Q - Topcon
Transcription
Q - Topcon
Outlook warm and sunny great deals and savings www.topcon.co.uk Summer 2012 | Issue three OCT makes business sense See page 6 for the full stories LensAR™ – A new dimension in cataract surgery T opcon Europe Medical BV (Rotterdam, Netherlands) (“Topcon”) and LensAR Inc (Orlando, Florida)(“LensAR”) announced in September that Topcon has made an equity investment in LensAR which also includes the distribution and marketing of the LensAR Laser System™ throughout Europe. The LensAR system has been custom designed for laser cataract refractive surgery and is designed to enhance the outcomes of surgery using technology to ensure precision and reproducibility. LensAR offers a unique 3D-CSI automated imaging and biometry along with a phako that has 40% less ultrasound energy compared to conventional phaco emulsification systems. It is compact and ergonomic, with multiple screens allowing both surgeon and scrub/circulating nurse visibility throughout the procedure. LensAR allows easy patient work flow and can be used in both sterile and non-sterile environments and with its retracting laser head, allows unrestricted access to the treated eye after the laser procedure. The surgeon’s position is also flexible with either a superior or temporal approach and it has a “no corneal touch” patient interface for greater comfort and reduced TOPCON releases i-Clarity Pro Following the launch of i-Clarity Core at Optrafair 2011, Topcon are pleased to announce the release of i-Clarity Pro Practice Management Software. i-Clarity Pro provides the complete suite of modules with the added functionalities of stock control, dispensing and till. This includes pointof-sale (till) system, patient accounts, direct debit and contact lens management, stock control and seamless integration for fundus and OCT imaging. With additional facilities such as email and SMS communications, i-Clarity is designed so that the practice can select the communication mechanism of choice to facilitate maximum impact with their patients. Whilst i-Clarity will be normally run within a practice, it is designed to run over wireless networks. For multiple practices, can be remotely hosted enabling each branch and/or head office to access other branch patients. risk. Its servo-controlled docking system creates ease of use and adds to patient comfort and also has added programmable algorithms for anterior capsulotomy and laser lens fragmentation. The technology will offer radical change in surgery and the use of controlled custom cuts will eliminate any uneven incisions which can cause high order aberrations and potentially poor outcomes. With Laser Assisted IOL cataract surgery, outcomes have been proven to be clearer immediately following surgery and also reduce the endothelium cell loss. The reduction of power also means less corneal complications and overall better outcomes. Mark Lansu, Surgical Director, Topcon Europe Medical BV comments: “This is a very exciting opportunity for Topcon to demonstrate our commitment to technologies that will have a positive and significant impact on enhancing patient outcomes that are synergistic with our portfolio of products in ocular surgery, implants and diagnostics. This latest announcement shows our commitment and confidence in the LensAR Laser System to expand our offering to our partner, the ophthalmic surgeon, and help us continue to combine our quality diagnostics with the newest surgical technologies”. To discuss the benefits that i-Clarity can bring to your practice please contact 01635 551120 or email [email protected] Topcon Achieves N3 Accreditation Who are Clinical Affairs? Divers Remarkable Story Paperless Success Stories Topdeals & Classifieds page 2 page 3 page 5 page 5 pages 10 & 11 i-Clarity screen shots more info In this issue Summer 2012 | Topcon Times 2 Topcon achieves N3 accreditation F or Topcon, it is a critical requirement to have an N3 accreditation in order to offer an even better and more robust means of connection to their medical systems within the NHS in order to resolve software or network related problems. Topcon as an organisation understand the need to work with our customers and provide the highest level of support and N3 will allow us to achieve this. We are therefore delighted to announce that Topcon have been awarded the N3 accreditation. We previously undertook research with our NHS customers and the feedback highlighted a variety of key requirements of which N3 will enable us to achieve. First and foremost, Topcon will provide a dedicated N3 support team at our Newbury office which for our NHS customers means a quick and direct route into a point of contact. In addition to this, if the problem is hardware related then we are able to organise a time and date with you on the spot and deploy one of our engineers to site to fix the problem. Alternatively we can offer quick on-line troubleshooting to systems which are not functioning at the optimal level. The need to have a physical person on site is reduced by around 70% when the fault can be diagnosed quickly and resolved using the N3 connection. This is highly convenient 20189 TPN Hen A4 ad3 HR.pdf C M Y CM MY CY CMY K 1 10/01/2011 12:24 to clinics where many devices are shared within the practice and gaining access can be extremely difficult due to busy clinics. Deploying upgrades and fixes can be made in a fast and efficient manner. These can also be delivered out of hours which will not disrupt clinical operations and therefore downtime on systems would be kept to a minimum level. The Topcon N3 Team is confident they can offer the NHS a much improved service and support platform. The dedicated team are using the latest technology to ensure the customer stays connected and receives a first class service. more info If you require any further information on N3 please contact Topcon and we will be more than happy to assist in your enquiry. Combined OCT preferred over fundus camera alone? D uring January’s Hawaiian Eye meeting in Maui, various presentations led to the conclusion that 3D optical coherence tomography may be more sensitive in detecting retinal abnormalities than traditional non-mydriatic fundus cameras alone. Dr Andrew Walsh of Envision Diagnostics claimed that ‘an ideal retinal screening system would efficiently screen out those not needing full examination, would be accurate enough to detect minor abnormalities and would be non-invasive for asymptomatic patients.’ So will OCT alone simply replace true colour fundus photography? The advent of optical coherence tomography has revolutionized the diagnosis and management of macular disease. Rather than moving directly to contact lens examinations as an initial step, some clinicians rely instead on OCT to facilitate the diagnosis. In part, that’s because some ophthalmologists find the contact lens exam to be more cumbersome, and have concerns that it may affect the quality of photography and/or angiography. Proponents of colour fundus photography will however quickly point out that certain morphologic features that can be seen on colour photographs are not easily visible on OCT (microaneurysms) and as such the ideal retinal screening solution would in fact incorporate both true colour fundus photography and optical coherence tomography. Dr Walsh’s retinal disease screening study compared the non-mydriatic colour fundus image to the 3D-OCT in screening 284 eyes of 144 asymptomatic subjects over a 6 month period. It concluded that the OCT image was more sensitive at detecting epiretinal, retinal and subretinal lesions than the colour fundus image alone. So for example when diabetic patients enter the practice, should they all be screened via OCT alone? The scientific data isn’t conclusive in this area as yet. However, many retinal specialists believe that if a patient has been diagnosed with diabetes and has at least minimal non-proliferative retinopathy, OCT can be sensitive in picking up subtle areas of macular edema that possibly can’t be seen clinically via ophthalmoscopy or fundus photography alone. This is important because these patients may benefit from earlier treatment or more frequent follow-up. Essentially the need to be armed with the correct tooling in practice is clear, the recording of true colour representation of the patients fundus for the purpose of trend analysis or primary/secondary grading is proven and remains the gold standard for the English national screening program for diabetic retinopathy. OCT however is clearly revolutionizing clinical practice with a more sensitive capability in certain diagnostic scenarios. So what would be the ideal retinal screening solution?... We’ll leave you to be the judge of that! Topcon Times | Summer 2012 With Topcon, you invest in a service not simply a product... the Clinical Affairs Team In order that our customers get the most from our equipment, Topcon have invested heavily in ensuring the knowledge and skills required by our customers are provided as part of the purchase process. The Clinical Affairs Team is made up of qualified professionals from both ophthalmic and optometric backgrounds and forms part of Topcon’s after-sales team. They provide clinical training, education and advice to our users at all levels on Topcon’s many technical products including equipment such as our 3D Ocular Coherence Tomographer, but probably more importantly the interpretation of the results. With the support of the Clinical Affairs Team you can be assured the return on your investment will be priceless, in respect to your patients’ overall care. 3 Marcos Lastra-Castro Clinical Product Specialist (South West) Marcos began his career as a Medical Photographer working for the NHS and Medical School in Sheffield. He followed on to North Nottinghamshire where he set up a brand new department at the Sherwood Forest Hospitals and started their first Ophthalmic imaging service. He later furthered his career and qualified with a Bachelor of Arts in Graphic Design. Tim Cole Clinical Product Specialist (North England & Scotland) Tim graduated as a Bachelor of Arts at Manchester University in 2002 and went onto become a graphic designer. Shortly after graduating, Tim became a fully trained ophthalmic imager at Manchester Royal Eye hospital, specialising in OCT technology. After four years he moved to Blackpool Victoria Hospital as a general medical photographer, specialising in ophthalmic imaging. Alison Blake Clinical Affairs Specialist (South East England) Alison is a qualified Optometrist and Dispensing Optician and has been registered with the GOC (General Optical Council) since August 1999. Throughout Alison’s career she has had experience of working for many independent opticians and multiples in the South East as well as Moorfields and The Institute of Optometry in London. In 2008 she joined Optegra Hospital in Guildford. Ben Turley Clinical Affairs Manager As a qualified Photographer and Medical illustrator Ben has over 15 years Ophthalmic imaging experience having provided an illustration service to Manchester’s Royal Eye Hospital and several key hospitals across the North West of England. Following the successful development of imaging software with ComMedica in London, Ben was invited to join the Topcon team. Ben has built a team of healthcare professionals who cover all areas of the UK to ensure Topcon customers receive the very best clinical education available, to complement their individual purchase. m11711 Topcon new OCT TCTimes AWP.indd 1 19/04/2012 13:00 Summer 2012 | Topcon Times 4 We couldn’t do without the OCT now says McCracken Opticans Optometrists Mark and Emily McCracken have been running their own busy independent practice in Uttoxeter since October 2002 and Specialist IP Optometrist Mark maintains the drive for clinical excellence goes hand-inhand with the need to invest in the best diagnostic equipment possible. “The fact that the Topcon 3D-OCT not only captures highly detailed cross-sectional scans through the maculae and optic discs, but compares them against a normative database, has been a boon to our ability to screen for and to detect pathology. Where a scanned eye falls inside or outside the normal range of the database it can help give valuable and reliable guidance in cases where there is uncertainty from findings of other tests such as visual fields examinations. Indeed, the fact that the OCT can detect evidence of retinal nerve fibre loss before it shows on visual fields testing means that we strongly encourage all patients with family history of glaucoma and all those at greater risk of developing glaucoma to undergo OCT scanning”. Emily describes the wider use of the OCT within the practice. “Since acquiring our Topcon OCT in September 2011 its diagnostic capabilities have given us a true “third dimension” to our investigative techniques. Aside from this the “wow factor” for the patients is a confidence builder for them; not only do they know they are getting the best examination possible but they can see that we as a practice are keeping as up to date with modern technology as much as we possibly can. They really do appreciate this.” “Using the OCT we have already confirmed several sight threatening conditions, including Wet AMD that has gone on to be treated successfully”. “As the only practice currently in our town to have OCT this gives us an exclusivity that we have been able to utilise to the best ability via press releases and leaflets / practice signage. The press release in particular has really got peo- ple talking in the town and we find that when patients have had it done often their friends and relatives will be looking forward to, and expecting to have it done at their next examination. Most patients are happy to pay the private fee when it is explained and demonstrated how the scanning will benefit them”. Mark adds “The OCT has helped to reinforce the perception of our practice by the public as being highly clinical and the place to go if you are worried about the health of your eyes. It has brought in a lot of new patients to the practice along with a greater number of referrals from local GPs. It has also helped to improve our standing with ophthalmologists, promoting increased dialogue about individual patient cases. Long term, we’re hoping that the OCT will help the case for the local commissioning of Glaucoma Co-management, something we’d love to become involved in”. Emily concludes “We couldn’t do without the OCT now!”