A-Scan Plus

User’s Guide

24-4016 Rev B
Federal law restricts this device to sale by or on
the order of a physician.
FEDERAL COMMUNICATIONS COMMISSION (FCC)
UNINTENTIONAL EMITTER PER FCC PART 15
This device has been tested and found to comply with the limits for a
Class B digital device, pursuant to Part 15 of the FCC rules. These
limits are designed to provide reasonable protection against harmful
interference in an office installation. This equipment generates,
uses, and can radiate radio frequency energy and, if not installed and
used in accordance with the instructions in the user manual, may
cause harmful interference to radio or television reception. However,
there is no guarantee that interference will not occur in a particular
installation. If this equipment does cause interference to radio and
television reception, which can be determined by turning the
equipment off and on, the user is encouraged to try to correct the
interference by one or more of the following measures:

™ Reorient or relocate the receiving antenna

™ Increase the separation between the equipment and
receiver
™ Connect the equipment to an outlet on a different circuit
from that to which the receiver is connected
™ Consult Accutome Ultrasound, Inc or an experienced
radio/TV technician for help.
This device complies with Part 15 of the FCC Rules. Operation of
this product is subject to the following two conditions: (1) this device
may not cause harmful interference, and (2) this device must accept
any interference received, including interference that may cause
undesired operation.
CAUTION:
Changes or modifications not expressly approved by Accutome
Ultrasound, Inc. could void the FCC compliance and negate your
authority to operate the product.
Authorized Representative in Europe (for regulatory affairs only):
Emergo Europe
P.O. Box 18510
2502 EM The Hague
The Netherlands

Tel: (31) 70 345 8570

Fax: (31) 70 346 7299

0086
Contents

Introduction - - - - - - - - - - - - - - - - - 1
Accutome A-Scan Plus Overview - - - - - - - - - -1
Features - - - - - - - - - - - - - - - - - - - -2
Measurements - - - - - - - - - - - - - - - - 2
IOL Calculations - - - - - - - - - - - - - - - - 3
Components - - - - - - - - - - - - - - - - - 4
Optional Components - - - - - - - - - - - - 4
About This Manual - - - - - - - - - - - - - - - -5

Safety - - - - - - - - - - - - - - - - - - - - 7
Safety Information - - - - - - - - - - - - - - - -7
Safety Issues to Consider When Using the Accutome A-
Scan Plus - - - - - - - - - - - - - - - - - - 7
Indications for use - - - - - - - - - - - - - - - 7
Symbol Definitions for the Accutome - - - - - - - -8
Safety Precautions - - - - - - - - - - - - - - - -9
Sterilization- - - - - - - - - - - - - - - - - - 9
Disinfection and Cleaning - - - - - - - - - - - - 10
Electrical Hazard and Safety - - - - - - - - - 12
Avoiding Equipment Damage - - - - - - - - - 12

Getting Started - - - - - - - - - - - - - - - 13
Assembling the Accutome A-Scan Plus - - - - - - 13
What you need - - - - - - - - - - - - - - - - 13
Probe - - - - - - - - - - - - - - - - - - - 14
Printer - - - - - - - - - - - - - - - - - - - 14
Serial Link Port - - - - - - - - - - - - - - - 15
Foot Switch - - - - - - - - - - - - - - - - - 15
Keyboard - - - - - - - - - - - - - - - - - - 15
Power Supply - - - - - - - - - - - - - - - - 15

i
Accutome A-Scan Plus User’s Guide

Placing the Accutome A-Scan Plus - - - - - - - - 16

Quick-Close Kickstand - - - - - - - - - - - - 16
Mounting - - - - - - - - - - - - - - - - - - 18
Connecting the Components - - - - - - - - - - 18
Connecting the Printer - - - - - - - - - - - - 19
Connecting the Footswitch - - - - - - - - - - 19
Connecting the Keyboard - - - - - - - - - - - 20
Connecting the Serial Link - - - - - - - - - - 21
Connecting the Power - - - - - - - - - - - - 22
Connecting the Probe - - - - - - - - - - - - 23
Probe Setup - - - - - - - - - - - - - - - - - - 25
Accutome Probe with an Immersion Shell - - - - - 26
Accutome Probe with Goldman Tonometer Adapter - 27
Accutome Probe with Handle Extension - - - - - - 28
Basic Operation - - - - - - - - - - - - - - - - 30
How to Power On the Accutome A-Scan Plus - - - 30
How to Adjust the Contrast - - - - - - - - - - - 32
Using the Test Block - - - - - - - - - - - - - - 33
How to Start a New Patient - - - - - - - - - - - 34
How to Enter Text without a Keyboard - - - - - 38
Screen Keyboard Features - - - - - - - - - - - 39
Entering a Patient with the Screen Keyboard - - 40
How to Take a Measurement - - - - - - - - - - 41
How to Perform a Calculation - - - - - - - - - - 43
How to Print a Record - - - - - - - - - - - - - 47
How to Save Patient Records - - - - - - - - - - 48

How to Use the Buttons and Screens - - - - 51

Overview - - - - - - - - - - - - - - - - - - - 51
Accutome A-Scan Plus Buttons - - - - - - - - - - 52
Dedicated Buttons - - - - - - - - - - - - - - - 52
Measure Button - - - - - - - - - - - - - - - 53
Patient Record Button - - - - - - - - - - - - 53
Calculate - - - - - - - - - - - - - - - - - - 53
Preferences - - - - - - - - - - - - - - - - - 53
Print - - - - - - - - - - - - - - - - - - - - 54
Check or Affirmative (9) - - - - - - - - - - - 54
Negative or Delete (X) - - - - - - - - - - - - 54

ii
Contents

Soft Menu Buttons - - - - - - - - - - - - - - - 55

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

Preferences - - - - - - - - - - - - - - - - 65
Setting Up the Accutomre A-Scan Plus - - - - - - 65
How to Access Preferences - - - - - - - - - - - 66
Top Level of Preferences - - - - - - - - - - - - 67
How to Add a New Eye Type - - - - - - - - - - - 68
Adding a New Lens Material - - - - - - - - - - - 69

iii
Accutome A-Scan Plus User’s Guide

Assigning a Velocity to the New Lens Material - - 72

Adding the New Eye Type Information - - - - - 73
Eye Type Screen Menu Selections - - - - - - - - 80
Reset Field to Factory - - - - - - - - - - - - - 80
Reset All to Factory - - - - - - - - - - - - - - 83
More Settings - - - - - - - - - - - - - - - - - 85
Setup Screen Fields - - - - - - - - - - - - - - 85
Setup Screen Soft Menu - - - - - - - - - - - - 85
How to Set the Print Title - - - - - - - - - - - - 87
How to Set the Printer - - - - - - - - - - - - - 91
How to Set the Serial Link - - - - - - - - - - - 96
Text with Data Driver - - - - - - - - - - - - 96
How to Set the Serial Baud - - - - - - - - - - 102
How to Set Delete Confirm - - - - - - - - - - 106
How to Adjust the Contrast - - - - - - - - - - 110
How to Set the Default Patient Eye Type - - - - 114
How to Set the Default ID - - - - - - - - - - 118
How to Set the Default Gain - - - - - - - - - 122
How to Set the Target Refraction - - - - - - - 124
How to Set the K Index - - - - - - - - - - - 128
How to Set the IOL Step - - - - - - - - - - - 133
How to Adjust the Date and Time - - - - - - - 137
How to Set the Auto Mode - - - - - - - - - - 141
Sound On/Sound Off - - - - - - - - - - - - - 148
Restart On/Restart Off - - - - - - - - - - - - 148
Scr Save On/Scr Save Off - - - - - - - - - - 148
Save and Restore Factory Default Gates
and Threshold - - - - - - - - - - - - - - - 149
About This Unit - - - - - - - - - - - - - - - 150

Performing Measurements - - - - - - - - 151

Overview - - - - - - - - - - - - - - - - - - -151
Measure Screen - - - - - - - - - - - - - - - -152
Information Displayed on the Measure Screen - - 153
Soft Menu Selections - - - - - - - - - - - - 153
Starting a New Patient - - - - - - - - - - - - 154
How to Set the Eye Type - - - - - - - - - - - -155
Eye Types - - - - - - - - - - - - - - - - - 155

iv
Contents

Eye Type Materials and Velocities - - - - - - - 156

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

v
Accutome A-Scan Plus User’s Guide

Customizing Eye Types - - - - - - - - - - 187

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

vi
Contents

Clinical History Method - - - - - - - - - - - - 211

Clinical History Fields - - - - - - - - - - - 211
Contact Lens Method - - - - - - - - - - - - 212
Shammas Clinical Method- - - - - - - - - - 213
Calculation Results - - - - - - - - - - - - - 214
Switching Between OD/OS - - - - - - - - - - 214

Setting Up IOL Groups - - - - - - - - - - 215

How are IOL Groups Used - - - - - - - - - - - -215
How to Set Up an IOL Group - - - - - - - - - - -216
Accessing the IOL Groups Screen - - - - - - - 216
IOL Calculation Groups Screen - - - - - - - - 217
Entering IOL Group Names - - - - - - - - - - 218
Entering the Group’s Lenses - - - - - - - - - 219

Personalizing Lens Constants - - - - - - - 225

Overview - - - - - - - - - - - - - - - - - - -225
Personalizing Lens Constants - - - - - - - - - 225
How to Personalize Constants - - - - - - - - - -226
Accessing the Personalize IOLs Screen - - - - - 226
Personalize IOLs Screen - - - - - - - - - - - 228
Personalize IOLs Screen Soft Menus - - - - - 228
Selecting an IOL Group and Lens - - - - - - - 229
Next IOL/Group - - - - - - - - - - - - - - 229
Selecting IOL Group with the Knob - - - - - -230
Entering Postoperative Results - - - - - - - - 231
Pasting Patient Information - - - - - - - - - -232
Manually Entering Patient Information - - - - 233
Entering Remaining Postoperative Results- - - 234
Deleting Postoperative Results - - - - - - - - 234
Deleting Current Postoperative Result - - - - 234
Deleting All Postoperative Results - - - - - - 235
How to View Individual Results for a Formula - - 235
How to Sort Postoperative Results - - - - - - - 235
How to Update IOL Constants - - - - - - - - - 236
Update IOL Constants Screen - - - - - - - - 237
Selecting an IOL Group and Lens - - - - - - - 238

vii
Accutome A-Scan Plus User’s Guide

Storing and Recalling Records - - - - - - - 241

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

viii
List of Figures

Figure 1 Accutome A-Scan Plus - - - - - - - - - - - - - - - - - - - - - - - 1

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

ix
List of Figures

Figure 32 Accutome A-Scan Plus Screen Hierarchy - - - - - - - - - 58

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

x
Accutome A-Scan Plus User’s Guide

Figure 71 Selecting the Delete Confirm Value - - - - - - - - - - - - 108

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

xi
List of Figures

Figure 110 Measure Screen Displaying Current Settings - - - - - 152

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

xii
Accutome A-Scan Plus User’s Guide

Figure 145 IOL Groups Screen - - - - - - - - - - - - - - - - - - - - - - - 217

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

xiii
List of Figures

xiv
List of Tables

Table 1 Keyboard Shortcuts - - - - - - - - - - - - - - - - - - - - - - - - 63

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

xv
List of Tables

xvi
 Introduction

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

Figure 1 Accutome A-Scan Plus

1
Accutome A-Scan Plus User’s Guide

Features The Accutome A-scan Plus is designed for easy access

to all screens and functions.
The advanced User Input Knob provides unsurpassed
ease of use and the straightforward Graphical User
Interface guides you through every operation.
What you can’t see on the surface is also important.
Industry-leading signal acquisition and processing helps
you assure accurate measurements. Reliable design
and efficient manufacturing provide fiscal value.
Upgradeable software protects your investment. The
Accutome A-Scan Pluslets you accomplish even the
complex simply.
The A-Scan provides the following general features:
™ Large 7.5 inch high resolution LCD screen with
intuitive User Interface
™ Rotary User Input knob and dedicated tactile
buttons
™ External, universal input, worldwide power
supply
™ Desktop, slit lamp, or wall mountable
™ Provides a variety of printouts
™ 1.9" thick, portable

Measurements
The accuracy of the Accutome A-Scan Plus
measurement is provided by the following:
™ High-resolution, real-time waveform display
with up to 8X zoom pinpoints tissue
boundaries
™ High-speed digitalization acquires over 4000
points per waveform
™ Continuous display of Axial Length, ACD, Lens
Thickness, and Vitreous dimensions
™ Audible feedback of contact, signal quality, and
capture
™ Immersion mode yields improved accuracy -
Contact mode also supported
™ Automatically or Manually capture up to 5
waveforms for each eye

2
Introduction Features

™ Adjustable Gain, Time Gates, and Amplitude

Thresholds
™ Modify all waveform parameters using real-
time or frozen waveforms
™ On-the-Fly customization makes unique
patients a breeze
™ Predefined Eye Types and Velocities handle
most situations such as phakic, dense
cataract, 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,
special pathologies, or future trends
™ Highly sensitive 10MHz composite
Broadband™ probe features fixation
light and multiple mounting options

IOL Calculations
The Accutome A-Scan Plus is also a leader in IOL
Calculations and provides the following:
™ Modern formulas including Hoffer Q, Holladay,
SRK/T, and Haigis
™ Compare results of all formulas simultaneously
on a single screen for selected lenses
™ Instantly calculates emmetropic and targeted
ametropoic IOL powers for dozens of lenses,
viewed three at a time, using the average of
selected waveforms, a single waveform, or
manually entered data
™ Conveniently group lenses by favorite
designation such as surgeon, user, type,
manufacturer, etc.
™ Personalization of IOL Constants is easy and
straightforward, encouraging improved patient
outcomes
™ Maintains individual IOL Constants for each
formula. Clearly identifies which IOL constant
is used with the selected formula
™ IOL Calculation for Post Refractive Surgery
Patients

3
Accutome A-Scan Plus User’s Guide

Components
The components that are standard with each Accutome
instrument are:
™ Ultrasonic probe
™ Power Supply
™ Keyboard
™ Footswitch

Optional Components
There are also several optional components which
further simplify the use of the Accutome A-Scan:
™ External Printer
™ Prager Shell
™ Printer Cable
™ Serial Cable
™ Mounting Options

4
Introduction About This Manual

About This This manual is a guide for technicians and

Manual opthamologists who are experienced in ultrasonographic
biometric techniques.
This manual is organized as follows:
Section 2 Safety Summarizes safety
precautions, warnings,
symbols and terms.
Section 3 Getting Started Provides assembly
instructions, overview
of Accutome A-Scan
Plus basic operation.
Section 4 How to Use the Describes the
Accutome interface and how to
Buttons and use all the buttons and
Screens screens.
Section 5 Accutome Provides instructions
A-Scan on how to set up eye
Preferences types and system
operational functions.
Section 6 Performing Provides detailed
Measurements instructions on how to
perform A-Scan
measurements.
Section 7 Customizing Eye Describes how to
Types customize an eye type
for an individual
Patient.
Section 8 Performing Describes the steps
Calculations necessary to calculate
IOL Power.
Section 9 Setting Up IOL Describes how to set
Groups up groups of IOLs for
easy access.
Section 10 Personalizing Provides instructions
Lens Constants on why and how to
personalize lens
constants

5
Accutome A-Scan Plus User’s Guide

Section 11 Storing and Provides instructions

Recalling Patient on how to save and
Records recall patient records,
and make adjustments
to saved records.
Section 12 Printing Records Provides detailed
instructions on how to
print patient records
and the available
printout formats
Section 13 Maintenance Provides general
maintenance
instructions
Section 14 Specifications Provides Accutome
A-Scan physical and
operational
specifications
Section 15 Warranty and Describes Accutome
Repairs A-Scan warranty
information and repair
procedures.

Having read this manual you will be able to assemble the

Accutome A-Scan, take measurements, calculate IOL
power, customize IOL constants and eye types, and print
and save Patient records.

6
 Safety

Safety The section lists:

Information
™ 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 the Accutome A-

Scan Plus
The Accutome A-Scan Plus is non-invasive. The
ultrasonic biometry probe touches the surface of the
anesthetized cornea during the scanning process. The
probe must be cleaned before and after use.

Indications for use

This instrument is used for measuring the axial length,
anterior chamber depth and lens thickness of the eye. It
also is used for calculating the optical power of the IOL
to be implanted during cataract surgery.

7
Accutome A-Scan Plus User’s Guide

Symbol Statements, graphics and symbols listed below are used

Definitions for on components of the Accutome A-Scan Plus.
the Accutome Descriptions and meanings are listed to the right of the
symbols.

"Attention! Consult instruction manual."

Single phase alternating current

When pressed turns the power on and off.

Serial Link connector

Printer connector

Keyboard connector

Foot switch input connector

8
Safety Safety Precautions

Power connector
12V DC

Safety Precau- There are several areas in the use of the Accutome
tions A-Scan that require special attention, as they may pose
a safety threat.

Sterilization
Sterilization issues are confined to the A-Scan probe that
comes in contact with the patient’s eye. In order to
prevent the transmission of disease, OSHA and CDC
guidelines are referenced for proper control of
sterilization issues. These guidelines are frequently
updated so be sure to contact OSHA, CDC, or your local
disease control officer for the latest information and
sterilization techniques.
Infection control techniques that are compatible with the
Accutome A-Scan Plus probe include:

1. Immersion of the probe tip in an antibacterial solu-

tion, such as SporicidinTM or CidexTM

*Note: Please follow the manufacturer’s written protocol

when using any antibacterial solution.

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 keeping doses

9
Accutome A-Scan Plus User’s Guide

and test repetition As Low As Reasonably Achievable to

achieve the required diagnostic information.

Disinfection and Cleaning

The recommended disinfection technique is to clean the
probe membrane and tip assemblies with isopropyl
alcohol (and no other substance). It is imperative that
the alcohol be given time to evaporate before applying a
probe to the patient’s eye.

WARNING! DO NOT
AUTOCLAVE!

Disinfection issues are confined to the Accutome probe

that comes in contact with the patient’s eye. In order to
prevent the transmission of disease, refer to the OSHA
and CDC guidelines for proper control of disinfection.
These guidelines are frequently updated so be sure to
contact OSHA, CDC, or your local disease control for the
latest information and disinfection technique.

WARNING! DO NOT IMMERSE

THE PROBE’S
CABLE OR METAL
CONNECTOR.
ALLOW TO DRY
BEFORE USE.

10
Safety Safety Precautions

CAUTION: General indications for

use of the Accutome
probe include on external
structurally intact areas of
the eye globe and orbit
areas only.

11
Accutome A-Scan Plus User’s Guide

Electrical Hazard and Safety

The instrument, foot switch 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 electrical equipment or
frayed electrical cords. If repair or maintenance is being
performed on the Accutome, the equipment must be
turned off and the power cord disconnected.
Covers must not be removed except by qualified
personnel. To avoid injury, do not operate the Accutome
without protective covers.
The system is intended to operate from a power source
of 100 - 240 VAC, 50/60 Hz. Protective earth grounding
through the grounding connection in the power cords is
essential for safe system operations.
Use only hospital-grade power cords and the connectors
supplied with the Accutome A-Scan Plus. Also, be sure
the power cords and connectors are in good condition.
To comply with IEC 601-1, the device should be
connected to earth via the ground terminal located next
to the DC input connector. Upon request, a ground cable
can be provided; Accutome part number: 24-4045.

