Documenti di Didattica
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L80 WAVE +
REV 3.5
This document contains proprietary and confidential material belonging to Luneau SAS.
Any unauthorized reproduction, use, disclosure of this material, or any part thereof, is
strictly prohibited. This document is solely for the use of Luneau SAS employees and
authorized Luneau users.
The contents of this manual are subject to change without notice. Reasonable efforts
have been made to ensure accuracy. If queries arise, please contact a Luneau
representative.
Copyright © 2010 Luneau SAS. All rights reserved.
Contact Information
LUNEAU SAS
1 avenue de Malaguet
28360 Prunay le Gillon
France
(33) 2 37 25 25 25
(33) 2 37 25 20 20 Fax
Email: export@luneau.fr
North America
Visionix, INC
1717 Swede Rd. Suite 109
Blue Bell, PA 19422
USA
(610) 277-8500
(973) 833-0274 Fax
visionixusa@visionix.com
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Table of Contents
1. Introduction .............................................................................................................. 7
1.1 Overview ........................................................................................................................ 7
1.2 Document Scope ........................................................................................................... 8
2. Safety ........................................................................................................................ 9
2.1 General ........................................................................................................................... 9
2.2 Electrical ........................................................................................................................ 9
2.3 Electromagnetic Interference .................................................................................... 10
2.4 Transport, Storage, and Handling ............................................................................. 10
2.5 Symbols ....................................................................................................................... 10
3. L80 Wave + Device Description ............................................................................. 11
3.1 Device Description ...................................................................................................... 11
3.1.1 L80 Connector Side ................................................................................................. 11
3.1.2 L80 Operation Side .................................................................................................. 12
3.1.3 L80 Patient Side ...................................................................................................... 13
3.1.4 The Joystick ............................................................................................................. 14
3.2 Accessories ................................................................................................................. 14
4. Operating the L80 Wave + ...................................................................................... 15
4.1 Getting Started ............................................................................................................ 15
4.1.1 Entering a New Patient ............................................................................................ 16
4.2 Measurement Options ................................................................................................ 17
4.2.1 Selecting the Measurement ..................................................................................... 18
4.2.2 Positioning the Patient for Measurement ................................................................ 19
4.3 Performing the Test – Automatic Mode .................................................................... 19
4.3.1 AR Measurement ..................................................................................................... 20
4.3.2 Sensor View............................................................................................................. 21
4.3.3 Topography Measurement ...................................................................................... 23
4.4 ARK-WF Measurement Results ................................................................................. 25
4.4.1 Refraction ................................................................................................................ 26
4.4.2 Aberrometry ............................................................................................................. 26
4.4.3 Keratometry ............................................................................................................. 27
4.4.4 Result Management Buttons ................................................................................... 27
4.5 AR-WF Measurement Results .................................................................................... 28
4.5.1 Refraction ................................................................................................................ 29
4.5.2 Aberrometry ............................................................................................................. 29
4.5.3 Result Management Buttons ................................................................................... 30
4.5.4 Export Management Button ..................................................................................... 30
4.6 ARK Measurement Results ........................................................................................ 32
4.7 AR Measurement Results ........................................................................................... 33
4.8 TOPO Measurement Results ...................................................................................... 34
4.8.1 SIM_K ...................................................................................................................... 34
4.8.2 Meridians ................................................................................................................. 34
4.8.3 K. Screening ............................................................................................................ 35
4.8.4 Peripheral Degrees .................................................................................................. 35
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Introduction Operator Manual
List of Figures
Figure 3-1: L80 Connector Side View ........................................................................................11
Figure 3-2: L80 Operation Side View .........................................................................................12
Figure 3-3: L80 Patient Side View ..............................................................................................13
Figure 3-4: Joystick ....................................................................................................................14
Figure 4-1: Measurement Screen Elements ..............................................................................15
Figure 4-2: New Patient Screen .................................................................................................16
Figure 4-3: New Patient Keyboard Screen.................................................................................16
Figure 4-4: New Patient Birthdate Screen..................................................................................16
Figure 4-5: New Patient Adjustment Screen ..............................................................................17
Figure 4-6: Measurement Menu .................................................................................................18
Figure 4-7: Measurement Screen...............................................................................................20
Figure 4-8: Measurement Image Window ..................................................................................20
Figure 4-9: Sensor View .............................................................................................................21
Figure 4-10: Measurement Screen.............................................................................................23
Figure 4-11: Measurement In Progress .....................................................................................23
Figure 4-12: Topography Rings..................................................................................................24
