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Pentacam AXL Wave: A Multifunctional Powerhouse for the New Generation of IOLs

Advances in intraocular lens technology demand a new level of precision and sophistication to unlock their optical prowess. Leading Thai surgeon Dr. Thuss Sanguansak, associate professor of the Faculty of Medicine at Khon Kaen University (Thailand) talked about what the OCULUS Pentacam® AXL Wave means to his clinic.

New optical frontiers are being explored at a breakneck pace in modern intraocular lens (IOL) design. From so-called monofocal-plus and extended-depth-of-focus lenses moving the goalposts on what can be accomplished without diffraction rings, to multifocal designs extending range of vision, cataract surgery patient outcomes are being pushed to new heights.

But these advancements mean nothing without the evolution of technology to support them. Pinpoint accuracy in optical biometry and corneal assessment has never been more necessary. The effects of decentration are even more pronounced. And an increasingly educated legion of patients are more demanding than ever in an era where cataract surgery enables better vision postoperatively than preoperatively.

OCULUS believes that their latest Pentacam AXL Wave rises to the challenges of modern cataract surgery with its cutting-edge, one-stop-shop suite of tools, including total wavefront aberrometry, retroillumination, Scheimpflug tomography, optical biometry and wavefront refraction. We sat down with long-time Pentacam user Dr. Thuss Sanguansak (Thailand) to see what he makes of this latest iteration, and how it has become a critical, time-saving tool for optimizing cataract surgery outcomes in his busy practice.

Multifeatured and highly functional

Like most clinicians, the most critical considerations for Dr. Sanguansak and his clinic in Thailand are space and time. Gone are the days where myriad bulky machines are the hallmark of a visit to the eye doctor. As offices shrink worldwide, the tools that ophthalmologists use must also—without sacrificing the increasing functional demands of modern cataract surgery.

For Dr. Sanguansak, this compact multifunctionality is where the power of Pentacam AXL Wave first separates itself from its competitors in cataract surgery. “There just isn’t another piece of technology like this that gives you such a complete view of the total anterior segment,” he said.

“With the combination of Scheimpflug tomography and total wavefront aberrometry, this gives much higher accuracy in detecting higher order aberrations and the many other factors in the eye that impact the implantation of modern and premium IOLs.”

Dr. Sanguansak related how having this information together has helped him with astigmatic patients. “With Pentacam’s Scheimpflug, you get that measurement for the total cornea. This is much more accurate than other machines that measure only the center,” he said.

“Normally we would use a Pentacam and another separate machine together, especially if the patient had astigmatism. We always want to know the power of the astigmatism, but with different machines, the power is sometimes different. This is why we use Pentacam AXL Wave now—everything is together.”

Having this data from Scheimpflug tomography, total eye wavefront aberrometry, objective refraction, retroillumination and optical biometry aggregated in one place also opens up more perspectives for Dr. Sanguansak to evaluate each unique eye.

“You can get a measurement for the curvature of both the anterior vs total corneal refractive power (TCRP), angle kappa and alpha, corneal and total higher order aberrations, and so many other features that may or may not qualify for your patient using a premium lens. On top of that you can also use their axial length together with this to get what you need,” he said, referring to the Pentacam AXL Wave’s onboard optical biometer.

Combining this suite of tools into one device doesn’t just mean accuracy and convenience for Dr. Sanguansak. It also directly translates into an all-important consideration for his busy clinic: speed.

“It’s so fast, and it’s an easier measurement—just a couple of seconds. This makes it much more comfortable for the patient,” he said. “At my fingertips I also have the ability to screen quickly for other things, like corneal opacity and seeing if the patient is at risk for glaucoma.”

Going premium with Pentacam AXL Wave

Dr. Sanguansak also believes that the Pentacam AXL wave bears significant advantages for modern cataract surgeons, especially when it comes to premium IOL selection. For starters, he noted several ways the Pentacam AXL Wave leads to a more successful, data-driven approach to confidently determining eligibility for a premium IOL.

“In the past, we simply examined the patient with the tools we had available,” Dr. Sanguansak said. “Selection for premium IOLs was much more subjective. But with Pentacam AXL Wave, we have much more data to make an objective measurement.”

“All the data I need to determine if this is a good candidate for a premium IOL is in one place,” he said. “On the right side, you can see angle kappa, the corneal coefficients, the power and astigmatism, you see the total aberration profile. With all of this information on the total cornea, it’s easy to see if this person is not a good candidate.”

For Dr. Sanguansak, the aggregation of this data into one report goes beyond the surgical decision to implant or not implant a premium IOL. It streamlines and clarifies patient communication, too.

“Many times, patients want to implant a premium IOL, but they aren’t ideal candidates for them,” he continued. “Five years ago, we would just tell them all, you can’t. But the new Pentacam helps me give all of the information to the patient. We can then explain the possible outcomes of putting a premium IOL in the patient so that they can much more easily understand and accept the recommendation.”

And in the world of Dr. Google, the ability to streamline and visually explain data can make all the difference to a patient with sky-high expectations.

What a surgeon needs

Ultimately, having speed and reliability in one single device are what makes the Pentacam AXL Wave an integral part of Dr. Sanguansak’s practice. And in an IOL landscape that requires these variables in greater quantities than ever before, this is what sets Pentacam AXL Wave apart in his eyes.

“It’s fast. It’s accurate. And it can be used for putting in the most demanding IOLs with confidence,” he said, when asked to summarize his thoughts on the device—a pointed assessment in step with the needs of an overwhelming majority of the world’s cataract surgeons.

Editor’s Note; A version of this article was first published on CAKE Magazine Issue 23.

Thuss 1

Dr. Thuss Sanguansak

a leading Thai ophthalmic surgeon, is an associate professor in the Department of Ophthalmology, Faculty of Medicine, at Khon Kaen University (Thailand).

[Email: thuss27@yahoo.com]

 

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