Eye Doctor Arizona
Haag Streit Lenstar Eye Surgery Arizona

  Haag Streit LENSTAR®
Online Users Instruction Manual
 
IOL Power Calculations IOL Power Calculations
Optical Biometry Optical Biometry
Lens Constants IOL Master Lens Constants
Validation Guidelines
Haag Streit LENSTAR® Haag Streit Lenstar
LENSTAR User Manual V.i2 Haag Streit LENSTAR Online User Manual
Operation Haag Streit Lenstar
mesa-arizona/Data Management
Biometry
IOL Calculation
Imaging
Zeiss IOLMaster® Zeiss IOLMaster
SIA Calculator
Disclaimer
Physician Downloads SIA Calculator
Links
References
Special Thanks
 

Haag Streit LENSTAR® - Operation


Haag Streit Lenstar

IOL Calculation


Click on images to enlarge for better viewing.

EyeSuite IOL is made for intraocular lens power calculation based on biometric measurements taken by the LENSTAR LS 900 Biometer or third party devices. All implemented formulas have been published in peer-reviewed publications and are known as the Haigis, the Holladay I, the Hoffer Q, the SRK/T and the SRK II formulas. Please read the respective publications for more details on the formula used to calculate the power of an IOL.

IOL Data Set

The backbone of the calculation software is the IOL data set. To perform any IOL power calculation, available power ranges, increments, and calculation constants have to be provided for each formula type and lens model. As the calculation constants not only depend on the IOL and the formula itself, but as well on the measurement technology used and the surgical technique. It is strongly recommended that the user optimizes the IOL constants to his clinical practice and the device type used for the biometry measurements.

Set up as a single user system, EyeSuite IOL allows you to enter, import, change, export and delete IOL data. To protect your data from accidental change by an other user, you may protect your system by setting up the multi-user mode, where only "Expert" and "Administrator" users have the permission to manipulate your data.

IOL Data Management

EyeSuite IOL manages all IOL data in the "IOL Editor". The editor is always accessible through the menu entry IOL -> IOL Editor or if you are in the IOL software, over the IOL Editor icon in the tool bar:
  Haag Streit Lenstar

IOL Calculation Editor Overview Haag Streit Lenstar

The IOL editor shows on the left side a tree of all IOLs available. The right hand side is split into three tabs or register cards: The "Manufacturer data" register is the place to define the manufacturer and model name, as well as the available power ranges and increments. The "Calculation" register allows you to enter the IOL calculation constants for the different formulas. Under "Properties" the user may define customized properties of a lens as needed.

For guidance you can find a box on the bottom of each card. This box will guide you through the entry process. Whenever an entry field turns red, you will find advice how to solve the problem.

New data entered, changes and imports are only saved after the OK button has been pressed. If you want to discard you changes, just press the "Cancel" Button.

Entering / Editing new IOL Data


To create a new IOL simply click on the IOL Calculation Plus Button Haag Streit Lenstar on the top left of the IOL screen.

Manufacturer Data Tab

Start by entering the manufacturer's name in the respective entry field. An auto complete function is going to support you. Then enter the IOL model name in the respective entry field, remember that a manufacturer - model has to be unique. Normally if the model field turn red, the lens is already in the database.

The next step is to define the available power ranges for the IOL. Click on the IOL Calculation  Plus Button Haag Streit Lenstar on the right hand side of the entry field to define a first power range and power increment step size for this IOL.

IOL Calculation  Editor Manufacturer Data Haag Streit Lenstar

EyeSuite will create a default power range from -10 to +40 diopters. and a increment step size of 0.5 diopters. It is possible to define multiple power ranges with different increment step sizes to reflect the true manufacturing availability of the IOL. The names given for the different power ranges may be given as free text by the user.

Calculation Tab

Entering Basic IOL Constants for All Users

In the calculation tab, the IOL constant for the different IOL calculation formula have to be entered. If the constants for all formulas provided by EyeSuite IOL are known it is easiest to click 6x on the Haag Streit Lenstar button on the right side of the entry field for the IOL constants. This way a table for all IOL constants is created.

If only some of the formulae are used simply click once on the Haag Streit Lenstar button and select the IOL constant to be entered form the pull down list provided.