Figure 4-13: ARK-WF Measurement Results.............................................................................26
Figure 4-14: AR-WF Measurement Results ...............................................................................28
Figure 4-15: select the root folder ..............................................................................................30
Figure 4-16: Warning when saving a measurement ..................................................................30
Figure 4-17: ARK Average Results ............................................................................................32
Figure 4-18: ARK All Value Results ...........................................................................................32
Figure 4-19: AR Average Results...............................................................................................33
Figure 4-20: AR All Value Results ..............................................................................................33
Figure 4-21: TOPO SIM_K Results ............................................................................................34
Figure 4-22: TOPO Meridians Results .......................................................................................34
Figure 4-23: TOPO K. Screening Results ..................................................................................35
Figure 4-24: Peripheral Degrees Results ...................................................................................35
Figure 4-25: Topography Map Screen .......................................................................................36
Figure 4-26: Wave Front Results ...............................................................................................37
Figure 4-27: Wave Front Map Screen ........................................................................................38
Figure 4-28: Accommodation Results ........................................................................................39
Figure 4-29: Pupil Meter Results ................................................................................................40
Figure 4-30: Managing Measurement Results ...........................................................................41
Figure 4-31: Database Retrieve Screen.....................................................................................41
Figure 32 - Manual Measurement ..............................................................................................43
Figure 5-1: Corneal Aberration View Screen .............................................................................44
Figure 5-2: Corneal Aberration Map Screen ..............................................................................45
Figure 5-3: Selecting Zernike .....................................................................................................45
Figure 5-4: Topography Zernike Screen ...................................................................................46
Figure 5-5: Topography MTF/PSF Screen .................................................................................46
Figure 5-6: Topography Rings....................................................................................................47
Figure 5-7: Corneal Visual Acuity Screen ..................................................................................48
Figure 5-8: Tool Selection ..........................................................................................................49
Figure 5-9: History Screen..........................................................................................................50
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Introduction Operator Manual
List of Tables
Table 1-1: L80 Function Summary ...............................................................................................8
Table 3-1: L80 Connector Side Key ...........................................................................................11
Table 3-2: L80 Operation Side Key ............................................................................................12
Table 3-3: L80 Patient Side Key.................................................................................................13
Table 4-1: Measurement Screen Elements Key ........................................................................15
Table 4-2: L80 Standard Mode Measurement Options ..............................................................17
Table 4-3: L80 WF Mode Measurement Options .......................................................................18
Table 7-1: Troubleshooting ........................................................................................................63
Table 8-1: Device Specifications ................................................................................................64
Table 8-2: General Specifications ..............................................................................................64
Table 8-3: AR and Power Mapping (Wave Front) Specifications ..............................................64
Table 8-4: Corneal Topography Specifications ..........................................................................64
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1. Introduction
Overview
Document Scope
1.1 Overview
The L80 Wave + device is a combined autorefractometer, keratometer, wave front
aberrometer and corneal topographer, with automatic focusing and centering.
The L80 features:
• Fully automatic 3-D, right and left eye alignments.
• Four types of automatic, simultaneous measurements.
• Operator independent measurements.
• High reproducibility of measurements.
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Introduction
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2. Safety
General
Electrical
Electromagnetic Interference
Transport, Storage, and Handling
Symbols
Abide by all safety information to ensure patient safety, to avoid system malfunction and to prevent
faulty readings. Luneau SAS will assume no responsibility for damages incurred to patients or
equipment due to disregard for safety warnings.
Safety information appears in the form of warnings and cautions.
WARNING: Warnings indicate danger that may result in personal injury.
CAUTION: Cautions indicate danger that may result in damage to equipment or impair the
quality of measurements.
2.1 General
WARNING: This is a Class 1 laser product with an embedded Class 3R laser.
WARNING: Do not attempt to remodel or disassemble the L80 Wave +. There are no user-
serviceable parts in the device.
WARNING: All repairs and maintenance should be performed by authorized service personnel
only.
WARNING: Operators and patients should keep hands and body clear from moving parts on
the device.
CAUTION: Do not touch the optical parts. Measurement
accuracy may be adversely affected.
2.2 Electrical
WARNING: Do not remove the electrical plug from the outlet with wet hands. Electric shock or
personal injury could result.
WARNING: Ensure that the power cord is not damaged before plugging in the L80 Wave + to
prevent fire or electric shock.
WARNING: To prevent electric shock, firmly connect the power cord to an electrical ground
(safety ground) at the power outlet.
WARNING: When connecting external devices such as a screen or printer, ensure that the
device conforms to IEC 60950-1:2005 Information Technology Equipment - Safety.
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Safety
2.5 Symbols
The following symbols appear on or apply to the L80:
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3. L80 Wave + Device Description
Device Description
Accessories
This section graphically depicts the L80 Wave + and identifies the device elements.
3
4 5 6
1
2 7
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L80 Wave + Device Description
Figure 3-2 depicts the operation side of the L80. The operator, typically a medical doctor, optician or
technician, activates the device by pressing the ON Button. Once on, the LCD touch screen displays
the user interface and the operator measures and performs all related tasks using a stylus (pointing
device). Measurement can be performed in automatic mode using image-processing software or the
operator may select manual mode and control the measurement with the joystick. The two-button
chin rest control enables the operator to position the patient's head in the optimal position.
