Compact Intuitiv Operator Manual Rev C
Compact Intuitiv Operator Manual Rev C
OPERATOR’S MANUAL
AMO Ireland
Block B
Liffey Valley Office Campus
Quarryvale, Co. Dublin, Ireland
Rx Only
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
About this Manual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
About Phacoemulsification. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Indications for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
COMPACT INTUITIV System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Advanced Fluidics System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3
COMPACT INTUITIV System Console . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4
COMPACT INTUITIV Operating Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-6
Safety Precautions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7
Warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-10
Symbol Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-14
Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-1
Physical Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-2
Electrical Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-3
Environmental Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-3
Storage Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-3
Diathermy Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-4
Phaco Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-4
I/A Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-4
Vitrectomy Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-4
Phaco Tip Velocity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-5
Bottle Height Pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-5
Power Graphs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-7
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Index-1
1
INTRODUCTION
About Phacoemulsification
Accessories
Safety Precautions
Warnings
Symbol Definitions
About this Manual This manual includes information about the design of the COMPACT INTUITIV
System for anterior segment (phacoemulsification) surgical procedures.
This manual includes information about optional system enhancements. Your
Abbott Medical Optics Inc. (AMO) representative can confirm the availability of
these features for your system configuration in your area.
About Over forty years ago, Doctor Charles Kelman conceived and developed
Phacoemulsification phacoemulsification, a method of cataract removal by use of ultrasonic
emulsification with aspiration of the cataract lens through a small incision.
Phacoemulsification is advantageous for both patient and surgeon for the following
reasons:
• Greater intraoperative control.
• The smaller incision requires fewer or no sutures, poses less risk of infection and
induced astigmatism, and gives better long-term and short-term predictability of
vision.
• Patients are able to resume normal activity much sooner and with fewer
restrictions than with traditional cataract extraction surgeries.
AMO supports phacoemulsification with sophisticated instrumentation that
optimizes the benefits of this surgical procedure.
Indications for Use The COMPACT INTUITIV System is an AC-powered device with a fragmenting
needle for cataract surgery to disrupt a cataract with ultrasound and extract the
cataract.
Advanced Fluidics One of the most advanced features of the COMPACT INTUITIV System is the
System fluidics system that allows for intraoperative intraocular control. An integral part of
the advanced fluidics is resident in the proprietary technology of the Single-Use
packs. The closed and isolated fluidics system provides the maximum safety and
minimum biohazard risk.
ELLIPS FX Handpiece
The ELLIPS FX phaco handpiece is available for use with the COMPACT
INTUITIV System. The ELLIPS FX handpiece provides both longitudinal and
transversal movement. You can use the handpiece with a straight tip or a curved tip.
Foot Pedal
The operating modes (Diathermy, I/A, Phaco, and Vitrectomy) are controlled by
the foot pedal. You can save the degree of travel for each foot pedal position for
each surgeon/procedure.
The foot pedal design offers control through the use of increased linearity with the
foot pedal movement. The design provides uniform pressure throughout the foot
pedal movement, easing foot and leg fatigue. You can select the degrees of
movement for each foot pedal position. You can save the foot pedal pitch settings
for each surgeon. Programmable switches can activate reflux, which gives an
immediate response. The system does not support the Sovereign Compact
closed-toe foot pedal.
Wireless Remote Control
You can access the surgical modes and adjust the surgical settings with the use of
the wireless remote control keypad. The back light supports low light operating
room conditions.
COMPACT INTUITIV System Cart
The cart’s solid wheel base and two locking wheels make the cart stable and
smooth rolling. An open design minimizes weight. A Mayo tray with a baling ring
accommodates either an instrument tray that can be put in an autoclave or a solid
tray. The Mayo tray provides easy access for the remote control under the sterile
cover. The open bin and the foot pedal platform are available for storage.
IV Pole
The automated IV pole allows adjustment of the bottle height through each
procedural phase. Use the up and down arrows on the screen or the remote control
to raise and lower the balanced salt solution bottle; this maintains the sterility of the
operating field. A separate up/down switch allows access at the rear of the system.
You can remove the pole from the cart for transport.
COMPACT The COMPACT INTUITIV System screen is easy to read and easy to operate.
INTUITIV System You can see at a glance the exact status of the machine. The LCD display gives you
Console visual indication of modes, settings, and system status. Event messages indicate
improper connections. You can access all handpiece connections from the front for
easy setup.
The design of the graphical user interface (GUI) gives you visual indication of the
status for the control systems at all times. When you select a mode (DIA, PHACO,
IA, or VIT), you see current settings on the screen. As you make adjustments to the
settings, the screen shows the changes.
Each surgical mode and submode has its own distinct screen:
• Diathermy
• Phaco
• Irrigation/Aspiration
• Vitrectomy
Continuous Irrigation
Continuous Irrigation is immediately available by way of the touch screen. Surgeon
control of continuous irrigation with the foot pedal is an available setting for the
foot pedal. You can use continuous irrigation to fill cups prior to prime/tune. You
can use the cup fill feature in place of continuous irrigation when you fill a cup. The
cup fill feature is only available from the prime/tune screen. (See “Prime/Tune” on
page 6-2. for detailed information.)
Programmable Operating Parameters
The COMPACT INTUITIV System is programmable through the GUI. The
surgeon may preselect their desired settings for each portion of the surgical
procedure. The instrument program memory can store 30 surgeon names, plus the
AMO Default Surgeon settings. Each surgeon can setup 8 unique programs, plus
the AMO Default settings program. This allows different users to preset their
preferences, or an individual user to preselect setups for different procedures.
Multiple Mode Programming (MMP)
Multiple submode memories are available within the COMPACT INTUITIV
System operating modes. The MMP allows users to preset their parameters for
specific techniques such as phaco chop or viscoelastic removal.
COMPACT The design of the system provides all the operating modes and surgical capabilities
INTUITIV that the anterior segment surgeon or the cataract surgeon requires. These
Operating Modes capabilities include:
Diathermy (DIA)
Most surgeons use diathermy to coagulate blood vessels during the procedure and
some surgeons use diathermy to close the conjunctiva at the end of the procedure.
An isolated output frequency allows non-contact tissue coagulation, eliminating
adhesion and traction. Also, the depth of penetration of the energy field is less than
that of higher frequency units, minimizing tissue shrinkage or charring. The
gentleness of the diathermy mode allows the surgeon to stop bleeding within the
incision with only minimal scleral shrinkage. The surgeon can stop bleeding from a
10-0 suture tract without melting the suture.
Phacoemulsification (Phaco)
The surgeon uses the Phacoemulsification mode to break up (emulsify) the nucleus
of the lens. The surgeon then aspirates the nucleus of the lens from the eye through
a small incision. The continuous auto-tuning circuitry maximizes the emulsification
efficiency for each lens density, even varying densities within the same lens. The
system displays Phaco time in minutes and seconds. Convenient selection of linear
or panel-preset phaco power, in a variety of power delivery options (pulsed, burst,
etc.), gives the surgeon increased precision and control.
Irrigation/Aspiration (I/A)
The Irrigation and Aspiration mode allows for controlled aspiration of cortical
material from the eye, while maintaining intraocular stability by replacing the
aspirated material with the irrigation solution. A peristaltic pump provides a
predictable and stable aspiration rate. You can achieve complete control with
“Aspiration” and “Vacuum”.
Note: The vacuum units are available in either mmHg or kPa. To set the vacuum
units go to System Setup and select Vacuum Units.
Irrigation is gravity-fed. You can regulate the gravity-fed irrigation pressure by
adjusting the height of the irrigation solution bottle. This mode gives you flexible
control of each case with the independently adjustable vacuum level settings and
flow rate settings. The adjustable volume tone indicates the vacuum level.
Vitrectomy (VIT)
You use Vitrectomy mode to remove vitreous from the anterior chamber of the eye
during:
• a secondary IOL (intraocular lens) implant procedure
• following vitreous loss associated with trauma
• vitreous loss during primary cataract surgery
If there is vitreous loss during cataract surgery, the vitrectomy capability can be
ready and available in seconds.
Safety Precautions Once you have set the system up and you have verified that all the functions are
operating properly, you are almost ready to use your system.
Read the following safety precautions and warnings carefully before you use the
system in surgery.
10. Do not operate the system in a condensing environment. Take care to protect
the instrument from fluid sprays or fluid buildup.
11. Do not exceed maximum weight of 25 pounds (11.25 Kg) on the Programmable
IV Pole bottle holder.
12. Do not use more than one IV pole extender with the IV pole.
13. If there is no IV pole attached to the system, hang the irrigation fluid container
at least 77 cm from the patient’s eye.
14. To protect the patient from contaminated fluids or handpieces, use only:
• sterile tubing sets
• sterile irrigation fluid
• sterile handpieces
15. Use caution when handling handpieces with sharp edges or pointed tips.
16. Wrap the excess power cord neatly around the cord wrap on the back of the IV
pole or cart.
17. Always replace the Single-Use Pack and irrigation solution bottle between
surgical cases.
