Optimizing A-Constants with Ease

1 November 2023
Omar Shakir, MD, MBA
About the expert Omar Shakir, MD, MBA Dr. Shakir is the founder of Coastal Eye Surgeons in Greenwich, Connecticut.

My colleagues contributing to the ZEISS VERACITY Surgery Planner Tip of the Month have focused on how this new innovation from ZEISS has improved surgical experiences in their individual practices, and for good reason: using a digital framework has streamlined surgical workflows, refined recommendations, and empowered surgeons to quantitatively track outcomes.

Sometimes overlooked, however, is how using ZEISS VERACITY Surgery Planner strengthens the collective surgical experience. By aggregating outcomes data from qualified surgeons who use the platform, this technology optimizes A-constants based on thousands (and sometimes tens of thousands) of cataract surgeries.

This is a benefit to both the specialty at large and individual surgical practices. Optimized A-constants give me a tool to perform even more precise surgery—which empowers my surgical practice to generate higher levels of satisfaction and optimal visual outcomes. Before you decide whether or not optimized A-constants are right for your surgical center (spoiler: they probably are), let’s learn more about how they’re generated.

How A-constant Optimization Occurs

IOLs often behave differently in the eye than planned. I have found that theorized A-constants, while useful at first, sometimes fall short of optimal refractive outcomes, leaving me on my own to make adjustments. If I wanted to know which A-constant would be the best fit for a particular lens based on specialty-wide results, I would need to analyze outcomes from a high-volume, high-fidelity case series performed by validated, experienced surgeons—a feat too complex for a single surgeon (or even a single specialty) to execute without the help of a complex data aggregation and computation system.

Before ZEISS VERACITY Surgery Planner, collecting such a dataset would be time-consuming, subject to transcription error, and cumbersome. In the VERACITY era, automated gathering of such a multispecialty case series occurs in the background, and ZEISS VERACITY Surgery Planner automatically integrates new, optimized A-constants into surgical plans.

The quality and application of ZEISS VERACITY Surgery Planner’s A-constant optimization rests in three key elements: coast-to-coast data harvesting, confirmed surgeon experience, automated outcomes analysis and software updates.

High volume. As a surgeon who sought to optimize my own A-constants, I had few options before the ZEISS VERACITY Surgery Planner. Manual tracking of outcomes from my single-surgeon practice led to volumes too low from which to draw conclusions; even at my colleagues’ surgical centers that performed hundreds of cases per week, the number of cases they logged involving a particular lens likely numbered in the dozens, not the thousands needed for a useful dataset.

My colleagues and I could generate the requisite volume if we were to develop a multisurgeon/multispecialty dataset, but the analog means of gathering and calculating data would be subject to slow collection and manual transcription. Further, our efforts would be bottlenecked by the productivity rate of whomever undertook the effort—hardly a high-tech process that reflects the innovative world of cataract surgery.

That’s where ZEISS VERACITY Surgery Planner steps in. With this technology, all validated users who use the platform for surgical planning and outcomes tracking contribute to the constantly growing outcomes database, which is used to calculate specialty-wide A-constants.

By participating in this initiative, I moved from working as an individual surgeon to working as an innovator collaborating with other experts in my specialty, and my practice benefited by being granted access to optimized A-constants.

High quality. A dataset is only as good as its inputs. To be eligible to contribute to A-constant optimization, ZEISS ensures that surgical centers meet a set of predefined measures that ensure only high-quality data are included.

Importantly, the surgeons whose data ZEISS VERACITY Surgery Planner includes in A-constant optimization are experienced. Newer surgeons, who may still be developing their surgical approaches and have not yet established repeatable technique, are still free to access the A-constants optimized by data from their validated counterparts. Indeed, part of the mission of A-constant optimization is to allow surgeons of all experience levels to yield the benefits of expertise from world-class specialists.

Automation. As a user of the ZEISS VERACITY Surgery Planner, I spend zero effort to optimize A-constants. Because data are automatically pulled from the OR and any connected devices, lags in data collection are nil and real-time gaps in the dataset do not exist. The turnkey nature of this aggregation is an important benefit to users, as no disruption to workflow occurs.

In short: I see updates to optimized A-constants instantly, keeping me at the cusp of innovation.

Closing Thoughts

By leveraging the power of optimized A-constants, I have improved the precision of my surgery and improved my outcomes without changing my protocols or investing time for manual data entry. A-constant optimization allows more choice than ever. As always, I am free to select whichever A-constant I prefer, and ZEISS VERACITY Surgery Planner never insists that I apply the optimized A-constant.

If you’re a surgeon seeking to unlock the power of specialty-wide optimized A-constants, consider integrating the ZEISS VERACITY Surgery Planner into your surgical center. And remember, there is something for every experience level. Seasoned surgeons who want to join me and my colleagues by contributing to the overall dataset can speak to their ZEISS representative to hear more about validating their centers, and newer surgeons whose surgical practices are still perfecting protocols are eligible to leverage optimized A-constants in their ORs.

The statements of the author reflect only his personal opinions and do not necessarily reflect the opinions of any institution with whom he is affiliated.
The author has a contractual or other financial relationship with Carl Zeiss Meditec, Inc. and has received financial support.

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