Quickly Assessing Outcomes of the ZEISS CT LUCIA 621P and ZEISS AI IOL Calculator Using ZEISS VERACITY Surgery Planner

As we enter the era of advanced monofocal technology, it can be difficult to discern which monofocal IOLs stand out above the rest. The same can be said for the variety of formulas at our fingertips.

As a surgeon who values objective quantitative data when assessing outcomes, relying on ZEISS VERACITY Surgery Planner to quickly calculate, collate, and compare postoperative outcomes data helps me better select lenses and formulas that optimize patient satisfaction.

Among the newest class of monofocal IOLs is the ZEISS CT LUCIA 621P, an IOL with a reinforced optic-haptic junction and step-vaulted C-loop haptics designed to enable easy centering while maximizing direct capsular contact. After I became comfortable with using the preloaded delivery system (pro tip: pronate your hand 90° when injecting the lens to ensure it comes out of the injector in a planar position), the ZEISS CT LUCIA 621P became one of my most frequently implanted IOLs, and as of this writing I have implanted approximately 450 patients with the ZEISS CT LUCIA 621P.

At the same time that I was adopting the ZEISS CT LUCIA 621P for my next-generation monofocal patients, I widened my use of the ZEISS AI IOL Calculator formula, which becomes an available formula within ZEISS VERACITY Surgery Planner when enough surgeons have implanted enough of a given lens to generate a reliable dataset upon which to calculate an accurate formula. The ZEISS AI IOL Calculator formula is available for ZEISS and non-ZEISS lenses alike, provided that enough patients from enough surgeons have undergone surgery with a given IOL.

Anecdotally, my patients reported satisfaction following implantation of the ZEISS CT LUCIA 621P after using the ZEISS AI IOL Calculator formula. But anecdotes are too squishy: some patients may feel satisfied but not report it, and vice versa, and the subjective nature of “satisfaction” does not provide an objective dataset.

As a data-driven clinician, I wanted to crunch the numbers to see if objective metrics matched my patients’ self-reported satisfaction. For this, I turned to ZEISS VERACITY Surgery Planner’s postoperative data analysis function. 

My EHR system feeds directly into ZEISS VERACITY Surgery Planner. Thus, I knew that a data report from ZEISS VERACITY Surgery Planner would be complete.

My central questions were these:

• What difference in refractive outcomes, if any, is observed following use of the Barrett formula or the ZEISS AI IOL Calculator formula among patients that received a next-generation monofocal IOL? 
• Was there a difference in refractive outcomes among patients who received a next-generation monofocal IOL that were implanted using the ZEISS AI IOL Calculator formula?

I compared the CT LUCIA 621P to another next-generation monofocal IOL (termed, for the purposes of this article, the IOL XYZ). Using the easy and intuitive filtering options in ZEISS VERACITY Surgery Planner, I quickly generated the following data:

I quickly found the answer to my first question: when the formula selection was the only variable, use of the ZEISS AI IOL Formula led to a 3% to 11% improvement among patients who received a next-generation monofocal IOL. (The only time a difference was not observed was among patients who received the ZEISS CT LUCIA 621P and who were within 0.75 D of their refractive target. The 95% success rate is nevertheless encouraging, and there is little room for improvement given this high floor.)

Knowing that my patients did better with the ZEISS AI IOL Calculator formula, I then wanted to know if there was a difference in refractive target success rates when the IOL itself was the variable. Again, ZEISS VERACITY Surgery Planner allowed me to generate a matrix comparing postoperative outcomes within these parameters after a few simple toggles in its interface. It generated the following data.

The outcome was clear: use of the ZEISS CT LUCIA 621P resulted higher rates of hitting refractive targets within 0.25 D, 0.50 D, and 0.75 D when the ZEISS AI IOL Calculator was selected as the formula.

Relying on data gives me an objective means of assessing my postsurgical outcomes. In the days before ZEISS VERACITY Surgery Planner, I would have calculated these outcomes by hand or transferred them to a spreadsheet with custom formulas, which would have been time-consuming and subject to transcription error.

Now that I rely on ZEISS VERACITY Surgery Planner to connect to my EHR to collect and filter data, I can quickly answer questions related to outcomes. In this instance, it showed me that, among those who opt for a next-generation monofocal IOL, postsurgical refractive outcomes are best when I use the ZEISS AI IOL Calculator and when I implant the ZEISS CT LUCIA 621P.

I encourage my colleagues to familiarize themselves with the ZEISS VERACITY Surgery Planner data analysis interface so they can assess how new IOLs and new formulas are affecting their rates of hitting refractive targets.

^{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.}