Avoiding Equipment Damage

Attach the Accutome A-Scan Plus only to medical grade
IEC-601-1 Medically Approved equipment.
The Accutome A-Scan Plus provides no explosion
protection from static discharge or arcing components.
Do not operate the instrument in the presence of
explosive gases such as flammable mixtures of
anesthetic and air, or nitrous oxide.
To prevent overheating, keep ventilation holes, located
on the back of the instrument, free from obstruction.

12
 Getting Started

Assembling The Accutome A-Scan Plus is designed to be used in

the Accutome multiple environments and can be rested on a surface,
A-Scan Plus mounted on a wall, or mounted on a pedestal, or
camera mount. The instrument requires little assembly.
All components, standard and optional, can be quickly
and easily connected.
The instrument is built with connectors for each
component that is part of the Accutome A-Scan Plus
environment. There is also a serial port used to transfer
data from the Accutome A-Scan Plus to a computer.

What you need

For a complete Accutome A-Scan environment you will
need the following:
™ Accutome A-Scan Plus instrument including
display
™ Ultrasonic Probe
™ Power Supply
™ Power Cord
™ Keyboard - optional from Accutome
™ Footswitch - optional from Accutome
™ Printer - optional
™ Printer Cable - optional from Accutome
™ Serial Cable - optional from Accutome, for
patient data download to computer

13
Accutome A-Scan Plus User’s Guide

Figure 2 Accutome A-Scan Plus Components

Probe
The probe provided with the Accutome A-Scan is an
essential component. No other probes should be used
with the instrument.

Printer
The Accutome A-Scan can be configured with either a
Laser Jet or Ink Jet printer. If using a Laser Jet printer,
an HP Laser is recommended, specifically any printer
that uses the HP PCL5 printer language. If using an Ink
Jet printer, an HP Ink Jet is recommended, specifically
any printer that uses the HP PCL3 printer language.
The Accutome A-Scan also provides generic text only
printing that is compatible with most printers. When you
print with the text only you will not be able to print graphic
items such as Patient waveforms.

14
Getting Started Assembling the Accutome A-Scan Plus

Serial Link Port

Another convenient feature of the Accutome A-Scan
Plus is the serial port that can be easily linked to a PC
(Personal Computer). The serial port makes it possible
to export patient and waveform data (in a text format) to
a Windows application that accepts generic text. You
can configure the baud rate for the serial port.

Foot Switch
The foot switch can be used to capture, review and
delete measurements.

Keyboard
The keyboard is not required for operation but provides
convenience for entering alphanumeric data and
performing shortcut operations.

Power Supply
The power supply provided with the Accutome A-Scan
Plus is a small, compact external unit with worldwide
power input capabilities.

15
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 provided with the instrument, or it can be
mounted on a wall, a pedestal, a camera mount, or a cell
phone mount.

Quick-Close Kickstand
The quick-close kickstand provided with the Accutome
A-Scan Plus provides an easy, stable base for the
instrument. To open the kickstand pull the kickstand
away from the bottom of the instrument. When opening
or closing the kickstand it is best to exert a small amount
of outward pressure on the inner sides of the kickstand.
Figure 3 below shows the kickstand in the closed
position and Figure 4 on page 17 shows the kickstand
opened.

Figure 3 Closed Kickstand

16
Getting Started Assembling the Accutome A-Scan Plus

Figure 4 Open Kickstand

17
Accutome A-Scan Plus User’s Guide

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
mounting.
In the center of the four holes is one larger hole. The
larger hole is designed to accept a camera tripod,
pedestal, or wall mount.

*Note: For more information on mounting the Accutome A-

Scan Plus and purchasing mounting hardware,
contact the Accutome Support Group

Figure 5 Accutome A-Scan Plus Mounted on a Pedestal

Connecting the Components

All of the connectors for the Accutome A-Scan Plus
components, except for the probe, are located on the
side, at the left of the instrument (facing the screen).

18
Getting Started Assembling the Accutome A-Scan Plus

Connecting the Printer

To install the printer:
1. Locate the printer connector, on the side, at the left
of the instrument (see Figure 6 on page 22).
2. Connect the printer cable from the printer to the
printer connector.
3. Set the printer driver according to the printer con-
nected (see "How to Set the Printer" on page 91 of
this manual).

WARNING! THE PRINTER IS

NOT HOT SWAPABLE
AND THE
INSTRUMENT AND
THE PRINTER
SHOULD BE
TURNED OFF WHEN
CONNECTING THE
PRINTER.

Connecting the Footswitch

To connect the footswitch:
1. Locate the footswitch connector, on the side, at the
left of the instrument (see Figure 6 on page 22).
2. Insert the connector of foot switch cable into the
foot switch connector.

19
Accutome A-Scan Plus User’s Guide

Connecting the Keyboard

To connect the keyboard:
1. Locate the keyboard connector, on the side, at the
left of the instrument (see Figure 6 on page 22).
2. The keyboard cable is keyed with a side that is flat.
3. Insert the connector of the keyboard cable, with
the flat side of the connector pointing to the back of
the instrument, into the keyboard connector.

WARNING! CONNECT THE

KEYBOARD ONLY
WHEN THE Accutome
A-Scan Plus IS
TURNED OFF.
DAMAGE TO THE
INSTRUMENT MAY
RESULT IF THE
POWER IS ON.

20
Getting Started Assembling the Accutome A-Scan Plus

Connecting the Serial Link

The settings required for the computer that will be
connected to the serial link port are as follows:
™ The baud rate can be set to 9600, 19200,
38400, 57600, or 115200.
™ The communication parameters are 1 start bit,
8 data bits, 1 stop bit, no parity, hardware flow
control
To utilize the serial link port, you must connect a serial
cable from the serial link connector to an empty serial
port on the PC. The cable required is required is a DB-9
Male to DB-9 Female Straight Through serial cable,
Accutome part number 24-4012. You must also
configure the serial link port in the Setup Screen. (Refer
to "How to Set the Serial Link" on page 96 of this
manual.)
1. Locate the serial port connector, on the side, at the
left of the instrument (see Figure 6 on page 22).
2. Insert the serial cable connector of the into the
serial link connector.

21
Accutome A-Scan Plus User’s Guide

Connecting the Power

There are two components to connect power to the
Accutome A-Scan Plus; there is a power supply which
regulates the voltage going to the instrument, and there
is a grounded power cable which connects from the
power supply to an outlet.
To connect the power:
1. Locate the grounded power cable and insert it into
the empty connector on the power supply.
2. Locate the power connector, on the side, at the left
of the instrument (see Figure 6 below).
3. Insert the power supply connector into the power
connector.

Serial Printer Keyboard

Link

Power
Foot
Switch

Figure 6 Component Connectors (Left Side of Instrument)

22
Getting Started Assembling the Accutome A-Scan Plus

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 Fig-
ure 7 below.)

Probe Connector

Figure 7 Probe Connector (Right Side of Instrument)

23
Accutome A-Scan Plus User’s Guide

2. The probe connector is keyed and has a red dot

indicating the key.
3. Insert the probe with the red dot facing the back of
the instrument. (Refer to Figure 8 below.)

Probe

Figure 8 Probe Connected

24
Getting Started Probe Setup

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:
™ With an immersion shell
™ Mounted into a Goldman Tonometer
™ With a probe handle extension

*Note: You cannot operate the Accutome A-Scan Plus

without the Accutome probe.

Probe Connector

Extension Handle Insertion Tool

Extension Handle

Goldman Tonometer
Adapter

Accutome Probe

Figure 9 Accutome Ultrasonic Probe Kit (PN 24-4001)

25
Accutome A-Scan Plus User’s Guide

Accutome Probe with an Immersion Shell

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 the probe and the bottom of the immersion
shell, as shown in Figure 11 below

Figure 10 Accutome Probe

Probe

Immersion Shell

5 - 14.5 mm

Shell Bottom

Figure 11 Probe Setup with Immersion Shell

26
Getting Started Probe Setup

Accutome Probe with Goldman Tonometer Adapter

The Accutome probe is designed to be used with an
Goldman Tonometer Adapter. When using the
Tonometer Adapter:
1. Slide the adapter over the end of the probe as
shown in Figure 12 below.
2. Mount the probe by inserting the Adapter into the
Goldman Tonometer.

Goldman Tonometer Adapter

Probe

Figure 12 Probe with Goldman Tonometer Adapter

27
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 13 below.
2. Slide the insertion tool into the handle extension
making sure that the probe cable runs through the
notched channel of the insertion tool.
3. Push the probe through the handle extension until
the tip of the probe emerges from the extension.
4. Remove the insertion tool by sliding it back away
from the handle extension.

Handle Extension Probe

Insertion Tool

Probe Cable

Removing Insertion Tool

Probe inside Handle Extension

Figure 13 Inserting the Probe into the Handle Extension

28
Getting Started Probe Setup

Figure 14 Probe with Handle Extension and Insertion Tool

Figure 15 Probe with Handle Extension

29
Accutome A-Scan Plus User’s Guide

Basic The basic operation of the Accutome A-Scan Plus

Operation 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 Patient Record.

How to Power On the Accutome A-Scan Plus

To power on the Accutome A-Scan Plus:
1. Push the power button located at the bottom left
corner of the instrument (see Figure 16 below).
When you power on the Accutome A-Scan Plus a
splash screen will appear. The instrument will go
through an initialization process and when com-
pleted will display the Measure Screen. The Accu-
tome A-Scan Plus will also beep once indicating
that the instrument is ready.

Power Button

Figure 16 Turning on the Accutome A-Scan Plus

30
Getting Started Basic Operation

2. The first screen you see will be the Measure

Screen. Scanning mode preferences are main-
tained while the instrument is powered off.

Patient Records Measure

Preferences

Calculate
Print

Negative
Affirmative

Figure 17 Measure Screen Displayed

31
Accutome A-Scan Plus User’s Guide

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 is
an LCD (Liquid Crystal Display) and depending upon the
angle from which you are viewing the screen, the images
displayed may not be bright enough or may be too bright.
To adjust the Accutome A-Scan Plus screen contrast:
1. Press and hold the Preferences button (see Figure
17 on page 31).
2. Rotate the knob while observing the change in
grey/white contrast on the screen.
3. When the contrast is properly adjusted release the
Preferences button.

32
Getting Started Basic Operation

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 Figure 18 below for location.
The test block is provided as a way to test the basic
operation of the instrument and the probe.
To test the Accutome A-Scan Plus and probe:
1. Apply some immersion fluid (water or BSS) to the
test block.
2. Place the probe on the test block.
3. You should receive a waveform and AXL measure-
ment in the Measure Screen.

*Note: If you cannot detect a waveform, call the Accutome

Service Group at (610) 889-0200.

Figure 18 Accutome A- Scan Plus Test Block (Top of Instrument)

33
Accutome A-Scan Plus User’s Guide

How to Start a New Patient

To start a new Patient:
1. Press the button under the "Start New Patient"
selection on the Measure, Calculate IOL or Patient
Records Screens. Refer to Figure 19 below.

Figure 19 Measure Screen Starting New Patient

34
Getting Started Basic Operation

2. When you start a new patient the Accutome A-

Scan Plus will clear all fields on the Measure
Screen as follows:
™ Gain set to default
™ Gates/Threshold set to default
™ Waveforms deleted
™ K readings deleted
™ Entered AXL (if any) deleted.
™ Patient field deleted
™ ID field set to default (which may be blank)
3. If you wish to enter a Patient Name select the
Patient field and press the knob or the √ button to
activate the field as shown in Figure 20 below.

Figure 20 Patient Field Activated

35
Accutome A-Scan Plus User’s Guide

4. Enter the Patient name. Press the knob or the √

button, to save the Patient name and deactivate
the field.

Figure 21 Entering New Patient Information

36
Getting Started Basic Operation

5. If you also need to enter an ID, select the ID field

by turning the knob. Press the knob or the √ but-
ton, to activate the ID field.
6. Enter the ID and press the knob or the √ button, to
save the ID and to deactivate the field.

Figure 22 New Patient Information Entered

37
Accutome A-Scan Plus User’s Guide

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 provides a method of
entering text that does not require a keyboard. If a field
is activated that requires text, and the keyboard has not
been used, the instrument displays a screen keyboard in
the soft menu area, shown in Figure 23 below, that
contains all the alphanumeric characters.

Figure 23 Screen Keyboard

38
Getting Started Basic Operation

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 to distinguish the
characters from the active buttons.
The screen keyboard also has the following soft menu
selections activated by buttons beneath the selection:
™ Undo - clears the active field.
™ Backspace - deletes the character immediately
to the left of the cursor.
™ Space - inserts a space after the last
character.
™ Case - toggles the selectable characters
between upper and lower case.
™ Done - exits the screen keyboard and returns
you to the Measure screen. The selected field
will display the edited text.
Special characters are located in between alpha and the
numeric letters. You can enter a space in a field by
selecting the space between the alpha and numeric
characters or by pressing the button below the "Space"
soft menu selection.
If you would like to switch to lower case press the button
below "Case". The Accutome A-Scan Plus automatically
selects upper case for a blank field, unless the field has
been previously edited in lower case and will then revert
to lower case.
The Accutome A-Scan Plus allows you to switch
between using the optional keyboard and the screen
keyboard. If you have the optional keyboard and would
like to use the screen keyboard, press Ctrl-K . The
screen keyboard will then be shown for current and
future text edits until you press a key on the optional
keyboard.

39
Accutome A-Scan Plus User’s Guide

To quickly select characters on the screen keyboard turn

the data knob quickly to accelerate the selection
location.

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 activate the
field. The screen keyboard will appear at the bot-
tom of the screen.
3. Rotate the knob to select the first letter, or number
of the Patient field.
4. Press the knob or the √ button, to enter the char-
acter in the field.
5. Rotate the knob to select the next character.
6. Press the knob or the √ button, to enter the char-
acter in the field.
7. Continue entering all the text characters in this
manner.
8. If you would like to insert a space, press the button
beneath the "Space" selection.
9. If you would to change the case of the letters,
press the button beneath the "Case" selection.
10. If you would like to remove a letter or more, press
the button beneath the "Backspace" selection. iF
you have made an error and would like to erase
the entire field, press the button beneath the
"Undo" selection.
11. When you have completed the Patient field, press
the button beneath the "Done" selection.
12. The Accutome A-Scan Plus will close the screen
keyboard and re-display the previous selections
over the buttons.

40
Getting Started Basic Operation

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 take the measurement automatic or
manual? Automatic allows the Accutome to
determine when the probe has acquired a
measurement and manual allows the operator
to determine when to capture the waveform.
™ Contact/Immersion - which method of applying
the probe are you using, contact or
immersion?
™ OD/OS which eye are you measuring, OD or
OS?
™ Eye type - which type of eye are you
measuring; i.e. phakic, aphakic, dense
cataract, etc.?

Figure 24 Measurement Fields Selected

41
Accutome A-Scan Plus User’s Guide

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) for each eye, Phakic is the default and is
fine for most cataractous eyes. If measuring an
aphakic or pseudo phakic eye, the eye type must
be set accordingly. To set the eye type, select the
eye type field by rotating the knob, activate it and
choose the appropriate type. The type is associ-
ated with each eye and is retained when the eye
(OD or OS) selected. It is necessary to set the
appropriate eye type for each eye if measuring
each eye.
3. When all measurement settings for the current
Patient are accurate apply the probe to the
Patient’s eye.
4. If you are not using the running mode, press the
foot switch or the Running/Frozen selection. The
Accutome A-Scan Plus will proceed to the next
empty waveform (if available).
5. If you are using the Automatic mode, the Accu-
tome A-Scan Plus will automatically freeze a mea-
surement upon sclera detection, steep retina
detection or upon capturing stable readings. (Auto
Mode settings are defined in the Setup Screen.)
The instrument will emit a high pitched chirp when
you have automatically acquired a measurement.
6. If you are using the Manual mode, and you wish to
capture the current waveform press the foot switch
or the "Running/Frozen" selection.

*Note: The user must review auto measurements for

quality. For more information on taking
measurements refer to "Performing Measurements"
on page 151 of this manual.

42
Getting Started Basic Operation

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
side of the front panel (see Figure 17 on page 31).
2. The Accutome will display the Calculate IOL
Screen as shown in Figure 25 below.

*Note: For more information on Calculating IOLs refer to

"Performing Calculations" on page 197 of this
manual.

3. Select the IOL Group, if necessary, by pressing the

button beneath the selection "Select IOL Group"
until the appropriate IOLs are displayed.

Figure 25 Calculate IOL Screen

43
Accutome A-Scan Plus User’s Guide

4. Select the Formula, if necessary, by pressing the

button beneath the selection "Select Formula" until
the appropriate formula is displayed.
5. If using the Haigis formula, and the ACD value
needs to be changed, rotate the knob to select the
ACD field and press the knob or the √ button to
activate the field. When the field is active either
rotate the knob or manually enter the ACD value in
millimeters (mm). If you would like the Accutome
to calculate the phakic ACD press the "Delete" key
or the X button to remove the entered value and
replace it with "Calc" for a calculated value

*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. If this value is unknown, the ACD
can be estimated by entering "0".

Figure 26 ACD Field Selected

44
Getting Started Basic Operation

6. Enter the K1 value in the designated area as

shown in Figure 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.
7. Enter K2 value in the same manner as K1.

*Note: When you first receive the Accutome A-Scan Plus

the IOL Groups are empty. If there are no IOL
Groups present on the Calculate IOL Screen you will
not be able to perform a calculation. Refer to
"Setting Up IOL Groups" on page 215 for further
information.

Figure 27 K1, K2 Values Entered

45
Accutome A-Scan Plus User’s Guide

8. After entering the K1 and K2 values, the emme-

tropic power is calculated and displayed for each
IOL.
9. Enter the Ametropoic Target value in the desig-
nated area as shown in Figure 28 below. Rotate
the knob to select the Target field and press the
knob or the √ button to activate the field. When
the field is active enter the Target value in Diopt-
ers.
10. The Calculate IOL Screen will display the
ametropoic power of the lens, for each lens, with
the bold, large, black numbers. These values are
the optimal lens, and do not necessarily exist in the
real world. The Accutome A-Scan Plus also pro-
vides you with the power of the IOL that would
achieve emmetropia. The emmetropic power is
calculated and displayed under the ametropoic
power in a smaller font.

Figure 28 Calculation Completed

46
Getting Started Basic Operation

How to Print a Record

After you have calculated the lens you will want to print
the Patient record. When you print from the Calculate
IOL Screen the printout displays the waveform selected
for the calculation, lens and formula information, and the
calculations for both eyes (OD and OS).
To print a record:
1. With the appropriate Patient record active, press
the "Print " button, located at the right side of the
front panel.
2. The Accutome A-Scan Plus will print the calcula-
tion record.

47
Accutome A-Scan Plus User’s Guide

How to Save Patient Records

The Accutome A-Scan Plus allows you to save patient
records at any time. You can save the record after you
have taken all the desired measurements or, after you
have taken the measurements and performed the
calculation.
You can recall a saved patient record and re-scan any of
the patient waveforms. You can also adjust the gates/
threshold on any of the waveforms and recalculate the
IOL power.
To save a Patient’s record:
1. Press the "Patient Records" button located to the
right of the instrument (see Figure 17 on page 31).
The instrument will display the Patient Record
Screen as shown in Figure 29 below.

Figure 29 Patient Record Screen

48
Getting Started Basic Operation

2. Press the button below "Save Patient". The Accu-

tome A-Scan Plus will store the Patient record.
The "Not Stored" prompt Patient ID will be
changed to "Stored" and a new entry will appear in
the Patient List.

