Z CALC 2.3 Quick Guide

Introduction to Z CALC

Z CALC® from ZEISS is a software application designed to assist users in selecting ZEISS Intraocular Lenses (IOLs). It facilitates the calculation of IOL power and the prediction of residual refraction. The software also supports IOL power calculations for patients who have undergone previous laser vision correction procedures such as LASIK, LASEK, and PRK.

Compatibility

• Apple Safari mobile for iOS (Version 15 or higher)
• Apple Safari for MacOS (Version 15 or higher)
• Google Chrome for Windows 10 (Version 102 or higher)
• Google Chrome mobile for Android (Version 102 or higher)
• Microsoft Edge for Windows 10 (Version 102 or higher)

Preconditions for Use

It is essential to ensure that your pop-up blocker is deactivated. For detailed instructions on how to deactivate pop-up blockers, please refer to the section titled "Pop-Up Blockers and how to deactivate". Before using the product, always consult the official instructions for use.

1. Region Selection / Terms & Condition / Data Protection

Upon launching, the application presents a welcome screen prompting the user to select their region. Users are required to read and agree to the terms and conditions of use by checking a designated checkbox and then clicking the "Agree and continue" button. Additional "Data protection guidelines" are also accessible.

2. Patient Information

This section collects essential patient data:

• Patient ID: Enter an anonymized patient identifier for unique identification. Patient names should not be used for data protection reasons.
• Laser Vision Correction (LVC): Indicate whether the patient has undergone a previous laser vision correction treatment (LASIK, LASEK, or PRK). This status must be selected for both eyes. If 'Yes' is selected, specify whether the treatment was myopic or hyperopic.
• Biometry date (optional): Enter the date of the biometry examination.
• Surgery date (optional): Enter the date of the surgery.

3. Calculation Screen

The calculation screen allows for the input of various biometric and refractive data:

• Axial Length (AL): Enter the axial length from the patient's record. Select 'IOLMaster' for measurements with an optical biometry device or immersion ultrasound, or 'Applanation' for measurements with applanation ultrasound.
• ACD (Anterior Chamber Depth): Enter the ACD and indicate if it has been measured from the epithelium or endothelium.
• Keratometry (K): Choose to enter standard 'K' values or 'Total Keratometry (TK)' values, which incorporate posterior corneal curvature measurements from devices like the IOLMaster 700. Enter K or TK readings in Diopters (D) or millimeters (mm).
• Flat Axis: Enter the flat axis value.
• Keratometric index: Select the appropriate keratometric index from the provided dropdown menu.
• Ast. K: Enter the astigmatism value.
• Z CALC Nomogram: Select if a Z CALC Nomogram is desired.
• Target Refraction: Input target refraction, incision position, and SIA (Surgical Induced Astigmatism) for personalized calculations.
• IOL Type: Choose between 'Toric' or 'Non-toric' IOL calculation.
• IOL Model: Select the desired IOL model from the dropdown menu.

Click the "Accept and calculate" button to proceed with the calculation.

Result Screen

The results are displayed in two modes:

• Standard Mode: Presents three calculation options from which the user can choose the most appropriate based on their requirements.
• Expanded Mode: Allows users to vary Spherical Equivalent (SE) and cylinder powers (for toric IOLs) to review associated residual refraction and Effective Lens Position (ELP).

Users can switch between 'Standard Mode' or 'Expanded Mode' via a toggle at the top right of the screen. The product model can be selected using a dropdown menu.

5. IOL Product Model Selection

Details on various IOL product models are provided, along with their suitability:

• M: MICS (Micro Incision Cataract Surgery), suitable for 1.8mm incision size.
• MP: MICS, suitable for 1.8mm incision size & Preloaded.
• MV: MICS, suitable for 1.8mm incision size & Violet and blue filtering (yellow).
• P: Fully Preloaded in injector.
• PY: Fully Preloaded in injector & Yellow blue-light filtering.
• "-": No variant available.

Users select desired product models from a dropdown menu and add them to a wish list using the "Add to wish list" button.

6. Navigate to the Wishlist/PDF-Printouts

The wish list can be accessed via a dedicated button at the bottom of the screen or by clicking a wish list symbol located in the top right corner. This allows users to select lenses for ordering or to generate PDF printouts.

7. Create PDF Printouts for Selected IOLs or Order via E-mail

Users can specify the desired quantity for the IOL.

Order by E-Mail: Clicking this option sends the order directly to the local ZEISS sales representative.

Save as PDF: This option creates a PDF document containing the calculation results and ordering information for the selected IOLs in the wish list. Alternatively, results can be saved as PDF directly from the calculation screen.

8. Order by E-mail or Create PDF Printouts

For Ordering

To place an order, enter all relevant details including clinic name, department, address, phone number, and email address. The local ZEISS partner's email address is automatically populated based on the country selection. Clicking the "Send" button dispatches the order email.

For Printing and/or Manually Faxing

For saving as PDF, data entry is not required for direct ordering. Simply scroll down and click "Save". The PDFs will be generated and opened in a new browser tab.

Note: Please ensure that pop-up blockers are deactivated in your browser. Refer to the addendum for specific instructions.

9. Start New Calculation

Users can close the wish list window by clicking the 'X' icon. To begin a new calculation, click the "New calculation" button. It is important to note that this action will delete all input data, calculation results, and the wish list. If the intention is to add another calculation to the existing wish list, do not click "New Calculation".

10. Addendum: Pop-Up Blockers and How to Deactivate

To successfully download IOL calculations and order forms, pop-ups must be allowed for the Z CALC page. Ensure that browser-based pop-up blockers are deactivated, as they can suppress PDF creation. Instructions for deactivation can be found within the settings of the specific browser being used. Some browsers may display a warning message, allowing the option to enable pop-ups directly. It may be necessary to restart the download process after adjusting these settings. Further information can be found on the respective homepages of browser providers.