IOL Calculation  New Haag Streit Lenstar

IOL constants entered are accepted in the following ranges:

IOL constant Allowed range Used in
Manufacturer A +100 ... +132 not used in any calculation
Haigis A0, A1 and A2 -10 ... +10 Haigis formula
Hoffer Q pACD -6 ... +20 Hoffer Q formula
Holladay SF -10 ... +20 Holladay I formula
SRK/T A +100 ... +132 SRK/T formula
SRK II A +100 ... +132 SRK II formula

For security purposes, if you enter a formula outside of these ranges, the entry field turns red and you will find the range to be entered in the guidance box.

Optical and Ultrasound Optimized IOL Constants

Every constant entered may be assigned either for optical biometry data (data directly acquired with the LENSTAR LS 900) or acoustical (e.g. axial length has been measured by contact ultrasound because of a dens cataract, and therefore the constant for optical biometry is not valid). Whenever the user manually enters an axial length in the IOL calculation section, the respective selection is going to be available beside the axial length measurement just entered. For calculations based on pure LENSTAR measurements, EyeSuite uses the constants marked as optical.

IOL Calculation  Ultrasound New Haag Streit Lenstar

Power Dependent IOL Constants

It is possible to define multiple constants for different power ranges in which a lens is available. An example is the ALCON MA60MA lens. The User Group for Laser Interference Biometry defines for this lens two sets of IOL constants, one for plus and one for minus power lenses of this particular type. EyeSuite allows the user to represent this in a single lens entry in the IOL database as shown in the sample screen-shot below.

IOL Calculation MA60MA Alcon Haag Streit Lenstar

Personalized IOL Constants

In multi-user mode it is possible to create personalized IOL constants. To do so, the user has to be logged-in as the user the personalization should be done for. In the Calculation tab not only a IOL Calculation Plus Button Haag Streit Lenstar and a IOL Calculation Minus Button button are available but also a IOL Calculation Personalization Button Haag Streit Lenstar personalization button. If the user clicks on the respective button an additional tab is displayed and all constants selected in the calculation tab are copied to the newly displayed Personal Calculation tab and might be customized to become the surgeon's personal constants. The "all users" constants are not affected by this change. Whenever the respective user is selected in the IOL calculation, only his personalized constants are going to be used where available.

IOL Calculation Editor Personalized Haag Streit Lenstar

For power values where no personalized constants available EyeSuite uses the all user's constants. For example, it would be possible to personalize constants in the range from 20.0 to 60.0. If the IOL power falls in this range, the personal constants are used, otherwise the all user's constants are considered. If a user prefers to not use a certain formula in a specific range, he may personalize the constant for this range and assign it an empty value (-). It this case, it will not be possible to calculate the IOL for this range.

Editing IOL Constants

All IOL constants may be edited at any time. To do so, simply select the IOL to be changed and change the constants in the Calculation tab. Save the changes by clicking on the OK button. Clicking on Cancel is going to discard any changes made.

Whenever an IOL constant has been changed EyeSuite increases the version count by one.

IOL Calculation Editor Edit Haag Streit Lenstar

EyeSuite always uses the latest revision of an IOL for the calculations. The revision tab allows the user to go back to an earlier revision of an IOL at any time. Simply select the desired revision and click on "go back to this revision". The Revision number is going to be increased by one but the IOL constants of the selected previous revision are going to be stored and used again form now on.

IOL Calculation Go Back Editor Haag Streit Lenstar

The same procedure applies for personalized IOL constants. The user who wants to edit his personalized IOL constant has to be logged-in. Change the constants in the tab "Personal Calculation" and store the changes by clicking on OK.

Properties Tab

The properties tab is purely user defined data, to an IOL entered. E.g. a user would like to enter the implantation cartridge used. Date entered is identified by a user defined Name and a value. If any name has been entered in an IOL before it becomes available for the pull down list after the IOL Calculation Plus Button Haag Streit Lenstar has been entered. Whenever a new name is entered the user has to define the property of the value of the respective name, either text or number. This done in a dialog displayed whenever a new name is entered.

IOL Calculation Editor Properties Haag Streit Lenstar

IOL Data Import / Export

EyeSuite allows importing IOL Data in three different formats: The .IOT format also supported by elder versions of EyeSuite, the new EyeSuite proprietary .IOL format, the .MDB and ZIP format of the Zeiss IOL Master.

