Facomulsificador Alcon Accurus Operator Manual
Facomulsificador Alcon Accurus Operator Manual
Facomulsificador Alcon Accurus Operator Manual
Telephone: 949/753-1393
800/832-7827
FAX: 949/753-6614
November 2002 X ECN 8065750203- Initial release of XS4+ operator's manual for
systems with software versions 4.51 or above.
November 2004 AA ECN 20043617 - Insert new EMC Statement, one new warning,
and edit Figure 4-10. Changes to old page numbers i, ii, iii, viii,
xii, 1.5-1.18, 4.16, 4.17, index.
June 2007 AC ECN 20071083 - Modify cleaning instructions. Update parts lists.
Pages affected are i, ii, 5.4, section 6, section 10, section 14.
April 2008 AD ECN 20081167 - Update consumable parts lists with new
footpedal, probe, and fiber optic data. Implement a minor grammar
correction. Pages affected are i, ii, 6.2, 11.16, 14.3.
April 2009 AF ECN 20090689 - New parts added to sections six and fourteen.
Pages affected are: i, ii, 6.1, 6.2, 6.3, 14.1, 14.2, 14.3, 14.4, 14.5.
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TABLE OF CONTENTS
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LIST OF FIGURES
FIGURE # TITLE PAGE #
Figure 1-1 The Accurus® Ophthalmic Surgical System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.1
Figure 1-2 Icons Used With the Accurus® Ophthalmic Surgical System. . . . . . . . . . . . . . . . . . 1.18
Figure 1-3 Labeling Used on the Accurus® Ophthalmic Surgical System. . . . . . . . . . . . . . . . . 1.19
Figure 1-4 Diathermy Power Through 75 Ohm Load . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.20
Figure 1-5 Diathermy Power vs. Load Impedance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.20
Figure 1-6 Diathermy Output Voltage vs. Output Control Setting. . . . . . . . . . . . . . . . . . . . . . . 1.20
Figure 1-7 Footpedal Operation when Controlling More Than One Proportional Function. . . 1.21
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LIST OF TABLES
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Table 12-1 Combined Default Settings and Adjustable Ranges (part 1) . . . . . . . . . . . . . . . . . . 12.1
Table 12-2 Combined Default Settings and Adjustable Ranges (part 2) . . . . . . . . . . . . . . . . . . 12.6
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PREFACE
This Operator's Manual is your written guide to the Accurus® Ophthalmic Surgical System and
considers all options available to the customer; therefore, when reading this manual disregard
options that do not apply to your specific unit. This operator's manual covers the CE certified
Accurus® Ophthalmic Surgical System.
Please read the entire manual carefully before operating the instrument. Recommended settings are
given only as guidelines, and are not meant to restrict the surgeon; however, before trying other
settings, the surgeon and support personnel should be experienced with the system and familiar with
the new settings.
Equipment improvement is an on-going process and, as such, changes may be made to the
equipment after this manual is printed.
Pay close attention to Warnings, Cautions, and Notes in this manual. A WARNING! statement is
written to protect individuals from bodily harm. A Caution statement, with the CAUTION heading
centered above the text, is written to protect the instrument from damage. A NOTE: is written to
bring attention to highlighted information.
If you have questions, or want additional information, please contact your local Alcon representative
or the Alcon Technical Services Department at:
ALCON
15800 Alton Parkway
Irvine, California 92618
(949) 753-1393
FAX (949) 753-6614
CAUTION: U.S. Federal Law restricts this device to sale by or on the order of a physician.
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SECTION ONE
GENERAL INFORMATION
Introduction
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Interaction is through the Accurus® console's hard keys, touch screen, remote control,
and footswitch. Information is provided via digital Light Emitting Diode (LED)
displays, a color Liquid Crystal Display (LCD), lighted indicators, sound, and tactile
feel. All of this, in combination with a variety of probes, handpieces, and accessories
provides the ophthalmic surgeon with up to the following features:
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The Accurus® system is designed with a flexibility that allows for a variety of system
configurations; this operator’s manual is written to cover all of the configurations. The
Accurus® system is capable of operating as either an anterior segment only, posterior
segment only, or multifunctional surgical tool for use in both anterior and posterior
segment ophthalmic surgeries. The Accurus® 800CS system is the premium combined
posterior/anterior system, designed with full-time cross-platform functionality.
The 600DS is a premium dual function posterior/anterior system. The 400VS is
a dedicated posterior system; and the 300VS is an entry level, fully upgradeable
posterior machine. The 200PS is a high performance venturi anterior system. While
reading this manual you should simply pay attention to the features included in your
Accurus® system.
POSTERIOR
Vitrectomy-Accurus® - x x x x
Vitrectomy-InnoVit® - - x x x
Fragmentation - x x x x
Pneumatic Scissors - x x x x
Extrusion - x x x x
Illumination - x x x x
VGFI™* - x x x x
MPC Scissors - - x x x
Viscous Fluid Control - x x x x
ANTERIOR
Phacoemulsification x - - x x
Irrigation/Aspiration x - - x x
Anterior Vitrectomy x - - x x
AVGFI x - - x x
COMBINED
Integrated Posterior &
Anterior Functionality - - - - x
Table 1-1 SYSTEM IDENTIFICATION - This table is a quick reference point to identify the surgical features
included in all of the Accurus® system models.
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System Installation
Upon arrival of your new Accurus® system, DO NOT OPEN CARTON. In the USA
contact the Alcon Technical Services Department for uncrating and installation at
800/832-7827. Outside the USA contact your local Alcon affiliate.
The Accurus® system is designed to operate using different levels of source air
pressure. Options/System has a Source Pressure parameter, with choices of Select,
Reduced (5 bar), and Standard. Select is the default setting. If the user selects the
Source Pressure parameter to be Reduced or Standard, then that will be the new
default setting. The pressure specifications for each setting are listed below.
Source Pressure Parameter is Select - When the source air pressure drops below a
minimum level a popup window will appear stating that the operator must select
either the Reduced or the Standard pressure parameter.
Source Pressure Parameter is Reduced - When the source air pressure drops below
a minimum level a popup window will appear stating that the operator must adjust
supply source pressure to between 5 bar and 8 bar. (1 bar = 14.5 psi.) Note: System
will not reach full vacuum or pressure levels if reduced is selected.
Source Pressure parameter is Standard - When the source air pressure drops below
a minimum level a popup window will appear stating that the operator must adjust
supply source pressure to between 90 psi and 120 psi.
Accessory Equipment
Settings Restoration
When a loss of power occurs, the Accurus® system retains its current settings and
mode in memory. When power is reestablished a System Information popup window
appears asking: "Do you want to restore the system's previous settings and mode?"
The user can press Yes to restore the previous settings, or No to enter the original
settings. Disconnecting the power cord, or turning the system off using the rear panel
power switch, is considered a loss of power; using the front panel standby switch is
not.
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Environmental Issues
The equipment that you have purchased requires the use of natural resources for its
production. This equipment may also contain hazardous substances which could have
potential effect on the environment and human health if disposed of improperly.
In order to avoid the entry of any such substances into our environment and to pro-
mote natural resource conservation, we encourage you to use the appropriate take-
back systems. Such take-back systems reuse or recycle many of the materials in your
end-of-life equipment in a beneficial way. Please contact your local Alcon office for
assistance in take-back options through Alcon or other providers.
The crossed-bin symbol located on this equipment reminds you to use take-back sys-
tems, while also emphasizing the requirement to collect waste equipment separately,
and not dispose of it as unsorted municipal waste.
If you need more information on the collection, reuse or recycle systems available to
you, please contact your local or regional waste administration, or contact your local
Alcon office for more information.
NRTL Mark
The Accurus® system is classified by TUV America with respect to Electric Shock,
Fire, Mechanical and other specified hazards only in accordance with UL 60601-1,
CAN/CSA 22.2 601.1, IEC 60601-2-2, and IEC 60601-2-18.
LED Statement
LED's used in this equipment are Class 1 LED products according to EN60825-1
amendment 11. Oct. 1996.
Universal Precautions
Universal precautions shall be observed by all people who come in contact with the
instrument and/or accessories to help prevent their exposure to blood‑borne pathogens
and/or other potentially infectious materials. In any circumstance, wherein the exact
status of blood or body fluids/tissues encountered are unknown, it shall be uniformly
considered potentially infectious and handled in accordance with OSHA guidelines.
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EMC Statement
It is important to install and use the equipment in accordance with the instructions
in order to prevent harmful interference with other devices in the vicinity. If this
equipment causes harmful interference to other devices (determined by turning the
equipment off and on), the user is encouraged to try to correct the interference by one
or more of the following measures:
RF emissions Group 1 The Accurus® Ophthalmic Surgical System uses RF energy only for its
CISPR 11 internal function. Therefore, its RF emissions are very low and are not
likely to cause any interference in nearby electronic equipment.
RF emissions Class A Based on extensive field experience the Accurus® System is suitable for
CISPR 11 use in all establishments including domestic and those directly connected
to the public low voltage power supply network that supplies buildings
Harmonic emissions Class A used for domestic purposes.
IEC 61000-3-2
The EMC Statement provides guidance on steps to take in case of
Voltage fluctuations/ Complies electromagnetic interference.
Flicker emissions
IEC 61000-3-3
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Immunity Test IEC 60601 Test Level Compliance Level Electromagnetic Environment-Guidance
Electrical fast • ±2 kV for power • ±2 kV for power Mains power quality should be that of a typical
transient/burst supply lines supply lines commercial or hospital environment.
IEC 61000-4-4 • ±1 kV for input/ • ±1 kV for input/
output lines output lines
Note: UT is the a.c. mains voltage prior to application of the test level.
Note 1: At 80 MHz and 800 MHz, the higher frequency range applies.
Note 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from
structures, objects, and people.
a Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) and land mobile radios, amateur radio, AM and
FM radio broadcast, and TV broadcast cannot be predicted theoretically with accuracy. To access the electromagnetic environment due
to fixed RF transmitters, an electromagnetic site survey should be considered. If the measured field strength in the location in which
the Accurus® System is used exceeds the applicable RF compliance level above, the Accurus® System should be observed to verify
normal operation. If abnormal performance is observed, additional measures may be necessary, such as re-orienting or relocating the
Accurus® System.
b Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.
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Table 1-4 Recommended Separation Distances Between Portable and Mobile RF Communications
Equipment and the Accurus® Ophthalmic Surgical System - The Accurus® System is intended
for use in an electromagnetic environment in which radiated RF disturbances are controlled.
The customer or the user of the Accurus® System can help prevent electromagnetic interference
by maintaining a minimum distance between portable and mobile RF communications
equipment (transmitters) and the Accurus® System as recommended below, according to
the maximum output power of the communications equipment.
For transmitters rates at a maximum output power not listed above, the recommended separation distance d in meters (m) can
be estimated using the equation applicable to the frequency of the transmitter, where P is the maximum output power rating of the
transmitter in watts (W) according to the transmitter manufacturer.
Note 1 - At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
Note 2 - These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from
structures, objects, and people.
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CAUTION
A qualified technician must perform a visual inspection of the following
components every twelve months: warning labels, power cord, and fuses. In case of
deficiency, do not use the system; call Alcon Technical Services.
CAUTION
A qualified technician must check ground continuity and both polarities for leakage
currents every twelve months to ensure they are within the applicable standards (for
example: EN 60601-1 / IEC 60601-1). Values must be recorded and if they are above
the applicable standards, do not use the system; call Alcon Technical Services.
WARNING!
Use of accessories and cables other than those provided may result in increased
emissions or decreased immunity of the system. Portable and mobile RF communications
equipment can affect this medical electrical equipment.
If you have any questions or require additional information, please contact your local
Alcon representative or the Technical Services Department. For locations outside the
USA, please contact your local authorized Alcon Service/Sales office.
• Good clinical practice dictates the testing for adequate irrigation, aspiration flow,
and operation as applicable for each handpiece prior to entering the eye.
• Use only Alcon-supplied A.C. power cords. Prior to plugging the power cord into
its power source, ensure that the proper voltage selection has been made. See
section fifteen of this manual for instructions.
• Provide at least two feet of clearance at the rear of the unit for fan intakes and
exhausts. This ensures unrestricted air flow for adequate console cooling.
• A handle on the instrument cart is used for moving the instrument. The cart should
be pulled, not pushed, over elevator and door thresholds.
WARNING!
The Accurus® power cord is a medical grade power cord with the least leakage
current per foot rating available. Extension of the power cord by hospital staff is not
recommended. Unauthorized extension of the power cord could result in injury.
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NOTE: If an inconsistency exists between the setup instructions in this manual and
the Directions For Use (DFU) supplied with a consumable pak, follow the DFU.
Vitreous Probes
Do not operate vitreous probes in air. This could result in performance degradation
and/or potential hazard.
MPC Scissors
WARNINGS!
Use of a MPC scissors handpiece at high cut rates continuously for over 2.5
minutes can result in excessive handpiece heating. Allow the scissors to cool for
approximately 30 minutes between heavy usage of this type.
The MPC scissors output is floating with respect to grounded metal front panel
surfaces. Water, BSS Plus®, or any other conductive liquid on, or in the vicinity of,
the MPC socket can short out the floating output. Ensure that the MPC front panel
socket is dry and clean prior to using the MPC scissors.
Ultrasonic Handpieces
Power loss may occur if handpiece tip is not securely tightened into Fragmatome™*
and Phaco handpieces.
WARNING!
Use of a Phaco handpiece at power settings greater than 80% continuously for
over 4 minutes can result in ultrasonic system failure. Allow the system to cool for
8 minutes between heavy usage of this type.
If proper cleaning procedures are not performed immediately after each surgical
procedure, tissue debris and salts from irrigating solution may collect. This could
permanently damage the handpiece and could jeopardize cleanliness and/or create
biohazard conditions for the patient. Remove all debris prior to autoclaving handpiece.
CAUTION
Never ultrasonically clean the Fragmatome™* and Phaco handpieces; irrepa-
rable damage will result.
WARNINGS!
Use of the phaco handpiece in the absence of irrigation flow and/or in the presence
of reduced or lost aspiration flow can cause excessive heating and potential corneal
and/or scleral burns.
Use of the Fragmatome™* handpiece in the absence of aspiration flow can cause
excessive heating and potential scleral burns.
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Handpiece Tips
Scissors, frag, and phaco handpiece tips must be fully tightened to their handpieces. If
not secured properly, the handpieces may not operate correctly. Ensure, however, that
tips are not so tight that they cannot be removed after use. Use only Alcon supplied
fragmentation tip wrenches; otherwise, damage to tips and/or handpiece may occur.
WARNINGS!
For phaco surgery use only Alcon-certified Mackool** or Turbosonics®
MicroTip™* configurations (.9 mm). Alcon does not recommend the use of
standard Turbosonics® tips (1.0 mm or 1.1 mm) with the Accurus® system.
During any ultrasonic procedure, metal particles may result from inadvertent
touching of the ultrasonic tip with a second instrument. Another potential
source of metal particles resulting from any ultrasonic handpiece may be the
result of ultrasonic energy causing micro abrasion of the ultrasonic tip.
Diathermy Function
To ensure safe operation of the Diathermy function, use only Alcon cables and
accessories. Diathermy performance can be guaranteed only when using Alcon
Surgical components or Alcon-endorsed components. Cables should always be
positioned in such a way that contact with the patient is prevented.
WARNING!
• Do not use the diathermy function on patients with pacemakers or implanted
defibrillatory devices. If electrosurgery is used on patients with implanted cardiac
pacemakers or defibrillatory devices or pacemaker electrodes, be aware that
irreparable damage to the pacemaker or defibrillatory device and its function
may occur and lead to ventricular fibrillation. Please check with the pacemaker
or defibrillatory device manufacturers for their recommendations.
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Listed below are general precautions to be followed when using the Diathermy function:
• To ensure safe operation of the Diathermy function, only approved cables and
accessories must be used (See your Alcon representative). Diathermy performance
can be guaranteed only when using Alcon components or Alcon-endorsed
components.
• To reduce the risk of accidental burns, caution should always be taken when
operating high-frequency surgical equipment.
• Interference produced by the operation of high-frequency surgical equipment may
adversely influence the operation of other electronic equipment.
• Accessories should be checked regularly; electrode cables should particularly be
checked for possible damage to the insulation.
• The lowest power level in Diathermy step should always be selected for the
intended purpose.
• Skin-to-skin contact (for example between the arms and body of the patient)
should be avoided, for example by insertion of dry gauze.
• When HF (high frequency) surgical equipment and physiological monitoring
equipment are used simultaneously on the same patient, any monitoring electrodes
should be placed as far as possible from the surgical electrodes. Needle monitoring
electrodes are not recommended.
• In all cases, monitoring systems incorporating high frequency current-limiting
devices are recommended.
• The cables to the surgical electrodes should be positioned in such a way that
contact with the patient or other leads is avoided.
• Temporarily unused active electrodes should be stored so that they are isolated
from the patient.
• The use of flammable anaesthetics or oxidizing gases such as nitrous oxide (N2O)
and oxygen should be avoided if a surgical procedure is carried out in the region of
the thorax or the head, unless these agents are sucked away.
• Non-flammable agents should be used for cleaning and disinfection wherever possible.
• Flammable agents used for cleaning or disinfecting, or as solvents of adhesives,
should be allowed to evaporate before the application of HF surgery. Some
materials, for example cotton, wool and gauze, when saturated with oxygen may
be ignited by sparks produced in normal use of the HF surgical equipment.
Illuminator Function
Housed inside the illuminator drawer are two bulbs that provide two channels of
illumination. Two front panel sockets accept fiber optic light guides to provide
intraocular illumination. To gain access for bulb replacement or servicing, follow
directions in section eleven of this manual. Be aware that using the illuminator at high
settings (HI 1, HI 2, or HI 3) will reduce the life of the bulbs.
WARNING!
The illuminator bulbs become extremely hot. Never handle a bulb until it has
cooled considerably from its operating temperature. Do not touch bulb directly
with fingers at any time.
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Footswitch
Never pick up or move the footswitch by holding the cable. Damage may result.
Cassette
During initialization the drain pump is rotated to the home position; therefore, keep
hands and fingers clear of cassette well during power-on initialization. Manually
rotating the hub roller in the cassette well when power is on and a cassette is not
installed can cause incorrect cassette loading and/or can cause injury to fingers.
WARNINGS!
All fluids aspirated during surgery should be treated as biohazards. Take appropriate
precautions when handling instruments and lines in contact with aspirated fluids.
Drain bag volume should not exceed 500cc “Max. Capacity.” Exceeding this
volume may result in a biohazardous condition.
Consumables
Do not use consumable paks beyond the expiration date stamped on the outer
packaging. Sterile consumable medical devices should not be reused (Accreditation
Manual for Hospitals, 1982); they are intended for single use only. Improper usage
or assembly could result in a potential hazardous condition for the patient. Alcon
assumes no responsibility for complications that may arise as a result of the reuse or
improper usage of consumables.
WARNING!
Attach only Alcon supplied consumables to console and cassette luer fittings. Do
not connect consumables to the patient's intravenous connections.
In all cases, the instrument setup instructions contained in this manual, and all label
instructions in the package, should be thoroughly understood prior to using any of the
Accurus® Pak configurations.
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Consumable Paks
If any item in a consumable pak is received in a defective condition, Alcon is to be
notified immediately. Do not use any of the contents if the sterile package is damaged
or the seal is broken in any way. Paks are identified by lot number that provides
traceability and should be given to the Customer Service Department.
In the past, some of Alcon’s products have referred to the feature “Cautery” or
"Coagulation." The Accurus® system and this operator's manual use the word
“Diathermy” based on the following definitions:
Product Service
For product service, please contact Alcon’s Technical Services Department at the
number provided below.
Operators experiencing problems with the system should refer to the Operating
Instructions and Troubleshooting sections of this manual. A problem which persists
should be referred to the Alcon Technical Services Department or your local
authorized service representative.
Safety performance should be verified by the user (e.g., qualified service personnel) at
least twice a year. Ground resistance must be under 0.1 ohms. Leakage current must
be under 75 µA (for 90 to 132 VAC, 60 Hz operation) and under 390 µA (for 198 to
264 VAC, 50/60 Hz operation).
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Limited Warranty
Alcon Laboratories, Inc., will repair or replace at its option, any system or
accompanying accessories found to be defective in material and/or workmanship for a
period of one (1) year from the date of initial installation. This warranty applies to the
original purchaser of the system, when said system is properly installed, maintained,
and operated in accordance with published instructions.
Alcon Laboratories shall not be obligated to provide services under this warranty for
damage to or destruction of systems covered where such damage or destruction is (i)
a result of or caused by fire or explosion of any origin, riot, civil commotion, aircraft,
war, or any Act of God including, but not limited to lightning, windstorm, hail,
flood, earthquake, or (ii) caused by customer’s misuse or improper servicing of said
systems.
The express warranty above is the sole warranty obligation of Alcon, and the
remedy provided above is in lieu of any and all other remedies. There are no
other agreements, guarantees, or warranties — oral or written, express or implied
— including without limitation warranty of merchantability or fitness for a particular
purpose. Alcon shall have no liability whatsoever for any incidental or consequential
damages arising out of any defect, improper use, or unauthorized service or repair.
WARNING!
The disposables used in conjunction with Alcon instrument products constitute
a complete surgical system. Use of disposables and handpieces other than those
manufactured by Alcon may affect system performance and create potential hazards.
If it is determined that disposables or handpieces not manufactured by Alcon have
contributed to the malfunction of the equipment during warranty period, service will
be provided at prevailing hourly rates.
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CONSOLE FOOTSWITCH
DIMENSIONS: DIMENSIONS:
Height: 50.8 cm (20.0 inches) Height: 14.0 cm (5.50 inches)
Width: 48.3 cm (19.0 inches) Width: 22.9 cm (9.00 inches)
Depth: 52.1 cm (20.5 inches) Depth: 43.2 cm (17.0 inches)
100-120 Vac 50/60 Hz 10 A max. Fuse: T 10 A / 250 V slow blow ENVIRONMENTAL LIMITATIONS:
220-240 Vac 50/60 Hz 6 A max. Fuse: T 5 A / 250 V slow blow Operating Temperature: 10° C – 40° C (50° F – 104° F)
Relative Humidity: 30% – 75%, non-condensing
PERFORMANCE SPECIFICATIONS
VITRECTOMY: TIMER:
Submodes: Proportional Vacuum, Momentary Cut†, Range: 0 to 99 h
3D Proportional Resolution: 1s
Accurus® Probe: 100 to 800 cpm
Accurus 1500 Probe: 100 to 1500 cpm
® TONE VOLUMES @ 1 Meter:
Accurus® 2500 Probe: 100 to 2500 cpm Errors/Faults/Invalid Key: 40 to 65 dB, short tones
InnoVit® Probe: 100 to 1800 cpm Diathermy: 40 to 65 dB, continuous tone
†
1 cpm is available in Momentary Cut submode Advisory/Timer Expire/Elev Infusion: 0 to 65 dB, short tones
Frag/Phaco/Vacuum: 0 to 65 dB, continuous tone
FRAGMENTATION: Valid Key: Factory set and not adjustable
Submodes: Linear, Momentary, Fixed, 3D Volume Accuracy: 6 dB
Tip Stroke @ 100%: 78.7 ±10.2 µm (.0031 ±.0005 in.)
Resonant Frequency: 39.0 ± 1.9 KHz VOICE CONFIRMATION: 0 to 65 dB
Pulse Rate Range: 0-15 pps
REMOTE CONTROL:
SCISSORS: Method: Infrared
Submodes: Proportional, Multiple Cut, MPC Channels: 4
Proportional Pressure: 3.5 to 275.8 KPascal (0.5 to 40 psi)
Multi Cut Rate: single cut to 300 cpm POWER IV POLE:
MPC Cut Rate: single cut to 450 cpm Pressure Ranges: 5 - 85 ±3 mmHg
Pole Speed: 8.0 cm/s (3.1 inches/second)
Table 1-5 ACCURUS® OPHTHALMIC SURGICAL SYSTEM SPECIFICATIONS - This table is a quick reference
point to identify system specifications, system requirements, and performance figures.
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BSS Plus® Balanced Salt Solution enriched with bicarbonate, dextrose, and glutathione.
Detent A discrete footpedal position at which more force is required to depress the footpedal to
the next position.
Diathermy The production of heat in body tissues by electric current for therapeutic purposes.
Frag Fragmentation.
Global Function A function whose status and controls are independent of the current footpedal position
and surgery mode.
Highlighted To center attention by video reversing the function key and changing the key color from
gray to blue.
I/A Irrigation/Aspiration.
IV Intravenous.
PEL Patient Eye Level. A difference in height between the cassette and the patient eye level.
U/S Ultrasound.
Table 1-6 TERMS AND ABBREVIATIONS - Terms and abbreviations used with the Accurus® system are
defined in this table.
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!
Caution, or
Irrigation/Aspiration System Error (yellow), or Equipotentiality
System Advisory (green)
Clean
Type BF Equipment Cassette Eject
Settings
Type B Equipment Illuminator Eject
Exit
PC CARD Flash Card Slot Hot
Combined Surgery
Anterior U/S-Fixed
Serial In/Out U/S non-continuous use symbol:
greater than 80% power
4 minutes on, 8 minutes off
Use appropriate take-back NRTL TUV mark with
system. (see Environ- respect to electrical shock, MPC Scissors
mental Considerations MPC non-continuous use symbol:
in this manual) fire, and mechanical 2.5 minutes on, 30 minutes off
hazards only in accordance
to UL 60601-1, CSA 22.2
Infusion
601-1, IEC 60601-1-2 and
IEC 60601-2-2.
Figure 1-2 ICONS USED WITH THE ACCURUS® OPHTHALMIC SURGICAL SYSTEM - Icons identifying modes,
functions, etc., that are used with the Accurus® system are identified in this chart.
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SERIAL IN/OUT
UPGRADE CONNECTORS LABEL
PC CARD
FLASH CARD INSERTION SLOT LABEL
!
®
ACCURUS NAMEPLATE LABEL (1/2 SCALE)
90 - 120 Psi
(620 - 825 kPa)
AIR PRESSURE INPUT LABEL FOOTSWITCH CONNECTOR LABEL I/V POLE CONNECTOR LABEL
SURGICAL ACCURUS®
202-1499-001 REV. __
MADE IN U.S.A.
100-120V T10A/250V
220/230-240V T5A/250V
REPLACEMENT BULB
Figure 1-3 LABELING USED ON THE ACCURUS® OPHTHALMIC SURGICAL SYSTEM - Labels used on the
Accurus® console are identified and illustrated here.
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25.0
15.0
10.0
5.0
0.0
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
25.0
15.0
10.0
5.0
0.0
10 100 1000
LOAD (LOG OHMS)
Figure 1-5 DIATHERMY POWER VS. LOAD IMPEDANCE
140
120
OUTPUT PEAK VOLTAGE
100
80
60
40
20
00
00 20 40 60 80 100
OUTPUT CONTROL SETTING
Figure 1-6 DIATHERMY OUTPUT VOLTAGE VS. OUTPUT CONTROL SETTING
Note: Maximum output peak-to-peak voltage is about 140V without resistive load.
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Cut Rate Max Limit Red Vacuum Max Limit Inject Max Limit
ucin
g C
ut R Extrude Max Limit
ate
e
ur m
ss uu
re ac
g P g V
um sin sin
acu ea ea
ing V cr cr
eas In In
Incr
uu
m U/S Power Max Limit uu
m U/S Power Max Limit
ac wer ac wer
g V /S Po g V /S Po
sin sin g U sin sin g U
ea rea ea rea
cr Inc cr Inc
In In
Irrigation ON
Figure 1-7 FOOTPEDAL OPERATION WHEN CONTROLLING MORE THAN ONE PROPORTIONAL
FUNCTION - The footpedal controls different system functions as it is depressed in proportional
modes of operation.
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REFERENCE
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SECTION TWO
GENERAL DESCRIPTION
The Accurus® Ophthalmic Surgical System is a multifunctional surgical tool for use in
anterior and posterior segment ophthalmic surgeries. Its capabilities include driving a
variety of probes and handpieces which provide the ability to cut vitreous and tissues,
emulsify the lens, illuminate the posterior segment of the eye, and apply diathermy to
stop bleeding. Vacuum is used to remove ocular matter from the eye, and is provided
by connecting tubing from the handpiece to a port on the fluidics cassette. Infusion or
irrigation capability is provided to replace fluid in the eye, and enters the eye either
directly via an infusion cannula or flows through a handpiece. The operator controls
console functions using the graphical user interface screen, front panel keys, wireless
remote, and footswitch. The Accurus® console is shown in Figure 2-1.
SURGICAL
Figure 2-1. THE ACCURUS® CONSOLE - The Accurus® console, shown here without accessories attached, houses
the mechanical, electrical, and pneumatic drive functions which power the connected accessories for
ophthalmic surgery. The controlling software and firmware reside inside the console, and overall system
coordination and hazard mitigation is centralized to the console. This illustration is representative of the
800CS, 600DS, 400VS, and 300VS models. The 200PS model is identical except the illuminator drawer
is removed.
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The front panel of the Accurus® system is a multifunctional user interface that allows
user control of most system functions. The descriptions of the front panel components
are coded to match the illustration in Figure 2-2, which is a helpful reference while
learning the system's functions.
1. Global Functions
The global functions area of the system is located at the top-left portion of the
front panel. Global functions can be used any time and in any mode. Its three
major components are described below.
The Diathermy global function is always enabled for footswitch activation, and
its LED readout is always lit; its icon key illuminates bright blue when activated.
Cassettes used with the Accurus® system convert vacuum generated by the
console into aspiration/extrusion, and collect the aspirated fluid into a small,
rigid, collection chamber. The collection chamber is continuously drained into
a sealed drain bag, hanging from the front of the cassette. The cassette's design
allows it to be removed from the console without spilling the collected fluids.
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SURGICAL
Irrigation In Port
5. Eject Button
! Illuminator Receptacles
Illuminator Adaptors
8. Standby Switch
Drain Bag
!
9. Speaker
Figure 2-2. THE ACCURUS® FRONT PANEL (Depicted: 300VS, 400VS, 600DS, 800CS) - The front panel consists
of five three-character, seven-segment LED displays; five sets of membrane up/down arrow keys;
a color LCD with touchscreen; a cassette eject button; two cassette port LED's; up to twelve
handpiece/probe connectors; an illuminator drawer with two illuminator ports; and a power On/
Off standby switch. Three cassettes are available for use with the Accurus® system; the anterior
cassette is shown in this illustration. NOTE: Item 7 (Illuminator Drawer) is removed in the 200PS
model.
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5. Eject Button
Pressing the Eject button, located to the left of the cassette, releases the latch
that secures the cassette within its receptacle, allowing removal of the cassette.
This button is active when the system is supplied with air pressure, but is invalid
when vacuum is activated or system power is turned OFF. The cassette will not
load or unload if MPC scissors are activated.
WARNING!
Connect only Alcon supplied consumables to console/cassette connectors. Do not connect
consumables to patient intravenous connections.
Connector LED's
There are twelve LED's located next to their respective connectors on the front
of the console. These LED's have dual functions:
• During surgery setup, when the operator selects a probe, handpiece or
accessory, the corresponding LED illuminates to guide the operator to the
correct connector.
• During surgery these LED's are used to indicate which connectors are active.
!
PNEUMATIC ELECTRICAL
CONNECTORS CONNECTORS
Figure 2-3. FRONT PANEL PNEUMATIC AND ELECTRICAL CONNECTORS, WITH CONNECTOR LED'S
(Depicted: 300VS, 400VS, 600DS, 800CS)
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7. Illuminator Drawer
The illuminator drawer contains bulbs, mirrors, and lenses to direct high intensity
light to fiber optic illumination probes. Pushing the illuminator release button on
the rear panel ejects the drawer from its slot (see Figure 2-4). When the illuminator
drawer is ejected, both illuminators turn off, allowing the user to replace burnt
bulbs. The bulbs only illuminate when the drawer is fully inserted into its slot.
• Illuminator Receptacles - Illuminator receptacles accept Intralux connectors.
• Illuminator Adaptors - Tethered ACMI adaptors are used to adapt Alcon
illumination probes to the illuminator receptacles.
8. Standby Switch
This switch is used to turn internal DC power ON and OFF, usually between
surgeries. Use the Main Power Switch (see Figure 2-4) to fully shut down the
system for extended periods of time (overnight) to reduce power consumption
and/or eliminate unnecessary operation of the Accurus® Power Supply.
9. Speaker
Voice confirmations and tones are emitted from the speaker, hidden behind the
front panel grill, to audibly alert operator to system operating status (see Table 2-1).
TONE DESCRIPTION
Alternate infusion/irrigation Single or double periodic tone, used when alternate irrigation/infusion
pressure enable/disable; pressure is enabled or disabled, and in the posterior domain when the
Alternate infusion alarm infusion pressure is greater than or equal to 51 mmHg.
Fault, Error, Advisory Single tone when system fault, error, or advisory is first displayed. The
advisory tone is unique from the error/fault tone.
Invalid key Single tone for an invalid touchscreen key or membrane button press,
including attempts to go beyond parameter limits.
Valid key Single tone for a valid touchscreen key or membrane button press.
Timer expire Single tone when count down timer has expired.
Table 2-1. VOICES/TONES AND THEIR DESCRIPTIONS - Voice and tone volumes, set at the
factory, can be adjusted in any screen where the Options key is available (in the Options/Volume
screen, or Options/Memory/Common/Sound screen). The Fault, Error, Diathermy, and Invalid
Key tones can not be lowered below a minimum value; all other adjustable tones can be turned
completely off. If the Voice volume level is set to zero, then tones are used for infusion changes
and when turning the vitreous cutter and fragmentation power on/off.
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The rear panel of the Accurus® system contains a variety of components. The
descriptions of the rear panel components are coded to match the illustration in Figure
2-4, which is a helpful reference while learning the system's functions.
1. PC Card Slot
The PC Card Slot is used to export and import doctors memories via a Doctor
Memory Card, or to install system software upgrades (if required). The memory
cards used for these functions are inserted into the slot and pushed in until it is
firmly in place and the eject button is pushed out. Pushing the eject button will
eject the card out of the slot.
2. Illuminator Exhaust Grate (not included with 200PS system)
Warm air is expelled from the Accurus® console through this grate. An internal
fan draws air past the illuminator components, keeping them cool for longer life.
For proper cooling at least two feet of clearance must be provided at the rear of
the unit to ensure unrestricted air flow.
SERIAL IN/OUT
PC CARD
4A. Selectable
Power Supply
! 5. Manual Cassette Ejector
Main Power Switch 90 - 120 Psi
(620 - 825 kPa)
Fuse Carriers
Figure 2-4. THE ACCURUS® REAR PANEL - The rear panel consists of a variety of components for functional
use and connection of accessories. Included are a PC slot, air input and exhaust grates, an
illuminator ejector button (800CS, 600DS, 400VS, 300VS only), a cassette ejector, a compressed air
connector, a footswitch connector, and a power supply.
