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Instruction Manual with Figures - Holladay IOL Consultant Software

1. O 31 6 7 TOC POODE a e 8 1 e Om 32 6 8 Individual Surgically Induced Refractive Change SIRC c ccsssccccccssseccceeeeseecceeeeeeeeceseeeeeeeeeeeeas 32 6 9 MOIVICH al Back CAClUlALIONS sarre E 34 7 Surgical Outcomes Analysis Program SOAP cccccccssssssccccscssscccsseensscccsseensessesseeeeessesseensessessegessessees 35 7 1 SOAR FCC UL OID ETTO mmm 37 5 11 Frequency Distribution 126 Of EY CS rissin EAR 37 5 1 2 Cumulative Distribution 96 of EVOS ccccccccccsssseccccceseeccccseeeecesceeeeeececeeeeeneecesseueeeeesessuenceestegenss 37 53 Suma SUO SEIES oie eir vtto rd REEL OPET EE ETUNEI DER A SEI OMM EO CUIUS REM MERC D IM PS ERR CDI EU PU EIePP PARC POM 38 7 2 SOAPSSIRC Changes 6 DOBLE gcc aie cerns vectors rs ERIT ce ie peng a once E EE VEU SUISSE URURRE 38 5 2 1 Surgically Induced Spherical Equivalent SIRC Upper left graph seeeeeeeeee 39 5 2 2 Actual PreOp Cylinder and Axis Lower left graph cccccccsssecccessececeesececeeesecesseseceseeeeceesegeeeetes 39 5 2 3 Surgically Induced Cylinder and Axis SIRC Upper right graph seen 39 5 2 4 Actual PostOp Cylinder and Axis Lower right graph ccccccssccccssececeeseceeeeeseceeeeeceseeneceesenseeeees 39 DaS BUON UE Gil AS ocean he secteur dace sae eee tedbe E M M RI RE ie 39 Updated 17 Dec 2011 pg 2 HICSOAP Professional and Deluxe User
2. A 1 IOL Calc Report HicSoapPro lol Calc Report Repot Date 10262010 Patient Patient H ormml ID 11AA Date of Birth 1 0ct 1224 Sex Female Pre Op D ata Surgeon Surgeon Example 10434996 Surgeon Surgeon Example 1043 Re fraction 0 50 0 50 X 180 AL US 2345 O D O S Refraction 1 00 1 00 X 180 AL U S 23 45 Vertex 12 00 Adj AL 23 45 Vertex 1 2 00 Adj AL 23 45 BCVA 20 7 0 HorW t W 11 70 BCVA 20400 HorW t W 11 70 UC VA 20 80 Phakic ACD 3 40 UCVA 2 0 200 PhakicACD 3 40 Ki 43 50 m90 Phakic Lens Th 4 0 Ki 4375 qn Phakic Lens Th 4 70 KZ 44 00 o Tange tRef 0 25 K2 43 75 Q0 TargetRef 0 25 Averagek 45 75 135975 Tg tAdd 5 00 Averagek 45 75 1 3575 TgtAdd 0 00 AdjustedK 4375 Bye Status Phakic New PO Leu in bag Adjusted K 33 50 Additional Data Prec p Pathokepy Ma Prev Fk Ha Erato Mo Scbral Backk Ma Skone h Vitreous Cavity Ma Formula Hlatky ll Lens 1 B amp L PSOBLS Procedure Std Phaco MFG ACUS 5 26 Lenzzz Alcon SMB T3 41 5 Procedure Std Phaen MFG AC EUS 5 2 Eje Stats Fhakic New PC Lens im bag Fep Pathog Mo Prev Rk Ha ke atocar Ma Sck ral Backe Ma Slikce h veci Cavity Mo Formula Hollacky Il BS LPSE L Procedure td Fraco Alcon SHOTS 4 5 Procedure Sd PFhacao OL Ret IOL Fef MF G ACD U S 5 26 MFG ACO US 6 20 20 50 0 20 20 50 042 1OL Pred Ref LOL Pred Ref 24 00 0 14 24 00 0 22 g50m ap 0 12 5 5030 00p 023 21 16 0 25 24 04
3. will display the visit Updated 17 Dec 2011 pg 16 HICSOAP Professional and Deluxe User s Manual e Edit Patient The Edit Patient button is activated by highlighting an item in the Patient List If the Edit Patient button is clicked the data entry screen for that item will be displayed and editing of the data allowed e Delete Patient Exam The delete buttons are activated by highlighting a Patient or Visit in the Patient Locator window If the Delete button is clicked the highlighted item will be deleted The most recent entry for an eye must be deleted before any previous older data can be deleted e The active Patient Locator PreOp IOL Calc Toric IOL Calc Surgery data PostOp Exam Back Calculation and SIRC Calculation Tabs at the top of the screen display the respective data entry screens for the patient If subsequent data has already been entered the screen will be read only For example if surgery data has already been entered for a patient s eye the PreOp Data screen will not allow data entry read only Data cannot be edited unless all subsequent data has been deleted e Export Print Patient List Pressing one of these buttons displays the Selection Criteria Screen After the selection criteria have been set the program generates a list of patients that satisfy all of the criteria selected which is exported to a csv file or printed Example Report R page 65 Updated 17 Dec 2011 pg 17 HICSOAP Professional and
4. 1532 msec Pseudophakic Setting Enter velocity Setting Phakic Setting 1550 ra 1555 m sec gt Astal length already adjusted WARMING Significant erar in IOL power calculation can result if A scan unit zetting i not known Eig always best to measure the aphakic eye using the aphakic velocity setting of 1532 m s and choose the amp phakic setting above Cancel Choose the velocity setting that corresponds to the velocity used to take the pseudophakic axial length measurement 4 2 3 Alternate K When the Previous RK PRK ALK LASIK box is checked the Alternate K button appears An alternate K may be calculated using different methods Updated 17 Dec 2011 pg 21 HICSOAP Professional and Deluxe User s Manual Average K from Refractive data Alternate Average K value Source Post Keratorefractive Surgery Comea Select R value to be used Far IOL power Calculation Average FK from Refraction l l a Refraction and K values prior to keratorefractive Calculated average K value from Refractive data surgery amp g Ak PRE ALK LASIK SFH UYL VTX E Kz J Calculated average F value from Rigid Trial CL le e l2 43259 43 50 b Stable Ref after keratorefractive surgery Measured average K from pre p data screen preferably before cataract Farmation SFH CYL VTX 0 25 10 50 12 2 Surgeon Entered Kalue NOTE Lowest K value tends towards myopic error Highest K value tends towards hyperopic er
5. Example Surgeon 1 Example Lens MA30BA Procedure Std Phaco Lens MA30BA Procedure Std Phaco Implant Power 57 0 27 0a 30 0p Implant Power 55 0 25 0a 30 0p Post Op Date 12 13 1996 PostOp Date 12 13 1996 SPH CYL AXIS SPH CYL AXIS IAE L25 X 180 12 50 1 00 X 180 0 43 0 00 X 90 0 40 0 00 X 0 SIRC from Ref SIRC from Ref plus Cyl form 11 68 1258 x190 plus Cyl form 11 90 100 x 90 minus Cyl form 12 93 L25 X 0 minus Cyl form 12 90 1 00 X 0 cross Cyl form 11 68 X 0 amp 12 93 X 90 cross Cyl form 11 90 X 0 amp 12 90 X 90 PreOpK s Ki 54 62 90 K2 52 25 0 PreOpKs Ki 54 50 90 K2 53 00 0 PostOp K s Ki 54 25 90 K2 52 25 0 PostOp K s Ki 54 25 0 K2 52 25 90 SIRC from K s SIRC from K s plus Cyl form 0 37 0 37 0 plus Cyl form 2 25 350 0 minus Cyl form 0 00 0 37 90 minus Cyl form 1 25 3 50 90 cross Cyl form 0 37 90 amp 0 00 e 0 cross Cyl form 2 25 90 a 125 0 sme 10 26 20 If postoperative K values and refractions have been entered the program calculates the Surgically Induced Refractive Change SIRC The SIRC values from the refraction are shown at the top of the screen and from the K values at the bottom of the screen The SIRC is displayed in cylinder form cylinder form and cross cylinder form The cylinder form is most helpful for compressing or steepening procedures the cylin
6. in Bag in Sulcus Standard IOL or Exchange IOL lens calc fram AL Secondary Figgy Back IOL lens calc fram Aef Acrylic For amp phakic and Pseudophakic eves results will be improved if the Preop Phakic Retraction is entered IF the Preop Phakic retraction rs unknown please leave the following fields blank Preop Phakic Retraction WT Cancel e Phakic Eye AC PC amp ILC Phakic IOL s e Aphakic Eye AC or PC IOL s Select whether secondary IOL is to be placed in Bag or in Sulcus e PseudoPhakic Eye e Select whether New PC lens is to be placed in bag or in sulcus e Select Exchange IOL Lens Calc or Secondary Piggy Back IOL Lens Calc Updated 17 Dec 2011 pg 20 HICSOAP Professional and Deluxe User s Manual e Select the intended location of the New PC lens in Bag or in Sulcus e Enter IOL Material in Eye and IOL Power in eye If the material and power of the IOL in the eye are entered the Correct AL button appears on the PreOp Data Screen that allows the surgeon to correct the pseudophakic axial length measurement e PreOp Phakic Refraction If this refraction is available the program will use it to improve the calculations 4 2 2 Correct AL When the Correct AL button is pressed the following screen is displayed AXIAL LENGTH MEASUREMENT ADJUSTMENT Some 4 scan units have Phakic amp phakic and PseudoPhakic settings What velocity setting was your unit set to For this measurement 2 Aphakic Setting
7. 10 Lens 3 AMO SI 30NB Procedure Std Phaco MFG ACD US 4 62 IOL Lens 4 Alcon MA30BA Procedure Std Phaco MFG ACD US 5 49 IOL Ref IOL Ref 25 50a428 00p 0 11 26 50a430 00p 0 14 26 00a428 00p 0 47 27 00a430 00p 0 21 26 00a428 03p 0 50 27 41a430 00p 0 50 26 50a428 00p 0 85 27 50a430 00p 0 56 27 00a428 00p 1 22 28 00a430 00p 0 92 Lens 3 AMO SI 30NB Procedure Std Phaco MFG ACD US 4 62 IOL Lens 4 Alcon MA30BA Procedure Std Phaco MFG ACD US 5 49 Ref IOL Ref 24 50a430 00p 0 16 25 00a430 00p 0 19 25 44a430 00p 0 50 25 50a430 00p 0 54 26 00a430 00p 0 89 25 00a426 00p 0 18 25 50a426 00p 0 18 26 00a425 93p 0 50 26 00a 26 00p 0 55 26 50a426 00p 0 92 Notes Notes The probability of the HWTW occuring in the population is 0 196 The probability of the HWTW occuring in the population is 0 196 The probability of the AXIAL LENGTH occuring in the population is 0 196 The probability of the AXIAL LENGTH occuring in the population is 0 196 The probability of the K READING occuring in the population is 0 196 The probability of the K READING occuring in the population is 0 196 The probability of the ACD occuring in the population is 2 396 The probability of the ACD occuring in the population is 3 196 The probability of the REFRACTION occuring in the population is 0 196 The probability of the REFRACTION occuring in the population is 0 196 Re