Figure 30 Patient Record Stored

49
Accutome A-Scan Plus User’s Guide

50
 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 powers including waveform display,
adding lens materials and eye types, adding IOLs,
setting up IOL groups, and setting preferences. Any task
performed with the Accutome A-Scan Plus is performed
using the buttons and screens.
The buttons located to the right of the screen are
dedicated to specific functions and display other screens
or execute printing. The buttons located beneath the
screen are soft menu buttons and provide functions that
change within each screen (see Figure 31 on page 52.)
The buttons have been designed to provide complete
functionality with ease of use.
There is also a large knob with an indented push-button
area located to the right of the screen, below the
dedicated function buttons. The knob is the central
component of the Accutome A-Scan Plus user interface.
The knob allows you to select and change fields on
every instrument screen.

51
Accutome A-Scan Plus User’s Guide

Functional/Screen Buttons

Measure
Patient
Records

Preferences

Print Calculate

Affirmative

Negative/Delete

Soft Menu Buttons

Navigation Controls

Figure 31 Accutome A-Scan Plus Buttons

Accutome A- There are two types of buttons available on the

Scan Plus Accutome A-Scan Plus front panel, dedicated buttons
Buttons and soft menu buttons.

Dedicated Buttons
The dedicated buttons, located at the side of the front
panel, in the same area as the knob, all perform a
dedicated function. All of the dedicated buttons except
the Print button, display other high level screens.
The buttons are as follows:
™ Measure
™ Calculate
™ Patient Records
™ Preferences
™ Print

52
How to Use the Buttons and Screens Accutome A-Scan Plus Buttons

*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. The Measure Screen can also
display stored Patient waveforms, in the state in which
the waveform was originally captured. From the
Measure Screen you can also access the Customize
Eye Type Screen.
The Measure button can also be used to replace the
footswitch. Pressing the measure button is the same as
pressing the footswitch.

Patient Record Button

The Patient Record button displays the Patient Record
Screen where you save and recall patient
measurements and calculations.

Calculate
The Calculate button displays the Calculate Screen
where IOL calculations are performed. From the
Calculate Screen you can also access the IOL Groups
Screen.
If you press the Calculate button multiple times the
Accutome will scroll and display the lower level logically
linked screens; i.e. IOL Groups Screen and Personalize
IOLs Screen.

Preferences
The Preferences button displays the Eye Types Screen
where you can define eye types and velocities. From the
Eye Types Screen you can access the Setup screen
where you define default settings.

53
Accutome A-Scan Plus User’s Guide

If you press the Preferences button a second time the

instrument will display the lower level logically linked
screen; i.e. Setup Screen.

Print
The Print button prints the information displayed on the
current screen. When pressed from the Measurement
Screen the print button will print up to five current eye
waveforms (if five exist). When pressed from the
Calculate IOL Screen the print button will print the
calculations for both eyes including all measurements,
lens and formula information.

Check or Affirmative (9)

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 second time, on an active field
the field is deactivated.
The Affirmative button also acts as "Yes" any time you
are required to confirm an action; e.g. do you want to
delete a record? Press the Affirmative button to continue
with deleting the record.

Negative or Delete (X)

The Negative button will clear the contents of a selected
field when pressed. For example, if the Patient field is
active, when you press the Negative button the current
Patient name will be wiped out.
The Negative button also acts as "No" any time you are
required to confirm an action; e.g. do you want to delete
a record? Press on the Negative button to cancel
deleting the record.

54
How to Use the Buttons and Screens Accutome A-Scan Plus Buttons

Soft Menu Buttons

There is a series of buttons directly below the Accutome
display. The buttons offer soft menu selections and
change from screen to screen.
There are three types of soft menu selection:
™ Buttons that perform a single action
™ Buttons that toggle
™ Buttons that display other screens or soft
menus

Buttons that Toggle between Two Selections

Soft menu buttons that toggle cause the Accutome to
switch between one state and another; e.g. on the
Measure Screen the button under the Running/Frozen
selection toggles the waveform between active and
frozen. The active choice is highlighted in reverse video.

Buttons that Display Other Screens or Soft Menus

Soft menu buttons that have an ellipsis... to the right of
the selection will display another screen or soft menu.

Accutome A-Scan Plus Knob

The large knob, located at the bottom of the right side of
the Accutome A-Scan Plus is for selecting and activating
fields and changing the parameters of the active field.

How the Knob Works

When a field on any screen requires data, you move
around on the screen and select the field by rotating the
knob until you have arrived at the appropriate field.
When a field is selected there will be a solid black border
around it. Also, when you move from one field to
another, the field that is to become active flashes.
Once you have selected a field and you want to enter or
change the data in the field, press on the knob. Pressing
the knob causes an action. In this case it activates the
field. After you have entered or changed data in a field, if

55
Accutome A-Scan Plus User’s Guide

you press the knob again it will save the changes to the
field and deactivate it.
If you are in a soft menu, requiring a user response, and
you turn the data knob or press another ignored button
the active soft menu will flash and beep.

Screens The Accutome A-Scan Plus is set up as a series of high

level screens with logically linked lower level screens.
Each of the high level screens is accessed by pressing
one of the dedicated function buttons. Two of the
dedicated function buttons, Calculate and Preferences
allow you to scroll through the lower level screens
through the dedicated button. 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 corner.

What the Screen Displays

Each screen displays tips for the active area, soft menus
at the bottom of the screen and tables of information
related to the screens function. For example, the
Calculate Screen displays the Patient name and ID, the
IOLs for the selected IOL Group, the calculation formulas
and the K1, K2 and Target values.

Types of Information
The information displayed on each screen is determined
by the screen’s function. For example, the Patient
Records Screen displays all saved patient records.
Screen items that have a white background may be
selected and modified using the knob.
Any item on a screen followed by an asterisk * indicates
that the value has been changed and that it is non-
standard, or, custom.
Any menu item followed by an ellipsis .... will take you to
another screen when you push button beneath the menu
item.

56
How to Use the Buttons and Screens Screens

Soft Menus
Each screen has selections that will perform functions
that change according to the screen.

Tips
One of the features that makes the Accutome A-Scan
Plus so intuitive to use is the tips available on every
screen. The tips are displayed at the top left of each
screen. The message displayed describes the currently
selected screen element.

Sounds
The Accutome A-Scan Plus will also provide you with
audio cues.
There is a constant tone initiated when the probe
contacts the eye. The frequency of the tone increases
the closer the waveform is to being acceptable according
to the criteria established in the Auto Mode.
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 the instrument will emit a high
pitched chirp, indicating completion.
A confirmation beep sounds after a patient is saved and
after a patient is recalled.

Error Messages
There are certain situations where the Accutome A-Scan
Plus will provide an error message, as well as the tones
indicating error. Error messages will be displayed when
there is a problem with printing or any condition that
requires user attention.

Moving between Screens

When moving from a high level to a lower level screen
you only have to press the button beneath the menu item
that indicates the lower level screen.

57
Accutome A-Scan Plus User’s Guide

You can get to the IOL Groups Screen and subsequently

the Personalize IOLs screen by pressing the dedicated
Calculate button a second and third time. You can also
access the Setup Screen by pressing the dedicated
Preferences button a second time.

Screen Hierarchy
Figure 32 below illustrates the hierarchy of the Accutome
A-Scan Plus screens. Notice how each high level
screen is logically associated with the screens linked at a
lower level.

High Level Screen Buttons

Figure 32 Accutome A-Scan Plus Screen Hierarchy

58
How to Use the Buttons and Screens Screens

Top Level Screens

The top level screens are:
™ Measure - for performing measurements
™ Calculate - for calculating IOL power
™ Patient Records - for saving and retrieving
patient records
™ Preferences - for defining eye types, velocities
and Accutome settings

Associated Sub-Level Screens

Each of the high level screens has associated lower
level screens that are accessed by pressing a soft menu
button on the high level screen.
The associated high level and sub-level screens are as
follows.

From the Measure Screen

From the Measure Screen you can access the on-the-fly
Customize Eye Type Screen.

From the Calculate Screen

From the Calculate Screen you can access the IOL
Groups Screen. From the IOL Groups Screen you can
access the Personalize IOLs Screen. From the
Personalize IOLs Screen you can access the Update
IOL Constants Screen.

From the Patient Records Screen

There is no lower level screen available from the Patient
Records Screen.

From the Preferences Screen

From the top level of the Preferences Screen, which is
Eye Types, you can access the Setup Screen. From the
Setup Screen you can access the About This Unit
Screen.

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Accutome A-Scan Plus User’s Guide

How Buttons, The buttons, screens and knob work together in the
Screens and following manner:
Knob Work
Together 1. Select a high level screen by pressing one of the
dedicated function buttons.
2. In the selected screen rotate the knob to select a
field requiring change.
3. Press the knob, or the Affirmative button to acti-
vate the field.
4. Make the appropriate changes to the field either by
selecting a pre-entered value or entering the
required information.
5. Press the knob, or the Affirmative button to save
the changes made to the field.
6. Rotate the knob to select the next field requiring
change.

Changing Fields and Table Cells

When you are in any screen every field that is in a white
box can be changed. Anything not in a white box can not
be changed.
When you are moving around in tables, such as the IOL
Group table, and you are making changes to a selected
cell, press once and the cell becomes active. Pressing
the same cell twice escapes the table.

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 has an optional keyboard, but if you don’t
have the keyboard the Accutome A-Scan Plus will
automatically provide you with a new soft menu of
alphanumeric characters. You select the various
characters by rotating the knob and enter the characters
into the text field by pressing on the knob or the
Affirmative button. When you have completed the text
entry you can return to the screens by pressing the
button beneath the selection "Done".

60
How to Use the Buttons and Screens Screens

Selecting a New Active Area

To select a new active area, you must first deactivate the
current active area by pressing the knob, or the
Affirmative button.

Changing Fields in the Active Area

There are two primary types of fields; pre-entered fields
that have been set up at the factory and that can not be
manually changed and fields that require information to
be entered.

Pre-entered Fields
There are many fields that contain pre-entered
information that cannot be changed. For example, in the
Setup Screen there is a limited number of selections
available for the Printer and three selections available for
Delete Confirm.
To change the value of a pre-entered field:
1. Select the field by rotating the knob.
2. Activate the field by pressing the knob or the Affir-
mative 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 input of
information. For example, the Patient name field.
To enter information in a field:
1. Select the field by rotating the knob.
2. Activate the field by pressing the knob or the Affir-
mative button.
3. When the field is active, enter the appropriate
information.

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Accutome A-Scan Plus User’s Guide

Numeric Fields
Fields that require a numeric value can be selected and
adjusted with the knob. To enter a numeric value in a
field:
1. Select the field by rotating the knob.
2. Activate the field by pressing the knob or the Affir-
mative button.
3. When the field is active, rotate the knob until you
reach the appropriate value.

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How to Use the Buttons and Screens Keyboard Shortcuts

Keyboard The Accutome A-Scan Plus allows you to perform

Shortcuts operations from the keyboard. There is no need to push
buttons to acquire patient measurements; all
measurement functions can be executed using the
keyboard shortcuts given in Table 1 below.
Table 1 Keyboard Shortcuts
Key Action
CTRL+N Start a New patient
CTRL+E Next Eye type
CTRL+SHIFT+E Previous Eye type
1, 2, 3, 4, 5 Select measurement
G or CTRL+G Gain, increase 1 dB, hold for default
Z or CTRL+Z Zoom, increase with wrap, hold for 1.6X
S or CTRL+S Scroll, increase 1 mm, hold for 0
V or CTRL+V View
O or CTRL+O OD/OS
C or CTRL+C Cornea Gate, hold to select ALL
A or CTRL+A Anterior Lens Gate, hold to select ALL
P or CTRL+P Posterior Lens Gate, hold to select ALL
R or CTRL+R Retina Gate, hold to select ALL
T or CTRL+T Threshold Gate, hold to select ALL
F1 to F6 Menu Keys 1 to 6
F8 Footswitch
F9 Measure
F10 Calculate
F11 Patient Records
F12 Preferences
PRINT SCREEN Print
ALT+P Print screen copy
ALT+S Send Screen copy
TAB Select next field
SHIFT+TAB Select previous field
ENTER Toggle select state of field
DELETE Delete current selection
CTRL+HOME First cell in table
CTRL+END Last cell in table
HOME First cell in current column
END Last cell in current column
PAGE UP Scroll table one page up
PAGE DOWN Scroll table one page down

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Accutome A-Scan Plus User’s Guide

Using the The footswitch performs four functions:

Footswitch
1. When you are acquiring measurements, the foot
switch will capture a waveform.
2. Will select one of the five waveforms on the Mea-
sure Screen.
3. Will delete the current waveform on the Measure
Screen.
4. Will access the Measure Screen from any other
screen.
If you are in a screen, other than the Measure Screen,
pressing the foot switch will bring you to the Measure
Screen. In the Measure Screen the foot switch allows
you to capture, select, or reject a waveform.
When on the eye and running, pressing the foot switch
captures the data.
The foot switch 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 foot switch. If you
would like to recapture that waveform, step on the foot
switch and keep pressing, for approximately one second,
until the selected waveform clears from the
measurements table.

64
 Preferences

Setting Up the The Accutome A-Scan Plus is equipped with personal

Accutomre A- preference options, and provides the flexibility necessary
Scan Plus to customize your machine. You can not only add eye
types and lens materials, you can also set many
operational defaults. All preferences are set up at the
Preferences screens.
Preference options include:
™ Adding new anterior/vitreous chamber and
lens materials and assigning velocities
™ Adding new eye types
™ Setting the Print Title
™ Setting the Printer
™ Setting the Serial Link
™ Setting the Serial Baud
™ Setting the Delete Confirmation
™ Adjusting the contrast
™ Setting the New Patient Defaults, including
Eye Type, ID, Gain and Target
™ Setting the K Index
™ Setting the IOL Power Table Step
™ Setting the Date and Time
™ Turning the sound on and off
™ Setting the Auto Restart option
™ Turning the screen saver on and off
™ Saving Default Gate/Threshold locations

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Accutome A-Scan Plus User’s Guide

How to Access To access the Accutome A-Scan Plus Preferences press

Preferences the Preferences button, located at the right side of the
front panel (see Figure 33 below).

Preferences Button

Figure 33 Preferences Button

*Note: If you press the Preferences button a second time

the Accutome A-Scan Plus will scroll to the Setup
Screen, which is the next lower level linked screen.

66
Preferences How to Access Preferences

Top Level of Preferences

When you press the Preferences button the Accutome
A-Scan Plus will display the Eye Types screen (see
Figure 34 below). In the Eye Types screen you can add
a new Eye Type, new lens material, new Anterior/
Vitreous material and assign velocities to each of these
materials.
The Eye Types screen also has the following soft menu
selections activated by buttons beneath the selection:
™ Reset Field to Factory - resets the current field
to the factory default.
™ Reset All to Factory - resets all fields to the
factory defaults. Fields labeled with * will be
reset.
™ More Settings... - displays the Setup screen.

[All eye types include an assumed cornea]

Figure 34 Eye Types Screen

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Accutome A-Scan Plus User’s Guide

How to Add a The Accutome A-Scan Plus provides the ability to

New Eye Type 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 table shown in Figure 35 on page 69.
Prior to adding the eye type to the table, you must define
all materials that may constitute the new eye type. You
must first, if necessary, add a new Lens Material and
Velocity, and new Anterior/Vitreous Material and Velocity.

*Note: It is also possible to edit existing Eye Type

information in the Accutome A-Scan Plus. To edit
eye type information follow the same procedure as
adding eye type information.

CAUTION: Changing eye type and

velocity information does not
effect the eye type information
for current and saved patients.

The changes will be in effect

the next time the changed
eye type is selected or a new
patient is started.

Current patient eye types that

do not match the settings on
the Eye Types Screen are
indicated with * on the
Measure and Calculate
screens.

68
Preferences How to Add a New Eye Type

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 surrounded by a
solid black border.

[All eye types include an assumed cornea]

Figure 35 Selecting the Lens Materials Table

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Accutome A-Scan Plus User’s Guide

2. 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 36 below.
3. When the table is activated rotate the knob until an
empty cell in the Material column is selected. The
cell will be selected when there it is surrounded by
a solid black border.
4. Activate the cell by pressing the knob.

[All eye types include an assumed cornea]

Figure 36 Selecting a Cell to Enter New Lens Material

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Preferences How to Add a New Eye Type

5. Enter the name of the new Lens Material.

6. Press the knob or the √ button, to save the Mate-
rial name and to deactivate the cell.

[All eye types include an assumed cornea]

Figure 37 Entering the Name for New Lens Material

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Accutome A-Scan Plus User’s Guide

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. For every eye type the Accutome A-Scan
Plus knows which velocity to use. Whenever possible
you should use one of the default lens materials and
velocities.
If you need to modify the velocity of a new lens material:
1. Rotate the knob and select the Velocity cell for the
newly added Lens Material, indicated by the solid
black border.
2. Press the knob or the √ button, to activate the
Velocity cell, indicated by the dashed border.
3. Enter the value of the new Velocity.
4. Press the knob or the √ button, to save the Veloc-
ity value and to deactivate the cell.
5. Press the knob or the √ button, a second time to
deactivate the Lens Materials table.

[All eye types include an assumed cornea]

Figure 38 Adding New Material Velocity

72
Preferences How to Add a New Eye Type

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, rotate the knob to
select an empty cell, indicated by a solid black
border, for entering the new eye type name.

[All eye types include an assumed cornea]

Figure 39 Selecting the Eye Type Name Cell

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Accutome A-Scan Plus User’s Guide

4. Enter the name of the new Eye Type.

5. Press the knob or the √ button, to save the Eye
Type Name and to deactivate the cell.

[All eye types include an assumed cornea]

Figure 40 Adding the New Eye Type Name

74
Preferences How to Add a New Eye Type

6. Within the Eye Types table, rotate the knob to

select the Lens cell associated with the Eye Type
Name you just entered.
7. Press the knob or the √ button, to activate the cell,
indicated by the dashed border.

[All eye types include an assumed cornea]

Figure 41 Activating the Area to Select New Lens Material

75
Accutome A-Scan Plus User’s Guide

8. Within the Lens cell, rotate the knob to select one

of the pre-entered Lens Materials. In the example
below, Glass is the newly added and selected lens
material. (If you previously added new lens mate-
rials, they should appear in this list.)
9. Press the knob or the √ button, to save the Lens
Material and to deactivate the cell.

[All eye types include an assumed cornea]

Figure 42 Lens Material Selected

76
Preferences How to Add a New Eye Type

10. Within the Eye Types table, rotate the knob to

select the Lens Thickness Cell associated with the
current Eye Type Name, and Lens.
11. Press the knob or the √ button, to activate the cell,
indicated by the dashed border.
12. If the Lens thickness can be measured using ultra-
sound the entry should be "Measured". If the
value for Lens Thickness is not "Measured" (and
it’s possible to measure the thickness), press the
X button to remove the entered thickness and dis-
play "Measured".
13. If the Lens thickness can not be measured using
ultrasound, enter an assumed lens thickness for
this type of lens by turning the knob. In the exam-
ple given, the thickness that has been entered is
"3".