Changing Irrigation
Use extreme caution when you lower or raise the irrigation solution bottle to
decrease fluid flow or increase fluid flow, and fluid pressure. If you lower the bottle
too much it can cause the anterior chamber to collapse or to become too shallow;
take care to avoid abrasion of tissues during phacoemulsification. If you raise the
bottle too high it can cause the anterior chamber to deepen.
Note: Use a new bottle of irrigation solution at the start of each case.
Phacoemulsification Without Adequate Irrigation
Operating phacoemulsification without an adequate irrigation flow can result in an
elevated temperature of the tip and subsequent damage to the eye tissue or could
cause the chamber to collapse. Confirm that there is irrigation flow before you
initiate phacoemulsification. A tight wound or the angle of the needle next to the
wound can also constrict the irrigation flow. Pinching of the coaxial irrigation
sleeve assembly on the needle of the phaco handpiece causes the constriction.
Power Failure During Surgery
If there is a loss of power during a procedure, you need to:
• Withdraw the handpiece from the eye; and
• Release the foot pedal to position 0.
When power is restored:
• Select Prime/Tune to reprime the fluids and tune the phaco handpiece. Use
Bypass to reduce the length of prime time.
• Select the mode that was in use when the system lost power (Phaco, IA,
Vitrectomy, or Diathermy).
Connecting Handpieces
It is very important that the electrical connectors on the handpieces are completely
dry prior to connecting them to the system receptacles. You may receive a “Phaco
Handpiece Error” message if the connector is wet.
Handling the Phaco Handpiece
The phaco handpiece is a very delicate instrument and you must handle the
handpiece with EXTREME care. If you drop the handpiece or the handpiece
receives any other significant impact, the handpiece might not work properly. The
ultrasonic titanium phaco tip must never touch any solid material while in use.
Always clear the handpiece of fluid immediately following surgery.
See cleaning instructions in Chapter 7 "Care and Cleaning".
Handpieces can be extremely hot immediately after sterilization. Use care and
caution when handling.
Phaco and Vitrectomy Operation
Do not activate the Phaco and Vitrectomy handpieces with the tips in air, as this
reduces the useful life of the handpiece and the cutter. When introducing power to
the Phaco or Vitrectomy handpieces, the tips should be in one of the following:
• a test chamber filled with irrigating solution,
• a container of irrigating solution, or
• the patient’s eye.
Vitrectomy
Failure to properly attach the tubing to the appropriate vacuum source or pressure
source affects the vitrectomy handpiece operation. Be sure to read the handpiece
package insert for correct assembly procedures and connection procedures.
Diathermy
When you select the Diathermy mode, you hear a tone or a voice. Also, you hear an
audible tone when you apply diathermy power.
You must check the diathermy cable periodically for damage. If the cable shows
signs of damage, replace the cable immediately with the same type of cable. Use of
other types of cables can affect the diathermy performance.
During surgery, the diathermy output power should be as low as possible for the
intended purpose. AMO recommends 30% setting to start.
The patient should not come into contact with ungrounded metal parts when using
diathermy.
Position the diathermy cable in such a way that the cable avoids contact with the
patient or other leads.
For proper operation of the diathermy, replace the handpiece with the same type.
Power IV Pole
Do not exceed maximum weight of 25 pounds (11.25 Kg) on the IV pole bottle
holder.
Foot Pedal
Never handle the foot pedal by its power cord.
Do not place the foot pedal on a wet surface.
Wireless Remote Control Battery Management System
This device complies with Part 15.19 of the Federal Communications Commission
(FCC) Rules. Operation is subject to the following two conditions:
• This device may not cause harmful interference.
• This device must accept any interference received, including interference that
may cause undesired operation.
Any changes or modifications not expressly approved by AMO can void the user's
authority to operate the equipment. (FCC Part 15.21)
Note: This equipment complies with the limits for a Class A digital device,
pursuant to Part 15.105 of the FCC Rules. These limits provide reasonable
protection against harmful interference when the equipment is operating in
a commercial environment. This equipment generates, uses, and can
radiate radio frequency energy and, if not installed and used in accordance
with the instruction manual, may cause harmful interference to radio
communications. Operation of this equipment in a residential area is likely
to cause harmful interference in which case the user has to correct the
interference at his own expense.
Warnings
WARNING: All personnel should read and understand the
instructions in this manual before they use the system. Failure
to do so may result in the improper operation of the system.
Only a trained and licensed physician is to use this device.
Symbol Definitions The following symbols appear on the COMPACT INTUITIV System:
Symbol Definition
This symbol on the power switch indicates Power is ON.
Indicates fuse.
Symbol Definition
Patient applied part is isolated from earth ground.
Communications Port
Ethernet Port
IV Pole Connection
Pack Eject
Symbol Definition
IPX4 is the International Protection code that indicates that
the device is protected against splashing water sprayed at all
angles.
Do not reuse
Symbol Definition
Do not re-sterilize.
Symbol Definition
Save As. Creates a new program with the current settings.
IV Pole
2
System Setup
Setup Sequence
OPO80 Installation
Handpiece Setup
System Check-Out
Receipt and When you receive your COMPACT INTUITIV System, inspect the exterior
Inspection packaging for any signs of shipping damage. Make a record of the damage on the
shipping documents. If there is any damage to the packaging, immediately file a
claim with the transporter. Transporters accept claims only from the recipient
(you), not the shipper (AMO).
Your AMO Representative will contact you to schedule both Installation and In-
Service Training upon receipt of your new COMPACT INTUITIV System. Leave
the COMPACT INTUITIV System in its original packaging and store it in a cool,
dry environment until AMO installation personnel arrive to assemble, install, and
test your equipment. Extreme heat, cold, or moisture can damage any electronic
equipment.
COMPACT Your COMPACT INTUITIV System CAN consist of some or all of the following
INTUITIV System components:
Components • COMPACT INTUITIV System Console
• Programmable IV Pole (Optional)
• IV Pole Extension (Optional)
• Cart with Mayo Stand (Optional)
• Instrument Sterilization Trays
• OPO80 Phaco Pack, Single-Use
• Foot Pedal with Cord
• Power Cord (detachable)
• COMPACT INTUITIV System Operator’s Manual
• Spike Mat
• Wireless Remote Control (Optional)
See Figure 2.1 – COMPACT INTUITIV System for a detailed layout of the
components.
1. Vitrectomy Connection
2. Diathermy Connection
3. Phaco Connection
Power Connections 1. Connect the Foot Pedal to the back of the COMPACT INTUITIV System
console. See Figure 2.5.
2. If you have a cart, store the foot pedal in the bottom storage bin of the cart
without disconnecting the foot pedal.
3. Connect the COMPACT INTUITIV System power cord to the rear of system.
Plug the power cord into a grounded power outlet.
4. Turn the system ON.
Use proper handling and disposal methods for biohazards when you
dispose of the single-use pack, optional tray cover, and touch
screen cover.
Setup Sequence The following is a general overview of the steps to take to prepare the COMPACT
INTUITIV System for surgery:
1. Attach the power cord to the rear of the system. Plug the power cord into a
grounded power outlet.
2. Attach the foot pedal to the rear panel receptacle.
3. Place the foot pedal within easy reach to the surgeon.
4. Attach the IV Pole connector (optional).
5. Turn the system on at the back of the console.
6. After completion of the self test, select the surgeon and program.
7. Pair the remote control with the system (optional).
8. Install the Single-Use Pack.
9. Assemble and attach the needed accessories (phaco, vitrectomy, or diathermy
handpieces).
10. Prime and tune the phaco handpiece.
11. Perform the final test of the fluidics for the phaco and vitrectomy handpieces
and the handpiece integrity with the foot pedal.
Note: If there is no IV pole attached to the system, hang the irrigation fluid
container at least 77 cm above the patient’s eye.
Note: Press the button (1) above the pack to remove the pack.
Handpiece Setup This section presents information about setting up the handpieces.
• Phacoemulsification Handpiece Setup
• Irrigation/Aspiration Handpiece Setup
• Diathermy Handpiece Setup
• Vitrectomy Handpiece Setup
Phacoemulsification Ultrasonic Handpiece
1. Remove the sterile handpiece and accessories from the packaging and place
them in the sterile area.
2. Assemble the ultrasonic handpiece as shown in Figure 2.9 – Assembling the
Phaco Handpiece. To assemble the handpiece you need the handpiece, titanium
phaco tip, the appropriate tip wrench, the irrigation sleeve, and the test
chamber.
3. Make sure the handpiece tip is the correct type to use with your settings.
4. Verify that the tip and sleeve combination is correct.
Note: If you change a tip during surgery, we recommend that you tune the
handpiece.
Note: You can use the ELLIPS FX handpiece with WHITESTAR Technology
phaco settings.
Note: The FX icon shows on the Phaco surgery screen when you attach the
ELLIPS FX handpiece to the system.
5. Attach the connector end of the handpiece to the phaco receptacle on the front
of the COMPACT INTUITIV System. Make sure there is no moisture on the
connectors prior to attaching. Moisture prevents the handpiece from operating
properly.