8. All lenses or a specific lens model may be chosen from the pull down menu If All lenses is chosen then three columns in the statistics at the bottom of the report are blank Personalized ACD Eqv Form Constant and Current Form Constant e Formula The IOL formula used may be changed at any time from the pull down menu e AL Either Ultrasonic US or Optical IOL Master or Lenstar may be selected e Step Size The step size for the graphs may be chosen to be 0 125 D 0 250 D or 0 500 D This allows the user to see the results as details as 1 8 diopter steps In addition all the SOAP screens share a common list of buttons near the bottom of the screen Help Quit Selection Criteria Export Selected Patients Print Selected Patients Print Current Page Next gt Updated 17 Dec 2011 pg 35 HICSOAP Professional and Deluxe User s Manual e Selection Criteria Displays the selection criteria pop up screen Soap Selection Criteria 8 Use enough cases to satisfy standard statistical criteria or Use the most recent cases up to 100 Use cases from 4 29 2010 E7 to That satisfy the following conditions Indude Only PostOp Results from 14 to 9999 days Post Op Include Only PostOp Results with BCVA of or better E Axial Length Lower Limit 21 mm Upper Limit 26 mm IOL Power Lower Limit D Upper Limit 34 D Avg K value Lower Limit D
9. Deluxe User s Manual 6 2 PreOp Data 8 Holladay IOL Consultant a File Edit View Help Utilities Name Patient Normal OD Date 10 13 1996 Surgeon Surgeoni Example Tech Calculation Type and Target Refraction Standard IOL Cataract Removal PC lens in Bag in Sulcus Other Calculations gt Click Here TargetRef 0 25 V Bifocal IOL Power Calc TargetAdd 3 00 v V Toric IOL Power Calc Pre existing condition Keratoconus Previous Rk Prk Alk Lasik Silicone in Vitreous Cavity Sderal Buckle Other Pathology Refraction and K s and Horizontal WTW Ref 0 50 0 50 x 180 yr 12 00 sova vow Ki 43 50 90 K2 44 00 Ge 0 Hor white to white 11 70 K s not measured with the primary keratometer 2 Axial Length mm AL US 23 45 UltraSound US AL Optical Optical IOLM Lenstar Anterior Segment mm Phakic ACD 3 10 Axial Length to Use for Calculations DOB 13 Oct 1924 Date 10 13 1996 Surgeon Surgeon1 Example z Tech Calculation Type and Target Refraction Standard IOL Cataract Removal in Bag in Sulcus Other Calculations gt GlickHere TargetRef 0 25 Bifocal IOL Power Calc Toric IOL Power Calc Pre existing condition Keratoconus V Previous Rk Prk Alk Lasik Silicone in Vitreous Cavity Sderal Buckle Other Pathology Refraction and K s and Horizonta
10. IOL Master Last Updated 19 May 2010 Haag Streit Lenstar Instructions Instructions on how to configure Lenstar Main Menu Help Quit System Information Next gt Ready 9 22 201 Several PDF files documenting how to use HICSOAP are included with the program Simply click the buttons to open the associated PDF file Updated 17 Dec 2011 pg 43 HICSOAP Professional and Deluxe User s Manual 8 3 Remove Registration 8 Holladay IOL Consultant a File Edit View Help Utilities Database Documentation Remove Registration You may remove the registration from this computer by dicking the button below CAUTION You will not be able to use HICSOAPPro on this computer after you remove the registration without a new unlock key a 10 26 20 We allow 3 active installations for each purchased license We keep track of the number of active installations via the registration code So if you no longer want to use the software on a computer then you need to remove the registration Remove Registration Click this to remove registration Doing so generates a registration removal number that you should email to support hicsoap com so that we can record you registration removal in our database System Information The System Information button starts the Microsoft System Information program Updated 17 Dec 2011 pg 44 HICSOAP Professional and Deluxe User s Manual A Sample Printouts
11. LC IOL K LC IOL Ref AL LC IOL Ref K AL IOL Ref Pred Ref PO Ref Pat Locator gt 10 26 20 The Back Calculation Screen very helpful for working up a refractive surprise following IOL implantation The Actual Values are shown on the top of the screen and the Back Calculated Values are shown at the bottom of the screen Each Back Calculated value shown is calculated from the four other Actual Values at the top of the screen Since the Avg K value Axial Length and Refraction can be checked postoperatively the ACD and IOL Power become the only unknown parameters If the ACD appears to be correct by comparing the other formulas or with direct measurement then the power of the mislabeled lens in the eye is the back calculated IOL Power The back calculated values can be obtained using any of the formulas Updated 17 Dec 2011 pg 34 HICSOAP Professional and Deluxe User s Manual 7 Surgical Outcomes Analysis Program SOAP SOAP provides the surgeon outcome analysis tools The following sections describe in detail the different analysis tools available All the SOAP screens share a common toolbar that control several parameters used in the analysis Surgeon Surgeon3 Example v Lens 1 Staar AA 4203V StdPhaco Formula Holladay Il Y AL Step Size D e Surgeon The pull down menu on the left of the tool bar allows the surgeon to be changed at any time e Lens
12. St Dev 0 485 Centroid 0 25 86 deg St Dev 0 339 45 Selection Criteria Export Selected Patients Print Selected Patients Print Current Page Next gt 10 26 20 Updated 17 Dec 2011 pg 38 HICSOAP Professional and Deluxe User s Manual 5 2 1 Surgically Induced Spherical Equivalent SIRC Upper left graph This graph displays the Frequency Distribution of the SIRC as a function SIRC spheroequivalent This is the actual soheroequivalent change from preoperative to postoperative 5 2 2 Actual PreOp Cylinder and Axis Lower left graph This graph displays the actual preoperative astigmatism on a double angle plot The centroid mean value standard deviation and ring values step size are shown on the plot WTR is the abbreviation for With the Rule astigmatism and ATR is the abbreviation for against the rule astigmatism The ellipse oval or circle represents one standard deviation 67 of the data for a normal distribution 5 2 3 Surgically Induced Cylinder and Axis SIRC Upper right graph This graph displays the actual Surgically Induced Cylinder and Axis on the double angle plot The centroid ring values and standard deviation are all displayed 5 2 4 Actual PostOp Cylinder and Axis Lower right graph This graph displays the actual PostOp astigmatism cylinder and axis on the double angle plot The centroid ring values and standard deviation are all displayed 5 2 5 B
13. Visual Acuity Standard Verify your Computer s Clock amp Feet e g 20 20 20 40 d Meters e g 6 6 6 72 D Decimal le g 1 0 05 IF this i nat corect please fis it Consult your Lagar amp q 0 00 1 00 Windows manual For instructions Current system clock 25 Oct 10 05 58 Printout alignment Positive offsets move the printout down and right Horizontal offset mm Vertical offset O Keratameter Settings Refractive Index 1 3375 7 DO NOT CHANGE FROM 1 3375 UNLESS YOU ARE SURE Other Clinic Settings Default Surgeon Hone ki Default Technician Mane Default Vertex 12 mr e Clinic Name The clinic name will be highlighted in blue and can be changed at any time e Technicians A technician s name may be added and edited PreOp records allow a technician to be entered e Visual Acuity Notation Select from the four choices for visual acuity notation feet metric decimal or LogMAR e Verifying Correct Computer Clock Time The clock is used to calculate age time between visits etc Please make sure the computer clock time is correct at all times e Printer Alignment Adjustment The printed reports can be shifted on the page by using this feature This feature is valuable if the left margin or top margin needs to be larger because the printout is placed in a chart with holes punched on the left side or top of the page Positive values shift the printout down or to the righ
14. Young PreOp Exam ID 11AA DOB 13 Oct 1986 Gender M Patient Locator IOL Calc Toric IOL Planner Surgery Data PostOp Exam SIRC Calculation Back Calculation Surgeon Surgeoni Example PreOp Exam date 10 13 1996 O S Ref 412 50 1 00 X 180 VTX 12 00 TargetRx 0 50 BCVA 20 100 UCVA CF Target Add 0 00 K1 54 50 90 HWTW 9 50 mm Avg K 53 75 n 1 3375 K2 53 00 0 ACD 2 95 mm Adj K 53 75 AL US 15 31 mm Lens Thick 4 72 mm Adj AL 15 31 Q Surgeon Surgeoni Example PreOp Exam date 10 13 1996 Ref 12 50 1 25X 180 VTX 12 00 TargetRx 0 50 BCVA 20 80 UCVA CF Target Add 0 00 K1 54 62 90 HWTW 9 50 mm Avg K 53 44 K2 52 25 0 ACD 2 90 mm Adj K 53 44 AL US 15 09 mm Lens Thick 4 60 mm Adj AL 15 09 Formula Holladay II v Formula Holladay II v Lens 1 B amp L P506UV Procedure Std Phaco MFG ACD US 5 26 IOL 26 50a 30 00p 27 00a 30 00p 27 50a 30 00p 27 50a 30 00p 28 00a 30 00p Lens 2 Alcon SN60T3 4 5 Procedure Std Phaco MFG ACD US 5 20 IOL 25 50a 30 00p 26 00a 30 00p 26 13a430 00p 26 50a 430 00p 27 00a 30 00p Ref 0 05 0 40 220 0 76 1 153 Lens 1 B amp L P506UV Procedure Std Phaco MFG ACD US 5 26 IOL 24 50a7 30 00p 25 00a 30 00p 25 44a430 00p 25 50a430 00p 26 00a 430 00p Lens 2 Alcon SN60T3 4 5 Procedure Std Phaco MFG ACD US 5 20 IOL 23 50a430 00p 24 00a 30 00p 24 16a430 00p 24 50a430 00p 25 00a430 00p Ref 0 03 0 38 0 50 Dat 1
