George O. Waring IV, MD, FACS, has been using Tracey Technologies’ iTrace ray tracing aberrometer and corneal topographer since it was released more than a decade ago. So, he speaks from experience when he says the latest software iteration for the device, iTrace Prime, takes vision assessment to another level.

“When I first started looking at the iTrace, I was intrigued because of the way it measures aberrations and how it presents that information in a usable way,” recalls Dr. Waring, a refractive cataract and corneal surgeon and founder and medical director of the Waring Vision Institute in Mt. Pleasant, S.C. “The previous generations were incredible tools for my practice, but with the Prime [software] upgrade, I am even more excited. It makes it even easier to acquire the key details I need to provide the best care for my patients.”

NEW AND IMPROVED

Introduced earlier this year, iTrace Prime (version 7.0) adds two new indices, the corneal performance index (CPI) and the quality of vision index (QVI) to the company’s proprietary dysfunctional lens index, which Dr. Waring helped validate. It also adds tear film analysis and a newly designed dashboard that makes data easier for practitioners to access for comprehensive eyesight analysis and treatment planning. Other additions: wavefront K analysis, an enhanced toric planner and external photography capability.

“In one system, with one sitting, the doctors can learn more about the patient’s quality of vision than they can with five or more devices,” says Ray Sievert, executive vice president of sales and marketing for Tracey Technologies. “It’s the only thing that measures visual function and quality of vision. Everything else just measures [eye] structure.”

VIEW THE INTERNAL OPTICS

Ivan Mac, MD, MBA, managing partner with Metrolina Eye Associates, Charlotte, N.C., is new to the iTrace, having acquired the technology for his practice in June. So far, Dr. Mac likes what he sees.

“What I really like is that it allows us to see the internal optics of the eye and how each structure affects the overall optical quality,” Dr. Mac says. “With the iTrace, I can see how the tear film, higher-order aberrations from the cornea, the lens or even the vitreous affects optical quality.”

Additionally, Dr. Mac says he’s especially impressed with the device’s ability to quantify the impact of vitreous pathology on internal optics.

“We’ve had perfect outcomes from a cataract surgery. The patient’s aberration profile looks good, the cornea looks good. They have no hazing of the lens capsule behind the IOL and their retina is completely normal. Yet they’re dissatisfied with their outcome, and it’s because they have vitreous floaters in their optical system. We have done measurements after they’ve had the floaters removed and compared them to the original iTrace image, and we can see how the internal optics improve.”

CORNEA AND TEAR FILM ANALYSIS

Drs. Waring and Mac find the new cornea performance and tear film indices especially useful. Designed to record images of the ocular surface for 12 seconds starting immediately after a blink, the iTrace can reveal the local shape and sharpness changes of the Placido rings. A proprietary algorithm then generates a number from 0 to 10 — the Tear Film Index — which assesses the degree to which the effects of dry eye disease are affecting a patient’s vision.

NEW DASHBOARD ENHANCES EFFICIENCY AND PATIENT EDUCATION

In addition to improving the patient’s examination, both ophthalmologists interviewed say iTrace Prime’s newly designed dashboard presents more comprehensive data, improving throughput and patient education. Indeed, the dashboard displays data on total eye optics, along with an axial map of the cornea, wavefront K readings, chord mu/angle kappa and angle alpha measurements and refraction.

“My technicians know immediately if the patient should be run through the tear film analysis while they are still in front of the device, saving time and giving me more and better information for decision making,” Dr. Waring says. “It’s a comprehensive view of pertinent data to aid in making surgical decisions for my patients, from cataract diagnostics to premium-lens candidacy and overall objective quality of vision metrics.”

“It’s all on one screen, so it really makes it easy to do a cataract evaluation without having to trudge through multiple screens,” Dr. Mac adds. “And the utility of that is, if this all looks good, I feel really comfortable proceeding with a multifocal or a premium IOL.”

The simplicity of the data presentation also enhances patient education, contributing to a greater understanding of their condition, as well as a greater likelihood of good outcomes and patient satisfaction. Dr. Mac and Dr. Waring believe this simplicity translates to faster understanding on the part of the patient of the treatment they are about to undergo.

“It helps patients to comprehend the treatment options we’re offering since we can easily demonstrate to patients the benefit of presbyopia-correcting IOLs with the iTrace software,” Dr. Waring says.

COMPLAINTS REDUCED

Dr. Mac notes that the iTrace helps him clearly inform patients about their condition and treatment options, eliminating a degree of fear among those who have chosen to spend significant sums of money for premium IOLs, which are not covered by most health insurance plans.

“If these patients are spending thousands of dollars out of pocket, and you don’t get a desirable outcome, they are going to complain. iTrace gives us the confidence to recommend the technology and know they are going to do well,” Dr. Mac says. OM