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3.1.3 L80 Patient Side
Figure 3-3 depicts the side of the device at which the patient is positioned for measurement. For a
full explanation of how to position the patient, see page 19.
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L80 Wave + Device Description
3.2 Accessories
The following accessories are supplied with the L80:
• Power cord
• Dust cover
• Headrest
• Chin rest paper
• Printer paper roll
• Spare fuse
• Stylus for use on the touch screen
• Operator Manual
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4. Operating the L80 Wave +
Getting Started
Measurement Options
Performing the Test – Automatic Mode
ARK-WF Measurement Results
AR-WF Measurement Results
ARK Measurement Results
AR Measurement Results
TOPO Measurement Results
WF Measurement Results
WF/TOPO Measurement Results
Managing Measurement Results
Manual Measurement
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Operating the L80 Wave +
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7. Select the sex of the patient.
8. Specify whether or not the patient is a
child to automatically adjust the pupil
distance and chin rest.
9. Use the Erase button to clear the
fields and re-enter information.
10.Verify that patient information is
correct and select OK to return to the
Measurement Screen.
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Operating the L80 Wave +
Table 4-3 lists and describes the measurement options for the L80 when the ARK
Measurement Mode is set to the WF configuration. Six measurement options are
available using the L80 device in five measurement configurations.
Table 4-3: L80 WF Mode Measurement Options
Measurement Measurement Measurement
Name Type Description
ARK-WF • Autorefractometer • Determines corrective prescription for a patient
with imperfect vision.
• Wave front Aberrometer
• Maps eye wave front distortion due to inherent
• Keratometer physical properties of the eye.
• Corneal Topography • Measures cornea curvature and detects
astigmatism.
• Maps eye surface to evaluate the cornea prior to
treatment and refractive vision correction.
AR-WF • Autorefractometer • Determines corrective prescription for a patient
with imperfect vision.
• Wave front Aberrometer
• Maps eye wave front distortion due to inherent
physical properties of the eye.
TOPO • Corneal Topographer • Maps eye surface to evaluate the cornea prior to
treatment and refractive vision correction.
ACCO • Accommodation • Measures the accommodation ability of the eye.
PUPIL • Pupil meter • Measures the pupil size in changing lighting
conditions
Note: The horizontal and vertical alignment can also be adjusted with a stylus or a
finger used directly on the image window touch screen.
5. Instruct the patient to look through the instrument aperture at the fixation target, an image
of a long road with a hot air balloon in the distance.
Note: If the patient does not see the balloon initially, instruct the patient to
continue to look until the balloon appears.
CAUTION: Do not use the joystick for the initial up/down movement of the pupil
centering in automatic mode. Using the joystick will reduce the range
for automatic alignment
CAUTION: Before measuring AR or WF instruct the patient to continue to fixate on
the balloon even when the red laser dot appears.
CAUTION: During Topo and ARK measurement, warn the patient against staring
at the sudden red bright light. Instruct the patient to blink a few times
prior to measurement starts in order to clean the cornea.
CAUTION: During accommodation measurement, instruct the patient to look at the
hot air balloon all the time and to try to maintain a clear focus on the
balloon. Tell the patient to look at the lines on the balloon and try to
differentiate between the different colors.
Note: For the manual measurement procedure, refer to section 4.14, Manual
Measurement, on page 42.
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Operating the L80 Wave +
4.3.1 AR Measurement
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If you ABORT the measurement,
choose Yes to skip the current
measurement and go to the next step.
Choose No to stop the
measurements. For example, you
might measure WF (left eye), abort
during the WF (right eye), but then
continue with TOPO for both eyes.
The L80 device contains a Shack-Hartman sensor, an internal camera that captures real
time images of the retina reflection. In any measurement (other than TOPO and
PUPIL) from the menu bar, select VIEW and then SENSOR to view a superimposed
image on the measurement screen of a live camera image.
In case of automatic measurement difficulties, the sensor image will appear
automatically.
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Operating the L80 Wave +
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4.3.3 Topography Measurement
Note: The TOPO Measurement is used as an example only. The procedure listed
below also applies to WF-TOPO
TO PERFORM THE TEST:
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Operating the L80 Wave +
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4.4 ARK-WF Measurement Results
This display is available for the ARK-WF measurement for the L80 when the ARK
Measurement Mode is set to the W.F. configuration (refer to section 6.1.2, General
Defaults, page 54). This display mode combines several result options in one view and
provides a convenient summary of the most commonly required measurements.
This mode displays refraction, aberrometry, and keratometry for both the left and the
right eyes, including:
• Refraction at 3 and 5 mm (for day and night vision).
• The main high order aberrations of the eye.
• Spherical aberration for the ocular and the corneal systems.
• The difference of the spherical aberration between the ocular and corneal measurements.
The screen is divided into three main sections:
• Refraction
• Aberrometry
• Keratometry
Note: For practitioners who would like maximum information at a glance without
the need to change between different screens the ARK-WF measurement
screen is recommended. In this screen autorefractometer information is
given for both eyes for two different pupil diameters to simulate daylight and
night time vision. The most common high order aberrations are shown.