15. do not agree the manufacturer s ACD is usually 0 30 mm less than the value converted from the A constant and is actually for in the sulcus A Personalized Lens Constant PLC is calculated after each postoperative data entry and overrides either of the previous constants when statistically significant 30 to 40 cases PLC will appear on the printout and the PLC constant may never be overridden e View Edit Lens PROPERTIES in Data base All of the properties of existing IOL s in the Data base may be viewed by clicking on the View Edit Lens PROPERTIES in Data base button Select the manufacturer and lens model from the pull down lists and the properties of the lens are displayed This feature is particularly useful for determining the available powers or characteristics of a specific lens model e Add lenses not in Data base Although every lens available at the time of printing is currently in the Data base it is possible to Add Lens not in Data base by clicking this button All of the lens properties must be completed except for a lens constant When one lens constant is entered the other two fill in automatically This feature is especially helpful for lens constant conversions If the A constant and ACD do not agree the A constant is usually the better value and is for in the bag placement When they do not agree the manufacturer s ACD is usually 0 30 mm less than the value converted from the A constant and is actually for in the sulcus
16. s Manual 7 3 SOAP Potential OUTCOMES cus rox ea a bietet me Feiadec caer aladeted hapten ti odavenscrmtawsesavucraamiowees 40 5 3 1 Frequency Distribution 96 of Eyes Upper Left Graph eeessseeeeeenn nnn 40 5 3 2 Cumulative Distribution 96 of Eyes Upper Right Graph ssssssssssessssrrrrsessrrrrsssrrrreessrrrreserrrreessens 40 5 3 3 Frequency Distribution 96 of VA Lower Left Graph eessseesssesrssserrrsesrrresrrrsesreresrrersereresrrreesreress 40 5 3 4 Cumulative Distribution 96 of VA Lower Right Graph cccccccssssecccceeessecceseeeeecceseeeeeeeeeeeeeees 40 5 3 5 Buttons under EEapllSussuoociebto suia idv E edv notai hood mt brtete uide iso oru d pep uiu Un 41 EBD See C M rM P NR PEE NER 42 8 1 Data ISE T n 42 8 2 BlerssIget qcin o gie Re eH CRM 43 8 3 hemove ReBISEFAtIOTIA ise ioo aree oit uiDue ua ooo euet os eiu oe spec ioc qutd E vitvs dett mE ete pU E cR Doe du E e eines 44 Bu Sam P CNP FIDES ssouscdoe id ned Pocta t EE bp Itcm Mum Mes md 45 A HIOL Calc ReBOFLD qutt es ee ulus i nU cotes e tu coe at bl EP oR aN Lu Sr Lo p QE A 45 AZ TOPIC b gl aan Rt isto M MM EM MI C ME 46 Updated 17 Dec 2011 pg 3 HICSOAP Professional and Deluxe User s Manual 1 Introduction This document describes both the professional and the deluxe editions They are identical except that the professional edition has additional functionalit
17. s Manual Enter the magnitude of the Surgically Induced Astigmatism SIA For current small incision cataract surgery this value is usually between zero and 0 50 D For a given surgeon if Pre and Post Op K s have been entered the mean value centroid may be found on the Aggregate SIRC Changes from the Main Menu as shown below The SIRC from K s button and Minus Cylinder must be checked to obtain the correct value In this example the magnitude of the SIA is 0 20 D The USER would enter 0 20 D ignoring the sign The meridional location of the cataract incision must be entered As soon as the magnitude and axis of the cataract incision have been entered a BLACK ARCUATE LINE is shown at the Limbus on the drawing s gt Holladay IOL Consultant Personal Joe File View Help Surgeon Surgeon3 Example vi Lens lt All Lenses v Formula Holladay Il vi AL Step Size D Soap Sirc Changes Frequency Distribution of Eyes Surgically Induced Cylinder and Axis SIRC 30 Centroid 0 20 81 deg St Dev 0 553 45 0 50 0 00 0 50 i i 1 135 Surgically Induced Astigmatism SIA Rings Equal 0 5 Steps Inner 0 5D Outer 2 0D A Drop down list of available Toric lOLs is shown The available Toric lOLs must be in the Active IOL List and on the IOL Calc Screen to be displayed in the drop down list Select the Toric IOL to be used and the IOL Formula to be used Holladay 2 recommended Once this ha
18. t W 11 70 Uc VA 20 80 PhakicACD 340 Uc VA 20 200 PhakicACD 3 40 K1 43 50 mot Phakic Lens Th 4 70 K1 43 75 Phakic Lens Th 4 70 KZ 44 00 Targe thet 0 25 Ke 43 75 TargetRief 0 25 Average 45 75 15375 TgtAdd 3 00 Averagek 45 75 21 5075 TgtAdd 0 00 AdjustedkK 43 7 5 AdjustedK 33 50 Ackitiona Data Bye Statis Phakic Prec p Pathoken Mo Eje Stat Phakic Prop Pathog Mo New PC Leas im bag Prev Pk Mo New PC Lens im bag Prev Pk Mo Keatas Mo ke atocar Mo Sckral Bice No Scb ral Bickk Ho Silo I Viteows Cavity No Silkoxe i Viteows Cavity Mo Lens Res Refraction SA60T3 1 500 irlOL 0 17 0 79 D x 33 1 31 D x 0 69 1 82 D x SABOTA 2 25D l OL SABOTS 3 000 il OL HicSoapPro Ver 2010 1010 Tex Eye Clinic Updated 17 Dec 2011 pg 46
19. 0 25 10 00226 50p 025 6 00a 30 00p D 14 21 50 0 48 21 50 0 57 10 00 326 5 1p 025 5 152F30 00p 0 25 22 00 0 53 22 00 0 92 10 50 ac26 5p 0 B2 6 50a 20 00 p O52 11 00 a 26 50p 1 00 7 00a 30 00p o 69 Lens 3 AMO SI XIMB Lens 4 Alcon MASUBA Procedure Std Praco Procedure Std Phaco AU nona Sii dE MFG ACDILISY 4 62 MFG ALDUS 5 49 Procedure Std Phacn Procedure 4d PHhacn oL Ref IOL Ref MFG ACD US 4 62 MFG ACD LS 5 43 19 00 0 41 21 00 0 18 OL Fred Ret IOL Fred Ref 19 50 0 05 21 50 0 15 25 00 aea 00 p 0 48 8 00a 27 Dp 0 6 19 92 0 25 27 B4 0 25 25 05 00 p 0 40 9 50a 27 00 p 0 40 20 00 0 34 22 00 0 49 25 007 5p 4 25 10 00a 26 a8p 4 25 20 50 0 67 22 50 0 84 2 O00e S 00p 0 25 10 00ert 2700p Def 25 505 000 p 40 66 10 50a 27 Dp 40 Er OL Consultant Notes The probability oft OL is 0 13 Amtenor Lens was ti m nimi m auallable Surgeon Technician Motes HicS oapPra Ver 2010 1010 Test Eye Clinic Page 1 of 1 Updated 17 Dec 2011 pg 45 HICSOAP Professional and Deluxe User s Manual A 2 Toric Iol Report HicSoapPro Toric lol Report Patient Patient H omml Report Date 102620140 Date of Birth 120 1921 Sec Female ID IAA Pre Op Data Surgeon Surgeont Example 10435419936 Surgeon Surgeon Example 1043 1996 Re fraction 0 50 0 50 X 180 AL U Sy 2345 O D O S Refraction 1 00 1 00 X 180 ALUS 23 45 Vertex 240 0 Adj AL 23 45 Vertex 2 00 Adj AL 23 45 BCVA 20 7 0 HorW t W 11 70 BCVA 20 400 HorW
20. 3 50D Toricity 2 25D Meridian 34 Formula Holladay II v Calculated from PO Ks amp PO REF Calculated from Observed IOL Meridian amp PO REF FlatK 47 43 124 Steep K 48 99 34 Ideal Placement Axis 34 No Rotation Necessary Pred Residual REF 0 09 0 19 X34 IOL Toricity amp Axis 1 39 96 0 Ideal Placement Axis 96 No Rotation Necessary Pred Residual REF 0 02 0 03 X96 12 17 20 The Toric PostOp Back Calculator allows the surgeon to determine the exact amount that the Toric IOL needs to be rotated to achieve the smallest residual astigmatism There are two methods available Method 1 uses 1 PostOp K s and 2 Postop Refraction to determine the a the toricity of the IOL and its current placement axis b ideal placement axis c the amount of clockwise rotation necessary to achieve the ideal placement axis and d predicted residual refraction at the ideal placement axis The blue line in the diagram illustrates the ideal axis of placement for the IOL Method 2 uses 1 observed IOL meridian at the slit lamp and 2 PostOp Refraction to determine the a the toricity of the IOL and its current axis b ideal placement axis c the amount of clockwise rotation necessary to achieve the ideal axis and d predicted residual refraction at the ideal placement The blue line in the diagram illustrates the ideal axis of placement for the IOL When the required PostOp data abov
21. HICSOAP Professional and Deluxe User s Manual User s Guide and Reference Manual Version 6 10 Jack T Holladay M D M S E E F A C S HICSOAP Professional and Deluxe User s Manual Contents MEE dceeedeimm E TU UU me 4 MERC iH o SM Umm mmr EEPR 5 SEC edo AREIS rm 6 T Program SUFBODTTSBELDID usos udimsicve PEE d tdeo diao c tado EU M deb Id srUrindidu s ern dare esata ME daw giu Mid S d RESTE 7 4 1 Progra SI ERR 7 4 2 SUPE COM Lens SEUD e E 8 4 3 Surgeon Piggy Back Lens And Toric Calc Setup cccccccssseccccsececeeeseceeeeeceeeeeeceeeeeeceseeaecessaeeeeetas 10 4 4 Advanced SS E doea uanceinacieedabevscaseausecceeosecesnmmeu at 13 SEE CIN 1 ewer nate ee ree seceneemie unre ae acne enn a nen ee ee ene eee eer ae 14 SE dg EE UI mmm 16 6 1 PF AVAL EO Cat OM c 16 6 2 diti econ 18 2S Cal uei d c 20 PZ COMPO gll estoneccea 21 LN ECPI IE i a EIU m Mm 21 6 3 IOL CIEGO ore E hoi dipped EPI Reis dene nde bs SP quM 26 6 4 TONCIOL PI IE UO OO OO m 27 5 4 1 Toric Lens Incision Optimizer scies coineep reci Feci x VA UY udi dete va qa ed V9d dq oro VIN RIBUS dS ERR RI EVE QUEE QUU ba GaU e otii e DIES 29 6 5 fpei Mie My RO m m umm 30 6 6 xoc Ta ag siesta