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4A. Selectable Power Supply with Main Power Switch, Power Input Connector,
Fuse Module, Equal Potentiality Lug, and Power Supply Exhaust Grate
The Main Power Switch is used to fully shut down the system for extended periods
of time (overnight) to reduce power consumption and/or eliminate unnecessary
operation of the Accurus® Power Supply. The Power Input Connector accepts main
power input from external electrical power source. The Fuse Module contains
the fuse drawer and fuses, as well as the voltage selector box. (See section fifteen
of this manual for fuse replacement and voltage selection.) The Equal Potentiality
Lug is for Service personnel use, and also for equipotential equipment connection.
Warm air is expelled from the Power Supply Exhaust Grate.
4B. Auto Ranging Power Supply with Main Power Switch, Power Input Connector,
two Fuse Holders, Equal Potentiality Lug, and Power Supply Exhaust Vent.
The Main Power Switch is used to fully shut down the system for extended
periods of time (overnight) to reduce power consumption and/or eliminate
unnecessary operation of the Accurus® Power Supply. The Power Input
Connector accepts main power input from external electrical power source.
(The power supply selects correct voltage automatically.) The Fuse Holders
contain two fuses. (See section fifteen of this manual for fuse replacement.) The
Equal Potentiality Lug is for Service personnel use, and also for equipotential
equipment connection. Warm air is expelled from the Power Supply Exhaust Vent.
9. Footswitch Connector
For connecting the footswitch cable to the Accurus® console.
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FOOTSWITCH
Functional operations to the Accurus® console are accepted from a footswitch. The
footswitch consists of a footpedal, left and right horizontal/vertical switches, and
left and right heel switches (see Figure 2-5). Functions controlled by the footswitch
are listed in tables located in sections three, seven, and eleven of this manual. Some
footswitch functions are programmable in the Options/Memory/Common/Footswitch
screen.
Right and left switches are used to enable and disable system functions. The switches
are nudged sideways (horizontal) for some functions, and pressed down (vertical) for
others.
A tension adjustment knob, located on the front of the footswitch, is used to regulate
the pressure needed to depress the footpedal. Additionally, the footpedal must be
pressed through detents to enter into new anterior and posterior mode positions. The
detent force levels are programmable in the Options/Memory/Common/Other screen
for phaco.
Footpedal
Figure 2-5. FOOTSWITCH - The footswitch is used to operate functions on the Accurus® system.
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out from the other buttons; this helps ensure that Figure 2-6. WIRELESS REMOTE CONTROL - Most of
a selection is not accidentally pressed. the functions of the wireless remote control are the same
as those on the console.
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Power Up Screen
The power-up initialization cycle lasts approximately two minutes. After the first ten
seconds of this cycle, the Power Up Screen is displayed while the system completes
initialization and self-test diagnostics (see Figure 2-7). All operator inputs are locked
out at this time. After self-test diagnostics the 200PS, 300VS, and 400VS systems
enter either the Posterior or Anterior domain of operation.
WARNING!
During initialization the drain pump is rotated to its home position. Therefore,
keep hands and fingers clear of cassette well during power-on initialization. After
initialization, do not manually turn hub roller. Finger pinch and/or improper cassette
installation can occur.
The 800CS and 600DS systems contain both Posterior and Anterior functionality, so
after the power-up initialization cycle one of the following can occur:
• The Procedure Selection Screen appears, allowing entry into either the Anterior,
Posterior, or the 800CS Combined domain (see Figure 2-8). The Procedure
Selection Screen also appears when the Exit key is pressed from a Surgery Setup
Screen.
When a new domain is entered, all settings are reset to their default values.
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®®
Figure 2-7. POWER UP SCREEN - After the first 10 seconds of the Power-Up Initialization cycle the Power Up Screen
is displayed while the system completes initialization and self-test diagnostics. No operator inputs are
allowed at this time.
Procedure Selection
Anterior
Posterior
Combined
Figure 2-8. PROCEDURE SELECTION SCREEN (600DS and 800CS only. 800CS screen shown) - The Procedure
Selection Screen is displayed after system initialization or when the Exit key is pressed from either the
Posterior, Anterior, or Combined Surgery Setup Screen. Pressing the Anterior, Posterior, or Combined
key on the touch screen quits this screen and brings up either the anterior, posterior, or combined
Surgery Setup Screen.
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The LCD display and touch screen is divided into eight windows, shown below
in Figure 2-9. Descriptions of the windows and their functions are written on the
following pages.
1. Modes Window
2. Global Functions Window
3. Title
4. Doctor Name
5. Memory Name
6. Miscellaneous Window
7. Primary Functions Window
8. Popup window
5. Memory Name
4. Doctor Name
3. Title
6. Miscellaneous Window
8. Popup Window
1. Modes Window
Figure 2-9. LCD DISPLAY AND TOUCH SCREEN - The color display screen for the Accurus® system displays modes
of operation and operating parameters, and also is used for operator input by pressing the touch keys
on the screen. This screen is the operator's main tool to input system commands. Operator input is
also received from the remote control and the footswitch.
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1. Modes Window
This window displays touch keys and their corresponding icons. There are two kinds
of keys displayed in this window: Setup Function keys and Mode keys, depending
on whether the screen is displaying its Setup Screen or its Surgery Screen. The Mode
keys are animated when selected. Figures 2-10 and 2-11 show the two screens.
Figure 2-10. SETUP FUNCTION SELECTIONS IN MODES WINDOW - This section of the display
screen offers either setup function selections or surgical mode selections in the modes window.
This illustration shows posterior setup function selections; the anterior setup function selections
are similar.
Figure 2-11. SURGICAL MODE SELECTIONS IN MODES WINDOW - This illustration shows
posterior surgical mode selections in the modes window; the anterior mode selections are similar.
The mode keys are animated when selected—in this case the system is set in Vit mode for use with
proportional vacuum.
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Global functions are available in all setup and surgery screens, regardless of system
status or footpedal position (see Figure 2-12). Functions are turned ON and OFF
via their icon keys, and their parameter values are adjusted by pressing the global
function up/down adjustment buttons. When turned ON, some global functions can be
affected from the footswitch.
The Diathermy global function icon key is always enabled for footswitch activation,
and its LED readout is always lit; its icon key illuminates bright blue when diathermy
is activated.
Global functions may be used in combination with other global functions. Selecting or
deselecting one function does not affect the others, with one exception: when VGFI™*
infusion is used, selecting Fluid/Air Exchange deselects Infusion; the reverse is also true.
Listed in the table below are the distinctions between global function icons when they
are turned ON and OFF, and what the ON/OFF conditions mean. Descriptions of the
global functions are located in sections three, seven, and eleven of this manual.
Table 2-2. GLOBAL FUNCTIONS KEYS - Icon/base keys in the Global Functions window are
pressed to turn global functions ON and OFF. The ON/OFF status is listed in this table. (The diathermy
global function icon key is always enabled for footswitch activation, and does not adhere to these
on/off conditions.)
Figure 2-12. GLOBAL FUNCTIONS WINDOW - Global functions are available in setup and surgery
screens. In this illustration illuminator 1 is turned on, indicated by the illuminated icon and bright
blue base.
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3. Title
This window displays the current setup, surgery modes, and submodes.
Figure 2-13. TITLE WINDOW - This window shows the current mode of operation.
4. Doctor Name
Figure 2-14. DOCTOR NAME WINDOW - This window shows the current doctor name and the
doctor names drop down arrow key.
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5. Memory Name
This window is used to display the current selected memory name. If the current
settings have been modified from the saved settings, the name text will be colored
blue.
Figure 2-15. DOCTOR MEMORY WINDOW - This window shows the current doctor memory in
use and the doctor memory drop down arrow key.
6. Miscellaneous Window
The Timer Display, Footswitch icon, and Options key are all located in this window
(see Figure 2-16). These three features are described below.
• Timer Display
Two Timer Displays can appear in the upper right hand corner of the Surgery Screens
and Setup Screens whenever a timer is activated:
General Purpose Timer - This timer appears after being activated in the Options
selections. This timer has a blue background, and is activated manually to count
either up from zero, or down from a pre-selected value (see the Timer in the
Options Functions on pages 2.19 and 2.38).
Elevated Infusion Timer - This timer with the yellow background appears in place
of the footswitch icon, and it automatically begins counting up from zero when
posterior infusion pressure is greater than or equal to 51 mmHg. It stops counting
when pressure goes below 51 mmHg, then begins from zero again each time
pressure is 51 mmHg or greater. Pressing the timer display when pressure is less
than 51 mmHg removes it from the screen, but it reappears and begins counting
from zero again when the pressure returns to 51 mmHg or greater.
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• Footswitch Icon
When the footswitch is activated this icon changes color. For footpedal activation it
progressively displays 1, 2, and 3 in its center to represent the amount of footpedal
depression through its detents; when released it displays 0. When the left and right
footswitches are pressed the icons at each side change color to indicate activation.
A small letter A, B, C, or D at the bottom of the icon indicates which footswitch map
is used. If the map has been modified from the default settings, the map letter will be
followed by the prime symbol i.e., A'. Pressing the icon displays a window that shows
the current footswitch mapping.
Figure 2-16. MISCELLANEOUS WINDOW - This window contains three items: the Timer Display
(when activated), Footswitch icon, and Options key.
• Options Key
Pressing the Options key presents a drop down menu of selections that offer the user a
variety of helpful tools (the selections are described beginning on page 2-19).
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The Primary Display window is used to select setup options in the Setup Screens, and
to adjust/view operating parameters in the Surgery Screens. The operating parameters
in the Vitrectomy Proportional Vacuum Surgery Screen are shown below.
Figure 2-17. PRIMARY DISPLAY WINDOW - This window is used to set up and adjust operating
parameters, and to view actuals.
8. Popup Window
This window is used to indicate system errors, advisories, and other messages to the
user. When a popup window appears, only the keys inside the popup window and
the Global Function keys not related to the popup window are available. For a list of
system messages turn to section sixteen of this manual.
Figure 2-18. POPUP WINDOW - Information popups communicate with the user, typically to
confirm a critical operator request or to provide status. The popup window disappears when the
action is completed, or when the operator presses a popup key to acknowledge the message.
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OPTIONS FUNCTIONS
The Options key and its functions are accessible in all screens except the Doctor Memory
screens and Irrigation/Infusion Settings screens. A drop down menu is displayed when
the Options key is pressed (see Figure below). The functions in this drop-down menu
consist of Quick Save, Memory, Volume, Timer, Metrics, Vit Probe, Test, System,
Standby, and About. Pressing any of the buttons in the drop-down menu displays its
associated pop-up window or display screen.
Options Key
1.
2.
3.
4.
5.
Drop-Down Menu
6.
7.
8.
9.
10.
Figure 2-19. OPTIONS DROP DOWN MENU - Pressing the Options key, located in the upper right
corner of the screen, activates a drop down menu offering ten choices. Pressing one of the choices
activates a screen or window for the choice selected.
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1. Quick Save
The Quick Save pop-up window allows the current mode settings or all mode settings
to be saved into a doctor memory. For anterior or posterior domains, the pop-up
window contains two drop downs for Dr. Name and Memory; for the combined
domain the pop-up window includes Memory drop downs for anterior and posterior.
Figure 2-20. QUICK SAVE POPUP WINDOW - Pressing the Quick Save key activates a small popup
window. Doctor and memory number to be written to are chosen on this window before saving.
The doctor name drop down in the Quick Save pop-up selects the doctor name the
settings will be saved to. Pressing the Doctor Name displays a drop-down list of
other current doctor names. Pressing the up/down arrows to the right of the drop-
down list allows scrolling through the list of names. Pressing a doctor name causes
it to be selected, the drop-down list to disappear, and the selected doctor name to be
displayed as the “save-to” doctor name.
The memory drop down is used to select a doctor’s memory location to save the
settings to. Pressing the down arrow to the right of the setting displays a drop-
down list of the five memory locations. Pressing the up/down arrows to the right of
the drop-down list allows scrolling through the list of memory locations. Pressing
a memory location causes it to be selected, the drop-down to disappear, and the
selected memory location to be displayed as the “save-to” memory location. (For
the combined domain there are two memory location settings to select from, anterior
memory or posterior memory).
Pressing the Save All key saves all the selected doctor’s parameters (the one-per-
memory-location parameters) for the current domain. Pressing the Save Mode
key saves the settings in the active screen to the selected doctor memory location.
Pressing Cancel returns to the previous screen without saving anything to memory.
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• The listing of available doctor names and memories is displayed by pressing their
associated drop-down keys. A doctor memory is retrieved when a new doctor name or
memory cell is selected in the “Retrieve From” box. The parameters of the retrieved
memory are displayed on the doctor memory screens. When a new doctor name is
selected, memory location one is retrieved.
• The name of the currently selected doctor and memory number or name are displayed
in all surgery and setup screens except the Irrigation/Infusion Settings screens. The
memory number or name is displayed in a different color when a value has been
changed from what is stored in that memory.
• A Personal Identification Number (PIN) can be added, which will then be required
when saving, editing, or deleting that doctor memory.
• The user is allowed to modify, remove, and add a PIN. The entry of the current PIN
is required for a modification or removal operation.
• The user is allowed to copy from one doctor memory (retrieve from) to another
doctor memory (save to).
• When the Exit key is pressed after a setting is changed, a popup is displayed to allow
the user to apply the settings in the memory screen to the system. This only happens
when changes are made to the memory screen.
• When leaving the Anterior, Posterior, or Common memory screen to go to another
memory screen after a parameter is changed, a popup is displayed to allow saving the
new settings.
• A different surgical state or domain cannot be entered from doctor memory screens.
Settings for both domains can be viewed, and memories can be altered, but the mode from
which doctor memory is entered is always the mode returned to when Exit is pressed.
• Parameter settings changed from what is currently stored in memory are displayed in
a different color.
• Pressing the Defaults key on a doctor memory screen resets all displayed settings
back to the factory default values. Pressing the Current key replaces all displayed
values with the current system values.
• Pressing the Save key in the Anterior or Posterior tab saves the domain's parameter
values to the doctor and memory number identified in the “Save To” box. Pressing the
Save key in the Common tab saves the doctor common parameters (the one per doctor
memory set) to the doctor identified in the "Save To" box. If this doctor memory is
protected by a PIN, a popup appears and the PIN must be entered before the save
operation is completed; otherwise, if the doctor memory is not protected by a PIN, a
confirmation popup appears to confirm the save operation.
• If a setting is changed, pressing the Exit key displays a popup asking the operator if
the new settings should be applied to the system. After answering, the system returns
to the mode from which doctor memory was entered.
• Settings may be Exported/Imported via a PCMCIA memory card.
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Table 2-3. DOCTOR MEMORY AND DATA TABS - Data groups are accessed by pressing
tabs under the Anterior, Posterior, Common, or Doctors memory domains.
Memory Domains
Data Tabs
Figure 2-21. DOCTOR MEMORY SURGICAL PARAMETERS - This display screen is typical of
the doctor memory tabs. In this case the Greg West doctor memory is being set in the Anterior
memory domain, under the Phaco data tab. If the Save key is pressed now, the new data will
replace the old Greg West data. If the Save To name or memory number is changed, the new
data will be saved to the newly-selected location.
The top section of the screen displays a set of tabs that are used to move between
these data groups. For example, in Anterior, to see parameters corresponding to the
Phaco function, the user simply presses the Phaco tab. Similarly, to see the other
parameters, press the I/A, Vit, Irrigation, or Other tab. The subsequent sections define
the contents of each tab group.
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Vit Tab
Selecting the Vit tab presents four selectable
probe types. The four probe type buttons
are mutually exclusive, with only one being
active at a time. Pressing a probe button
causes it to become the active setting. When
a probe is active, the values displayed below
it are for that probe type only. If Accurus®
or Accurus® 2500 is the selected probe, both
the Wet and Dry settings are displayed. If
Accurus® 1500 or InnoVit® is the selected
probe, only the Wet group is displayed.
Figure 2-24. ANTERIOR VIT TAB DATA
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Vit Tab
Selecting the Vit tab presents four selectable probe types. The four probe type buttons
are mutually exclusive, with only one being active at a time. Pressing a probe button
causes it to become the active setting. When a probe is active, the values displayed below
it are for that probe type only.
Vit Tab: Proportional Vacuum - This group
contains values for maximum Vacuum level
and Cut Rate.
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The tone and voice volume for high infusion are both controlled by the Infusion Alarm
volume setting. For all other parameters, voice volume is controlled by the Voice volume
setting while tone volumes are set individually by each associated setting.
Most volume levels may be set to one of twenty levels. These are 0% of maximum
volume (muted), 5% of maximum, 10% of maximum, and on up to 100% of maximum.
(Note: Invalid key, Diathermy, and Error can only be adjusted between 20% and 100%
of maximum volume.)
Adjustments can be made to all values simultaneously by pressing the Master Override
button. Pressing this button causes the master override function to become active, and
all values may then be increased or decreased by pressing its volume arrow keys.
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Footswitch Tab
The Footswitch tab is divided into four groups/functions: Map, Domain, Swap button,
and Footswitch Map. This tab allows the operator to custom program the footswitch
functions to conform to his own preferences. Factory default settings are listed in
tables in sections seven, eleven, and fifteen of this manual.
Map
Footswitch Map
Domain
Swap Button
Footswitch Tab: Map - This selection allows the operator to select footswitch map A, B,
C, or D. Each map name corresponds to a different footswitch setup. In maps A and C,
five of the switches have preset functions, while the function of the left heel switch is
programmable and can be selected from a drop-down list. In map B, four of the switch
functions have preset functions, while the two heel switch functions are programmable.
In map D, five of the switches have preset functions, while the right vertical switch is
programmable.
Pressing the down arrow to the right of the map name presents a drop-down list with
map names A, B, C, and D. Selecting one of the map names causes it to be displayed,
and its corresponding functions to be displayed on the footswitch map.
Footswitch Tab: Domain - Here the operator can select either the anterior or posterior
domain's footswitch settings. Selecting one of the domains allows selection of the
programmable functions (functions nominally assigned to the heel switches) for that
domain.
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Footswitch Tab: Swap button - Pressing this button activates the swap feature (see
Figure 2-36). The six switches are displayed with the same functions as in the
previous screen. Pressing the down arrow to the right of one of the function names
presents a drop-down list of the six functions. Selecting a new function for that switch
swaps it with the switch that previously had that function.
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Other Tab: Default Vit Handpiece - This group allows the user to select one-of-four
default vit handpieces.
Other Tab: Display Brightness - The user can adjust the brightness of the LCD
display.
Other Tab: Treadle Firmness - The user can adjust the firmness of the footpedal to either
Hard, Medium, or Soft.
Other Tab: Heelswitch Activation - Provides
the user with the option of selecting single-
click or double-click activation of all
heelswitch functions. Single-click is the
default setting.
Other Tab: Vit Cut-off Vacuum - Allows
the user to enable or disable the cut-off
max vacuum parameter. When enabled, an
additional parameter adjustment is visible
on the surgery screen that allows for a max
vacuum setting when the cutter is turned off. Figure 2-42. COMMON OTHER TAB DATA.
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To add a character, press the applicable key. Capital letters may be entered by first
pressing the Lock key or Shift key (single capital letter). Special characters may be
entered by first pressing the letter, then pressing the special character key (for example:
ñ may be entered by pressing the n key and then pressing the ˜ key). Pressing the Save
button saves the inputted doctor name to memory. Pressing the Cancel button results in
no changes to memory.
If the selected doctor’s name is not PIN protected, pressing the Delete button will result
in a confirmation popup being displayed before the doctor name can be deleted from
the list. If the selected doctor’s name is PIN protected, pressing the Delete button will
result in a PIN popup window being displayed. The PIN popup window functions are
described on the next page.
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Pressing the Modify button presents the PIN window. The display line contains “Enter
current PIN.” Input the numbers and press the Enter button; the display line will change
to “Enter a new four digit PIN.” Input your secret numbers, and press the Enter button;
the display line will change to “Enter new PIN again.” Input the numbers again and
press the Enter button.
Pressing the Delete button presents the PIN window. The display line contains “Enter
current PIN.” Input the numbers, and press the Enter button to delete the PIN.
Import Tab: Copy to System - This group
displays a scrollable list of all doctors
contained on the PCMCIA memory card
that may be imported to the system memory.
Doctors may be selected by pressing on
the name on the list. If a selected doctor is
already saved to the system memory, a dialog
box will appear that asks whether or not the
doctor should be overwritten with the doctor
contained on the memory card.
PIN protected doctors can be copied to and Figure 2-46. IMPORT TAB WINDOW.
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Import Tab: Selection - Pressing the All button selects all names on the list while pressing
the None button deselects all names. Within the selection box, the system also indicates
the number of available memory slots on the system.
Import Tab: Import Button - Pressing the Import button imports the selected doctors
from the memory card to the system memory.
Export Tab: Selection - Pressing the All button selects all names on the list while pressing
the None button deselects all names. Within the selection box, the system also indicates
the number of available memory slots on the memory card.
Export Tab: Export Button - Pressing the Export button exports the selected doctors
from the system memory to the memory card.
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3. Volume
The Options/Volume key allows adjustments to be made to various tone and voice
volumes. Volume values may be adjusted for the following: elevated Infusion Alarm,
Diathermy is active, Error messages, Invalid Key presses, Voice confirmation,
Vacuum is active, U/S is active, and Auxiliary.
Figure 2-49. SOUND VOLUMES POPUP - This popup window allows the user to set tone and
voice volume preferences. The settings take effect after pressing the Done key.
Most volume levels may be set to one of twenty levels. These are 0% of maximum
volume (muted), 5% of maximum, 10% of maximum, and on up to 100% of maximum.
(Note: Invalid key, Diathermy, and Error can only be adjusted between 20% and 100%
of maximum volume.)
Adjustments can be made to all values simultaneously by pressing the Master Override
button. Pressing this button causes the master override function to become active, and
all values may then be increased or decreased by pressing its volume arrow keys.
Pressing the Done button results in the Sound Volumes pop-up window being removed
and the previous screen being displayed, with any volume adjustments being in effect.
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4. Timer
The Options/Timer key allows the user to program a general purpose timer. When
activated, the timer display appears in the upper-right corner of the surgery and
surgery setup screens, next to the footswitch icon (see Figure 2-9).
Figure 2-50. TIMER POPUP - This timer popup window allows the user to program a count up or
count down timer, displayed next to the footswitch icon in the upper-right corner of the screen.
When the Timer key is pressed, a popup window appears for entering the timer value
in hh:mm:ss format. Pressing the Start key without entering a timer value removes the
popup and the timer display begins counting up from zero. If the Start key is pressed
after a value is entered, the popup disappears and the timer display begins counting
down, emitting an audible beep when it reaches zero.
The timer popup is removed when the Cancel key is pressed. The timer value is
cleared when the Clear key is pressed. If a new timer is started when another one
is counting, the new timer value replaces the existing one. The timer is stopped and
removed from the screen when the Timer Display is pressed.
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5. Metrics
Pressing the Options/Metrics key allows the user to view applicable data, by domain,
in a pop-up window. Pressing the Reset button resets the currently displayed values.
Pressing the Done button removes the Metrics pop-up window and returns to the
previous screen.
Figure 2-51. ANTERIOR DOMAIN METRICS - The metrics system automatically tracks Phaco time
and its average setpoint, and anterior vitrectomy (Ant. Vit) time and its average cuts per minute.
Figure 2-52. POSTERIOR DOMAIN METRICS - The metrics system automatically tracks Vitrectomy
cutting time and its average cuts per minute, Frag time and its average power, Elevated Infusion
time, Scissors time, VFC Inject time, and VFC Extract time.
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6. Vitrectomy Probes
The Options/Vit. Probe key allows the user to select a preferred Vitrectomy Probes
type: Accurus®, Accurus® 1500, Accurus® 2500, and InnoVit®. Only one can be
active at a time, so selecting a probe causes it to become the active setting.
Pressing the Done button removes the Vitrectomy Probes pop-up window, returning
the system to the previous screen with any probe selection modifications taking effect.
Pressing the Cancel button removes the pop-up window and returns the system to the
previous screen with no modifications.
Figure 2-53. VITRECTOMY PROBES SELECTION - This popup allows the user to select a preferred
vitrectomy probe type.
7. Test
This Options/Test key is used to prime, test, and tune probes/handpieces from the
surgery screen. Its functionality is the same as the Test key in the surgical setup
screens.
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8. System
The Options/System key allows the user to instantly view, and change, current system
parameters. These parameters are applicable to the entire system, independent of
which doctor or doctor memory is currently selected.
Figure 2-54. SYSTEM PARAMETERS - This screen allows the user to instantly view, and change,
current system parameters.
The Remote Channel group is used to set the remote control channel. Pressing A,
B, C, or D causes it to become the active setting, and its background color changes
to blue. See Section Fifteen of this manual for instructions to set the remote control
selector to match the selection made here.
The Startup Domain group allows the user to select the system's default domain
upon system startup: Anterior, Posterior, Combined, or Select. This setting is only
applicable for Accurus® 600DS and 800CS models.
The Source Pressure group contains a setting for the type of air pressure plugged into
the rear panel: Standard, Reduced, or Select. Pressing a button causes it to become the
active setting. See Section One of this manual for an explanation of source air pressure.
The Cassette to PEL group allows the user to set the vertical distance from the top of
the cassette fluid chamber to the patient’s eye level, and also offers a setting for units
of measurement: cm or inches. The vertical distance can be adjusted by pressing the
up/down arrows next to the distance readout.
The Language group contains languages the user can load into the system. The
selections offered are populated based on the resource file loaded into the system, and
therefore any subset of the number of available languages may be displayed at any time.
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9. Standby
The Options/Standby key allows the user to blank the screen and the global LED’s.
Pressing anywhere on the touch screen, pressing a remote control button, or activating
the footswitch causes to system to re-display the screen.
10. About
The Options/About key allows the user to view the current system configuration, a
popup titled About Accurus®.
Figure 2-55. ABOUT ACCURUS® - This screen allows the user to view the current system
configuration.
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There are four categories of system status conditions, each communicated to the user
with fault message screens or popup windows. Each status condition is described on the
display screen, and a dedicated color is assigned to each. The colors are shown below
in ranking of severity:
A system Fault condition is displayed across the whole screen. Error, Advisory, and
System Information conditions are displayed in popup windows.
Faults
System faults are the most severe system status conditions. Each fault is assigned
a priority; i.e., if more than one fault exists, the fault with the highest priority is
displayed first. The Accurus® system must be shut down completely when a system
fault is detected, then turned ON.
Figure 2-56 SYSTEM FAULT SCREEN - System faults require that system power be recycled. To
help troubleshooting, record information displayed on the fault screen before recycling
power.
A popup window appears over the current display screen to indicate system Error,
Advisory, or System Information messages. The popup remains on the screen until the
operator presses OK to acknowledge the condition, or until the condition no longer
exists.
NOTE: For listings of popup messages, see the Troubleshooting section of this manual.
When a popup window is active, only the popup window keys, the illuminator global
function keys, and the cassette Eject button are available. In the anterior domain,
Irrigation ON/OFF is also available.
• Errors
When an Error is detected an error tone is heard and, simultaneously, a System Error
popup window is displayed. The popup window remains displayed until the operator
acknowledges the Error condition (the Error status remains until the system power is
turned OFF/ON).
Global functions and mode functions related to the Error are put in a safe state; keys
and icons are faded to indicate unavailability. If the Error does not affect the current
active functions, they will remain active.
Figure 2-57 SYSTEM ERROR POPUP MESSAGES - System Errors require user intervention to
address popup messages. Affected system functions remain unavailable until the
popup message is resolved.
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• Advisories
Advisories relay a message to the user, who can usually correct the condition by
following the instructions printed in the System Advisory popup window.
When the Accurus® system detects an Advisory, an advisory tone is sounded and its
popup window is displayed. Functions related to the Advisory are not available. The
popup is removed when the condition is corrected or when the user presses OK.
Figure 2-58 SYSTEM ADVISORY POPUP MESSAGES - System Advisories can usually be corrected
by following the instructions printed in this popup window.
• System Information
When a condition corresponding to System Information is displayed, an associated
message is printed in the popup window. System Information messages usually
confirm a critical operator request or provide system status. The popup window is
removed when the requested action is completed, or when the operator presses a
touch key to acknowledge the message.
Figure 2-59 SYSTEM INFORMATION POPUP MESSAGES - System Information messages usually
confirm a critical operator request or provides system status.
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SECTION THREE
POSTERIOR DESCRIPTION
Upon entering the Posterior domain, the system displays the Vitreoretinal Surgery
Setup screen, shown below in Figure 3-1. On this screen the user can prepare the
Accurus® system for surgery, then enter another screen by pressing one of the
following keys on the touch screen:
The Vitreoretinal Surgery Setup screen can also be entered by pressing the Exit key
from the Infusion Settings screen or a Posterior Surgery screen.
Popup windows can appear over these screens to advise the user of certain conditions.
See Figure 2-18 for an example of a popup window.
There are six Vitreoretinal Surgery Setup screen components offered to prepare for
surgery. Two components—the Handpieces/Probes and Accessories components—are
in the Primary Functions Window; and four components—Test, Clean, Surgery, and
Settings—are in the Modes Window (see Figure 2-9).
Figure 3-1 VITREORETINAL SURGERY SETUP SCREEN - Entering the VitreoRetinal Surgery Setup
screen allows the user to prepare the Accurus® system for surgery.
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When entering a surgery screen from the Vitreoretinal Surgery Setup screen, or upon
successful prime/tune/test, the mode of the currently tested handpiece is automatically
selected. If more than one probe or handpiece was tested, priority is given to Vit mode.
• Accessories
Pressing Diathermy, Scissors, VFC, VGFI-F/AX, or MPC illuminates an LED at its
corresponding front panel connector to identify where to plug in the handpiece or
accessory. Making one selection automatically deselects any other selection. Only the
last-selected accessory or handpiece LED illuminates.
• Test
When the Test key is pressed, the selected vitrectomy probe, Fragmatome™*
handpiece, and extrusion handpiece are primed sequentially, and a popup window
appears indicating that priming, testing, and tuning are active. Only the popup
Test window keys (Stop and Skip), global function Illuminator keys, and diathermy are
operable while the Test function is active. The surgery screen is entered automatically
upon a successful prime, test, and tune sequence.
If the Stop key is pressed during priming, the test function is aborted. If Skip is
pressed during priming, priming is skipped and handpiece testing/tuning begins.
An invalid error tone sounds when pressing the Test key with no probe or handpiece
selected. An advisory popup window appears when the Frag handpiece is selected but
not connected, when no cassette is inserted, or when priming/tuning has failed.
• Clean
Pressing the Clean key transfers fluid from the cassette into the drain bag. When
Clean is pressed, a popup window indicates cleaning is in progress. Only the Stop
key in the popup window, and global function Illuminator keys, are operable while
Clean the clean function is active. Pressing the Stop key during cleaning aborts the function.
If fluid is not fully transferred to the drain bag, press the Clean key a second time.
(There will always be some residual fluid left in the cassette due to surface tension.)
• Surgery
Surgery When the Surgery key is pressed, the system exits the Vitreoretinal Surgery Setup
screen and enters the selected surgery screen. If prime/tune is not finished, a popup
reminder appears.
•Settings
When the Settings key is pressed, the system exits the Vitreoretinal Surgery Setup
Settings screen and enters the Infusion Settings screen (see Figure 3-2).
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The Infusion Settings screen (see Figure 3-2) is entered by pressing the Settings key
on the Vitreoretinal Surgery Setup screen. In this posterior domain there are two data
tabs available on the screen: the Type tab and the Infusion tab. (The Irrigation tab is
not available and is grayed-out.) Pressing the Exit key closes this screen and returns
to the Vitreoretinal Surgery Setup screen.
• Type Tab
The infusion Type tab determines how infusion pressure is provided for surgery, and
is divided into three groups: Anterior Irrigation, Posterior Infusion, and Combined
Infusion/Irrigation. In this domain, only the Posterior Infusion group is available.
Figure 3-2 INFUSION SETTINGS SCREEN: TYPE TAB - The Type tab allows the user to select the
type of Posterior Infusion desired. Selecting the Infusion tab offers alternate infusion
and F/AX choices, shown in Figure 3-3.
The Type tab contains keys for the following irrigation methods: VGFI, Power Pole,
and Gravity. Pressing the Cancel key exits the Infusion Settings screen and returns to
the previous screen without any modifications taking effect. Pressing the Apply key
accepts the settings, exits the Infusion Settings screen, and returns to the previous screen.
When VGFI is selected, infusion pressure is provided by applying air pressure into
the fluid bottle. An internal air pump creates pressurized air, and VGFI™* tubing
delivers it to the bottle from a front panel connector. The air pressure setting is adjusted
with the infusion up/down buttons on the front panel; the corresponding LED readout is
immediately to the left of the buttons and indicates air pressure at the console. Note:
Fluid bottle should be positioned at patient eye level.
The Power Pole selection requires that the optional cart with power IV pole be
connected to the Accurus® system. With the fluid bottle hanging from the cart's power
IV pole, infusion pressure is set by pressing the global up/down keys to the desired
pressure, and the power pole automatically moves up or down to the required height.
When Gravity infusion is selected, infusion pressure is dependent on the fluid bottle
height, set manually by the operator.
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• Infusion Tab
The Alternate Infusion group contains a value for the alternate Pressure and a setting
for alternate pressure Available Yes/No. Alternate pressure works with VGFI™*
infusion and power pole infusion; therefore, when gravity infusion is selected, these
selections are grayed out and not functional. The Pressure value can be adjusted by
pressing the up/down arrows next to the value. The nominal and alternate pressures
are toggled by pressing the footswitch's right vertical switch.
The Alternate F/AX group contains a value for the alternate Pressure and a setting for
alternate pressure Available Yes/No. The Pressure value is adjusted by pressing the
up/down arrows next to the value. Selecting Yes or No determines whether alternate
pressure will be available with the footswitch.
The Alternate Infusion / F/AX group allows the user to select either Recall or Preset
alternate pressure values, giving the ability to select whether the alternate infusion
level will always go to the preset value, or recall the last-used alternate infusion level.
Figure 3-3 INFUSION SETTINGS SCREEN: INFUSION TAB - The Infusion tab allows the user to
select the type of Alternate Infusion and Alternate F/AX desired.
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Global functions are available in all surgery and setup screens. There are five
global functions which, generally, can be selected, adjusted, and displayed at any
time. When a global function is selected its color icon and LED readout illuminate
brightly. (An exception is diathermy. Its LED readout is always lit, and its color icon
illuminates brightly when activated with the footswitch.)
A global function setting can be adjusted, even when the function is OFF, by pressing
its corresponding Up/Down arrow buttons. If the function is OFF, the LED readout
becomes dimly lit while making adjustments, then becomes blank after a few seconds
(except for diathermy as mentioned above).
