMR's transformative impact on their clinic’s workflow and the value of structured data.
Prof. Oliver Findl (left), Chairman of the Department of Ophthalmology at Hanusch Hospital (Vienna, Austria), and Dr. Christoph Hackl, Consultant Ophthalmologist and Clinical Project Lead for the HEYEX EMR implementation
“When a system like HEYEX EMR supports structured data, the possibilities to use the data are unlimited. Diagnoses and activities can be recorded in a semiautomated manner and sent to the billing system. But there are also much more complex use cases, for example the link between treatment procedures and visual acuity progression…and surgical outcomes.” Read the full story on how Hanusch Hospital in Vienna used HEYEX EMR to streamline their workflow.
Integrating HEYEX EMR and the HEYEX 2 image and data management platform into your clinic workflow allows for improved efficiency by centralizing patient information and making it accessible anywhere in the clinic. Images and data are immediately available on your desired device, viewing station, and in the patient record.
Visualising all relevant data and images from the refractive workup contributes to an optimal diagnostic workflow, facilitates confident decision-making, and assists you in effective treatment planning.
Patient Selection and Screening
Despite technological advances making most refractive procedures safe and effective, the success of refractive surgery relies heavily on meticulous patient selection and screening, especially for postoperative corneal ectasia risk. Improved diagnostics like Anterior Segment OCT, keratoconus screening tools, and corneal epithelial mapping enhance ectasia screening precision, leading to better patient selection and fewer postoperative issues.
ANTERION®, with the Cornea App, provides you with a comprehensive set of measurements, including posterior cornea surface, for the thorough evaluation of your patient’s cornea. All tomographic data is acquired with swept-source OCT technology and ray tracing, giving you precise measurements with high repeatability, supporting the diagnosis and monitoring of corneal diseases and enhancing surgical treatment planning.
The SCORE (Screening4 Corneal Objective Risk of Ectasia) Analyzer, developed by Dr Damien Gatinel and Alain Saad at the Rothschild Foundation in Paris, is a unique visualization and analysis tool that assists you in the evaluation of corneal ectasia.
Dr. Alain Saad, Rothschilds Foundation, Paris
“Until we developed SCORE, the subjective evaluations had been made by individual surgeons, which might differ from day to day on the same patient. There was no scientifically based objective evaluation. …with SCORE we have devised a measurement threshold of zero where normal, low-risk corneas register. A positive score value registers a cause for suspicion. Our senior and junior colleagues have welcomed this guidance, which removes ambiguity and provides a clear reference point for patients who should be assessed for an alternative refractive surgery option.”
Read about how “At Risk” corneas are more easily identified with SCORE here
Dr Alain Saad discusses why and how SCORE was developed, and how it can be used clinically with case examples in this recorded webinar (Video 1).
Given that SCORE is a relatively new algorithm for assessing corneal ectasia risk, comparing it to other established methods is of significant interest. In these two videos, Dr. Rohit Shetty (Video 2) discusses his work comparing ANTERION's SCORE Analyzer to an established method, while Dr. Robert Herber (Video 3) explores how the SCORE Analyzer can detect ectasia before any changes are observed in corneal topography.
Epithelial thickness mapping has become a valuable tool when screening for ectasia risk, as it enhances the ability to detect corneal abnormalities at an early stage. The ANTERION Epithelial Thickness Module brings together all the information you need to thoroughly assess the epithelium and stroma of your patient’s eyes. Precise epithelial thickness measurements based on high-resolution swept-source OCT imaging allow for diagnostic confidence and support effective treatment planning (Image 1). The parameters and maps offer support in ocular surface evaluation, an important consideration in refractive surgery planning.
Download the Journal Article Review: Heidelberg ANTERION Swept-Source OCT Corneal Epithelial Thickness Mapping: Repeatability and Agreement with Optovue Avanti here.