Figure 2.12 – Handpiece Receptacles
1. Vitrectomy
2. Diathermy
3. Phaco
6. Insert the male luer (white) end of the irrigation tubing into the phaco
handpiece.
7. Attach the female luer (blue) fitting end of the aspiration tubing to the phaco
handpiece.
Note: To protect the patient from contamination, use only:
• sterile tubing sets
• sterile irrigation solution
• sterile handpieces
1. Irrigation 2. Aspiration
Irrigation/Aspiration Handpiece
1. Assemble the Irrigation/Aspiration (I/A) Handpiece by attaching the irrigation
sleeve and test chamber.
The test chamber is part of the COMPACT INTUITIV System Pack, OPO80.
Use the LAMINAR Flow irrigation sleeves and LAMINAR phaco tips that
are compatible with the COMPACT INTUITIV System.
3. Attach the connector end of the vitrectomy cord to the vitrectomy receptacle on
the front panel.
System Check-Out The purpose of the check-out sequence is to verify that the installation is complete
and that the COMPACT INTUITIV System is operating properly. Perform the
check-out sequence prior to the first case of the day and any time you make
program changes as outlined in the following steps. Test the I/A function and
handpiece first, then the Phaco function and handpiece, so that the phaco handpiece
(which you use first) is setup and ready for surgery.
Repeat any of the check-out steps if not successfully performed. If the instrument is
still not working correctly, refer to Chapter 8 "System Messages, Troubleshooting,
and Diagnostics".
Prime/Tune
Refer to Chapter 6 "Surgical Mode" for instructions on priming/tuning the system.
Irrigation/Aspiration
1. Attach the tubing to the I/A handpiece.
2. Select I/A mode on the touch screen.
3. Hold the test chamber near the tip.
4. Press and hold the foot pedal in position 2.
5. Observe the irrigation flow.
Phacoemulsification
1. Attach the irrigation and aspiration tubing to the Phacoemulsification
Ultrasonic Handpiece.
2. Screw the phaco tip onto the handpiece. Use your fingers to first engage the
screw thread, then use the tip wrench to tighten the tip so that it is quite snug.
Screw the irrigation sleeve over the tip.
3. Make sure you have primed and tuned the system.
4. Select the Phaco mode on the touch screen.
5. Remove the test chamber from the handpiece.
6. Press and hold the foot pedal in position 2. Use a cup to capture the fluid.
7. Observe the irrigation flow.
8. Hold the handpiece approximately at patient’s eye level.
9. Fill the test chamber with irrigation fluid.
10. Place the test chamber over the irrigation sleeve.
11. Occlude the aspiration line just below the phaco handpiece. The actual vacuum
level should rise to the preset level.
12. Release the occlusion and watch the test chamber to make sure that it does not
collapse. A slight shallowing of the chamber is normal.
13. To test irrigation, pinch the irrigation tubing at the I/A handpiece and watch for
the test chamber to collapse.
14. Release the irrigation line and the test chamber should refill.
15. Press and hold foot pedal in position 3.
16. Observe the Phaco the timers are recording phaco time.
17. Press NEXT CASE to reset the phaco timer.
Diathermy
1. Connect the Diathermy forceps to the cable, then connect the cable to the front
panel.
2. Select the Diathermy mode on the touch screen.
3. Press the foot pedal. When you press the foot pedal you should hear a tone.
3
System Settings
Self Test
IV Pole (Optional)
Vacuum Units
Event Log
Software Versions
Import/Export Database
System Setup Screen Press the System Setup button from the Surgeon Settings screen, the Program
Settings Screen, or the Surgeons and Program screen.
Self Test To run the system self test from the System Setup screen:
Set Date and Time Follow these steps to set the system date and the system time from the System
Setup screen.
IV Pole (Optional) The programmable IV pole is controlled by the up and down arrows on the touch
screen, next to the bottle height indicator. You can use the buttons on the remote
control and the switch on the side of the IV Pole to control the IV pole. Use these
controls to raise and lower the pole. The IV pole moves at a rate of approximately 6
cm (2 inches) per second.
The IV pole is adjustable from 0 to 77 centimeters. You can set the unit of
measurement for either inches or centimeters. The height measurement is relative
to the distance from the irrigation valve to the center of the drip chamber. The
system memory retains the IV pole height for each fluidic mode or submode
(phaco, irrigation/aspiration, vitrectomy). You can set an IV pole height for each
submode.
When you select a surgical mode, the IV pole automatically moves to the preset
height. To manually adjust the IV pole height, use the up and down arrows on the
touch screen. You can make manual adjustments to the IV pole by pressing the
rocker switch on the side of the console.
Use IV Pole Setup and Test screen to select the units displayed and to test the
movement of the IV Pole.
3. Select the Extension Added check box, if you are using an extension.
4. Press the buttons on the right of screen to move the IV pole.
5. Press OK to close the screen.
Vacuum Units Follow these steps to set the units of measure for vacuum from the System Setup
screen.
Wireless Remote Use the wireless remote control keypad to move between the surgical modes and
Control (Optional) submodes. You can make adjustments to the surgical mode and submode settings
using the remote control. On the remote keypad, press the I/A, Vacuum, Power or
Cut Rate button, then use the Up and Down buttons to change the value. (Numbers
11 and 12 in Figure 3.6 – Wireless Remote Control.)
Note: Remove the batteries when shipping or transporting the remote control.
When not in use, store the wireless remote control in the storage bin on the cart, if
available.
After you turn the system on, press any of the buttons to activate the remote
control.
Note: After two (2) minutes of idle time, the remote control goes into a
power-save mode. To turn the remote control on, press any of the buttons.
Use the Wireless Remote Control function to pair the remote control to the system
and then to test the paired remote control.
Note: Make sure that the wireless remote control is active before you start the
wireless setup process.
3. Press the buttons in the order as indicated on the screen. Press Cancel Pairing to
stop the pairing process.
4. Press the Unpair button to break the Bluetooth connection with the system. You
must do this before you can pair another remote control with this system or use
this remote with another system.
5. Follow the instructions on the screen to test the wireless remote control.
Touch Screen You should calibrate the system touch screen as part of the system setup. Follow
Calibration the steps below to calibrate the touch screen from the System Setup screen.
1. Press the Touch Screen Calibration button.
2. Press and hold the target until the next target appears.
3. Repeat Step 2 for all the calibration points.
4. Press OK on the confirmation screen to complete the calibration process.
Note: If you do not press OK or you cannot press OK, the Touch Screen
calibration process restarts after 20 seconds.
Language Setup Follow these steps to select a language from the System Setup screen.
1. Make sure that the Language USB device is in the USB port on the back of the
console.
2. Press the Install additional languages button on the Select Language screen.
3. Select the languages to install from the USB device
4. Follow the instructions on the screen.
5. Press OK to close the screen when the system completes the installation.
Surgical Media The Surgical Media Center (SMC) integrates and records the video image from the
Center (Optional) surgical microscope and the surgical operating data for viewing at another date and
time. You can view the surgery on a separate monitor with the instrument settings.
Attach the SMC hardware to the communications port on the rear panel.
(Figure 2.5 – Power Connections.)
Follow these steps to configure the Surgical Media Center from the System Setup
screen:
Event Log Follow these steps to view the event log from the System Setup screen.
4. Press the Export Log button to export the Event Log to an external storage
device.
5. Press OK to close the screen.
Software Versions Follow these steps to see the software versions installed on the system.
Import/Export Import
Database Follow these steps to import a database.
3. Select the database you want to import from the list. Use the up and down
arrows to locate the file name.
4. Press the Import button to import the database from the USB device.
5. Select OK on the dialog box to complete the import process.
6. Select OK to close the screen.
Export
You cannot export Default Surgeon or Default Anterior Program settings.
Follow these steps to export a database.
4
SURGEON SETTINGS
Edit a Surgeon
Remove a Surgeon
Foot Pedal
Sounds
Display Adjustment
Reflux Modes
Vent Modes
The AMO Default settings are the starting point for creating new surgeons and
programming for your COMPACT INTUITIV System.
Surgeons and This chapter covers the information needed to define your personal settings. Refer
Programs Screen to Chapter 5 "Program Settings" for information on specific program settings.
You can continue on to surgery using the Default Surgeon and the Default Anterior
Program as the program. If you make any changes to the default surgeon settings
during surgery, you can not save those changes.
Add a New Surgeon When you create a new surgeon, the system automatically assigns the Default
Anterior Program settings to that surgeon. You can customize the settings with
your preferred settings. You can also create new settings for existing surgeons. You
can define 30 different surgeons on the system. When you reach the system’s limit,
the system disables the Add function on the Surgeon Setup screen.
4. Press OK to save the new surgeon and exit the keyboard screen. The new
surgeon is now on the list of available surgeons.
Import Surgeon 1. Press the Surgeon Settings button on the Surgeons and Programs screen.
Settings Note: Make sure that you place the USB device into the USB port on the
back of the system.
2. Press the Import button.
3. Select the file to import from the list.
4. Press the Import button.
5. Press OK to close the screen.
Export Surgeon 1. Press the Surgeon Settings button on the Surgeons and Programs screen.