• Infusion
Infusion pressure is delivered through one of three types: VGFI™* infusion, Power
Pole, or Gravity. Selection of infusion type is made in the Infusion Settings screen
(see Figures 3-2 and 3-3).
mmHg
When VGFI is selected in the Infusion Settings screen and activated by pressing its
global icon, the Accurus® system delivers filtered, pressurized air through a tubing set
into the infusion bottle, which in turn pressurizes fluid through tubing to the eye (F/
AX, if in use, is deselected). Up/Down arrow buttons are used to adjust fluid pressure,
displayed in mmHg or cmH2O.
The Power Pole selection uses gravity to pressurize fluid when the bottle is hanging
from the optional power IV pole. Infusion pressure can be set by pressing the global
function up/down adjustment buttons until the desired LED pressure readout is
displayed. The power IV pole automatically raises or lowers to the correct height, and
the LED pressure readout blinks as the pole is moving. Activation of MPC scissors, or
loading/unloading a cassette, will momentarily interrupt power IV pole movement.
When Gravity is selected in the Infusion Settings screen, the infusion icon fades,
and the Accurus® system does not provide infusion pressure; pressure is adjusted by
manually raising or lowering the infusion bottle.
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• Diathermy
The Diathermy global function provides fixed diathermy capability through the use
of diathermy probes and handpieces. Diathermy output is available at all times,
% controlled by the footswitch, and is based on the percent of maximum voltage output.
When the Diathermy icon is pressed a popup window is displayed to remind the
operator to use the footswitch to control this function. This popup window can be
removed by pressing the screen's Continue key or activating the diathermy function.
The diathermy function can be activated in all modes by pressing the footswitch's
left vertical switch. In Frag, VFC, and Scissors modes the footpedal must be released
before you can activate diathermy; in Extrude mode the footpedal is inconsequential.
Diathermy power is adjusted with the up/down arrow buttons on the front panel, with
the percentage of maximum diathermy voltage output displayed.
Illum2
In the event of a burnt bulb a System Advisory appears on the screen, and the
illuminator's icon dims and is covered with a strike. The user should then remove and
plug the light pipe into the other illuminator receptacle, press OK, and proceed.
Illum2 NOTE: Upon completion of the procedure it is recommended that the burnt bulb
be replaced. Two illuminator sources should always be available. (See Care and
Maintenance, Section Fifteen of this manual, for instructions to replace bulb.)
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The Accurus® system offers five surgery modes in the posterior domain—depicted
as icons in the Modes Window at the bottom of the touch screen—and each surgery
mode has submodes (see Table 3-1). The active mode and submode keys are
highlighted, and their names are displayed in the Title Window.
To enter a surgery mode, press its associated icon key on the touch screen. The
previous surgery mode or submode is deactivated when a new mode or submode is
selected, and front panel LED's illuminate to indicate which connectors are active.
To enter a surgery submode, press the key above its associated mode key. Pressing a
mode key successively causes the system to cycle through the available submodes.
NOTE: The footpedal must be released, and none of the footswitches depressed,
to enter or change a surgery mode.
When a surgery mode is first entered after power up, the system enters its factory
default settings, or if a doctor memory has been selected, the doctor's programmed
values are used. If the defaults are then adjusted, re-entry to that mode will display the
new values. Turning system power OFF resets all values back to the factory default
settings, as does exiting the posterior domain.
Functional operations to the Accurus® console are accepted from a footswitch. The
footswitch consists of a footpedal, right and left horizontal/vertical switches, and right
and left vertical heel switches. Functions controlled by the footswitch are listed in
Tables 3-2, 3-3, 3-4, and 3-5.
MODE SUBMODES
Table 3-1 POSTERIOR DOMAIN SURGERY MODES - Five surgery modes are available in the
posterior domain. Each mode has submodes, as shown in this table, with the default
submode shown in bold type.
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Vit Prop. Diathermy Cut Disable Programmable Alt. Inf. Cut Enable Reflux
Frag Linear Diathermy U/S Disable Programmable Alt. Inf. U/S Enable Reflux
Fixed Diathermy U/S Disable Programmable Alt. Inf. U/S Enable Reflux
Vacuum/Multi-Cut Diathermy Prop Submode Programmable Alt. Inf. Momentary Cut Reflux
Vacuum/MPC Diathermy Close Blade Programmable Alt. Inf. Momentary Cut Reflux
Dual Diathermy Pressure Toggle Programmable Alt. Inf. Vacuum Toggle Reflux
(vac on)
Table 3-2 POSTERIOR FOOTSWITCH FUNCTIONS FOR DEFAULT MAP A - The footswitch contains a
footpedal, left and right switches which are either actuated horizontally or depressed vertically
with the user's toe, and left and right vertical heel switches. These four tables represent the
factory default settings for Map A, Map B, Map C and Map D, but can be programmed otherwise as
instructed in section two of this manual (Options/Memory/Common/Footswitch).
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Vit Prop. Diathermy Reflux Programmable Alt. Inf. Cut Toggle Programmable
Frag Linear Diathermy Reflux Programmable Alt. Inf. U/S Toggle Programmable
Dual Diathermy Reflux (vac on) Programmable Alt. Inf. Vac/Press Cycle Programmable
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Vit Prop. Diathermy Reflux Programmable Inf. Pres. + Cut Toggle Inf. Pres. –
Momentary Diathermy Reflux Programmable Inf. Pres. + Momentary Cut Inf. Pres. –
Frag Linear Diathermy Reflux Programmable Inf. Pres. + U/S Toggle Inf. Pres. –
Fixed Diathermy Reflux Programmable Inf. Pres. + U/S Toggle Inf. Pres. –
Momentary Diathermy Reflux Programmable Inf. Pres. + Momentary U/S Inf. Pres. –
Scissors Prop. Diathermy N/A Programmable Inf. Pres. + N/A Inf. Pres. –
Multi-Cut Diathermy N/A Programmable Inf. Pres. + Close Blade Inf. Pres. –
Vacuum/Multi-Cut Diathermy Reflux Programmable Inf. Pres. + Close Blade Inf. Pres. –
(treadle up)
Momentary Cut
(treadle down)
MPC Diathermy N/A Programmable Inf. Pres. + Close Blade Inf. Pres. –
Vacuum/MPC Diathermy Reflux Programmable Inf. Pres. + Close Blade Inf. Pres. –
(treadle up)
Momentary Cut
(treadle down)
Extrusion Low Diathermy Reflux Programmable Inf. Pres. + Diathermy Inf. Pres. –
VFC Inject. Diathermy N/A Programmable Inf. Pres. + N/A Inf. Pres. –
Dual Diathermy Reflux (vac on) Programmable Inf. Pres. + Vac/Press Cycle Inf. Pres. –
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Vit Prop. Diathermy Reflux *Inf. Pres. - Programmable Cut Toggle **Inf. Pres. +
Momentary Diathermy Reflux *Inf. Pres. - Programmable Momentary Cut **Inf. Pres. +
Frag Linear Diathermy Reflux *Inf. Pres. - Programmable U/S Toggle **Inf. Pres. +
Fixed Diathermy Reflux *Inf. Pres. - Programmable U/S Toggle **Inf. Pres. +
Momentary Diathermy Reflux *Inf. Pres. - Programmable Momentary U/S **Inf. Pres. +
Scissors Prop. Diathermy N/A *Inf. Pres. - Programmable N/A **Inf. Pres. +
Multi-Cut Diathermy N/A *Inf. Pres. - Programmable Close Blade **Inf. Pres. +
Multi-Cut w/Vac Diathermy Reflux *Inf. Pres. - Programmable Close Blade **Inf. Pres. +
(treadle up)
Momentary Cut
(treadle down)
MPC Diathermy N/A *Inf. Pres. - Programmable Close Blade **Inf. Pres. +
MPC w/Vac Diathermy Reflux *Inf. Pres. - Programmable Close Blade **Inf. Pres. +
(treadle up)
Momentary Cut
(treadle down)
Extrusion Low Diathermy Reflux *Inf. Pres. - Programmable Diathermy **Inf. Pres. +
VFC Inject Diathermy N/A *Inf. Pres. - Programmable N/A **Inf. Pres. +
Dual Diathermy Reflux (vac on) *Inf. Pres. - Programmable Vac/Press Cycle **Inf. Pres. +
* Pressing the Left Heel switch decreases pressure by 5 (mmHg or cmH20) when pressure is equal to 30 or higher, or by 2 if below
30. If the switch is held down for 1 second, pressure changes to Normal Pressure preset value if currently above the preset value;
otherwise, pressure remains at the current setting.
** Pressing the Right Heel switch increases the pressure by 5 (mmHg or cmH20) when pressure is equal to 30 or higher, or by 2 if below
30. If the switch is held down for 1 second, pressure changes to Alternate Pressure preset value if currently below the preset value;
otherwise, pressure remains at current the setting.
• The reflux controlled by the Left Horizontal switch is pulsed.
• In Dual VFC, the Right Horizontal switch shall cycle from Vacuum only to Vacuum and Pressure to Pressure only and then back to
Vacuum only.
• The default for the Right Vertical is Next Mode.
• The Left and Right Heel switches may be programmed to have single-click or double-click activation of all heel switch functions.
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Accurus®
The Vit (vitrectomy) mode provides vitreous cutting and vacuum using a
pneumatically powered vitrectomy probe connected by tubing to a pulsed air pressure
source and a vacuum port. The available probes, selected in the Vitreoretinal Surgery
Setup screen, are Accurus®, Accurus® 1500, Accurus® 2500, and InnoVit®.
Vit
The Vit mode is entered when the Surgery key is pressed in the Vitreoretinal Surgery
Setup screen. Three submodes are available, each with its own default cut rate and
vacuum level. Values are adjusted using touch arrow keys, even when the footpedal is
depressed. When a function is disabled, its setting turns from blue to gray.
Cutting and/or vacuum is begun when the footpedal is pressed. Cutting can be
disabled/enabled using the footswitch or by pressing the Set Point key, and can be
changed regardless of footpedal position. If cutting is enabled, “Cut On” is displayed
in the title window; if cutting is disabled, “Cut Off” is displayed. Vacuum can be
disabled/enabled by pressing the vacuum Max Limit display. Cutting and vacuum
cannot both be disabled at the same time (one must always be enabled).
Visible only
when option
is enabled.
Figure 3-4 VIT MODE SCREEN - This screen shows the proportional vacuum submode, set up
to operate with the Accurus® probe. This screen is similar for the other vitrectomy
probes using proportional vacuum or momentary cut. 3D vitrectomy has its own unique
screen that includes Treadle Start and Full Treadle settings for both vacuum and cut
rate (see Figure 3-5).
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Accurus®
Prop Vac
The Vitrectomy Proportional Vacuum submode contains values for maximum vacuum
level and cut-rate set point. As the footpedal is depressed the vacuum increases, with
the actual vacuum displayed in the Actual Value box and its linear equivalent reflected
in the bar.
The amount of vacuum delivered to the probe is regulated by the amount of footpedal
depression up to the max limit. The Vacuum Max Limit is numeric, and can be
adjusted by pressing the up/down arrows to the right of the value. The Actual Value is
a progression bar for display only, and can not be modified by the user. The vacuum
on/off status is signified by the background color of the Max Limit key; pressing the
key toggles the status between on (blue) and off (light gray).
Probe cutting at a preset rate begins when the footpedal is pressed. The Cut Rate Set
Point value is numeric, and can be adjusted by pressing the up/down arrows to the right
of the value. The cutting on/off status is signified by the background color of the Set
Point key; pressing the key toggles the status between on (blue) and off (light gray).
A cut-off max vacuum adjustment is provided for each Vit probe when the
Vit Cut-off Setpoint is enabled (see Figure 3-4). This option is enabled in the doctor
memory area (Options -> Memory -> Common -> Other) and the controls function as
follows:
When cutting is enabled: The Vacuum Max Limit display background is blue and the
displayed value is used as the maximum when applying vacuum. The Cut-off Setpoint
display is gray to indicate that it is not the value currently in force, however the
setting can still be adjusted.
When cutting is disabled: The Cut-off Setpoint display background is blue and the
displayed value is used as the maximum when applying vacuum. The Vacuum Max
Limit display is gray to indicate that it is not the value currently in force, however the
setting can still be adjusted.
Moment
The Vitrectomy Momentary Cut submode has the same characteristics as the Prop Vac
submode, except that the cutter is activated when the applicable footpedal switch is
momentarily activated (the default activation switch is the right horizontal switch).
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3D
The Vitrectomy 3D (Dual Dynamic Drive) mode has similar characteristics as the
Prop Vac submode, except that vacuum delivered to the probe and the probe cutting
rate are both regulated by the amount of footpedal depression. The display contains
adjustable values for vacuum level at footpedal start, vacuum level at full depression;
and cut rate at footpedal start, cut rate at full depression. A unique feature of this
mode is that 1) vacuum can be set to start at 0 and rise to its maximum setting at full
footpedal depression, while the cutting rate can be set to start at its maximum setting
and decrease as the footpedal is depressed (or any combination thereof) and that 2) to
ensure that not too much flow is generated when the footpedal is first depressed, the
vacuum level is ramped up from 0 to the set starting level during the first part of the
pedal travel.
Figure 3-5 VIT 3D (Dual Dynamic Drive) MODE SCREEN - This screen shows the 3D submode.
The footpedal controls both proportional vacuum and proportional cut rate. Treadle
Start and Full Treadle settings for vacuum and cut rate are fully adjustable to start
high and finish low, or to start low and finish high according to preference.
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Frag Four submodes are available, each with its own default U/S power and vacuum limits.
Values are adjustable using touch arrow keys, regardless of footpedal position. U/S
power is enabled and disabled by pressing foot switches or by pressing the power
setting on the touch screen (except in momentary mode). Micro reflux is available via
the footswitch.
U/S Pulse controls are available in all four submodes, and can be turned on/off by
pressing the Pulse Rate touch key. The pulse rate can be adjusted using the up/down
arrow keys, even with the footpedal depressed.
Figure 3-6 LINEAR FRAGMENTATION SCREEN - In Linear Fragmentation mode vacuum builds
up to its maximum value at the footpedal's halfway point, then U/S power begins and
rises to its maximum value at full footpedal depression.
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Accurus®
Fixed - When the Fixed Fragmentation submode is enabled, depressing the footpedal
activates the preset U/S power and provides vacuum proportional to footpedal
depression, up to the maximum limit.
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Prop - The Proportional submode (see Figure 3-7) provides proportional control of
the opening and closing of the scissor blades, dependent upon the amount of footpedal
depression. The amount of scissors closure is indicated in the Pressure window. When
the footpedal is fully depressed, the Max Limit is reached, and scissors should be fully
closed. Max Limit pressure is adjustable with the Up/Down triangle keys.
Multi and MPC - In the Multiple Cut or MPC submode pressing the footpedal
activates the scissors at a Cut Rate proportional to the footpedal position up to the
preset Max Limit, set by pressing the Up/Down triangle keys next to the Max Limit
readout. Single cuts are possible by adjusting the cut rate to a low Max Limit and
momentarily pressing the footpedal.
Figure 3-7 PROPORTIONAL SCISSORS SCREEN - Pressing down on the footpedal in this mode
provides proportional control of the closing of the scissor blades.
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Accurus®
Pressing the Vacuum Max Limit key turns scissors off and activates proportional
vacuum for aspiration. When vacuum is activated the scissors can be momentarily
activated at the preset value when the right horizontal switch is pressed, and vacuum
is controlled proportional to the amount of footpedal depression up to its Max Limit.
WARNING!
Use of a MPC scissors handpiece at high cut rates continuously for over 2 1/2 minutes
can result in excessive handpiece heating. Allow the scissors to cool for approximately
30 minutes between heavy usage of this type.
Figure 3-8 MULTIPLE CUT SCISSORS SCREEN - Depressing the footpedal in Multiple Cut mode
activates scissors (shown in this figure) or vacuum progressively up to its preset Max
Limit. When the Cut Rate key is activated, proportional scissors are controlled with the
footpedal. When the Vacuum key is activated, aspiration is controlled with the footpedal,
and momentary cutting is enabled by pressing the right horizontal switch.
Figure 3-9 SCISSORS CALIBRATION SCREEN - To enter the calibration screen the Calibrate
key must be pressed on the SCISSORS: Proportional screen. This screen shows the
start and close pressures for scissors activation; pressing the arrow keys adjusts the
pressures. Pressing the Default key sets the pressures back to the factory defaults.
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Accurus®
This mode provides vacuum from the cassette's left port through tubing to an
extrusion handpiece. Three submode vacuum levels are available: Low, Medium, and
High; with Medium as the default setting.
Extrude Depressing the footpedal activates vacuum proportional to pedal position. The preset
maximum vacuum level, adjustable using the arrow keys, is reached at full treadle
depression, and pressing the heel switch activates pulsed reflux. The preset maximum
vacuum level can be adjusted with the footpedal in any position.
Figure 3-10 MEDIUM EXTRUSION SCREEN - Three extrusion submodes are offered: Low, Medium,
and High. Full depression of the footpedal is required to reach the preset maximum
vacuum.
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Accurus®
The VFC (Viscous Fluid Control) mode provides pressure at the front panel VFC
connector for fluid injection (i.e., silicone oil), or vacuum for extraction, through
tubing to a syringe. Using vacuum the VFC mode also provides a means of extruding
fluid through an extrusion handpiece (in Dual submode injection and extrusion are
VFC done simultaneously). Pressure and vacuum levels are adjustable via the arrow keys
next to the Max Limit display boxes.
CAUTION
Always use Alcon-supplied Viscous Fluid Control Paks and follow all Directions
for Use. Do not aspirate fluids directly into the console; this will cause damage to
the console, increase risk of electrical shock, and void all warranties.
Inject - In this submode injection pressure to the syringe is provided proportional to the
footpedal position up to the Max Limit setting.
WARNINGS!
• Double check the cannula connected to the syringe for a tight connection. It must
not be allowed to come loose.
• Adjust the Max Limit air pressure in accordance with the viscosity of fluids to be
injected. Excessively high settings may endanger the patient.
Figure 3-11 VFC INJECTION SCREEN - This Inject screen indicates the system is prepared to
deliver a maximum of 50 psi to the syringe with the footpedal fully depressed.
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Accurus®
Dual - In the Dual submode injection and extrusion are performed simultaneously
using the syringe and extrusion handpiece. Pressing sideways on the footswitch's
left and right horizontal switches, or pressing the Max Limit keys, turns the two
individual functions on and off. In this submode, with both functions enabled,
injection pressure to the syringe in detent 1, then vacuum to the extrusion handpiece
in detent 2 (with sustained pressure to the syringe) is provided proportional to the
footpedal position (see Figure 1-7).
Figure 3-12 DUAL VFC INJECTION/EXTRUSION SCREEN - This screen indicates the system is
prepared to deliver a maximum of 50 psi to the injection syringe in footpedal detent
1, then sustained injection and a maximum of 250 mmHg extrusion.
Figure 3-13 VFC EXTRACTION SCREEN - This screen indicates the system is prepared to extract
fluid through a syringe at up to a maximum of 500 mmHg.
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Accurus®
Different probes and handpieces are required for each operating mode of the Accurus®
system. Following is a representative selection of probes and handpieces with a
general description of each. See the Accessories and Parts section of this manual, or
consult your Alcon representative, for a complete selection of all probes, handpieces,
and handpiece tips available.
Vitrectomy Probes
The InnoVit® probe is a high-speed, cross-action (or radial) guillotine vitreous cutter
with an ergonomically designed probe handle. The Accurus®, Accurus® 1500, and
Accurus® 2500 probes are axial oscillating guillotine vitreous cutters. Both probes are
are designed for a single use and must be properly disposed of when the surgery is
completed.
Fragmatome™* Handpiece
The Fragmatome™* handpiece is configured to provide simultaneous vacuum and
fragmentation, or vacuum only, depending upon the console setup. The handpiece has
a stainless steel shell for improved reliability and durability. Other than attaching and
removing the needle and aspiration line, no assembly or disassembly is required.
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Accurus®
Scissors Handpiece
The Intraocular Scissors (IOS) Handpiece is used for membrane dissection.
Pneumatic power to drive the scissors is provided through tubing which is attached
to the barbed shaft. Scissors tips come in single use and reusable configurations, and
are screwed into the IOS handpiece. The scissors adjustment is used to increase or
decrease the opening of the scissors blades. Additionally, it can be used to manually
close the scissors in the event of air pressure and/or electrical power failure.
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Accurus®
Diathermy/Coagulation Handpieces
Single use Bipolar Coagulation Brushes are available in a wide variety of
configurations: straight, curved, 20-gauge, 23-gauge, tapered, and widestroke. All
single use bipolar accessories are available with and without cables. Also available
are reusable and single-use bipolar cables.
ALCON
3.24
* FORLast
REFERENCE
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Accurus®
SECTION FOUR
POSTERIOR OPERATING INSTRUCTIONS
Introduction
This section of the manual contains typical setup procedures using posterior Accurus®
paks, then guidelines to navigate through the posterior domain.
The Accurus® pak setup procedures are written for a surgical team of three people:
Surgeon and Scrub Nurse in the sterile field, and Circulating Nurse in the non‑sterile
field. The instuctions are divided into two columns. In the left column a directive is
given, and in the right column a team member is identified to perform the task. These
procedures assume that a sterile drape is not being utilized; if it is applied to the front
of the console, the roles of the Circulating Nurse and the Scrub Nurse change.
If you have problems with the system when performing the setup instructions, you
should first refer to the Troubleshooting section of this manual. If questions still exist,
contact the Alcon Technical Services Department or your local Alcon representative.
Power Up Sequence
Follow these steps each time you turn system power ON. This helps ensure that the
Accurus® system is set up correctly and is ready for surgery.
2. Connect the air hose between the Accurus® system and the pressure supply
(compressed air or nitrogen). Verify that pressure is between 90 to 120 psi
(500 kpa minimum for reduced operation).
5. First turn system power ON using the rear panel ON/OFF switch and then the
front panel Standby switch. Alcon's Accurus® logo is displayed on the viewing
screen while the system completes its initialization and self-test diagnostics
(approximately 2 minutes). While completing diagnostics, confirm that the five
Global Function LED displays on the front panel flash 888 before the system
enters either the Procedure Selection screen or a Surgery Setup screen.
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Accurus®
An Accurus® 600DS or 800CS system enters the Procedure Selection screen upon
successful completion of self-test diagnostics. At this point you must select the
posterior domain of operation on the touch screen, then a variety of operating
selections are available to you. Navigating through domains and their modes of
operation is flexible, controlled by system software, and is generally structured as
diagrammed in Figure 4-1.
If your system only offers posterior functions, or if the system has been programmed
in the System Parameters screen (Options/System) to automatically enter the
posterior domain, the Procedure Selection screen is bypassed. For systems that offer
it, the operator can return to the Procedure Selection screen by pressing the Exit key.
After entering a mode of operation, most surgical operations are controlled through
the doctor's footswitch, but before any surgery can be performed there are system
modes and parameters that must be selected. Most presurgical system preparation
is performed by inserting a cassette, connecting handpieces and accessories to
the Accurus® system, then pressing buttons to navigate through the system touch
screens to make operating selections. A brief outline of screens and their functions is
presented below.
You first insert a cassette, then in the Handpieces/Probes section of the screen
you select handpieces and probes you want to use. Plug handpieces and probes
into the illuminated front panel connectors, then press the Test key to test and
prime/tune the selections. The system automatically advances to the appropriate
surgery mode after testing is done.
One accessory can be selected at a time by pressing the desired item from the
Accessories choices. The associated front panel connectors illuminate to help
you plug the accessory into the correct connectors.
Continued on page 4.4
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Accurus®
Infusion Settings
Vit
Frag
FRAGMENTATION: Linear
FRAGMENTATION: Momentary
FRAGMENTATION: 3D
FRAGMENTATION: Fixed
Scissors
Extrude
EXTRUSION: Medium
EXTRUSION: Low
EXTRUSION: High
VFC: Inject
VFC: Dual
VFC: Extract
Figure 4-1 POSTERIOR MODES FLOW CHART - This flow chart highlights the system's posterior operating domain
with a general map to help you navigate through its modes of operation.
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Accurus®
The Settings key is pressed to open the Infusion Settings screen. In the Type tab
you can select either VGFI™* infusion, Power Pole, or Gravity infusion. In the
Infusion tab, depending on your infusion type, you can set an Alternate Infusion
pressure, an Alternate F/AX pressure, and select whether you want the alternate
pressure to be the preset value or recalled from the last alternate pressure used.
Pressing the Apply key returns you to the setup screen.
The Clean key is pressed to drain fluid from the cassette chamber into the drain
bag. During normal operation this function is performed automatically, but prior
to removing the cassette you may want to drain the remainder of fluid from the
chamber into the drain bag.
Depending on the last handpiece tuned, pressing the Surgery key opens the
associated surgery screen for that mode of operation.
The settings can be adjusted by pressing touch screen arrow keys, increasing or
decreasing the values. If the settings are adjusted, re-entry to that mode will display
the new values. Tables 4-1 and 4-2 show the factory default settings for each mode,
and the adjustment ranges of each.
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Accurus®
Table 4-1 VITRECTOMY DEFAULT SETTINGS AND ADJUSTABLE RANGES - Listed here are the Accurus® factory
default settings for the posterior vitrectomy modes of operation. The factory settings can be changed
during surgery, but turning system power OFF resets all values back to the factory default settings.
Figures in this table inside parenthesis are for reduced settings systems.
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Accurus®
Table 4-2 OTHER DEFAULT SETTINGS AND ADJUSTABLE RANGES - Listed here are the Accurus® factory
default settings for modes of operation other than vitrectomy. The factory settings can be changed
during surgery, but turning system power OFF resets all values back to the factory default settings.
Figures in this table inside parenthesis are for reduced settings systems.
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Accurus®
The global keys are used to select global functions (except for the Diathermy key
which is always enabled for footswitch control). When selected, the global function
key is highlighted, the corresponding global parameter value in the LED display is
illuminated, and the console connector is illuminated to help connect the accessory.
The corresponding rubber arrow buttons are used to adjust the global function
parameter values, which change at a faster update rate when the key is held down.
The preset parameter values are displayed on the LED displays.
Five global functions, accessed by pressing their icon keys on the left side of the
touch screen, are unique to the system's posterior domain.
Infusion - The top global selection on the touch screen is enabled in the posterior
domain when VGFI or Power Pole is selected in the Infusion Settings screen.
VGFI™* infusion utilizes the Accurus® low pressure air supply to provide regulated
pressure into the infusion bottle. Alternate infusion pressure, set and enabled in the
mmHg Infusion Settings screen, is activated by pressing a switch on the footswitch. If Power
Pole is the selected infusion method, this control is used to set the desired infusion
pressure which automatically sets the power IV pole height. If Gravity is selected in
the Infusion Settings screen, this choice is blanked out (manually adjusted gravity fed
infusion is independent of the Accurus® system).
F/AX Infusion - While in the posterior domain, selecting F/AX (Fluid/Air Exchange)
cancels VGFI™* infusion. F/AX utilizes the Accurus® low pressure air supply to
provide regulated pressure into the eye. Using a VGFI™* tubing set you can provide
air to the eye through its stopcock valve. Alternate F/AX pressure, chosen in the
mmHg Infusion Settings screen, is activated by pressing a footswitch switch.
Diathermy - The diathermy global selection is activated through the footswitch, and
not through the global selection touch screen. Diathermy power is only provided to
the handpiece when the switch is depressed, and turns OFF when released.
%
Illuminators - Pressing the Illum 1 or Illum 2 global key turns the lamp in the
1 selected illuminator port ON or OFF.
Illum1
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Accurus®
Sterile materials packaged inside Alcon Paks must be set up to protect the
sterile surgical environment. These instructions are written to help you
protect that environment.
WARNING!
Follow local governing ordinances and recycling plans regarding
disposal or recycling of device components and packaging.
Initial Preparation
1. Peel lid from pak and aseptically transfer inner pouch to Scrub Nurse. Circulating Nurse
2. Accept inner pouch from Circulating Nurse. Tear open pouch and Scrub Nurse
remove components.
3. Turn system power ON, and if required after initial self tests are Circulating Nurse
completed, select Posterior mode of operation. Remove cassette with
attached drain bag from pak. Unfold drain bag, allowing it to hang
freely, and insert cassette into console cassette well (see Figure 4-2).
Ensure that latch engages.
500
400
300
200
100
Figure 4-2. POSTERIOR FLUID CASSETTE INSERTION - With power turned ON,
and initial self tests completed, the fluid cassette with drain bag is inserted into the
front of the Accurus® cassette housing.
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Accurus®
Infusion Setup
6. Accept infusion spike from Scrub Nurse, spike infusion bottle, close Circulating Nurse
the infusion line roller clamp (green striped tubing), and hang bottle
from IV pole. Squeeze drip chamber until it is a little more than half
full of fluid.
7. Press the Settings key on the Vitreoretinal Surgery Setup screen, then Scrub Nurse
in the Infusion Settings Type tab select Gravity or Power Pole. Press
the Infusion tab and select options. Press Apply.
8. Connect the green male luer fitting to the stopcock (see Figure 4-3). Scrub Nurse
Infusion cannula
Infusion line
O
F
F
Stopcock handle in down position
Figure 4-3. STOPCOCK - The stopcock is prepared with the infusion cannula.
9. Connect the infusion cannula to the stopcock. Ensure the stopcock Scrub Nurse
handle is positioned as illustrated in Figure 4-3. If desired, alternate
stand alone cannulas can be used in place of the standard cannula.
• If oil is to be injected later in the procedure, you can connect the
alternate silicon oil infusion cannula.
• An end irrigating fiber optic probe may be used. The lumen of
this probe is more restrictive to flow than a standard infusion
cannula, so it requires higher infusion pressure and lower vacuum.
WARNING!
Addition of extension tubing to infusion and/or vacuum lines will change
fluidic characteristics of the Accurus® system, and is NOT recommended.
10. Set the stopcock/cannula in the sterile field. Prepare a cup to accept Scrub Nurse
fluid from the infusion line.
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Accurus®
11. Open the roller clamp to prime the infusion line, and after Scrub Nurse Circulating Nurse
partially fills a cup, close roller clamp. The cup of fluid will be used to
prime the aspiration lines.
WARNING!
Visually confirm adequate infusion flow from the infusion cannula prior
to attachment to the eye.
12. Select the appropriate vitrectomy probe in the Vitreoretinal Surgery Scrub Nurse
Setup screen.
13. Remove the protective cover from the vitrectomy probe and place Scrub Nurse
the probe tip into the fluid-filled cup for aspiration line priming and
testing. Present the tubing connectors to Circulating Nurse.
14. Accept tubing connectors from Scrub Nurse and connect them to the Circulating Nurse
console's illuminated connectors as instructed below (see Figure 4-4):
• Connect aspiration line (blue striped tubing with blue connector) to
the cassette's upper-right connector.
• Connect pressure line (clear tubing/clear connector) as follows:
- For Accurus®, Accurus® 1500, or InnoVit® probe, connect pressure
line to the console's top connector.
- For Accurus® 2500 probe, connect pressure line to the console's
second connector from the top.
- For InnoVit® probe, connect its other pressure line (white striped
tubing with white connector) to the second connector from the top.
ASPIRATION LINE for vitrectomy probes
(blue connector)
TM
15. Disconnect tubing in center of aspiration line (see Figure 4-5). Scrub Nurse
16. Remove syringe from the pak and plug into female connector on Scrub Nurse
aspiration line.
17. Upon completion of suction or backflushing procedure, remove syringe Scrub Nurse
from aspiration line and plug aspiration line connectors back together.
20
15
10
Aspiration line
5
To Cassette and Accurus®
®
18. Press the Extrude key in the Vitreoretinal Surgery Setup screen. Scrub Nurse
20. Accept the handpiece from Circulating Nurse. Open the extrusion line Scrub Nurse
tubing and connect the male luer connector to the handpiece. Place
handpiece in the fluid filled cup for aspiration line priming. Present
the female luer connector to Circulating Nurse.
21. Accept the connector from Scrub Nurse and connect it to the left Circulating Nurse
illuminated cassette connector (see Figure 4-6).
22. Remove the fiber optic illuminator probe/fiber from the pak, carefully Scrub Nurse
uncoil the fiber, and present the metal connector to Circulating Nurse.
23. Accept the metal connector from Scrub Nurse and, using the adaptor Circulating Nurse
chained to the illuminator drawer, plug it into the desired illuminator
connector (see Figure 4-7). Verify it is fully seated in the adaptor.
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Accurus®
24. Slide the protective sheath from the tip of the illuminator probe. Scrub Nurse
25. Press the appropriate Illuminator icon on the Global Function screen Scrub Nurse
to turn the illuminator ON. Adjust the intensity as needed. Turn
illuminator OFF when not in use.
SURGICAL
TM
Figure 4-6 EXTRUSION LINE CONNECTION - The extrusion line is connected between
the extrusion handpiece and Accurus® system as diagrammed above.
SURGICAL
TM
Figure 4-7 ILLUMINATOR PROBE CONNECTOR - The fiber optic illuminator plugs
into an adaptor and then into the illuminator drawer.
4.12
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Accurus®
1. Open Fragmatome™* accessory pak and present contents to Scrub Nurse. Circulating Nurse
4. Accept the handpiece from Circulating Nurse and present the Scrub Nurse
handpiece connector to Circulating Nurse.
5. Accept the connector from Scrub Nurse. Select Frag on the Circulating Nurse
Vitreoretinal Surgery Setup Vacuum screen and plug the connector into
the illuminated receptacle (see Figure 4-8); the red dot on the handpiece
connector must align with the red dot on the console receptacle.
6. Thread Fragmatome™* tip into handpiece and tighten with tip wrench. Scrub Nurse
Use only the tip and wrench from the accessory pak. Open extrusion
line tubing and present the female connector to Circulating Nurse.
7. Accept the connector from Scrub Nurse and connect it to the left Circulating Nurse
illuminated cassette connector (see Figure 4-8).
8. Using a female-to-female luer adapter, supplied in the Total Plus® Scrub Nurse
Pak, attach the extrusion line tubing male luer connector to the
Fragmatome™* male luer connector. Place Fragmatome™* tip into
the fluid-filled cup for aspiration line priming and handpiece tuning.
TM
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Accurus®
1. Before priming and testing/tuning, verify the tips of aspirating Scrub Nurse
probes and handpieces are immersed in the fluid-filled cup. The
Fragmatome™* tip must be freely suspended in the fluid, not
touching the walls or the bottom of the cup, to successfully tune.
2. Before priming and testing/tuning, verify the correct modes of Scrub Nurse
operation are selected on the Vitreoretinal Surgery Setup screen.
3. Press Test on the Vitreoretinal Surgery Setup screen. The popup screen Scrub Nurse
disappears upon completion of the prime and test/tune sequences, and
the appropriate submode is automatically entered.