These aberrations can be used to plan for and then determine the success
of refractive and cataract surgery. A comparison is given of the spherical
aberration from the corneal and ocular measurements for IOL
determination. Full keratometer data for both eyes is shown. More
information is still available from other screens.
An effort has been made to concentrate all relevant information into a single
screen to save valuable time and reduce the need to waste time searching
for that extra vital piece of data.
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Operating the L80 Wave +
4.4.1 Refraction
The ARK-WF Results screen presents the three refractometry measurements in two
increments: 3 mm and 5 mm.
• SPH: Sphere Measurement
• CYL: Cylinder Measurement
• Ax: Axis measurement
Note: Including data for these two increments enables quick access to day and
night vision information.
4.4.2 Aberrometry
This section of the screen presents the data for the following measurements:
• Pupil – actual pupil size
• Aperture (as defined in the settings) – The aperture of the pupil for the aberrometry results
(in topography settings for corneal and in wave front setting for ocular)
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• Display of three of the most common high order aberrations Coma, Trefoil and Spherical
aberrations, including:
• Ocular SA –the ocular spherical aberration (Z4)
• Corneal SA - the corneal spherical aberration (Z4)
• Internal SA –the difference between the ocular and corneal spherical aberration (Z4).
Note: This information is used to define the (IOL) intraocular lens for pre- and
post- cataract patients.
The map of the eye in this section represents the high order aberrations (HOA). That
is, the residual aberrations after low order (Sphere, Cylinder) correction.
4.4.3 Keratometry
• K1 & K2: Two orthogonal radii values.
• AVG: Average of the K1 & K2.
• CYL: Corneal Cylinder measurement
4.4.4 Result Management Buttons
The Result Management buttons at the bottom of the screen are used to save, print, or
export the results.
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Operating the L80 Wave +
This display is available for the AR-WF measurement for the L80 when the ARK
Measurement Mode is set to the W.F. configuration (refer to section 6.1.2, General
Defaults, page 54). This display mode combines two result options in one view and
provides a convenient summary of the most commonly required measurements.
This mode displays refraction and aberrometry for both the left and the right eyes,
including:
• Refraction at 3 and 5 mm (for day and night vision)
• The main high order aberrations of the eye
• Spherical aberration for the ocular and the corneal systems
This mode also displays the difference of the spherical aberration between the ocular
and corneal measurements.
The screen shown below is divided into two main sections: Refraction and
Aberrometry
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4.5.1 Refraction
The AR-WF Results screen presents the three refractometry measurements in two
increments: 3 mm and 5 mm.
• SPH: Sphere Measurement
• CYL: Cylinder Measurement
• Ax: Axis measurement
Note: Including data for these two increments enables quick access to day and
night vision information.
4.5.2 Aberrometry
This section of the screen presents the data for the following measurements:
• Pupil – actual pupil size
• Aperture (as defined in the settings) – The size of the opening of the pupil is used for the
aberrometry results.
Note: It is recommended that this value be set to 5mm in the topography and
wavefront settings. Using the same aperture will provide the most accurate
information of the internal spherical aberration data.
• Display of three of the most common high order aberrations Coma, Trefoil and Spherical
aberrations, including:
• Ocular SA –the ocular spherical aberration (Z4)
• Corneal SA - the corneal spherical aberration (Z4)
• Internal SA –the difference between the ocular and corneal spherical aberration (Z4).
Note: This information is used to define the (IOL) intraocular lens for pre- and
post- cataract patients.
The map of the eye in this section represents the high order aberrations (HOA). That
is, the residual aberrations after low order (Sphere, Cylinder) correction.
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Operating the L80 Wave +
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The entire data of the measurement will be saved in an internal format
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Operating the L80 Wave +
This display is available for the ARK measurement when the ARK Measurement Mode
is set to the Standard configuration (refer to section 6.1.2, General Defaults, page 54).
Figure 4-17: ARK Average Results Figure 4-18: ARK All Value Results
Both the ARK Average Results Screen and the ARK All Value Results Screen contain
separate displays for right (OD) and left (OS) eyes.
The PD value at the top left of each screen indicates the distance between the pupils and
appears only if both eyes were measured. The vertex distance is also shown.
Refractometry results appear in the top value window and provide separate values for:
• SPH: Sphere
• CYL: Cylinder
• Ax: Axis
• Equiv. Sphere: Sphere in diopters
In the ARK Average Results Screen, refractometry values are displayed as averages of all of
the measurements performed. Select All Values to view the individual results of each
measurement.
Select the C+/- icon to toggle between positive, negative, and automatic cylinder convention.
Keratometry results appear in the bottom value window and display measurement values in
mm and in diopters. Cylinder and axis values are also given.
Select the print icon to print the results on the internal device printer.
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4.7 AR Measurement Results
This display is available for the AR measurement when the ARK Measurement Mode is
set to the Standard configuration (refer to section 6.1.2, General Defaults, page 54).