Settings Note: Make sure that you place the USB device into the USB port on the
back of the system.
2. Press the Export button.
3. Enter the name of the file to export.
4. Press OK to complete the export.
Remove a Surgeon Use Remove to remove a surgeon from the Select Surgeon screen. You cannot
delete the Default Anterior Program.
Foot Pedal The foot pedal controls all of the system functions, therefore, it is essential that you
understand the foot pedal operation.
The system software automatically detects if a foot pedal is present and the type of
foot pedal.
Note: The system does not support any closed-toe foot pedals.
You can select and set the foot pedal settings and adjustments in the Foot Pedal
Configuration screen. The foot pedal housing incorporates a handle, making the
foot pedal easy to grip for repositioning and storage.
The foot pedal cable attaches to the foot pedal connector on the rear of the console.
Note: You must NEVER handle the foot pedal by the cable.
Figure 4.4 – Three Button Foot Pedal
Note: The foot pedal position determines the function of the handpiece. The
delivery of that function depends on the mode selected. Once you attach
the foot pedal, place your foot on the pedal and press the pedal to the
desired position. Refer to Table 4.2 – Foot Pedal Positions and the
associated Handpiece Behavior.
Select any of the following options and adjustments to preset the foot pedal:
• Threshold = P1, P2, P3
• Switch Actions = Off, Reflux, CASE Up/Down, IV Pole Up/Down, Major
Mode Next/Previous, Submode Next/Previous, Active Mode Next/Previous,
Continuous Irrigation, Single Cut
Note: If Side Vit is selected as a vitrectomy setting, any settings for either
side switch will be over written by this setting. For example, if Reflux
was selected as a foot pedal switch setting, Side Vit will be used for
that switch when you are in vitrectomy.
The foot pedal position determines the function of the handpiece, which depends on
the selected mode (Diathermy, Phaco, Irrigation/Aspiration, or Vitrectomy). The
foot pedal display indicates foot pedal position (0, 1, 2, or 3). Refer to Table 4.2 –
Foot Pedal Positions and the associated Handpiece Behavior for a description of
each position.
Table 4.2 – Foot Pedal Positions and the associated Handpiece Behavior
Modes
Foot Diathermy Continuous Phaco Irrigation/ Vitrectomy Vitrectomy Vitrectomy
Pedal Irrigation Aspiration IAC ICA Side VIT
Positions Enabled
0 Off On Off Off Off Off Off
1 On On Irr (Only) Irr (Only) Irr (Only) Irr (Only) Irr (Only)
2 On On Irr/Asp Irr/Asp Irr/Asp Irr/Cut Irr/Asp
3 On On Irr/Asp/Phaco Irr/Asp Irr/Asp/Cut Irr/Cut/Asp Irr/Asp
Threshold P1, P2, and P3 – Allows the surgeon to program where the foot pedal
transitions from Position 0 to Positions 1, 2, and 3. The basis of the percentage
figure is on 100% of total foot pedal travel. (Halfway down = 50% travel.)
Tactile Feedback – When ON, provides tactile feedback that allows the surgeon to
feel when the foot pedal transitions between the different positions.
Reflux – Assigned to any of the switched. When ON, reflux occurs when you press
the assigned switch. When OFF, the switches have no function. Reflux is
essentially a reversal of aspirated fluid flow to assist in the release of unwanted
material. Activate Reflux by pressing the assigned foot pedal switch.
The pinch valve opens the aspiration line to the positive bottle head pressure
(dependent on IV pole height and gravity). This action causes fluid to flow toward
the handpiece. When the system releases the pinch valve, Reflux turns off.
Do not use Reflux to clear clogged handpieces but you can use Reflux to identify a
blockage.
Tap for Continuous Irrigation – This is a feature that allows surgeon control of
Continuous Irrigation. When ON, the surgeon may quickly tap the foot pedal from
P0 (foot position 0) to P1 (foot position 1) to toggle Continuous Irrigation ON/OFF.
3. Select Tactile Feedback to be able to feel when the fool pedal moves into the
different pitch zones.
4. Use the Up and Down arrows to change the threshold for each of the foot pedal
pitch zones. P1 is the first zone, P2 is the second, and P3 is the final zone.
5. Press OK to close the screen or select the Configuration tab to set up the foot
pedal switches.
Configuration
Follow these steps to configure the foot pedal switches from the System Setup
screen.
5. Press OK to close the screen. Repeat this step for each switch.
6. Press OK to close the screen.
Follow these steps to set the foot pedal thresholds from the System Setup screen.
4. Use the Up and Down arrows to change the threshold for each of the foot pedal
pitch zones. P1 is the first zone, P2 is the second, and P3 is the final zone.
5. Press OK to close the screen or select the Configuration tab to set up the foot
pedal switches.
Configuration
Follow these steps to configure the foot pedal switches from the System Setup
screen.
5. Press OK to close the screen. Repeat this step for each switch.
6. Press OK to close the screen.
Note: If the Foot Pedal handle blocks the movement of your foot on the pedal,
you can remove the handle.
Removing the Handle from the Foot Pedal
1. To remove the handle, press the clips on either side of the handle.
3. Select the applicable buttons to activate sound for each of the following:
• Occlusion/CASE
• High Vacuum
• Key Press
• Voice Confirmation
4. Press OK to close the screen.
Display Adjustment Follow these steps to set the display brightness from the Surgeon Settings screen.
Reflux Modes Select either the Bottle or Motor buttons to set the type of reflux and the type of
venting.
Reflux is the controlled back flow of fluid through the aspiration port of the
handpiece. Use Reflux to gently release or dislodge unwanted material from the
handpiece tip. You can also use Reflux to “tent” the incision site allowing easier tip
insertion. Reflux does not clear a clogged handpiece. However, you can use Reflux
to identify a blockage.
You can program the Reflux action on any available foot pedal switch. Reflux is
active until you release the foot pedal switch.
For Bottle Reflux: When reflux is requested, fluid is expelled from the aspiration
line via the bottle. Reflux pressure is dependent on bottle head pressure (IV pole
height and gravity).
For Motor Reflex: When reflux is requested, fluid is expelled from the aspiration
line via the peristaltic pump running backwards.
Vent Modes Venting is the process of the system alleviating any residual vacuum when you
release the foot pedal to position 1 or 0.
For Bottle Venting: During an occlusion and after you release the foot pedal, the
pinch valve opens and the line pressure vents to the bottle pressure until the vacuum
reaches 20 mmHg. The bottle vent results in a "passive micro-reflux" or "poof"
function that gently pushes particles away from the handpiece tip
For Motor Venting: During an occlusion and after you release the foot pedal, the
peristaltic pump runs backwards until the vacuum reaches 20 mmHg.
5
Program Settings
Program Settings
Add a Program
Import
Export
Remove a Program
Settings
Diathermy
Phaco
Vitrectomy
This section provides instructions on how to set up and select a program (preset
parameters) for phacoemulsification procedures in the COMPACT INTUITIV
System.
Use the Default Anterior Program settings as the starting point for creating new
presets and programming for your COMPACT INTUITIV System.
Program Settings This chapter covers the information needed to define your program settings. Refer
to Chapter 4 "Surgeon Settings" for information on specific surgeon settings.
You can continue on to surgery using the Default Surgeon and Default Anterior
Program for the program. If you make any changes to the default settings during
surgery, you can not save those changes. The system allows the creation of eight (8)
programs for each surgeon. You can use either a Standard Name or create your own
name for the program.
Select Initial Submode for the first submode used when you start surgery.
Add a Program 1. Press Program Settings on the Surgeons and Programs screen.
2. Press the Add button
3. Press the Standard Names button or enter a name using the keyboard.
4. Select a name from the list if you opened the Standard Names list.
5. Press OK to close the screen.
6. Press OK again to close the keyboard screen and to save your selection.
Lock a Program Once you lock a program, you cannot save any changes to the settings. You would
need to create a new program with a different name to save the setting changes. A
locked program cannot be unlocked or deleted.
Edit a Program 1. Press Program Settings on the Surgeons and Programs screen.
Name 2. Press the Edit Name button
3. Press the Standard Names button or enter a name using the keyboard.
4. Select a name from the list if you opened the Standard Names list.
5. Press OK to close the screen.
6. Press OK again to close the keyboard screen and to save your selection.
Remove a Program You can remove a program from the database if you no longer need or use that
program.
Settings You must program at least one submode “Active” in each of the major modes.
Diathermy
The system provides power for bipolar coagulation or diathermy. The Diathermy
screen shows the amount of diathermy power. Press the up or down arrows on the
Power control panel to increase or decrease Panel power. If you selected the linear
mode, the power is controlled with the foot pedal up to the maximum preset value.
1. Press the Program Settings tab. You can configure the other major mode
buttons by pressing the applicable button.