[All eye types include an assumed cornea]

Figure 43 Lens Thickness Entered

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Accutome A-Scan Plus User’s Guide

14. Within the Eye Types table, rotate the knob to

select the AC cell associated with the current Eye
Type Name, and Lens.
15. Press the knob or the √ button, to activate the cell,
indicated by the dashed border.
16. Within the AC cell, rotate the knob to select one of
the pre-entered Anterior Materials. (If you previ-
ously added new anterior chamber materials, they
should appear in this list.)
17. Press the knob or the √ button, to save the
selected Anterior Material and to deactivate the
cell.

[All eye types include an assumed cornea]

Figure 44 Anterior Chamber Material Selected

78
Preferences How to Add a New Eye Type

18. Within the Eye Types table, rotate the knob to

select the VC cell associated with the current Eye
Type Name, Lens, and Anterior Chamber.
19. Press the knob or the √ button, to activate the cell,
indicated by the dashed border.
20. Within the VC cell, rotate the knob to select one of
the pre-entered Vitreous Materials. (If you previ-
ously added new vitreous chamber materials, they
should appear in this list.)
21. Press the knob or the √ button, to save the
selected Vitreous Material and to deactivate the
cell.
22. Press the knob or the √ button, a second time to
deactivate the Lens Materials table.

[All eye types include an assumed cornea]

Figure 45 Vitreous Chamber Material Selected

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Accutome A-Scan Plus User’s Guide

Eye Type There are three menu selections available for execution
Screen Menu at the bottom of the Eye Types Screen. Two of the
Selections selections, "Reset Field to Factory" and "Reset All to
Factory" can be used to restore eye type information.
Any information that is displayed in a white field on the
Eye Type screen can be changed. Most of these fields
(excluding the empty fields for adding eye type
information) contain default values for that have been
pre-entered at the factory.

Reset Field to Factory

The Reset Field to Factory selection provides you with
the ability to return any pre-entered field on the Eye
Types Screen to its default factory value.
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 46 below.

[All eye types include an assumed cornea]

Figure 46 Non-Factory Field

80
Preferences Eye Type Screen Menu Selections

2. Press the button beneath the "Reset Field to Fac-

tory" selection.
3. The Accutome A-Scan Plus will prompt you with
the message "Are you sure?" as shown in Figure
47 below. You must select either "Cancel" or
"Yes".
4. Press the button beneath the selection "Yes". (You
can also press the Affirmative button located at the
right side of the front panel.)

[All eye types include an assumed cornea]

Figure 47 Restore Selected Field Prompt

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Accutome A-Scan Plus User’s Guide

5. The Accutome A-Scan Plus will reset the selected

field to its factory default as shown in Figure 48
below.

[All eye types include an assumed cornea]

Figure 48 Selected Field Restored

82
Preferences Eye Type Screen Menu Selections

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 fields
on the Eye Type screen and you would like to reset
them:
1. Press the button beneath the selection "Reset All
to Factory".

[All eye types include an assumed cornea]

Figure 49 Non-Factory Fields Displayed

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Accutome A-Scan Plus User’s Guide

2. The Accutome A-Scan Plus will prompt you with

the message "Are you sure?" as shown in Figure
50 below. You must either cancel or continue.
3. Press the button beneath the selection "Yes". (You
can also press the Affirmative button located at the
right side of the front panel.)
4. The Accutome A-Scan Plus will reset all fields to
their factory default as shown in Figure 48 on page
82.

[All eye types include an assumed cornea]

Figure 50 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.

84
Preferences More Settings

More Settings From the high level Eye Types Screen you can access
the remainder of the preference options. When you
press the button beneath the selection "More Settings"
the Accutome A-Scan Plus will display the Setup Screen
as shown in Figure 51 on page 86.

Setup Screen Fields

In the Setup screen you can change the following fields:
™ Print Title
™ Printer
™ Serial Link
™ Serial Baud
™ Delete Confirm
™ Contrast
™ New Patient Defaults including; Eye Type, ID,
Gain and Gates/Threshold
™ Default K Index
™ IOL Step for IOL Calculation Power Table
™ 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 - toggles the
measurement quality sound on and off
™ Restart On/Restart Off - toggles automatic
restart on and off
™ Scr Save On/Scr Save Off - toggles the 30
minute inactivity screen saver on and off
™ Save Gates - saves the location of the gates/
threshold as they as they are currently set, as
the new patient default
™ About This Unit - displays the "About Screen"
™ Done... - exits the Setup Screen and returns
you to the Eye Types Screen

85
Accutome A-Scan Plus User’s Guide

Figure 51 More Settings - Setup Screen

86
Preferences More Settings

How to Set the Print Title

The Accutome A-Scan Plus provides you with the ability
to have a title appear on every patient printout. For
example, you may want to have a clinic name printed at
the top of every page.

To set a Print Title:

1. Within the Setup Screen, rotate the knob to select
the Print Title field, indicated by a solid black bor-
der.

Figure 52 Print Title Field Selected

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Accutome A-Scan Plus User’s Guide

2. Press the knob or the √ button, to activate the

field, indicated by the dashed border.

Figure 53 Print Title Field Activated

88
Preferences More Settings

3. Within the Print Title field, enter the title you would
like printed on every record.

Figure 54 Entering the Print Title

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Accutome A-Scan Plus User’s Guide

4. Press the knob or the √ button, to save the

entered Print Title and to deactivate the field.

Figure 55 Print Title Added

90
Preferences More Settings

How to Set the Printer

In order to obtain the best printouts from the Accutome
A-Scan Plus, it is recommended that all records be
printed on a laser printer that is compatible to an HP
LaserJet. However, the Accutome A-Scan Plus provides
many printer options to meet most printing needs. The
printers available are as follows:
™ HP LaserJet - the printer will operate with the
HP PCL 5 print driver
™ HP InkJet (Quality) - the printer will operate
with the HP PCL 3 print driver and will print
higher quality images
™ HP InkJet (Speed) - the printer will operate
with the HP PCL 3 print driver and will print
records quicker
™ None - no printer selected
™ Generic / Text Only - for any printer not
compatible with HP PCL 5 or HP PCL 3, the
Accutome will print text only
The two InkJet graphics printer drivers HP InkJet
(Quality) and ‘HP InkJet (Speed)’ will print all data the
same as the HP LaserJet driver but on printers that are
compatible to DeskJet printers. There are some
differences in the graphics between HP LaserJet and HP
InkJet.
The Quality version of the HP InkJet driver prints
waveforms using 300 DPI and the Speed version of the
driver prints waveforms at 150 DPI.

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Accutome A-Scan Plus User’s Guide

To set the Printer:

1. Within the Setup Screen, rotate the knob to select
the Printer field, indicated by a solid black border.

Figure 56 Printer Field Selected

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Preferences More Settings

2. Press the knob or the √ button, to activate the

field, indicated by the dashed border.

Figure 57 Printer Field Activated

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Accutome A-Scan Plus User’s Guide

3. Within the Printer field, rotate the knob to select

one of the pre-entered options; HP LaserJet
Compatible, HP InkJet (Speed), HP InkJet
(Quality), Generic / Text Only, or None.

HP Laser Jet Compat ible

Figure 58 Selecting the Printer

94
Preferences More Settings

4. Press the knob or the √ button, to save the

selected Printer and to deactivate the field.

H P La serJ et Co mpat ible

Figure 59 New Printer Selected

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Accutome A-Scan Plus User’s Guide

How to Set the Serial Link

The Accutome A-Scan Plus provides a serial port as a
means of transferring information from the Accutome A-
Scan Plus to a PC (Personal Computer). You can
enable the port to link to a text application on the PC.
Once you have the text data on the computer it can be
used in many applications. The format of the data is the
same as the Generic/ Text Only printer driver output
The three choices for setting the Serial Link are:
™ Generic/Text Only
™ Text with Data
™ None
When the serial link is enabled, the current screen data
is sent when the Print key is pressed. If both the Serial
Link and the Printer are enabled, data will be both
printed and sent out the serial port.
The receiving application on the PC and the serial baud
must be set to the same rate. The user can select 9600,
19200, 38400, 57600, or 115200 as the serial link baud
rate. The factory default is 38400.
The communication parameters for the serial link are: 1
start bit, 8 data bits, 1 stop bit (no parity), and hardware
flow control. This is commonly shown as 8-N-1. 8-N-1 is
the most common setting for serial devices.

Text with Data Driver

The “Text with Data” Serial Link driver sends waveform
data after the standard patient Text Only printout. An
example is given in Figure 60 on page 97. Waveform
data is tab delimited for easy use in Microsoft Excel.
Data sent for each waveform includes settings (gain,
method, mode, date, and time), gate locations, tissue
locations, and measurement data for both OD and OS.

96
Preferences More Settings

Figure 60 Serial Data Printout

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Accutome A-Scan Plus User’s Guide

To set the Serial Link:

1. Within the Setup Screen, rotate the knob to select
the Serial Link field, indicated by a solid black bor-
der.

H P La serJ et Co mpat ible

Figure 61 Serial Link Field Selected

98
Preferences More Settings

2. Press the knob or the √ button, to activate the

field, indicated by the dashed border.

H P La serJ et Co mpat ible

Figure 62 Serial Link Field Activated

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Accutome A-Scan Plus User’s Guide

3. Within the Serial Link field, rotate the knob to

select one of the pre-entered options; Generic /
Text Only, Text with Data, or None. The applica-
tion to which you are connecting the serial port
must be able to receive text. The Accutome A-
Scan Plus will only transmit text.

H P La serJ et Co mpat ible

Figure 63 Selecting the Serial Link

100
Preferences More Settings

4. Press the knob or the √ button, to save the

selected Serial Link and to deactivate the field.

H P La se rJe t Comp ati bl e

Figure 64 New Serial Link Selected

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Accutome A-Scan Plus User’s Guide

How to Set the Serial Baud

The Accutome A-Scan Plus allows you to set the baud
rate at which data will be transmitted from the serial port
to the computer. The factory default baud is 38400. The
baud rates which you can select are:
™ 9600 8-N-1
™ 19200 8-N-1
™ 38400 8-N-1
™ 57600 8-N-1
™ 115200 8-N-1
The "8-N-1" at the end of each baud rate indicates the
communication parameters; 1 start bit, 8 data bits, 1 stop
bit (no parity).
To set the Serial Baud:
1. Within the Setup Screen, rotate the knob to select
the Serial Baud field, indicated by a solid black
border.

H P La serJ et Co mpat ible

Figure 65 Serial Baud Field Selected

102
Preferences More Settings

2. Press the knob or the √ button, to activate the

field, indicated by the dashed border.

H P La serJ et Co mpat ible

Figure 66 Serial Baud Field Activated

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Accutome A-Scan Plus User’s Guide

3. Within the Serial Baud field, rotate the knob to

select one of the pre-entered options; 9600 8-N-1,
19200 8-N-1, 38400 8-N-1, 57600 8-N-1 or 115200
8-N-1

H P La serJ et Co mpat ible

Figure 67 Selecting the Serial Baud

104
Preferences More Settings

4. Press the knob or the √ button, to save the

selected Serial Baud and to deactivate the field.

H P La serJ et Co mpat ible

Figure 68 New Serial Baud Selected

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Accutome A-Scan Plus User’s Guide

How to Set Delete Confirm

The Delete Confirm field allows you to set the times that
the Accutome A-Scan Plus will cue you when you are
going to delete a Patient record, an IOL, or any other
stored information. In other words, when you are going
to delete something, the Accutome A-Scan Plus will
require you, or not require you to confirm the deletion.
To set the Delete Confirm field:
1. Within the Setup Screen, rotate the knob to select
the Delete Confirm field, indicated by a solid black
border.

H P La serJ et Co mpat ible

Figure 69 Delete Confirm Field Selected

106
Preferences More Settings

2. Press the knob or the √ button, to activate the

field, indicated by the dashed border.

H P La serJ et Co mpat ible

Figure 70 Delete Confirm Field Activated

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Accutome A-Scan Plus User’s Guide

3. Within the Delete Confirm field, rotate the knob to

select one of the pre-entered options; All, Some, or
None (all of the time, some of the time, or none of
the time).
When Delete Confirm is set to All or Some (unless
confirm set to None) the Accustome A-Scan Plus will ask
for delete confirmation for the following situations:
™ Start New Patient
™ Reset All to Factory (Eye Types Screen)
™ Delete All Results (IOL Personalization
Screen)
™ Reset Gates/Threshold to Factory (Setup
Screen)
In addition, when Delete Confirm is set to All (unless
confirm is set to None or Some) confirmation is required:
™ Reset Field to Factory (Eye Types Screen)
™ Delete IOL (IOL Groups Screen)
™ Delete Result (IOL Personalization Screen)
™ Delete Patient (Patient Records Screen)

HP La serJet C om pati ble

Figure 71 Selecting the Delete Confirm Value

108
Preferences More Settings

4. Press the knob or the √ button, to save the

selected Delete Confirm and to deactivate the
field.

H P La serJ et Co mpat ible

Figure 72 New Delete Confirm Entered

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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 contrast can be adjusted at any time, on any

screen, by pressing and holding the preferences
button while turning the knob.

To adjust the Accutome A-Scan Plus Contrast:

1. Within the Setup Screen, rotate the knob to select
the Contrast field, indicated by a solid black bor-
der.

H P La serJ et Co mpat ible

Figure 73 Contrast Field Selected

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Preferences More Settings

2. Press the knob or the √ button, to activate the

field, indicated by the dashed border.

H P La serJ et Co mpat ible

Figure 74 Contrast Field Activated

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Accutome A-Scan Plus User’s Guide

3. 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 Con-
trast field by a solid grey bar, that increases or
decreases as you adjust the contrast.

H P La se r J et Co mp ati b le

Figure 75 Adjusting the Contrast

112
Preferences More Settings

4. Press the knob or the √ button, to save the altered

Contrast and to deactivate the field.

HP L aserJet Compa tible

Figure 76 Contrast Adjusted

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Accutome A-Scan Plus User’s Guide

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 the Measure Screen
will be the default eye type selected in the Setup Screen.
To change the default eye type:
1. Within the Setup Screen, rotate the knob to select
the Default Eye Type field, indicated by a solid
black border.

H P La serJ et Co mpat ible

Figure 77 Default Eye Type Field Selected

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Preferences More Settings

2. Press the knob or the √ button, to activate the

field, indicated by the dashed border.

H P La serJ et Co mpat ible

Figure 78 Default Eye Type Field Selected

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Accutome A-Scan Plus User’s Guide

3. Within the Default Eye Type field, rotate the knob

to select one of the pre-entered Eye Types as
shown in Figure 79 below

H P La serJ et Co mpat ible

Figure 79 New Default Eye Type Selected

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Preferences More Settings

4. Press the knob or the √ button, to save the

selected Default Eye Type and to deactivate the
field.

H P La serJ et Co mpat ible

Figure 80 Default Eye Type Changed

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Accutome A-Scan Plus User’s Guide

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 clinic’s name as a Default ID.

To set a Default ID:

1. Within the Setup Screen, rotate the knob to select
the Default ID field, indicated by a solid black bor-
der.

H P La serJ et Co mpat ible

Figure 81 Default ID Field Selected

118
Preferences More Settings

2. Press the knob or the √ button, to activate the

field, indicated by the dashed border.

H P La serJ et Co mpat ible

Figure 82 Default ID Field Activated

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Accutome A-Scan Plus User’s Guide

3. Within the Default ID field, enter the default ID.

H P La serJ et Co mpat ible

Figure 83 Entering the Default ID

120
Preferences More Settings

4. Press the knob or the √ button, to save the

entered Default ID and to deactivate the field.

H P La serJ et Co mpat ible

Figure 84 Default ID Added

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Accutome A-Scan Plus User’s Guide

How to Set the Default Gain

The Default Gain parameter allows you to adjust the new
patient ultrasound gain. You can adjust the gain for any
waveform from the Measure Screen, but when you
adjust the gain value on the Setup Screen the adjusted
gain becomes the default gain for all new patients. The
gain can be adjusted throughout the range of 0dB to 20
dB in increments of 1dB.
To adjust the gain:
1. Within the Setup Screen, rotate the knob to select
the Gain field, indicated by a solid black border.
2. Press the knob or the √ button, to activate the
field, indicated by the dashed border.

H P La se r J et Co mp ati b le

Figure 85 Default Gain Field Selected

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Preferences More Settings

3. 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 - 20
dB.
4. When the gain is at the appropriate level, press
either the knob or the √ button, to save the
adjusted value and to deactivate the field.

HP La s erJ et Co mp a tib le

Figure 86 Default Gain Field Changed

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Accutome A-Scan Plus User’s Guide

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 common for patients. It is
also possible to modify the target refraction on a per
patient basis.

To set the Target Refraction:

1. Within the Setup Screen, rotate the knob to select
the Target field of the New Patient Defaults, indi-
cated by a solid black border.

H P La serJ et Co mpat ible

Figure 87 Target Field Selected

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Preferences More Settings

2. Press the knob or the √ button, to activate the

field, indicated by the dashed border.

HP La s erJ et Co mp a tib le

Figure 88 Target Field Activated

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Accutome A-Scan Plus User’s Guide

3. With the Target field active, rotate the knob until

you reach the appropriate value or enter the target
number on the keyboard.

H P La serJ et Co mpat ible

Figure 89 Adjusting the Target

126
Preferences More Settings

4. Press the knob or the √ button, to save the

adjusted Target and to deactivate the field.

HP L aserJ et Co mpa tible

Figure 90 Target Adjusted

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Accutome A-Scan Plus User’s Guide

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 1.3375. European keratometers
may have an index of refraction of 1.3315. The factory
default is 1.3375.
The K Index value is only used when entering
keratometer readings in diopters. K readings can be
entered on the Calculate IOL screen as well as the
Personalize IOL screen. The K index associated with
diopter entries is not explicitly shown. When a
keratometer reading is entered in diopters the default K
index is copied from the setup screen. If the K. index of
an entry is different than the Setup screen default K
Index, a * appears beside the entry. To change or view
the K index, change or reenter the diopter entry. The
Accutome A-Scan Plus will prompt you with the default
and current K indexes and ask which one you want
associated with the entry.

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Preferences More Settings

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.

HP La s erJ et Co mp a tib le

Figure 91 K Index Field Selected

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Accutome A-Scan Plus User’s Guide

2. Press the knob or the √ button, to activate the

field, indicated by the dashed border.

HP La s erJ et Co mp a tib le

Figure 92 K Index Field Activated

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Preferences More Settings

3. 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.

HP La s erJ et Co mp a tib le

Figure 93 Adjusting the K Index

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Accutome A-Scan Plus User’s Guide

4. When the K index is correct, press either the knob

or the √ button, to save the adjusted value and to
deactivate the field.

HP La s erJ et Co mp a tib le

Figure 94 K Index Field Adjusted

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Preferences More Settings

How to Set the IOL Step

The Accutome A-Scan Plus allows you to modify the
diopter step used when calculating IOL power lists.

To adjust the IOL Step:

1. Within the Setup Screen, rotate the knob to select
the IOL Step field, indicated by a solid black bor-
der.

HP La s erJ et Co mp a tib le

Figure 95 IOL Step Field Selected

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Accutome A-Scan Plus User’s Guide

2. Press the knob or the √ button, to activate the

field, indicated by the dashed border.

HP La s erJ et Co mp a tib le

Figure 96 IOL Step Field Activated

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Preferences More Settings

3. 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.

HP La s erJ et Co mp a tib le

Figure 97 Adjusting the IOL Step

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Accutome A-Scan Plus User’s Guide

4. When the IOL Step is at the appropriate value,

press either the knob or the √ button, to save the
adjusted value and to deactivate the field.

