Technology
From the early beginnings, Sjonlag Eye Center has placed great emphasis on offering the best technology in the field. The eye center was based on the principles of being able to offer service for the diagnosis and ultimately the treatment of all eye diseases. We have now reached the point of being the most technologically advanced eye center in the country. In order to reach our goal, we have highlighted the importance of several key areas and issues, including doctor and staff education and skills, proper housing facilities for our expanding clinic as well as the most technologically advanced diagnostic equipment and treatment modalities available. Since the outset, our Chief of Technology has played a pivotal role in the Eye Center and ensured that all the latest technological advances are translated as soon as possible into caring for our patients.
Sjonlag Eye Center has grown steadily since the year 2001. Laser refractive treatments have always played an important role and we have spared no expense in keeping our precision and safety standards at the highest level possible.
In 2005, we added an important feature to our clinic, including a state-of-the art retinal diagnostic center as well as a fully operable surgical suite in order to perform various complicated procedures, incuding cataract surgery and lens-related refractive surgery. In 2008, we established a contract with the Icelandic Government, in which Sjonlag Eye Center was to perform 800 cataract operations over a 2-year period. With the exception of a short period during the 90s, this was the first time cataract surgery was moved out of the hospital setting in Iceland to be performed in a private clinic setting. This is an important step towards decreasing the national waiting list for cataract surgery, which has been steadily increasing for many years up to 1-2 years. Since June 2008, we have performed hundreds of cataract operations with excellent results.
We also offer so-called ICL refractive procedures, in which a thin lens (Staar ICL) is placed behind the iris of the eye, in front of our natural lens. These lenses can correct high myopia, high hyperopia and astigmatism.
In addition, we offer CLE operation, in which the natural lens is replaced with a multifocal or unifocal lens for the treatment of hyperopia, myopia and astigmatism. This operation is aimed mainly at individuals over the age of 60, who have not yet formed cataracts and who would like to be as independent from glasses as possible. With multifocal lenses, the opportunity arises for the first time to be able to see at near as well as far without the help of special reading glasses. This is an exciting and expanding field of treatment and is now being offered for the first time here in Iceland.
We will now give you a brief overview of our technical equipment and software . The company is the only health care facility in the country in which all patient data, both from clinicians as well as the technical diagnostic equipment, is stored in computer databases. Measurements are in most cases transferred automatically into the corresponding database. Our clinic is therefore fully "paper-free".
The five main databases are interconnected: Our Icelandic Patient Data program SAGA, the Ophthalmological Data Program NAVIS (Nidek Advanced Vision Information System), the Visual Field System for Glaucoma Analysis program PeriData, Fundus Photography Database WinStation 5000 and finally Retinal Computerized Tomography system for our OCT (Optical Coherence Tomography).
Laser Refractive Treatment
We offer the latest laser refractive technology. The heart of our treatment center is the NIDEK EC 5000, which is one of the leading lasers in the world for laser refractive surgery. Several of the best known laser refractive surgeons in the world use NIDEK, including
Howard Gimbel, Calgary, Canada www.gimbeleyecentre.com
Douglas Koch, TX, USA
www.baylorvision.org
George Waring, GA, USA
www.inviewvision.com
Paolo Vinciguerra, Milan, Italy
www.paolovinciguerra.com
Arturo Chayet, Tijuana, Mexico
www.codetvision.com
In the last few years, NIDEK's status as a world leader in refractive technology has been validated over and over again. In an article in the well-known ophthalmology publication Eye from 2008, the NIDEK EC 5000 laser is compared to the Bausch & Lomb Technolas 217 Planoscan laser.
http://www.nature.com/eye/journal/v22/n9/abs/6702856a.html
Although the article reports a successful refractive outcome in the majority of cases, the NIDEK laser showed a statistically better performance, with an 88% successful refractive outcome compared with a 78% with the Technolas laser.
Another article describes the performance of NIDEK treatment compared with the results of Alcon Laboratories CustomCornea treatment and VISX CustomVue treatment. The NIDEK treatments compared very favorably with the other treatments.
NIDEK EC 5000
works by applying so-called scanning slit laser beam technology in LASIK and PRK. The laser is in the form of a slit beam, which is scanned across the cornea according to the information programmed into the laser.
One of the main feature of NIDEK EC 5000 is it's modular structuring. This makes it very easy to adapt the laser to the latest technology available. With many lasers, it is necessary to change the entire unit whenever a new technology, such as tracking equipment or custom treatment module, is invented. This is not necessary with the NIDEK EC 5000 and our equipment is totally equivalent to the latest technology the NIDEK company has to offer, including rotational tracking using an iris marker, a 200Hz tracker, and the latest NAVEX custom treatment technology. With this treatment, we are able to customize treatment for all corneas, using surface (topographical) data from the cornea to tailor-make the treatment for each patient. We mainly use this treatment for corneas that have irregular astigmatism due to corneal scarring, but it can also be used for normal corneas. Every case is evaluated individually and at our clinic customized laser treatment does not carry additional cost to the patient.