2. Select the Diathermy button.
Figure 5.4 – Diathermy Submode Program Screen
Phaco
The purpose of phacoemulsification or phaco is to emulsify the lens material. The
phaco handpiece provides ultrasonic energy, irrigation, and aspiration
simultaneously so that the handpiece can extract the emulsified lens material. The
phaco handpiece has a hollow needle that vibrates longitudinally at an ultrasonic
frequency or a blend of longitudinal and transversal vibration, if you use the
ELLIPS FX handpiece. The rapid movement of the needle and the resulting
cavitational energy disintegrates the cataract on contact. The hollow needle
(aspiration) uses suction to remove the debris. Incoming irrigation solution
(irrigation) compensates the resulting loss in volume of the anterior chamber.
Phaco Submodes
There are four phaco submodes. Within each submode, there are programmable
parameters for General (Occlusion Mode), Aspiration (Limits and Pump Mode),
Vacuum (Limits and CASE), and Power (Limits, Modality, WhiteStar, and Pulse
Shaping).
Phaco power is a combination of stroke length, frequency, and handpiece
efficiency. A preset power setting of 30% using linear control allows you the
ultimate control during phaco. Adjustments to phaco power depend on factors that
include nuclear density, your preferences, and your experience.
Phaco mode lets you set four submodes with different settings. You can adjust the
individual parameters of each submode.
For each phaco submode, you can change the following settings:
• General
• Aspiration
• Vacuum
• Power
Before performing phaco, you must complete the steps to Verify Irrigation/
Aspiration Balance, as recommended in Chapter 6 "Surgical Mode".
Override Phaco Submode Settings During Surgery
You can override the settings for a phaco submode by selecting the submode, and
either press the up and down arrows to increase or decrease Aspiration Rate,
Vacuum, or Power settings, or press Settings. If you pressed the Settings button, the
Settings dialog box opens.
Note: The default settings are based on a 20 gauge tip phaco tip.
General Tab
IV Pole Height 0 - 77 cm 65 cm 77 cm 77 cm 77 cm
With IV Pole Extension 15 - 92 cm
Max Vacuum 0 - 650 mmHg 50 mmHg 405 mmHg 375 mmHg 310 mmHg
Max Aspiration Rate
• Unoccluded 10 - 60 cc/min 20 cc/min 36 cc/min 36 cc/min 28 cc/min
• Occluded 10 - 60 cc/min 20 cc/min 28 cc/min 16 cc/min 24 cc/min
Occlusion parameters appear only
when Occlusion Mode is ON.
Vacuum Mode. Linear, Panel Linear Linear Linear Linear
Flow Mode Linear, Panel Panel Panel Panel Linear
Occlusion Threshold 35 mmHg 125 mmHg 60 mmHg 150 mmHg
Occlusion parameters appear only when
Occlusion Mode is ON
Occlusion Mode On, Off Off Off Off Off
Max Power 0 - 100% in 5% 60% 40% 40% 20%
increments
Power Delivery Type Linear, Panel Linear Linear Linear Linear
Power Delivery Modes Continuous Long Pulse Long Pulse Continuous
Power Delivery Modes (Occluded) Long Pulse Long Pulse Long Pulse Continuous
Short Pulse Rate 1 - 14 pps 6 pps 6 pps 6 pps 6 pps
Long Pulse Rate 1 - 6 pps 4 pps 3 pps 6 pps 4 pps
WHITESTAR Mode (Occluded) On On On On
WHITESTAR Technology - Pulse On/Off Duty 6/12 (33%) 6/12 (33%) 6/12 (33%) 6/12 (33%)
Cycle
CASE mode On, Off Off Off Off Off
Pump Ramp 10% - 100% 50 50 50 50
1. Press the Program Settings tab on the Surgeons and Programs screen.
2. Press the Phaco button if not already selected.
3. Press the applicable submode tab.
4. Press the General tab.
11. Make sure that the Submode Active button has a green check mark. This box
must have the check mark to have the submode available during surgery.
12. Check the Occlusion Mode box to activate the Occlusion Mode function. If
Occlusion Mode is selected, adjust the Pump Ramp settings for both
Unoccluded and Occluded on the Aspiration tab.
Note:
• Occlusion Mode
With Occlusion Mode phaco, you can set different aspiration rates for
occluded aspiration as opposed to unoccluded aspiration.
You can set a different vacuum rise time for when the phaco tip occludes
without changing the aspiration rate through an unoccluded needle.
• Occlusion Vacuum Threshold
In Occlusion Mode phaco, you can set an occluded threshold value for
vacuum.
When in Occlusion Mode phaco, there is an additional control panel for
vacuum. The vacuum threshold setting lets you choose the vacuum level at
which occluded settings take effect.
To adjust the occluded vacuum threshold, press the up or down arrows, in
occlusion mode, to increase or decrease the occluded vacuum threshold.
When you decrease the threshold, the occlusion settings take effect sooner.
• Occlusion Aspiration Rate
In Occlusion Mode phaco, you can set a different maximum flow value for
aspiration. There is an additional control panel for occluded aspiration below
the standard aspiration control panel.
13. Press Save or Save As, if you changed any of the AMO Default settings.
14. Press the Aspiration tab to configure the Aspiration Settings.
Aspiration Tab
The aspiration flow rate is the speed the system removes material from the eye
through the aspiration tubing. A pump provides the necessary aspiration flow to
withdraw the fluid and the lens material from the eye chamber through the
handpiece. With this aspiration flow system, the vacuum builds when material
blocks or occludes the aspiration port. The vacuum reduces as the occlusion clears.
Adjust the aspiration rate in 1 cc increments from 0 to 60 cc per minute. You can
also choose panel or linear flow.
The flow rate decreases as the vacuum approaches maximum.
6. Use the up and the down arrows to change the Unoccluded setting.
7. Use the up and the down arrows to change the Occluded setting, if you selected
Occlusion Mode on the General tab.
8. Press the Vacuum tab to configure the Vacuum Settings.
Vacuum
The vacuum is the exerted force on the aspirated fluid in the aspiration tubing. To
make sure you have fluidic balance while in phacoemulsification, adjust the
maximum vacuum from 0 to 650 mmHg (Peristaltic pump), as indicated on the
Vacuum panel.
Figure 5.14 – CASE One Touch and CASE One Touch Expanded
Power Tab
1. Press the Power tab. The system defaults to the Limits tab.
1. Press the WhiteStar tab to configure the Duty Cycles for Power.
When the variable WHITESTAR Technology is on, the system applies different
duty cycles as the foot pedal moves through the power delivery zone. The zone has
four equal size quadrants, and you can apply a different duty cycle in each
quadrant.
The system maintains duty cycles to use with the Variable WHITESTAR
Technology. (Variable WS). Variable WS contains the four duty cycles for the
different quadrants. You can also use the Up/Down arrows to create custom duty
cycles for Variable WS.
Pulse Shaping Tab
The Pulse Shaping technology modifies the standard square wave pulse, by
increasing the amplitude of the first millisecond of the on time “kick”, and then
setting the remaining part of the on time to the standard power setting. This repeats
for each on time period, resulting in increased control and efficiency in
phacoemulsification.
1. Press the Program Settings tab on the Surgeons and Programs screen.
2. Press the Settings button.
3. Press the I/A button.
Aspiration Tab
General Tab
8. Use the up and the down arrows to change the Bottle Height setting.
9. Select either ICA, IAC, or Side Vit. Refer to Chapter 4 "Surgeon Settings" for
additional information.
10. Press the Aspiration tab.
Aspiration Tab
1. Press the Aspiration tab.
6. Use the up and the down arrows to change the Unoccluded setting.
7. Press the Vacuum tab.
Vacuum Tab
2. Use the up and the down arrows to change the Maximum Vacuum setting.
3. Use the up and the down arrows to change the Minimum Vacuum setting, if
you selected Linear.
4. Press the Cut Rate tab.
2. Use the up and the down arrows to change the Maximum Cut Rate setting.
3. Use the up and the down arrows to change the Minimum Cut Rate setting, if
you selected Linear.
Note: Linear is not available with Side Vit.
6
Surgical Mode
Prime/Tune
Diathermy
Phacoemulsification
Vitrectomy
End Case
System Shutdown
Prime/Tune
You must prime/tune:
• before each procedure
• anytime you reattach the handpiece
• after you have inserted or replaced a Single-Use Pack
The prime/tune process fills the I/A tubing with fluid, performs a vacuum check,
and tests and characterizes the phaco handpiece.
You can select Continuous Irrigation to allow fluid to free flow from the bottle to
collect fluid.
The design of I/A Prime allows for a procedure that does not require a phaco
handpiece. The design of tune allows for a quick tune of the phaco handpiece with
an I/A tubing set. You can use tune if you replace a phaco tip during a procedure.
To shorten the overall prime sequence, select Bypass prime. Using Bypass also
reduces the time to prime the system. Use Bypass if Continuous Irrigation is On or
if the I/A tubing is already primed.
WARNING: If you do not properly prime the I/A tubing, errors can
occur.
To access the prime/tune routines, press the Prime/Tune button. The console shows
the Prime/Tune screen with all the prime and the tune options.
Note: Prime/tune is a combination of I/A prime then tune.
The system tracks the successful completion of the prime and tune cycles
independently. If you need to tune the system again (new tip, failed tune), you only
need to select and run the tune process.