. The OCT has helped to reinforce the perception of our practice by the public as being highly clinical and the place to go if you are worried about the health of your eyes. Mark McCracken Latest technologies from Topcon that have the world of surgery talking Get optimised vision for your patients For more information, contact Topcon now TOPCON GB LTD • t: 01635 551120 [email protected] • www.topcon.co.uk i-Clarity software in action As the owner of an established single independent practice, I had recognised the potential benefits of practice management software, for a long time. Andrew Pinn My existing manual systems were accurate and reliable, but increasingly inflexible and time consuming. Some of the inertia for the existing system was a result of the plethora of choice of practice management software, none of which looked entirely ideal for my practice needs. Topcon introduced me to i-Clarity at the 2011 BCLA Conference. I was immediately impressed by the user friendly and flexible format of the software. I have now been running i-Clarity Core in my practice for six months, and in this time it has transformed the way my practice operates. The installation of i-Clarity, staff training and subsequent support have more than lived up to my previous experience of excellent customer service from Topcon. I was apprehensive when we introduced the new system as my staff had variable and limited IT experience, however, they all embraced the new way of working and have been motivated by learning new skills. i-Clarity’s intuitive format provided a rapid and smooth learning process. My practice staff were immediately using the i-Clarity diary to provide clients with accurate appointments optimising available consulting room time. Administration is simple and infinitely flexible enabling any letter or document to be linked to a patient record, or merged with the patient data as a planned recall or individual communication. I have found this invaluable with the increasing number of shared schemes we are involved with. The i-Clarity ‘Point of Sale’ enables my staff to rapidly create and process customer transactions and quickly reconcile payments from the NHS and other corporate clients. In the past I was responsible for reconciling the accounts, and now i-Clarity gives me instant information on cash flow and debtors and has enabled me to discard my old time consuming manual systems that controlled the day-book and till. In the consulting room I use Topcon i-Base for my image capture and storage. i-Clarity integrates seamlessly with i-Base enabling me to view existing images from the i-Clarity patient record and create a new i-Base record with a click of the mouse! I am now looking forward to upgrading to i-Clarity Pro which will manage our registered contact lens patients, provide stock control and dispensing function. Topcon Times | Summer 2012 5 Top Harley Street clinic uses Synergy P Diver sees through Lentis W hen a 52-year-old pro fessional diver found that he was struggling with his occupation with poor vision, he contacted Optegra, private eye care specialists. At the initial consultation with Mr Robert Morris, Surgeon and Medical Director at Optegra, he identified that he had hyperopic presbyopia and recommended the type of refractive surgery that he needed. His job involved diving in a pressurised diving chamber over a one month period which required clear vision at both distance and near so that he could clearly see the diving cages. The nature of diving means that spectacles and contact lenses are not appropriate or practical and although he thought laser refractive surgery would be the answer, Mr Morris recommended that refractive lens surgery with a multifocal IOL, a Lentis Mplus, would be more appropriate for him. This was arranged at Optegra as part of their Clarivu programme. Following his surgery, at his one week post-operative review, his unaided visual acuity was 6/5 in each eye with a reading vision of N.5. Functionally he felt that his distance and near vision were excellent and he was able to read small print without difficulty. At his three month follow-up visit he had returned to work and had no difficulties working in the diving chamber. Mr Morris says this case is an excellent example of how the use of refractive lens surgery with the Lentis Mplus is an effective procedure in the management of hyperopic presbyopes. It can help patients both maintain and function in their occupation and with their leisure activities. more info For more information www.oculentis.com www.clarivu.com rivate healthcare pro vider ‘The London Clinic’ has recently gone live with an electronic ophthalmology data system as part of an on-going programme to expand the use of its ‘Meditech’ electronic medical record system. The clinic, which is based in Harley Street, London, and describes itself as the largest, independently-owned, nonprofit hospital in the UK, has been working to bring more specialities into the Meditech system, which it first installed in 2003. The ophthalmology department has gone paperless with the implementation of ‘EyeRoute Synergy’ from Topcon. The data from Synergy is being integrated with information from the Meditech system, which is passed into a SQL database using integration tools from Meditech integration specialist ‘IPeople’. With the introduction of Synergy, ophthalmologists will be able to see all the data collected from different devices within one system. Previously, information captured on one device could only be viewed from that device; so a lot of manual data entry was required to pass it between systems. This helps eradicate data entry errors and reduces the need of clinicians to review paper prints and photographs. Clinicians are able to access the system electronically from any internet-enabled device through a secure virtual private network. All accesses to patient information is logged and reviewed. More Synergy success Eye care in South Wales has recently had a boost as Cym Taf Health Board based in Merthyr Tydfil have introduced Synergy to improve the efficiency and provision of ophthalmic care for all patients in the trusts area. ‘Synergy’ allows data from the majority of the instruments and equipment used in the trusts three hospital