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Accurus®
1. Open a sterile Fluid/Gas Exchange Tubing Set and present contents to Circulating Nurse
Scrub Nurse.
2. Accept contents of Fluid/Gas Exchange Tubing Set. Remove tubing Scrub Nurse
from package and attach its male luer connector to the female
connector on the infusion stopcock (see Figure 4-9). Present the filter
end of the tubing to Circulating Nurse. Select CVGFI-F/AX on the
Vitreoretinal Surgery Setup screen.
3. Accept the filter end of the tubing from Circulating Nurse and plug it Circulating Nurse
into the console's illuminated connector.
WARNING!
Ensure filter is in place and is used in conjunction with the consumable.
Removal of filter can expose patient to contamination.
4. Turn on the air pump by pressing the F/AX global function key and Scrub Nurse
adjust the pressure level as required.
SURGICAL
Infusion
cannula
O
F
F
Figure 4-9 F/AX INFUSION LINE CONNECTION - The filter end of the F/AX infusion
line connects to the Accurus® system as diagrammed above. The male
luer connector plugs into the infusion line stopcock.
8065750203
* FOR REFERENCE ONLY * 4.15
Accurus®
1. Press Settings on the Vitreoretinal Surgery Setup screen. In the Scrub Nurse
Infusion Settings Type tab select VGFI, and in the Infusion tab select
your desired options. Press Apply.
2. Open VGFI™* Tubing Set package and present contents to Scrub Nurse. Circulating Nurse
3. Remove top coil from the VGFI™* Tubing Set package. Position Scrub Nurse
snap clamp along tubing to preferred location and snap closed.
Remove infusion cannula from Total Plus® Vitrectomy Pak and
attach it to VGFI™* stopcock (see Figure 4-10). If desired, the extra
stopcock included in the tubing set can be inserted between the
cannula and the first stopcock, allowing gas infusion capability.
5. Connect the air line filter to the illuminated VGFI™* connector. Circulating Nurse
WARNING!
Ensure filter is in place and is used in conjunction with the consumable.
Removal of filter can expose patient to contamination.
6. Turn the air pump ON by pressing the Infusion global function key Scrub Nurse
(the top key labeled either mmHg or cmH20) and adjust the pressure
level set point as required.
7. Pre-spike the infusion bottle using the spiking tool, wait three Circulating Nurse
seconds, then remove. Carefully insert drip chamber/vent tube into
bottle. Hang the bottle so its drip chamber is at patient eye level.
Squeeze drip chamber until it is a little more than half full of fluid.
8. Prepare a cup to accept fluid from the infusion line. Scrub Nurse
9. Open the snap clamp to prime the infusion line, and after scrub nurse Circulating Nurse
partially fills a cup with approximately 50 ml of fluid, close the snap
clamp. The cup of fluid will be used to prime the aspiration lines.
WARNING!
Visually confirm adequate infusion flow from the infusion cannula
prior to attachment to the eye.
4.16
* FOR REFERENCE ONLY * 8065750203
Accurus®
SURGICAL
TM
O
F
F
Snap clamp
Figure 4-10 VENTED GAS FORCED INFUSION CONNECTION - VGFI™* tubing is connected to the Accurus® console,
the bottle of BSS Plus® intraocular irrigating solution, and the infusion cannula as diagrammed above.
A second stopcock can be added to include gas infusion as well.
8065750203
* FOR REFERENCE ONLY * 4.17
Accurus®
4. Accept IOS handpiece from Circulating Nurse and screw MicroScissors Scrub Nurse
tip onto handpiece; tighten finger tight.
6. Accept IOS tubing from Circulating Nurse and press its bare end over Scrub Nurse
the handpiece's shaft. Pass IOS tubing connector to Circulating Nurse.
7. Accept IOS tubing connector from Scrub Nurse. Select Scissors Circulating Nurse
on the Vitreoretinal Surgery Setup screen and connect tubing to the
illuminated scissors connector (see Figure 4-11). Calibrate scissors tip
as required (see Scissors Mode in Section Three of this manual).
Scissors adjustment
SURGICAL
TM
Figure 4-11 SCISSORS LINE CONNECTION - The scissors line is connected between
the scissors handpiece and Accurus® console as diagrammed above.
4.18
* FOR REFERENCE ONLY * 8065750203
Accurus®
1. Press MPC in the Accessories section of the Vitreoretinal Surgery Circulating Nurse
Setup screen.
5. Accept connector from Scrub Nurse and plug into illuminated MPC Circulating Nurse
scissors connector on front of Accurus® console (see Figure 4-12).
6. Select Surgery on the Vitreoretinal Surgery Setup screen, then press Circulating Nurse
Scissors/MPC.
MPC HANDPIECE
SURGICAL
TM
Figure 4-12 MPC SCISSORS CABLE CONNECTION - The MPC scissors cable is
connected to the Accurus® console as diagrammed above.
8065750203
* FOR REFERENCE ONLY * 4.19
Accurus®
DIATHERMY SETUP
There are two types of diathermy probes and cables: reusable and single use.
Reusable probes and cables must be steam sterilized prior to use. Sterilization
instructions are included in Section Five of this operator's manual.
1. Press Diathermy in the Accessories section of the Combined Surgery Circulating Nurse
Setup screen.
3. Accept diathermy probe/cable from Circulating Nurse. Connect cable Scrub Nurse
to diathermy probe (see Figure 4-13), ensuring that instrument pins
are fully seated in cable receptacle. Present banana plug connectors to
Circulating Nurse.
4. Accept banana plug connectors from Scrub Nurse. Select Diathermy Circulating Nurse
on the Vitreoretinal Surgery Setup screen and connect the banana
plugs into the illuminated Diathermy receptacles. Adjust the
Diathermy power level as required.
SURGICAL
TM
4.20
* FOR REFERENCE ONLY * 8065750203
Accurus®
1. Open a sterile Viscous Fluid Control (VFC) Pak and present contents Circulating Nurse
to Scrub Nurse.
2. Accept contents of pak from Circulating Nurse. Pass connector end of Scrub Nurse
VFC tubing to Circulating Nurse.
3. Accept tubing connector from Scrub Nurse. Press the VFC key on Circulating Nurse
the Vitreoretinal Surgery Setup screen and connect tubing to the
illuminated VFC connector (see Figure 4-14).
4. Press the Surgery mode key, then press the VFC mode key—the Circulating Nurse
VFC: Inject screen appears. For injection proceed to step 5. For
extraction proceed to step 7.
5.1 Ensure syringe tip cap is properly engaged. Following the Scrub Nurse
directions for use supplied with the sterile viscous fluid,
aseptically transfer viscous fluid to the syringe barrel. Care should
be taken to prevent air bubbles from entering the fluid. Take
special care if transferring 5000 centistoke fluid.
5.2 Initiate syringe stopper insertion (found in small parts tray). Scrub Nurse
5.3 Orient barrel as shown, with tip cap up. Remove the syringe tip Scrub Nurse
cap to allow air to escape, and complete syringe stopper insertion.
5.4 Keeping the cannula cover on, attach the desired surgical cannula Scrub Nurse
to the syringe (0.9mm [20 gauge] diameter, 8mm long blunt
cannula provided).
5.5 Using the plastic push rod (found in the small parts tray), advance Scrub Nurse
the syringe stopper to position the viscous fluid level at the
cannula. Remove push rod.
5.6 Connect the syringe barrel to the white syringe adapter by Scrub Nurse
pushing down and rotating the barrel 90°. Ensure barrel flanges
are totally engaged within the adapter.
8065750203
* FOR REFERENCE ONLY * 4.21
Accurus®
AIR
Push
Rod
Step 5.2 Step 5.3 Step 5.4 Step 5.5 Step 5.6 Step 5.7
10
1
2
3
4
5
6
7
8
9
B-D
SURGICAL
TM
Figure 4-14 VISCOUS FLUID INJECTOR CONNECTION - For viscous fluid injection the barrel of the syringe is
filled with sterile fluid and connected to the Accurus® console as diagrammed above. Do not use this
diagram for fluid extraction, although extraction uses this same port on the connector panel.
4.22
* FOR REFERENCE ONLY * 8065750203
Accurus®
5.7 Remove the cannula cover. Tilt the cannula tip up and carefully Scrub Nurse
pressurize the syringe to expel any remaining air. Wrap the
cannula tip in sterile gauze, lint free cloth, or sponge to capture
any expelled fluid. The VFC system is now ready to use.
WARNINGS!
Do not use if air bubbles are observed passing through the fluid.
5.8 Press the arrow keys to adjust the Max Limit Pressure. Circulating Nurse
WARNINGS!
Adjust Max Limit Pressure in accordance with the viscosity of fluids to
be injected. Excessively high settings may endanger the patient.
6.1 Perform Viscous Fluid Control Setup procedure, then select the Staff
Dual submode. Circulating Nurse
7.1 Perform Viscous Fluid Control Setup procedure steps 1-4. Staff
CAUTION
Failure to insert syringe stopper can allow fluids to enter the
console, resulting in damage to its internal parts.
7.4 Press white syringe adapter into syringe barrel. When fully Scrub Nurse
inserted, turn 90˚to secure adapter to barrel.
8065750203
* FOR REFERENCE ONLY * 4.23
Accurus®
7.5 Carefully depress the footpedal to pressurize the injector, pushing Scrub Nurse
the syringe stopper to the bottom of the barrel. Release footpedal.
Alternately, the plastic push rod may be used to push the syringe
stopper to the bottom of the barrel.
7.6 Select the Extract submode, then press the arrow keys to adjust Circulating Nurse
the Max Limit vacuum setting.
4.24
* FORLast
REFERENCE
page of this section ONLY * 8065750203
Accurus®
SECTION FIVE
POSTERIOR DISASSEMBLY AND CLEANING
NOTES: If an inconsistency ever exists between the procedures in this section and the DFU,
follow the instructions in the DFU. During these procedures discard all consumables per
specific hospital/clinic requirements.
1. Remove bottle from hanger and disconnect drip chamber from bottle.
2. Remove the vacuum lines from the cassette. Remove all consumable/accessory
pneumatic and/or electric connections from the lower front panel of the console.
Remove drape (if used).
3. Use the female and male twistlock port plugs from the parts kit to seal the two
vacuum ports on the cassette. Press Exit to go to the Vitreoretinal Surgery Setup
screen, then push the Clean key to transfer fluid collected in the cassette to its
drain bag.
4. Press the Eject button. This initiates a two to three second sequence that
releases the drain pump tubing and unlatches the cassette. After visually
confirming that the cassette is unlatched, grasp the cassette handle and remove
cassette from cassette well in an outward motion (see Figure 5-1).
500
400
300
200
100
FIGURE 5-1 CASSETTE REMOVAL - With power turned ON, the fluid cassette with drain bag is
ejected from the Accurus® cassette well by pressing the Eject button on the front
panel. If no pressure or electrical power are available, lift the rear panel lever and
wiggle the cassette out.
8065750203
* FOR REFERENCE ONLY * 5.1
Accurus®
5. Use the small rubber stopper from the parts kit to plug the cassette's vacuum
port (see Figure 5-2).
If a fluid sample is being sent to the lab for testing, the drain bag can be
detached from cassette. Wipe the drain bag's injection site with alcohol to ensure
that the exposed rubber is clean. Use a non-coring needle less than 1” long to
draw a lab sample. Discard consumbles.
CAUTION
If 1" needles are used, take care to push the needle hub into the injection site’s
rubber plug. Otherwise, the needle tip could extend beyond the length of the
injection site’s protective body.
Vacuum port
FIGURE 5-2 PLUG THE VACUUM PORT - The vacuum port must be plugged with a rubber stopper
immediately after each surgery to prevent fluid leakage.
7. Remove the tubing from the handpiece and unplug the handpiece connector
from the console.
8. Remove all consumables from the handpiece and discard according to hospital
guidelines.
10. Using a clean syringe, draw a minimum of 120 cc of distilled water through the
aspiration path.
11. Using the same syringe, flush the aspiration port with air.
5.2
* FOR REFERENCE ONLY * 8065750203
Accurus®
WARNINGS!
If these cleaning procedures are not performed immediately after each surgical
procedure, tissue debris and salts from irrigating solution may collect. This could
permanently damage the handpiece and could jeopardize cleanliness and/or create
biohazard conditions for the patient. Do not autoclave the handpiece until all debris
has been removed.
If in the medical opinion of the physician a patient with a prion related disease
undergoes a high risk procedure, the instrument should be destroyed or be
processed according to local requirements.
Never immerse the handpiece in liquid after autoclaving; allow it to air cool for
at least 15 minutes. Be sure the handpiece connector is completely dry before
connecting it to the console.
Prior to sterilization, the Fragmatome™* handpiece should always have the connector
end cap secured and placed in the sterilization tray. This will prevent damage to
connectors and handpieces during handling, and especially during autoclaving.
Handle the handpiece carefully. Dropping or otherwise striking the handpiece may
fracture piezoelectric elements contained within and degrade performance or render
the handpiece inoperable.
15. Wipe down the IOS handpiece with a damp cloth and flush the tubing at least
once with a syringe filled with 30 cc of warm distilled water. Flush immediately
with air to clear any water from the handpiece and tubing.
16. Please refer to Grieshaber® literature that came with your MPC scissors for
cleaning and sterilization instructions.
Clean the Extrusion Handpiece:
18. Remove the extrusion needle. If it is a single use needle, properly discard it.
19. Flush extrusion handpiece and reusable extrusion needle at least two times with
a syringe filled with 30 cc of warm distilled water. Flush immediately with air to
clear any water from the handpiece and needle.
8065750203
* FOR REFERENCE ONLY * 5.3
Accurus®
22. Clean reusable handpiece by wiping off residual tissue with a soft, non-abrasive
cloth. Rinse the handpiece and cable with distilled water to remove any
remaining debris.
23. Hand wash the reusable handpiece and cable using a soft bristled cleaning
brush. The use of abrasive cleaners or solvents is not recommended.
24. Thoroughly flush all handpiece and cable surfaces with distilled water until no
visible debris remains. Dry the handpiece and cable with a sterile wipe.
NOTE: If the Accurus® system remains plugged in, always ensure that the
rear panel On/Off switch is in the OFF position.
2. If required, the console and remote control may be cleaned with non-corrosive
germicidal solution, alcohol, or mild soap and water.
CAUTIONS
• Do not clean console or accessories using solvents or abrasives.
• Avoid spilling BSS® solution, or moisture of any kind, around the
electrical handpiece connectors.
5.4
* FOR REFERENCE ONLY * 8065750203
Accurus®
STERILIZATION
The following accessories for the Accurus® Ophthalmic Surgical System may be flash or steam
autoclaved. Additionally, per the Sterilizer Equipment Manual, the sterilizer reservoir is to be filled
with distilled or deionized water.
• Fragmatome™* Handpiece
• Intraocular Scissors (IOS) Handpiece and IOS Tubing
• Extrusion Handpiece
• Reusable Diathermy Handpiece and Cable
• Reusable Infusion Accessories
NOTE: The list of reusable accessories above will withstand steam autoclave cycles at 134º C
(273º F). Due to the variation found in steam autoclaves and the variable bioburden on
instruments in clinical use, it is not possible for Alcon to provide specific parameters to ensure
an adequate sterility assurance level. Validation of the individual autoclave, and verification of
the sterility assurance level achieved with a given steam sterilization cycle, must be performed
by each hospital.
The specifications in Table 5-1 represent industry standard guidelines for steam sterilization cycles.
The sterility assurance level achieved with these parameters must be validated by each
hospital. Please refer to current ANSI/AAMI Standards or your hospital’s standard procedures for
the most current specifications.
NOTE: For maximum life and optimum performance, allow handpieces to air cool after steam
or flash autoclaving. Cooling for Fragmatome™* handpieces should be a minimum of 15
minutes.
NOTE: For instructions to sterilize the Membrane Peeler Cutter (MPC) scissors handpiece,
please refer to the Grieshaber® literature that came with your MPC scissors.
8065750203
* FOR REFERENCE ONLY * 5.5
Accurus®
5.6
* FORLastREFERENCE
page of this section
ONLY * 8065750203
Accurus®
SECTION SIX
POSTERIOR ACCESSORIES AND PARTS
Following is a list of Alcon‑approved accessories and replacement parts for the Accurus® Ophthalmic
Surgical System. To order parts, please refer to your Alcon price list and/or contact Alcon Customer
Service at:
Phone: Write:
(800) 862‑5266 or Alcon
(817) 293‑0450 6201 South Freeway
Ask for Customer Service Fort Worth, TX. 76134‑2099
Important Note: Use of accessories and parts not approved by Alcon is not recommended.
Paks
AccuPak® with Accurus® Probe 8065400045
AccuPak® with Accurus® 1500 Probe 8065741013
AccuPak® with Accurus® 2500 Probe 8065741012
AccuPak® with Accurus® 23 Ga Probe 8065750827
AccuPak® with Accurus® 25 Ga Probe 8065750930
AccuPak® Vitrectomy Set with Accurus® 25+ Probe 8065751490
AccuPak® with InnoVit® Probe 8065400145
Total Plus® Pak with Accurus® Probe 8065740252
Total Plus® Pak with Accurus® 1500 Probe 8065741015
Total Plus® Pak with Accurus® 2500 Probe 8065741017
Total Plus® Pak with Accurus® 23 Ga Probe 8065750828
Total Plus® Pak with Accurus® 25 Ga Probe 8065750220
Total Plus® Pak with Accurus® 25+ Probe 8065751493
Total Plus® Pak with InnoVit® Probe 8065740253
Fragmatome™* Accessory Pak 1021HP
VGFI™* Tubing Set 8065808002
Fluid/Gas Exchange Tubing Set 8065807001
Viscous Fluid Control Pak 8065750118
Scleral Plugs, 19 and 20 gauge (6) 8065807550
Consumable Accessories
2.5 mm Infusion Cannula 8065820001
4.0 mm Infusion Cannula 8065820101
6.0 mm Infusion Cannula 8065820201
Silicone Oil Infusion Cannula 8065740262
Remote Control Aseptic Transfer 20000TP
Accurus® Replacement Drain Bags 8065740743
Trocar Blade, 23 Ga, 3 Ct 8065750882
Trocar Cannula Set, 23 Ga, 1 Ct 8065750839
8065750203
* FOR REFERENCE ONLY * 6.1
Accurus®
Console Accessories
Cart w/IV Pole 8065740943
Cart w/Power IV Pole 8065740825
Remote Control 8065740942
Remote Control, English Text 8065750105
Footswitch (5 switch) 8065740240
Pneumatic Pressure Hose 804-1193-501SVC
Illuminator Bulb 8065740243
Operator’s Manual 8065750203
Accurus® Doctor Memory Card 8065750200
Footpedal (6 switch) 8065740997
6.2
* FOR REFERENCE ONLY * 8065750203
Accurus®
Vit Accessories
2.5 mm Infusion Cannula 800-2A
4.0 mm Infusion Cannula 800-2B
6.0 mm Infusion Cannula 800-2D
Silicone Oil Infusion Cannula 8065740262
Blunt Tip Needle, Straight, 20 ga. 800-26A
Blunt Tip Needle, Tapered, 20 ga. 800-26B
Blunt Tip Needle, Tapered, 19 ga. 800-26D
Infusion Needle Tubing 800-7
Intraocular Scissors Tubing 8065740265
Cross Action Plug Forceps 830-20A
Scleral Plugs, 20 ga. (4/tablet) 830-18
Scleral Plugs, 19 ga. (4/tablet) 830-24
Vit Handpieces
375/40 Fragmentation Handpiece 8065740242
Extrusion Handpiece (set of 4) 8065808601
19 ga. Straight Extrusion Handpiece 8065808701
19 ga. Tapered Extrusion Handpiece 8065808801
20 ga. Straight Extrusion Handpiece 8065808901
20 ga. Tapered Extrusion Handpiece 8065809001
Charles O’Malley Extrusion Kit 800-26
Extrusion Kit Handpiece 800-26E
Intraocular Scissors Handpiece 8065808101
MPC Scissors, Lightweight 0.9 mm 625.13
MPC Scissors, Fine Tip Handle 0.7 mm 625.12
8065750203
* FOR REFERENCE ONLY * 6.3
Accurus®
Probes
InnoVit® 8065740244
Accurus® 8065740241
Accurus® 1500 8065741016
Accurus® 2500 8065741018
Accurus® 23 Ga Probe 8065750821
Accurus® 25 Ga Probe 8065750226
Accurus® 25+ Probe 8065751122
Fiber Optic Assy, 23 Ga 8065750802
Fiber Optic Assy, 25 Ga 8065750190
Illuminator (DFOI) 8065812001
Fiber Optic Assy, Bare End 8065740257
Fiber Optic Assy, 25+ 8065751165
Fiber Optic Assy, Wide Angle 8065740264
Fiber Optic Assy, End Irrigating 8065740259
Fiber Optic Assy, Straight Pick 8065740260
Fiber Optic Assy, Pre-Bent 8065740258
Vertical Micro Scissors (1mm) 8065813701
Vertical Micro Scissors (1.5mm) 8065803701
Laser Probe, Straight Needle, 23 Ga 8065750803
Laser Probe, Straight Needle, 25 Ga 8065750133
Illuminated Laser Probe, HGM* Connector, Curved Needle, ACMI 8065103040
Illuminated Laser Probe, HGM* Connector, Straight Needle, ACMI 8065010320
Illuminated Laser Probe, Alcon®/Coherent* Connector, Curved Needle, ACMI 8065010404
Illuminated Laser Probe, Alcon®/Coherent* Connector, Straight Needle, ACMI 8065010420
Shielded Bullet Endo Illuminator, 20 GA, ACMI 8065109203
Shielded Bullet Endo Illuminator, with Pick, 20 GA, ACMI 8065109219
Sapphire Wide Angle Probe 8065750425
Laser Probe, Aspirating, Curved, 20 Ga 8065010703
Laser Probe, Aspirating, Straight, 20 Ga 8065010719
Laser Probe, Aspirating, Soft Tip, Straight, 20 Ga 8065010739
Laser Probe w/RFID, Aspirating, Curved, 20 Ga 8065750979
Laser Probe w/RFID, Aspirating, Straight, 20 Ga 8065750980
Laser Probe w/RFID, Aspirating, Soft Tip, Straight, 20 Ga 8065750981
Illuminated Laser Probe w/RFID, Alcon®/Coherent® Connector, Curved, 20 Ga, ACMI 8065750982
Illuminated Laser Probe w/RFID, Alcon®/Coherent® Connector, Straight, 20 Ga, ACMI 8065750983
Articulating Illuminated Laser Probe w/RFID, Alcon®/Coherent® Connector, 20 Ga, ACMI 8065751105
Articulating Illuminated Laser Probe w/RFID, Alcon®/Coherent® Connector, 23 Ga, ACMI 8065751106
Articulating Illuminated Laser Probe w/RFID, Alcon®/Coherent® Connector, 25 Ga, ACMI 8065751107
6.4
* FORLastREFERENCE
page of this section ONLY * 8065750203
Accurus®
SECTION SEVEN
ANTERIOR DESCRIPTION
Upon entering the Anterior domain, the system displays the Cataract Surgery Setup
Screen, shown below in Figure 7-1. On this screen the user can prepare the Accurus®
Ophthalmic Surgical System for surgery, then exit to another screen by pressing one
of the following keys on the touch screen:
The Cataract Surgery Setup screen can also be entered by pressing the Apply or
Cancel keys from the Cataract Irrigation Settings screen or the Exit key from an
Anterior Surgery screen.
Popup windows can appear over these screens to advise the user of certain conditions.
See Figure 2-55 for an example of a popup window.
There are six Cataract Surgery Setup screen components offered to prepare for
surgery. Two components—the handpiece and accessory selections—are in the
Primary Functions Window; and four components—Test, Clean, Surgery, and
Settings—are in the Modes Window (see Figure 2-9).
Figure 7-1 CATARACT SURGERY SETUP SCREEN - Entering the Cataract Surgery Setup screen
allows the user to prepare the Accurus® system for surgery.
8065750203
* FOR REFERENCE ONLY * 7.1
Accurus®
When entering a surgery screen from the Cataract Surgery Setup screen, or upon
successful prime/tune/test, the surgery mode corresponding to the currently tested
handpiece is selected automatically.
• Accessories
Pressing Diathermy or AVGFI illuminates an LED at its corresponding front panel
connector to identify where to plug in the handpiece or accessory. Making one
selection automatically deselects any other selection. Only the last-selected accessory
or handpiece LED illuminates.
• Test
When the Test key is pressed, the selected probe or handpiece is primed, and a popup
window indicates that priming and testing are active. Only the popup window keys
(Stop and Skip), global function Illuminator keys, and diathermy are operable
Test while the Test function is active. The surgery screen is entered automatically upon a
successful prime, test, and tune sequence.
If the Stop key is pressed during priming, the test function is aborted. If Skip is
pressed during priming, priming is skipped and handpiece testing/tuning begins.
An invalid error tone sounds when pressing the Test key with no probe or handpiece
selected. An advisory popup window appears when the U/S handpiece is selected but
not connected, when no cassette is inserted, or when priming/tuning has failed.
• Clean
Pressing the Clean key transfers fluid from the cassette into the drain bag. When
the Clean key is pressed, a popup window indicates cleaning is in progress. Only
the Stop key in the popup window, Continuous Irrigation On/Off keys, and global
Clean function Illuminator keys are operable while the clean function is active.
Pressing the Stop key during cleaning aborts the clean function. If fluid is not fully
transferred to the drain bag, press the Clean key a second time.
• Surgery
Surgery When the Surgery key is pressed, the system exits the Cataract Surgery Setup screen
and enters the selected surgery screen.
•Settings
When the Settings key is pressed, the system exits the Cataract Surgery Setup screen
and enters the Irrigation Settings Screen.
Settings
7.2
* FOR REFERENCE ONLY * 8065750203
Accurus®
The Irrigation Settings screen (see Figures 7-2 and 7-3) is entered by pressing the
Settings key on the Cataract Surgery Setup screen. In this anterior domain there
are two data tabs available on the screen: the Type tab and the Irrigation tab. (The
Infusion tab is not available and is grayed-out.) Pressing the Apply/Cancel key closes
this screen and returns to the Cataract Surgery Setup screen. Cancel returns with no
changes made; Apply returns and applies Type and Irrigation settings to the system.
• Type Tab
The irrigation Type tab determines how irrigation pressure is provided for surgery,
and is divided into three groups: Anterior Irrigation, Posterior Infusion, and Combined
Infusion/Irrigation. In this domain, only the Anterior Irrigation group is available.
Figure 7-2 IRRIGATION SETTINGS SCREEN: TYPE TAB - The Type tab allows the user to select
the type of Anterior Irrigation desired. Selecting the Irrigation tab offers alternate
irrigation choices, shown in Figure 7-3.
The Type tab contains keys for the following irrigation methods: AVGFI (Anterior
Vented Gas Forced Infusion), Power Pole, and Gravity. Pressing the Cancel key exits
the Irrigation Settings screen and returns to the previous screen without any modifications
taking effect. Pressing the Apply key accepts settings for both this tab and the Irrigation
tab, exits the Irrigation Settings screen, and returns to the Cataract Surgery Setup screen.
When AVGFI is selected, infusion pressure is provided by applying air pressure into
the fluid bottle. An internal air pump creates pressurized air, and Anterior VGFI™*
tubing delivers it to the bottle from a front panel connector. The air pressure setting is
adjusted with the global irrigation up/down buttons; the corresponding LED readout is
immediately to the left of the buttons and indicates air pressure at the console. Note:
Fluid bottle should be positioned at patient eye level.
The Power Pole selection requires that the optional cart with power IV pole be
connected to the Accurus® system. With the fluid bottle hanging from the cart's power
IV pole, irrigation pressure is set by pressing the global up/down keys to the desired
pressure, and the power pole automatically moves up or down to the required height.
8065750203
* FOR REFERENCE ONLY * 7.3
Accurus®
• Irrigation Tab
The Irrigation tab allows the user to set Regular and Alternate irrigation pressures,
and the ability to select whether Alternate pressure is Available Yes/No. Alternate
pressure works with AVGFI and power pole irrigation; therefore, when gravity
irrigation is selected, these selections are grayed out and not functional. The pressure
values for Phaco, I/A, and Vit can be adjusted by pressing the up/down arrows next to
the value. The regular and alternate pressures are toggled by pressing the footswitch's
right vertical switch. Selecting Alternate Yes or No determines whether alternate
pressure will be available with the footswitch.
Pressing the Cancel key exits the Irrigation Settings screen and returns to the
previous screen without any modifications taking effect. Pressing the Apply key
accepts the settings, exits the Irrigation Settings screen, and returns to the Cataract
Surgery Setup screen.
Figure 7-3 IRRIGATION SETTINGS SCREEN: IRRIGATION TAB - The Irrigation tab allows the
user to adjust the Regular and Alternate Irrigation pressures, and the ability to select
whether alternate pressure is available.
7.4
* FOR REFERENCE ONLY * 8065750203
Accurus®
Global functions are available in all surgery and setup screens. There are four global
functions which, generally, can be selected, adjusted, and displayed at any time.
When a global function is selected its color icon turns blue and its LED readout
illuminates brightly. (There are two exceptions. One exception is diathermy. Its LED
readout is always lit, and its color icon turns blue when activated with the footswitch.
The second exception is AVGFI. After activation the air pump remains ON and the
LED readout remains dimly lit, unless continuous irrigation is turned ON, when its
color icon and LED readout remain illuminated.)
A global function setting can be adjusted, even when the function is OFF, by pressing
its corresponding Up/Down arrow buttons. If the function is OFF, the LED readout
becomes dimly lit while making adjustments, then becomes blank after a few seconds
(except for diathermy as mentioned above).
• Irrigation
Irrigation pressure is delivered through one of three types: Anterior VGFI™*, Power
IV Pole, or Gravity. Selection of irrigation method is provided in the Irrigation
Settings screen (see Figure 7-2).
cmH20
In anterior surgeries the fluid is delivered to the eye via a handpiece connected by
tubing to the cassette. Irrigation ON/OFF control is maintained by the footpedal;
depressing the footpedal starts irrigation, and releasing the pedal stops it. (Continuous
irrigation is also available.) When footpedal activates irrigation the LED readout
cmH20 illuminates brightly, and the icon's water drop enlarges and turns blue. For Continuous
Reflux the icon background also turns bright blue.
When AVGFI (Anterior Vented Gas Forced Irrigation) is selected in the Irrigation
Settings screen and activated by pressing its global icon, the Accurus® system delivers
filtered, pressurized air through a tubing set into the infusion bottle, which in turn
pressurizes fluid through the cassette and handpiece to the eye. The global up/down
arrow buttons are used to adjust the fluid pressure, displayed as cmH2O or mmHg.
Pressing down on the footswitch's right vertical switch during surgery toggles between
regular and alternate irrigation pressure, when available.
The Power Pole selection uses gravity to pressurize fluid when the bottle is hanging
from the optional power IV pole. Irrigation pressure can be set by pressing the global
up/down buttons until the desired LED pressure readout is displayed. The power
IV pole automatically raises or lowers to the correct height, and the LED pressure
readout blinks as the pole is moving. Pressing down on the footswitch's right vertical
switch toggles between regular and alternate irrigation pressure, when available.
• Continuous Irrigation
Continuous irrigation, independent of the footpedal, is turned ON/OFF by pressing
either the global irrigation icon or pressing sideways on the footswitch's right
horizontal switch. Continuous irrigation is available in Gravity, Power Pole, and AVGFI.
cmH20
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• Diathermy
The diathermy global function provides fixed diathermy capability through the use
of diathermy probes and handpieces. Diathermy output is available at all times,
% controlled by the footswitch, and is based on the percent of maximum voltage output.
Diathermy power is adjusted with the up/down arrow buttons on the front panel, with
the percentage of maximum diathermy voltage output displayed.
When the diathermy % icon is pressed, a popup window is displayed to remind the
operator to use the footswitch to control this function. This popup window can be
removed by pressing the screen's Continue key or activating the diathermy function.
The diathermy function can be activated in all modes by pressing the footswitch's left
vertical switch. In Phaco mode the footpedal must be released before you can activate
diathermy; in I/A and Vit modes the footpedal is inconsequential.
Illum2
In the event of a burnt bulb a System Advisory appears on the screen, and the
illuminator's icon dims and is covered with a strike. The user should then remove and
plug the light pipe into the other illuminator receptacle, press OK, and proceed.
Illum2 NOTE: Upon completion of the procedure it is recommended that the burnt bulb
be replaced. Two illuminator sources should always be available. (See Care and
Maintenance, Section Fifteen of this manual, for instructions to replace bulb.)
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The Accurus® system offers three surgery modes in the anterior domain—depicted
as icons in the Modes Window at the bottom of the touch screen—and each surgery
mode has submodes (see Table 7-1). The active mode and submode keys are
highlighted, and their names are displayed in the Title Window.
To enter a surgery mode, press its associated icon key on the touch screen. The
previous surgery mode or submode is deactivated when a new mode or submode is
selected, and front panel LED's illuminate to indicate which connectors are active.
To enter a surgery submode, press the key above its associated mode key. Pressing a
mode key successively causes the system to cycle through the available submodes.
NOTE: The footpedal must be released, and none of the footswitches depressed,
to enter or change a surgery mode. However, for Phaco and I/A modes,
submodes may be changed while footpedal is in first detent position.
When a surgery mode is first entered after power up, the system enters its factory
default settings, or if a doctor memory has been selected, the doctor's programmed
values are used. If the defaults are then adjusted, re-entry to that mode will display the
new values. Turning system power OFF resets all values back to the factory default
settings, as does switching to another domain.
Functional operations to the Accurus® console are accepted from a footswitch. The
footswitch consists of a footpedal, right and left horizontal/vertical switches, and right
and left vertical heel switches. Functions controlled by the footswitch are listed in
Tables 7-2, 7-3, 7-4, and 7-5.
MODE SUBMODES
Table 7-1 ANTERIOR DOMAIN SURGERY MODES - Three surgery modes are available in the
anterior domain. Each mode has submodes, as shown in this table, with the default
submode shown in bold type.
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Phaco Linear Diathermy Cont. Reflux Programmable Alternate Irr. Continuous Irr. Reflux
Burst Diathermy Cont. Reflux Programmable Alternate Irr. Continuous Irr. Reflux
Fixed Diathermy Cont. Reflux Programmable Alternate Irr. Continuous Irr. Reflux
I/A CapVac Diathermy Cont. Reflux Programmable Alternate Irr. Continuous Irr. Reflux
Max Diathermy Cont. Reflux Programmable Alternate Irr. Continuous Irr. Reflux
Vit Wet Diathermy Cut Disable Programmable Alternate Irr. Cut Enable Reflux
Dry Diathermy Cut Disable Programmable Alternate Irr. Cut Enable Reflux
Setup N/A Diathermy N/A Programmable Alternate Irr. Continuous Irr. N/A
Table 7-2 ANTERIOR FOOTSWITCH FUNCTIONS FOR DEFAULT MAP A - The footswitch contains a
footpedal, left and right switches which are either actuated horizontally or depressed vertically
with the user's toe, and left and right vertical heel switches. These three tables represent the
factory default settings for Map A, Map B, and Map C, but can be programmed otherwise as
instructed in section two of this manual (Options/Memory/Common/Footswitch).