Export is only in IOL format a proprietary xml format of EyeSuite IOL.

Importing IOL Data

To import IOL data click on the import IOL Calculation Import Button Haag Streit Lenstar button on the top left of the IOL editor window. A standard open file dialog is going to open. Select the desired IOL file to be imported and click on OK. Abort the action by clicking on Cancel. If IOL Data form the Zeiss MDB format is imported, then EyeSuite defines for all IOL imported form this database a available power range of -10 to 40 diopters.

IOL Calculation Editor Import Haag Streit Lenstar

All imported IOL data is available for every user. It is not possible to import personalized IOL constants at the moment.

If an IOL already exists while importing form a file, then the user is asked what EyeSuite should do with the respective IOL data. If the user chooses to overwrite, then EyeSuite creates a new revision of the respective IOL. If the user chooses "Cancel", then the respective IOL is not imported. At he end of the import, EyeSuite informs the user in a summary dialog about the success of the import. Every new or changed IOL is marked with a star until the IOL Editor is closed and the imported data is persisted.

Exporting IOL Data

To export IOL data select the IOLs to be exported and click on the export IOL Calculation Export Button Haag Streit Lenstar button. The selected IOL, including the personalized data are exported in .IOL format to a location selected in a standard save dialog. Even tough personalized IOL data is stored in the export it is currently not available for import into EyeSuite IOL.

IOL Calculation Editor Export Haag Streit Lenstar

Use the "Shift" and "CTRL" keys for multiple selection as used by any other Windows application. Select individual IOL form a single or multiple manufacturers or if all IOL form a particular manufacturer should be exported simply select the respective manufacturer form the list.

IOL Calculation

EyeSuite IOL allows the user to perform IOL calculations based on measurements of LENSTAR LS 900 optical biometer or on manual entry. To perform an IOL calculation a patient has to be selected or created.

If the selected patient has got LENSTAR LS 900 biometry measurements in his examination list, then EyeSuite selects the most recent biometry measurement to perform the IOL calculation on if the user did not select any biometry measurement.

If the selected patient has not got any LENSTAR LS 900 biometry measurement, then EyeSuite open the IOL calculation with blank entry fields to manually enter measurement data needed for the IOL calculation.

Measurement Data Screen

The display mode of the IOL "Measurement Data" screen can be switched between "Standard", "US", and "Simple". The default display may be chosen by clicking on the pin IOL Calculation Pin Button Haag Streit Lenstar while the respective display mode is active. The name of the display mode is now marked with an asterisk and he next time the IOL calculation is opened it will show the respective display mode.

The "Measurement Data" screen allows the selection of any biometry measurement available for a patient. Opening the locks IOL Calculation Lock Button Haag Streit Lenstar just left of the selection boxes for the biometry data allows the combination of measurement data of different measurement sessions. If measurements of different session are combined, then EyeSuite marks matching measurement sessions with matching background colors in the session date field in the "Measurement Data" screen.

If any of the data of a biometry measurement is changed, the session information of the respective data set is going to change to "Manual entry".

IOL Calculation Meaurement Standard Haag Streit Lenstar

Standard displays:

Axial length (AL)

Central corneal thickness (CCT)

Aqueous depth (AD)

Lens thickness (LT)

Flat meridian and the respective axis position (R1 / K1)

Steep meridian and the respective axis position (R2 / K2)

Average corneal curvature or power (R / K)

Index of refraction of the cornea (n)

The display mode for the corneal curvature may be changed on the fly by clicking on the respective radio button.

IOL Calculation Measurement USA Haag Streit Lenstar

US displays

Axial length (AL)

Central corneal thickness (CCT)

Anterior chamber depth (ACD)

Lens thickness (LT)

Flat meridian and the respective axis position (R1 / K1)

Steep meridian and the respective axis position (R2 / K2)

Average corneal curvature or power (R / K)

Index of refraction of the cornea (n)

The display mode for the corneal curvature may be changed on the fly by clicking on the respective radio button.

IOL Calculation Measurement Simple Haag Streit Lenstar

Simple displays

Axial length (AL)

Anterior chamber depth (ACD)

Average corneal curvature (R)

Average corneal power (D)

Index of refraction of the cornea (n)

The Surgeon selection box displayed in the above sample screen shots is only available if EyeSuite is used in multi-user mode. It allows selecting an operating surgeon and gives access to the selected surgeon's personalized IOL constants and private IOL calculation templates if available. The default selection is General and provides access to all non personalized IOL Constants and all public IOL calculation templates.

