Cassini Bets on Total Corneal Analysis to Drive Premium Channel

The key to growing the toric intraocular lens (IOL) sector for cataract surgery lies in obtaining more accurate measures of total corneal astigmatism, and Cassini thinks it has that key in its novel total corneal analysis (TCA), Chief Medical Officer Mark Packer, MD, said at OIS@ASCRS 2016.

Cassini uses patented, colored, LED ray-tracing technology to measure total corneal astigmatism, including that of the posterior cornea. As Dr. Packer described it, the device uses GPS-like coordinates on the corneal surface to absolutely measure magnitude and axis, and reflections of the second Purkinje image to measure posterior corneal astigmatism.

Dr. Packer cited Marketscope data to describe the potential for growing the toric IOL market: last year 3.7% of all IOLs implanted were toric, “but really if you look at all indications for toric IOLs it could be 50%.”

Using iris registration, Cassini TCA can be integrated into existing femtosecond platforms, he said. Cassini creates a “technological ecosystem” that allows seamless flow of information between clinic and operating suite, and has already signed LensAR, Leica, Ophtec, and TrueVision as partners, Dr. Packer said.

He reported a case series from Elizabeth Yeu, MD, at Virginia Eye Consultants that showed that 94% of eyes were within 0.50 D of residual manifest refractive cylinder postoperatively using Cassini TCA. “We really think the new standard of correction of corneal astigmatism is measuring the posterior cornea using the Cassini, using image-guided software to place that toric IOL exactly where it ought to be and getting 94% of patients within 0.50 D of postoperative astigmatism,” Dr. Packer said.

More accurate measurement of astigmatism prior to cataract surgery could reduce the typical ophthalmologist’s annual cost of postoperative enhancements from $90,000 using existing technologies to around $20,000, Dr. Packer said.

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