Both the AR Average Results Screen and the AR All Value Results Screen contain separate
displays for right (OD) and left (OS) eyes.
The PD value at the top left of each screen indicates the distance between the pupils and
appears only if both eyes are being measured. The vertex distance is also shown.
Refractometry results appear in the top value window and provide separate values for:
• SPH: Sphere
• CYL: Cylinder
• AX: Axis
In the AR Average Results Screen, refractometry values are displayed as averages of the total
number of measurements performed. Select All Values to view the individual results of each
measurement.
Select the C+/- icon to toggle between positive and negative cylinder conventions.
Select the print icon to print the results from the internal device printer..
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Operating the L80 Wave +
4.8.2 Meridians
Select MERIDIANS to view the radius of
eye curvature in three increments, 3 mm,
5 mm, and 7 mm.
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4.8.3 K. Screening
Select K. SCREENING to view Keratoconus
screening results.
• KPI: index of probability of
keratoconus.
• SI: (symmetry index) difference
between the mean power of two
circular zones centered in the vertical
axis.
• AGC: (apical gradient of curvature)
mean variation per unit of length of
the corneal power between the
corneal apex and the periphery of Figure 4-23: TOPO K. Screening Results
keratoconus.
• AK: (apical keratometry) curvature of
the corneal apex.
Select SWITCH LEFT to view measurements for the left eye. Select the print icon from
any of the result screens to print the results from the internal device printer.
4.8.4 Peripheral Degrees
Select PERIPH. DEG to view the radius of
curvature and the eccentricity of the cornea
at various predefined positions.
• The positions are defined by the
meridian and by the angle from the
keratometric measurement axis. R0 is
the apical position (corneal apex) and the
angles are 10º, 15º, 20º, 25 º, and 30º.
• The meridians used are the nasal,
temporal, inferior, and superior semi
meridians and the horizontal and vertical
meridians. The mean is the average of
the horizontal and vertical meridians.
Figure 4-24: Peripheral Degrees Results
Select SWITCH LEFT to view measurements for the left eye. Select the print icon from
any of the result screens to print the results from the internal device printer
4.8.5 Map Displays
The following four different map types can be displayed:
• Axial map
• Instantaneous (tangential) map
• Elevation
• Refraction
The range and color for the maps can be set in the topographic settings (refer to
section 6.1.4, Corneal Topography Defaults). The scale is set in the Tools menu.
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Operating the L80 Wave +
The axial map and an instantaneous (tangential) map of the cornea are displayed on the
screen. Double click on any of the two maps to manipulate them. The elevation and
refraction maps are accessed from the axial and tangential map views when these maps
are enlarged.
Use the menu at the bottom right corner of the screen to choose the map type. See
Appendix B for the color scale defaults.
Remove color scale
View rings
View pupil
Sim-K represents the simulation of the readings See the description of SIM_K on Page
34for an explanation of SIM_K terms.
that would be obtained with an ophthalmometer.
When the Sim-K icon is selected, the steepest
and most curved meridians and the related
keratometric simulated data are shown on the
map.
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4.9 WF Measurement Results
This display is available for the wavefront measurement and for the ARK-WF or AR-
WF measurement for the L80.when the ARK Measurement Mode is set to the W.F.
configuration (refer to section 6.1.2, General Defaults, page 54).
When the WF measurement ends, the ocular aberrations view is displayed.
The Wave Front Results screen measures refractometry and high order aberrations in
two increments: 3 mm and 5 mm.
REF: Refractometry
• Sph: Sphere Measurement
• Cyl: Cylinder Measurement
• AXIS: Axis measurement
W.F.: Wave Front
• RMS: Root mean square of the total
aberrations in microns
• LOA: Low Order Aberrations as a
percentage of the total RMS
• HOA: High order aberrations as a Figure 4-26: Wave Front Results
percentage of the total RMS
Select SWITCH LEFT to view measurements for the left eye. Select the print icon
from any of the result screens to print the results from the internal device printer
4.9.1 Map Displays
The following two maps are shown:
• Total Aberrations Map: Illustrates the wave front shape of the total Zernike coefficients.
• HOA Aberration Map: Illustrates the wave front shape of the high order Zernike
coefficients (excluding defocus and astigmatism).
Double clicking on the maps enables map manipulation, as specified below.
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Operating the L80 Wave +
View 3 mm pupil
diameter
View 5 mm pupil
diameter
View 7 mm diameter
(if available)
View three zone
visualization and
goniometer
View three, five or
seven mm if available.
Figure 4-27: Wave Front Map Screen View cross wire.
Step: Sets the level color difference.
Print
Middle Value: In the color scale, manipulate the colors in
relation to the values. Save (to disk on key)
Apply: Select to apply the changes to the Step and Middle Value.