Calculation Screen

The calculation screen allows the user to perform IOL calculations and to create, edit and delete IOL calculation templates.

IOL Calculation Blank Haag Streit Lenstar

The calculation screen shows the IOL calculations as well as all biometrical measurements on the bottom.

Perform IOL Calculation

To perform an IOL Calculation, IOL/formula combinations have to be added to the blank screen use the large plus button to add an IOL/formula combination box to the left or right eye. Select the desired target refraction for the IOL calculation at the top if the "Calculation" screen. Depending on your settings, default target refraction might be defined globally or stored in IOL calculation template.

IOL Calculation Plus Button Haag Streit Lenstar creates a new IOL/formula combination box.

In the calculation box any combination of an IOL and a calculation formula might be selected. It is possible to add as many IOL/formula combination boxes per eye and calculation as the user would like to have. On a printout a maximum of 6 boxes per eye and page are printed. If the IOL calculation includes more than 6 IOL/formula combinations then EyeSuite simply prints more than one result page.

In multi-user mode EyeSuite supports the use of personalized IOL constants. If there are personalized IOL constants available for a user that has been selected in the "Surgeon" field in the "Measurement Data" screen, then those are used and not the general ones. Personalized IOL constants are marked in the IOL/formula combination box by a small surgeon IOL Calculation Surgeon Sign Haag Streit Lenstar sign on the left of the IOL constants displayed in the IOL/formula combination box on the bottom.

IOL Calculation Formula Box Haag Streit Lenstar

To remove an IOL/formula combination box form an IOL calculation, simply click on the close IOL Calculation Close Button Haag Streit Lenstar button.

IOL calculations may be stored using the save IOL Calculation Save Button Haag Streit Lenstar button or directly printed using the print IOL Calculation Print Button Haag Streit Lenstar button. Whenever an IOL calculation is printed directly it is also automatically saved. Whenever a calculation is saved or printed, EyeSuite shows the respective result in an overview similar to the print out the user will get.

IOL Calculation Result Haag Streit Lenstar

Create / Edit and Delete IOL Calculation Template

Any IOL calculation might be stored as a template to be used with other patients to perform the IOL calculation. To create an IOL calculation template, the user has to set up an IOL calculation as in the section "Perform an IOL calculation".

IOL Calculation Created Haag Streit Lenstar

To save a IOL calculation as a template click on the small plus IOL Calculation Plus Button Template Haag Streit Lenstar button. The save dialog displayed below is going to be displayed.

IOL Calculation Template Dialogue Haag Streit Lenstar

The user may now either enter a name in the section where it currently says "unsaved" or the user selects an already existing template name to overwrite the existing template with the new IOL calculation just created.

The radio buttons "Scope" are only active when EyeSuite is used in multi-user mode and the user is logged in with either "Expert" or "Administrator" rights. If a template is selected to be "Public" it is going to be available for all users. If a template is selected to be "Personal" it is stored for the currently logged in user and will only available if the respective user has been chosen in the "Surgeon" field in the "Measurement Data" screen or if the respective user is logged in and performs the calculation personally.

To delete an IOL template, simply select the respective template and click on the small minus IOL Calculation Minus Button Haag Streit Lenstar right of the template name selected. A dialog is going to ask if the IOL calculation template selected really should be deleted or not.

The default IOL template may be selected by clicking on the pin IOL Calculation Pin Button Haag Streit Lenstar. The selected default template is now marked with an asterisk. In multi-user mode of EyeSuite the default is stored with the users preferences and may vary form user to user.

Preference Settings

The parameters for IOL calculation can be adjusted using the Tools -> Preferences menu item.

Calculation Printout

IOL Calculation Printout Haag Streit Lenstar

This function lets you adjust the content of the printout. It allows to add additional information to the IOL print out. Please consider that the number of IOL/formula combinations printable on a single page is up to six, but might go down to four per page if all options are selected.

Possible Options:

Print Anterior Chamber Depth (ACD)
This option adds the ACD to the printed measurement data on the IOL calculation.

Print IOL Manufacturer
This option adds the IOL Manufacturer under the IOL type in the printout.