Phaco Linear Diathermy Reflux Programmable Alternate Irr. Continuous Irr. Programmable
I/A CapVac Diathermy Reflux Programmable Alternate Irr. Continuous Irr. Programmable
Vit Wet Diathermy Reflux Programmable Alternate Irr. Cut Toggle Programmable
Setup N/A Diathermy N/A Programmable Alternate Irr. Continuous Irr. Programmable
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Phaco Linear Diathermy Reflux Programmable Irr. Pressure + Continuous Irr. Irr. Pressure –
Burst Diathermy Reflux Programmable Irr. Pressure + Continuous Irr. Irr. Pressure –
Fixed Diathermy Reflux Programmable Irr. Pressure + Continuous Irr. Irr. Pressure –
I/A CapVac Diathermy Reflux Programmable Irr. Pressure + Continuous Irr. Irr. Pressure –
Max Diathermy Reflux Programmable Irr. Pressure + Continuous Irr. Irr. Pressure –
Vit Wet Diathermy Reflux Programmable Irr. Pressure + Cut Toggle Irr. Pressure –
Dry Diathermy Reflux Programmable Irr. Pressure + Cut Toggle Irr. Pressure –
Setup N/A Diathermy N/A Programmable Irr. Pressure + Continuous Irr. Irr. Pressure –
• In all modes except Vit, reflux will be continuous if supported by the anterior single use cassette, or pulsed if not.
• The default for the Left Heel is Next Memory.
• The Left and Right Heel switches may be programmed to have single-click or double-click activation of all heel switch functions.
Table 7-4 ANTERIOR FOOTSWITCH FUNCTIONS FOR DEFAULT MAP C
Phaco Linear Diathermy Reflux *Irr. Pressure - Programmable Continuous Irr. **Irr. Pressure +
Burst Diathermy Reflux *Irr. Pressure - Programmable Continuous Irr. **Irr. Pressure +
Fixed Diathermy Reflux *Irr. Pressure - Programmable Continuous Irr. **Irr. Pressure +
I/A Cap Vac Diathermy Reflux *Irr. Pressure - Programmable Continuous Irr. **Irr. Pressure +
Max Diathermy Reflux *Irr. Pressure - Programmable Continuous Irr. **Irr. Pressure +
Vit Wet Diathermy Reflux *Irr. Pressure - Programmable Cut Toggle **Irr. Pressure +
Dry Diathermy Reflux *Irr. Pressure - Programmable Cut Toggle **Irr. Pressure +
Setup N/A Diathermy N/A *Irr. Pressure - Programmable Continuous Irr. **Irr. Pressure +
* Pressing the Left Heel switch decreases pressure by 5 (mmHg or cmH20) when pressure is equal to 30 or higher, or by 2 if below
30. If the switch is held down for 1 second, pressure changes to Normal Pressure preset value if currently above the preset value;
otherwise, pressure remains at the current setting.
** Pressing the Right Heel switch increases the pressure by 5 (mmHg or cmH20) when pressure is equal to 30 or higher, or by 2 if below
30. If the switch is held down for 1 second, pressure changes to Alternate Pressure preset value if currently below the preset value;
otherwise, pressure remains at current the setting.
• The reflux controlled by the Left Heel switch is pulsed.
• The default for the Right Vertical is Next Memory.
• Adjustments made with the Left and Right Heel switches are considered "temporary," as they will not change either the preset value or
preset alternate value. These preset values can be changed from the Irrigation settings screen or the Doctor Memory screens.
• The Left and Right Heel switches may be programmed to have single-click or double-click activation of all heel switch functions.
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The Phaco function provides vacuum and U/S power to the ultrasonic handpiece.
Irrigation and aspiration lines must be plugged into the handpiece, and its electric
cable plugged into the illuminated front panel connector.
Phaco The Phaco mode is entered when the Phaco handpiece is selected in the Cataract
Surgery Setup screen and the Surgery key is pressed, or when the Phaco key is
available from another mode. The Phaco mode consists of four submodes: Linear,
Burst, 3D, and Fixed, with Linear being the factory default. Each submode has its
own default values which are adjustable by pressing Up/Down triangle keys.
U/S Pulse controls are available in Linear and Fixed submodes, and can be turned
on/off by pressing the Pulse Rate touch key. The pulse rate can be adjusted using its
Up/Down triangle keys.
WARNINGS!
Use of a Phaco handpiece at power settings greater than 80% continuously for
over 4 minutes can result in ultrasonic system failure. Allow the system to cool for
8 minutes between heavy usage of this type.
During any ultrasonic procedure, metal particles may result from inadvertent
touching of the ultrasonic tip with a second instrument. Another potential source
of metal particles resulting from any ultrasonic handpiece may be the result of
ultrasonic energy causing micro abrasion of the ultrasonic tip.
Linear - In Phaco Linear submode (see Figure 7-4) irrigation is provided when the
footpedal is depressed. Linear vacuum, up to the Max Limit, is provided from detent
one through detent two, and sustained from detent two to full footpedal depression.
Linear U/S power is provided from detent two to full footpedal depression, with the
Figure 7-4 PHACO LINEAR MODE SCREEN - The Phaco Linear screen has an Actual Value % in the
U/S box which represents the amount of Max Power Limit delivered to the handpiece,
controlled with the footpedal. The U/S Fixed mode does not contain a U/S power Actual
Value box; it is not needed because U/S power turns ON at its Power Setpoint when
the pedal enters detent 2.
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preset Power Max Limit reached at full depression. Pulse On/Off control is available
by pressing the Pulse Rate touch key, and pulses per second (pps) is adjusted with its
up/down keys.
In the Phaco Burst submode fixed U/S power (Power %) can be adjusted for
frequency (Duty Cycle) and duration (Burst Length) of U/S power pulses. The
frequency of bursts is controlled with the footpedal from detent two to full treadle
depression, while the fixed burst length is set in milliseconds (ms). The actual percent
of time U/S power is activated is reflected in the Duty Cycle window.
Figure 7-5 PHACO BURST MODE SCREEN - In the Phaco Burst submode fixed U/S power can
be adjusted for frequency and duration of U/S power pulses.
Figure 7-6 PHACO 3D MODE SCREEN - In the Phaco 3D submode vacuum and U/S power delivered
to the probe are simultaneously regulated by the amount of footpedal depression.
The I/A mode provides irrigation and vacuum for aspiration to the I/A handpiece. This
function consists of two vacuum submodes: I/A Max (Maximum, the factory default)
and I/A CapVac (reduced vacuum). Each submode has its own default Max Limit
I/A vacuum level, adjustable using up/down keys, even when the footpedal is depressed.
Irrigation begins when the footpedal is depressed, and linear vacuum is provided from
detent two to full footpedal depression, with the preset Max Limit reached at full
depression.
Figure 7-7 I/A MAX MODE SCREEN - Shown here is the I/A Max display screen. The I/A CapVac
screen looks similar, but the Max Limit default setting is 30 mmHg. These modes
provide irrigation and vacuum to the I/A handpiece.
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The Anterior Vitrectomy function provides vacuum and cutting capabilities using a
pneumatically powered vitreous probe connected to a pulsed pressure source. The
preset vacuum and cut rate values are adjustable using the up/down keys, even when
Vit the footpedal is depressed. Wet Vit is the default mode, and is entered when the Vit
key is first pressed.
Wet - Pressing the footpedal into detent 1 initiates bimanual or coaxial irrigation.
Linear vacuum and cutting, when enabled, is provided from detent two to full
footpedal depression, reaching the preset maximum vacuum at full depression.
Dry - When cutting is enabled, pressing the footpedal into detent 1 initiates cutting
and linear vacuum, reaching the preset maximum vacuum at full depression. In this
mode irrigation flow is inhibited.
Figure 7-8 VIT MODE SCREEN - Shown here is the Wet Anterior Vitrectomy submode screen.
Anterior vitrectomy has two submodes, Wet and Dry, which are selected above the
Vit key. The Dry screen also looks like this screen, but the Dry mode doesn't have
irrigation control.
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Different handpieces and probes are required for each operating mode of the Accurus®
system. Following is a representative selection of handpieces and probes with a
general description of each. See the Accessories and Parts section of this manual,
or consult your Alcon representative, for a complete selection of all handpieces,
handpiece tips, and probes available.
CAUTION
Following autoclaving, ensure handpiece is at room temperature. Never immerse
handpiece in water or other fluid to cool it as it will cause serious damage to the
handpiece. Allow it to air cool for at least 15 minutes.
Irrigation/Aspiration Handpiece
The Irrigation/Aspiration (I/A) handpiece, connected to the Accurus® system with I/A
tubing, is used to remove cortical material via aspiration while maintaining chamber
pressure with irrigation.
INFUSION SLEEVE
A
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Vitrectomy Probes
The Accurus® and Accurus® 2500 probes are axial oscillating guillotine vitreous
cutters. These probes are designed for a single use and must be properly disposed of
when surgery is completed.
Diathermy/Coagulation Handpieces
Single use Bipolar Coagulation Brushes are available in a wide variety of
configurations: straight, curved, 20-gauge, 23-gauge, tapered, and widestroke. All
single use bipolar accessories are available with and without cables. Also available
are reusable and single-use bipolar cables.
ALCON
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SECTION EIGHT
ANTERIOR OPERATING INSTRUCTIONS
Introduction
This section of the manual contains typical setup procedures using anterior Accurus®
paks, then guidelines to navigate through the anterior domain.
The Accurus® pak setup procedures are written for a surgical team of three people:
Surgeon and Scrub Nurse in the sterile field, and Circulating Nurse in the non‑sterile
field. The instuctions are divided into two columns. In the left column a directive is
given, and in the right column a team member is identified to perform the task. These
procedures assume that a sterile drape is not being utilized; if it is applied to the front
of the console, the roles of the Circulating Nurse and the Scrub Nurse change.
If the system has problems when you perform the setup instructions, you should first
refer to the Troubleshooting section of this manual. If questions still exist, contact the
Alcon Technical Services Department or your local Alcon representative.
Power Up Sequence
Follow these steps each time you turn system power ON. This helps ensure that the
Accurus® Ophthalmic Surgical System is set up correctly and is ready for surgery.
2. Connect the air hose between the Accurus® console and the pressure supply
(compressed air or nitrogen). Verify that pressure is between 90 to 120 psi
(500 kpa minimum for reduced operation).
5. First turn system power ON using the rear panel ON/OFF switch and then the
front panel Standby switch. Alcon's Accurus® logo is displayed on the viewing
screen while the system completes its initialization and self-test diagnostics
(approximately 3 minutes). While completing diagnostics, confirm that the five
Global Function LED displays on the front panel flash 888 before the system
enters either the Procedure Selection screen or a Surgery Setup screen.
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If your system only offers anterior functions, or if the system has been programmed
in the System Parameters screen (Options/System) to automatically enter the anterior
domain, the Procedure Selection screen is bypassed. For systems that offer it, the
operator can return to the Procedure Selection screen by pressing the Exit key.
After entering a mode of operation, most surgical operations are controlled through
the doctor's footswitch, but before any surgery can be performed there are system
modes and parameters that must be selected. Most presurgical system preparation is
performed by inserting a cassette, connecting handpieces and accessories to the Accurus®
system, then pressing buttons to navigate through the system touch screens to make
operating selections. A brief outline of screens and their functions is presented below.
• Cataract Surgery Setup Screen - This screen is designed to help the operating
room staff prepare the system for anterior surgery.
You first insert a cassette, then in the Handpieces/Probes section of the screen
you select handpieces and probes you want to use. Plug handpieces and probes
into the illuminated front panel connectors, then press the Test key to test and
prime/tune the selections. The system automatically advances to the appropriate
surgery mode after testing is done.
One accessory can be selected at a time by pressing the desired item from the
Accessories choices. The associated front panel connectors illuminate to help
you plug the accessory into the correct connectors.
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Irrigation Settings
Phaco
PHACO: Linear
PHACO: Burst
PHACO: 3D
PHACO: Fixed
I/A
I/A: Maximum
I/A: CapVac
Vit
Figure 8-1 ANTERIOR MODES FLOW CHART - This flow chart highlights the system's anterior operating domain
with a general map to help you navigate through its modes of operation.
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The Settings key is pressed to open the Irrigation Settings screen. In the Type
tab you can select either AVGFI, Power Pole, or Gravity irrigation. In the
Irrigation tab, depending on your irrigation type, you can set a Regular and
Alternate Irrigation pressure, and select whether you want the alternate pressure
to be Available Yes/No. Pressing the Apply key returns you to the setup screen.
The Clean key is pressed to drain fluid from the cassette chamber into the drain
bag. During normal operation this function is performed automatically, but prior
to removing the cassette you may want to drain the remainder of fluid from the
chamber into the drain bag.
Depending on the last handpiece tuned, pressing the Surgery key opens the
associated surgery screen for that mode of operation.
The settings can be adjusted by pressing touch screen up/down arrow keys, increasing
or decreasing the values. If the settings are adjusted, re-entry to that mode will display
the new values. Table 8-1 shows the factory default settings for each mode, and the
adjustment ranges of each.
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Table 8-1. FACTORY DEFAULT SETTINGS AND ADJUSTMENTS - Listed here are the Accurus® system factory
default settings for the anterior modes of operation. The factory settings can be changed during
surgery, but turning system power OFF resets all values back to the factory default settings.
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The global keys are used to select global functions (except for the Diathermy key
which is always enabled for footswitch control). When selected, the global function
key is highlighted, the corresponding global parameter value in the LED display is
illuminated, and the console connector is illuminated to help connect the accessory.
The corresponding rubberized arrow buttons are used to adjust the global function
parameter values, which change repeatedly when the key is held down. The preset
parameter values are displayed on the LED displays.
Four global functions, accessed by pressing their icon keys on the left side of the
touch screen, are unique to the system's anterior domain.
Irrigation - The top global selection on the touch screen turns continuous irrigation
ON in the anterior domain when AVGFI irrigation or Power Pole is selected in the
Irrigation Settings screen. Pressing it again turns continuous irrigation OFF. Anterior
cmH20 VGFI™* irrigation utilizes the Accurus® low pressure air supply to provide regulated
pressure into the irrigation bottle. Alternate irrigation pressure, set and enabled in
the Irrigation Settings screen, is activated by pressing the footswitch's right vertical
switch. If Power Pole is the selected irrigation method, this control is used to set the
desired irrigation pressure which automatically sets the cart's power pole height. If
Gravity is selected, this global key can be used to turn continuous irrigation on and
off (manually adjusted gravity fed irrigation is independent of the Accurus® system).
Diathermy - The diathermy global selection is activated through the footswitch's left
vertical switch, and not through the global selection touch screen. Diathermy power is
% only provided to the handpiece when the vertical switch is depressed, and turns OFF
when released.
1
Illuminators - Pressing an Illuminator 1 or 2 global key turns the lamp in the selected
illuminator port ON or OFF (not available on 200PS).
Illum1
Sterile materials packaged inside Alcon Paks must be set up to protect the sterile surgical
environment; these instructions are written to help you protect that environment.
NOTE: If inconsistencies exist between these instructions and Directions For Use
(DFU) supplied with a consumable pak, follow the DFU.
WARNING!
Follow local governing ordinances and recycling plans regarding disposal or recycling
of device components and packaging.
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Initial Preparation
1. Peel lid from pak and aseptically present contents to Scrub Nurse. Circulating Nurse
2. Accept inner pouch from Circulating Nurse and place contents in Scrub Nurse
sterile field. Present cassette and drip chamber to Circulating Nurse.
3. Turn system power ON, and if required after initial self tests are Circulating Nurse
completed, select Anterior mode of operation. Unfold drain bag,
allowing it to hang freely, and insert cassette into console cassette
well (see Figure 8-2). Ensure that latch engages.
NOTE: After Accurus® system accepts the cassette and performs
a vacuum test, the Test and Clean icons return to normal colors.
5. Press Settings to enter Irrigation Settings screen. In the Type Scrub Nurse
tab select Power Pole or Gravity. If using power pole, press the
Irrigation tab and adjust Regular and Alternate fluidic pressures.
Press Apply. If using gravity, circulating nurse manually adjusts
bottle height.
500
400
300
200
100
Figure 8-2. ANTERIOR FLUID CASSETTE INSERTION - With power turned ON, the fluid
cassette with drain bag is inserted into the front of the Accurus® cassette housing.
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7. Plug handpiece cable into illuminated connector on console (see Figure Circulating Nurse
8-3). Present sterile phaco handpiece to Scrub Nurse.
8. Accept handpiece from Circulating Nurse and connect it to the blue Scrub Nurse
luer aspiration line and the white luer irrigation line. Screw a 0.9 mm
tip onto handpiece and tighten with tip wrench supplied in Pak. Install
irrigation sleeve with bubble suppression insert.
CAUTIONS
• Use of a tool other than the tip wrench supplied in the Pak may
cause damage to the phaco tip and handpiece.
• The Mackool** handpiece utilizes a reverse thread on its tip. To tighten
the tip turn it counterclockwise, to loosen the tip turn it clockwise.
9. Enable Continuous Irrigation by pressing the Irrigation key (top key Scrub Nurse
in the Global Function screen, labeled either mmHg or cmH20), or by
pressing and releasing the right horizontal switch on the footswitch.
10. Fill the test chamber with fluid as it streams out of the handpiece Scrub Nurse
irrigation ports, then slide the test chamber over the sleeve/tip.
11. Press Test; the system primes, tests, and tunes the tubing/handpiece. Scrub Nurse
The popup screen will disappear, Continuous Irrigation will turn OFF,
and the system will enter the Phaco: Linear screen upon completion
of the prime and test/tune sequence.
12. Select either Phaco Linear, Burst, or Fixed and proceed to step 20. Scrub Nurse
WARNINGS!
• The ultrasonic (U/S) handpiece must be at room temperature before
use. Allow handpiece to AIR COOL for at least 15 minutes after steam
autoclave. Never immerse in liquid to cool.
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SURGICAL
TM
Figure 8-3 PHACO SETUP - For phacoemulsification procedures the anterior pak requires connection of the
irrigation spike into the irrigation bottle, the irrigation and aspiration lines into the handpiece, and
the cable into the front panel connector. For the Anterior VGFI™* irrigation method refer to its setup
procedure later in this section of the manual.
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15. Accept handpiece from Circulating Nurse and connect it to the blue Scrub Nurse
luer aspiration line and the white luer irrigation line (see Figure 8-4).
Screw an I/A tip onto handpiece and tighten with wrench supplied in
Pak. Install irrigation sleeve.
CAUTION
Use of a tool other than the tip wrench supplied in the Pak may
cause damage to the I/A tip and handpiece.
16. Enable Continuous Irrigation by pressing the Irrigation key (top key in Scrub Nurse
the Global Function screen, labeled either mmHg or cmH20), or by
pressing and releasing the right horizontal switch on the footswitch.
17. Fill the test chamber with fluid as it streams out of the handpiece Scrub Nurse
irrigation ports, then slide the test chamber over the sleeve/tip.
18. Press Test; the system primes the tubing/handpiece. The popup screen Scrub Nurse
will disappear, Continuous Irrigation will turn OFF, and the system
will enter the Surgery screen upon completion of the prime sequence.
19. Select either I/A Max or I/A Cap Vac and proceed to step 18. Scrub Nurse
20. To test tip and handpiece integrity, perform a fluidics balance test: Scrub Nurse
20.3 Release aspiration line and observe test chamber. The chamber
should maintain its shape or dimple slightly and recover its shape.
After observing chamber, release footpedal to stop fluid flow.
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Test Irrigation
Chamber Sleeve
SURGICAL
Figure 8-4. I/A SETUP - For irrigation/aspiration procedures the anterior pak requires connection of the
irrigation spike into the irrigation bottle, and the irrigation and aspiration lines into the handpiece.
For the Anterior VGFI™* irrigation method refer to its setup procedure later in this section of the
manual.
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NOTE: This procedure is not written for the AVGFI Cassette Pak; it
is written for the AVGFI Tubing Set.
1. Press Settings to enter Irrigation Settings screen. In the Type tab Scrub Nurse
select AVGFI. Press the Irrigation tab and adjust Regular and
Alternate fluidic pressures. Press Apply.
3. Using aseptic procedures, peel lid from Anterior VGFI™* Tubing Circulating Nurse
Set. Aseptically remove the irrigation tubing from center connector
on cassette. Discard gravity irrigation line (see Figure 8-5). Plug
irrigation line into center connector on cassette, then plug pressure line
with filter into illuminated connector on front panel (see Figure 8-5).
WARNING!
Ensure filter is in place and is used in conjunction with the consumable.
Removal of filter can expose patient to contamination.
4. Press the Irrigation key twice (the top key in the Global Function Scrub Nurse
screen, labeled either cmH20 or mmHg). The irrigation pump turns
ON and irrigation turns OFF.
5. Pre-spike the irrigation bottle using the spiking tool, wait three Circulating Nurse
seconds, then remove. Carefully spike with drip chamber and hang
the bottle so its liquid level is at patient eye level (PEL). Squeeze drip
chamber until it is a little more than half full of fluid.
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Anterior VGFI™*
pressure line
with filter
Irrigation line
and Aspiration line
to phaco or I/A handpiece
Figure 8-5 ANTERIOR VGFI™* TUBING SET SETUP - The Anterior VGFI™* Tubing Set contains the materials
to replace the gravity irrigation drip chamber and tubing. This setup can be used with the phaco
or I/A handpieces, but continuous reflux cannot be accessed using this pak. Note that continuous
reflux is not available using this pak.
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1. Peel lid from pak and aseptically present inner pouch to Scrub Nurse. Circulating Nurse
2. Accept inner pouch from Circulating Nurse and place contents in Scrub Nurse
sterile field. Present cassette, drip chamber, and pressure line with
filter to Circulating Nurse.
3. Turn system power ON, and if required after initial self tests are Circulating Nurse
completed, select Anterior mode of operation. Unfold drain bag,
allowing it to hang freely, and insert cassette into console cassette
well (see Figure 8-2). Ensure that latch engages.
5. Plug pressure line with filter into illuminated connector on front panel Circulating Nurse
(see Figure 8-6).
6. Press Settings to enter Irrigation Settings screen. In the Type tab Scrub Nurse
select AVGFI. Press the Irrigation tab and adjust Regular and
Alternate fluidic pressures. Press Apply.
7. Press the Irrigation key twice (the top key in the Global Function Scrub Nurse
screen, labeled either cmH20 or mmHg). The irrigation pump turns
ON and irrigation turns OFF.
8. Pre-spike the irrigation bottle using the spiking tool, wait three Circulating Nurse
seconds, then remove. Carefully spike with drip chamber and hang
the bottle so its liquid level is at patient eye level (PEL). Squeeze drip
chamber until it is a little more than half full of fluid.
8.14
* FOR REFERENCE ONLY * 8065750203
Accurus®
SURGICAL
TM
Anterior VGFI™*
pressure line
with filter
Irrigation line
and Aspiration line
to phaco or I/A handpiece
Figure 8-6 ANTERIOR VGFI™* CASSETTE PAK SETUP - The Anterior Vented Gas Forced Irrigation Pak contains
materials to perform anterior surgeries using pressurized irrigation control. This setup can be used
with the phaco and I/A handpieces. Note that continuous reflux is available using this pak.
8065750203
* FOR REFERENCE ONLY * 8.15
Accurus®
1. Aseptically peel apart pouch and present contents to Scrub Nurse. Circulating Nurse
2. Remove Vit handpiece with tubing from pouch. Disconnect aspiration Scrub Nurse
line from U/S or I/A handpiece and connect to short aspiration line
from Vit handpiece (see Figure 8-7). Remove protective cover from
Vit probe.
3. Press Exit to enter the Cataract Surgery Setup screen, then press the Scrub Nurse
AntVit mode key. Pass pressure line to Circulating Nurse.
4. Accept the pressure line from Scrub Nurse and plug it into the upper Circulating Nurse
illuminated connector on the front panel.
6. Accept irrigation handpiece from Circulating Nurse, then disconnect Scrub Nurse
irrigation line from U/S or I/A handpiece and connect to irrigation
handpiece. Proceed to step 10.
9. Accept irrigation sleeve from Circulating Nurse, then disconnect Scrub Nurse
irrigation line from U/S or I/A handpiece and connect to irrigation
sleeve tubing. Slide irrigation sleeve over tip of Vit handpiece.
Prime
10. Place tip of Vit probe into a cup of sterile fluid for aspiration line Scrub Nurse
priming and testing. (For wet bimanual procedure, place tip of
irrigation handpiece in cup, also.)
11. Press Test to prime the tubing and test the probe. After a successful Scrub Nurse
test, the system will enter the Surgery screen. Press either the Wet or
Dry submode key.
8.16
* FOR REFERENCE ONLY * 8065750203
Accurus®
Irrigation Line
Aspiration Line
®
SURGICAL
® Pressure Line
Figure 8-7. ANTERIOR VITRECTOMY SETUP - For anterior Vit procedures the handpiece's air pressure tubing
and aspiration tubing must be plugged into their illuminated connectors. For Wet procedures the
irrigation tubing must be connected between a fluid bottle and either a cannula or irrigating Vit
handpiece.
8065750203
* FOR REFERENCE ONLY * 8.17
Accurus®
8.18
* FORLastREFERENCE
page of this section
ONLY * 8065750203
Accurus®
SECTION NINE
ANTERIOR DISASSEMBLY AND CLEANING
NOTES: If an inconsistency ever exists between the procedures in this section and the DFU,
follow the instructions in the DFU. During these procedures discard all consumables per
specific hospital/clinic requirements.
1. Remove bottle from hanger and disconnect drip chamber from bottle.
4. Press the Eject button. This initiates a two to three second sequence that
releases the drain pump tubing and unlatches the cassette. After visually
confirming that the cassette is unlatched, grasp the cassette handle and remove
cassette from cassette well in an outward motion.
500
400
300
200
100
FIGURE 9-1 CASSETTE REMOVAL - With power turned ON, the fluid cassette with drain bag is
ejected from the Accurus® cassette well by pressing the Eject button on the front panel.
If no pressure or electrical power are available, lift the rear panel lever and wiggle the
cassette out.
8065750203
* FOR REFERENCE ONLY * 9.1
Accurus®
5. Use the small rubber stopper from the parts kit to plug the cassette's vacuum
port (see Figure 9-2).
FIGURE 9-2 PLUG THE VACUUM PORT - The vacuum port must be plugged with a rubber stopper
immediately after each surgery to prevent fluid leakage.
7. Remove the irrigation and aspiration tubing from the handpiece and unplug the
handpiece connector from the console.
8. Remove the infusion sleeve and tip from the handpiece and discard according to
hospital guidelines.
10. Using a clean syringe, draw a minimum of 120 cc of distilled water through
both the irrigation and aspiration paths.
11. Using the same syringe, flush both ports with air.
WARNINGS!
If these cleaning procedures are not performed immediately after each surgical
procedure, tissue debris and salts from irrigating solution may collect. This could
permanently damage the handpiece and could jeopardize cleanliness and/or create
biohazard conditions for the patient. Do not autoclave the handpiece until all debris
has been removed.
If in the medical opinion of the physician a patient with a prion related disease
undergoes a high risk procedure, the instrument should be destroyed or be
processed according to local requirements.
9.2
* FOR REFERENCE ONLY * 8065750203
Accurus®
WARNINGS!
Never immerse the handpiece in liquid after autoclaving; allow it to air cool for
at least 15 minutes. Be sure the handpiece connector is completely dry before
connecting it to the console.
Prior to sterilization, the ultrasonic handpiece should always have the connector
end cap secured and placed in the sterilization tray. This will prevent damage to
connectors and handpieces during handling, and especially during autoclaving.
Handle the handpiece carefully. Dropping or otherwise striking the handpiece may
fracture piezoelectric elements contained within and degrade performance or render
the handpiece inoperable.
13. Remove the handpiece tip. If it is a single use tip, properly discard it.
14. Flush I/A handpiece and reusable tip at least two times with a syringe filled with
30 cc of warm distilled water. Flush immediately with air to clear any water
from the handpiece and needle.
17. Clean reusable handpiece by wiping off residual tissue with a soft, non-abrasive
cloth. Rinse the handpiece and cable with distilled water to remove any
remaining debris.
18. Hand wash the reusable handpiece and cable using a soft bristled cleaning
brush. The use of abrasive cleaners or solvents is not recommended.
19. Thoroughly flush all handpiece and cable surfaces with distilled water until no
visible debris remains. Dry the handpiece and cable with a sterile wipe.
NOTE: If the Accurus® system remains plugged in, always ensure that the
rear panel On/Off switch is in the OFF position.
2. If required, the console and remote control may be cleaned with mild soap and
water. DO NOT USE SOLVENTS OR ABRASIVES.
8065750203
* FOR REFERENCE ONLY * 9.3
Accurus®
STERILIZATION
The following accessories for the Accurus® Ophthalmic Surgical System may be flash or steam
autoclaved. Additionally, per the Sterilizer Equipment Manual, the sterilizer reservoir is to be filled
with distilled or deionized water.
NOTE: The list of reusable accessories above will withstand steam autoclave cycles at 134º C
(273º F). Due to the variation found in steam autoclaves and the variable bioburden on
instruments in clinical use, it is not possible for Alcon to provide specific parameters to ensure
an adequate sterility assurance level. Validation of the individual autoclave, and verification of
the sterility assurance level achieved with a given steam sterilization cycle, must be performed
by each hospital.
The specifications in Table 9-1 represent industry standard guidelines for steam sterilization cycles.
The sterility assurance level achieved with these parameters must be validated by each
hospital. Please refer to current ANSI/AAMI Standards or your hospital’s standard procedures for
the most current specifications.
NOTE: For maximum life and optimum performance, allow handpieces to air cool after steam
or flash autoclaving. Cooling for U/S phaco handpieces should be a minimum of 15 minutes.
* For 375/40 U/S & Mackool** handpieces the recommended exposure time is 20 minutes minimum.
9.4
* FORLastREFERENCE
page of this section
ONLY * 8065750203
Accurus®
SECTION TEN
ANTERIOR ACCESSORIES AND PARTS
Following is a list of Alcon‑approved accessories and replacement parts for the Accurus® Ophthalmic
Surgical System. To order parts, please refer to your Alcon price list and/or contact Alcon Customer
Service at:
Phone: Write:
(800) 862‑5266 or Alcon
(817) 293‑0450 6201 South Freeway
Ask for Customer Service Fort Worth, TX. 76134‑2099
Important Note: Use of accessories and parts not approved by Alcon is not recommended.
Paks
Accurus® Turbosonics® Microtip™ PEA Basic Pak 8065740884
Accurus® Turbosonics® Microtip™ PEA Tipless Pak 8065740885
Accurus® Turbosonics® Microtip™ PEA Round 0° Pak 8065740886
Accurus® Turbosonics® Microtip™ PEA Round 30° Pak 8065740887
Accurus® Turbosonics® Microtip™ PEA Round 45° Pak 8065740888
Accurus® Turbosonics® Microtip™ PEA Kelman® 30° Pak 8065740889
Accurus® Turbosonics® Microtip™ PEA Kelman® 45° Pak 8065740890
Accurus® Turbosonics® Microtip™ Mackool** Round 0° Pak 8065740891
Accurus® Turbosonics® Microtip™ Mackool** Round 30° Pak 8065740892
Accurus® Turbosonics® Microtip™ Mackool** Round 45° Pak 8065740893
Accurus® Turbosonics® Microtip™ Mackool** Kelman® 30° Pak 8065740894
Accurus® Turbosonics® Microtip™ Mackool** Kelman® 45° Pak 8065740883
Accurus® Microtip™ PEA Flared Round 0° Pak 8065740921
Accurus® Microtip™ PEA Flared Round 30° Pak 8065740922
Accurus® Microtip™ PEA Flared Round 45° Pak 8065740923
Accurus® Microtip™ PEA Flared Kelman® 30° Pak 8065740924
Accurus® Microtip™ PEA Flared Kelman® 45° Pak 8065740925
Accurus® Microtip™ Flared Mackool** Round 0° Pak 8065740926
Accurus® Microtip™ Flared Mackool** Round 30° Pak 8065740927
Accurus® Microtip™ Flared Mackool** Round 45° Pak 8065740928
Accurus® Microtip™ Flared Mackool** Kelman® 30° Pak 8065740929
Accurus® Microtip™ Flared Mackool** Kelman® 45° Pak 8065740930
Accurus® 1.1 mm PEA Flared Round 0° Pak 8065740931
Accurus® 1.1 mm PEA Flared Round 30° Pak 8065740914
Accurus® 1.1 mm PEA Flared Round 45° Pak 8065740915
Accurus® 1.1 mm PEA Flared Kelman® 30° Pak 8065740937
Accurus® 1.1 mm PEA Flared Kelman® 45° Pak 8065740936
Accurus® 1.1 mm Flared Mackool** Round 0° Pak 8065740934
8065750203
* FOR REFERENCE ONLY * 10.1
Accurus®
Accurus® Anterior Pak w/AVGFI, 0.9 mm Mackool** Flared ABS® 45° Kelman® 8065740913
Accurus® Anterior Pak w/AVGFI, 1.1 mm Flared ABS® 0° 8065740941
Accurus® Anterior Pak w/AVGFI, 1.1 mm Flared ABS® 30° 8065740935
Accurus Anterior Pak w/AVGFI, 1.1 mm Flared ABS 45°
® ® 8065740916
Accurus® Anterior Pak w/AVGFI, 1.1 mm Flared ABS® 30° Kelman® 8065740917
Accurus® Anterior Pak w/AVGFI, 1.1 mm Flared ABS® 45° Kelman® 8065740918
Accurus® Anterior Pak w/AVGFI, 1.1 mm Mackool** Flared ABS® 0° 8065740919
Accurus Anterior Pak w/AVGFI, 1.1 mm Mackool** Flared ABS 30°
® ® 8065740938
Accurus® Anterior Pak w/AVGFI, 1.1 mm Mackool** Flared ABS® 45° 8065740940
Accurus® Anterior Pak w/AVGFI, 1.1 mm Mackool** Flared ABS® 30° Kelman® 8065740904
Accurus® Anterior Pak w/AVGFI, 1.1 mm Mackool** Flared ABS® 45° Kelman® 8065740902
Accurus® Anterior Pak w/AVGFI, Tipless 1.1 mm 8065741068
AVGFI Set 8065740701
Small Parts Kit 201SPS
10.2
* FOR REFERENCE ONLY * 8065750203
Accurus®
Console Accessories
Cart w/Tray and IV Pole 8065740943
Cart w/Power IV pole 8065740825
Remote Control 8065740942
Remote Control, English Text 8065750105
Footswitch 8065740240
Pneumatic Pressure Hose 8041193501SV
Illuminator Bulb 8065740243
Operator’s Manual 8065750203
Accurus® Doctor Memory Card 8065750200
Phaco Accessories
.9mm TurboSonics® Microtip™ 0° Round Tip 8065740478
.9mm TurboSonics® Microtip™ 30° Round Tip 30RTS
.9mm TurboSonics® Microtip™ 45° Round Tip 45RTS
.9mm TurboSonics® Microtip™ 30° Kelman® Tip 30KTS
.9mm TurboSonics® Microtip™ 45° Kelman® Tip 45KTS
.9mm ABS® Microtip™ 0˚ Round Tip 8065790019
.9mm ABS® Microtip™ 30˚ Round Tip 8065790020
.9mm ABS® Microtip™ 45˚ Round Tip 8065790021
.9mm ABS® Microtip™ 30˚ Kelman® Tip 8065790022
.9mm ABS® Microtip™ 45˚ Kelman® Tip 8065790023
Sterilization Tray 8065803602
8065750203
* FOR REFERENCE ONLY * 10.3
Accurus®
Phaco Handpieces
375/40 Ultrasonic Handpiece TURBOSONIC-375
Mackool** Ultrasonic Handpiece 8065-M002-01
Probes
Accurus® Anterior Vitrectomy w/Irrigation Needle 8065803650
Anterior Vitrectomy Irrigation Sleeve 8065801351
Illuminator (DFOI) 8065812001
Fiber Optic Assy, Wide Angle 8065740264
Fiber Optic Assy, End Irrigating 8065740259
10.4
* FORLast
REFERENCE
page of this section
ONLY * 8065750203
Accurus®
SECTION ELEVEN
COMBINED DESCRIPTION
Upon entering the Combined domain, the system displays the Combined Surgery
Setup screen, shown below in Figure 11-1. On this screen the user can prepare the
Accurus® Ophthalmic Surgical System for anterior and posterior surgery, then enter
another screen by pressing one of the following keys on the touch screen:
The Combined Surgery Setup screen can also be entered by pressing the Exit key
from the Irrigation / Infusion Settings screen or a Surgery screen.