HP La s erJ et Co mp a tib le

Figure 98 IOL Step Adjusted

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Preferences More Settings

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 three separate fields. You adjust
each field individually. The date is set up as: Year (Y),
Month (M), and Day (D). The time is set up as: Hour (H),
Minute (M), and Second (S). In the example given below
the day of the date is adjusted.

To adjust the Date and Time:

1. Within the Setup Screen, rotate the knob to select
the Day field of the date, indicated by a solid black
border.

HP LaserJet Compati bl e

Figure 99 Day Field Selected

137
Accutome A-Scan Plus User’s Guide

2. Press the knob or the √ button, to activate the

field, indicated by the dashed border.

H P La serJ et Co mpat ible

Figure 100 Day Field Activated

138
Preferences More Settings

3. With the Day field active, rotate the knob until you
reach the appropriate day number or enter the
number with the keyboard.

HP La s erJ et Co mp a tib le

Figure 101 Adjusting the Day

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Accutome A-Scan Plus User’s Guide

4. Press the knob or the √ button, to save the

adjusted Day and to deactivate the field.

HP La s erJ et Co mp a tib le

Figure 102 Day Adjusted

5. If necessary, adjust the Month (M) and Day (D)

fields of the date in the same manner.
6. If necessary, adjust the Hour (H), Minute (M), and
Seconds (S) fields of the time in the same manner.

140
Preferences More Settings

How to Set the Auto Mode

The Accutome A-Scan Plus allows you to define the
Automatic measurement mode by specifying how a
measurement is automatically captured. There are a
total of three criteria available and each can be turned off
or on by the user on the Setup screen. The criteria are:
™ Sclera - automatic capture determined by
sclera detection
™ Retina - automatic capture determined by
retina detection
™ Stable - automatic capture determined by
measurement stability
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’, displayed as ‘Auto (S__)’. Sclera
must have a distinct sclera echo after the retina, above
the threshold. Between the Retina and Sclera the signal
must go below the threshold.
’Retina’, displayed as ‘Auto (_R_)’, must begin at the
base line, have no data greater than 10% of the
threshold in front it (for 1.5 mm), and be steeply rising.
"Stable’, displayed as ‘Auto (__S)’, means the
measurement needs to be within a tolerance for a certain
amount of time.

*Note: The Stable Auto Mode setting is not recommended

for contact method measurements. The
measurement variance caused by hand or eye
movements may make the stable auto lock
requirement difficult to achieve.

*Note: Sound, if enabled, reflects the quality of the

measurement with respect to the current auto mode
settings, even if you are using the Manual capture
mode.

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Accutome A-Scan Plus User’s Guide

To specify the Auto Mode:

1. Within the Setup Screen, rotate the knob to select
the Sclera field of the Auto Mode, indicated by a
solid black border.

HP La se rJe t Comp ati bl e

Figure 103 Auto Mode Sclera Selected

142
Preferences More Settings

2. Press the knob or the √ button, to activate the

field, indicated by the dashed border.

HP L aser Jet Co mpa tible

Figure 104 Auto Mode Sclera Field Activated

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Accutome A-Scan Plus User’s Guide

3. With the Sclera field active, rotate the knob until

you the word "Off" is displayed. Automatic mode
will no longer be triggered by sclera detection.

HP L aserJ et Co mpa tible

Figure 105 Changing the Auto Mode - Turning Off Sclera

144
Preferences More Settings

4. Press the knob or the √ button, to save the

adjusted Sclera and to deactivate the field.

HP L aserJ et Co mpa tible

Figure 106 Auto Mode - "Sclera" Off

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Accutome A-Scan Plus User’s Guide

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 border.
3. Rotate the knob to switch from "Off" to "On"
4. Press the knob or the √ button, to save the
adjusted Retina and to deactivate the field.
5. If you would like to define the Auto Mode by a sta-
ble measurement, rotate the knob to select the
"Stable" field.
6. Press the knob or the √ button, to activate the
field, indicated by the dashed border.
7. Rotate the knob to switch from "Off" to "On"
8. Press the knob or the √ button, to save the
adjusted Stable and to deactivate the field.

HP L as erJet Compa tib l e

Figure 107 Auto Mode - "Stable" Selected

146
Preferences More Settings

9. Press the knob or the √ button, to save Stable as

On and to deactivate the field.

H P La serJ et Co mpat ible

Figure 108 Auto Mode Defined by "Stable" Measurement

10. Select and turn on or off all the Auto Mode criteria
until you have accurately defined how a measure-
ment will be automatically captured.

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Accutome A-Scan Plus User’s Guide

Sound On/Sound Off

The Sound On/Sound Off selection toggles between the
two. When "Sound On" is selected there will be sound
during measurement. When "Sound Off" is selected
there will be no sound during measurement.
The audible feedback is a constant tone initiated when
the probe contacts the eye. The frequency of the tone
increases as the waveform is closer to being acceptable
according to the criteria associated with the Auto Mode
(see "How to Set the Auto Mode" on page 141 of this
manual).

Restart On/Restart Off

The Restart On/Restart Off selection toggles between
the two and will prompt the Accutome, when operated in
the "Automatic" mode, to automatically restart
measuring after a successful reading or to stop after
each successful reading.
When "Restart On" is selected the Accutome A-Scan
Plus will automatically restart for up to five automatic
readings. When "Restart Off" is selected the Accutome
A-Scan Plus will stop after each reading.

Scr Save On/Scr Save Off

The Scr Save On/Scr Save Off selection toggles
between the two and will display the screen saver or not.
The screen saver feature is provided to protect the LCD
from unnecessary wear. If the screen saver is enabled
and the Accutome A-Scan Plus is unused for 30
minutes, the instrument will display the screen saver and
the display will go dark.
When " Scr Save On" is selected the screen saver will be
displayed when the instrument is not in use. When "Scr
Save Off" is selected the screen saver will not be
displayed at all.
To restore the screen after the screen saver has blanked
it, press any and the first key press will be ignored and
the screen will be restored.

148
Preferences More Settings

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 want to save
the adjusted settings as the default for gates/threshold.
When you save gates/threshold the current locations of
the gates and threshold become the new patient default
locations.
To save gate/threshold settings as the default:
1. After you made gate adjustments to the current
waveform in the Measure Screen, return to the
Setup Screen (press the Preferences button, press
more settings...). Refer to "How to Adjust Gates/
Threshold" on page 168 of this manual for more
information.
2. Press the button beneath the selection "Save
Gates". The Accutome A-Scan Plus will cue with a
message displayed at the top of the screen indicat-
ing you have saved the current location of the
gates and threshold as the default.

To restore the locations of the gate and threshold to the

factory default:
1. Press and hold Save Gates button for approxi-
mately 1 sec. You will be prompted if you want to
restore gates/threshold to the factory default.

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Accutome A-Scan Plus User’s Guide

About This Unit

When you press the button beneath the "About This
Unit..." selection, the Accutome A-Scan Plus displays
another screen, the "About this Unit" screen as shown in
Figure 109 below. This screen is informational only and
lists the software version, boot version, and the status of
the probe. When you press the button beneath the
"Done..." selection you will return to the More Settings
screen.

A-Scan
3.0.0

Figure 109 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.

150
 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 ultrasonic
probe. The signal echoes off the various parts of the eye
(cornea, lens, retina) and returns a signal through the
probe. The returned signal is translated and displayed
as the Patient waveform. The Accutome A-Scan Plus
examines each of the echoes in the waveform and
calculates the measurements from one echo to the next.
All measurements are then displayed on the Measure
Screen. The number of echoes detected is determined
by a user selectable eye type, including Phakic, Aphakic,
and Pseudophakic.
Five waveforms can be captured for each eye. Review
and gate adjustment can be done after waveform
capture to ensure proper measurement.
The Accutome A-Scan Plus provides many user controls
to obtain accurate measurements. These include the
support for contact or immersion method, individual
velocities, automatic capture of readings, gain control,
manual and automatic gate adjustment, and zoom.
During measurement, the instrument will provide audible
feedback of contact, signal quality, and capture.
This chapter provides you with information to control,
capture, and review waveforms.

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Accutome A-Scan Plus User’s Guide

Measure When you power on the Accutome A-Scan Plus the

Screen Measure Screen is displayed as shown in Figure 110
below. You can get to the Measure Screen at any time
by pressing the Measure button located at the right side
of the front panel or pressing the foot switch.
When you power on the instrument, or start a new
Patient, all settings are set to predetermined values. The
patient eye type, gain, gates/threshold, and ID are set as
determined by the Setup Screen. The patient name field
and all measurements are cleared.
Capture mode (automatic or manual), and probe
coupling method (contact or immersion) remain as last
set by the user and are retained while the Accutome A-
Scan Plus is turned off.

Figure 110 Measure Screen Displaying Current Settings

152
Performing Measurements Measure Screen

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 waveform display are time gates
and amplitude threshold to control the capture and
measurement of the waveforms.
Below the waveform is a scale in millimeters (mm) that
displays the location of detected echoes within the eye.
Located to the immediate right of the current waveform is
the current eye indicator, OD or OS, and its associated
eye type. Below the eye type is the current waveform’s
live Axial Length, ACD, Lens Thickness, and Vitreous
dimensions. These dimensions will change as you
acquire data or change waveform parameters.
The bottom left corner displays the Patient name and ID.
The bottom right corner displays the measurements for
the currently selected eye of the patient.

Soft Menu Selections

The Measure Screen displays one of two soft menus at
the bottom of the screen, the Main menu and the
Waveform Control menu.
The Waveform Control menu is displayed when the
waveform is actively selected, otherwise the main menu
is displayed.
The Measure Screen Main Menu has the following soft
menu selections located at the bottom of the screen:
™ Running/Frozen - toggles between the live and
frozen captured waveform
™ Auto (_ _ _)/Manual - toggles between the
automatic and manual mode of capturing
patient waveforms
™ Contact/Immersion - toggles between the
contact and immersion methods of coupling
the probe

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Accutome A-Scan Plus User’s Guide

™ OD/OS - toggles between the OD and OS eye;

selecting OD or OS displays the waveforms for
that eye. OD/OS must be set accordingly
before capturing waveforms.
™ 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 type for the current patient
or review the current eye type definition.
Custom Eye Types are associated with the
current patient only and are not available to
other patients. Permanent changes to eye
types can be made on the Eye Types Screen.

Starting a New Patient

You can start a new patient from either the Measure
Screen, Calculate IOL Screen, or from the Patient
Records Screen. Once you start a new patient, the
Accutome A-Scan Plus will clear all previous patient
information and set gain, gate and ID to the default
values.
After starting a new patient, select the eye to be
measured, OD or OS, and verify the eye type for that
eye.

154
Performing Measurements How to Set the Eye Type

How to Set the When the Accutome A-Scan Plus is set up at the factory,
Eye Type it is equipped with predefined eye types and specific
velocities for the predefined eye types. Descriptions of
the factory installed eye types and their characteristics
are given below, followed by instructions on modifying
eye types on a per patient basis.

Eye Types
The following eye types are preset at the factory:
™ Phakic - Setting for most patients.
™ Silicone Filled - Phakic eye with Silicone Oil in
the Vitreous.
™ Dense Cataract - Use this setting when a
dense cataract prevents measurement of lens
thickness.
™ Aphakic - Patient with no lens, lens is not
measured or assumed.
™ Pseudo PMMA - Patient with Pseudophakic
PMMA IOL
™ Pseudo Silicone - Patient with Pseudophakic
Silicone IOL
™ Pseudo Acrylic - Patient with Pseudophakic
Acrylic IOL

*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 measurment.

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Accutome A-Scan Plus User’s Guide

Eye Type Materials and Velocities

The tables below list the preset eye types and define the
materials and velocities for each eye type.

Table 2 Eye Types

Eye Type Name Lens Thickness AC VC

Phakic Phakic Measured Aqueous Vitreous

Silicone Filled Phakic Measured Aqueous Silicone Oil
Dense Cataract Phakic 4.70 Aqueous Vitreous
Pseudo PMMA PMMA 0.70 Aqueous Vitreous
Pseudo Silicone Silicone 1.40 Aqueous Vitreous
Pseudo Acrylic Acrylic 0.70 Aqueous Vitreous
Aphakic [none] [none] 1532

Table 3 Lens Materials and Velocities

Material Velocity [m/s]

Phakic 1641
PMMA 2660
Silicone 980
Acrylic 2120

Table 4 Anterior/Vitreous Materials and Velocities

Material Velocity [m/s]

Aqueous 1532
Vitreous 1532
Silicone Oil 980

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Performing Measurements How to Set the Eye Type

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 at the top right side
of the screen. Selection is indicated by a solid
black border. (See Figure 111 below.)
Tip: You can use CTRL+E to select the next eye
type directly from the keyboard. You can use
CTRL+SHIFT+E to select the previous eye type
directly from the keyboard.

Figure 111 Eye Type Selected

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Accutome A-Scan Plus User’s Guide

2. Press the knob or the √ button, to activate the

field, indicated by the dashed border. (See Figure
112 below.)

Figure 112 Eye Type Active

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Performing Measurements How to Set the Eye Type

3. Within the eye type field, rotate the knob to scroll

through the list of eye types. Select the appropri-
ate eye type. Press the knob or the √ button to
save the new eye type.

Figure 113 Eye Type Changed

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Accutome A-Scan Plus User’s Guide

Probe Applica- The Accutome A-Scan Plus supports two different

tion Methods methods of applying the probe to the cornea, contact
and immersion.
Select the method you will be using by pressing the
Contact/Immersion soft menu button.

Immersion
The Accutome A-Scan Plus makes it easy to use the
Immersion method. The immersion method yields
improved accuracy by allowing direct detection of the
corneal echo and eliminating compression of the ACD
associated with the contact method.
The immersion probe application method is used in
conjunction with a Prager shell or Hansen shell with an
immersion fluid. While using the immersion method the
probe should be placed from 5 - 14.5 mm above the
cornea.

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 will
affect IOL calculations.

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Performing Measurements Capture Modes

Capture Modes The Accutome A-Scan Plus provides two methods of

capturing measurements; Automatic, or ’Auto’, and
Manual. The Automatic mode allows the instrument to
determine, based upon user established criteria, when a
measurement is captured. The Manual mode allows the
user to determine when a measurement is captured.

Auto Mode
When you are using the Auto mode the Accutome A-
Scan Plus uses the definition of automatic measurement
that has been set up in the unit’s preferences.
The user is allowed define the Automatic measurement
mode by specifying how a measurement is
automatically captured. There are a total of three criteria
available and each can be turned off or on by the user on
the Setup screen. The criteria are:
™ Sclera - automatic capture determined by
sclera detection
™ Retina - automatic capture determined by
retina detection
™ Stable - automatic capture determined by
measurement stability
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’, displayed as ‘Auto (S__)’. Sclera
must have a distinct sclera echo after the retina, above
the threshold. Between the Retina and Sclera the signal
must go below the threshold.
’Retina’, displayed as ‘Auto (_R_)’, must begin at the
base line, have no data greater than 10% of the
threshold in front it (for 1.5 mm), and be steeply rising.
"Stable’, displayed as ‘Auto (__S)’, means the
measurement needs to be within a tolerance for a certain
amount of time.

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Accutome A-Scan Plus User’s Guide

*Note: For more information on setting the Auto mode refer

to "How to Set the Auto Mode" on page 141 of this
manual.

Another aspect of the Auto Mode that is established in

the Accutome A-Scan Plus setup is the Restart feature.
If ’Restart’ is set to ’ON’ and less than five
measurements have been taken, the Auto mode restarts
measurement after automatic capture. The Restart
setting is available on the Setup screen, by pressing the
Preferences button and then the More Settings... soft
menu selection, or by pressing the Preferences button
twice.

*Note: For more information on setting the Auto mode refer

to "Restart On/Restart Off" on page 148 of this
manual.

Manual Mode
Using the manual mode of capture you determine when
a waveform is good and capture it manually.

162
Performing Measurements How to Capture a Waveform

How to Cap- You can "freeze" or, capture, the waveform with the
ture a Wave- optional footswitch or by pressing the button beneath the
form Run/Frozen selection on the front panel, or by pressing
the Measure button at the top right corner.

Using the Foot Switch

When you want to capture a waveform simply press on
the footswitch. The Accutome A-Scan Plus will switch
from "Running" to "Frozen".

Using the Running/Frozen Button

When you want to capture a waveform press the button
beneath the Running/Frozen selection. The Accutome
A-Scan Plus will switch from Running to Frozen.

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.

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Accutome A-Scan Plus User’s Guide

How to Select After you have taken measurements you may want to go
a Measure- back and review one of the captured waveforms. There
ment are two ways to select a previous measurement; using
the knob and button, or by using the foot switch.

Selecting a Measurement with the Knob

To select a measurement using the knob:
1. Within the Measurement Screen, rotate the knob
to select the measurements table located at the
bottom right corner of the screen. Selection is indi-
cated by a solid black border.
2. Press the knob or the √ button, to activate the
table, indicated by the dashed border. (See Figure
114.)
3. Within the measurements table, rotate the knob to
scroll through the list of measurements. You can
also just press the number (1 - 5) of the measure-
ment on the keyboard. The measurement outlined
with white text against a black background is the
active measurement.

Figure 114 Measurement Selected

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Performing Measurements How to Select a Measurement

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 Review
Menu:
1. Within the Measurement Screen, rotate the knob
to select the waveform area. Selection is indi-
cated by a solid black border.
2. Press the knob or the √ button, to activate the
waveform area, indicated by the dashed border.
(See Figure 115 below.) The soft menu selections
on the Measure Screen will change from the Main
menu to the Waveform Review Menu.

Figure 115 Measurement Activated with Waveform Review Menu

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Accutome A-Scan Plus User’s Guide

3. 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 all the measurements in the Mea-
surement Table.
Tip: You can use CTRL+V to scroll through the
measurements directly from the keyboard.

Selecting a Measurement with the Foot Switch

If you are in a screen, other than the Measure Screen,
pressing the foot switch will bring you to the Measure
Screen. In the Measure Screen the foot switch allows
you to capture, select, or delete a waveform.
To select a measurement with the foot switch:
1. Within the Measure Screen, press and release the
foot switch to select a measurement. The foot
switch will scroll through the table of measure-
ments each time you press it. Scrolling proceeds
from top to bottom and then back to the top of the
table again.

166
Performing Measurements How to Delete a Measurement

How to Delete You may want to delete one of the captured patient
a Measure- measurements. You can delete a measurement with the
ment "X" button, the keyboard delete key or by using the foot
switch

Deleting a Measurement with X Button or Keyboard

To delete a selected waveform press on the "X" button or
the delete key on the keyboard when the waveform or
measurement table is selected.

Deleting a Measurement with the Foot Switch

You can also press on the footswitch to delete the active
measurement and start a new measurement. With the
measurement you would like to delete selected, press on
the footswitch and hold for approximately one second.
The line in the measurement table will clear and you can
recapture the waveform.
Tip: You can use DELETE on the keyboard to delete
the active measurement.