Default: Reverts to default color scale. 3 D view
On the drop down menu - Power Map: Select the aberration Zoom
to be displayed as the local power map (sphere, cylinder,
prism or coma). This feature calculates and displays the
chosen aberration at each point over the pupil separately
unlike the Wavefront map which shows global parameters for
the whole eye.
Note: The ocular aberration map shows total aberration or just HOA aberration
according to choice for the entire eye. For example if the patient has 1m
of coma at an axis of 45 and -0.5m of spherical aberration, the map will
show a combination of these two aberrations over the requested pupil area.
Information is determined for the entire eye but no information regarding the
locality of defects within the eye is available.
The map calculation uses all the Shack-Hartmann spots in the given pupil
area. The local power map is based on a different calculation. Small
groups of Shack-Hartmann spots are calculated separately. In each small
group of points the sphere, cylinder, prism and coma are calculated. A
position map based on these calculations is displayed. Separate maps are
available for sphere, cylinder, prism and coma.
Localized defects within the eye can be seen in these maps. For example a
small protrusion in the various ocular surfaces may show a change in the
sphere power at that point.
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4.10 WF/TOPO Measurement Results
To view the measurement results for WF/TOPO, refer to section 4.9, WF Measurement Results on
page 37, and section 4.8, TOPO Measurement Results, on page 34.
The Accommodation Results screen shows the changes in the eye power during the accommodation
process.
Note: The machine contains an automated fixation target that is used for patient
fixation. In WF and AR / ARK modes the target is used for auto fogging to
reduce the risk of patient accommodation during measurement.
In ACCO mode the target initially moves to the auto fogging position, and
then slowly moves closer to the patient. The patient views the target image
and must try to focus on the picture. As the target comes closer to the
patient, the patient will accommodate and measurements are taken. The
machine automatically detects the point when the patient cannot
accommodate any more and will end the measurement.
A graph is then displayed of the change of the eye power as the target
position changes. A comparison is shown with the expected
accommodation ability typical of the patient’s age.
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Operating the L80 Wave +
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4.13 Managing Measurement Results
Measurement results can be saved or printed by accessing the File menu
from any measurement screen.
FILE MENU BUTTONS
• Retrieve - Use the Retrieve option to access measurements stored in
the device database. Measurements are accessed according to the
patient name entered prior to measurement, or by the Ident number
(Refer to section 4.1.1, Entering a New Patient).
1. Select Retrieve to access the Retrieve Measurement Screen.
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Operating the L80 Wave +
• Print Ticket – Select Print Ticket or use the Print Ticket button to
create a numerical measurement printout on the internal device
printer.
• Report– Select Report to print a result report on the pre-prepared
results form. See Appendix A for examples of the report types. Up to
three report options are available, depending on the device model:
Topo: Refer to the TOPO 2 Maps and TOPO 4 Maps sections of
Appendix B: Topography Map for report examples.
WF: L80 only
Topo and WF: L80 only
• Setup – Select Setup to access the factory default setting screens.
• Shutdown – Select Shutdown to end the measurement session and
turn the device off.
Note: Check the Refraction setting (WF/AR Diam) to choose the pupil
diameter of the refraction to be sent to the Photopter or EMR.
The L80 default measurement mode is automatic. Manual measurement provides the operator with
complete control over focus and alignment of the eye using the joystick and the image window.
Access the manual mode by changing the system defaults (refer to section 6).
TO PERFORM MANUAL MEASUREMENT:
1. Instruct the patient to place the chin on the motorized chin rest and support the forehead on the
forehead rest.
2. Using the chin rest control, bring the patient pupil into the image in the image window. Use the
joystick to focus and align the eye in the image window. For detailed information on using the
joystick, refer to section 3.1.4, The Joystick, on page 14. You can also use the stylus or a finger to
adjust the vertical and horizontal alignment of the eye in the image window.
Press GO AR (for AR measurement example). Rings will appear over the pupil and you will see
the following on the screen:
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Figure 32 - Manual Measurement
3. Use the joystick to focus and align the rings in the image window. Use the focus bar on the left
for interactive focus guide.
4. Once the rings are centered and focused, press the Start Button on the joystick to take the
measurement.
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Additional Views
5. Additional Views
Corneal Aberration
Zernike
MTF/PSF
Rings
Visual Acuity
Additional Tools
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View 3 mm pupil diameter
Middle Value: In the color scale manipulate the colors in Save (to disk on key)
relation to the values.
Apply: Select to apply changes to Step and Middle Value. 3 D view
Default: Reverts to default color scale.
Zoom
5.2 Zernike
The Zernike measurements are relevant for Topography and Wave Front. Results for both options
are interpreted in the same manner.
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Additional Views
5.3 MTF/PSF
The MTF/PSF measurement is applicable to Topography and Wave Front (for L80, only). Results
for both options are interpreted in the same manner.
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Two viewing options are available; single and dual display. Single display shows results
for just one case, no correction, LOA correction, HOA correction or LOA and HOA
correction. Dual display allows for two different cases to be viewed together allowing
for a visual comparison.