eye departments, to be stored on a central server and accessed UK homeless charity A supported by Topcon t Vision Care for Homeless People, the UK charity which provides eye examinations and glasses for many of our cities’ dispossessed, we have been “overwhelmed” by the support from Topcon. Elaine Styles, Chair of the Charity, explains – “Topcon has been amazingly generous. When we were setting up London’s Hammersmith Broadway clinic we sent out a wish list. Topcon delivered all of this and more – they exceeded our expectations. The most amazing thing was a binocular indirect headset – which many practices don’t have.” The Topcon fundus camera, donated to the East Lon- at any pc via a secure password. Clinicians can now view images from OCT’s, retinal cameras alongside visual field plots, ultrasound images etc with just the click of a mouse. The information is stored on the trusts central ‘Synergy’ server and is accessed at PC terminals using Internet Explorer. Cym Taf has 14 instruments connected currently with access for all clinicians who require it. The speed of access to patient data has been greatly increased with the launch of ‘Synergy’ along with a marked reduction in running costs by going paperless when recalling patient records. don Skylight clinic, proved its worth on the first day – “A gentleman was found to have a retinal haemorrhage which turned out to be caused by high blood pressure, known as “the silent killer” because it rarely has any obvious symptoms. Early diagnosis and treatment can prevent a heart attack or a stroke, so thanks to Topcon this was picked up.” In addition, Topcon provides on-going support with free servicing and calibration of the donated equipment. Vision Care for Homeless People has centres in London, Birmingham and we are soon to open another in Brighton. Volunteer optometrists and dispensing opticians are always needed to run the clinics – perhaps for just a few hours each month. Our charity is particularly busy during the festive period when it supports Crisis at Christmas with a full time eye clinic and dispensing service, supported by Essilor. Neil Harding, Head of Medical Illustration at Cym Taf Health Board Issued for Vision Care for Homeless People By Janice English more info To find out more visit: visioncareforhomelesspeople.org Summer 2012 | Topcon Times 6 The winners story Topcon 3D-OCT at Linda Pope Opticians A year after winning the Topcon OCT at Optrafair, optometrist Tanya McKie, and practice manager Liz King at Linda Pope Opticians share with us a question and answer spotlight on how it has improved their practice and patient management. Q How have you integrated OCT into your patient pathway/ examination? Either a 45 minute appointment is booked for a full eye examination and OCT or it is discussed with a patient after a standard eye examination and rebooked for a 15 minute OCT at another time. Q Have you felt the OCT has given more clinical knowledge and helped improve patient management? It has been invaluable for the macular and glaucoma diagnosis. It is a very useful tool when working with private referrals as all reports can be e-mailed and sometimes dealt with, without having to see the patient. Unfortunately this is not the case with the NHS. Q Has it improved your confidence in examinations/diagnosis? It has hugely improved my confidence to the extent that if I am locum elsewhere, I am acutely aware of the absence of my OCT. Q Have you gained more clinical skills and knowledge using the OCT? Yes definitely. Initially there was a steep learning curve, but this has boosted my enthusiasm for learning and improving on my clinical skills. Q How have your patients viewed the technology? Do they see it as a value added service? Has it improved their confidence in you as a practice? All have been amazed and think that it is great value for money. The OCT has improved the local GP’s confidence in the practice as well. Q What other feedback do your patients give you? Patients have found it very interesting and informative. Q Has it improved your business financially and increased your number of patients? It has increased the number of patients and therefore the test fees but we need to get the right balance between time during the test and time for dispense. We are still in that early phase of wanting to use it on almost everybody but sometimes at the cost of dispensing time, which of course is important. Q You have used press releases and ads, but what do you feel has worked the best and increased patient traffic to your practice? Word of mouth and GP referrals. Q Are you charging your patients a fee for the OCT examination? If so how have the patients responded to this? £35.00 with only one objection. Q Is there anything else you wish to share with us? A plea to the NHS to let us email reports!! Currently in West Kent all colour OCT reports and referrals are sent to the hospital as black and white photocopies which are no use to anyone. The same applies to disc reports as well. These are DEFINITELY used if the patient is referred privately for suspect glaucoma. Pinder’s invest in OCT at both branches “ I don’t know how I managed before, it’s such a valuable tool to have in the consulting room. Hannah Shooter, Optometrist and Director North Nottingham based independent optometrists Pinder’s, invested in the Topcon OCT-2000 back in August 2011 in their Mansfield store and recently added another to their Southwell store in February. Before its launch it was decided that the OCT should be offered to every patient who wanted it. The OCT is now included as part of an advanced eye examination to both private and NHS patients. The more the OCT has been used in practice the more things we are discovering. Only last week a gentleman having a routine sight test, who was asymptomatic was found to have a small cyst at the macula. No referral was required at the time but he is able to be monitored much more closely in the future. Optometrist and Director Hannah Shooter says ‘I don’t know how I managed before, it’s such a valuable tool to have in the consulting room. Customers really like the fact that such a detailed examination can be carried out, and are amazed when shown what their eyes look like in 3D!’