22. Optimize Surgically Induced Astigmatism 9 50 p Surgically Induced Astigmatism 9 50 p Incision Location E Incdision Location 328 Holladay II z AMO Tecnis Toric ZCTxxx AMO Tecnis Toric ZCTxxx Procedure Std Phaco Procedure Std Phaco SRG Entrd ACD Opt 5 60 SRG Entrd ACD Opt 5 60 IOL SEQ SEQ Ref IOL SEQ SEQ Ref 23 50 1 08 29 00 0 07 24 00 0 73 29 50 0 29 24 14 0 63 3 29 79 0 50 24 50 0 37 30 00 0 65 25 00 0 01 30 50 1 01 Res Astiom 7 Lens Res Astiom 1 65 D x 84 in p 1 07 D x 129 0 58 D x 84 0 02 Dx 39 0 05 D x 84 0 56 D x 39 0 48 D x 174 1 11D x 39 IOL Placement Axis 84 IOL Placement Axis 129 IOL Ideal Toricity 2 25D IOL IOL Ideal Toricity 1 48D IOL Residual Ref 0 706 0 050D Residual Ref 0 657 0 016D x39 40 824 84 39 176 174 Post Incision K 44 787 129 43 713 39 Ready 12 17 20 The Toric IOL Planner allows the User to determine the Ideal Toricity and Axis of Placement for a Toric IOL using the K s and Surgically Induced Astigmatism from the cataract incision Confirm that the K readings and the axis for the flat and steep K are correct before starting The magnitude and axis of the manifest refraction are irrelevant since the crystalline lens will be removed Values for a patient may not be saved if Surgical or Post Op data have already been entered Updated 17 Dec 2011 pg 27 HICSOAP Professional and Deluxe User
23. The other properties are used in various calculations such as optic diameter and vault so all properties must be entered before a lens can be added Lenses Added to the Data base by the user can be edited at any time on this Screen Editing lens properties in the program s ORIGINAL DATA BASE can never be performed ONLY LENSES THAT HAVE BEEN ADDED BY THE USER Exception The Range of available dioptric powers may be changed by the user on any lens in the Database original or added Note The format for the range of power of an IOL is min power max power and dioptric steps e g 10 0 25 0 0 5 25 0 34 0 1 0 indicates that the lens is available from 10 0 to 25 0 in 0 5 D steps and from 25 0 to 34 0 in 1 0 D steps The min and max power are separated by commas and the step size is followed by a semicolon e Search Lens Database The Lens Search button will display the lens search dialog when the lens database may be searched based on various criteria 4 3 Surgeon Piggy Back Lens And Toric Calc Setup Piggy Back lenses are used when the required implant exceeds the power available for a given lens style The choices below direct the program on how to handle this situation This choice can be changed at any time on this screen by choosing the Lens Setup button on any screen If both lenses are to be placed in the bag then this should be chosen on the preoperative screen If the posterior piggyback lens goes in the bag and the anterior piggy ba
24. Upper Limit 50 PreOp Ref Lower Limit 10 D Upper Limit 10 C PostOp Ref Lower Limit 10 D Upper Limit 10 F Pred Error Lower Limit 0 25 p ker Fama fe amp Include cases within limits only Indude cases outside limits only Previous Rk Lasik No Yes Exdude PreOp Pathology Exdude Surgery Complication Exdude PostOp Complication This screen allows the user to choose the number of cases periods of time and various other conditions that may be of specific interest The prediction error can look at the cases within the interval or outside the interval chosen This is especially useful for looking at the outliers with large prediction errors e Export Selected Patients The patients found by the Selection Criteria will have their data exported as a comma separated variable CSV format file which can be imported by EXCEL etc e Print Selected Patients A two page summary of the preoperative surgical and postoperative data is printed for the Surgeon Lens es and the Selection Criteria chosen Updated 17 Dec 2011 pg 36 HICSOAP Professional and Deluxe User s Manual e Print Current Page The entire page is printed including graphs and the summary statistics See Example A in the Appendix 7 1 SOAP Prediction Error 8 Holladay IOL Consultant a 52 x File Edit View Help Utilities ins 1 Staar AA 4203V X Std Phaco X Soap Prediction Error Soap Sirc Changes Soap Potential Ou
25. ady 10 26 20 The patient s demographic and preoperative data are shown at the top of the screen with the surgeon s primary default formula displayed in the pull down box If a different formula is desired click on the Formula pull down menu and select the desired formula The calculated values for the selected formula change instantly In the example IOL Calculation Screen above Lens 1 for the right eye requires a Primary Piggy Back IOL Calculation because the IOL power necessary for this patient s desired postoperative refractive target exceeds the maximum power for that lens style e g the PSO6UV maximum power is 30 D and the power needed is greater The program is showing that you need a 27 5 D lens as the FRONT anterior Piggy Back IOL and a 30 0 D lens as the BACK posterior IOL If the in the bag box is checked then the calculation is for both of the lenses in the bag only recommended for PMMA lenses or rigid lenses or if in the sulcus is checked it is for the FRONT lens in the sulcus and the BACK lens in the bag The bold value for each IOL in the box is the IOL power nearest to the Target Refraction on the PreOp Data Screen Updated 17 Dec 2011 pg 26 HICSOAP Professional and Deluxe User s Manual Values for Bifocal IOL Add Power are shown under notes at the bottom of the screen and printout NOTE Previous versions of the program also displayed ideal toricity in the comments section if selected This
26. am will pick a default database file and for most users that may be sufficient Advanced users may move this file to a different location for networking or enterprise backup e Automatic Database Backup The program maintains automatic backups over several days weeks The backup should not be turned off unless an alternate backup scheme is implanted in the clinic e Soap Graph Printing Mode Some printers may not be capable of printing some of the SOAP graphs If this is the case the alternate or the screen dump modes may be tried in that order e Other Options Additional options are specified in this section and the default options would be appropriate for most clinics It is strongly recommended to enable the first option check for newer version so that you always run the latest version of the software Updated 17 Dec 2011 pg 13 HICSOAP Professional and Deluxe User s Manual 5 Main Menu m Holladay IOL Consultant a File View Help Version 2010 0918 HP 15181731 a Windows Ver 6 1 7600 ETE mm e Enter New Patient Data Displays the Patient Locator screen for data input of a new patient s demographic data e Locate Patient Record Displays the Patient Locator screen to search for an existing patient e Program amp Surgeon Setup Displays the Program Setup Surgeon Lens Setup and Surgeon Piggy Back Lens Setup screens for initially setting up the program e SOAP Formula and Lens Constant Analysis Displays the For
27. c 2011 pg 41 HICSOAP Professional and Deluxe User s Manual 8 Utilities 8 1 Database s Holladay IOL Consultant a co 5 mium File Edit View Help Utilities d E Database Documentation Remove Registration Patient Database File C HicSoapPro Data HicDatabase hdf Restore Open Database Folder Utilities for users of Holladay Consultant Version 2 50 3129c or earlier Convert US AL to OPTICAL Main Menu Help Quit System Information Next gt Ready 10 26 20 Patient Database File Indicates the database file currently open Backup Backs up the database by first displaying the SAVE AS dialog box to specify the directory and drive to be used for the backup operation Restore Restores from a list of automatic backups made by this program or restores from another backup If more than one backup file is created on the same day the older file will be replaced by the new file The most recent backup file should be used Move Database Moves the database to a different location drive and folder The program will continue to open the database at the new location when the program is started Repair and Compact Database Repairs the database This is useful when the program is not working right and should be done at least once a year Updated 17 Dec 2011 pg 42 HICSOAP Professional and Deluxe Use
28. ck lens goes in the sulcus then in the sulcus Updated 17 Dec 2011 pg 10 HICSOAP Professional and Deluxe User s Manual should be selected on the PreOp screen Note Piggy Back lenses are calculated using the Holladay 2 Formula ONLY Program Clinic Setup Surgeon Lens Setup Surgeon Piggy And Toric Lens Setup Surgeon Surgeon Example Piggy preferences MOTE Piggy Back lenses are calculated using the HOLLADAY 2 FORMULA ONLY I C Ma piggyback lens Fix Posterior lens power ta mas available power C Fix Posterior lens power to 5 Use two equal IOL s when power exceeds mas available power 5 Use two equal IOL s when power exceeds O Fis Front IOL ta Toric Cale preferences Residual Refraction Made i Plus O Minus Print Inverted text an the Toric report Surgery Induced Astigmatism Temporal 0 2 Superior D 3 e No Piggy Back Lens The surgeon does not want piggy back calculations performed e Fix Posterior lens power to max available power The surgeon wants the program to use the maximum available power from the manufacturer for a given lens model to be used as the posterior piggy back lens This is the standard choice since most experts recommend placing the highest available power for the posterior lens and the remaining power for the anterior lens Since the maximum power for each lens model may be different the posterior piggy back lens power on the screen and printout may be different for each lens mo