5.4 Rings
During the topography measurement, the eye is mapped with rings. The rings enable the operator to
examine separate sections of the eye by manipulating the rings. To open the ring view, double click
on the Axial map or the Instantaneous map with the stylus or select VIEW and then the RINGS
option.
The eye is mapped with 24 rings. To manipulate a ring, select the ring number from the list. The
rings appear in red and green to assist in identifying the individual ring. The following options are
available:
Note: Access the Visual Acuity measurement screen for Topography or for WF by
selecting TOOLS from the Menu Bar and select VIS. ACUITY. From the
popup menu either TOPO VIS. ACUITY or WF VIS. ACUITY.
Figure 5-7 reflects the actual quality of patient eyesight.
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Additional Views
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5.6 Additional Tools
The L80 has a set of additional applications to help you get the most from your
machine. The tools are:
Visual Acuity: measures the eye's ability to distinguish object details and shape
using HOA and LOA.
Eject Disk on Key: Safe removal of the USB storage.
Keratoconus screening: view Keratoconus screening results.
Patient History: see previous results for patients.
Contact Lens Fitting: allows you to proceed directly to lens fitting
Depth of Focus:
Sensor View:
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Additional Views
5.6.4 History
Select a patient.
Select a date to compare two
maps with the difference
map or display three
different maps.
Examination: Select which
eye to examine.
Select the type of map to
display.
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5.6.5 Contact lens fitting
Tilt lens
Tilt lens
Move meridian
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Additional Views
In a typical eye exam, the optometrist will search for the best prescription by
changing lenses and asking for a patient response. Typically s/he will add
or reduce sphere power in steps of 0.25D and will determine the best
prescription from the patient response according to various criteria and his /
her experience. Some patients have the ability to differentiate between
steps of 0.25D, others cannot. In this function, the patient’s wavefront is
measured and the MTF and Strehl Ratio are calculated. A calculation is
then made of how the MTF and Strehl ratio would change if the sphere
power is changed from best corrected vision (LOA correction).
The depth of focus here is defined as the change in sphere power for a
20% reduction in the Strehl Ratio. This is effectively the difference in
sphere power that the patient is capable of discriminating. [See for example
Susana Marcos et al Journal of Refractive Surgery Volume 21 May/June
2005].
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5.6.7 Sensor View
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Settings and User Maintenance
6.1 Settings
CAUTION: Become completely familiar with the original L80
configurations before changing the factory defaults.
The L80 arrives from the manufacturer optimized with default settings. Advanced operators, familiar
with the device, may choose to change the defaults to customize device settings.
Six factory default screens allow the user to change factory defaults. The next sections present
descriptions of the elements that are included in the factory default options.
To access the default screens, open the File Menu and select the Setup option.
6.1.1 General Action Buttons
These four buttons are located at the bottom of all the setting screens.
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• CHIN REST: Select the child mode if
relevant or select another value for tall or
short patients.
• MTF/PSF Default Display: Select
single or dual display for MTF/PSF
display.
• Visual Acuity Display: Select single or
dual display for the visual acuity display.
• ARK Measurement Mode: Select
Standard or W.F.
Note: Standard gives the AR measurement with pupil diameter of 3.5mm. The WF mode gives 3
and 5 mm measurements and all the ocular wavefront maps and data.
Note: If you requested a full corneal topography, AR-K in the WF mode will also collect the data
to display.
Note: To gain full benefit from the L80 capabilities, we recommend using the WF mode.
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Settings and User Maintenance
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Number of Measurements
• Use ▼ or ▲ to set the number of measurements taken in a single test. The maximum
number of measurements is 10.
Aperture
• The aperture used to calculate the ocular or corneal wavefront, either TOPO or WF
Note: It is advisable to select for 5mm and Topo WF. This allows removal of
spherical aberration (Z4) and ocular lenses.
AR/WF
• Zernike: Select the units (microns or diopters) for the display measurements.
Note: Measurement is based on: Thibos LN, Bradley A, Hong X “A statistical
model of the aberration structure of normal well corrected eyes” Ophthalmic
and Physiological Optics 22 427-433 2002
• Transmission: Select to view the image of the luminosity of the wavefront sensor. If this
feature is selected an additional icon will appear at the enlarged wavefront map.
Accommodation
• Reading Distance (D): Use ▼ or ▲ to set the reading distance for the addition calculation.
Note: the units are diopters.
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Settings and User Maintenance
Default View: choose the function icons to For an explanation of the icons, see the
display in the default view. descriptions on Page 36 for Figure 4-25:
Topography Map Screen.
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• Report: Use the Report options to change the
configuration of the topography in the
settings and what is displayed in the
topography reports.
Map Instant: Displays the report axial map and
the instantaneous map.
View Pupil
Invert Black: Replaces the black background
with white. Figure 6-4: Corneal Topography Report Screen
Polar Grid
SIMK Zones
Goniometer
See background.