. Within the first few weeks of the OCT being installed the Mansfield branch had already had experience of viewing WET AMD, Diabetic Maculopathy and even a peripheral retinoschsis. The ability to use it as a standalone fundus camera is also great. All the optical assistants who take standard fundus images love how easy it is to use. Hannah added ‘I am so glad we invested in the Topcon 3D OCT at both branches, we now are able to cover a wide patient base with such a fantastic piece of technology’. Duffy optometrists delighted at patients response S ince investing in a Topcon 3D OCT in September 2011, Duffy optometrists have received a great response from both patients and optometrists. With both an old and young uptake and with clear explanation to every patient on the OCT scan illustrations, it enhances a regular NHS and private eye examination not just for the practice but more importantly for the patient. The Optometric Assistants prefer to take the OCT scan before the eye examination as this allows the Optometrist to discuss the results with the patient. Although this takes a little longer, as 30 minutes is already allocated for each ap- pointment, they rarely find the OCT scans interfere with the timing of appointments. Practice Manager, Rakhee Patel says “It’s important that we keep up to date with technology, especially if this means providing a better service of care for our patients, and our Topcon OCT enables us to do this”. Topcon Times | Summer 2012 7 Topcon support charity trip to Africa My name is Mark Histed and I used to be a photographer within the military before joining the NHS where I have been involved in Diabetic Eye screening as a program manager for over 10 years. The photographic subjects are different but no less interesting. I think it is fair to say that we all have people in life that we look up to, as a source of inspiration and my step daughter is the person I look up to. She is a lovely little girl who suffers with a rare genetic medical condition called ‘Gaucher’s Disease’, so when the opportunity arose for me to do something for her and the charity who have supported us as a family, I jumped at it. After a long flight and a dusty journey in a mini bus, that had seen better days, Mount Kilimanjaro came into sight, complete with cloud cover. The next morning after breakfast we set off through the gate into the national park and the journey began. What most of us didn’t appreciate was the effect that altitude would have on us as we climbed day after day, some days gaining more than 1000m. Weather was also a challenge as we had high winds; rain; hail and snow to cope with and toward the end of the day a tent never looked so inviting. Once we had reached the last camp ‘Kibo Camp’ everyone in the team was feeling the effects of the past few days and the altitude was taking its toll. Team members, who were normally very chatty, fell silent, everyone was focussing on getting ready and ensuring they had everything they would need. The final departure was in pitch black with only our head torches for light. After what felt like an eternity we finally reached Gillman’s Point on the rim of the crater and a nice warm sugary cup of tea went down a treat. We then had to walk around the crater rim to the higher ground ‘Uhuru point’ (5896m) and the big sign highlighting that you’d made it. Our guides had timed our walk to perfection as we all watched the sun rise over Kenya and over the limited glaciers, still evident on the summit area. I can honestly say this trek has been the hardest thing I have ever done, both physically and mentally, and whilst trekking I’d unknowingly developed pneumonia. The difficulties I was suffering, I thought were the effects of altitude, so I continued on. The trek was a once in a life time experience and I would like to thank Topcon for their generous assistance with getting me out to Africa, to do the trek. I’m pleased to have done it and have raised just over £3,000 for the charity. Every penny is greatly appreciated and all monies raised will be going to the charity, as the trip has been paid for by very generous donations from several companies, who I’m greatly indebted to and also very thankful. more info http://uk.virginmoneygiving.com/markkilimanjaro Images of my trek are available at mghphotography.co.uk/kilimanjaro Topcon introduces ‘End point Management’ to Pascal Streamline The clinical effectiveness and treatment advantages of the Pascal Streamline have now been enhanced by the addition of ‘End Point Management’ (EPM) to its retinal treatment protocols. ‘End Point Management’ sharpens titration with fine gradation of laser output, allowing enhanced precision for setting visible, or nonvisible endpoints, as well as increasing therapeutic treatment options. Using landmark patterns, ‘EPM’ provides a marker for the treated area. It provides intra-operative feedback on laser dose, as well as providing a tool to help improve comfort levels and the understanding of sub-visible laser therapy. The aim of EPM is to produce sub threshold therapeutic burns, marked by visible boundary burns. Treating in this way, helps protect photoreceptors, whilst providing a clinically effective and pain free treatment for the patient. The first Pascal Streamline pattern scan laser with ‘EPM’ is now installed with Professor Paulo Stanga at Manchester Royal Eye Hospital and will be used on a range of retinal conditions, but particularly on those patients suffering from proliferative diabetic retinopathy. Summer 2012 | Topcon Times 8 Topcon launches a brand new range of refraction units Topcon’s range of refraction units have always been known to deliver a good mix of practicality with good function. Now, Topcon have built on these qualities and introduce a whole new range of units for the modern practice. Can you afford NOT to have a Topcon OCT? Leasing a Topcon OCT through Performance Finance is not only incredibly easy, it is also the best way to gain an immediate return from such an impressive machine. Here’s how: Use a Performance 5 year lease. Fixed rate of just 3.99% pa: Monthly Cost Annual Cost £799 +vat £9,588 +vat Income generated on a 5 day test week at £35 per scan: Monthly Income Annual Income 1 patient a day £758 £9,100 2 patients a day £1,517 £18,200 3 patients a day £2,275 £27,300 4 patients a day £3,033 £36,400 IS-1 refraction unit IS-1 series is Topcon’s premier stand system and comes in a variety of configurations. Along with complimentary optional furniture it is possible to configure a working system customised for your own personal requirements. Generate more income and more profit Contact us today: Performance Finance 01536 529696 [email protected] Events IS-1 IS-1 can be specified in a number of colours and finishes to compliment the practice décor. Your chance to see Topcon’s kit in real life... May 14th 14th 15th – 17th 25th – 27th UKISCRS Cornea and Cataract Day Hilton Hotel, Liverpool RCO Annual Congress Retina Day Arena & Convention Centre, Liverpool RCO Annual Congress Arena and Convention Centre, Liverpool BCLA International Convention Centre, Birmingham June Optional items can also be included such as trial lens drawers; PC workstation desks as well as special power supply holders for our CV5000 computerised vision testers. 