29. cs The summary statistics window near the bottom of the screen yields the numerical results for the Surgeon Lens es and Formula selected These statistics are similar to the values given on the Formula and Lens Constant Analysis Screen in the Holladay IOL Consultant Excluded Cases Patients who are outliers and have been excluded from the Formula and Lens Constant Analysis Table Summary Statistics Window may be listed The patient s name chart number eye and reason for exclusion are listed The possible reasons for exclusion are listed below e PO period less than 14 days e BCVA best corrected visual acuity below criteria selected usually selected as less than 20 50 outliers e Back calculated lens constant for this case is more than 2 standard deviations from the mean e Preoperative pathology surgical or postoperative complication were selected on the respective screen 7 2 SOAP SIRC Changes Report 8 Holladay IOL Consultant a File Edit View Help Utilities Surgeon Surgeon3 Example v Lens 1 Staar AA 4203V StdPhaco Formula Holladay Il v Aulus Step Size D Soap Prediction Error Soap Sirc Changes Soap Potential Outcomes Frequency Distribution of Eyes Surgically Induced Cylinder and Axis SIRC 30 Centroid 0 20 81 deg St Dev 0 553 0 50 0 00 0 50 1 00 Surgically Induced Astigmatism SIA Actual Pre op Cylinder and Axis Actual Post op Cylinder and Axis Centroid 0 06 103 deg
30. del e Fix Posterior Lens Power to Same as number 2 but the user has chosen to fix the power of the posterior IOL to a value other than the maximum available power This selection is useful if the user wants to override the maximum power of a lens model in the Data base For example if the manufacturer makes a 34 diopter lens but the maximum power available in the current inventory is 32 the value can be set to 32 This value will be used for all lens models in the IOL calculation e Use Two Equal IOL s when power exceeds max available The surgeon wants piggy back calculations performed using two lenses that are as close to equal power as possible and would like this to occur when the necessary lens power exceeds the maximum available power from the manufacturer Updated 17 Dec 2011 pg 11 HICSOAP Professional and Deluxe User s Manual e Use Two Equal IOL s when power exceeds Same as 4 above but the maximum value is set by the user e Fix Front IOL to The surgeon has chosen to fix the power of the anterior IOL This is often helpful when the front lens required is very low i e 1 to 5 diopters and the lenses are not readily available The front lens can be set to the lowest available power such as 4 or 6 diopters e Toric Calculation Residual Refraction Mode If Plus is selected then all residual refractions in the toric reports will be using the plus cylinder mode If Minus is selected then they will be displayed printed u
31. der form is most helpful for Updated 17 Dec 2011 pg 33 HICSOAP Professional and Deluxe User s Manual relaxing or flattening procedures and the cross cylinder form is most helpful for seeing the actual change in each meridian 6 9 Individual Back Caclulations a Holladay IOL Consultant a File Edit View Help Utilities Name Nanophthalmos Young Patient Locator PreOp Exam IOL Calc Toric IOL Planner 11 13 1996 Surgeoni Example MA30BA Procedure Std Phaco 57 0 27 0a 30 0p 12 13 1996 Formula Holladay Il zj Actual Values Implanted Lens Pwr 57 00 PostOp Ref Sph Eqv 0 428 PreOp AL 15 09 PreOp Avg K 53 44 Lens Constant LC 5 491 MFG BackCalculated Values Calculated from 4 measured values IOL Power Ref Axial Length Avg K value From K AL LC Ref K AL LC IOL K LC IOL Ref AL LC IOL Ref K AL IOL Ref Pred Ref PO Ref ID 11AA PostOp Exam DOB 13 Oct 1986 Implant Power Post Op Date Gender M SIRC Calculation Back Calculation 11 13 1996 Surgeoni1 Example MA30BA Procedure Std Phaco 55 0 25 0a 30 0p 12 13 1996 Formula Holladay II Actual Values Implanted Lens Pwr PostOp Ref Sph Eqv PreOp AL PreOp Ava K Lens Constant LC 55 00 0 404 15 31 53 75 5 491 MFG BackCalculated Values Calculated from 4 measured values From K AL LC Ref K AL
32. e Edit View Help Utilities Name Nanophthalmos Young ID 1AA DOB 13 Oct 1986 Gender M Patient Locator PreOp Exam IOL Calc Toric IOL Planner Surgery Data PostOp Exam SIRC Calculation Back Calculation Q D Surgery Date 11 13 1996 11 13 1996 Surgeon Surgeoni Example Surgeon1 Example Lens MA30BA Procedure Std Phaco Lens MA30BA Procedure Std Phaco Implant Power 57 0 27 0a 30 0p Implant Power 55 0 25 0a 30 0p 4m Postopsi 48m Postop 1 12 13 1996 12 13 1996 54 25 90 52 25 0 Complications Back Calc gt gt 10 26 20 Patient demographics and surgery information is displayed at the top of the screen Check PostOp Complication if the patient s eye is to be ignored for personalized constant calculations Up to 3 postoperative exams for OD and OS are shown on the postoperative exams screen If there are more than 3 postoperative exams clicking the bold arrows allows the user to move forward and backward chronologically through the exams Clicking the Setup button displays the Setup Screens Clicking Surgery button returns to the Surgery Data Entry Screen Clicking Print button prints a log of the postoperative data Clicking BackCalcs button displays the Back Calculations screen Clicking SIRC Tab at the top displays the SIRC Surgically Induced Refractive Change from keratometry and refraction Updated 17 Dec 2011 pg 31 HICSOAP Professional and Deluxe User s Ma
33. e has NOT been entered an Enter Missing Data Button is present for Method 1 and or 2 in place of the illustration When this button is clicked the PostOp EXAM screen appears and the missing data can be entered Updated 17 Dec 2011 pg 32 HICSOAP Professional and Deluxe User s Manual It is prudent to measure both the PostOp K s and observed IOL meridian along with the PostOp Refraction as a double check of the amount to rotate the IOL to the ideal axis of placement The two methods should agree to within a few degrees When they do not match something is wrong and measurements should be repeated until they agree As with the Toric IOL Planner forward calculation the equations for the back calculation are exact and utilize the effective lens position ELP and IOL Power and Toricity Approximation calculators that use a constant ratio to convert the cylinder at the IOL plane to the cylinder at the corneal plane will not get the same answer especially for low and high power IOLs If a CALCULATOR does not require the SEQ power of the IOL as input data the calculator uses the approximation method 6 8 Individual Surgically Induced Refractive Change SIRC m a Holladay IOL Consultant a File Edit View Help Utilities Name Nanophthalmos Young Patient Locator PreOp Exam IOL Calc Toric IOL Planner Surgery Data PostOp Exam SIRC Calculation Back Calculation Surgery Date 11 13 1996 11 13 1996 Q S Surgeon Surgeon1
34. ediction Error 30 Myopic Prediction Error ll Opt sc Cumulative Distribution of Eyes D Opt SC AMfg SC SEZZZZIZIZLLLL LE LLL ED 0 25 0 50 0 75 1 00 1 25 1 50 200 Absolute Value of Spherical Equivalent Prediction Error D 1 75 Spherical Equivalent Prediction Error D PRED REF Actual PO REF Frequency Distribution of VA Select Improvements Q Distance BSCVA Distance UCVA Optimize Surgeon Constant Zero Induced Astigmatism Cumulative Distribution of VA Zero Post op Astigmatism Export Selected Patients Print Selected Patients Print Current Page Ready 10 26 20 5 3 1 Frequency Distribution of Eyes Upper Left Graph This graph displays the Spherical Equivalent Prediction Error D with the Optimized Surgeon Constant Opt SC in solid bars and with the manufacturers recommended constant in hatched bars 5 3 2 Cumulative Distribution of Eyes Upper Right Graph This graph displays the cumulative distribution of the Spherical Equivalent Prediction Error D The line with boxes represents the distribution with the Optimized Surgeon Constant and the line with triangles with the manufacturers recommended constant 5 3 3 Frequency Distribution of VA Lower Left Graph This graph displays the visual acuity s at various acuity levels The solid bars are the actual acuity s and the hatched bars are the theoretical acuity s that would be p
35. l WTW Ref 1 00 100 x 180 yx 12 00 sova uova Ki 43 75 90 K2 43 75 0 Hor white to white 11 70 Alternate K gt 33 50 K s not measured with the primary keratometer 2 Axial Length mm Axial Length to Use for Calculations UltraSound US AL Optical Optical IOLM Lenstar AL US 23 45 CorrectAL gt 23 45 Anterior Segment mm Phakic ACD 3 10 Pat Locator IOL Calc gt 10 26 20 This screen is used to enter all the PreOp information Incorrect or missing items are highlighted in red while optional values are highlighted in yellow The program allow for either standard IOL calculations cataract removal or advanced calculations grouped under the Other Calculations button see section below for more information It is necessary to enter all the pre existing conditions for best accuracy The following conditions influence the IOL Calculations and Personalization of the Lens Constant e Keratoconus Necessary for the program to differentiate a normal steep K reading in a small anterior segment from a patient with keratoconus e Previous RK PRK ALK LASIK When this box is checked the Alternate K button appears Select the Alternate K button and the Alternate Average K value Source screen appears see below for details e Silicone in Vitreous Cavity Changes the IOL calculations to compensate for Silicone in the Vitreous Cavity Although convexo