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How to Adjust The Accutome A-Scan Plus takes measurements by

Gates/ sending a signal through the eye via the ultrasonic
Threshold probe. The various parts of the eye have different
velocities. The signal passes through each part of the
eye at different speeds depending upon the acoustic
velocity of the eyes’ components. (If there is already an
IOL in the eye the signal will travel at a different speed
than it would through a natural lens.)
Each time the signal encounters a change in velocity,
due to the difference in material, the signal echoes off
that part of the eye and is transmitted through the probe
as a vertical spike in waveform. The vertical spikes in
the waveforms are events, or the point in time when the
signal encountered the different material. The Accutome
A-Scan Plus measures the distances between these
spikes and calculates the AXL value by summing all
pieces of the waveform.
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 echoes to meet to be
included as part of the measurement.
Accuracy depends upon the location of the gates and
threshold along the waveform. The purpose of the
gates/threshold is to delimit events. The gates/threshold
tell the Accutome A-Scan Plus when to start looking for
the different events in the waveform. Events will be
detected to the right of the gate and above the threshold.
The location of detected events are displayed in the
scale below the waveform as indicated by solid black
triangles.
If an event is not detected or is associated with an
anomalous echo the user must reposition the gates/
threshold to properly measure the waveform.

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Performing Measurements How to Adjust Gates/Threshold

The process of adjusting gates/threshold consists of:

™ Selecting the gates/threshold
™ Repositioning the gate location

Available Gates/Threshold
A gate delimits an event, such as the detection of the
cornea. There are four vertical gates and one horizontal
threshold along the horizontal and vertical axis of the
waveform. The gates/threshold are as follows:
™ Cornea Gate
™ Anterior Lens Gate (visible if the eye type is
not Aphakic)
™ Posterior Lens Gate (visible if lens thickness
is measurable)
™ Retina Gate
™ Threshold

The event being measured should be located to the right

of the gate and above the threshold. You can reposition
the gates/threshold if the events, gates and threshold do
not align properly.

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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 current waveform area, indicated by a
solid black border.

Figure 116 Current Measurement Waveform Selected

2. Press the knob or the √ button, to activate the cur-

rent waveform area, indicated by the dashed bor-
der.
3. When the current waveform is active, the Accu-
tome A-Scan Plus will display a new soft menu at
the bottom of the Measure screen.

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Performing Measurements How to Adjust Gates/Threshold

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 rotate the
knob to make the adjustment.

Figure 117 Waveform Review Menu Activated

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Accutome A-Scan Plus User’s Guide

How to Adjust the Cornea Gate

The cornea gate should be located before the start of
the cornea echo. The active gate is displayed with
dashed line while gates/threshold are indicated by dotted
lines.
To adjust the cornea gate:
1. Press the button beneath the Gate selections until
the "Gate Cornea" is displayed.
Tip: You can use CTRL+C to select the Cornea Gate
directly from the keyboard, or hold to select
cornea gates for all measurements.
2. Rotate the knob to move the cornea gate close to
the cornea echo.
3. When the gate is in the proper position, either
press the the button beneath the gate selections to
select another gate for adjustment or press the
button beneath "Done", the knob or the √ button to
deactivate the menu.

Figure 118 Cornea Gate Selected

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Performing Measurements How to Adjust Gates/Threshold

How to Adjust the Anterior Lens Gate

The anterior lens gate should be located before the start
of the first lens echo.

*Note: The anterior lens gate is only visible for non-Aphakic

eye types

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 CTRL+A to select the Anterior
Lens Gate directly from the keyboard, or hold to
select anterior lens gates for all measurements.
2. Rotate the knob to move the anterior gate close to
the first lens echo.

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3. When the gate is in the proper position, either

press the the button beneath the gate selections to
select another gate for adjustment or press the
button beneath "Done", the knob or the √ button to
deactivate the menu.

Figure 119 Anterior Lens Gate Selected

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Performing Measurements 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 thickness to be Measured and
not assumed.

To adjust the posterior lens gate:

1. Press the button beneath the Gate selections until
the "Gate Post Lens" is visible.
Tip: You can use CTRL+P to select the Posterior
Lens Gate directly from the keyboard, or hold to
select posterior lens gates for all
measurements.
2. Rotate the knob to move the posterior lens gate
before the last lens echo.

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3. When the gate is in the proper position, either

press the the button beneath the gate selections to
select another gate for adjustment or press the
button beneath "Done", the knob or the √ button to
deactivate the menu.

Figure 120 Posterior Lens Gate Selected

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Performing Measurements How to Adjust Gates/Threshold

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 can use CTRL+R to select the Retina Gate
directly from the keyboard, or hold to select
retina gates for all measurements.
2. Rotate the knob to move the retina gate before the
start of the retina echo.
3. When the gate is in the proper position, either
press the the button beneath the gate selections to
select another gate for adjustment or press the
button beneath "Done", the knob or the √ button to
deactivate the menu.

Figure 121 Retina Gate Selected

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Accutome A-Scan Plus User’s Guide

How to Adjust the Threshold

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 Threshold" is visible.
Tip: You can use CTRL+T to select the Threshold
Gate directly from the keyboard, or hold to
select threshold gates for all measurements.
2. Rotate the knob to move the threshold below the
minimum height of the echo.
3. When the gate is in the proper position, either
press the the button beneath the gate selections to
select another gate for adjustment or press the
button beneath "Done", the knob or the √ button to
deactivate the menu.

Figure 122 Threshold Gate Selected

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Performing Measurements How to Adjust Gates/Threshold

How to Apply Gate Adjustments to All Waveforms

You may want to apply a gate adjustment to all current
eye waveforms.
To apply a gate adjustment:
1. Press and hold the button beneath the Gate selec-
tions for approximately one second. The text on
the Gate menu selection will then read "Gate
(All)..." for whichever gate is selected. For exam-
ple, you just completed selecting the anterior lens
gate and you hold the Gate menu button; the
selection will then read "Gate (All) Ant Lens Gate".
2. 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 mea-
surement table.

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Accutome A-Scan Plus User’s Guide

How to Adjust The Gain parameter on the Measure Screen allows you
the Gain to adjust the gain of the signal received from the
ultrasonic probe that is displayed as the waveform. The
waveform must be selected and active to display the
waveform Review menu. This feature can be useful if
you are having difficulty getting a strong waveform
image. The intensity of the signal ranges from a 20 dB to
a minimum of 0 dB that can be adjusted in increments of
1.
To adjust the gain:
1. Press the button beneath the "Gain" selection.

Figure 123 Gain Selected

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Performing Measurements How to Adjust the Gain

2. Rotate the knob to select one of the pre-entered

gain values.

*Note: To return the gain to the new patient default value,

press and hold the gain button for approximately 1
second.

Tip: You can use CTRL+G to increase the gain 1dB

directly from the keyboard, or hold to set the
gain to the default.

Figure 124 Gain Field Changed

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Accutome A-Scan Plus User’s Guide

How to Use The zoom feature allows you to zoom in on a selected

Zoom 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 waveform Review menu. Zoom can
be useful if you are having difficulty detecting all the
events in a reading, or if you are scanning an abnormal
eye type. Zoom has eight preset values of multiplication;
8.0, 4.0, 2.7, 2.0, 1.6, 1.3, 1.1, and 1.0. Zoom value of
1.6 is typical setting.
To use the Zoom feature:
1. Press the button beneath the "Zoom" selection.

Figure 125 Zoom Selected

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Performing Measurements How to Use Zoom

2. Rotate the knob to select one of the preset zoom

values.
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 126 Zoom Changed

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Accutome A-Scan Plus User’s Guide

How to Scroll The Scroll feature moves the active waveform from left
to right and from right to left. Scroll allows you to view
the horizontal dimension of a waveform. This feature
can be useful if you are zooming in on a certain area of
the measurement and you would like to look at another
area of the waveform.
To scroll an image:
1. Press the button beneath the "Scroll" selection.

Figure 127 Scroll Selected

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Performing Measurements How to Scroll

2. Rotate the knob to move the waveform.

Tip: You can use CTRL+ S to scroll the waveform
increasing 1mm directly from the keyboard, or
hold to set the scroll to 0.
3. When the waveform is in the correct position,
either press another waveform menu selection or
press the button beneath "Done", the knob or the
√ button to deactivate the menu.
*Note: To scroll to the start of the waveform, press and hold
the scroll button for approximately 1 second.

Figure 128 Measurement Scrolling Changed

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Accutome A-Scan Plus User’s Guide

Switching It is very simple to switch between eyes using the

Eyes 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
eye will be displayed.
Tip: You can use O or CTRL+O to switch between
OD and OS.

Customize Eye You can also customize a Patient’s eye type on the fly.
Type The soft menu selection "Customize Eye Type..."
launches the Customize Eye Type Screen where
customizing on a per patient basis occurs.
Refer to "Customizing Eye Types" on page 187 of this
manual for customizing eyes.

*Note: At this point you should either calculate the

replacement lens or save the measurement record.
Refer to either "Performing Calculations" on
page 197 or "Storing and Recalling Records" on
page 241 of this manual.

186
 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 velocities for either
the OD or OS while performing live measurements. A
Custom Eye Type is linked to a patient eye, and is not a
machine setting available for other patients.
All on-the-fly customization is performed at the
Customize Eye Type Screen. Customization features
include:
™ Creating a new OD/OS eye type
™ Changing/creating AC material and velocity for
new eye type
™ Changing/creating Lens material and velocity
for new eye type
™ Changing/creating Vitreous material and
velocity for new eye type

*Note: An eye type is considered 'custom' if its definition, as

displayed on the Customize Eye Type Screen, does
not match an eye type definition displayed in the Eye
Types Screen. This will occur if you customize the
eye type directly. An eye type will be displayed as
custom if its definition is permanently changed on
the Eye Types screen and the current patient's eye
type no longer matches. If you change the Eye Type
definition on the Eye Type screen, and you wish to
use that definition for the current patient, reselect the
eye type from the Measure Screen.

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Accutome A-Scan Plus User’s Guide

An eye type that is considered custom will have a *

beside its name on all patient data screens.

Customize Eye The Accutome A-Scan Plus provides access to the

Type Screen 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 Type" the
Customize Eye Type screen will be displayed.
In the Customize Eye Type screen you can create and
define new eye types or review the current eye type
definition. You can select pre-entered selections in each
field, or you can create your own.

Customize Fields and Menu Selections

The Customize Eye Type screen displays the following
fields.

OD
The OD eye type name.

OS
The OS eye type name.

Eye Type Table

Located to the right of each eye type name is a table with
fields defining the material and velocity for AC, Lens, and
VC. You can change all the fields that are white. You
cannot change any field that is filled grey.

AC
The AC (Anterior Chamber) material name and velocity

Lens
The Lens material name and velocity and thickness
setting. Thickness can be measured or assumed. Press
the Delete key to change the Lens Thickness field from
assumed to measured.

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Customizing Eye Types Customize Eye Type Screen

VC
The VC (Vitreous Cavity) name material and velocity
The Customize Eye Type screen also has the following
soft menu selections activated by the buttons beneath
the selection:
™ 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 * (asterisk) to the right of any field in the

Customize Eye Type Screen, it indicates that a value
has been changed and that it is non-standard, or,
custom.

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Accutome A-Scan Plus User’s Guide

How to To customize an eye type for an active patient:

Customize an
Eye Type
1. In the Measure Screen, press the button beneath
the selection "Customize Eye Type...". The Cus-
tomize Eye Type screen as shown in Figure 129
below will be displayed.

Figure 129 Customize Eye Type Screen

190
Customizing Eye Types How to Customize an Eye Type

2. Within the Custom Eye Type Screen, rotate the

knob to select the Material/Velocity table, indi-
cated by a solid black border. There are two mate-
rial/velocity tables on the screen. You should
select the one to the right of the patient’s eye that
you are customizing.

[All eye types include an assumed cornea]

Figure 130 OS Materials Table Selected

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Accutome A-Scan Plus User’s Guide

3. Press the knob or the √ button, to activate the

table, indicated by the dashed border.
4. Within the Material/Velocity table, rotate the knob
to select the table cell you would like to change. In
the example given in Figure 131 below the cell
selected is the VC Material cell.

[All eye types include an assumed cornea]

Figure 131 OS Materials Table Activated

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Customizing Eye Types How to Customize an Eye Type

5. Within the VC Material cell, rotate the knob to

select one of the pre-entered materials as shown
in Figure 132 below,
6. You can also press the button beneath the selec-
tion "Edit Text" and enter the material name; the
material doesn’t have to be pre-entered.

[All eye types include an assumed cornea]

Figure 132 Changing VC Material

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Accutome A-Scan Plus User’s Guide

7. 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 133
below is now followed by an * indicating that is a
custom eye type.

[All eye types include an assumed cornea]

Figure 133 VC Material Cell Changed

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Customizing Eye Types How to Customize an Eye Type

8. 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.
9. Within the VC Velocity cell, rotate the knob to
adjust the velocity.
10. You can also press the button beneath the selec-
tion "Edit Text" and enter the material name; the
material doesn’t have to be pre-entered.

[All eye types include an assumed cornea]

Figure 134 Changing Velocity Field

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Accutome A-Scan Plus User’s Guide

11. All the custom changes to the Patient Eye Type will
be followed by an asterisk (*), as shown in Figure
135 below.
12. Adjust any other eye type fields following the same
procedures.
13. When you have completed customizing the patient
eye, press the button beneath the selection
"Done..." to deactivate the Custom Eye Type
Screen. You will return to the Measure Screen and
the new eye type information will be displayed for
the patient.

[All eye types include an assumed cornea]

Figure 135 OS Eye Type Customized

196
 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 calculates
emmetropic and targeted ametropoic IOL powers for
dozens of lenses, viewed three at a time, using the axial
length from the average of valid waveforms, a single
waveform, or manually entered AXL.

Calculating the The IOL calculation provides the required power of IOLs
Lens using a measured or entered axial length, entered K1
and K2 values, and entered desired post operative
refraction.
All calculations are made on the Calculate IOL Screen.
To access the Calculate IOL Screen press the Calculate
button, located at the right side of the instrument.

Calculation after Corneal Refractive Surgery

The A-Scan also has the advanced capability to
calculate IOLs for patients that have had corneal
refractive surgery.
For patients who have had corneal surgery, the
characteristics and power of the cornea have been
altered.
Calculations for post surgery patients are made using
the Double K method, which uses both the pre and post
corneal refractive surgery K values. For more
information on the Double K method refer to page 207 of
this manual.

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Accutome A-Scan Plus User’s Guide

Calculate Button

Figure 136 Calculate Button

198
Performing Calculations Calculate IOL Screen

Calculate IOL The Calculate IOL Screen shown in Figure 137 below
Screen 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 current IOL Group.
The Accutome A-Scan Plus allows the user to fine tune
the calculation by providing the ability to change the AXL
value, the lens, formula and desired postoperative result
refraction (the target).
The process for calculating the power of a lens is to
select or enter an AXL value, select an IOL Group, select
a formula, and enter the K1, K2 and Target values.
*Note: The Rx Surg (Post Refractive Corneal Surgery) field
should be left at "No". Change the field to "Yes" to
calculate IOLs for patients that have had corneal
refractive surgery. Refer to "Calculating IOL Power
After Corneal Refractive Surgery" on page 207 for
instructions on changing the Rx Surg field.

Figure 137 Calculation Fields

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Accutome A-Scan Plus User’s Guide

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 of IOL Groups. Stop when you
have reached the correct group. (Refer to "How to Set
Up an IOL Group" on page 216 of this manual for further
information.)

Selecting a Formula
You may want to change the formula used to calculate
the IOL. To scroll through the list of available formulas
press the button beneath "Select Formula" selection.
The IOL constant used by the currently selected formula
is highlighted as white text on black background for each
IOL.

Entering an ACD Value with the Haigis Formula

The Haigis formula uses the measured ACD or
calculated ACD value, as well as the axial length (AXL).
The ACD is shown in the measurement history list, and
an ACD field is added where the user can specify a
calculated or manually entered ACD. ACD should be
calculated for Aphakic and Pseudophakic eye types.
The other formulas do not use the measured ACD field in
any way and the field is only shown when Haigis is
selected or the formula compare mode is on.
Specify the ACD value by allowing the Accutome A-Scan
Plus to calculate (Calc) the value or manually enter the
value.
To manually enter the ACD value:
1. Rotate the knob to select the ACD field and press
the knob or the √ button to activate the field.
When the field is active either rotate the knob, if
necessary, to select "Calc" for a calculated value
or manually enter the ACD value in millimeters
(mm).
2. If you would like the A-Scan to calculate the ACD
press the "Delete" key or the X button to remove

200
Performing Calculations Calculate IOL Screen

the entered value and replace it with "Calc" for a

calculated value

*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

The Accutome A-Scan Plus allows the user to fine tune
the calculation by providing the ability to change the AXL
value. You can select the AXL from any of the five
measurements, the average of the measurements, or
you can enter your own axial length.

Selecting a Measurement
You may want to select a particular measurement with
which to perform the calculation.
To select one of the available measurements:
1. Within the Calculate IOL Screen, rotate the knob to
select the "AXL" list, located in the bottom right
corner of the screen. Selection is indicated by a
solid black border.
2. Press the knob or the √ button, to activate the list,
indicated by the dashed border.
3. Within the AXL list, rotate the knob to select one of
the AXL measurement values or the average.
4. Press the knob or the √ button, to save the
selected AXL value and to deactivate the field.

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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 allows you to
manually enter an AXL value.
To enter an AXL value:
1. Within the Calculate IOL Screen, rotate the knob to
select the "AXL" field, located in the top right side
of the screen. Selection is indicated by a solid
black border.
2. Press the knob or the √ button, to activate the
field, indicated by the dashed border.
3. Within the AXL field, enter the new AXL value.
4. Press the knob or the √ button, to save the
entered AXL value and to deactivate the field.
5. The A-Scan will indicate that the AXL value is
entered with the text "[entered]" below the AXL
field.

Entering the K1, K2 Values

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 1.3375. European keratometers
may have an index of refraction of 1.3315. The factory
default is 1.3375.
The K Index value is only used when entering
keratometer readings in diopters. K readings can be
entered on the Calculate IOL screen as well as the
Personalize IOL screen. The K index associated with
diopter entries is not explicitly shown. When a
keratometer reading is entered in diopters the default K
index is copied from the setup screen. If the K index of
an entry is different than the Setup screen default K
Index, a * appears beside the entry. To change or view
the K index, change or reenter the diopter entry. The
Accutome A-Scan Plus will prompt you with the default

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Performing Calculations Calculate IOL Screen

and current K indexes and ask which one you want

associated with the entry.
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 a
keratometer index of refraction associated with them to
allow for conversion to mm as needed by some of the
formulas.
Enter the optical power of the cornea in diopters or mm,
as measured on a keratometer or corneal topographer,
as K1, K2.
To enter an K1, K2 values:
1. Within the Calculate IOL Screen, rotate the knob to
select the "K1" field, located in the middle right
side of the screen. Selection is indicated by a solid
black border.
2. Press the knob or the √ button, to activate the
field, indicated by the dashed border.
3. Within the K1 field, enter the K1 value or rotate the
knob until you arrive at the value.
4. Press the knob or the √ button, to save the
entered K1 value and to deactivate the field.
5. Enter the K2 value in the same manner.

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Accutome A-Scan Plus User’s Guide

Entering the Target Value

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
black border.
2. Press the knob or the √ button, to activate the
field, indicated by the dashed border.
3. Within the Target field, enter the target value or
rotate the knob until you arrive at the value. The
Target Value changes in 0.25 D steps. You can
use the keyboard to enter a value within 0.01 D.
4. Press the knob or the √ button, to save the
entered Target Value and to deactivate the field.

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 exist in the real world.
A list of five IOL powers and their expected refraction, in
0.5 D increments and centered on the result closest to
the target power, is displayed for each IOL.
The Accutome A-Scan Plus also provides you with a
lens value for a zero target (Emmetropic). The zero
target values are listed below the optimal IOL powers in
small numbers.