Popup windows can appear over these screens to advise the user of certain conditions.
See Figure 2-18 for an example of a popup window.
There are six Combined Surgery Setup screen components offered to prepare for
surgery. Two components—the Handpieces/Probes and Accessories components—are
in the Primary Functions Window; and four components—Test, Clean, Surgery, and
Settings—are in the Modes Window (see Figure 2-9).
Figure 11-1 COMBINED SURGERY SETUP SCREEN - Entering the Combined Surgery Setup screen
allows the user to prepare the Accurus® system for surgery. In this image there is no
cassette installed, nor any accessories connected to the system.
8065750203
* FOR REFERENCE ONLY * 11.1
Accurus®
When entering a surgery screen from the Combined Surgery Setup screen, or upon
successful prime/tune/test, the mode of the currently tested handpiece is automatically
selected. If more than one probe or handpiece was tested, priority is given to the
modes in the following order: Linear Phaco or I/A Max, PropVac Vit, Prop Frag or
Medium Extrude.
• Accessories
Pressing Diathermy, Scissors, VFC, VGFI-F/AX, or MPC illuminates an LED at its
corresponding front panel connector to identify where to plug in the handpiece or
accessory. Making one selection automatically deselects any other selection. Only the
last-selected accessory or handpiece LED illuminates.
• Test
When the Test key is pressed, the selected handpieces and probes are primed
sequentially, and a popup window appears indicating that priming, testing, and tuning
are active. Only the popup window keys (Stop and Skip), global function Illuminator
Test keys, and diathermy are operable while the Test function is active. A surgery screen is
entered automatically upon a successful prime, test, and tune sequence.
If the Stop key is pressed during priming, the test function is aborted. If Skip is
pressed during priming, priming is skipped and handpiece testing/tuning begins.
An invalid error tone sounds when pressing the Test key with no probe or handpiece
selected. An advisory popup window appears when a handpiece is selected but not
connected, or when priming/tuning has failed.
• Clean
Pressing the Clean key transfers fluid from the cassette into the drain bag. When
Clean is pressed, a popup window indicates cleaning is in progress. Only the Stop
key in the popup window, Continuous Irrigation On/Off key, and global function
Clean Illuminator keys are operable while the clean function is active. Pressing the Stop key
during cleaning aborts the function.
If fluid is not fully transferred to the drain bag, press the Clean key a second time.
(There will always be some residual fluid left in the cassette due to surface tension.)
• Surgery
When the Surgery key is pressed, the system exits the Combined Surgery Setup screen
and enters the selected surgery screen. If prime/tune has not been performed, a popup
reminder appears.
Surgery
11.2
* FOR REFERENCE ONLY * 8065750203
Accurus®
•Settings
When the Settings key is pressed, the system exits the Combined Surgery Setup
screen and enters the Irrigation/Infusion Settings screen (see Figure 11-2).
Settings
• Pump
During setup in the combined domain, if power pole or gravity is the selected infusion
method, the Pump key appears in the Modes window. Pressing this key turns the air
pump ON, allowing the user to test the Fluid/Air Exchange (F/AX) tubing by noting
Pump air flow at the infusion cannula. Pressing the key again turns the pump OFF. After
entering a posterior mode of operation the F/AX key appears in place of the global
irrigation key, allowing ON/OFF and pressure control of the F/AX function.
The Irrigation/Infusion Settings screen (see Figure 11-2) is entered by pressing the
Settings key on the Combined Surgery Setup screen. In the Combined domain there
are three data tabs available on the screen: the Type tab, Irrigation tab, and Infusion
tab. Pressing Exit closes this screen and returns to the Combined Surgery Setup screen.
• Type Tab
The Type tab is selected to determine how sterile irrigating/infusing solution is
provided for surgery, and is divided into three groups: Anterior Irrigation, Posterior
Infusion, and Combined Infusion/Irrigation. In this domain, only the Combined
Infusion/Irrigation group is available.
The Type tab contains keys for the following fluid delivery methods: CVGFI
(Combined Vented Gas Forced Irrigation/Infusion), Power Pole, and Gravity.
Pressing Cancel exits the Irrigation/Infusion Settings screen and returns to the
previous screen without any modifications taking effect. Pressing Apply accepts the
settings, exits the Irrigation/Infusion Settings screen, and returns to the previous screen.
Figure 11-2 IRRIGATION/INFUSION SETTINGS SCREEN: TYPE TAB - The Type tab allows the user
to select the type of fluid delivery desired. Selecting the Irrigation and Infusion tabs
offers more choices, shown in Figures 11-3 and 11-4.
8065750203
* FOR REFERENCE ONLY * 11.3
Accurus®
When CVGFI is selected, an internal air pump creates pressurized air, and Combined
VGFI™* tubing delivers it to the fluid bottle from a front panel connector. The air
pressure setting, which affects the rate of fluid delivery to the eye, is adjusted with
the global function Up/Down arrow buttons; the corresponding LED readout is
immediately to the left of the buttons. Note: Fluid bottle should be positioned at
patient eye level.
The Power Pole selection requires that the optional cart with power IV pole be
connected to the Accurus® system. With the fluid bottle hanging from the cart's power
IV pole, fluid pressure is set by pressing the global function Up/Down arrow buttons
to the desired pressure, and the power pole automatically moves up or down to the
required height.
When Gravity pressure is selected, fluid pressure is dependent on the fluid bottle
height, independent of Accurus® system controls, and is set manually by the operator.
• Irrigation Tab
The Irrigation tab allows the user to set Regular and Alternate irrigation pressures,
and the ability to select whether Alternate pressure is Available Yes/No. The pressure
values for Phaco, I/A, and anterior Vit can be adjusted by pressing the Up/Down
triangle keys next to the value. Alternate pressure works with CVGFI and power pole
delivery; therefore, when gravity pressure is selected, the Irrigation tab pressures
are grayed out and not functional. The regular and alternate pressures are toggled
by pressing the footswitch's right vertical switch. Selecting Alternate Yes or No
determines whether alternate pressure will be available with the footswitch.
Pressing the Cancel key exits the Irrigation/Infusion Settings screen and returns to
the previous screen without any modifications taking effect. Pressing the Apply key
accepts the settings, exits the Irrigation/Infusion Settings screen, and returns to the
previous screen. Note: Infusion/irrigation type cannot be changed with infusion
or irrigation active.
Figure 11-3 IRRIGATION/INFUSION SETTINGS SCREEN: IRRIGATION TAB - The Irrigation tab allows
the user to adjust the Regular and Alternate Irrigation pressures, and the ability to
select whether alternate pressure is available.
11.4
* FOR REFERENCE ONLY * 8065750203
Accurus®
• Infusion Tab
The Alternate Infusion group contains a value for the alternate Pressure and a setting
for alternate pressure Available Yes/No. Alternate pressure works with CVGFI and
power pole infusion; therefore, when gravity infusion is selected, these selections are
grayed out and not functional. The Pressure value can be adjusted by pressing the Up/
Down triangle keys next to the value. The nominal and alternate pressures are toggled
by pressing the footswitch's right vertical switch.
The Alternate F/AX group contains a value for the alternate Pressure and a setting for
alternate pressure Available Yes/No. The Pressure value is adjusted by pressing the
Up/Down triangle keys next to the value. Selecting Alternate Yes or No determines
whether alternate pressure will be available with the footswitch.
The Alternate Infusion / F/AX group allows the user to select either Recall or Preset
alternate pressure values, giving the ability to select whether the alternate infusion
level will always go to the preset value, or recall the last-used alternate infusion level.
Figure 11-4 IRRIGATION/INFUSION SETTINGS SCREEN: INFUSION TAB - The Infusion tab allows
the user to select the type of Alternate Infusion and Alternate F/AX desired.
8065750203
* FOR REFERENCE ONLY * 11.5
Accurus®
Global functions are available in all surgery and setup screens. There are five
global functions which, generally, can be selected, adjusted, and displayed at any
time. When a global function is selected its color icon and LED readout illuminate
brightly. (An exception is diathermy. Its LED readout is always lit, and its color icon
illuminates brightly when activated with the footswitch.)
A global function setting can be adjusted, even when the function is OFF, by pressing
its corresponding Up/Down arrow buttons. If the function is OFF, the LED readout
becomes dimly lit while making adjustments, then becomes blank after a few seconds
(except for diathermy as mentioned above). The LED's are dimly lit if the proper
cassette is inserted and the LPA pump is on or the I/V pole is at position.
• Irrigation/Infusion
Fluid pressure is delivered through one of three methods: CVGFI, Power Pole, or
Gravity. The type of fluid delivery method is selected in the Irrigation/Infusion
Settings screen (see Figures 11-2, 11-3, and 11-4).
mmHg
OR In posterior surgeries the fluid is delivered to the eye via an infusion cannula or
infusion handpiece. Infusion ON/OFF control is maintained by the footpedal;
depressing the footpedal starts irrigation, and releasing the pedal stops it. (Continuous
irrigation is also available.)
mmHg In anterior surgeries the fluid is delivered to the eye via a handpiece connected by
tubing to the cassette. Irrigation ON/OFF control is maintained by the footpedal;
depressing the footpedal starts irrigation, and releasing the pedal stops it. (Continuous
irrigation is also available.)
When CVGFI (Combined Vented Gas Forced Infusion) is selected in the Irrigation/
cmH20 Infusion Settings screen and activated by pressing this global icon, the Accurus®
system delivers filtered, pressurized air through a tubing set into the fluid bottle,
OR
which in turn pressurizes fluid through tubing to the eye. Up/Down arrow buttons
are used to adjust fluid pressure, displayed in mmHg or cmH2O. NOTE: F/AX is
controlled by the Infusion/ F/AX global.
mmHg The Power Pole Irrigation/Infusion selection uses gravity to pressurize fluid when the
bottle is hanging from the optional power IV pole. Fluid pressure can be set by pressing
the global function Up/Down arrow buttons until the desired LED pressure readout is
displayed. The power IV pole automatically raises or lowers to the correct height, and
the LED pressure readout blinks as the pole is moving. Activation of MPC scissors, or
loading/unloading a cassette, will momentarily interrupt power IV pole movement.
11.6
* FOR REFERENCE ONLY * 8065750203
Accurus®
• F/AX
This F/AX key is only available in the Combined Posterior domain when power pole
or gravity infusion is the selected fluid delivery method. The F/AX key replaces the
mmHg global function Irrigation key when a posterior surgery screen is entered. The F/AX
function provides pressurized, filtered room air for Fluid Air Exchange (F/AX). The
air is supplied through tubing to the eye from a front panel pneumatic connector.
When activated, the global function Up/Down arrow buttons are used to adjust the air
pressure, displayed in mmHg or cmH2O.
• Diathermy
The Diathermy global function provides fixed diathermy capability through the use
of diathermy probes and handpieces. Diathermy output is available at all times,
% controlled by the footswitch, and is based on the percent of maximum voltage output.
When the Diathermy icon is pressed a popup window is displayed to remind the
operator to use the footswitch to control this function. This popup window can be
removed by pressing the screen's Continue key or activating the diathermy function.
The diathermy function can be activated in all modes by pressing a footswitch switch.
In Frag, VFC, and Scissors modes the footpedal must be released before you can
activate diathermy; in Extrude mode the footpedal is inconsequential.
Diathermy power is adjusted with the global function Up/Down arrow buttons, with
the percentage of maximum diathermy voltage output displayed.
Illum2
In the event of a burnt bulb, a System Advisory appears on the screen, and the
illuminator's icon dims and is covered with a strike. The user should then remove and
plug the light pipe into the other illuminator receptacle, press OK, and proceed.
Illum2 NOTE: Upon completion of the procedure it is recommended that the burnt bulb
be replaced. Two illuminator sources should always be available. (See Care and
Maintenance, Section Fifteen of this manual, for instructions to replace bulb.)
8065750203
* FOR REFERENCE ONLY * 11.7
Accurus®
The Accurus® system offers seven surgery modes in the combined domains—depicted
as icons in the Modes Window at the bottom of the touch screen—and each surgery
mode has submodes (see Table 11-1). The active mode and submode keys are
highlighted, and their names are displayed in the Title Window.
To enter a surgery mode, press its associated icon key on the touch screen. The
previous surgery mode or submode is deactivated when a new mode or submode is
selected, and front panel LED's illuminate to indicate which connectors are active.
To enter a surgery submode press the key above its associated mode key, or press the
mode key successively to cycle through the available submodes.
NOTE: In posterior surgical modes the footpedal must be released, and none of
the footswitches depressed, to enter or change a surgery mode or submode. In
anterior surgical modes the footpedal must be in position 1 or lower to change
surgical submodes. Major mode changes are not allowed in anterior surgical modes.
When a surgery mode is first entered after power up, the system uses its factory
default settings, or if a doctor memory has been selected, the doctor's programmed
settings are used. If the settings are then adjusted, re-entry to that mode will display
the new values. Turning system power OFF resets all values back to the factory
default settings, as does exiting and reentering the active domain.
Functional operations to the Accurus® console are accepted from a footswitch. The
footswitch consists of a footpedal, right and left horizontal/vertical switches, and right
and left vertical heel switches. Functions controlled by the footswitch are listed in
Tables 11-2 through 11-7.
MODE SUBMODES
Table 11-1 COMBINED DOMAIN SURGERY MODES - Seven surgery modes are available in the combined domain.
Each mode has submodes, as shown in this table, with the default submode shown in bold type.
11.8
* FOR REFERENCE ONLY * 8065750203
Accurus®
Vit Prop. Diathermy Cut Disable Programmable Alt. Inf. Cut Enable Reflux
Frag Linear Diathermy U/S Disable Programmable Alt. Inf. U/S Enable Reflux
Fixed Diathermy U/S Disable Programmable Alt. Inf. U/S Enable Reflux
Vacuum/Multi-Cut Diathermy Prop Submode Programmable Alt. Inf. Momentary Cut Reflux
Vacuum/MPC Diathermy Close Blade Programmable Alt. Inf. Momentary Cut Reflux
Dual Diathermy Pressure Toggle Programmable Alt. Inf. Vacuum Toggle Reflux
(vac on)
Table 11-2 FOOTSWITCH FUNCTIONS FOR COMBINED POSTERIOR DEFAULT MAP A - The footswitch
contains a footpedal, left and right switches which are either actuated horizontally or depressed
vertically with the user's toe, and left and right vertical heel switches.
These eight footswitch tables (Tables 11-2 through 11-9) represent the factory default settings for
Map A, Map B, Map C, and Map D the in posterior and anterior domains, but can be programmed
otherwise as instructed in section two of this manual (Options/Memory/Common/Footswitch).
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Accurus®
Vit Prop. Diathermy Reflux Programmable Alt. Inf. Cut Toggle Programmable
Frag Linear Diathermy Reflux Programmable Alt. Inf. U/S Toggle Programmable
Dual Diathermy Reflux (vac on) Programmable Alt. Inf. Vac/Press Cycle Programmable
11.10
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Vit Prop. Diathermy Reflux Programmable Inf. Pres. + Cut Toggle Inf. Pres. –
Momentary Diathermy Reflux Programmable Inf. Pres. + Momentary Cut Inf. Pres. –
Frag Linear Diathermy Reflux Programmable Inf. Pres. + U/S Toggle Inf. Pres. –
Fixed Diathermy Reflux Programmable Inf. Pres. + U/S Toggle Inf. Pres. –
Momentary Diathermy Reflux Programmable Inf. Pres. + Momentary U/S Inf. Pres. –
Scissors Prop. Diathermy N/A Programmable Inf. Pres. + N/A Inf. Pres. –
Multi-Cut Diathermy N/A Programmable Inf. Pres. + Close Blade Inf. Pres. –
Vacuum/Multi-Cut Diathermy Reflux Programmable Inf. Pres. + Close Blade Inf. Pres. –
(treadle up)
Momentary Cut
(treadle down)
MPC Diathermy N/A Programmable Inf. Pres. + Close Blade Inf. Pres. –
Vacuum/MPC Diathermy Reflux Programmable Inf. Pres. + Close Blade Inf. Pres. –
(treadle up)
Momentary Cut
(treadle down)
Extrusion Low Diathermy Reflux Programmable Inf. Pres. + Diathermy Inf. Pres. –
VFC Inject. Diathermy N/A Programmable Inf. Pres. + N/A Inf. Pres. –
Dual Diathermy Reflux (vac on) Programmable Inf. Pres. + Vac/Press Cycle Inf. Pres. –
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Accurus®
Vit Prop. Diathermy Reflux *Inf. Pres. - Programmable Cut Toggle **Inf. Pres. +
Momentary Diathermy Reflux *Inf. Pres. - Programmable Momentary Cut **Inf. Pres. +
Frag Linear Diathermy Reflux *Inf. Pres. - Programmable U/S Toggle **Inf. Pres. +
Fixed Diathermy Reflux *Inf. Pres. - Programmable U/S Toggle **Inf. Pres. +
Momentary Diathermy Reflux *Inf. Pres. - Programmable Momentary U/S **Inf. Pres. +
Scissors Prop. Diathermy N/A *Inf. Pres. - Programmable N/A **Inf. Pres. +
Multi-Cut Diathermy N/A *Inf. Pres. - Programmable Close Blade **Inf. Pres. +
Multi-Cut w/Vac Diathermy Reflux *Inf. Pres. - Programmable Close Blade **Inf. Pres. +
(treadle up)
Momentary Cut
(treadle down)
MPC Diathermy N/A *Inf. Pres. - Programmable Close Blade **Inf. Pres. +
MPC w/Vac Diathermy Reflux *Inf. Pres. - Programmable Close Blade **Inf. Pres. +
(treadle up)
Momentary Cut
(treadle down)
Extrusion Low Diathermy Reflux *Inf. Pres. - Programmable Diathermy **Inf. Pres. +
VFC Inject Diathermy N/A *Inf. Pres. - Programmable N/A **Inf. Pres. +
Dual Diathermy Reflux (vac on) *Inf. Pres. - Programmable Vac/Press Cycle **Inf. Pres. +
* Pressing the Left Heel switch decreases pressure by 5 (mmHg or cmH20) when pressure is equal to 30 or higher, or by 2 if below
30. If the switch is held down for 1 second, pressure changes to Normal Pressure preset value if currently above the preset value;
otherwise, pressure remains at the current setting.
** Pressing the Right Heel switch increases the pressure by 5 (mmHg or cmH20) when pressure is equal to 30 or higher, or by 2 if below
30. If the switch is held down for 1 second, pressure changes to Alternate Pressure preset value if currently below the preset value;
otherwise, pressure remains at current the setting.
• The reflux controlled by the Left Horizontal switch is pulsed.
• In Dual VFC, the Right Horizontal switch shall cycle from Vacuum only to Vacuum and Pressure to Pressure only and then back to
Vacuum only.
• The default for the Right Vertical is Next Mode.
• The Left and Right Heel switches may be programmed to have single-click or double-click activation of all heel switch functions.
• Adjustments made with the Left and Right Heel switches are considered "temporary," as they will not change either the preset value or
preset alternate value. These preset values can be changed from the Infusion settings screen or the Doctor Memory screens.
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Phaco Linear Diathermy Cont. Reflux Programmable Alternate Irr. Continuous Irr. Reflux
Burst Diathermy Cont. Reflux Programmable Alternate Irr. Continuous Irr. Reflux
Fixed Diathermy Cont. Reflux Programmable Alternate Irr. Continuous Irr. Reflux
I/A CapVac Diathermy Cont. Reflux Programmable Alternate Irr. Continuous Irr. Reflux
Max Diathermy Cont. Reflux Programmable Alternate Irr. Continuous Irr. Reflux
Vit Wet Diathermy Cut Disable Programmable Alternate Irr. Cut Enable Reflux
Dry Diathermy Cut Disable Programmable Alternate Irr. Cut Enable Reflux
Setup N/A Diathermy N/A Programmable Alternate Irr. Continuous Irr. N/A
Phaco Linear Diathermy Reflux Programmable Alternate Irr. Continuous Irr. Programmable
I/A CapVac Diathermy Reflux Programmable Alternate Irr. Continuous Irr. Programmable
Vit Wet Diathermy Reflux Programmable Alternate Irr. Cut Toggle Programmable
Setup N/A Diathermy N/A Programmable Alternate Irr. Continuous Irr. Programmable
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Accurus®
Phaco Linear Diathermy Reflux Programmable Irr. Pressure + Continuous Irr. Irr. Pressure –
Burst Diathermy Reflux Programmable Irr. Pressure + Continuous Irr. Irr. Pressure –
Fixed Diathermy Reflux Programmable Irr. Pressure + Continuous Irr. Irr. Pressure –
I/A CapVac Diathermy Reflux Programmable Irr. Pressure + Continuous Irr. Irr. Pressure –
Max Diathermy Reflux Programmable Irr. Pressure + Continuous Irr. Irr. Pressure –
Vit Wet Diathermy Reflux Programmable Irr. Pressure + Cut Toggle Irr. Pressure –
Dry Diathermy Reflux Programmable Irr. Pressure + Cut Toggle Irr. Pressure –
Setup N/A Diathermy N/A Programmable Irr. Pressure + Continuous Irr. Irr. Pressure –
Phaco Linear Diathermy Reflux Irr. Pressure - Programmable Continuous Irr. Irr. Pressure +
Burst Diathermy Reflux Irr. Pressure - Programmable Continuous Irr. Irr. Pressure +
Fixed Diathermy Reflux Irr. Pressure - Programmable Continuous Irr. Irr. Pressure +
I/A Cap Vac Diathermy Reflux Irr. Pressure - Programmable Continuous Irr. Irr. Pressure +
Max Diathermy Reflux Irr. Pressure - Programmable Continuous Irr. Irr. Pressure +
Vit Wet Diathermy Reflux Irr. Pressure - Programmable Cut Toggle Irr. Pressure +
Dry Diathermy Reflux Irr. Pressure - Programmable Cut Toggle Irr. Pressure +
Setup N/A Diathermy N/A Irr. Pressure - Programmable Continuous Irr. Irr. Pressure +
* Pressing the Left Heel switch decreases pressure by 5 (mmHg or cmH20) when pressure is equal to 30 or higher, or by 2 if below
30. If the switch is held down for 1 second, pressure changes to Normal Pressure preset value if currently above the preset value;
otherwise, pressure remains at the current setting.
** Pressing the Right Heel switch increases the pressure by 5 (mmHg or cmH20) when pressure is equal to 30 or higher, or by 2 if below
30. If the switch is held down for 1 second, pressure changes to Alternate Pressure preset value if currently below the preset value;
otherwise, pressure remains at current the setting.
• In all modes except Vit, reflux will be continuous if supported by the anterior single use cassette, or pulsed if not.
• The default for the Right Vertical is Next Memory.• Adjustments made with the Left and Right Heel switches are considered
"temporary," as they will not change either the preset value or preset alternate value. These preset values can be changed from the
Irrigation settings screen or the Doctor Memory screens.
• The Left and Right Heel switches may be programmed to have single-click or double-click activation of all heel switch functions.
11.14
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Accurus®
The Phaco function provides vacuum and U/S power to the ultrasonic handpiece.
Irrigation and aspiration lines must be plugged into the handpiece, and its electric
cable plugged into the illuminated front panel connector.
Phaco The Phaco mode is entered when the Phaco handpiece is selected in the Combined
Surgery Setup screen and the Surgery key is pressed, or after a tune of a phaco
handpiece, or when the Phaco key is available from another mode. The Phaco mode
consists of four submodes: Linear, Burst, 3D, and Fixed, with Linear being the
factory default. Each submode has its own default values which are adjustable by
pressing Up/Down triangle keys.
U/S Pulse controls are available in two submodes (linear and fixed), and can be turned
on/off by pressing the Pulse Rate touch key. The pulse rate can be adjusted using its
Up/Down triangle keys.
WARNING!
Use of a Phaco handpiece at power settings greater than 80% continuously for
over 4 minutes can result in ultrasonic system failure. Allow the system to cool for
8 minutes between heavy usage of this type.
During any ultrasonic procedure, metal particles may result from inadvertent
touching of the ultrasonic tip with a second instrument. Another potential source
of metal particles resulting from any ultrasonic handpiece may be the result of
ultrasonic energy causing micro abrasion of the ultrasonic tip.
Figure 11-5 PHACO LINEAR MODE SCREEN - The Phaco Linear screen has an Actual Value % in the
U/S box which represents the amount of Max Power Limit delivered to the handpiece,
controlled with the footpedal. The U/S Fixed mode does not contain a U/S power Actual
Value box; it is not needed because U/S power turns ON at its Power Setpoint when
the pedal enters detent 2.
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Accurus®
power is provided from detent two to full footpedal depression, with the preset Power
Max Limit reached at full depression. Pulse On/Off control is available by pressing
the Pulse Rate touch key, and pulses per second (pps) is adjusted with its Up/Down
triangle keys.
In the Phaco Burst submode fixed U/S power (Power %) can be adjusted for
frequency (Duty Cycle) and duration (Burst Length) of U/S power pulses. The
frequency of bursts is controlled with the footpedal from detent two to full treadle
depression, while the fixed burst length is set in milliseconds (ms). The actual percent
of time U/S power is activated is reflected in the Duty Cycle window.
Figure 11-6 PHACO BURST MODE SCREEN - In the Phaco Burst submode fixed U/S power can
be adjusted for frequency and duration of U/S power pulses.
Frag The Fragmentation mode is entered when the Frag handpiece is selected in the Combined
Surgery Setup screen and the Surgery key is pressed, or when a Frag handpiece is tuned,
or when the Frag key is available from another mode. Four submodes are available, each
with its own default U/S power and vacuum limits. U/S power is enabled and disabled by
pressing foot switches or by pressing the power setting on the touch screen (except in
momentary mode). Micro reflux is available via the footswitch.
U/S Pulse controls are available in all submodes, and can be turned on/off by pressing the
Pulse Rate touch key. The pulse rate can be adjusted using its Up/Down triangle keys.
Figure 11-7 LINEAR FRAGMENTATION SCREEN - In Linear Fragmentation mode vacuum builds
up to its maximum value at the footpedal's halfway point, then U/S power begins and
rises to its maximum value at full footpedal depression. The F/AX global key is available
because Power Pole or Gravity is the selected irrigation method.
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Accurus®
Fixed - When the Fixed Fragmentation submode is enabled, depressing the footpedal
activates the preset U/S power and provides vacuum proportional to footpedal
depression, up to the maximum limit.
The I/A mode provides irrigation and vacuum for aspiration to the I/A handpiece. This
function consists of two vacuum submodes: I/A Max (Maximum, the factory default)
and I/A CapVac (reduced vacuum). Each submode has its own default Max Limit
vacuum level, adjustable using Up/Down triangle keys, even when the footpedal is
I/A depressed.
Irrigation begins when the footpedal is depressed, and linear vacuum is provided
from detent one to full footpedal depression, with the preset Max Limit reached at full
depression.
Figure 11-8 I/A MAX MODE SCREEN - Shown here is the I/A Max display screen. The I/A CapVac
screen looks similar, but the Max Limit default setting is 30 mmHg. These modes
provide irrigation and vacuum to the I/A handpiece.
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Accurus®
The Vit (vitrectomy) mode provides vitreous cutting and vacuum using a
pneumatically powered vitrectomy probe connected by tubing to a pulsed air pressure
source and a vacuum port. The available probes, selected in the Combined Surgery
Setup screen, are Accurus®, Accurus® 1500, Accurus® 2500, and InnoVit®. Probe
Vit availability depends up on system model number.
After selecting a vitrectomy probe, the Vit mode is entered when the Surgery key is
pressed in the Combined Surgery Setup screen. Four submodes are available, each
with its own default cut rate and vacuum level. Values are adjusted using Up/Down
triangle keys, even when the footpedal is depressed. The vacuum and cutting on/off
status is shown in the background color of their display keys; pressing a key toggles
the status between ON (blue) and OFF (light gray).
Cutting and/or vacuum is begun when the footpedal is pressed (cutting is enabled
in Momentary Vit mode via a footswitch switch). Cutting can be disabled/enabled
using the footswitch or by pressing its display key, and can be changed regardless of
footpedal position. If cutting is enabled, “Cut On” is displayed in the title window;
if cutting is disabled, “Cut Off” is displayed. Vacuum can be disabled/enabled by
pressing its display key. Cutting and vacuum cannot both be disabled at the same time
(one must always be enabled).
Wet Ant - For wet anterior vitrectomy, pressing the footpedal into detent 1 initiates
bimanual or coaxial irrigation. Linear vacuum and cutting, when enabled, is provided
from detent two to full footpedal depression, reaching the preset maximum vacuum at
full depression.
Figure 11-9 WET ANT MODE SCREEN - Shown here is the Wet Anterior Vitrectomy submode
screen. This is the default mode when entering from an anterior mode or the Combined
Surgery Setting screen after selecting an anterior handpiece/probe.
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Accurus®
Prop Vac
The VIT: Proportional Vacuum submode contains values for maximum vacuum limit
and cut-rate set point. As the footpedal is depressed the vacuum increases, with the
actual vacuum displayed in the Actual Value box and its linear equivalent reflected
in the bar. The Actual Value is a progression bar for display only, and can not be
modified by the user.
The amount of vacuum delivered to the probe is regulated by the amount of footpedal
depression up to the Max Limit. The Vacuum Max Limit is numeric, and can be
adjusted by pressing its Up/Down triangle keys.
Probe cutting at a preset rate begins when the footpedal is pressed. The Cut Rate Set
Point value is numeric, and can be adjusted by pressing its Up/Down triangle keys.
Visible only
when option
is enabled.
Figure 11-10 VIT PROP VAC MODE SCREEN - This screen shows the Proportional Vacuum submode,
set up to operate with the Accurus® probe. This is the default mode when entering
from a posterior mode or the Combined Surgery Setting screen after selecting a
posterior handpiece/probe. This screen is similar for the other vitrectomy probes,
and similar to the Momentary cut submode screen. The 3D submode has its own
unique screen that includes Treadle Start and Full Treadle settings for both vacuum
and cut rate (see Figure 11-11).
A cut-off max vacuum adjustment is provided for each Vit probe when the
Vit Cut-off Setpoint is enabled (see Figure 11-10). This option is enabled in the
doctor memory area (Options -> Memory -> Common -> Other) and the controls
function as follows:
11.20
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Accurus®
When cutting is enabled: The Vacuum Max Limit display background is blue and the
displayed value is used as the maximum when applying vacuum. The Cut-off Setpoint
display is gray to indicate that it is not the value currently in force, however the
setting can still be adjusted.
When cutting is disabled: The Cut-off Setpoint display background is blue and the
displayed value is used as the maximum when applying vacuum. The Vacuum Max
Limit display is gray to indicate that it is not the value currently in force, however the
setting can still be adjusted.
Moment
The VIT: Momentary Cut submode has the same characteristics as the Prop Vac
submode, except that the cutter is activated when the applicable footpedal switch is
momentarily activated (the default activation switch is the footpedal's right horizontal
switch).
Figure 11-11 VIT 3D MODE SCREEN - This screen shows the 3D submode. The footpedal controls
both proportional vacuum and proportional cut rate. Notice that vacuum begins at 0
mmHg and increases to 150 mmHg at full footpedal depression; while cut rate begins
at 800 cpm and decreases to 100 cpm at full footpedal depression. The vacuum and
cut rate settings are fully adjustable.
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Accurus®
Prop - The Proportional submode (see Figure 11-12) provides proportional control of
the opening and closing of the scissor blades, dependent upon the amount of footpedal
depression. The amount of scissors closure is indicated in the Pressure window. When
the footpedal is fully depressed, the Max Limit is reached, and scissors should be fully
closed. Max Limit pressure is adjustable with the Up/Down triangle keys.
Multi and MPC - In the Multiple Cut or MPC submode pressing the footpedal
activates the scissors at a Cut Rate proportional to the footpedal position up to the
preset Max Limit, set by pressing the Up/Down triangle keys next to the Max Limit
readout. Single cuts are possible by adjusting the cut rate to a low Max Limit and
momentarily pressing the footpedal.
Figure 11-12 PROPORTIONAL SCISSORS SCREEN - Pressing down on the footpedal in this mode
provides proportional control of the closing of the scissor blades.
11.22
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Accurus®
Pressing the Vacuum Max Limit key turns scissors OFF and activates proportional
vacuum for aspiration. When vacuum is operating the scissors can be momentarily
activated at the preset value when a footswitch switch is pressed (default is right
horizontal switch), and vacuum is controlled proportional to the amount of footpedal
depression up to its Max Limit.
WARNING!