36. lities Patient b d Patient Locator PreOp Exam IOL Calc Toric IOL Planner OD Surgery Date 11 13 1996 v Surgeon Surgeoni Example z Lens Model Used amp Procedure 4 Alcon MA30BA No of Lenses Implanted this procedure ilens Lens Power 2 Lenses Piggy back Posterior 30 Anterior 27 Surgery Complication Corneal Astigmatism Proceduce LRI AK etc PostOp Exam SIRC Calculation Back Calculation Surgery Date 11 13 1996 O S Surgeon Surgeoni Example M Lens Model Used amp Procedure 4 Alcon MA30BA No of Lenses Implanted this procedure 1Lens 2 Lenses Piggy back Posterior 30 Anterior 25 Surgery Complication T Corneal Astigmatism Proceduce LRI AK etc 10 26 20 All the items in the screen must be entered Surgery Complication should be selected if this patient is to be ignored in the personalized constant calculations Corneal Astigmatism Procedures are also ignored for personalization and SIRC calculations Clicking the Print button prints the Surgery Data Screen Clicking IOL Calc button returns to the IOL Calculation Screen Clicking PostOp Data displays the PostOp Data Screen Clicking on the Setup button displays the Program Setup Surgeon Lens Setup and Surgeon Piggy Back Lens Setup Screens Updated 17 Dec 2011 pg 30 HICSOAP Professional and Deluxe User s Manual 6 6 PostOp Data 8 Holladay IOL Consultant a Fil
37. mula and Lens Constant Analysis Table at the bottom of the screen e SOAP Prediction Error Report Displays the Prediction Error Report Screen e SOAP SIRC Changes Report Displays the SIRC Report screen e SOAP Potential Outcomes Displays the Potential Outcomes screen e Utilities Database Displays the Data base Operations screen for Backup and Restore Data base operations If the shift key is depressed when the Data Operations Button is clicked the Program and Data base Versions are displayed e Utilities Documentation Displays the documentation list page Updated 17 Dec 2011 pg 14 HICSOAP Professional and Deluxe User s Manual e Utilities Send Database to Tech Support Sends a copy of the database to tech support Before sending the database all patient last names are removed e Utilities Remove Registration The program registration may be removed from the computer e Quit Displays the Exiting IOL screen for Backup amp Exit or Exit when leaving the program Daily backups are recommended or immediately after entering large amounts of data e Help Displays the Help Screen for the Main Menu Updated 17 Dec 2011 pg 15 HICSOAP Professional and Deluxe User s Manual 6 Patient Screens 6 1 Patient Locator ia Holladay IOL Consultant a c3 5 mtm File Edit View Help Utilities Name Patient Normal ID 11AA DOB 13 Oct 1924 Gender F d Patient Locator PreOp Exam IOL Calc Toric IOL Planner Surgery Data PostO
38. ns The procedure defaults to Std Phaco but may be changed to any description For example one may choose AC Backup for an anterior chamber backup lens or ECCE for a lens that is used for a large incision extracapsular cataract extraction The procedure code is particularly valuable when the same lens model is used for different procedures requiring a different lens constant f the lens constant is the same there is no need to create a separate procedure group Once the Manufacturer Lens Model and Procedure have been chosen click the Add button to place the lens in the Active Lens List There is no limit to the number of active lenses that can be added All Active Lenses will be displayed and printed with four lenses per page e Removing lenses from the surgeon s Active Lens list A Lens Model with no data may be removed from the surgeon s Active Lens List If the Lens Model has data it cannot be removed To remove a lens model with no data highlight the lens with a single click then click the remove button e Changing the lens order number of printed lenses The order of lenses selected for printing may be rearranged by using the Move Up Move Down buttons below the Active Lens List Simply highlight a lens move it up or down to the desired position in the list e Over riding the Manufacturer s lens constant with a Surgeon Entered lens constant Surgeon Entered Lens Constant Surgeon Surgeoni Example Lens Manuf Alcon Cilco Le
39. ns Model SNGOUT3 4 5 Procedure Std Phaco Please enter your constant Constant for Ultrasound AL Constant for Optical Biometer AL Holladay 2 or R ACD ACD Holladay 1 SF SF SRK T I amp I A Constant A Constant Hoffer Q ACD ACD Binkhorst I amp II ACD ACD If the A constant and ACD do not agree the A constant is usually the better value and is for in the bag placement When they do not agree the manufacturer s ACD is usually 0 30 mm less than the value converted from the A constant an is actually for in the sulcus The program automatically retrieves the manufacturer s lens constant from the Data base for IOL Updated 17 Dec 2011 pg 9 HICSOAP Professional and Deluxe User s Manual calculations If the surgeon already has a personalized lens constant he may override the manufacturer s lens constant by clicking the Enter Constant Select the formula that the surgeon has been using and enter the personalized constant This value overrides the manufacturer s constant and will be displayed on the IOL calculation screen and printout as Entered Cst in place of Manuf Cst The program automatically converts the Surgeon Entered personalized constant for any of the formulas to the appropriate constant for the formula that has been chosen on the IOL Calculation Screen If the A constant and ACD from the manufacturer do not agree the A constant is usually the better value and is for in the bag placement When they
40. nt Cystoid macular edema Pupillary block Macular degeneration Fibrin in pupil Optic atrophy Distorted pupil Hyphema Cortical remnants Flat anterior chamber F Nucdear remnants Vitreous in anterior chamber I IOL dislocation Vitreous to wound L IOL optic decentration if gt 1 0 mm E Secondary glaucoma If yes Vitritis Optic atrophy Cyditic membrane E Retinal detachment _ Anterior synechiae Diabetic retinopathy Posterior synechiae Other E Significant pigment deposits on IOL NOTE Eyes with pathology will not use personalized constants NOTE The Vertex Distance VTX must be specified for any refraction entered into the Data base The Vertex Distance VTX Default may be set on the Program Setup Screen The average value for Updated 17 Dec 2011 pg 19 HICSOAP Professional and Deluxe User s Manual spectacles and trial frames is 12 mm The average vertex distance for the phoropter is 14 mm If the refraction exceeds 4 diopters the vertex should be measured to avoid computation errors 4 2 1 Other Calculations Selecting Other Calculations enables the Click Here button which when clicked pops up the following dialog when additional advance setting may be entered OSiLeft Pre Op Special Data Phakic Eve Aphakic Eve AC IOL always in Angle For PC lens calc for inBag in Sulcus J PseudoPhakic Eve AC IOL only in Angle a
41. nual 6 7 Toric PostOp Back Calculator W Holladay IOL Consultant Test Eye Center File View Help Patient Locator PreOp Exam IOL Cale Toric PreOp Planner RIGHT Surgeon Surgeon3 Example PreOp Date 11 24 2011 Ref 3 00 2 00 X 180 VTX 12 00 FlatK 39 00 180 Steep K 41 00 290 PostopOp Date 12 05 2011 Ref 1 63 2 04 X148 VTX 12 00 FlatK 39 00 0 Steep K 41 00 90 PreOp Intended SIA 0 50 110 0 Actual SIA 0 00 45 0 SIA Error Mag 0 50D Angle 65 Lens Implanted Tecnis Toric ZCT xx SEQ 24 50D Toricity 3 00D Meridian 120 Formula Holladay II v Target Rx 0 63 n 1 3375 Caku amp ted from PO Ks amp PO REF IOL Toricity amp Axis 2 96 0120 0 Ideal Placement Axis 90 Rotate 30 clockwise Pred Residual REF 0 63 0 04 x90 Calaulated from Observed IOL Meridian amp PO REF FlatK 38 73 0 SteepK 40 75 90 Ideal Placement Axis 90 Rotate 30 clockwise Pred Residual REF 0 63 0 04 X90 Surgery Data PostOp Exam Toric PostOp BackCalc SIRC Calculation Back Calculation Surgeon Surgeon3 Example LEFT PreOp Date 11 24 2011 Ref 0 00 0 00 X 0 FlatK 43 50 45 PostopOp Date 12 10 2011 Ref 0 00 0 00 XO FlatK 44 00 6 VTX 12 00 Steep K 45 00 135 Target Rx 0 50 pa LE T VTX 12 00 Steep K 45 00 96 PreOp Intended SIA 0 50 328 0 Actual SIA 1 62 154 0 SIA Error Mag 1 12D Angle 174 Lens Implanted Tecnis Toric ZCT ox SEQ 2
42. nufacturer Veriseye YVASMBUS Phakic sees PSO6L Std Praca SMBOT 3 4 5 Std Phaco Lens Model Verseve YASMBLS Phakic SI 30NB Std Phaco 11 C 11 BC B mi Web ACRIMED Std Phaco Procedure B aikaff3 Phakic ACL Std FPhaca EE L122Lv AL Backup Frodorovl Phakic ICL Manufacturer s Comments Move Up Move Down Enter Constant Add Lens nat in data base e New Edit Surgeon Click the New button to add a New surgeon or the edit button to edit an existing surgeon The Last Name First Name and Primary Formula must be entered Holladay 2 Formula is recommended If the Active box is checked this surgeon will appear in the active group of surgeons alphabetized at the beginning of the surgeon pull down list Inactive surgeons appear alphabetically in a list after the active surgeons e Number of lenses to be printed on IOL Calculation report from active lens list The program can print up to 4 IOL models on each page on the IOL calculation screen and on a single page report Updated 17 Dec 2011 pg 8 HICSOAP Professional and Deluxe User s Manual Any number of lenses may be chosen and the default is 4 If more than 4 lenses are on the active lens list then multiple pages will be printed with 4 lenses per page There is no limit to the number of pages that may be printed e Adding lenses to surgeon s Active Lens List To add a lens to the surgeon s Active Lens List choose the manufacturer and the lens model from the pull down scree