15th 23rd – 24th IS-1D IS-1D is another version of the IS-1 but now offering even greater functionality with 3 tables as opposed to the normal 2. IS-1D just as with the IS-1 can be specified with multiple choice colours or just a single theme. State of the Art Refractive and Cataract Surgery Symposium University of Hull British Society for Refractive Surgery (BSRS) Belfry Hotel, Birmingham July 2nd – 3rd 9th 12th Other options: Oxford Ophthalmological Congress Randolph Hotel, Oxford Independent’s Day National Motorcycle Museum, Birmingham RCO Skills in Retinal Imaging, Diagnosis and Therapy The Institute of Physics, London September 26th – 28th 29th – 30th IS-1 units offer incredible flexibility while at the same time keeping the overall footprint to the minimum. UKISCRS The Dome, Brighton ABDO Holiday Inn, Stratford upon Avon October Auxiliary desk with PC cupboard Programmable control pad 15th 16th 17th 18th 21st Johnson & Johnson Clinical Roadshow Arnolfin, Bristol Johnson & Johnson Clinical Roadshow Austin Court, Birmingham Johnson & Johnson Clinical Roadshow Digital World Centre, Salford Quays, Manchester Johnson & Johnson Clinical Roadshow Royal International Armouries, Leeds Johnson & Johnson Clinical Roadshow Royal College of Physicians, London November Near vision reading lamp, white light Counterbalanced vision tester arm more info Debuting at Royal College of Ophthalmologists meeting, Liverpool & British Contact Lens Association at ICC, Birmingham in May 2012. 16th – 17th Ophthalmic Imaging Association Annual Conference (OIA) Holiday Inn, Stratford upon Avon December 6th – 7th UK & Eire Glaucome Society Meeting (UKEGS) Dynamic Earth, Edinburgh Topcon Times | Summer 2012 9 Refractive correction without the use of spectacles is growing KR-1W 5-in-1 Wavefront Analyser R efractive correction with out the use of spectacles is growing increasingly common. The widespread use of laser assisted “in situ” keratomileusis (LASIK), photorefractive Keratectomy (PRK), and intraocular lenses (IOLs), illustrates just how varied and sophisticated refractive correction techniques have be- come. The outcomes achieved with these techniques can be exceptional when rigorous pre-, peri- and post-operative assessments of visual parameters and overall ocular health are performed. Such assessment, typically involves the use of topography to evaluate corneal health and curvature, Aberrometry to measure re- fractive error, and Pupillometry to determine pupil size. Conventional practice would call for a different device per assessment performed, however, a comprehensive machine, such as the KR-1W, can assist in significantly reducing the time, equipment and spatial requirements associated with visual assessment. The KR-1W in clinical practice By Pierre-Jean Pisella, MD, PhD Professor of Ophthalmology, University François Rabelais, Tours, France, and Chairman of the Department of Ophthalmology. Bretonneau Hospital, Tours, France. I started using the KR-1W approximately 3 years ago, with the aim of evaluating how helpful such a system would be in the Pre and Postoperative management of cataract surgery patients. This idea arose from my awareness that three key surgical steps – Pupillometry, IOL selection and IOL implantation – are all supported by the capabilities of the KR-1W. Specifically, the system permits the measurement of the types of aberration – higher order aberration (HOA) – that cannot be corrected by IOL implantation. Corneal asphericity and astigmatism are also measurable with the system. Doing so at a preoperative stage allows the physician to ascer- Results captured by the KR-1W are presented visually as maps, allowing the doctor to easily identify the cause of a patient’s visual complaints. The KR-1W features a component map display which shows the high order aberrations for the entire ocular system. tain the amount of correction and asphericity required from any toric IOL proposed for astigmatism correction and for the correct IOL power to be selected before implantation. It also helps to identify and rule out candidates who are unsuitable for multifocal IOL implantation by nature of very high levels of astigmatism. The system is also designed to perform post refractive surgery index calculations – a function that I have found important when presented with post refractive surgery patients who wish to undergo cataract surgery. In such patients, this calculation ensures that residual corneal irregularities from previous surgery can be identified, and non-conventional formulas devised to accommodate the presence of such corneal irregularities can be used to calculate preoperative lens power rather than standard formulas. Finally, postoperative measurement of residual ocular astigmatism can be conducted with the machine to ensure prompt identification of required postoperative refractive adjustments. Pupillometry – during which pupil diameter and centration are measured – is another function of the KR-1W that I find useful for accurate IOL selection and implantation, particularly in patients opting for a multifocal IOL. Not only does it facilitate the selection of the most appropriate type of IOL for each patient, it also allows patients with marked decentration to The KR-1W is a highly relevant machine in ophthalmic practice today. Not only is it valuable in determining procedural suitability and maximizing postoperative visual outcome among refractive and cataract surgery patients, it is also useful in general ophthalmology. Topcon Medical Systems, Inc. be identified and ruled out for IOL implantation. A variety of uses Although I have only used the KR-1W in the cataract surgery setting, it is important to highlight that the machine holds value in several other settings – namely the detection of corneal pathology and the assessment of refractive surgery candidates. Pupillometry is an examination always required by preoperative refractive surgery patients, as a pupil diameter greater than 6.5mm when in scotopic conditions, puts an individual at elevated risk of poor night vision after LASIK and flags them as poor LASIK candidates. Poor visual quality and blur can be troublesome for patients and their physician if the true cause is not identified. The KR1W is designed to identify the source of blur – corneal or lens pathology and quantify the level of existing blur via map plotting and root mean square (RMS) value calculation. This capability of the system has numerous roles in clinical practice, allowing correct diagnosis of patient pathology, determination of cataract severity, and assessment of visual quality before and after contact lens treatment, cataract surgery, or corneal transplant. The potential way forward While researching the clinical applications of the system, my colleagues and I identified potential future clinical uses for the KR-1W. For example, we investigated the machine’s continuous measurement function and found it assisted in the evaluation of visual quality in patients with dry eye syndrome. This tool, which is currently only used in a research capacity, allows up to 10 continuous measurements of visual quality to be captured as RMS values, which can then be analysed to determine existing