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Performing Calculations Calculate IOL Screen

Figure 138 Calculate IOL Screen - All Fields Entered

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Accutome A-Scan Plus User’s Guide

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 refraction with the expected postoperative
refraction as calculated by each formula.
To compare calculations for all formulas, press on the
button beneath "Compare On/Compare Off". This button
toggles between the two and will display the calculations
for one formula or all formulas as the button is toggled.

Figure 139 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
readings for either OD or OS as the button is switched.

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Performing Calculations Calculate IOL Screen

Calculating The Accutome A-Scan Plus also provides the ability to

IOL Power calculate IOLs for patients who have had corneal
After Corneal refratcitve surgery.
Refractive
Surgery Corneal refractive surgery alters the characteristics and
power of the cornea.

*Note: Calculating IOL powers for post refractive surgery

patients is an evolving topic and requires research
and careful planning on the part of the
opthalmologist. The methods and formulas
presented by the Accutome A-Scan Plus for this type
of patient should only be used by a qualified
individual who has done due diligience to determine
the best method, and how to execute that method,
for each patient. If a more appropriate formula or
method for determining the current corneal power is
available, the result of this formula can be used by
selecting the 'Entered' Kpost formula and entering
the power manually.

Double K Method
All IOL formulas, except for the Haigis formula, use the K
measurement in two ways: to know the power of the
cornea, and to help estimate the position of the IOL.
The power of the cornea needs to be the current K of the
patient (post refractive surgery). Estimating the position
of the IOL should be based on the pre refractive surgery
K of the patients. Using both the post and pre corneal
refractive K is called the Double K Method.
When the Rx Surg field is set to Yes, indicating corneal
refractive surgery, the Kpre and Kpost fields are
displayed in the place of K1/K2. Both of these fields must
have data for the formulas to calculate the IOL power.
When using the Haigis formula, the Kpre field is not
shown. The Haigis formula does not use Kpre to
determine the IOL position, the Haigis formula uses the
measured ACD.

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Determining Corneal Power after Refractive Surgery

(Post Rx Surg)
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, or methods, are available in the Accutome A-
Scan Plus to determine the current corneal power for
refractive patients (Kpost).

*Note: If you do not know the patients prerefractive surgery

corneal power, you may want to consider using the
Haigis formula which does not require this
information.

Post Rx Surg IOL Calculation Steps

The steps to complete a post refractive surgery IOL
Calculation are almost the same as non refractive
surgery eye calculations with the addition of selecting a
Post K method.
To complete a post refractive surgery calculation:
1. Set the Rx Surg field to "Yes".
2. Select an IOL Group (see "Selecting an IOL
Group" on page 200).
3. Select or enter an AXL value (see "Changing the
AXL Value" on page 201 for instructions).
4. Enter the applicable averaged K1and K2 readings,
Sphere, and Cyclinder values.
5. Enter the target value (see "Entering the Target
Value" on page 204).

Selecting a K Post Calculation Method

The K Post calculation methods are:
1. Clinical History method - Calculates Kpost based
on Kpre, refraction before and after refractive sur-
gery.
2. Contact Lens method - Calculates Kpost based on
refraction after refractive surgery with and without
a hard contact lens of a known curve and power.

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Performing Calculations Calculate IOL Screen

3. Shammas Clinical method - Calculates Kpost by

adjusting on manual K reading after refractive sur-
gery using simple formula Kpost = 1.14 * Kmea-
sured – 6.8
4. Entered - The user can enter the Kpost value pre-
sumably calculate using some external method.
The Kpost calculation methods are listed in order of
preference, with the Clinical History method as the
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
stored and becomes the default for the next patient.

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Changing Rx Surg Field to Yes

*Note: The only time the Rx Surg field should be changed

to yes is for a patient that has had corneal refraction
surgery.

In Figure 140 below the Rx Surg field is selected. To

activate the Rx Surg field and change the field:
1. Rotate the knob to select the Rx Surg field and
press the knob or the √ button to activate the field.
When the field is active either rotate the knob to
change "No" to "Yes".
2. Press the knob or the √ button to activate the Post
Surgery function.

Figure 140 Post Rx Surgery Field (Rx Surg) Selected

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 of measured
K1and K2 prior to corneal refractive surgery.

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Performing Calculations Calculate IOL Screen

Clinical History Method

When using the Clinical History method, the default and
preferred method, the Calculate IOL screen displays
Kpre and Kpost fields and all fields associated with the
Clinical History method.

Clinical History Fields

When using the Clinical History method for post
refractive surgery IOL calculations you must enter the
value in the following fields:
™ Kpre - the average K value before refractive
surgery
™ Sphere and Cylinder before refractive surgery
and the current refraction
1. Rotate the knob to select each field and press the
knob or the √ button to activate the field. When
the field is active either rotate the knob to change
the value or manually enter the value with the key-
board.

Figure 141 Post Rx Surgery Calculation Activated - Clinical History

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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 the contact lens)
™ Power (of the contact lens)
1. Rotate the knob to select each field and press the
knob or the √ button to activate the field. When
the field is active either rotate the knob to change
the value or manually enter the value with the key-
board.

Figure 142 Post Rx Surgery Calculation with Contact Lens Method

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Performing Calculations 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 keratometer on the post

refractive surgery cornea.
1. Rotate the knob to select each field and press the
knob or the √ button to activate the field. When
the field is active either rotate the knob to change
the value or manually enter the value with the key-
board.

Figure 143 Post Rx Surgery Calculation with Shammas Clinical

Method

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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 exist in the real world.
A list of five IOL powers and their expected refraction, in
0.5 D increments and centered on the result closest to
the target power, is displayed for each IOL.
The Accutome A-Scan Plus also provides you with a
lens value for a zero target (Emmetropic). The zero
target values are listed below the optimal IOL powers in
small numbers.

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
readings for either OD or OS as the button is switched.

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 Setting Up IOL
Groups

How are IOL IOLs can be grouped by type, manufacturer, physician,

Groups Used location, patient pathology, or other criteria. IOLs are
organized in groups of three. Each group can be given a
custom name to distinguish its purpose. Any IOL group
can be selected directly from the Calculate IOL Screen
for quick selection of the desired IOLs for the current
patient. You can setup 15 IOL Groups, each with up to 3
IOLs, for a system total of 45 IOLs.
When you set up IOL groups you set them up in the IOL
Groups Screen. The IOL Groups Screen is the only
location within the Accutome A-Scan Plus for entering
IOL information.

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How to Set Up The process for setting up an IOL Group consists of:
an IOL Group
™ Entering an IOL Group Name
™ Entering lens information associated with each
group
All entry of IOL Groups takes place at the IOL Groups
Screen. The IOL Groups screen is accessed from the
Calculate IOL Screen.
To access the Calculate IOL Screen press the Calculate
button, located at the right side of the instrument. The
Calculate IOL Screen shown in Figure 144 below will
then be displayed.

Accessing the IOL Groups Screen

In the Calculate IOL Screen:
1. Press the button beneath the selection "IOL
Groups...". The IOL Calculation Groups Screen
will then be displayed.

Figure 144 Select IOL Groups

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Setting Up IOL Groups How to Set Up an IOL Group

IOL Calculation Groups Screen

The IOL Groups Screen as shown in Figure 145 below,
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 side of the screen displays a field for the group
name. To the right of the group name field is the lens
table for that group.
The screen can display four groups at a time. If you
would like to view another of the possible 15 groups,
press the button beneath the "Scroll Groups Down" or
"Scroll Groups Up" selections.
The Delete IOL selection allows you to delete a selected
IOL. The Personalize IOLs selection displays the
Personalize IOL screen for personalizing the constants
used with selected IOLs.

Figure 145 IOL Groups Screen

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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 can also press the buttons
beneath the "Scroll Groups Up" and Scroll Groups
Down" selections to locate an empty space.
2. Press the knob or the √ button, to activate the
field, indicated by the dashed border.
3. Within the Group field enter the name of the Group
for which you are entering lenses.
4. Press the knob or the √ button, to save the
selected Group name and to deactivate the field.

Figure 146 Entering the IOL Group Name

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Setting Up IOL Groups How to Set Up an IOL Group

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, indicated by
the dashed border.
3. Within the lens table, rotate the knob and select
the Description cell. (Selection is indicated by a
solid black border).
4. Enter the description of the first lens you are enter-
ing.
5. Press the knob or the √ button, to save the
description and to deactivate the field.

Figure 147 Entering the IOL Description

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Accutome A-Scan Plus User’s Guide

*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 constants for the Hoffer, Holladay
and SRK/T are calculated if they are all empty. At
the same time the Haigis constants a0, a1 and a2
are calculated. a1 is always 0.4, and a2 is always
0.1 unless specified by the user as a result of triple
optimization. a0 is the IOL factor, a1 is the measured
ACD factor, and a2 is the is the axial length factor for
determining the post operative ACD of the IOL.

If you have more than one constant for your lens,

such as an A-Constant and a personalized SF, enter
the non personalized A-Constant first, then overwrite
the calculated SF with your personalized SF.
Personalized constants should only be used with the
formula they were derived from.

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Setting Up IOL Groups How to Set Up an IOL Group

6. Within the lens table, rotate the knob and select

the A-Con cell. (Selection is indicated by a solid
black border).

Figure 148 Selecting the A-Constant Field

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Accutome A-Scan Plus User’s Guide

7. Enter the A-Constant for the first lens you are

entering.

Figure 149 Entering the IOL Constant

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Setting Up IOL Groups How to Set Up an IOL Group

8. 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 fill out the formula
cells in the table.

Figure 150 First Lens Entered for Group 1

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Accutome A-Scan Plus User’s Guide

9. Continue to enter all lens information for the IOL

Group in the same manner. When you have com-
pleted the table press the knob or the √ button,
once, to save the last cell entered and then again
to deactivate the table.
10. If you have completed entering all IOL Group infor-
mation press the button beneath the selection
"Done..." to return to the Calculate IOL Screen.

Figure 151 First IOL Group Complete

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 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
outcomes.
*Note: The Personalize IOLs screen does not allow the
pasting of patient data for an eye that has Rx Surg
set to Yes. If you attempt to personalize IOLS with
post refractive surgery eyes the following message
is shown: "Refractive surgery eyes cannot be used."

Personalizing Lens Constants

IOL constant personalization is a method for removing
consistent errors from the entire IOL implant procedure.
It is important that as many variables as possible be
consistent when personalizing constants for an IOL.
These variables include:
™ Diagnostic Technician
™ Diagnostic Equipment (A-scan, Keratometer)
™ Surgical Technique
™ Surgical Equipment
™ Patient Pathology
™ IOL Manufacturer and Model
™ IOL Calculation Formula
For this reason, the Accutome A-Scan Plus tracks
personalized constants for each IOL and formula
separately.
The process for personalizing lens constants involves
entering postoperative results and allowing the
Accutome A-Scan Plus to recalculate the constants used
in the calculation formulas. The instrument tracks all the
data entered in the postoperative results and optimizes
all the data to determine the new formula constant.

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How to The process of personalizing IOLs consists of:

Personalize ™ Selecting IOL Groups and Lenses
Constants ™ Entering Postoperative Results
™ Updating the IOL Constants

All personalization of IOL Constants takes place at the

Personalize IOL Screen. The Personalize IOL Screen
can be accessed from the Calculate IOL Screen via the
IOL Groups Screen, or by pressing the Calculate button
twice. To access the Calculate IOL Screen, and
subsequently the IOL Groups screen, press the
Calculate button, located at the right side of the front
panel. The Calculate IOL Screen shown in Figure 152
below will be displayed.

Accessing the Personalize IOLs Screen

Starting at the Calculate IOL Screen:
1. In the Calculate IOL Screen, press the button
beneath the selection "IOL Groups...". The IOL
Groups screen will be displayed.

Figure 152 Calculate IOL Screen - IOL Groups Selection

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Personalizing Lens Constants How to Personalize Constants

2. In the IOL Groups screen press the button beneath

the selection "Personalize IOLs...". The Personal-
ize IOLs screen will be displayed.

Figure 153 Personalize IOLs Screen

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Accutome A-Scan Plus User’s Guide

Personalize IOLs Screen

The Personalize IOLs screen displays a group field at
the top left corner and to the right of the group field is an
IOL table that displays the lenses for the currently
selected group. Below the group field and IOL table is
the Postoperative Results table.
To personalize an IOL’s constants it is first necessary to
enter postoperative results for a selected IOL group and
lens.

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
Group and associated lenses
™ Delete Result - deletes the currently selected
postoperative results, for the selected IOL
within the selected IOL group
™ Delete All Results - deletes all postoperative
results for the selected IOL within the selected
IOL Group
™ Paste Patient - pastes current Patient records
into the Postoperative Results table
™ Update IOL Constant... - displays the Update
IOL Constant screen for updating constants

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Personalizing Lens Constants How to Personalize Constants

Selecting an IOL Group and Lens

There are two ways to select an IOL Group and Lens:
you can use the knob and first select and activate the
IOL Group, and then select and activate the IOL Table,
and then select and activate the IOL, or you can
continuously press the button beneath the Next IOL/
Group soft menu selection.

Next IOL/Group
The Next IOL/Group selection scrolls through all entered
IOL Groups and their associated lenses. Once you
reach the last IOL in a group, the selection moves down
to the next IOL group and scrolls through the next
group’s IOLs, and so on until the user reaches the end of
the IOL Groups. If you then continue to press the button
for the Next IOL/Group selection, the A-Scan will display
the top of the list.

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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
an IOL Group.)
2. Press the knob or the √ button, to activate the
field, indicated by a dashed border.
3. Within the IOL Group field, rotate the knob to
select one of the pre-entered IOL groups.
4. Press the knob or the √ button, to save the
selected IOL Group and to deactivate the field.
5. Rotate the knob to select the IOL table which con-
tains the lenses for the selected IOL group; selec-
tion indicated by a solid black border.
6. Press the knob or the √ button, to activate the IOL
table, indicated by a dashed border.
7. Within the IOL table, rotate the knob to select the
lens for which you will be entering postoperative
results. (You can also press the button beneath
the selection ’Next Group/IOL’ to select the IOL.)
8. Press the knob to save the IOL selection and to
deactivate the IOL table.

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Personalizing Lens Constants How to Personalize Constants

Entering Postoperative Results

Part of the process personalizing IOLs is to enter patient
postoperative results so that the results can be used in
calculating the new constant. It is important that as
many variables of the postoperative results be kept
constant; e.g. the results are all taken from the same
machine using the same lens and formula. See
"Overview" on page 225 for more information.
Part of each postoperative result is the Patient
information that includes:
™ Patient Name/ID
™ AXL
™ ACD
™ K1
™ K2
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 menu selection
’Paste Patient...’.

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Accutome A-Scan Plus User’s Guide

Pasting Patient Information

When you press the button beneath the soft menu
selection ’Paste Patient...’ the soft menu on the
Personalize IOLs screen changes to Paste Patient
selections. At any point on Personalize IOLs screen, no
matter what field is active you can paste current patient
info.

*Note: The Past Patient function is only available for the

currently selected patient.

1. Press the button beneath the ’Paste Patient’ selec-

tion.
2. The soft menu selections will change as follows:
™ Paste Name, Paste ID - will toggle between
pasting the patient name or ID
™ Paste OD - will paste all Patient OD
information
™ Paste OS - will paste all Patient OS
information
3. Press the button beneath the ’Paste OD’ soft menu
selection and all Patient OD information will be
automatically entered into the Postoperative
Results table.
4. Press the button beneath the ’Paste OS’ soft menu
selection and all Patient OS information will be
automatically entered into the Postoperative
Results table.
5. Enter the Postoperative Results described in
"Entering Remaining Postoperative Results" on
page 234 of this manual.

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Personalizing Lens Constants How to Personalize Constants

Manually Entering Patient Information

To enter patient information manually:
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 of the
first postoperative result that you are entering.
The last row of the table is where you can enter
post operative results. If the row is not there, you
have reached the maximum number of results
(50).
4. Enter the Patient ID.
5. Press the knob or the √ button, to save the
entered ID.
6. Rotate the knob and select the AXL field of the first
postoperative result that you are entering.
7. Enter the AXL value.
8. Enter the ACD value - required for Haigis formula.
9. Press the knob or the √ button, to save the
entered value.
10. Rotate the knob and select the K1 field.
11. Enter the K1 value.
12. Press the knob or the √ button, to save the
entered value.
13. Continue entering the field values until you have
keyed in all the postoperative values for:
™ AXL- Axial Length in mm
™ K1, K2 - Keratometry measurements in
Diopters or mm

*Note: The "0.00" values for the Sph and Cyl cells of the
Postoperative Results table are present to indicate
the last row of the table.

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Accutome A-Scan Plus User’s Guide

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 Diopters
™ Sphere - Spherical postoperative refraction in
Diopters
™ Cyl - Cylinder postoperative refraction in
Diopters

Deleting Postoperative Results

Normal Postoperative results are essential in
determining an effective personalized IOL constant.
There may be times that you would like to delete some
or all of the postoperative results; e.g. a value is very
high or very low with respect to the average (outliers),
entered data inaccurate, etc.
The Personalize IOLs Screen provides two methods of
deleting postoperative results; you can delete the
currently selected result or you can delete all
postoperative results for the current IOL.

Deleting Current Postoperative Result

To delete the current postoperative result:
1. Ensure that the result you would like to delete is
selected (there should be a cell with a solid black
border).
2. Press the button beneath the selection "Delete
Current Result".
3. The Accutome A-Scan Plus will then query you
"Are you sure?". Press the button beneath the
selection "Yes" to continue, or press the Check
button (√ ) located at the right side of the front
panel.
4. To discontinue deleting the current result press the
button beneath the selection "Cancel", or press the
Delete button (X ) located at the right side of the
front panel.

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Personalizing Lens Constants How to Personalize Constants

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 "Yes" to continue, or press the Check
button (√ ) located at the right side of the front
panel.
3. To discontinue deleting the all results press the
button beneath the selection "Cancel", or press the
Delete button (X ) located at the right side of the
front panel.

How to View Individual Results for a Formula

To view the individual results for a formula:
1. Select the Average Table.
2. Press the knob or the √ button.
3. Select the formula.
Individual results are shown for the selected formula for
each patient. This is a view option only and does not
affect the averages or results in any way.

How to Sort Postoperative Results

The Accutome A-Scan Plus provides the ability to sort
Patient records by several fields:
™ Patient
™ AXL
™ ACD
™ K1
™ K2
™ Pwr
™ Sph
™ Cyl
™ Formula & Constant
The sort fields are located above the Postoperative
Results table.

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Accutome A-Scan Plus User’s Guide

To sort Postoperative results by a field:

1. 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 cur-
rent sort field. To select another sort field you must
activate the current sort field first.
2. Press the knob or the √ button, to activate the
field, indicated by the dashed border.
3. If you want to select another of the sort fields,
rotate the knob until you have selected the appro-
priate field.
4. With the field selected by which you would like to
sort, press the knob to change the sort order. If
you activate the field more than once the A-Scan
will toggle the sort order of the active field from
ascending to descending and vice versa.
5. Press the knob or the √ button, to save the sort
and to deactivate the field.