Use of a MPC scissors handpiece at high cut rates continuously for over 2 1/2 minutes
can result in excessive handpiece heating. Allow the scissors to cool for approximately
30 minutes between heavy usage of this type.
Figure 11-13 MULTIPLE CUT SCISSORS SCREEN - Depressing the footpedal in Multiple Cut
mode activates scissors (shown in this figure) or vacuum progressively up to its
preset Max Limit. When the Vacuum key is activated, aspiration is controlled with
the footpedal, and momentary cutting is enabled by pressing a footswitch switch.
Figure 11-14 SCISSORS CALIBRATION SCREEN - To enter the calibration screen the Calibrate
key must be pressed on the SCISSORS: Proportional screen. This screen shows the
start and close pressures for scissors activation; pressing the arrow keys adjusts the
pressures. Pressing the Default key sets the pressures back to the factory defaults.
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Accurus®
This mode provides vacuum from the cassette's red port through tubing to an
extrusion handpiece. Three submode vacuum levels are available: Low, Medium, and
High, with Medium as the default setting.
Extrude Depressing the footpedal activates vacuum proportional to pedal position. The preset
Max Limit, adjustable using the Up/Down triangle keys, is reached at full footpedal
depression. The preset maximum vacuum level can be adjusted with the footpedal in
any position.
Figure 11-15 MEDIUM EXTRUSION SCREEN - Three extrusion submodes are offered: Low, Medium,
and High. Full depression of the footpedal is required to reach the preset Vacuum
Max Limit.
11.24
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Accurus®
The VFC (Viscous Fluid Control) mode provides pressure at the front panel VFC
connector for fluid injection (i.e., silicone oil), or vacuum for extraction, through
tubing to a syringe. Using vacuum the VFC mode also provides a means of extruding
fluid through an extrusion handpiece (in Dual submode injection and extrusion are
VFC performed simultaneously). Pressure and vacuum levels are adjustable via the Up/
Down triangle keys next to their Max Limit displays.
CAUTION
Always use Alcon-supplied Viscous Fluid Injector Paks and follow all Directions
for Use. Do not aspirate fluids directly into the console; this will cause damage to
the console, increase risk of electrical shock, and void all warranties.
Inject - In this submode injection pressure to the syringe is provided proportional to the
footpedal position up to the Max Limit setting.
WARNINGS!
• Double check the cannula connected to the syringe for a tight connection. It must
not be allowed to come loose.
• Adjust the Max Limit air pressure in accordance with the viscosity of fluids to be
injected. Excessively high settings may endanger the patient.
Figure 11-16 VFC INJECTION SCREEN - This Inject screen indicates the system is prepared to
deliver a maximum of 50 psi to the syringe with the footpedal fully depressed.
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Accurus®
Dual - In the Dual submode injection and extrusion are performed simultaneously
using the syringe and extrusion handpiece. Pressing sideways on the footswitch
switches (default is left and right horizontal switches), or pressing the Max Limit
keys, turns the two individual functions on and off. In this submode, with both
functions enabled, injection pressure to the syringe in detent 1, then vacuum to the
extrusion handpiece in detent 2 (with sustained pressure to the syringe) is provided
proportional to the footpedal position (see Figure 1-7).
Figure 11-17 DUAL VFC INJECTION/EXTRUSION SCREEN - This screen indicates the system is
prepared to deliver a maximum of 50 psi to the injection syringe in footpedal detent
1, then sustained injection and a maximum of 250 mmHg extrusion.
Figure 11-18 VFC EXTRACTION SCREEN - This screen indicates the system is prepared to extract
fluid through a syringe at up to a maximum of 500 mmHg.
11.26
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Accurus®
Different probes and handpieces are required for each operating mode of the Accurus®
system. Following is a representative selection of probes and handpieces with a
general description of each. See the Accessories and Parts section of this manual, or
consult your Alcon representative, for a complete selection of all probes, handpieces,
and handpiece tips available.
CAUTION
Following autoclaving, ensure handpiece is at room temperature. Never immerse
handpiece in water or other fluid to cool it as it will cause serious damage to the
handpiece. Allow it to air cool for at least 15 minutes.
Irrigation/Aspiration Handpiece
The Irrigation/Aspiration (I/A) handpiece, connected to the Accurus® system with I/A
tubing, is used to remove cortical material via aspiration while maintaining chamber
pressure with irrigation.
IRRIGATION SLEEVE
A
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* FOR REFERENCE ONLY * 11.27
Accurus®
Fragmatome™* Handpiece
The Fragmatome™* handpiece is configured to provide simultaneous vacuum and
fragmentation, or vacuum only, depending upon the console setup. The handpiece has
a stainless steel shell for improved reliability and durability. Other than attaching and
removing the needle and aspiration line, no assembly or disassembly is required.
Vitrectomy Probes
The InnoVit® probe is a high-speed, cross-action (or radial) guillotine vitreous cutter
with an ergonomically designed probe handle. The Accurus®, Accurus® 1500, and
Accurus® 2500 probes are axial oscillating guillotine vitreous cutters. All probes
are designed for a single use and must be properly disposed of when surgery is
completed.
Figure 11-23 ACCURUS® PROBE, ACCURUS® 1500 PROBE, and ACCURUS® 2500 PROBE
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Accurus®
Scissors Handpiece
The Intraocular Scissors (IOS) Handpiece is used for membrane dissection.
Pneumatic power to drive the scissors is provided through tubing which is attached
to the barbed shaft. Scissors tips come in single use and reusable configurations, and
are screwed into the IOS handpiece. The scissors adjustment is used to increase or
decrease the opening of the scissors blades. Additionally, it can be used to manually
close the scissors in the event of air pressure and/or electrical power failure.
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Accurus®
Diathermy/Coagulation Handpieces
Single use Bipolar Coagulation Brushes are available in a wide variety of
configurations: straight, curved, 20-gauge, 23-gauge, tapered, and widestroke. All
single use bipolar accessories are available with and without cables. Also available
are reusable and single-use bipolar cables.
ALCON
11.30
* FORLastREFERENCE
page of this section ONLY * 8065750203
Accurus®
SECTION TWELVE
COMBINED OPERATING INSTRUCTIONS
Introduction
This section of the manual contains typical setup procedures using Accurus®
TotalPlus® Combined Procedure Paks, then guidelines to navigate through the
combined posterior and anterior domains.
The Accurus® pak setup procedures are written for a surgical team of three people:
Surgeon and Scrub Nurse in the sterile field, and Circulating Nurse in the non‑sterile
field. The instuctions are divided into two columns. In the left column a directive is
given, and in the right column a team member is identified to perform the task. These
procedures assume that a sterile drape is not being utilized; if it is applied to the front
of the console, the roles of the Circulating Nurse and the Scrub Nurse change.
If you have problems with the system when performing the setup instructions, you
should first refer to the Troubleshooting section of this manual. If questions still exist,
contact the Alcon Technical Services Department or your local Alcon representative.
Power Up Sequence
Follow these steps each time you turn system power ON. This helps ensure that the
Accurus® Ophthalmic Surgical System is set up correctly and is ready for surgery.
2. Connect the air hose between the Accurus® console and the pressure supply
(compressed air or nitrogen). Verify that pressure is between 90 to 120 psi
(500 kpa minimum for reduced operation).
5. First turn system power ON using the rear panel ON/OFF switch and then the
front panel Standby switch. Alcon's Accurus® logo is displayed on the viewing
screen while the system completes its initialization and self-test diagnostics
(approximately 2 minutes). While completing diagnostics, confirm that the five
Global Function LED displays on the front panel flash 888 before the system
enters either the Procedure Selection screen or a Surgery Setup screen.
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Accurus®
The Accurus® 800CS system enters the Procedure Selection screen upon successful
completion of self-test diagnostics (if not programmed otherwise; see next paragraph).
At this point you can select the Combined domain of operation on the touch screen,
upon which a variety of operating selections are available to you in its Combined
Surgery Setup screen.
After entering a mode of operation, most surgical functions are controlled through
the doctor's footswitch, but before any surgery can be performed there are system
modes and parameters that must be selected. Most presurgical system preparation
is performed by inserting a cassette, connecting handpieces and accessories to the
Accurus® console, then pressing buttons to navigate through the system touch screens
to make operating selections. A brief outline of the Combined screens and their
functions is presented below.
• Combined Surgery Setup Screen - This screen assists the operating room staff
to prepare the system for simultaneous vitreoretinal and cataract surgeries using
materials from an Accurus® TotalPlus® Combined Procedure Pak.
You first insert a cassette, then in the Handpieces/Probes section of the screen
you select handpieces and probes you want to use. After making selections, plug
handpieces and probes into the illuminated front panel connectors, then press
the Test key to test and prime/tune the selections. The system automatically
advances to the appropriate surgery mode after testing is done.
One accessory can be selected by pressing the desired item from the Accessories
choices. Its associated front panel connector illuminates to help you plug the
accessory into the correct connector.
In the Settings/Irrigation tab, unless Gravity is selected, you can set Regular
and Alternate Irrigation pressures, and select whether you want the alternate
pressure to be Available Yes/No. Pressing the Apply key returns you to the
setup screen with your new settings. Pressing Cancel returns you to the setup
screen without modifying the current system settings.
Continued on page 12.4
12.2
* FOR REFERENCE ONLY * 8065750203
Accurus®
Vit
Scissors
Extrude
EXTRUSION: Low
EXTRUSION: Medium
EXTRUSION: High
Phaco
or Frag I/A Vit Scissors Extrude VFC Exit
VFC
VFC: Inject
VFC: Dual
VFC: Extract
Phaco
or Frag I/A Vit Scissors Extrude VFC Exit
Figure 12-1 COMBINED MODES FLOW CHART - This flow chart highlights the system's combined operating domains
with a general map to help you navigate through its modes of operation.
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Accurus®
In the Settings/Infusion tab, depending on your infusion type, you can set an
Alternate Infusion pressure, an Alternate F/AX pressure, and select whether you
want the alternate pressure to be Available Yes/No. You can also select whether
you want the alternate pressure to be the preset value or recalled from the last
alternate pressure used. Pressing the Apply key returns you to the setup screen
with your new settings. Pressing Cancel returns you to the setup screen without
modifying the current system settings.
The Clean key is pressed to drain fluid from the cassette chamber into the drain
bag. During normal operation this function is performed automatically, but prior
to removing the cassette you may want to drain the remainder of fluid from the
chamber into the drain bag.
Depending on the last handpiece tuned, pressing the Surgery key opens the
associated surgery screen for that mode of operation.
• Surgery Screens - Entering a surgery screen gives the doctor a variety of
operating parameters and adjustments unique to that mode of operation.
Pressing a key at the bottom of the screen for another mode of operation
automatically opens the surgery screen for that mode.
Table 12-1 COMBINED DEFAULT SETTINGS AND ADJUSTABLE RANGES (part 1) - Listed here are the Accurus®
factory default settings for the combined modes of operation. The factory settings can be changed
during surgery, but turning system power OFF resets all values back to the factory default settings.
Figures in this table inside parenthesis are for reduced settings systems.
12.4
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Accurus®
Anterior Vitrectomy: Wet Accurus® Vacuum Max Limit 150 mmHg 0-600 mmHg (0-450)
Cut Rate 250 cpm 100-800 cpm
InnoVit® Vacuum Max Limit 100 mmHg 0-600 mmHg (0-450)
Vit: Cut Rate 800 cpm 100-1800 cpm
Proportional Vacuum Accurus® Vacuum Max Limit 150 mmHg 0-600 mmHg (0-450)
Cut Rate 600 cpm 100-800 cpm
Accurus® 1500 Vacuum Max Limit 150 mmHg 0-600 mmHg (0-450)
Cut Rate 1000 cpm 100-1500 cpm
Accurus® 2500 Vacuum Max Limit 150 mmHg 0-600 mmHg (0-450)
Cut Rate 1500 cpm 100-2500 cpm
Table 12-1 COMBINED DEFAULT SETTINGS AND ADJUSTABLE RANGES (part 1 continued)
8065750203
* FOR REFERENCE ONLY * 12.5
Accurus®
12.6
* FOR REFERENCE ONLY * 8065750203
Accurus®
The global keys, shown in Figure 2-9, are used to select global functions (except for
the Diathermy key which is always enabled for footswitch control). When selected,
the global function key is highlighted, the corresponding global parameter value
in the LED display is illuminated, and the console connector is illuminated to help
connect the accessory. The corresponding rubber arrow buttons are used to adjust the
global function parameter values, which change at a faster rate when the key is held
down. The preset parameter values are displayed on the LED displays.
Five global functions, accessed by pressing their icon keys on the left side of the
touch screen, are unique to the system's posterior domain.
Infusion - The top global selection on the touch screen is enabled in the posterior
domain. When CVGFI is selected in the Irrigation/Infusion Settings screen, the
Accurus® low pressure air supply provides regulated pressure into the infusion
mmHg bottle and to the F/AX stopcock. Alternate infusion pressure, set and enabled in
OR the Irrigation/Infusion Settings screen, is activated by pressing a switch on the
footswitch. If Power Pole is the selected infusion method, this control is used to set
the desired infusion pressure which automatically sets the power IV pole height. If
Gravity is selected, infusion value is non-adjustable (manually adjusted gravity fed
infusion is independent of the Accurus® system).
mmHg
Irrigation - The second global selection from the top turns continuous irrigation
ON in the anterior submode domain (Phaco, I/A, Wet Ant). Pressing it again turns
continuous irrigation OFF. CVGFI utilizes the Accurus® low pressure air supply to
cmH20 provide regulated pressure into the irrigation bottle. Alternate irrigation pressure, set
and enabled in the Irrigation Settings screen, is activated by pressing the footswitch's
OR
right vertical switch. If Power Pole is the selected irrigation method, this control is
used to set the desired irrigation pressure which automatically sets the cart's power
pole height. If Gravity is selected in phaco and I/A modes, this global key can be
used to turn continuous irrigation on and off (manually adjusted gravity fed irrigation
mmHg is independent of the Accurus® system).
F/AX Infusion - While in a posterior submode domain (Frag, Scissors, Extrude, VFC,
non-anterior Vit modes) and using either Power Pole or Gravity infusion, selecting
F/AX (Fluid/Air Exchange) cancels infusion and places the global F/AX key in the
second position from the top. F/AX utilizes the Accurus® low pressure air supply to
provide regulated pressure into the eye. Using a CVGFI tubing set you can provide
mmHg air to the eye through its stopcock valve. Alternate F/AX pressure, chosen in the
Irrigation/Infusion Settings screen, is activated by pressing a footswitch switch.
8065750203
* FOR REFERENCE ONLY * 12.7
Accurus®
Illuminators - Pressing the Illum 1 or Illum 2 global key turns the lamp in the
1
selected illuminator port ON or OFF.
Illum1
The following setup instructions include one column for user's directions, and a
second column that lists the responsible team member. Generally, the Circulating
Nurse is in the non-sterile field, and the Scrub Nurse is in the sterile field.
Sterile materials packaged inside Alcon Paks must be set up to protect the sterile surgical
environment. These instructions are written to help you protect that environment.
NOTE: If inconsistencies exist between these instructions and Directions For Use
(DFU) supplied with a consumable pak, follow the DFU.
WARNING!
Follow local governing ordinances and recycling plans regarding disposal or
recycling of device components and packaging.
Initial Preparation
1. Peel lid from Total Plus® Combined Procedure Pak and aseptically Circulating Nurse
transfer inner pouch to Scrub Nurse.
2. Accept inner pouch from Circulating Nurse. Tear open pouch and Scrub Nurse
remove its contents. Unfold the tray cover and aseptically wrap it over
the tray. Unfold the instrument drape and attach it over the Accurus®
control panel.
3. Turn system power ON, and after initial self tests are completed, select Circulating Nurse
Combined mode of operation. or Scrub Nurse
12.8
* FOR REFERENCE ONLY * 8065750203
Accurus®
4. Remove cassette with attached drain bag from pak. Unfold drain bag, Circulating Nurse
allowing it to hang freely, and insert cassette into console cassette well
(see Figure 12-2). Ensure that latch engages.
500
400
300
200
100
Figure 12-2. COMBINED FLUID CASSETTE INSERTION - With power turned ON, and
initial self tests completed, the fluid cassette with drain bag is inserted into the front
of the Accurus® cassette housing.
Infusion Setup
5. Remove green striped tubing from Total Plus® Combined Procedure Scrub Nurse
Pak and pass yellow connector to Circulating Nurse. Remove infusion
cannula from pak and connect to stopcock (see Figure 12-3). Ensure
the stopcock handle is positioned as illustrated. Set the stopcock/
cannula in the sterile field.
WARNING!
Addition of extension tubing to infusion and/or vacuum lines will change
fluidic characteristics of the Accurus® system, and is NOT recommended.
8065750203
* FOR REFERENCE ONLY * 12.9
Accurus®
6. Connect yellow connector on green striped tubing to yellow connector Circulating Nurse
on cassette.
8. Aseptically spike irrigation bottle with the drip chamber and hang it Circulating Nurse
from IV pole. Squeeze drip chamber until it is a little more than half
full of fluid.
9. Press the Settings key on the Combined Surgery Setup screen, then Scrub Nurse
in the Irrigation/Infusion Settings Type tab select Gravity or Power
Pole. Select options in the Infusion and Irrigation tabs. Press Apply.
11. Prepare a cup to accept fluid from the infusion line cannula (the cup of Scrub Nurse
fluid will be used to prime the vitrectomy probe's aspiration line). With
the snap clamp on the infusion line open, press the top infusion global
key to prime the infusion line. After partially filling a cup, press the
infusion global key to turn the fluid flow off.
WARNING!
Visually confirm adequate infusion flow from the infusion cannula prior
to attachment to the eye.
Infusion cannula
Infusion line
OFF
Figure 12-3. INFUSION LINE STOPCOCK - The stopcock is prepared with the
infusion cannula.
12.10
* FOR REFERENCE ONLY * 8065750203
Accurus®
12. Select the appropriate vitrectomy probe in the Combined Surgery Scrub Nurse
Setup screen.
13. Remove the protective cover from the vitrectomy probe and place Scrub Nurse
the probe tip into the fluid-filled cup for aspiration line priming and
testing. Present the tubing connectors to Circulating Nurse.
14. Accept tubing connectors from Scrub Nurse and connect them to the Circulating Nurse
console's illuminated connectors as instructed below (see Figure 12-4):
• Connect aspiration line (blue striped tubing with blue connector) to
the cassette's upper-right connector.
• Connect pressure line (clear tubing/clear connector) as follows:
- For Accurus®, Accurus® 1500, or InnoVit® probe, connect pressure
line to the console's top connector.
- For Accurus® 2500 probe, connect pressure line to the console's
second connector from the top.
- For InnoVit® probe, connect its other pressure line (white striped
tubing with white connector) to the second connector from the top.
TM
8065750203
* FOR REFERENCE ONLY * 12.11
Accurus®
Phaco Setup
16. Press Phaco. Plug phaco handpiece cable into illuminated connector Circulating Nurse
on console (see Figure 12-5). Present sterile handpiece to Scrub Nurse.
17. Accept handpiece from Circulating Nurse. Remove clear (irrigation) and Scrub Nurse
red-striped (aspiration) tubing from pak. Plug blue and white connectors
into phaco handpiece. Pass other end of tubing to Circulating Nurse.
18. Accept tubing from Scrub Nurse. Plug red and white tubing connectors Circulating Nurse
into the cassette's red and white connectors.
19. Screw a 0.9 mm tip onto handpiece and tighten with tip wrench. Install Scrub Nurse
irrigation sleeve with bubble suppression insert.
CAUTIONS
• Use of a tool other than the tip wrench supplied in the Pak may
cause damage to the phaco tip and handpiece.
• Mackool** handpiece utilizes a reverse thread on its tip; to tighten
the tip turn it counterclockwise, to loosen the tip turn it clockwise.
20. Enable Continuous Irrigation by pressing the Irrigation key (second Scrub Nurse
global key from the top, labeled either mmHg or cmH20), or by
pressing and releasing the correct switch on the footswitch.
21. Fill the test chamber with fluid as it streams out of the handpiece Scrub Nurse
irrigation ports, then slide the test chamber over the sleeve/tip. Turn
Continuous Irrigation OFF by pressing the Irrigation key.
22. Test handpiece as instructed below and at step 33, then select either Scrub Nurse
Linear, Burst, or Fixed submode.
23. Before priming and testing/tuning, verify the tips of aspirating probes Scrub Nurse
and handpieces are immersed in the fluid-filled cup or test chamber.
U/S tips must be freely suspended in fluid to successfully tune.
24. Before priming and testing/tuning, verify the correct modes of Scrub Nurse
operation are selected on the Combined Surgery Setup screen.
25. Press Test on the Combined Surgery Setup screen. Upon completion Scrub Nurse
of the prime and test/tune sequences the popup screen disappears,
continuous irrigation turns OFF, and the system enters the Surgery
screen.
12.12
* FOR REFERENCE ONLY * 8065750203
Accurus®
SURGICAL
TM
Figure 12-5 PHACO SETUP - For phacoemulsification procedures the combined pak requires connection of the
irrigation and aspiration lines between the cassette and handpiece, and the cable into the front panel
connector. For the CVGFI method of irrigation, refer to its setup procedure later in this section of the
manual.
8065750203
* FOR REFERENCE ONLY * 12.13
Accurus®
The I/A handpiece uses the same tubing as the phaco handpiece. If the
phaco handpiece was set up in the prior procedure, the tubing must be
disconnected from that handpiece and used with this I/A handpiece.
26. Aseptically present sterile I/A handpiece to Scrub Nurse. Circulating Nurse
27. Accept handpiece from Circulating Nurse. Remove clear (irrigation) Scrub Nurse
and red-striped (aspiration) tubing from pak and plug blue and white
connectors into I/A handpiece (see Figure 12-6). Pass other end of
tubing to Circulating Nurse.
28. Accept tubing from Scrub Nurse. Plug red and white tubing connectors Circulating Nurse
into the cassette's red and white connectors.
29. Screw an I/A tip onto handpiece and tighten with wrench supplied in Scrub Nurse
pak. Install irrigation sleeve.
CAUTION
Use of a tool other than the tip wrench supplied in the pak may
cause damage to the I/A tip and handpiece.
30. Enable Continuous Irrigation by pressing the Irrigation key (second Scrub Nurse
global key from the top, labeled either mmHg or cmH20), or by
pressing and releasing the correct switch on the footswitch.
31. Fill the test chamber with fluid as it streams out of the handpiece Scrub Nurse
irrigation ports, then slide the test chamber over the sleeve/tip. Turn
Continuous Irrigation OFF by pressing the Irrigation key.
32. Test handpiece as instructed on next page, then select either I/A Max Scrub Nurse
or I/A Cap Vac submode.
12.14
* FOR REFERENCE ONLY * 8065750203
Accurus®
Test Irrigation
Chamber Sleeve
SURGICAL
TM
Figure 12-6 I/A SETUP - For irrigation/aspiration procedures the combined pak requires connection of the irrigation
and aspiration lines between the cassette and handpiece. For the CVGFI method of irrigation, refer
to its setup procedure later in this section of the manual.
8065750203
* FOR REFERENCE ONLY * 12.15
Accurus®
WARNINGS!
• The ultrasonic (U/S) handpiece must be at room temperature before
use. Allow handpiece to AIR COOL for at least 15 minutes after steam
autoclave. Never immerse in liquid to cool.
33. Remove test chamber from tip, then depress footpedal to position 1 Scrub Nurse
and observe the fluid streaming from the handpiece irrigation ports.
If the fluid stream is absent or weak, good fluidics response will be
jeopardized. Replace test chamber.
34. Pinch aspiration line close to the handpiece to simulate an occlusion. Scrub Nurse
Fully depress footpedal to start fluid flow.
35. Release aspiration line and observe test chamber. The chamber should Scrub Nurse
maintain its shape or dimple slightly and recover its shape. After
observing chamber, release footpedal to stop fluid flow.
36. If results are not as described, adjust irrigation pressure and/or vacuum Scrub Nurse
and repeat test.
12.16
* FOR REFERENCE ONLY * 8065750203
Accurus®
The extrusion handpiece uses the same tubing (aspiration only) as the
phaco handpiece and I/A handpiece. If one of these handpieces was set up
in a prior procedure, the tubing must be disconnected from that handpiece
and used with this extrusion handpiece.
37. Present a sterilized white extrusion handpiece to Scrub Nurse. Circulating Nurse
38. Accept handpiece from Circulating Nurse. Remove clear (not used) Scrub Nurse
and red-striped (extrusion) tubing from pak and, using the white
male/male adapter in the accessories kit, plug the blue connector into
handpiece (see Figure 12-7). Place handpiece in fluid filled cup for
aspiration line priming. Present red connector to Circulating Nurse.
39. Accept the red tubing connector from Scrub Nurse and connect it to Circulating Nurse
the red cassette connector.
40. Press Extrude key. Press Options/Test to prime extrusion handpiece. Scrub Nurse
SURGICAL
White
TM
male/male
adapter
Figure 12-7 EXTRUSION LINE CONNECTION - The red striped tubing is connected
between the extrusion handpiece and Accurus® system as diagrammed
above.
8065750203
* FOR REFERENCE ONLY * 12.17
Accurus®
41. Remove the fiber optic illuminator probe/fiber from the pak, carefully Scrub Nurse
uncoil the fiber, and present the metal connector to Circulating Nurse.
42. Accept the metal connector from Scrub Nurse and, using the adaptor Circulating Nurse
chained to the illuminator drawer, plug it into the desired illuminator
connector (see Figure 12-8). Verify it is fully seated in the adaptor.
43. Slide the protective sheath from the tip of the illuminator probe. Press Scrub Nurse
the appropriate global Illuminator key to turn the illuminator ON.
Adjust the intensity as needed. Turn illuminator OFF when not in use.
SURGICAL
TM
Figure 12-8 ILLUMINATOR PROBE CONNECTOR - The fiber optic illuminator plugs
into an adaptor and then into the illuminator drawer.
12.18
* FOR REFERENCE ONLY * 8065750203
Accurus®
44. Disconnect tubing in center of aspiration line (see Figure 12-9). Scrub Nurse
45. Remove syringe from the pak and plug into female connector on Scrub Nurse
aspiration line.
20
15
10
Aspiration line
8065750203
* FOR REFERENCE ONLY * 12.19
Accurus®
1. Press Settings on the Combined Surgery Setup screen. In the Scrub Nurse
Irrigation/Infusion Settings Type tab select CVGFI, and in the
Irrigation/Infusion tabs select your desired options. Press Apply.
2. Open Combined Procedure VGFI™* Tubing Set package and present Circulating Nurse
contents to Scrub Nurse.
3. Remove the top clear tubing coil and attach clear tubing connector Scrub Nurse
to side port of infusion line stopcock. Press CVGFI-F/AX in the
Accessories section of the Combined Surgery Setup screen.
4. Remove remaining contents from package and connect lines as follows Circulating Nurse
(see Figure 12-10):
• Attach air line filter to illuminated front panel connector.
• Disconnect irrigation tubing/drip chamber from cassette and discard.
• Connect green irrigation line to illuminated connector on cassette.
WARNING!
Ensure filter is in place and is used in conjunction with the consumable.
Removal of filter can expose patient to contamination.
5. Press the Irrigation key two times (second global function key from Scrub Nurse
the top, labeled either mmHg or cmH20) to turn the air pump ON and
irrigation OFF. Press its up/down buttons to adjust the pressure level
set point.
6. Pre-spike the infusion bottle using the spiking tool, wait three seconds, Circulating Nurse
then remove. Carefully insert drip chamber/vent tube into bottle.
Hang the bottle so its liquid level is at patient eye level. Squeeze drip
chamber until it is a little more than half full of fluid.
7. Prepare a cup to accept fluid from the infusion line. With the infusion Scrub Nurse
line snap clamp open, press the Infusion key (top global function key,
labeled either mmHg or cmH20)to prime the infusion line, and after
partially filling a cup with approximately 50 ml of fluid, press the
Infusion key again to stop. The cup of fluid will be used to prime the
aspiration line of the vitrectomy probe.
WARNING!
Visually confirm adequate infusion flow from the infusion cannula prior
to attachment to the eye.
12.20
* FOR REFERENCE ONLY * 8065750203
Accurus®
SURGICAL
TM
yellow
Gas infusion line with stopcock
can be added here
green
O
F
F clear
Infusion cannula
PATIENT EYE LEVEL
(PEL)
clear
Snap clamp
Figure 12-10 COMBINED VENTED GAS FORCED INFUSION CONNECTIONS - CVGFI tubing is connected to the
Accurus® system, the bottle of BSS Plus® intraocular irrigating solution, and the infusion cannula as
diagrammed above. A second stopcock can be added to include gas infusion as well.
8065750203
* FOR REFERENCE ONLY * 12.21
Accurus®
1. Open Fragmatome™* accessory pak and present contents to Scrub Nurse. Circulating Nurse
4. Accept the handpiece from Circulating Nurse and present the Scrub Nurse
handpiece cable connector to Circulating Nurse.
5. Accept cable connector from Scrub Nurse. Select Frag on the Circulating Nurse
Combined Surgery Setup screen and plug the cable connector into
the illuminated receptacle (see Figure 12-11); the red dot on the cable
connector must align with the red dot on the console receptacle.
6. Thread Fragmatome™* tip into handpiece and tighten with tip wrench. Scrub Nurse
Use only the tip and wrench from the accessory pak.
7. Remove clear (irrigation) and red-striped (aspiration) tubing from Scrub Nurse
Combined pak. Plug blue connector into handpiece (let white connector
hang freely). Pass other end of tubing to Circulating Nurse.
8. Accept tubing from Scrub Nurse and plug red tubing connector into Circulating Nurse
the red cassette connector (let white connector hang freely).
9. Place Fragmatome™* tip into the fluid-filled cup for aspiration line Scrub Nurse
priming and handpiece tuning.
10. Before priming and testing/tuning, verify the tips of aspirating probes Scrub Nurse
and handpieces are immersed in the fluid-filled cup or test chamber.
U/S tips must be freely suspended in fluid to successfully tune.
11. Before priming and testing/tuning, verify the correct modes of Scrub Nurse
operation are selected on the Combined Surgery Setup screen.
12. Press Test on the Combined Surgery Setup screen. Upon completion Scrub Nurse
of the prime and test/tune sequences the popup screen disappears,
continuous irrigation turns OFF, and the system enters the Surgery
screen.
12.22
* FOR REFERENCE ONLY * 8065750203
Accurus®
blue connector
SURGICAL
red connector
Figure 12-11 FRAGMATOME™* HANDPIECE TUBING CONNECTIONS - Handpiece tubing and electrical connections
are plugged in as diagrammed above.
8065750203
* FOR REFERENCE ONLY * 12.23
Accurus®
1. Open a Vertical Microscissors package (containing a sterile, single use, Circulating Nurse
1 mm MicroScissors tip) and present contents to Scrub Nurse.
4. Accept IOS handpiece from Circulating Nurse and screw MicroScissors Scrub Nurse
tip onto handpiece; tighten finger tight (see Figure 12-12).
6. Accept IOS tubing from Circulating Nurse and press its bare end over Scrub Nurse
the handpiece's shaft. Pass IOS tubing connector to Circulating Nurse.
7. Accept IOS tubing connector from Scrub Nurse. Select Scissors on the Circulating Nurse
Combined Surgery Setup screen and connect tubing to the illuminated
scissors connector. Calibrate scissors tip as required (see Scissors
Mode in Section Eleven of this manual).
Scissors adjustment
SURGICAL
TM
Figure 12-12 SCISSORS LINE CONNECTION - The scissors line is connected between
the scissors handpiece and Accurus® console as diagrammed above.
12.24
* FOR REFERENCE ONLY * 8065750203
Accurus®
1. Press MPC in the Accessories section of the Combined Surgery Setup Scrub Nurse
screen.
5. Accept connector from Scrub Nurse and plug into illuminated MPC Circulating Nurse
scissors connector on front of Accurus® console (see Figure 12-13).
6. Select Surgery on the Combined Surgery Setup screen, then press Circulating Nurse
Scissors/MPC.
MPC HANDPIECE
SURGICAL
TM
Figure 12-13 MPC SCISSORS CABLE CONNECTION - The MPC scissors cable is
connected to the Accurus® console as diagrammed above.
8065750203
* FOR REFERENCE ONLY * 12.25
Accurus®
DIATHERMY SETUP
There are two types of diathermy probes and cables: reusable and single use.
Reusable probes and cables must be steam sterilized prior to use. Sterilization
instructions are included in Section Thirteen of this operator's manual.
1. Press Diathermy in the Accessories section of the Combined Surgery Scrub Nurse
Setup screen.
3. Accept diathermy probe/cable from Circulating Nurse. Connect cable Scrub Nurse
to diathermy probe (see Figure 12-14), ensuring that instrument pins
are fully seated in cable receptacle. Present banana plug connectors to
Circulating Nurse.
4. Accept banana plug connectors from Scrub Nurse. Select Diathermy Circulating Nurse
on the Vitreoretinal Surgery Setup screen and connect the banana plugs
into the illuminated Diathermy receptacles. Adjust the Diathermy
power level as required.
SURGICAL
TM
12.26
* FOR REFERENCE ONLY * 8065750203
Accurus®
1. Open a sterile Viscous Fluid Injector (VFI) pak and present contents to Circulating Nurse
Scrub Nurse.
2. Accept contents of pak from Circulating Nurse. Pass connector end of Scrub Nurse
VFI tubing to Circulating Nurse. Press the VFC key on the Combined
Surgery Setup screen.
3. Accept tubing connector from Scrub Nurse and plug it into the Circulating Nurse
illuminated VFC connector (see Figure 12-15).
4. Press the Surgery mode key, then press the VFC mode key—the Scrub Nurse
VFC: Inject screen appears. For injection proceed to step 5. For
extraction proceed to step 6.
5.1 Ensure syringe tip cap is properly engaged. Following the Scrub Nurse
directions for use supplied with the sterile viscous fluid,
aseptically transfer viscous fluid to the syringe barrel. Care
should be taken to prevent air bubbles from entering the fluid.
Take special care if transferring 5000 centistoke fluid.
5.2 Initiate syringe stopper insertion (found in small parts tray). Scrub Nurse
5.3 Orient barrel as shown, with tip cap up. Remove the syringe Scrub Nurse
tip cap to allow air to escape, and complete syringe stopper
insertion.
5.4 Keeping the cannula cover on, attach the desired surgical cannula Scrub Nurse
to the syringe (0.9mm [20 gauge] diameter, 8mm long blunt
cannula provided).
5.5 Using the plastic push rod (found in the small parts tray), Scrub Nurse
advance the syringe stopper to position the viscous fluid level at
the cannula. Remove push rod.
5.6 Connect the syringe barrel to the white syringe adapter by Scrub Nurse
pushing down and rotating the barrel 90°. Ensure barrel flanges
are totally engaged within the adapter.