Our microkeratome is the precise third generation Amadeus microkeratome from Ziemer Group www.ziemergroup.ch
This microkeratome makes ultra thin flaps (120 microns, or 0,12mm) on the cornea with great precision. The flap has a nasal-based hinge, which may decrease ocular dryness following surgery.
Corneal diagnostics
We have sophisticated equipment in order to diagnose all corneal diseases, including keratoconus, corneal scarring, irregular astigmatism, macular corneal dystrophy and Fuchs' endothelial dystrophy.
Magellan Mapper - The Magellan Mapper accurately diagnoses corneal surface diseases with unsurpassed precision. The equipment has a 30-ring projector, dual edge ring finder with an astounding 60 rings detected, 21 600 data points and a high resolution camera. It produces a single or multiple 2D or 3D map displays, showing topographic and fluorescein maps, tear film layer, lens profile and 3D fitting displays. The examination is transferred directly into our NAVIS database for easy retrieval.
OPD Optical Path Difference corneal analyzer - This analyzer provides information on corneal topography, wavefront, autorefraction, keratometry and pupillometry in one unit, utilizing precision imaging and analysis technology developed specifically to measure normal to highly aberrated eyes. The system offers a variety of data maps to provide
information on the total refractive error, wavefront, corneal shape, internal aberrations and visual quality of the eye, allowing highly accurate and reliable information for optic diagnostics. The examination is transferred directly into our NAVIS database.
ConfoScan 4 - This is a unique state-of-the-art diagnostic instrument that combines a confocal microspoe, a non-contact endothelial microscope and a precision pachymeter in one innovative and compact unit. The unit carries a fully automatic endothelial analysis with confocal technology as well as being able to analyze the full corneal cell structure framework, including the diagnosis of corneal scarring, amoebal cysts, various endothelial dystrophies etc. The examination is transferred directly into our NAVIS database.
Retinal diagnostics
Stratus OCT (Optical Coherence Tomography) - With this equipment, high resolution cross-sectional imaging for the comprehensive management of glaucoma and retinal disease. The Stratus OCT is the gold standard in vivo imaging device for the posterior segment and offers proven reproducibility for disease management. The Stratus OCT provides real-time cross-sectional images and quantitative analysis of retinal features to optimize the diagnosis and monitoring of retinal disease and for enhanced pre- and post-therapy assessment. The device is beneficial for evaluation of various retinal disorders, such as cystoid macular edema, age-related macular degeneration, macular hole evaluation, optic nerve head analysis as well as various vascular disorders, such as branch or central retinal vein occlusion and diabetic macular edema.
NIDEK MP-1 - With this equipment, a fully automatic assessment of the macular function is achieved by effectively integrating in a single instrument the objectivity of fundus imaging and the subjectivity of computerized perimetry. This is a 45 degree non-mydriatic digital fundus camera, using IR light for observation of real-time, non-mydriatic retinal images we are able to capture into our NAVIS database. With this equipment, scotomas can be mapped accurately with more precision than in standardized visual field testing. This is especially valuable when evaluating retinal diseases.
Zeiss VISUPAC and FF450 plus Fundus Camera - This combined system provides the sharpest retinal fundus detail available with advanced digital sensor technology. The images provided by this high precision apparatus is seamlessly integrated into our NAVIS system, giving us a unique opportunity to evaluate the retinal images taken over time of our patients.
NIDEK US-4000 - With this equipment, B-scan, accurate biometry and pachymetry are combined in one instrument. This allows for superior scans of the posterior part of the eye, allowing high precision imaging of delicate conditions such as retinal detachment, ora dialysis of the retina as well as optic nerve analysis, such as optic nerve head drusen. These images are directly transferred into our NAVIS database.
Glaucoma diagnostics
Zeiss Humphrey Field Analyzer/HFA II-i - This is the gold standard for visual field evaluation in glaucoma diseases, validated by decades of research and clinical experience. In a time-frame of just 6 minutes, visual fields can be tested with great accuracy. We also offer the recent blue-yellow threshold testing for evaluating early glaucoma. The images are transferred into our PeriData database, where they are evaluated and compared to earler visual field maps. This allows for a fast, efficient and precise follow-up for our patients.
Imaging and Communication Software
NAVIS (NIDEK Advanced Vision Information System) Imaging and communication software was developed as a comprehensive in ophthalmology for our patients. With the system it is easy to manage large amounts of image and information data. The data is received from various data channels connected directly to the equipment. This basically means that when an image is captured, the intraocular pressure measured or the visual acuity assessed, the information goes directly into the system automatically without the need for entering the data. This increases the accuracy of the system and benefits our patients tremendously in various ways. The information can then be used to make prescription for glasses, insert directly into our treatment modalitites or send reports to our colleagues. The Icelandic patient database system most widely used is SAGA patient database system. This system is for example used in all General Health clinics throughout the country. This system is combined uniquely to the NAVIS database, making it possible for us to send the data directly to other health providers in a format widely recognized by them.