changes in higher order aberrations over a 10 second period. Given the high prevalence of dry eye in the general population, I believe it will be exciting to see the use of this function move from research to clinical in the near future. We also observed that although the KR-1W is currently designed for use by ophthalmologists during patient consultations, my experience with the machine has highlighted that the KR-1W is extremely adaptable and may provide great benefit when used during pre-consultation workup by optometrists or trained technicians. Nonetheless, I believe that the KR1W is a highly relevant machine in ophthalmic practice today. Not only is it valuable in determining procedural suitability and maximizing postoperative visual outcome among refractive and cataract surgery patients, it is also useful in general ophthalmology – assisting in the identification of ocular pathology. Summer 2012 | Topcon Times 10 Topdeals Topdeals OCTs & Retinal Cameras Special offers across the entire Topcon range. All offers end 31st August 2012. Subject to availability. Call 01635 551120 or email [email protected] 3D OCT-2000 (50K) Auto refractors/Keratometers KR-1 Auto refractor/keratometer Featuring all the accuracy of the rotary prism, now also comes with a rotating operator screen. This allows the operator to be sat alongside the patient or behind, meaning the unit can be placed in a corner and requires a very small footprint. TRK-1P 4 in 1 instrument; refractometer/keratometer/tonometer and pachymeter. Key features: quick measurement acquisition and small footprint. Special price £14,645 Huge saving £2,441 RRP £17,086 Special price £7,564 Saving £1,261 RRP £8,825 Ocular Coherence Tomographer Key features: 50,000 bscans per second; high resolution colour still and live Fundus image capture. Includes glaucoma; drusen, optic disc and Ganglion Cell analyses. Special price £39,995 Huge saving £5,627 RRP £45,622 Buy Keeler Call 01635 551120 or email [email protected] Analysers & Topographers Henson 8000 PSL Portable Slit Lamp Visual fields analyser Key features: offers both full threshold and suprathreshold test strategies; ZATA tests included, which significantly speed up threshold test; DVLA approved. Complete on table with printer. Only £5,995 Saving £555 Very small and ergonomic slit lamp. Ideal for domicilliary use or where space is at a premium. Big slit lamp features for portable usability, including fixation targets; x10 & x16 magnifications and 2,000 hours of bulb life. RRP £6,550 MPOD Macular pigment/AMD screener Key features: repeatable analysis software; low cost and small footprint; portable; LED flicker photometry; links to Windows PC. Now only £2,995 Huge saving £2,455 Only £3,250 RRP £5,450 Saving £545 RRP £3,795 Free iPhone 4 adapter (worth £299) or Slit Lamps & accessories SL-D7 with DV-3 Digital camera system Key features: magnification up to 40x; Haag Streit style illumination system; serves as a delivery system for Topcon’s slit lamp OCT device. Comes with full range of filters and can accept both ‘R’ & ‘T’ type tonometers. Just like the DC 3, the DV 3 fits the same slit lamps, but the DV 3 has a higher resolution live image and suits people who want to record video more than still images. Special price £8,750 Free carrying case (worth £100) when you buy a PSL portable slit lamp KAT ‘T’ Applanation tonometer Goldmann style applanation tonometer which can fit to any slit lamp with a tonometer plate. This is the removeable type Now only £695 Saving £55 RRP £750 Saving £1,309 RRP £10,059 KAT ‘R’ Applanation tonometer Chart Systems LCD Chart Projector with polarized test CC-100XP Only £3,017 Saving £503 RRP £3,520 LCD VA Chart with integrated screen and pc CC-90SW Now only £2,052 Saving £235 RRP £2,287 Goldmann style applanation tonometer which can fit to any slit lamp with a top mount on the microscope housing. This is the fixed type. Now only £735 Saving £65 RRP £800 NB. Tables and tops where required are not included. All prices exclude VAT. Images for illustration purposes only. Topcon Times | Summer 2012 11 Classifieds Classifieds – items for sale Ex-demonstration / loan products. Subject to availability – first come first served. One year warranty provided as standard. Call 01635 551120 or email [email protected] for more information. Subjective Refraction Systems BV-1000 Subjective Refraction System Fully automated Binocular Subjective Refraction system £9,995 SAVING £14,686 Chart Systems CC-100 XP Topcon Test Type without Remote Control Latest development in the field of LCD chart systems. High quality 22” LCD screen, 100% polarization £2,750 SAVING £400 Tonometers CT-80-A Computerised Tonometer Non contact computerised tonometer, offers automatic alignment, automatic focus and automatic measurement, for easier operation £1,995 SAVING £2,386 Lensmeters LM-8 Lensmeter The standard in bench lensmeters £675 SAVING £188 CL-2800 Computerised Lensmeter with TM-2 Computerised lensmeter complete with UV measurement facility £2,995 SAVING £1,671 Keeler Keeler All-Pupil Wireless Ind Oph Kit A One of Keelers most popular Indirect Ophthalmoscopes Corneal Analysers Auto refractors/ Keratometers CA-100 Base Unit only CA-100 Control Unit CA-100 Placido Head only KR-8100PA Kerato/ Refracto Auto Align/Picture Chart Placido ring based corneal topographer complete with software CA-100 SW-Basic PACKAGE PRICE £2,995 SAVING £982 CA-100F Placido Fluo Head with Software Placido ring based corneal topographer complete with live video fluorescein capture option + software CA-100-PC Control Unit CA-100 Base Unit Complete PACKAGE PRICE £4,995 SAVING £1,752 CA-200 with Chinrest Placido ring based corneal topographer complete with software £2,995 SAVING £1,471 CA-200F Analyser with Base Plate Chinrest & PC-Link S/W £4,250 SAVING £1,106 Auto Kera/ Refractometer which provides fully automatic alignment, focussing and measurement £7,995 SAVING £4,082 KR-8800 Auto Kerato/ Refractometer Henson 6000 Compact Plus Field Analyser Meridian SL Laser 532 Full threshold & Supra threshold field analyser £3,995 SAVING £1,479 Henson 7000 Central Field Analyser Central suprathreshold field screener £1,500 SAVING £1,441 Solid state ophthalmic photocoagulator £5,500 SAVING £5,413 Meridian SL Laser Nd Yag Joystick Version Solid state ophthalmic YAG laser £9,000 SAVING £9,097 Meridian SL Laser Slit Lamp Adaptor for SL-D7 Henson 8000 Central Field Analyser KR-8900 Auto Kerato/ Refractometer £5,500 SAVING £566 Fundus Cameras PHP Foresee AMD Screener TRC 50DX Retinal Camera £4,995 SAVING £409 Auto Kera/ Refractometer which provides fully automatic alignment, focussing and measurement Full threshold & Supra threshold field analyser complete with fast ‘Zata’ thresholding Subjective AMD screener £2,500 SAVING £6,560 TRK-1P Digital Slit Lamp Cameras £10,250 SAVING £4,882 DC-1 Integrated Digital Camera with USB-2 i-base Topcon newest 4 in 1 Auto Kera/Refac’ Tono