Image 1: Precise measurements support confident diagnostics
In a recent publication by Feng et al., the repeatability and agreement of epithelial thickness measurements in keratoconic corneas between6 ANTERION and two other OCT devices were investigated. The authors had this to say in the discussion section of the publication:
“We assume that 65 radial scans used by the Anterion versus the 12 radial scans used by the MS-39 and 8 radial scans used by the Avanti (both repeated five times for each meridian) as well as the Anterion’s eye-tracking ability, are the likely factors explaining the better repeatability with the Anterion. We hypothesize that the repeated, wider-spread radial scans used by both the MS-39 and Avanti do not compensate for the denser coverage of the Anterion.” Feng et al. Read the full publication, “Epithelial Thickness Mapping in Keratoconic Corneas: Repeatability and Agreement Between CSO MS-39, Heidelberg Anterion, and Optovue Avanti OCT Devices” here.
Confident Diagnostic and Treatment Decisions
With the wide range of refractive surgical procedures available, it’s crucial to review all relevant information to select the most appropriate treatment for your patient. The ANTERION Metrics App leverages the full power of swept-source OCT to assist you in visualizing the entire anterior chamber and quantitatively assess the relevant parameters (Image 2). High-resolution OCT images and precise anterior chamber data support you in treatment planning and can assist you in identifying complex ocular properties. Additionally, these high-quality images serve as visual aids during the informed consent process, helping to explain planned surgical procedures to your patients, enhancing their understanding and compliance.
Image 2: Detect and assess anterior chamber metrics automatically
In this Healio video interview, Dr. Mitchell W. Dul, OD (Video 4) explains how he uses the ANTERION Metrics App to show his patients their own eyes, helping them become more invested in their care.
A retinal examination prior to refractive surgery, especially in patients with higher grades of myopia, allows you to check for peripheral lesions. The exclusive SPECTRALIS® pan and tilt camera head facilitates fundus and OCT imaging, allowing you to assess the retina, both centrally and peripherally.
Integrating ANTERION, SPECTRALIS, and third-party images and reports into the HEYEX 2 Multimodality Viewer (MMV) provides a comprehensive overview by combining data and images from all devices. This consolidated information ensures you have all relevant diagnostic details to determine the most suitable refractive procedure for your patient.
Evaluation of Surgical Outcomes
Comprehensive corneal data from the ANTERION Cornea App enables you to evaluate surgical procedures and monitor change over time (Image 3). The Follow-Up View allows you to compare corneal tomography data from the initial visit to any subsequent follow-up visit, ensuring thorough assessment and tracking of corneal health.
Image 3: ANTERION allows for the monitoring of surgical procedures
Dr. Peter Vamosi, head of Peterfy Hospital and Saint Rokus Hospital one-day surgery unit, Hungary
“The ANTERION is a very useful tool for follow-up examinations. You often can’t see the position of the DMEK flap at the slit-lamp, but with this device, the correct position of the flap is straightforward. You can also see the delicate precipitates on the DMEK flap in case of a rare immunologic reaction.” Dr. Peter Vamosi, head of Peterfy Hospital and Saint Rokus Hospital one-day surgery unit, Hungary
The ANTERION Metrics App supports you in visualising the success of surgical procedures by comparing pre- and post-op images and measurements. Detailed anterior chamber information from high-resolution SS-OCT images helps you assess refractive cataract surgery outcomes, anterior and posterior chamber phakic lens implantation, DMEK procedures, and corneal inlay positioning, ensuring optimal patient care and satisfaction (Image 4).
Image 4: Eye with Implantable Collamer Lens (ICL), including manual measurement for lens vault.
The Heidelberg Engineering Ecosystem integrates seamlessly into your refractive practice, enhancing diagnostic precision and treatment planning. By leveraging these advanced tools and technologies, you can navigate the complexities of refractive planning more effectively, improving patient outcomes.
Delve deeper into how these solutions can transform your practice.
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