1. Use the Cup Fill feature to fill the test chamber with fluid and to eliminate all
air. Remember to remove the test chamber from the handpiece, if needed,
before you start the cup fill process.
2. Place the test chamber over the handpiece tip and the sleeve hub.
3. Press the Prime & Tune button, this starts the prime and the tune sequences.
• To perform a prime only, press the Prime button.
• To perform a tune only, press the Tune button.
4. Make sure that low ceilings do not block the movement of the IV pole.
5. Watch the fluid fill the drip chamber. The fluid moves toward the handpiece
and fills the test chamber.
6. The touch screen indicates the progress of the prime and the tune process.
7. As the tubing lines fill, the system software performs functional checks. The
checks include:
• Monitoring for the presence of irrigation flow (bottle height)
• Leaks (via vacuum rise checks)
8. When you attach the phaco handpiece and you select Prime & Tune, the system
automatically includes a handpiece tuning test concurrently with the prime
cycle.
• At the end of the priming sequence, the system tells you that the prime
process is complete.
• At the end of the phaco tuning test, the system tells you that tune process is
complete.
9. To discontinue prime or tune during the process, select Cancel.
10. When prime and tune are complete, the system automatically proceeds to the
first phaco operating mode or the Initial Submode. It is important that you
verify the Irrigation and Aspiration balance prior to operating.
Verify Irrigation/ We strongly recommend that you verify the balance of Irrigation/Aspiration.
Aspiration Balance
Figure 6.2 – Irrigation/Aspiration Balance Procedure
1. In the first Phaco mode, hold the handpiece at the approximate patient eye
level. Refer to Figure 6.2 – Irrigation/Aspiration Balance Procedure.
2. Occlude the aspiration line just below the handpiece, as you press and hold the
foot pedal in position 2.
3. The actual vacuum level should rise to the preset level.
4. Release the aspiration line and then watch the test chamber to make sure that
the test chamber does not collapse. A slight shallowing of the test chamber is
normal.
5. If the test chamber collapses, raise the IV bottle height or lower the vacuum
setting.
6. Pinch the irrigation tubing at the handpiece and watch for the test chamber to
collapse.
7. Release the irrigation line and the test chamber should fill.
8. Press the Time icon in the middle of the screen to open the Reset Timers dialog
box.
9. Press Reset Timers to set the timers back to zero.
10. Touch anywhere on the screen to close the dialog box. You are now ready to
begin surgery.
Priming for Before performing vitrectomy, we recommend priming the handpiece to reduce the
Vitrectomy chance of errors. Each time you select vitrectomy mode, a dialog box displays
asking you to prime the vitrectomy handpiece. If you do not need to prime, press
Bypass.
To prime the handpiece:
1. Attach the irrigation tubing and the aspiration tubing of the pack together.
2. Press Prime on the Prime/Tune screen.
3. Press the VIT button to access VIT mode.
4. Follow the instructions on the screen.
5. Press the Start button. The screen closes automatically after the system primes
the handpiece.
Note: If you must perform vitrectomy in the middle of phaco surgery, perform
steps 3 through 5.
Selecting and The design of the system's graphical user interface (GUI) and touch screen is for
Changing Mode ease-of-use, consistent look, and maximum informational display during all
Parameters operating modes.
Your interface with the system requires only three basic steps, which apply to all
the selections, settings and operations. Once you understand this basic
organization, you can move quickly and easily through all the system functions and
system operations.
Panels organize the text on the touch screen. The top panel shows current status,
configuration options, the bottle height, and the foot pedal icon. The left-side
column lists the operating modes and submodes. The main panel that dominates the
screen shows current operating levels for aspiration, vacuum and power.
• To switch operating modes, press a button in the left panel. The control panels in
the main panel show the operating levels for that mode.
• To make basic changes to the settings, press the up and down arrows to increase
or decrease a value.
• To change other control panel settings, such as Panel or Linear power, press the
Settings button on that control panel. A Settings screen opens, and you can make
your selections.
Diathermy While the system is priming, you can select the diathermy (DIA) mode and perform
diathermy procedures. This process is diathermy during prime.
When you are in diathermy mode during prime, the screen indicates the prime/tune
status and any messages associated with the prime or tune.
The system provides power for bipolar coagulation or diathermy. The Diathermy
screen shows the amount of diathermy power. Press the up or down arrows on the
Power control panel to increase or decrease diathermy power. If you selected the
linear mode, the power is controlled with the foot pedal up to the maximum preset
value.
Using Diathermy
To begin diathermy:
1. Press DIA.
2. Press the desired diathermy submode button (DIA 1 is the default).
Note: The elapsed diathermy time (DT) is in the upper center of the screen.
3. Press the up or down arrows to increase or decrease the power. You can use the
foot pedal to increase or decrease the linear power up to the maximum preset
value. See Chapter 5 "Program Settings" for the system default settings.
Note: Take care then using a high power setting during Diathermy.
4. Press the Settings button to change the power delivery.
• Panel – Diathermy power delivered consistently at the power level (%)
selected and indicated on the screen as Panel Maximum Power.
• Linear – Diathermy power delivered from 1% to the maximum selected
value (Maximum Power) as you press the foot pedal.
• Burst – Diathermy delivered as a single 150 ms pulse, at the selected power,
as you press the foot pedal.
Phacoemulsification The purpose of phacoemulsification or phaco is to emulsify the lens material. The
phaco handpiece provides ultrasonic energy, irrigation, and aspiration
simultaneously so that the handpiece can extract the emulsified lens material. The
phaco handpiece has a hollow needle that vibrates longitudinally at an ultrasonic
frequency or a blend of longitudinal and transversal vibration, if you use the
ELLIPS FX handpiece. The rapid movement of the needle and the resulting
cavitational energy disintegrates the cataract on contact. The hollow needle
(aspiration) uses suction to remove the debris. Incoming irrigation solution
(irrigation) compensates for the resulting loss in volume of the anterior chamber.
1. Press Phaco.
2. Press Sculpt, Chop, Quadrant, or Epinucleus to select the submode. The main
panel shows the settings for Aspiration, Vacuum, and Power. Each submode
has different default settings.
Note: Make sure the handpiece tip is the correct type to use with your
settings.
3. Press the foot pedal to activate phacoemulsification. The Aspiration, Vacuum,
and Power control panels indicate the associated levels throughout the
procedure. The foot pedal icon in the upper portion of the screen shows the
position of the foot pedal.
Note: Take care then using a high vacuum setting or a high power setting
during Phaco.
Venting an Occlusion
When there is a blockage or an occlusion to the aspiration port by some tissue or
other material, the vacuum pressure builds up. The aspiration flow vents to the
bottle when you release the foot pedal. Another choice is that you can release the
foot pedal to position 1 and that causes the aspiration system fluid to vent using
pump rotation (Motor Vent).
Note: For chamber stability, maintain foot pedal position 1 or use Continuous
Irrigation.
Both of the methods release the material at the aspiration port and give you full
control if the tip accidentally grabs the capsule or iris. The internal fluidic system
maintains the desired vacuum level when you hold the foot pedal at a constant
position. The two adjustments associated with aspiration flow are the Maximum
Vacuum setting and Maximum Aspiration setting.
Irrigation and Aspiration flow is necessary to remove the emulsified cataract material from the
Aspiration (I/A) eye. An irrigation supply is necessary to replace fluid removed through aspiration
of cortical material and fluid that leaked from the incision.
This fluid balance maintains the anterior chamber during surgery. Irrigation is
controlled by gravity.
The height of the drip chamber (head pressure) determines the flow rate of
irrigation solution through the irrigation sleeve on the phaco tip. The drip chamber
hangs from the bottle on the optional IV pole. AMO recommends that at the start of
a procedure, place the drip chamber approximately 65–70 cm above the patient's
eye level. To increase irrigation pressure, raise the IV bottle. To decrease irrigation
pressure, lower the bottle.
The irrigation tubing runs through the Single-Use Pack and irrigation is controlled
by the foot pedal. When you press the foot pedal, the pinch valve opens and the
irrigation fluid flows. Irrigation runs in foot pedal positions 1, 2, and 3.
1. Press I/A.
2. Select the desired I/A submode. I/A 1 is the system default.
3. Press the up or down arrows in the control panels on the main panel to increase
or decrease the aspiration rate or the vacuum. You can also press the Settings
button to change the aspiration mode or the vacuum settings.
Note: Take care then using a high vacuum setting when aspirating.
4. Use the up and down arrows to change the minimum parameters. (Minimum
vacuum is available only in Linear mode.)
5. Use the up or down arrow to change the Maximum parameters.
Note: The maximum value can force the minimum value lower, but the
minimum value cannot force the maximum value higher.
1. Press the up or down arrows to increase or decrease the aspiration rate, vacuum,
or cut rate. You can also press the Settings button to change aspiration mode,
vacuum mode, or cut rate settings.
Note: Take care then using a high vacuum setting or a high Cut Rate during
Vitrectomy.
2. Use the up and down arrows to change the minimum parameters. (Minimum
vacuum is available only in linear mode.)
