Centricity Vision’s new ZEPTOLink IOL Positioning System integrates with any phaco system to streamline surgery.

Vance Thompson, MD, has always appreciated the orchestration that occurs inside the operating room (OR) with the surgical team when performing cataract surgery. But the expectations for what constitutes efficiency today continues to evolve, with more value placed on time spent in the OR than ever before. As technology advances, any modification that can be made to improve surgical workflow saves the OR space, allows for more procedures to be scheduled, and equates to better patient care.

Among the most recent advances that have Dr. Thompson and other surgeons adjusting to a more independent approach to creating consistent and precise capsulotomies is Centricity Vision’s ZEPTOLink IOL Positioning System. The platform received 510(k) clearance from the FDA this spring. The new technology integrates the previously cleared ZEPTO precision pulse capsulotomy technology with any phacoemulsification system to better streamline cataract surgery.

“We always had our cataract surgery choreographed nicely in the OR, but ZEPTOLink has eliminated the need for a circulating nurse to operate the power console,” says Dr. Thompson, a specialist in laser vision correction and advanced cataract surgery who serves as director of refractive surgery at Vance Thompson Vision in Sioux Falls, S.D. “I’m able to control this entire new device myself.”

That control of the capsulotomy workflow is attained through the phaco foot pedal and allows for consistent capsulotomies.

CENTERED ON FULL CONTROL

Centricity Vision says ZEPTOLink is the first and only device that creates an instantaneous capsulotomy with consistent 360-degree IOL overlap for optimal lens positioning and improved outcomes. The original ZEPTO was cleared by the FDA in 2017.

As a new collaborative component, the ZEPTOLink uses suction and irrigation provided by the phaco system to enable surgeons to have full control over the handpiece applanation, suction, energy delivery and release using the foot pedal.

“When I depress the foot pedal, I get maximum suction within 1-2 seconds; energy is automatically delivered to create the capsulotomy,” explains Dr. Thompson. “The precise, centered and consistent capsulotomy enables me to provide the best long-term outcomes for my cataract patients.”

Other key features of the new system include a disposable handpiece for efficient and sterile setup and priming by one nurse; a small, ergonomic console that connects to any phaco system; and a touchscreen display equipped with voice-supported functions to further promote the independence.

“ZEPTOLink’s direct integration with the phaco system provides full control of the entire procedure,” says Toby Tyson, MD, FACS, a partner and founder at Florida-based Tyson Eye, who participated in the initial 510(k) clinical trial when the original ZEPTO received its FDA clearance. “It also enables me to meet my goal to maximize surgical efficiency in my ASC, so that I can continue to deliver high-quality outcomes with time-efficient procedures.”

PRECISE FOR CATARACT PATIENTS

ZEPTOLink is ideal for those patients choosing an astigmatism- or presbyopia-correcting lens as well as for those patients living with complex cataracts that require enhanced precision and safety, notes Dr. Thompson. “For example, white cataracts are known to increase the tension inside the lens capsule — and when you puncture that with forceps, a needle or laser the capsule can tear. What’s nice about ZEPTO is, with those white cataracts under tension, when you make those capsulotomies it’s 360 degrees all at once. It’s the safest device for complex cataracts.”

Dr. Tyson believes the system is also ideal for any premium IOL patient. “Creating a fast and accurate capsulotomy every single time for my premium cases allows me to perform efficient surgery with outstanding visual outcomes, resulting in happy patients,” he says.

ZEPTOLink is contraindicated in pediatrics and patients living with posterior polar cataracts, according to Dr. Thompson.

TECHNICAL SURGICAL TACTICS

Recent research, including a study that Dr. Thompson was involved in, has generally found that creating a consistent, centered capsulotomy is among the most challenging tasks conducted during surgery, yet it is an essential element for effective IOL positioning and stability. By applying 12 micro-pulses of energy in 4 milliseconds, the ZEPTOLink enables surgeons to center the capsulotomy with the 360-degree IOL overlap on the patient’s visual axis for improved outcomes.

“ZEPTO allows me to center the capsulotomy on the patient’s visual axis using Purkinje reflections,” Dr. Thompson says. “This technique supports me in achieving consistent capsular IOL overlap and improved IOL centration. Knowing the fixational relationship between the P1 and P4 Purkinje reflections allows me to reproduce that relationship manually intraoperatively and to center my implant and capsulotomy every time.”

INTEGRATION WITHIN THE OFFICE

Both Dr. Tyson and Dr. Thompson say they have successfully transitioned the ZEPTOLink into their everyday practice and that the clinical and business benefits have been evident. They suggest incorporating the cost of the system into premium packages, as with all other types of equipment or lenses that are used to deliver refractive outcomes.

“And the ZEPTO technology is more accessible to surgeons, because of the lower cost compared to laser and faster performance than femto, allowing surgeons to complete more surgeries per day,” says Dr. Thompson. “In addition to enhanced precision and safety, ZEPTO also provides significant time and cost savings with easy workflow integration and increased efficiency per case.”

Both Dr. Tyson and Dr. Thompson also say they have taken advantage of valuable training and online resources offered by the manufacturer for streamlining the product into the clinic setting. Training is conducted with the Centricity Vision team completing approximately 10 cases collaboratively.

“Centricity Vision does a fantastic job of training surgeons and staff,” says Dr. Tyson.

THE PERFECT PACKAGE

For reimbursement purposes, those interviewed suggest that ZEPTOLink is perfect for any refractive package.

“It saves time and supply costs when used in complex cataract cases,” says Dr. Tyson. “ZEPTO enables surgeons to meet the high visual demands of today’s patients while maximizing efficiency and productivity in a high-volume premium practice.” OM