Print theoretical lens power for target refraction
This option adds the theoretical lens power for the selected target refraction of the patient under the IOL calculation.

Print theoretical lens power for emmetropia
This option adds the theoretical lens power for the patient at emmetropia under the IOL calculation.

Print IOL properties page
This option adds a page at the end with all properties information of the IOLs used.

Printouts

This screen allows the user to create manual and automatic print jobs for the IOL extension of EyeSuite

IOL Calculation Printout Settings Haag Streit Lenstar

Activation - Sets the mode of the print job.

Automatic
The selected / defined print outs are generated whenever a new measurement is acquired or the user changes anything on an existing measurement.

Manual
The selected / defined print outs are only created if the print job button IOL Calculation Print Job Button Haag Streit Lenstar is pressed within EyeSuite. The user may also create his own print job icon.

Disabled
Print job is not active.

Toolbar
Allows the user to name the print job and create a user defined print job icon. Click on the IOL Calculation Print Job Button Haag Streit Lenstar to select the desired graphics (only PNG format accepted) to be fit on the print button displayed in EyeSuite. Please keep in mind that the print button is a small button (28x28 Pixel) when selecting a graphics.

Output and Naming

Printer
Select any installed Windows printer or the EyeSuite internal PDF generator or the EyeSuite internal Image Printer. The image printer generates a jpg image of the selected printouts.

Filename
Is only active in the EyeSuite internal PDF generator or Image Printer has been selected. If no filename is defined, then they are created by EyeSuite as follows:

Selected printout AutomaticallyGeneratedFilenameExtension.xxx
Calculation Printout ID_NAME_FIRSTNAME_TIMESTAMPSTD_IOL.xxx

e.g.: 205_Zoss_Christian_2010_11_23_16_24_13_IOL.pdf

Please note the Extension is added to any file name, also user defined ones, to identify the print created.

The above mentioned file names are used as a post fix to any user defined file name. The user may define a fixed or a dynamic file name. A fixed file name is a simple text entered in the file name input field. A dynamic file name is built out of Patient and Examination details, using the Haag-Streit script language. The following script language tags may be used to create a file name, every tag has be be used in {} (e.g. {NAME} will return the patient's name) to be recognized by the system:

TAG Description
ID Patient ID
NAME Patient family name
FIRSTNAME Patient first name
BIRTHDAY Patient birthday in system format
BIRTHDAYSTD Patient birthday in standard format yyyy.mm.dd (for file names, "." and "spaces" are replaced by "_")
BIRTHDAYYEAR Patient birthday's year in the format yyyy
BIRTHDAYSHORTYEAR Patient birthday's year in the format yy
BIRTHDAYMONTH Patient birthday's month in the format mm
BIRTHDAYDAY Patient birthday's day in the format dd
TIMESTAMP Returns information when the exam was taken in the system format (dependant on the local settings of your PC operating system)
TIMESTAMPSTD Returns information when the exam was taken in standard format yyyy.mm.dd HH:mm:ss (for file names, "." ":" and "spaces" are replaced by "_"
YEAR Returns the year the exam was taken in the format YYYY
SHORTYEAR Returns the year the exam was taken in the format YY
MONTH Returns the month the exam was taken in the format MM
DAY Returns the day the exam was taken in the format DD
HOUR Returns the hour the exam was taken
MINUTE Returns the minute the exam was taken
SECOND Returns the second the exam was taken

Folder
Is only active in the EyeSuite internal PDF generator or Image Printer has been selected. Please select where EyeSuite should store the PDF or JPG of the printout. Use the IOL Calculation Browse Button Haag Streit Lenstar to browse through the directory structure of your PC or to create a new output folder

Printouts
Allows the user to select what printouts are generated either automatically or manually by pressing on the generated print icon. Available are all print outs of the IOL extension of EyeSuite.

Exports

This screen allows the user to create manual and automatic export jobs for the IOL extension of EyeSuite. All measurement results may be exported in several formats to be used by EMR systems, third party IOL calculations programs, for incremental backup and more...

IOL Calculation Export Settings Haag Streit Lenstar

Activation - Sets the mode of the export.

Automatic
The selected / defined export is generated whenever a new IOL calculation is saved or printed.