Note: The maximum value can force the minimum value lower, but the
minimum value cannot force the maximum value higher.
End Case End Case is available in the left panel from any surgical mode. End Case allows
you terminate the surgical case. If you made changes to the program settings, select
Yes, No, or Cancel at the prompt. If you make any changes to the default settings
during surgery, you can not save those changes.
System Shutdown The following is a general overview of the steps to take to shut the system down
after surgery:
7
Care and Cleaning
Phaco Handpiece
Irrigation/Aspiration Handpiece
Diathermy Handpiece
Vitrectomy Cutter
Cleaning and Handle all previously used reusable items according to the Directions for Use for
Sterilization the particular product. Dispose of all single-use items or items which have
Procedures completed their recommended useful life in accordance with:
• accepted hospital practices and hospital procedures
• local governing ordinance and recycling plans
Phaco Handpiece Refer to the phaco handpiece product Directions for Use for cleaning, handling, and
sterilization instructions.
Irrigation/ Refer to the irrigation/aspiration handpiece product Directions for Use for cleaning,
Aspiration handling, and sterilization instructions.
Handpiece
Diathermy Refer to the diathermy handpiece product Directions for Use for cleaning, handling,
Handpiece and sterilization instructions.
Fan Filter Cleaning There are two air filter fans located on the bottom of the system. You need to
inspect and clean the filters once a year. To clean the filters of dust and lint:
1. Disconnect the power cord and all other cables from the system.
2. Place the console on its side. If the system is on the cart you do not need to
remove the console from the cart.
5. Inspect and clean the filter of debris or replace with a new filter. Contact
Technical Service to order a replacement if the filter (2601-0157-L) or
assembly is damaged.
6. Reassemble the filter and the filter retainer.
7. Snap the fan filter assembly back on to the fan. Be careful not to break the tabs
on the cover.
COMPACT 1. Turn the power switch on the back of the system Off before you unplug the
INTUITIV System system from the wall outlet.
Cleaning 2. At the end of the day, thoroughly wipe down the system, cart, IV pole and
foot pedal using a cloth dampened with a germicidal detergent and sterile
non-pyrogenic water. Be careful not to saturate any part of the system or the
foot pedal with liquid. Excessive liquid can damage the system electronics.
3. Do not push or pull on the system components.
4. AMO recommends that you leave the foot pedal cable and the power cords
attached to the system to prevent loss and unnecessary wear on the electrical
connectors.
5. Although the foot pedal is water-resistant, make sure that you keep the
foot pedal as dry as possible.
6. Place the foot pedal in the storage bin on the cart, if applicable.
7. Place the wireless remote control in the storage bin on the cart, if applicable.
If you have set up the COMPACT INTUITIV System in accordance with the
instructions given in this manual and have been unable to successfully complete the
System Check-Out, the information presented in this section may be helpful to you.
Before calling AMO for technical service, consult this chapter to see if you can find
a solution to the problem you are experiencing.
Fuse Replacement Replace the fuse if the COMPACT INTUITIV System does not boot up when the
Procedure power switch is ON and you have:
• confirmed that you have connected the power cord to the console, and
• plugged the power cord into the wall outlet.
To prevent the risk of fire or damage to the instrument, replace the fuses with the
exact type and rating as indicated below (check the voltage sticker on the back
panel of the COMPACT INTUITIV System to confirm your machine voltage)
1. Fuse Holder
3. Use a small screwdriver to gently pry open the cover to expose the fuse holder.
4. Gently pry out the fuse holder.
5. Remove the bad fuse and replace it with a new fuse (value and size specified
above).
6. Replace the fuse holder, make sure that the arrows are pointing to the right of
the back panel. Tilt the fuse holder slightly to the right and push in.
7. Push the fuse holder cover up and in until it snaps closed.
8. Reconnect the power cord to the back panel and the power cord plug into the
wall receptacle.
Wireless Remote To replace the alkaline batteries in the wireless remote control:
Control Battery Note: Remove the batteries when shipping or transporting the remote control.
Replacement
Figure 8.2 – Back View Wireless Remote Control
Advisory, Warning, The display on the COMPACT INTUITIV System is capable of displaying
and System Status, Warning, and Event Messages for certain problems. Frequently, the
Messages message shows possible solutions to resolve the event or recommendations to clear
the event. Event messages can also indicate available options should a component
or subsystem fail.
The messages listed in the following pages have possible corrective actions to clear
the error.
If you are not successful in correcting an error, be sure to document the message
prior to calling AMO for Technical Service. This information helps Technical
Service to diagnose and correct the problem.
9
Warranty and Maintenance
Warranty Statement
Warranty Statement AMO Sales and Service, Inc (“AMO”) warrants for a period of twelve (12) months
from the date of installation of the COMPACT INTUITIV System console, foot
pedal, wireless remote control, IV pole, and the phaco handpiece to be free from
defects in materials and workmanship when properly installed, maintained, and
used for its intended purpose. Notwithstanding the foregoing, the warranty period
for the Irrigation/Aspiration Handpiece Set, Diathermy Forceps and Diathermy
Cord shall be ninety (90) days from the date of installation. In no event shall the
date of installation be deemed to occur later than six months from the date of
delivery of the COMPACT INTUITIV System by AMO to the common carrier.
You are required to provide AMO with prompt written notice of any defect or
defects and permit AMO to have access to the COMPACT INTUITIV System
within a reasonable time after notification of any defect. In the event that you do
not provide AMO with prompt notification of a defect or permit access to the
COMPACT INTUITIV System within a reasonable time after notification, AMO
is hereby released from all liability with reference to such defect and subsequent
damage, if any, resulting from the inability of AMO to correct such defect.
MISUSE AND MISHANDLING ARE NOT COVERED AND WILL VOID THIS
WARRANTY.
This warranty is null and void if:
• The Customer attempts to service, modify or repair the COMPACT INTUITIV
System itself (other than performing the maintenance described in the operator
and technician manuals),
• The COMPACT INTUITIV System is serviced or modified by any person who
is not certified by AMO to perform such service, or
• The COMPACT INTUITIV System is used in a manner not provided for in this
manual.
In the event of a breach by AMO of this warranty, AMO's sole and exclusive
liability to you and your sole and exclusive remedy shall be limited, at AMO's
option, to either (1) the repair or replacement of the COMPACT INTUITIV
System, or (2) a refund of the purchase price paid by you for the COMPACT
INTUITIV System (which may be conditioned upon returning the COMPACT
INTUITIV System). You may be responsible for any shipping charges incurred in
connection with the repair or replacement of the COMPACT INTUITIV System.
This warranty applies only to the original purchaser/user of the device and may not
be transferred. This warrant will be void if and only so long as the equipment is
used in any country other than the country to which it was originally shipped by
AMO. This warranty does not apply to any used equipment unless otherwise stated
by AMO in writing.
THIS WARRANTY IS IN LIEU OF ALL OTHER WARRANTIES, EXPRESSED
OR IMPLIED, INCLUDING WITHOUT LIMITATION THE WARRANTIES OF
MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. IN NO
EVENT SHALL AMO BE LIABLE TO THE PURCHASER/USER FOR
CONSEQUENTIAL, SPECIAL, INCIDENTAL, OR PUNITIVE DAMAGES,
LOSS OF PROFITS OR LOSS OF USE.
Service Contracts
Service Contracts (excluding the phaco handpiece) are available. Contact AMO for
information on the availability of a Service Contract.
Note: If outside the United States, contact your local AMO office or
representative for service information.
Maintenance
User maintenance of the COMPACT INTUITIV System may only be performed
in connection with those adjustments and corrective actions specified in Chapter 8
"System Messages, Troubleshooting, and Diagnostics" chapter of this manual.
There are no user serviceable components within the console and you must not
attempt to access the internal components. Any attempt by you to perform any
maintenance, adjustment, or corrective actions not expressly permitted by this
manual will void the warranty.
AMO recommends, at least once every two (2) years, routine or periodic
maintenance of the COMPACT INTUITIV System by an AMO representative.
AMO recommends the measurement of PE resistance and leakage current
according to IEC 601-1 every two (2) years.
If a problem continues following setup, check-out and troubleshooting as per the
procedures in this manual, then contact AMO for corrective action
(1-800-511-0911). Please contact your local AMO office for region-specific phone
numbers, http://www.abbottmedicaloptics.com/customer-service/service-contact-
center.
