ZEISS QUATERA 700: First Impressions Paul G. URSELL, MD, UK Paul G. Ursell, MBBS, MD, FRCOphth (United Kingdom) discussed the ZEISS QUATERA 700 during his presentation and explained three primary benefits of the phacoemulsifier. “It’s called QUATERA because of the pump,” Dr. Ursell stated. The ZEISS patented QUATTRO Pump of the QUATERA 700 is a synchronized fluid exchange system that directly measure and simultaneously control both infusion and aspiration values in real-time. With constant fluid going in and out with four membranes (two pushing in fluid and two pushing out fluid), surgeons are able to control the amount of fluid very precisely. “The main thing this feature gives you is a very stable anterior chamber,” Dr. Ursell said. “If For doctors, neck and back pain have been a long-time occupational hazard, especially if one is trained to sit in an awkward position. With the ZEISS ARTEVO 800, surgeons can finally sit upright and relax, look at the screen, and perform surgery with ease. For patients, the visualization system operates at a significantly lower illumination so that they are much more cooperative. Finally, for trainees, there is a shorter learning curve. There is no limit to the number of fellows and trainees a surgeon can have on deck because they can use simple and cheap 3D glasses to look at the screen. They are able to see the depth of each step of surgery which is crucial in building their skills as surgeons. But are good machines and good hands enough for a smooth surgical process? Dr. Shetty states that we additionally need a seamless connection of machines and hands. The ZEISS EQ Workplace does just that. Workup such as biometry measurements, topography, 3D OCT data, and slit lamp imaging can be done, and all data can be wirelessly transferred to the EQ Workplace. The data can be easily accessed in one’s office or the operating room. Surgical planning can also be done easily with the EQ Workplace. Surgeons are able to personalize their experience by inputting what formulas and IOLs they typically use, how they they orient the IOL, what axis the IOL should be oriented, and where they want to create incisions. Furthermore, surgeons can personalize the IOL constant rather than using the default constant that comes with the IOL. In order to determine how efficient the EQ Workplace is, Dr. Shetty conducted a study to evaluate the efficiency in time and resource utilization using manual data transcription or the digital workflow solution. This study was conducted for cataract surgeries on monofocal non-toric IOLs. Dr. Shetty recorded time efficiency at various steps in the workflow: time for patient data entry, time for preoperative measurements (OCT, microscopy, etc.), time for calculating IOL power, time to operate, and finally, time for data verification. The results of Dr. Shetty’s study showed staggering differences between the digital workflow and the manual workflow. There was a 25% reduction in total workflow time with the digital workflow being superior to the manual workflow. There was a 56.9% reduction in time for total data entry, and there was a 26.4% reduction in total staff required for the surgical process. All results were statistically significant. “This is simply amazing,” Dr. Shetty said. And because fewer staff is required when the digital workflow is utilized, more patients can be served. In the scenario that the hospital already as an electronic medical record (EMR), time efficiency can also be seen when compared to using the digital workflow. Dr. Shetty was able to show a time savings of 7.5 minutes when using the EQ Workplace compared to using an EMR. Every 7.5 minutes saved during a procedure for 150 surgeries per day (the number of surgeries that typically occur at Dr. Shetty’s hospital) translates to a savings of 18.75 hours per day. Since a cataract surgery typically takes 5 minutes for Dr. Shetty, “we can do an extra 225 surgeries per day, 5,850 surgeries per month, and 70,200 surgeries per year. A small difference like this creates a very significant impact on your outcome.” Media placement sponsored by Carl Zeiss Meditec AG Not all products, services or offers are approved or offered in every market and approved labeling and instructions may vary from one country to another. The statements of the authors of this supplement reflect only their personal opinion and experience and do not necessarily reflect the opinion of Carl Zeiss Meditec AG or any institution with whom they are affiliated. Carl Zeiss Meditec AG has not necessarily access to clinical data backing the statements of the authors. The statements made by the authors may not yet been scientifically proven and may have to be proven and/or clarified in further clinical studies. Some information presented in this supplement may only be about the current state of clinical research and may not be part of the official product labeling and approved indications of the product. The authors alone are responsible for the content of this supplement and any potential resulting infringements resulting from, in particular, but not alone, copyright, trademark or other intellectual property right infringements as well as unfair competition claims. Carl Zeiss Meditec AG does not accept any responsibility or liability of its content. “Comparing marker and markerless systems, when you look at quality of vision, markerless systems are significantly better, especially if you’re implanting trifocal or extended depth of focus (EDOF) IOLs.” Naren SHETTY, MD you have a stable anterior chamber, you’re safe.” The fast sampling time of the volume of liquid that goes in and out provides this safety net. The second benefit of the ZEISS QUATERA 700 is giving the surgeon the choice of using either the vacuum (Venturi) or flow (peristaltic) mode. Having the choice means that surgeons are able to operate at their desired intraocular pressure (IOP) and aspiration values. What makes the QUATERA 700 stand out from other devices for Dr. Ursell, though, is the dual linear foot pedal control. “I’m in big favor of [the foot pedal],” he said. “What I find most difficult to deal with is post-occlusion surge. All machines struggle with this. The reason for that is the foot pedal.” Surgeons need to operate with high vacuum and high phaco, and “with normal foot pedal control, you can’t do that.” The dual linear foot pedal allows for surgeons to move up and down as well as sideways. The QUATERA 700 allows for many options, which one may not have with a traditional foot pedal. “You can have
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