Manual
The selected / defined export is only created if the export button IOL Calculation Export Settings Job Button Haag Streit Lenstar is pressed within EyeSuite. The user may also create his own export icon (as you can see form the screen shot above).

Disabled
Export is not active.

Toolbar
Allows the user to name the export and create a user defined export icon.
Click on the IOL Calculation Settings Export Job Button Haag Streit Lenstar to select the desired graphics (only PNG format accepted) to be fit on the export button displayed in EyeSuite. Please keep in mind that the export button is a small button (28x28 Pixel) when selecting a graphics.

Export file

Format
Allows the user to select a file format for the export file, the available options are as follows

EyeSuite Template Exporter
Creates a user defined Export file based on a template created in script language by the user

EyeSuite ESX
Creates an export the measurements in EyeSuite exchange format, a proprietary data exchange format of all Haag-Streit EyeSuite applications (XML based, see section 11 EyeSuite Handbook for details).

No Export, only executable
Allows calling an other application form within EyeSuite Biometry without the creation of export data.

EyeSuite IOL Export File
Creates an EyeSuite proprietary export format of the IOL calculation. This file might be re-imported to EyeSuite any time.

EyeSuite GDT Output
Creates a GDT examination result file. The GDT file created only contains patient information and information that a Biometry measurement has been taken and when. No measurement date is currently included as this has not been specified yet in the GDT norm.

Template
This field is only active if EyeSuite Template Exporter has been selected in the Format field. The user has to select a template for the export desired. Click on the IOL Calculation Settings Browse Button Haag Streit Lenstar button to browse for a template created by the user.

Filename
This field is only active if EyeSuite Template Exporter, EyeSuite ESX or System Interconnect Export has been selected. The file name may be created as described in section Printouts. If no file name is specified, then EyeSuite creates the file.

Options
Options available depend on the format selected, click on the check box to select an option available.

Invoke External Application

This section allows the user to call a third party application directly form within EyeSuite.

Executable
Select the executable file to be called form within eye suite when this particular export is chosen. Use the IOL Calculation Settings Browse Button Haag Streit Lenstar button to browse for a executable file.

Working folder
Specify the working folder the executable file is called in. Usually it is the same folder the executable file is stored in. Use the IOL Calculation Browse Button Settings Haag Streit Lenstar button to browse for a folder.

Calculation

IOL Calculation Settings Haag Streit Lenstar

This screen allows you to set global calculation and display option for the IOL calculation:

Target Refraction

Default Target Refraction
Sets a default target refraction to be used when the calculation panel is activated for the first time in a session. May only be set if target refractions are not saved to the templates.

Save target refraction to template
If this option is selected, an own target refraction is saved with each template. Whenever another template is selected, the target refraction of that template will be used. If this option is deselected, the target refraction does not change when switching templates.

Details

Show Eye Summary
Displays the biometry of the eye as a summary at the bottom of the IOL calculation screen

Show theoretical lens power for target refraction
Displays the theoretical lens power for the selected target refraction of the patient under the IOL calculation.

Shoe theoretical lens power for emmetropia
Displays the theoretical lens power for the patient at emmetropia under the IOL calculation.

Calculation Formulas

Allows you to select what formula should be available for IOL calculation. If no formula is selected all are available.

Measurement Data

IOL Calculation Settings Measurement Haag Streit Lenstar

This screen allows you to set the default settings for the index of refraction of the cornea and the display of the corneal curvature for manually entering measurement data if no biometry data is available for a patient.


LENSTAR Help
TOP

Haag Streit LENSTAR®

Optical Biometry

Intraocular Lens Power Calculations


East Valley Ophthalmology
5620 East Broadway Road
Mesa, Arizona 85206

Tel: +1-480-981-6111
FAX: +1-480-985-2426

Arizona's Top Eye Doctors - East Valley Ophthalmology provides this online information for educational and communication purposes only and it should not be construed as personal medical advice. Information published on this website is not intended to replace, supplant, or augment a consultation with an eye care professional regarding the viewer/user's own medical care. East Valley Ophthalmology's disclaims any and all liability for injury or other damages that could result from use of the information obtained from this site. Please read our full Terms, Privacy, Infringement

Eye Doctors for Mesa, Gilbert, Chandler, AZ and surrounding areas.

A few of our featured topics:


TOP

Copyright East Valley Ophthalmology. All rights reserved.