10
Specifications
Physical Specifications
Electrical Specifications
Environmental Specifications
Storage Conditions
Diathermy Specifications
Phaco Specifications
I/A Specifications
Vitrectomy Specifications
Power Graphs
Physical
Specifications English / U.S. Metric:
COMPACT INTUITIV System Console:
Console Width 14 inches 35.6 cm
Dimensions Depth 18 inches 45.7 cm
(with display)
Height 7.5 inches 20.8 cm
Weight 31 pounds 14 kg
Power Cord 10 feet 305 cm
Length
Electrical IEC 60601 compliance
Enclosure Current Leakage
Cart Width 15 inches 38 cm
Dimensions: Depth 22 inches 56 cm
Height 42 inches 107 cm
Wheel Base Width 25 inches 64 mm
Depth 24 inches 61 mm
Weight 66 pounds 30 kg
Foot Pedal Dimensions:
Three Button Width 6 inches 15 cm
Depth 10 inches 25 cm
Height 5 inches 13 cm
Weight 9 pounds 4 kg
Cord Length 11.8 feet 360 cm
Four Button Width 9.82 inches 25 cm
Depth 15.57 inches 39.6 cm
Height 4.88 inches 12.4 cm
Weight 13 pounds 5 kg
Cord Length 12 feet 366 cm
Power IV Pole:
Max. Power IV Pole Travel* 30 inches 77 cm
Settings Range* 0-30 inches 0-77 cm
Velocity 2.4 inches/sec. 6 cm/sec.
Maximum Lift Weight 10 pounds 4.5 kg
Remote Control Width 4 inches 10.2 cm
Depth 4 inches 10.2 cm
Height 1 inch 2.5 cm
Weight 6.35 oz 180g w/o batteries
8.47 oz 240g w/batteries
Electrical
Specifications
Voltage Frequency Power Fuse Rating Enclosure
Consumption Current
Leakage
System 100-240 Vac 50-60 Hz 225 VA 6.3A, 250V, Bussman <100μA
GDA 6.3 (or
equivalent)
Environmental
Specifications Operating Temperature 10 to 40°C
Humidity 0 to 95% RH, non-condensing
Ambient Pressure See Vitrectomy Specifications for
additional information.
Storage Conditions
Storage Temperature -20 to 60°C
Humidity 0 to 95% RH, non-condensing
Diathermy
Specifications Power Adjustment 5 to 100%, in 5% increments
Diathermy Frequency 386 KHz +/ 10KHz
Diathermy Power (maximum power 8.5 Watts +/- 20% into a 350 ohm
into rated load) load
Diathermy Type Bipolar
Rated Peak Voltage (No Load) 160 Volts
Connector of diathermy forcep/ Ø.072 RECEPTACLE (2)
probe
Phaco Specifications
Phaco Power 0 to 100%, in 5% increments
Phaco Vacuum Levels 0 to 650 mmHg, in 5 mmHg increments
Pump Flow Rate 10 to 60 cc/minute, in 1 cc increments
I/A Specifications
Vacuum Level 0 to 650 mmHg, in 5 mmHg increments
Pump Flow Rate 0 to 60 cc/minute, in 1 cc increments
Vitrectomy
Specifications Cutter Rate 100 to 1200 cuts per minute (CPM)
Atmospheric Pressure/Altitude Density Altitude (DA) conditions are
1,200 cpm from sea level to 3,000 feet
(914.4 m) elevation and shall be de-rated
by 100cpm per 1,000ft (304.8 m)
additional elevation up to a maximum of
10,000 ft (3,048 m).
Phaco Tip Velocity Nominal Velocity for the ELLIPS FX handpiece and the WHITESTAR
handpiece at 100% power, continuous, with the OPOR3020L phaco tip is shown in
the following table.
Bottle Height The COMPACT INTUITIV System has an optional IV pole to generate positive
Pressure pressure using balanced salt solution to provide positive irrigation fluid.
All measurements are taken with a pressure meter reference point defined as
36 inches or 91.5 cm from the floor using the COMPACT INTUITIV cart.
Power Graphs
Figure 10.2 – Diathermy Output Power Typical (10 ohm rated load)
Figure 10.3 – Diathermy Output Power Typical (50 ohm rated load)
Figure 10.4 – Diathermy Output Power Typical (200 ohm rated load)
Figure 10.5 – Diathermy Output Power Typical (350 ohm rated load)
Figure 10.6 – Diathermy Output Power Typical (500 ohm rated load)
Figure 10.7 – Diathermy Output Power Typical (1000 ohm rated load)
11
Accessories and Parts Reordering
Parts Reordering
Parts Reordering Following is a list of accessories that you may periodically need to reorder for your
COMPACT INTUITIV System. Your AMO representative can advise you of
recommended inventory levels based on the volume of phacoemulsification
procedures that you do in your facility. You can order all of the items listed below
through your AMO representative or directly through AMO Customer Service.
Your AMO representative can confirm the availability of these items in your area.
A Charging
Wireless Remote Control 3-6
Adjustments, aspiration Check-Out, diathermy 2-14
foot pedal 4-6 irrigation/aspiration 2-13
Advanced Control Pedal 4-5 phacoemulsification 2-13
Aspiration Flow vitrectomy 2-14
troubleshooting 8-6 Cleaning
Aspiration Flow Rate 5-10 Fan Filter 7-3
Aspiration Rate System 7-5
Occlusion 5-10 Touch Screen 7-2
Phaco 5-8 Cleaning/Care 7-2
Vitrectomy 5-24 Connecting, diathermy cord
Assembly, irrigation/aspiration handpiece 2-8 handpieces, safety precautions 1-9
phaco handpiece 2-9 Connections, power 2-5
Continuous Burst
Phaco Power 5-16
B Continuous Irrigation 6-3
Cup Fill 6-2
Balance
Continuous Phaco Power 5-16
Irrigation/Aspiration 6-4
Custom Duty Cycles 5-18
Begin Tune 6-4
Cut Rate
Bezel Test 8-4
Vitrectomy 5-24
Blocked
Cuts per minute 5-28
Aspiration port 6-9
Cutter
Bypass 6-3, 6-5
Vitrectomy 2-12
C D
Care of the System 7-5
CASE ONE Touch 5-14 Delete
CASE Vacuum 5-13 Surgeon 4-5
Cassette DIA time 6-8
Loading 2-7
Changing
Mode Parameters 6-6
Diathermy 6-7
check-out 2-14 H
Forceps 2-12 Handpiece
Handpiece 2-12, 7-2 Cleaning 7-2
specifications 10-4 Priming 6-3
troubleshooting 8-7 Setup
Using 6-8 Diathermy 2-12
DT 6-8 Vitrectomy 2-12
Duty Cycles 5-16 Handpiece, irrigation/aspiration 2-11
phaco ultrasonic precautions 2-8
High Power
E Limit 5-19
Effective Phaco Time 6-13 High Power Pulse
Electrical Specifications 10-3 Phaco Power 5-16
ELLIPS Handpiece 2-9
Environmental Specifications 10-3
EPT 6-13 I
IA
Submodes 6-10
F ICE Pulse Shaping
Fan Filter 7-3 WHITESTAR Technology 5-19
Foot Pedal 4-5 In-Service Training 2-2
adjustments 4-6 Inspection 2-2
Pitch 4-6 Installation 2-2
Positions 4-6, 5-18 OPO80 2-7
programming settings 4-2 Irrigation
specifications 10-2 Continuous 6-3
Standard 4-5 troubleshooting 8-4
storage 2-5 Irrigation/Aspiration 5-20, 6-10
Vitrectomy 5-24 Balance 6-4
Forceps check-out 2-13
Diathermy 2-12 IV Pole
Fuse Holder, back panel 8-2 Programmable 3-3, 5-20, 6-10
Fuse Replacement Procedure 8-2 IV Pole, adjustments
Fuse Specifications 8-2 specifications 10-2
FX icon 2-10
K
G Kick 5-19
Gas Sterilization 5-10
P
Panel 5-5, 5-10, 6-7
S Touch Screen
Cleaning 7-2
Service Contracts 9-3 Using 6-6
Settings Training, in-service 2-2
Anterior Segment 5-15 Troubleshooting, aspiration system
Occlusion Mode 5-10 irrigation system 8-4
Override 5-8 Tubing Cassette
Setup, default Install 2-7
overall sequence 2-6 Tune 6-3
Short Pulse Begin 6-4
Phaco Power 5-16
Shutdown
Sequence 6-15 U
System 6-15 Ultrasonic (U/S) Time 6-13
Single-Use Pack Up Time
OPO80 2-5 Threshold 5-13
Specifications, diathermy 10-4 Upper Threshold 5-13
electrical 10-3 User-Correctable Problems 8-3
environmental 10-3 Using
foot pedal 10-2 Diathermy 6-8
fuse 8-2 Phaco 6-8
physical 10-2 Touch Screen 6-6
power pole 10-2
storage 10-2
system 10-2 V
Storage Conditions 10-3
Submode Vacuum 5-12
IA 6-10 monitoring 5-13
Phaco 5-7, 5-8 Phaco 5-8
Surgeon pressure 6-9
Delete 4-5 Vitrectomy 5-24
System Variable WHITESTAR Technology 5-18
Cleaning 7-5 Variable WS 5-18
components 2-2 Venting
Shutdown 6-15 Occlusion 6-9
System, check-out 2-13 Vitrectomy 2-12, 5-24
specifications 10-2 check-out 2-14
Cut Rate 5-28
Handpiece 2-12
T Prime 6-5
Vitrectomy, troubleshooting 8-7
Threshold
Vacuum 5-10
Timers
Reset 6-5
W
Warranty Statement 9-2
WHITESTAR Technology 5-16
Wireless Remote Control 3-5
Charging 3-6