with Pachy Slit Lamps SL-8Z Slit Lamp Topcons Zoom slit lamp offering continuous magnification up to 31.75x mag SL-Scan 1 PC only Topcon integrated Slit lamp OCT Nikon D300 Camera Body only PACKAGE PRICE £13,995 £575 SP-3000 Specular Microscope SAVING £9,562 Non contact automated endothelial microscope £12,250 SAVING £1,882 £1,995 SAVING £728 Digital capture device for Topcon Digital slit lamps £1,600 SAVING £662 DC-3 Integrated Digital Camera with USB-2, i base Digital camera offering an integrated 8.3 megapixel camera and 1 megapixel video capture £1,350 SAVING £1,486 DV-1 Digital Video Camera with Base Software £2,750 SAVING £1,606 DV-3 Digital Video Camera with Base Software Digital camera incorporating high resolution digital camera for excellent quality images. With built in yellow filter and diaphragm unit £2,750 SAVING £778 NB. Tables and tops where required are not included. All prices exclude VAT. Slit lamp adaptor for the photocoagulator £1,995 SAVING £1,934 Full mydriatic fundus camera offering Colour/ RF/FA facility, no software £6,300 SAVING £7,916 £4,995 SAVING £367 Misc. SAVING £721 Lasers Auto Kera/ Refractometer which provides fully automatic alignment, focussing and measurement SL-Scan 1 with i-Base Fully integrated 8.0 million pixel non mydriatic camera Field Analysers TRC 50IX ICG Fundus Camera Full mydriatic fundus camera offering Colour/RF/ FA/ICG facility, no software £3,250 SAVING £10,765 NW8 Retinal Camera with Relay Non mydriatic fundus camera, no software £8,750 SAVING £5,008 Once they’ve gone, they’ve gone forever! Call 01635 551120 or email medical@ topcon.co.uk to snap up the latest deals. Topcon Times | Summer 2012 12 Coffee break Crossword competition The first 20 winning entries will receive £10 M&S vouchers. Only one entry per practice. How to enter Complete the crossword and send this page to: Topcon GB Ltd, Topcon House, Kennetside, Bone Lane, Newbury, Berks RG14 5PX Closing date for all entries is 31st August 2012 T&C’s available on request. Name: Company: Address: Tel: Email: Winners of Topcon Times Issue 2 Spot the Difference £10 Winners – all 10 correct Roxanne Saunders – John Harwood Optometrists, Camberley Philip Saunders – John Harwood Optometrists, Camberley £5 Winners – runners up Hardeep Ghedia – Eyesite Opticians, Reading / Salvatore Camilleri – Dollond & Aitchison, London / Julie Bonner – Ipswich Hospital / Lucy Titcomb – Birmingham & Midland Eye Centre / Elizabeth Brewington – Boots, Scarborough / Frances O’Kane – GJ McKeague, Co.Derry / Mohammed Shahin – Boots of Dollond & Aitchison, Eastbourne / Ziggy Shah – Kingsley Opticians, London / Nick Bailey – Bailey Opticians, Dover / Cheryl Chappel – Bangor Eye Care, Bangor / Claire Rodrigues – Beresfords Opticians, Cardiff / Suzanne McIntyre – Leightons Opticians, Swindon / Aysha Salam – St Pauls Eye Unit, Liverpool Royal Hospital ACROSS 1 Examination of anterior chamber angle 5 The ‘Y’ of YAG 6 Complete colour blindness 11Receptor cell 12Junction in eyelids 15Inflammation of optic disc 17Flashes of light sometimes in early stages of retinal detachment Puzzle made at puzzle-maker.com 18Has letters, numbers and shapes used by all 19Partial paralysis 20Linked with muscle balance testing DOWN 2 Inflammation of the conjunctiva 3 Night blindness 4 Some contain vitamins 7 Covers the sclera 8 Instrument for measuring eyes refractive error 9 Cells in retina 10Process of cell division 13Natural disinfecting agent in tears 14Not a river but has locks 16Acronym involving light And finally... Topcon install state of the art equipment for Ethiopian project N ovember 2011 saw Topcon UK taking on a totally new equipment installation challenge when Richard Ball and Lee Fuller travelled to the ‘Black Lions Hospital’ in Addis Ababa, Ethiopia. They travelled out to support Prof Paul Dodson, from Birmingham Heartlands Hospital and his team that included Mr Paul Galsworthy, (Grading Centre Manager, BHH) & Haley Richard Ball Topcon Tanzanian engineer visits Topcon GB Chambers, (Diabetic Screener) in the on-going support of staff involved in the Ethiopian Diabetic Screening program, which has the acronym, LEOPARD Lions Ethiopian Ophthalmic Programme Against Retinal Disease & Diabetes Despite adverse weather conditions and power cuts causing a constant challenge to the installation, the ‘Black Lions Diabetic Screening Centre’ in Addis Ababa is now home to two Topcon Slit Lamps, four Topcon Non Mydriatic Retinal Cameras and two Pascal Streamline Pattern Scan lasers, complete with video teaching facility. The equipment was requested, agreed and pooled together in association with Dr Ahmed Reja, (President); Misrak Tarekegn, (Programme Manager) and the Ethiopian Diabetes Association. The Topcon Retinal Cameras were connected to ‘Digital Healthcare’ grading software which was installed on laptops and the training was given by Paul and his team for the grading of images. Topcon then assisted the team with the retinal cameras and carried out the training on the Pascal Streamline Pattern Scan Lasers. History was made in Ethiopia as the first patient was treated in Addis on the Pascal. The Topcon retinal cameras are to be shipped to various regions throughout Ethiopia which will significantly improve the diagnosis and treatment of this prevalent disease, in Africa. Topcon’s thanks must go to Dr Tedla Kebede from the ‘Black Lions Diabetic Screening Department’, who was involved at the early stages of planning the trip whilst work- ing at Heartlands Hospital with the team here in the UK. In addition his assistance with logistics was also invaluable as we had no idea of what to expect! Dr Ahmed Reja said “I am extremely happy to see that our eye project has become successful. This was made possible due to the great effort by all of you. You have given us ‘state of the art’ equipment to help our people preserve and save sight. We have all benefitted from your recent visit & we look forward to working together. Thank you so much” more info For more information about the Ethiopian diabetic screening service please visit diabetesethiopia.org.et Following the visit by our own Clinical Affairs Manager Ben Turley in Tanzania 18 months ago, the Muhimbili Hospital Biomedical equipment engineer James Mayo, who took it upon himself to support and educate future medical staff on its use, joined Ben at Topcon GB headquarters on his first ever visit to the UK. Ben was proud to announce, “This is only the second occasion James has been given the opportunity to travel outside of Africa. For him to join us at Topcon’s HQ in the UK is an unprecedented eye opener for James, a wonderful cultural experience and one he himself states he will treasure for many years to come.” James returned to Africa at the end of March, rich in Topcon knowledge with the ability to support the portfolio of Topcon equipment installed at one of East Africa’s pioneering Ophthalmic Hospital clinics.