43. p Exam SIRC Calculation Back Calculation V Show Example Patients i Date of Birth Add New Patient 13 Oct 1922 13 Oct 1970 Import Patient s from 13 Oct 1986 IOL Master or Lenstar 13 Oct 1924 13 Oct 1946 Edit Patient 13 Oct 1925 12 Nov 1915 30 Jun 1914 Delete Patient 07 May 1920 07 Apr 1936 15 Dec 1912 17 Aug 1928 25 Jan 1922 18 Feb 1908 7 zn a zai az x x D b Oct 13 1996 Nov 13 1996 Dec 13 1996 Export Patient List Print Patient List 10 26 20 e Show EXAMPLE Patients The Program has 3 EXAMPLE Surgeons and several EXAMPLE patients to illustrate many features of the program The EXAMPLE patients may be hidden from the patient list by un checking this box e Add New Patient This button will popup the new patient dialog where the demographic data may be entered Selecting the PreOp Data button displays the PreOp Data Screen for data entry e Import from IOL Master or Lenstar Data that has been exported from the IOL Master to a 1 44 Meg floppy disk may be directly imported into the program e Existing Patient List All of the existing patients can be found on the Patient Locator Screen A patient may be located by Last Name First Name or Chart Number Once a patient has been selected all of their PreOp Surgical and PostOp visits are displayed in the window below Any visit may be highlighted and when double clicked
44. plano IOLs flat posterior surface are recommended since they minimize this effect the program calculates for any lens selected including biconvex The increase in lens power usually ranges from 3 to 6 diopters for convexoplano lenses and from 4 Updated 17 Dec 2011 pg 18 HICSOAP Professional and Deluxe User s Manual to 10 diopters for biconvex lenses Only PMMA lenses are recommended Note Selecting this option does not correct the axial length for Silicone in the vitreous Axial lengths measured with Silicone in the vitreous cavity are unreliable even when corrected for ultrasound speed in silicone It is much more accurate to measure the eye without Silicone and use this value for the calculation If both eyes have Silicone and no pre Silicone axial lengths were measured a useful approximation is to use 23 5 mm as a nominal axial length and add or subtract 1 mm for every 3 diopters of myopia or hyperopia respectively e Scleral Buckle A scleral buckle artificially lengthens the eye and makes the measured axial length inappropriate for use in calculating the size of the anterior segment e Other Pathology Used for flagging a patient that is not to be included in the personalization of a lens constant When this checkbox is pressed a popup dialog is displayed that is used to enter more detailed information Other Pathology or Complications C No Q Yes If yes check all that apply Wound leak T Raised IOP requiring treatme
45. r s Manual Open Other database This feature allows the user to Open a different HICSOAP database When this button is clicked the File Open Window below appears with a Select a file from the following list for existing Databases If the Database has been opened before it will appear in the list to select If the Database has never been opened before but is a hdf file the select a new file to open radio button should be clicked and an Open File dialog box will appear from which you may choose the file Open Database Folder Clicking this simply opens the folder containing the current database using Windows Explorer 8 2 Documentation 8 Holladay IOL Consultant a o x File Edit View Help Utilities Database Documentation Remove Registration List of available documents Last Updated 19 Sep 2011 l User s Manual The Main User s Guide Last Updated 2 Dec 2010 Helpful information to setup your system for the first time Last Updated 11 May 2011 HICSOAP Edition Features Differences between STANDARD DELUXE PROFESSIONAL editions Lists news features Last Updated 27 May 2010 It answers several frequently asked questions Last Updated 7 Oct 2010 Information on networking HicSoapPro not for Deluxe version Last Updated 4 May 2011 HICOSAP Maintenance and Troubleshooting Last Updated 15 Dec 2010 Zeiss IOL Master Instructions Instructions on how to configure
46. redicted from the patients refractions 5 3 4 Cumulative Distribution of VA Lower Right Graph This graph displays the cumulative distribution of the visual acuity s at various acuity levels The line with boxes is the actual acuity s and the line with triangles is the theoretical acuity s that would be predicted from the patients refractions Updated 17 Dec 2011 pg 40 HICSOAP Professional and Deluxe User s Manual 5 3 5 Buttons under graphs 5 3 5 1 Distance BSCVA When this radio button is chosen all acuity values are displayed using the actual Best Spectacle Corrected Visual Acuity BSCVA 5 3 5 2 Distance UCVA When this radio button is chosen all acuity values are displayed using the actual or theoretical Uncorrected Visual Acuity UCVA values 5 3 5 3 Optimize Surgeon Constant When this box is checked the theoretical values for visual acuity for patients refractive error are displayed with the optimized surgeon constant When this is not checked the theoretical values using the manufacturer s recommended constant are displayed 5 3 5 4 Zero Induced Astigmatism When this box is checked the theoretical visual acuity s reflect the results if the surgeon had not induced any astigmatism on any patient 5 3 5 5 Zero PostOp Astigmatism When this box is checked the theoretical visual acuity s reflect the results if the surgeon had reduced every patient s postoperative astigmatism to zero Updated 17 De
47. ror Ced Allows the surgeon to calculate an average K value from the data taken before and after the refractive surgery The K values before the refractive surgery and the refraction before and after the refractive surgery are needed Updated 17 Dec 2011 pg 22 HICSOAP Professional and Deluxe User s Manual Average K from Rigid Trial Contact Lens Alternate Average K value Source Post Keratorefractive Surgery Comea Select R value to be used Far IOL power Calculation Average E from Rigid Trial CL Calculated average K value from Refractive data a Refraction without Rigid Contact Lens SFH UTL VTA 0 50 1 00 12 Calculated average K alue fram Rigid Trial CL b OverRetraction w Hiaid Contact Lens SFH UTL VTA 1 50 0 12 Measured average K from prep data screen c Contact Lens BC in mm or D 35 2 Surgeon Entered Kalue d Contact Lens Power NOTE Lowest K value tends towards myopic error Highest K value tends towards hyperopic error Cancel Help Allows the surgeon to calculate the K value from the base curve and power of a rigid trial contact lens and the refraction with and without the contact lens Updated 17 Dec 2011 pg 23 HICSOAP Professional and Deluxe User s Manual Measured Average K from PreOp Screen Alternate Average K value Source Post Keratorefractive Surgery Comea Select K value to be used Far IOL power Calculation Measured average K Calculated a
48. s been done the resulting Steep Axis of the Cornea and correct axis for the IOL are shown Below the picture is the 1 Axis of Placement 2 Ideal Toricity of the IOL and 3 the remaining Residual Refraction with the nearest available Toric IOL All available Toricities are shown with the nearest to the Ideal Toricity highlighted in Bold Print and the Residual Refraction for each available toricity Updated 17 Dec 2011 pg 28 HICSOAP Professional and Deluxe User s Manual 5 4 1 Toric Lens Incision Optimizer Clicking the Optimize button in the preop toric screen will display the toric incision optimizer dialog which graphs the residual astigmatism as a function of the incision angle Surgically Induced Astigmatism 90 0 50 D SIA 180 0 50 p These values may be configured in the Surgeon Toric Settings Incision at Residual Astigmatism 74 0 50 254 0 50 106 0 50 286 0 50 RIGHT EYE Incision Angle The SIA values at 90 and 180 are pre populated with the values entered in the Surgeon Toric setup screen see section 4 3 above The radio buttons on the right specify the incision locations that minimize the residual astigmatism Select one of these points and press OK to copy the incision angle into the Preop toric screen incision angle Updated 17 Dec 2011 pg 29 HICSOAP Professional and Deluxe User s Manual 6 5 Surgery Data Entry 8 Holladay IOL Consultant a File Edit View Help Uti