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Settings and User Maintenance
6.1.6 Maintenance
The Maintenance screen functionality is used to calibrate specific settings. Select the
Maintenance button to access the Maintenance screen.
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TEAM VIEWER
The Team Viewer is used to allow Visionix technical
support to connect directly to the machine in order to
perform maintenance.
6.2 Cleaning
To clean the plastic surface of the L80, dampen a cloth with a commercial, non-abrasive
cleaner and gently wipe the top, bottom and front surfaces.
CAUTION: Do not spray or pour any liquid directly on the device.
CAUTION: Do not use caustic or abrasive cleaners.
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7. Troubleshooting
A number of options are available from the Maintenance Setup Menu to help in the event of
problems.
Motors Reset – Motors reset can be used to reset the motors in the event that the
positioning becomes unstable.
Reset – Reset can be used to restart the software in the event of software failure.
Measurement Problem:
Pupil size different from expected or actual pupil size: Irregular and large light
conditions on the patient or on the unit.
High order aberration: Direct light coming to the optics or on the patient.
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Table 7-1 lists potential problems and suggestions for resolving them. If the problem persists and the
suggested solution does not remedy the problem, contact a qualified service representative or your
local distributor.
Table 7-1: Troubleshooting
Problem Possible Causes Action
• Paper jam • Open the print paper door and
The ticket does not print release the paper.
• Out of paper
• Replace the paper roll.
In manual mode, eye is not visible Patient is out of range due patient • Adjust the chin rest using the
on the screen size. chin rest buttons.
• If problem is recurring enter
the set up menu and select
maintenance → motor reset to
automatically recalibrate.
• Pupil is too small Open sensor image window to
Does not measure AR or WF check Shack Hartmann pattern
• Pupil is not centered and realign using the joystick until
• Centering is not optimal clear image of spots is visible
without significant reflection.
• Poor image quality • Open ringer window and edit
Corneal topography results are poor quality rings.
very noisy • Patient eyes are not fully open
• Remeasure.
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8. Specifications
Specifications
Compliance with International Standards
8.1 Specifications
Table 8-1: Device Specifications
Height 500mm (19.5 inches)
Length 530mm (20.8 inches)
Width 310mm (12.2 inches)
Weight 25 Kg max (44 lbs.)
Power Source/Consumption 100/120, 220/240 V AC, 50/60 Hz
Operating Temperature 10°C (50°F) to 40°C (104°F) Relative Humidity 30%-85%
Storage Temperature 10°C (50°F) to 60°C (140°F) Relative Humidity below 70%
Table 8-2: General Specifications
Working Distance 91 mm
Alignment XYZ automatic
Display Touch Screen (640 x 480)
Color LCD TFT Screen 10.4”
Observation Area ø 14 mm
Printer Built in BW - External color available
Operating System Windows XP
Footprint 390mm (L) x 300 mm (W)
Regulations CE MDD
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Diameter of Covered Corneal From 0.75 mm > 10 mm
Area at 43D
Diopters Measured Field 1-60
Repeatability 0.02 D
Method Placido Disk
This symbol is located on the L80 Wave + and indicates that the equipment consists of electronic assemblies
and other components that may be subject to Directives 2002/96/EC, 2003/108/EC and 2002/95/EC of the
European parliament, which advises that electrical and electronic devices must not be disposed of as normal
domestic refuse. In order to prevent environmental risks or endangerments by non-professional disposal, the
disposal of this product, including any accessories, must comply with valid practices as outlined in Directives
2002/96/EC, 2003/108/EC and 2002/95/EC and local regulations. All electronic components and systems
should be returned to Original Manufacturer for disposal.
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9. Appendix A: Report Examples
This appendix shows the different type of reports that can be issued.
Note: In addition to these report you can print each screen by using the function
Print Screen – Select Print Screen from the File menu to print the visible
screen to an external printer connected to the device.
Report
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Appendix A: Report Examples
9.3 Wavefront
This report shows the default wavefront map
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10. Appendix B: Topography Map
This appendix shows different types of axial maps with different settings.
10.1 Patient #1
Patient with keratoconus and a corneal cylinder of -9.25D
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Appendix B: Topography Map
If ANSI is set the map range will be from 54D to If ISO is set the map range will be from 54D to
29D with 1 D interval 29D with 1 D interval
If custom is set the map range will be in this case If you choose to show the data in D press
from 58 D to 42D with 0.65 D interval
and the different axis
You can also change the interval manually to
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10.2 Patient #2
Patient with a corneal cylinder of -1.50D post LASIK
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Appendix B: Topography Map
DEFAULT DIOPTER
If ANSI is set the map range will be from 54D to 29D If ISO is set the map range will be from 54D to 29D
with 1 D interval with 1 D interval
different axis
You can also change the interval manually to 0.50 D by
DEFAULT Millimeter
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If ANSI is set there is no display (ANSI is only in If ISO is set the map range will be from 7mm to
Diopter) 9.50 mm with 0.20 mm interval
n/a
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Appendix B: Topography Map
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