How to Update IOL Constants

While you enter postoperative results you will notice the
data change in the Average table, located at the bottom
right corner of the screen. The Average Table displays a
count of postoperative results for each Calculation
Formula (Hoffer Q, Holladay, and SRK/T and Haigis).
The Average Table also displays the average IOL
Constant extracted from the postoperative results.
The process for updating IOL constants consists of going
to the Personalize IOLs Screen and selecting an IOL
Group, associated lens and formula, and updating the
constant for the selected formula. When you have
determined you have enough postoperative results to
update the IOL constants:
1. In the Personalize IOLs Screen, press the button
below the selection "Update IOL Constant...". The
Update IOL Constants Screen will be displayed.
You can also press the dedicated Calculate button
a second time to reach the screen.

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Personalizing Lens Constants How to Personalize Constants

Update IOL Constants Screen

The Update IOL Constants Screen (see Figure 154
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’s lenses and the
lenses’ current formula constants. The lens name that is
in white text against a black background is the currently
selected lens.
The Average Table (from the Personalize IOLs Screen)
is also displayed in the bottom right corner of the screen.
The table displays the IOL constant information,
optimized from postoperative results, for the currently
selected lens. From this screen it is possible to select an
IOL Group and update the IOL Constants for a selected
lens and formula.
*Note: The Haigis formula does not do an average but
rather a best fit regression. The other formulas
calculate the 'average'.

Figure 154 Update IOL Constants Screen

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Accutome A-Scan Plus User’s Guide

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 the IOL Group, and then select and activate
the IOL Table, and then select and activate the IOL, or
you can continuously press the button beneath the Next
IOL/Group soft menu selection. Refer to "Next IOL/
Group" on page 229 for more information.
If you are selecting and IOL Group IOL with the knob:
1. In the Update IOL Constants 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
an IOL Group.)
2. Press the knob or the √ button, to activate the
field, indicated by the dashed border.
3. Within the IOL Group field, rotate the knob to
select one of the pre-entered IOL Groups.
4. Press the knob or the √ button, to save the
selected IOL Group and to deactivate the field.
5. Rotate the knob to select the lens constant table
for the selected IOL group. (Table selection is indi-
cated by a solid black border.)
6. Press the knob or the √ button, to activate the
table, indicated by the dashed border.
7. Within the IOL Constants Table, rotate the knob to
scroll through the list of lenses.
8. After you have selected the lens, press the knob or
the √ button, to activate the appropriate lens and
to deactivate the table.
9. 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.
10. At the bottom of the screen, press the button
beneath the appropriate formula to update:
™ Update Hoffer Q ACD

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Personalizing Lens Constants How to Personalize Constants

™ Update Hol SF
™ Update SRKT ACD
™ Update Haigis a0
11. After pressing the button beneath the formula
requiring its IOL constant to be updated, the new
constant will replace the old one in the IOL table.

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Accutome A-Scan Plus User’s Guide

240
 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 a later date.
The Accutome A-Scan Plus makes storing patient
records an easy process. Push the Patient Record
button and the Patient Records Screen, where you can
store and recall all measurement parameters and
calculations, will be displayed. All waveform
measurement and IOL calculation settings and data are
stored with each patient record when it is saved.
Recalling a patient record at a later date allows you to
view the patient record exactly as it was saved. Changes
to instrument settings including Eye Types and
measurement controls made after the patient is stored
and before the patient is recalled do not effect the
recalled patient measurements or IOL calculations.
When you recall a patient record the instrument is set to
same settings as when you stored the record. Asterisks
will appear if settings have altered.

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How to Store a After you have taken all the desired measurements you
Record can save a Patient’s measurements to a record so that
you can recall it at a later time.
To save a Patient’s record:
1. Press the "Patient Records" button located at the
right side of the instrument. The Patient Record
Screen as shown in Figure 155 below will be dis-
played.

Figure 155 Patient Record Screen

242
Storing and Recalling Records How to Store a Record

2. Press the button below "Save Patient". The Accu-

tome 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 the Patient
Records table.

Figure 156 Patient Record Stored

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Accutome A-Scan Plus User’s Guide

How to Recall You may need to recall a patient record at a later date to
a Record review a measurement, or execute a calculation.
To recall a Patient’s record:
1. Press the "Patient Records" button located at the
right side of the instrument. The Patient Record
Screen as shown in Figure 157 below will be dis-
played.
2. Within the Patient Records list, rotate the knob to
select the correct patient record
3. Press the 'Recall Patient' soft menu button to recall
the patient. If the current patient has not been
saved the A-Scan will confirm that the current
patient data will be lost when the stored patient is
recalled.

Figure 157 Recalling a Patient Record

244
Storing and Recalling Records How to Recall a Record

4. Press the Measure or Calculate button, located at

the right side of the front panel. The A-Scan will
display the recalled patient record.

Figure 158 Recalled Patient Record

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Accutome A-Scan Plus User’s Guide

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 adjust parameters refer to the section "Performing
Measurements" on page 151 of this manual.

How to Update Calculations

You can update calculations on a saved record in exactly
the same manner as you would perform a calculation on
an active measurement.
To update calculations refer to the section "Performing
Calculations" on page 197 of this manual.

*Note: Changing a saved patient record does not change

the saved record, and the patient record must be
saved again. You may also want to delete the
previously saved patient so that there is only one
record of that patient.

246
Storing and Recalling Records How to Sort Patient Records

How to Sort The Accutome A-Scan Plus provides the ability to sort
Patient Patient records by several fields:
Records
™ Patient
™ ID
™ Date Saved
The sort fields are located above the Patient Records.
To sort Patient records by a field:
1. Within the Patient Records Screen, rotate the knob
to selected sort field, indicated by a solid black bor-
der. The A-Scan will only select the current sort
field. To select another sort field you must activate
the current sort field first.
2. Press the knob or the √ button to activate the field,
indicated by the dashed border.
3. If you want to select another of the sort fields,
rotate the knob until you have selected the appro-
priate field.
4. With the field selected by which you would like to
sort, press the knob to change the sort order. If
you activate the field more than once the A-Scan
will toggle the sort order of the active field from
ascending to descending and vice versa.
5. Press the knob or the √ button to save the sort and
to deactivate the field.

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248
 Printing Records

How to Print a The Accutome A-Scan Plus makes printing accessible

Record 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 you with
organized, accurate records of patient waveforms and
calculations. You can also print any screen by keying
"ALT+P" on the keyboard.
Printing also makes a permanent record of the entire
state of the instrument including velocity, probe
application method, capture mode, eye type, i.e. all
recent settings, on an 81/2 X 11" piece of paper.

Screen Printout Formats

The type of page the Accutome A-Scan Plus prints is
determined by the screen from which you execute the
print command.
The screens and associated printout formats are:
™ Measure Screen - will print up to five
waveforms for either OD/OS and will display
textual description of each waveform
™ Calculate IOL Screen - will print out lens
calculations, table of measurements and a
selected waveform for both OD/OS
™ Other Screens - print the data that is displayed
on the screen

*Note: The Measure Screen print is available only for

graphic printers. The Generic/Text Only printout is
the same as the Calculation screen

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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
information, you should print the Calculation printout.

Sample Printouts
Figure 159 below and Figure 160 through Figure 163 on
page 255 are given to provide you samples of the
printout formats.

250
Printing Records How to Print a Record

A-Scan Plus
Figure 159 Measurement Printout

251
Accutome A-Scan Plus User’s Guide

Rx Surgery: No

Which
Eye

Eye Type Time/Date

Stamp

Measurement Table

Measure Settings
Rx Surgery: No

Eye Type Information

Calculations for selected IOL Group

Figure 160 Calculation Printout

252
Printing Records How to Print a Record

Accutome
A-Scan

Rx Surgery: No

Rx Surgery: No

Figure 161 Waveform Text Printout

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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 Serial
Link is enabled on the Setup Screen, records that are
batch printed will be sent out the serial link.
Holding down the ‘Select for Batch Print’ for
approximately a second selects/deselects all patients in
the patient list. If any patients are selected, all are
unselected for batch print. If no patients are selected, all
are selected for batch print.
To perform a batch print from the Patient Records
screen:
1. Press the "Patient Records" button, located at the
right side of the front panel. The Patient Records
screen shown below will be displayed.

Figure 162 Saved Patient Record Screen

254
Printing Records How to Print a Record

2. Rotate the knob until you have selected the

Patient’s record you would like to print.
3. Press the button below the "Select for Batch Print"
selection.
4. If you would like to select all Patients, hold the
"Select for Batch Print" 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.
5. Continue to select all Patient records that you want
to print.
6. Press the "Print" button located at the right side of
the front panel.
7. The Accutome A-Scan Plus will print all records
selected for batch print.

Figure 163 Saved Patient Record - Select for Batch Print

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Accutome A-Scan Plus User’s Guide

Required The Accutome A-Scan Plus will only print the waveforms
Printer when you have a printer that uses the HP LaserJet or the
HP InkJet print driver. In order to obtain the best
printouts from the instrument, it is recommended that all
A-Scan records be printed on a laser printer that is HP
LaserJet compatible. An HP Laser Jet printer is
recommended, but any LaserJet or InkJet compatible
printer will work.
If you do not have an HP LaserJet or HP InkJet printer,
the Accutome A-Scan Plus also provides a generic
printer driver that will print text only. You will not be able
to print any of the waveforms when you use the generic
printer driver.

256
 Maintenance

General Maintenance that should be performed on the Accutome

Maintenance 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 taken to use only proper non-linting cloths
and non-corrosive solvents when cleaning the screen.

CAUTION: No abrasives or harsh

cleaning solutions should
be used while cleaning
the Accutome A-Scan
Plus.

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Accutome A-Scan Plus User’s Guide

258
 Specifications

Overview This section provides the physical and operational

specifications of the Accutome A-Scan Plus.

Physical Table 5 below lists the physical specifications of the

Specifications instrument and associated peripherals.

Table 5 Accutome A-Scan Plus Physical Specifications

Main Unit
Dimensions 30.2 X 19.05 x 4.83 cm (11.9” x 7.5” x 1.9”)
Weight 1.98 Kg (4 lbs, 6 oz).
DC Input 12 V, 1.25 A

Display
Type Monochrome Liquid Crystal Display (LCD)
Size 18.29 cm (7.2”) diagonal viewable area
Resolution 640 x 480 pixels, 16-shades of gray

External I/O Connectors

Printer IEEE-1284 type C
Serial RS-232C, DCE, 9-pin D-Sub, female
Keyboard PS/2, 6-pin mini-DIN, female
Foot Switch 3.5 mm mono phone jack
DC Power 2.5 mm DC coaxial

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Accutome A-Scan Plus User’s Guide

Table 5 Accutome A-Scan Plus Physical Specifications

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 adapter, extension handle with
installation tool

Keyboard (Use only Accutome PN 24-4003)

Dimensions 28.19 X 13.21 X 2.29 cm
(11.1” x 5.2” x 0.9”)
Number of Keys 83

Footswitch (Use only Accutome PN 24-4004)

Dimensions 8.89 X 6.60 X 2.54 cm (3.5" x 2.6" x 1")
Weight 198 g (7 oz.)
Environmental IP20, IP68

External Power Supply (Use only Accutome PN 24-4008)

Dimensions 12.95 X 7.87 X 4.06 cm (5.1” x 3.1” x 1.6”)
Weight 425 g (15 oz.)
Input Voltage 100 to 240 VAC 50/60 Hz
Power (typical) 15 Watts
Output 12V, 1.25A
Safety IEC601-1, UL2601, CSA601, CE

260
Specifications Physical Specifications

Table 5 Accutome A-Scan Plus Physical Specifications

Printer
Connector IEEE-1284 type C
Language HP Laser Jet PCL5 printer or HP Ink Jet
PCL3 language
Example Model HP LaserJet Model 1200

Serial Link Port

Connector RS-232C, DCE, 9-pin D-Sub, female
Communication 9600, 19200, 38400, 57600, or 115200
Parameters baud
8 data bits, 1 stop bit, no parity, hardware
flow control
Output Format ASCII text format

Safety
Meets IEC 601 Series electrical standards for medical equipment

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Accutome A-Scan Plus User’s Guide

Environmental Table 6 below lists the Accutome A-Scan Plus system

Specifications operating and storage values for temperature and
humidity.

Table 6 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 hPa

262
Specifications Measurement Accuracy

Measurement Table 7 below lists the accuracy for each type of

Accuracy measurement.
Clinical Accuracy (1 σ) 0.1 mm
Electronic Resolution (@1550 m/s) 0.016 mm

Table 7 Measurement Accuracy

Measurement Clinical Accuracy (1 σ) Range

Axial Length 0.1 mm 0.01 to 63.6
mm @1555 m/s
Anterior Chamber Depth 0.1 mm 0.01 to 62.7
mm @1532 m/s
Lens Thickness 0.1 mm 0.01 to 67.2
mm @1641 m/s
Vitreous 0.1 mm 0.01 to 62.7
mm @1532 m/s

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Accutome A-Scan Plus User’s Guide

Operating The following table summarizes the mode/application

Modes possibilities for each system/transducer combination:

Table 8 Operating Mode(s)

Com-
Clinical Other†
A B M PWD CWD CD bined
Application (Specify)
(Specify)

Ophthalmic X
Fetal Imaging &
Other*

Cardiac, Adult &

Pediatric

PeripheralVes-
sel

* Abdominal, Intraoperative, Pediatric, Small Organ (breast, thyroid,

testes, etc.), Neonatal Cephalic, Adult Cephalic, Musculo-Skeletal
(conventional), Musculo-Skeletal (superficial)
† Examples may include: Amplitude Doppler, 3-D Imaging, Harmonic
Imaging, Tissue Motion Doppler, Color Velocity Imaging.

264
Specifications Formula References

Formula Table 9 below lists the references for the calculation

References formulas used in the Accutome A-Scan Plus.

Table 9 Formula References

Hoffer Q Hoffer Q formulas are implemented as defined in “The

Hoffer Q formula: A comparison of theoretic and regres-
sion formulas”, by HOFFER KJ: The Hoffer Q formula: A
comparison of theoretic and regression formulas. J Cat-
aract Refract Surg, 19:700-712, 1993; ERRATA 20:677,
1994.

The article and its errata do not mention that restricting

the calculated post operative ACD to 2.5 to 6.5 should
no longer be done, as Dr. Hoffer now requires.
Holladay Holladay formulas are implemented as defined in “A
Three Part System For Refining Intraocular Lens Power
Calculations”, by Jack T. Holladay,
Journal of Cataract and Refractive Surgery, Vol 14, Jan
1988.
SRK/T SRK/T formulas are implemented as defined in “Lens
Implant Power Calculation, A Manual For
Ophthalmologists & Biometrists”, by John A. Retzlaff,
Donald R. Sanders, Manus Kraff, Third Edition.
Haigis "Formulas for the IOL calculation according to Haigis",
by Dr. W. Haigis, Wuerzburg July 8, 2002. The formula
has been implemented as specified by Dr. Haigis and
has received compliance certification from Dr. Haigis.

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Accutome A-Scan Plus User’s Guide

Storage/Range Table 10 below lists the data storage and range

Specifications specifications of the Accutome A-Scan Plus .

Table 10 Data Specifications

Stored Data Capacity
Waveforms / Patient 10
Stored Patients 100
IOLs 45 total; 15 groups of 3
Post Operative Results 1000 total; 50 per IOL

Waveform Data
Data Points Per Waveform 4096
Max Depth At 1555 m/sec 64 mm
Gain Adjustment Range 20 dB

Eye Type Storage

Factory Eye Types 7
User Eye Types 2
Custom Eye Types Unlimited
Factory Aqueous/Vitreous Materials 3
User Aqueous/Vitreous Materials 2
Factory Lens Materials 4
User Lens Materials 2
Material Velocity Range 500 to 9999 m/sec
Assumed Lens Thickness Range 0 to 9.99 mm
K Readings Range 20 to 60 D
5 to 19.99 mm

266
Specifications Storage/Range Specifications

Table 10 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 mm to 9.99 mm
Entered IOL a0 constant range -9.999 to 9.999
Entered IOL a1 constant range -0.999 to 0.999
Entered IOL a2 constant range -0.999 to 0.999

Accutome Clock
Clock/calendar valid Through year 2099

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Accutome A-Scan Plus User’s Guide

Acoustic Table 11 below provides the acoustic output reporting for

Output the following:
Transducer Model: Accutome A-Scan
Operating Mode: A-Scan
Application(s): Ophthalmic

Table 11 Acoustic Output Reporting Table for Track 1

Non-Autoscanning Mode

Acoustic ISPTA.3 ISPPA.3

MI
Output (µW/cm ) 2
(W/cm2)

Global Maximum Value 0.14 2.62 4.11

Pr.3 0.41 ----- -----

(MPa)

Wo ----- 0.198 0.198

(mW)

fc 9.34 9.34 9.34

(MHz)

Zsp 0.50 0.50 0.50

(cm)
Associ-
Beam x-6 (cm) ----- 0.246 0.246
ated
Dimen-
Acoustic sions y-6 (cm) ----- 0.332 0.332
Parame-
ter PD 0.11 ----- 0.11
(µsec)

PRF 5.8 ----- 5.8

(Hz)

EBD Az. (cm) ----- 0.35 -----

Ele. (cm) ----- 0.35 -----

268
Specifications Acoustic Output

Table 11 Acoustic Output Reporting Table for Track 1

Non-Autoscanning Mode

Control 1

Control 2
Operat-
Control 3
ing Con-
trol Control 4
Condi-
tions Control n

These values are based on measurements of production units.

The “derated” intensity calculations are based on the measured center

frequency of the acoustic signal (fc, MHz) and the distance from the
transducer under test to the hydrophone (z, cm) using the derating
factor e-0.069fcz.

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Accutome A-Scan Plus User’s Guide

270
 Warranty & 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 by the initial user of the equipment from
Accutome, Inc. or any of its authorized distributors.
This warranty covers all repairs and servicing of parts
that proved defective by manufacture and not by misuse
or mishandling. This type of service will be handled by
our trained sales force, or if necessary, in our home
office. Shipping charges for returns or repair of non-
warranted items will be the responsibility of the
customer. Alteration, repair or modification of any
product that is performed by persons not authorized by
Accutome, Inc. will result in immediate loss of warranty.

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Accutome A-Scan Plus User’s Guide

Product Follow the instructions given below to return products to

Returns 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): 1-800-979-2020
Tech Service: 1-610-889-0200
Fax: 1-610-889-3233
After receiving authorization, print the RGA number on
the outside of the package and send the instrument to:
Technical Service Group
Accutome, Inc.
263 Great Valley Pkwy
Malvern, PA 19355

All Other Returns

Returns for non-service related reasons must be
authorized by the Accutome Customer Service
Department. Please contact Customer Service for an
RGA number.
Merchandise returned within 60 days of date of invoice
will be credited as follows:
™ Full credit for all merchandise returned in
resalable condition

Non-Returnable Merchandise
Accutome Inc. will not authorize a return for:
™ Merchandise held longer than 60 days

272
Warranty & Repairs Replacement Parts

Replacement Table 12 below lists items that are available from

Parts 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 12 Accutome Replacement Parts

Description Accutome Part No.

Standard Parts
Probe Kit 24-4001
Foot Switch 24-4004
Keyboard 24-4003
Power Supply 24-4008
Power Supply Cable 24-4012 (United States)
Ground Cable 24-4045

Optional Parts
Immersion Shell 24-4100
Printer Cable 24-4010
Serial Link Cable 24-4012

Documenta- Accutome will make available on request circuit

tion diagrams, component parts, lists, descriptions,
calibration instructions or other information that will
assist qualified technical personnel to repair the
Accutome A-Scan Plus.

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274