49. sing the minus cylinder mode e Toric Calculations Reversed Text If the checkbox is checked then the Toric calculation report will print the IOL and Incision Angles using both normal and upside down text 6 9 uoisiou S 101 Incision 9 IOL 5 e Surgical Induced Astigmatism Temporal Superior This values are used in the preop toric optimizer Please refer to section 6 4 below for more details Updated 17 Dec 2011 pg 12 HICSOAP Professional and Deluxe User s Manual 4 4 Advanced Setup Holladay IOL Consultant Setup Program Clinic Setup Surgeon Lens Setup Surgeon Piggy back Lens Setup Advanced Settings Database File Configuration Current database file L HicS aapPre sD atasHicD atabase hdi Automatic Database Backup 4 Enable Automatic Backup Recommended Database Backup Directory HicS aapPresB ackup Change Soap Graph Printing Mode Some printers may nat print the SOAP graphs properly with the standard setting IF your printer does not print the graph properly please try the other modes Standard Recommended d Alternate J Screen capture and Dump Other Options V Automatically check for newer version on the Web recommended Limit the application to a single instance Enable Patient ACD display not recommended e Database File Configuration The database file used by the program is specified Normally the progr
50. t and negative values shift the printout up or to the left e Keratometer Settings The refractive index used in the clinic keratometers must be selected NOTE Both lOLMaster and Lenstar export the index of the refraction which is used by the program Updated 17 Dec 2011 pg 7 HICSOAP Professional and Deluxe User s Manual e Default Surgeon A default surgeon for the PreOp exam may be entered here When a default Surgeon other than None is selected then this Surgeon is entered automatically for new PreOp exams only e Default Technician A default technician for the PreOp exam may be entered here When a default Technician other than None is selected then this Technician is entered automatically for new PreOp exams only e Vertex Distance VTX Default The default value for the vertex distance of all refractions may be entered here The average value for spectacles and trial frames is 12 mm The average vertex distance for the phoropter is 14 mm If the refraction exceeds 4 diopters the vertex should be measured to avoid computation errors 4 2 Surgeon Lens Setup Holladay IOL Consultant Setup Program Clinic Setup Surgeon Lens Setup Surgeon Piggyback Lens Setup Advanced Settings Surgeon Surgeon Example E dit Mew Total Number of Lenses to appear in your IOL Power Cale repart 4 4 lenses per page Select Lens for Active Lens List or Search Active Lens List Lens Ma
51. tcomes Frequency Distribution of Eyes Cumulative Distribution of Eyes Hyperopic Prediction Error 3 Myopic Prediction Error 1 50 1 00 0 50 0 00 0 50 1 00 1 50 2 1 0 25 0 50 0 75 1 00 1 25 1 50 Spherical Equivalent Prediction Error D PRED REF Actual PO REF Absolute Value of Spherical Equivalent Prediction Error D Number Personalized Eqv Form Current Mean Mean Abs StdDevof MaxRx cases gt ACD mm Constant Form RxErr D RxErr D RxErr D Err D 2DRx 5 307 0 037 ACD 5 307 0 023 5 450 0 044 SF 1 693 5 461 0 044 ACD 5 461 5 503 0 042 ACst118 920 0 000 0 000 ACD 0 000 coisas erent Ready 10 26 20 5 1 1 Frequency Distribution of Eyes This graph demonstrates the Spherical Equivalent Prediction Error D for the surgeon lens es and formula selected for each interval of prediction error as a percentage of the total number In the example above the surgeon has 37 of his cases with zero prediction error 5 1 2 Cumulative Distribution of Eyes This graph demonstrates the Spherical Equivalent Prediction Error D for the surgeon lens es and formula selected as a cumulative percentage The surgeon can determine his cumulative absolute error for any level of prediction error In the example above the surgeon has 85 of his cases less than or equal to 0 50 D Updated 17 Dec 2011 pg 37 HICSOAP Professional and Deluxe User s Manual 5 1 3 Summary Statisti
52. uttons under Graphs 5 2 5 1 SIRC from K The SIRC from K calculates the surgically induced refraction change based on the preoperative and postoperative K readings This is the normal choice and reflects what changes the surgeon has made in the cornea 5 2 5 2 SIRC From Ref The SIRC from refraction calculates the surgically induced refraction change based on the preoperative and postoperative refractions This value would reflect any changes in the pre and postoperative refraction Since this value is affected by the power and cylinder of the crystalline lens and the power of the IOL it often has limited value in cataract surgery 5 2 5 3 Plus or Minus Cylinder Notation If the Plus radio button is selected then all values are displayed in plus cylinder notation If the Minus radio button is selected then all values are displayed in minus cylinder notation Usually steepening procedures are best displayed in Plus cylinder notation and flattening procedures are best displayed in Minus cylinder notation Updated 17 Dec 2011 pg 39 HICSOAP Professional and Deluxe User s Manual 7 3 SOAP Potential Outcomes amp Holladay IOL Consultant a File Edit View Help Utilities Surgeon Surgeon3 Example Lens 1 Staar Soap Prediction Error AA 4203V Std Phaco Formula Holladay II x Aulus Step Size D 0 25 Soap Sirc Changes Soap Potential Outcomes Frequency Distribution of Eyes Hyperopic Pr
53. verage K value from Refractive data 43 75 Calculated average E value from Rigid Trial CL C Surgeon Entered E alue NOTE Lowest K value tends towards myopic error Highest K value tends towards hyperopic error Cancel Help Allows the surgeon to use the actual measured values from the PreOp Data Screen Updated 17 Dec 2011 pg 24 HICSOAP Professional and Deluxe User s Manual Surgeon Entered K Alternate Average K value Source Post Keratorefractive Surgery Comea Select K value to be used Far IOL power Calculation Surgean Entered K 0 Calculated average E value fram Retractive data 3350 OD Because the K readings prior to kerato refractive surgery are nat always available amp Contact Lens Trial i not always possible the surgeon may choose to enter the central carmeal power obtained from topography Eff RF J Calculated average E value from Rigid Trial CL O Measured average K from preOp data screen i Surgeon Entered Kalue NOTE Lowest K value tends towards myopic error Highest K value tends towards hyperopic error RH Allows the surgeon to put in an average K value directly This value may be an average of the previous values or one from another source such as a corneal topography instrument Updated 17 Dec 2011 pg 25 HICSOAP Professional and Deluxe User s Manual 6 3 IOL Calculations 8 Holladay IOL Consultant a File Edit View Help Utilities Name Nanophthalmos
54. version however has a new advanced Toric Calculation tab that should be used instead The EXACT bifocal IOL Add Power is calculated from the desired add entered on the preoperative screen at the vertex specified The power shown on the IOL Calculation under screen notes is the add necessary on the IOL to achieve the specified add at the spectacle plane and vertex Click the Print button to print out the results Click the PreOp button to return to PreOp Data Screen Clicking on the Surgery button displays the Surgery data entry screen Clicking on the Lens Setup button displays the Program Setup Surgeon Lens Setup and Surgeon Piggy Back Lens Setup Screens 6 4 Toric IOL Planner a Holladay IOL Consultant Test Eye Center File View Help Patient Locator PreOp Exam IOL Calc Toric PreOp Planner Surgery Data PostOp Exam Toric PostOp BackCalc SIRC Calculation Back Calculation RIGHT Surgeon Surgeon3 Example PreOpDate 11 24 2011 Surgeon Surgeon3 Example PreOpDate 11 24 2011 LEFT Ref 3 00 2 00 X 180 VTX 12 00 Target Rx 0 63 Ref 0 00 0 00 X 0 VTX 12 00 Target Rx 0 50 BCVA UCVA Adj AL BCVA 20 20 UCVA 20 50 Adj AL Flat K 39 00 180 Steep K 41 00 90 n 1 3375 Flat K 43 50 45 Steep K 45 00 135 n 1 3375 Avg K 40 00 Adj K 40 00 Avg K 44 25 Adj K 44 25 Toric Lens from Active Lens List Tecnis Toric ZCTxxx StdPhaco v Toric Lens from Active Lens List Tenis Toric ZCTxxx StdPhaco
55. y not found in the deluxe edition 1 Networking Network setup is simple with all of the security protections now present no longer causing problems for multiple users on the same station B2 Multiple Users accessing the same database simultaneously Network downloads from biometers such as the IOL MASTER Zeiss or LenStar HAAG STREIT 4 Rununder CompuLink and other practice management systems os Updated 17 Dec 2011 pg 4 HICSOAP Professional and Deluxe User s Manual 2 System Requirements The program runs on any IBM compatible computer that is running Windows XP or newer For best results the Display should be set to a Desktop area of no less than 1024 X 768 pixels or larger with the Font Size set to Small Fonts If a smaller desktop area 640 X 480 or Large Fonts are chosen then the entire screen cannot be seen at one time and scroll bars are necessary Updated 17 Dec 2011 pg 5 HICSOAP Professional and Deluxe User s Manual 3 Getting Started This section has moved to a new improved and expanded document HICSOAP Getting Started Updated 17 Dec 2011 pg 6 HICSOAP Professional and Deluxe User s Manual 4 Program and Surgeon Setup 4 1 Program Setup Holladay IOL Consultant Setup Program Clinic Setup Surgeon Lens Setup Surgeon Piggyback Lens Setup Advanced Settings This software is registered for use at the following Clinic Test Clinic Technicians Men

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