8065750203
* FOR REFERENCE ONLY * 12.27
Accurus®
AIR
Push
Rod
Step 5.2 Step 5.3 Step 5.4 Step 5.5 Step 5.6 Step 5.7
10
1
2
3
4
5
6
7
8
9
B-D
SURGICAL
TM
Figure 12-15 VISCOUS FLUID INJECTOR CONNECTION - For viscous fluid injection the barrel of the syringe is
filled with sterile fluid and connected to the Accurus® console as diagrammed above. Do not use this
diagram for fluid extraction, although extraction uses this same port on the connector panel.
12.28
* FOR REFERENCE ONLY * 8065750203
Accurus®
5.7 Remove the cannula cover. Tilt the cannula tip up and carefully Scrub Nurse
pressurize the syringe to expel any remaining air. Wrap the
cannula tip in sterile gauze, lint free cloth, or sponge to capture
any expelled fluid. The VFC system is now ready to use.
WARNINGS!
Do not use if air bubbles are observed passing through the fluid.
5.8 Press the arrow keys to adjust the Max Limit Pressure. Circulating Nurse
WARNINGS!
Adjust Max Limit Pressure in accordance with the viscosity of fluids
to be injected. Excessively high settings may endanger the patient.
6.1 Perform Viscous Fluid Control Setup procedure, then select the Staff
Dual submode. Circulating Nurse
7.1 Perform Viscous Fluid Control Setup procedure steps 1-4. Staff
CAUTION
Failure to insert syringe stopper can allow fluids to enter the
console, resulting in damage to its internal parts.
7.4 Press white syringe adapter into syringe barrel. When fully Scrub Nurse
inserted, turn 90˚to secure adapter to barrel.
7.5 Carefully depress the footpedal to pressurize the injector, pushing Scrub Nurse
the syringe stopper to the bottom of the barrel. Release footpedal.
Alternately, the plastic push rod may be used to push the syringe
stopper to the bottom of the barrel.
7.6 Select the Extract submode, then press the arrow keys to adjust Circulating Nurse
the Max Limit vacuum setting.
8065750203
* FOR REFERENCE ONLY * 12.29
Accurus®
1. Remove Vit handpiece with tubing from Total Plus® Combined Scrub Nurse
Procedure Pak and present tubing connectors to Circulating Nurse.
Select probe type in Combined Surgery Setup screen, then press
Surgery key to enter surgery screen. Select WetAnt mode.
2. Accept tubing connectors from Scrub Nurse and plug them to Circulating Nurse
console's illuminated connectors as instructed below (see example for
Accurus® and Accurus® 1500 probes in Figure 12-16):
• Connect aspiration line (blue striped tubing with blue connector) to
the cassette's upper-right connector.
• Connect pressure line (clear tubing/clear connector) as follows:
- For Accurus®, Accurus® 1500, or InnoVit® probe, connect pressure
line to the console's top connector.
- For Accurus® 2500 probe, connect pressure line to the console's
second connector from the top.
- For InnoVit® probe, connect its other pressure line (white striped
tubing with white connector) to the second connector from the top.
For Dry Vit procedure proceed to step 8 (irrigation tubing is not used).
4. Disconnect irrigation line from U/S, or I/A handpiece and connect to Scrub Nurse
irrigation handpiece/manifold. Proceed to step 9.
7. Disconnect irrigation line from U/S or I/A handpiece and connect to Scrub Nurse
irrigation sleeve tubing. Press irrigation sleeve over tip of Vit handpiece.
Prime
8. Place tip of Vit probe into a cup of sterile fluid for aspiration line Scrub Nurse
priming and testing. (For wet bimanual procedure, place tip of
irrigation handpiece in cup, also.)
9. Press Test to prime the tubing and test the probe. After a successful Scrub Nurse
test, the system will enter the Surgery screen. Press either the Wet or
Dry submode key.
12.30
* FOR REFERENCE ONLY * 8065750203
Accurus®
Irrigation Line
clear tubing
SURGICAL
Figure 12-16 ANTERIOR VITRECTOMY SETUP - For Anterior Vitrectomy procedures in the Combined domain
the handpiece's air pressure tubing and aspiration tubing must be plugged into their illuminated
connectors. For Wet procedures the irrigation tubing must be connected between the cassette
and either an irrigation sleeve or irrigating Vit handpiece.
8065750203
* FOR REFERENCE ONLY * 12.31
Accurus®
1. Open a sterile Fluid/Air Exchange Tubing Set and present contents to Circulating Nurse
Scrub Nurse.
2. Accept contents of Fluid/Air Exchange Tubing Set. Remove tubing Scrub Nurse
from package and attach its male luer connector to the female
connector on the infusion stopcock (see Figure 12-17). Present the
filter end of the tubing to Circulating Nurse. Select CVGFI-F/AX on
the Combined Surgery Setup screen.
3. Accept the filter end of the tubing from Circulating Nurse and plug it Circulating Nurse
into the console's illuminated connector.
WARNING!
Ensure filter is in place and is used in conjunction with the consumable.
Removal of filter can expose patient to contamination.
4. Turn the air pump ON by pressing the F/AX global function key and Scrub Nurse
adjust the pressure level as required.
Infusion
SURGICAL cannula
TM
Figure 12-17 AIR INFUSION LINE CONNECTION - The filter end of the Fluid/Air
Exchange Tubing Set connects to the Accurus® console as diagrammed
above. The male luer connector plugs into the infusion line stopcock.
12.32
* FORLastREFERENCE
page of this section ONLY * 8065750203
Accurus®
SECTION THIRTEEN
COMBINED DISASSEMBLY AND CLEANING
NOTES: If an inconsistency ever exists between the procedures in this section and the DFU,
follow the instructions in the DFU. During these procedures discard all consumables per
specific hospital/clinic requirements.
1. Remove bottle from hanger and disconnect drip chamber from bottle.
2. Remove the vacuum lines from the cassette. Remove all consumable/accessory
pneumatic and/or electric connections from the lower front panel of the console.
Remove drape (if used).
3. Press Exit to go to the Combined Surgery Setup screen, then push the Clean key
to transfer fluid collected in the cassette to its drain bag.
4. Press the Eject button. This initiates a two to three second sequence that
releases the drain pump tubing and unlatches the cassette. After visually
confirming that the cassette is unlatched, grasp the cassette handle and remove
cassette from cassette well in an outward motion (see Figure 13-1).
500
400
300
200
100
FIGURE 13-1 CASSETTE REMOVAL - With power turned ON, the fluid cassette with drain bag is
ejected from the Accurus® cassette well by pressing the Eject button on the front
panel. If no pressure or electrical power are available, lift the rear panel lever and
wiggle the cassette out.
8065750203
* FOR REFERENCE ONLY * 13.1
Accurus®
5. Use the small rubber stopper from the parts kit to plug the cassette's vacuum
port (see Figure 13-2).
If a fluid sample is being sent to the lab for testing, the drain bag can be
detached from cassette. Wipe the drain bag's injection site with alcohol to ensure
that the exposed rubber is clean. Use a non-coring needle less than 1” long to
draw a lab sample. Discard consumbles.
CAUTION
If 1" needles are used, take care to push the needle hub into the injection site’s
rubber plug. Otherwise, the needle tip could extend beyond the length of the
injection site’s protective body.
Vacuum port
FIGURE 13-2 PLUG THE VACUUM PORT - The vacuum port must be plugged with a rubber stopper
immediately after each surgery to prevent fluid leakage.
7. Remove the tubing from the handpiece and unplug the handpiece connector
from the console.
8. Remove all consumables from the handpiece and discard according to hospital
guidelines.
10. Using a clean syringe, draw a minimum of 120 cc of distilled water through the
aspiration path.
11. Using the same syringe, flush the aspiration port with air.
13.2
* FOR REFERENCE ONLY * 8065750203
Accurus®
WARNINGS!
If these cleaning procedures are not performed immediately after each surgical
procedure, tissue debris and salts from irrigating solution may collect. This could
permanently damage the handpiece and could jeopardize cleanliness and/or create
biohazard conditions for the patient. Do not autoclave the handpiece until all debris
has been removed.
If in the medical opinion of the physician a patient with a prion related disease
undergoes a high risk procedure, the instrument should be destroyed or be
processed according to local requirements.
Never immerse the handpiece in liquid after autoclaving; allow it to air cool for
at least 15 minutes. Be sure the handpiece connector is completely dry before
connecting it to the console.
Prior to sterilization, the ultrasonic handpiece should always have the connector
end cap secured and placed in the sterilization tray. This will prevent damage to
connectors and handpieces during handling, and especially during autoclaving.
Handle the handpiece carefully. Dropping or otherwise striking the handpiece may
fracture piezoelectric elements contained within and degrade performance or render
the handpiece inoperable.
13. Remove the handpiece tip. If it is a single use tip, properly discard it.
14. Flush I/A handpiece and reusable tip at least two times with a syringe filled with
30 cc of warm distilled water. Flush immediately with air to clear any water
from the handpiece and needle.
18. Wipe down the IOS handpiece with a damp cloth and flush the tubing at least
once with a syringe filled with 30 cc of warm distilled water. Flush immediately
with air to clear any water from the handpiece and tubing.
19. Please refer to Grieshaber® literature that came with your MPC scissors for
cleaning and sterilization instructions.
8065750203
* FOR REFERENCE ONLY * 13.3
Accurus®
21. Remove the extrusion needle. If it is a single use needle, properly discard it.
22. Flush extrusion handpiece and reusable extrusion needle at least two times with
a syringe filled with 30 cc of warm distilled water. Flush immediately with air to
clear any water from the handpiece and needle.
25. Clean reusable handpiece by wiping off residual tissue with a soft, non-abrasive
cloth. Rinse the handpiece and cable with distilled water to remove any
remaining debris.
26. Hand wash the reusable handpiece and cable using a soft bristled cleaning
brush. The use of abrasive cleaners or solvents is not recommended.
27. Thoroughly flush all handpiece and cable surfaces with distilled water until no
visible debris remains. Dry the handpiece and cable with a sterile wipe.
NOTE: If the Accurus® system remains plugged in, always ensure that the
rear panel On/Off switch is in the OFF position.
2. If required, the console and remote control may be cleaned with mild soap and
water. DO NOT USE SOLVENTS OR ABRASIVES.
13.4
* FOR REFERENCE ONLY * 8065750203
Accurus®
STERILIZATION
The following accessories for the Accurus® Ophthalmic Surgical System may be flash or steam
autoclaved. Additionally, per the Sterilizer Equipment Manual, the sterilizer reservoir is to be filled
with distilled or deionized water.
The specifications in Table 13-1 represent industry standard guidelines for steam sterilization
cycles. The sterility assurance level achieved with these parameters must be validated by each
hospital. Please refer to current ANSI/AAMI Standards or your hospital’s standard procedures for
the most current specifications.
1 For 375/40 U/S & Mackool** and Fragmatome™* handpieces the recommended exposure time is 20 minutes minimum.
Table 13-1 STERILIZATION TEMPERATURE AND TIME SETTINGS
NOTE: For maximum life and optimum performance, allow handpieces to air cool after steam
or flash autoclaving. Cooling for Fragmatome™* handpieces should be a minimum of 15
minutes.
NOTE: For instructions to sterilize the Membrane Peeler Cutter (MPC) scissors handpiece,
please refer to the Grieshaber® literature that came with your MPC scissors.
8065750203
* FOR REFERENCE ONLY * 13.5
Accurus®
13.6
* FORLast
REFERENCE
page of this section
ONLY * 8065750203
Accurus®
SECTION FOURTEEN
COMBINED ACCESSORIES AND PARTS
Following is a list of Alcon‑approved accessories and replacement parts for the Accurus® Ophthalmic
Surgical System. To order parts, please refer to your Alcon price list and/or contact Alcon Customer
Service at:
Phone: Write:
(800) 862‑5266 or Alcon
(817) 293‑0450 6201 South Freeway
Ask for Customer Service Fort Worth, TX. 76134‑2099
Outside the U.S.A. please contact your local Alcon representative.
Important Note: Use of accessories and parts not approved by Alcon is not recommended.
Combined Paks
Total Plus® Combined Procedure Paks
Tipless w/Accurus® probe (for use with all 0.9mm tips) 8065740960
Tipless w/InnoVit® probe (for use with all 0.9mm tips) 8065740959
0° TurboSonics® Mackool** MicroTip™ 8065740958
30° TurboSonics® Mackool** MicroTip™ 8065740957
45° TurboSonics® Mackool** MicroTip™ 8065740956
30° TurboSonics® Mackool** Kelman® MicroTip™ 8065740955
45° TurboSonics® Mackool** Kelman® MicroTip™ 8065740954
0° TurboSonics® Flared ABS® Mackool** MicroTip™ 8065740953
30° TurboSonics® Flared ABS® Mackool** MicroTip™ 8065740952
45° TurboSonics® Flared ABS® Mackool** MicroTip™ 8065740951
30° TurboSonics® Flared ABS® Mackool** Kelman® MicroTip™ 8065740950
45° TurboSonics® Flared ABS® Mackool** Kelman® MicroTip™ 8065740949
0° TurboSonics® Flared ABS® Mackool** 8065740948
30° TurboSonics® Flared ABS® Mackool** 8065740947
45° TurboSonics® Flared ABS® Mackool** 8065740946
30° TurboSonics® Flared ABS® Mackool** Kelman® 8065740945
45° TurboSonics® Flared ABS® Mackool** Kelman® 8065740944
Tipless w/Accurus® probe (for use with flared 1.1mm tips) 8065750169
Tipless w/InnoVit® probe (for use with flared 1.1mm tips) 8065750170
Tipless w/Accurus® 1500 probe (for use with all 0.9mm tips) 8065750114
Tipless w/Accurus® 1500 probe (for use with all 1.1mm tips) 8065750116
Tipless w/Accurus® 2500 probe (for use with flared 0.9mm tips) 8065750115
Tipless w/Accurus® probe 2500 (for use with flared 1.1mm tips) 8065750117
Tipless w/Accurus® 23 Ga probe (for use with 0.9mm tips) 8065750814
Tipless w/Accurus® 23 Ga probe (for use with 1.1mm tips) 8065750816
Tipless w/Accurus® 25 Ga probe (for use with 0.9mm tips) 8065750817
Tipless w/Accurus® 25 Ga probe (for use with 1.1mm tips) 8065750819
Tipless w/Accurus® 25+ probe (for use with 0.9mm tips) 8065751491
Tipless w/Accurus® 25+ probe (for use with 1.1mm tips) 8065751494
8065750203
* FOR REFERENCE ONLY * 14.1
Accurus®
Consumable Accessories
CVGFI Tubing Set 8065740962
2.5 mm Infusion Cannula 8065820001
4.0 mm Infusion Cannula 8065820101
6.0 mm Infusion Cannula 8065820201
Silicone Oil Infusion Cannula 8065740262
Remote Control Aseptic Transfer 20000TP
Accurus® Replacement Drain Bags 8065740743
Fragmatome™* Accessory Pak 1021HP
Fluid/Gas Exchange Tubing Set 8065807001
Scleral Plugs, 19 and 20 gauge (6) 8065807550
Anterior Small Parts Kit 201SPS
Viscous Fluid Control Pak 8065750118
Trocar Blade, 23 Ga, 3 Ct 8065750882
Trocar Cannula Set, 23 Ga, 1 Ct 8065750839
Trocar Cannula Set, 23 Ga, 2 Ct 8065750838
Trocar Cannula Set, 23 Ga, 3 Ct 8065750823
Trocar Cannula Set, 25 Ga, 1 Ct 8065750236
Trocar Cannula Set, 25 Ga, 2 Ct 8065750405
Trocar Cannula Set, 25 Ga, 3 Ct 8065750406
Trocar Plug Set, 23 Ga 8065750837
Trocar Plug Set, 25 Ga 8065750189
Infusion Cannula, 23 Ga 8065750841
Infusion Cannula, 25 Ga 8065750188
Small Parts Kit, 23 Ga 8065750842
Small Parts Kit, 25 Ga 8065750404
14.2
* FOR REFERENCE ONLY * 8065750203
Accurus®
Console Accessories
Cart w/IV Pole 8065740943
Cart w/Power IV Pole 8065740825
Remote Control 8065740942
Remote Control, English Text 8065750105
Footswitch 8065740240
Pneumatic Pressure Hose 8041193501SV
Illuminator Bulb 8065740243
Operator’s Manual 8065750203
Accurus® Doctor Memory Card 8065750200
Vit Accessories
2.5 mm Infusion Cannula 800-2A
4.0 mm Infusion Cannula 800-2B
6.0 mm Infusion Cannula 800-2D
Silicone Oil Infusion Cannula 8065740262
Blunt Tip Needle, Straight, 20 ga. 800-26A
Blunt Tip Needle, Tapered, 20 ga. 800-26B
Blunt Tip Needle, Tapered, 19 ga. 800-26D
Infusion Needle Tubing 800-7
Intraocular Scissors Tubing 8065740265
Cross Action Plug Forceps 830-20A
Scleral Plugs, 20 ga. (4/tablet) 830-18
Scleral Plugs, 19 ga. (4/tablet) 830-24
8065750203
* FOR REFERENCE ONLY * 14.3
Accurus®
Vit Handpieces
375/40 Fragmentation Handpiece 8065740242
Extrusion Handpiece (set of 4) 8065808601
19 ga. Straight Extrusion Handpiece 8065808701
19 ga. Tapered Extrusion Handpiece 8065808801
20 ga. Straight Extrusion Handpiece 8065808901
20 ga. Tapered Extrusion Handpiece 8065809001
Charles O’Malley Extrusion Kit 800-26
Extrusion Kit Handpiece 800-26E
Intraocular Scissors Handpiece 8065808101
MPC Scissors, Lightweight 0.9 mm 625.13
MPC Scissors, Fine Tip Handle 0.7 mm 625.12
MPC Scissors, Traditional Handle 1.3 mm 625.01
Probes
InnoVit® 8065740244
Accurus® 1500 8065741016
Accurus® 2500 8065741018
Accurus® 8065740241
Accurus® 23 Ga Probe 8065750821
Accurus® 25 Ga Probe 8065750226
Accurus® 25+ Probe 8065751122
Accurus® Anterior Vitrectomy w/Irrigation Needle 8065803650
Anterior Vitrectomy Irrigation Sleeve 8065801351
Illuminator (DFOI) 8065812001
Fiber Optic Assy, 23 Ga 8065750802
Fiber Optic Assy, 25 Ga 8065750190
Fiber Optic Assy, Bare End 8065740257
Fiber Optic Assy, 25+ 8065751165
Fiber Optic Assy, Wide Angle 8065740264
Fiber Optic Assy, End Irrigating 8065740259
Fiber Optic Assy, Straight Pick 8065740260
Fiber Optic Assy, Pre-Bent 8065740258
Vertical Micro Scissors (1mm) 8065813701
Vertical Micro Scissors (1.5mm) 8065803701
Laser Probe, Straight Needle, 23 Ga 8065750803
Laser Probe, Straight Needle, 25 Ga 8065750133
Illuminated Laser Probe, HGM Connector, Curved Needle, ACMI 8065103040
Illuminated Laser Probe, HGM Connector, Straight Needle, ACMI 8065010320
Illuminated Laser Probe, Alcon®/Coherent® Connector, Curved Needle, ACMI 8065010404
Illuminated Laser Probe, Alcon®/Coherent® Connector, Straight Needle, ACMI 8065010420
Shielded Bullet Endo Illuminator, 20 GA, ACMI 8065109203
Shielded Bullet Endo Illuminator, with Pick, 20 GA, ACMI 8065109219
Sapphire Wide Angle Probe 8065750425
Laser Probe, Aspirating, Curved, 20 Ga 8065010703
Laser Probe, Aspirating, Straight, 20 Ga 8065010719
Laser Probe, Aspirating, Soft Tip, Straight, 20 Ga 8065010739
Laser Probe w/RFID, Aspirating, Curved, 20 Ga 8065750979
Laser Probe w/RFID, Aspirating, Straight, 20 Ga 8065750980
Laser Probe w/RFID, Aspirating, Soft Tip, Straight, 20 Ga 8065750981
14.4
* FOR REFERENCE ONLY * 8065750203
Accurus®
Illuminated Laser Probe w/RFID, Alcon®/Coherent® Connector, Curved, 20 Ga, ACMI 8065750982
Illuminated Laser Probe w/RFID, Alcon®/Coherent® Connector, Straight, 20 Ga, ACMI 8065750983
Articulating Illuminated Laser Probe w/RFID, Alcon®/Coherent® Connector, 20 Ga, ACMI 8065751105
Articulating Illuminated Laser Probe w/RFID, Alcon®/Coherent® Connector, 23 Ga, ACMI 8065751106
Articulating Illuminated Laser Probe w/RFID, Alcon®/Coherent® Connector, 25 Ga, ACMI 8065751107
8065750203
* FOR REFERENCE ONLY * 14.5
Accurus®
14.6
* FORLast
REFERENCE
page of this section
ONLY * 8065750203
Accurus®
SECTION FIFTEEN
CARE AND MAINTENANCE
CAUTION
The Accurus® system is shipped with a kit containing the fuses and fuse carriers
used for 220-230-240 VAC. Prior to applying power levels of 220-230-240 VAC
the fuses must be changed or DAMAGE MAY RESULT.
Replace Fuses
2. Using a flat tip screwdriver, turn 2 fuse carriers 1/4 turn CCW and remove from
power supply (see Figure 15-1).
3. Insert fuse carriers with fuses of the correct rating and size (see Table 15-1).
FIGURE 15-1 FUSE CARRIERS AND FUSES - When shipped, the Accurus® system is configured
for 100 to 120 VAC operation. 220 to 240 VAC systems must have their fuse carriers
and fuses changed for the supplied voltage.
100 - 120 VAC 10A / 250V SLOW BLOW, 1/4" x 1-1/4" 130-023
TABLE 15-1 FUSE SELECTION - Use appropriate fuses for the supplied line voltage.
8065750203
* FOR REFERENCE ONLY * 15.1
Accurus®
To ensure secondary illuminator source availability at all times, replace a burned out
bulb immediately upon completion of surgery (not included in 200PS system).
WARNING!
The illuminator bulbs become extremely hot. Never handle a bulb until it has cooled
considerably from its operating temperature. Do not touch bulb directly with fingers
at any time!
1. Push the Illuminator release button on the rear panel to eject illuminator drawer.
2. Pull the illuminator drawer out to full extension. Do not attempt to remove the
burnt bulb until it is cool to the touch.
3. Using a soft cloth or protective glove, grip the bulb at its base and pull out of
socket. Discard bulb.
4. Using a soft cloth or glove, insert the new bulb's two leads into the two holes of
the socket. Press the bulb down until it is fully inserted into the socket. Gently
clean any smudges or dirt from the bulb with a soft cloth.
CAUTION
Handling bulb with bare hands can reduce brightness and life of the bulb.
5. Ensure bulb is straight (see Figure 15-2). To do this, look into the fiber optic
illuminator probe receptacle; the bulb filament should be centered within the
receptacle.
6. Gently push illuminator drawer back into its receptacle. The illuminator is now
ready for use.
SURGICAL
TM
FIGURE 15-2 BULB ALIGNMENT - For proper illumination, ensure that bulb is inserted correctly
into its socket as diagrammed above.
15.2
* FOR REFERENCE ONLY * 8065750203
Accurus®
The hand-held remote control contains four batteries (size AA, 1.5 volts). It is
recommended that the Eveready® Energizer® Industrial Alkaline batteries, No. EN91,
be used with this remote control.
2. Locate the battery cover panel, and using a standard screwdriver remove the
panel by turning the captive screw counterclockwise. Set the panel aside.
3. Remove the old batteries from the remote control. Install the new batteries
taking care to observe the polarity indicated on the battery housing.
4. Replace the battery cover panel on the remote control, and using a standard
screwdriver tighten the captive screw by turning clockwise.
The remote control operates on one-of-four channels (A, B, C, or D), and is similar
for both the Accurus® and Legacy® Ophthalmic Surgical Systems. The Accurus®
system and its remote control are factory preset to channel D. To ensure proper
remote control operation when two or more systems are used in the same area, set
each to a separate channel as instructed below.
2. Locate the battery cover panel, and using a standard screwdriver remove the
panel by turning the captive screw counterclockwise. Set the panel aside.
4. Replace the battery cover panel on the remote control, and using a standard
screwdriver tighten the captive screw by turning clockwise.
5. After selecting a channel in the remote, the same channel must be selected in the
Options/System screen in the Accurus® system (see Figure 2-51).
Remote Channel Remote Channel Remote Channel Remote Channel
A B C D
S1
0 N
0 N 0 N 0 N 0 N
S1 S1 S1 S1
1 2
1 2 1 2 1 2 1 2
FIGURE 15-3 REMOTE CONTROL CHANNEL SELECTION SWITCHES - Four different channels are offered for
remote control operation. After selecting a channel in the remote, the same Remote Channel must
be selected in the Options/System screen in the Accurus® system.
8065750203
* FOR REFERENCE ONLY * 15.3
Accurus®
CRATING INSTRUCTIONS
FIGURE 15-4 C R AT I N G O F T H E A C C U R U S ®
OPHTHALMIC SURGICAL SYSTEM - This diagram shows
the proper way to crate the Accurus® system prior to
transport.
15.4
* FOR REFERENCE ONLY * 8065750203
Accurus®
SURGICAL
8065750203
* FOR REFERENCE ONLY * 15.5
Accurus®
15.6
* FORLast
REFERENCE
page of this section
ONLY * 8065750203
Accurus®
SECTION SIXTEEN
TROUBLESHOOTING
This section of the manual is designed to help you identify problems that you
may encounter with your Accurus® system, then how to correct the problems. The
following tables contain information about possible problems observed, the possible
reasons for the observed problem, and suggestions about what you can do to correct
the problem.
These charts are presented as an aid to rapid location of failed or malfunctioning parts
or components. They are not meant to replace standard troubleshooting methods.
Care should be used during the troubleshooting process to prevent the introduction of
additional problems.
If, after performing the recommended corrective action, the system continues to
malfunction, call your local Alcon service representative.
8065750203
* FOR REFERENCE ONLY * 16.1
Accurus®
GENERAL CONDITIONS
System won’t turn ON. No electrical power supplied to system. Check electrical plug connection.
Check fuses on rear panel.
Check power source and fuses.
Bad power supply. Call Alcon.
Blank or logo screen only. System has detected a power on self test error Cycle power.
due to corrupted data or bad hardware. Call Alcon Field Service.
Vacuum Leak. Cassette improperly seated. Eject and reinsert cassette.
Tubing not loaded or noise Cassette tubing not loaded properly. Eject and reinsert cassette.
from cassette area.
Defective or damaged cassette. Eject and insert a new cassette.
Press Clean to drain Drain Bag is full. Eject cassette without full transfer of fluid.
cassette leaves fluid in cas-
sette. Drain Bag is clogged. Eject cassette without full transfer of fluid.
Cassette was very full prior to cleaning. Press Clean again.
Footswitch not operational. Footswitch not connected properly. Connect footswitch.
Check that the footwitch cable is firmly seated.
Blown fuse. Replace fuse. Refer to section 15, Care and Mainte-
nance, for Fuse Replacement procedure.
Table 16-1 ACCURUS® OPHTHALMIC SURGICAL SYSTEM PROBLEM CONDITIONS - Listed in this table are
problem conditions that may be observed. These conditions do not include information popups, but
are simply observations.
16.2
* FOR REFERENCE ONLY * 8065750203
Accurus®
POSTERIOR CONDITIONS
Low Inlet Pressure. Air pressure supply less than 62 psi when Check air supply.
not cutting, or less than 49 psi when cutting. Set regulator between 90-120 psi (5-BAR 72-120 psi).
Check air supply hose and connections.
Regurgitation. Vacuum too low. Check and, if necessary, increase vacuum level.
Cassette is above the patient eye level. Check and, if necessary, adjust the patient eye level in
the Options/System Screen.
Cannot activate/deactivate Footswitch too close to another object to Remove obstruction.
cutting and/or scissors allow for full range of movement of side
closure from footswitch switches.
side switches.
Broken or faulty side switch. Call Alcon Technical Services.
8065750203
* FOR REFERENCE ONLY * 16.3
Accurus®
Illuminator not lit. Intensity turned OFF or too low. Press illuminator ON key or, if necessary, increase
illuminator intensity.
Light source drawer not securely shut. Push drawer firmly into its receptacle.
Illuminator dim. Illuminator intensity setting too low. Increase illuminator intensity.
Bulb not installed correctly (not straight). Properly reinstall and align bulb.
Fiber optic light guide defective. Replace fiber optic light guide.
Scissors do not cut or open Scissors not connected properly. Check all tubing connections to scissors.
or close completely.
Scissors bent or damaged. Replace scissors tip.
FRAGMATOME™* HANDPIECE
Fragmatome™* handpiece Handpiece may not be plugged in. Plug handpiece cable into illuminated connector on
does not tune. console.
Handpiece tuned while hot. Allow handpiece to cool for at least 15 minutes
before tuning.
Handpiece tuned while hot. Allow handpiece to cool for at least 15 minutes
before tuning.
16.4
* FOR REFERENCE ONLY * 8065750203
Accurus®
ANTERIOR CONDITIONS
Regurgitation. Vacuum too low. Check and, if necessary, increase vacuum level.
Cassette is above the patient eye level. Check and, if necessary, adjust the patient eye level in
the Options/System Screen.
Diathermy does not work. Power level is set too low. Check and, if necessary, increase power.
U/S HANDPIECE
U/S handpiece does not tune. Handpiece may not be plugged in. Plug handpiece into U/S connector on console.
Handpiece tuned while hot. Allow handpiece to cool for at least 15 minutes
before tuning.
Handpiece tuned while hot. Allow handpiece to cool for at least 15 minutes
before tuning.
8065750203
* FOR REFERENCE ONLY * 16.5
Accurus®
1 "Footswitch not detected. Please The footswitch is incorrect or not Connect an Accurus® footswitch.
check for proper connection.” connected.
3 “Please install an Alcon Ultrasonic The Test key was pressed or a U/S Connect, and prime/test the correct
handpiece for the current mode.” mode was entered with no U/S U/S handpiece.
handpiece connected
4 “Ultrasonic handpiece is not tuned. The system is in a U/S mode, and With the tip of the U/S handpiece
Press Test to prime/tune.” the U/S handpiece is installed but suspended in fluid, press the Test key to
not tuned. prime/tune the handpiece.
5 “Ultrasonic handpiece tune failure. Loose handpiece tip. Check to see if the U/S handpiece tip is
Check tip for proper installation.” loose or otherwise improperly installed.
6 “Priming unsuccessful. Fluid not Fluid not detected in cassette dur- Ensure handpiece/probe tip is in fluid
detected in cassette. Please attempt ing priming sequence. and reprime.
re-prime.”
7 “Bulb failure detected. Please re- An illuminator bulb burned out, or Replace bulb or use other illuminator.
place bulb.” an Illuminator key was pressed for
a burned out illuminator.
8 “Cassette is not ready. Please check Cassette is not installed or did not Eject the cassette and check for damage.
cassette for proper installation.” pass the vacuum test. Check the cassette tubing for leaks. Re-
place with a new cassette if damaged.
9 “Drainbag may be full. Replace System detects that approximately If full, press Yes and wait for "Replace
Drainbag?” 500cc of fluid has been transfered drainbag now. Press OK when done"
to the drain bag. popup and replace drainbag.
10 “Cassette failed vacuum test. Please The cassette failed the vacuum Eject the cassette and check the O-Ring
eject and reinsert, or replace cas- test. and cassette tubing. Replace with a new
sette.” cassette if damaged.
Table 16-2. ADVISORIES - Advisories appear in popups on the display screen. An advisory is usually corrected
by following the instruction in the popup.
16.6
* FOR REFERENCE ONLY * 8065750203
Accurus®
11 "Please adjust supply source pressure Source pressure is too low Adjust source pressure to between 90
for standard pressure operation." and 120 psi.
12 “Press Reduced for low pressure Source pressure is not appropriate Select a source pressure and adjust
operation or press Standard and for pressure selection. source pressure setting.
increase air pressure.”
13 “Please adjust supply source air Source pressure is too low. Increase source air pressure.
pressure for reduced pressure op-
eration.”
14 “Vacuum surges detected. Check The vacuum level exceeds its up- Check the tubing and connections for
aspiration lines and connections for per tolerance. leaks. Reconnect or replace if neces-
leaks.” sary.
15 “Pressure surges detected. Check Proportional pressure exceeds its Check that VFC or Scissors (whichever
VFC/Scissors lines and connections upper tolerance. is applicable) is properly connected.
for leaks.” Check tubing and connections for leaks.
18 “Cassette detected full. PLEASE Cassette pump failure. If cassette is loaded, eject, discard, and
REPLACE CASSETTE.” replace cassette with a new one.
20 "Please check cassette." Cassette unloading problem. Manually eject cassette and inspect
receiver mechanism for blockage.
21 “Apply vacuum to enable additional Operator requests more than 10 Apply vacuum to enable additional
Reflux pulses." consecutive reflux pulses in the refluxes and remove the popup.
posterior domain, or 20 consecutive
reflux pulses in the anterior domain
without requesting vacuum.
22 "Cassette type does not match surgi- Cassette is the wrong type for the Eject cassette and replace with cassette
cal mode. Please insert the correct current surgical domain. for current domain.
cassette."
23 "Memory error, capabilities may System version number and model Press OK. System provides 400VS
be limited." is invalid. capabilities.
24 "Low battery condition. Please A low battery condition exists. Replace remote control batteries.
replace the battery on the remote
control."
8065750203
* FOR REFERENCE ONLY * 16.7
Accurus®
25 "Doctor memories do not match SRAM doctor memories CRC Press CPU Bd key to overwrite SRAM
backup copy. Which copy do you does not match Sound board doc- doctor memories, or press Snd Bd
want to overwrite?" tor memories CRC. key to overwrite Sound board doctor
memories, or press Ignore key to use
SRAM doctor memories and skip all
writes to sound board memory.
26 "Light sensor triggered. Remove Top fluid level sensor triggered Redirect ambient light source away
flashlight and release treadle if when the transmitting LED is from cassette receiver mechanism.
vacuum was on." turned off.
27 Posterior Domain - "Check VGFI™* LPA Output out of lower tolerance Press the Ignore key to remove the
F/AX setup. Select 30 mmHg backup for more than 5 seconds. popup message and ignore the condi-
pressure, or Ignore low pressure tion until it is corrected, or press the 30
condition." mmHg key to evoke the non-adjustable
backup pressure (VGFI™*, and F/AX
are unavailable).
Anterior Domain - "Check VGFI™* Press the Gravity key to switch to grav-
setup. Select Gravity irrigation, or ity irrigation. "Disconnect VGFI™*
Ignore low pressure condition." lines and raise the bottle." appears,
and will disappear when OK key is
pressed (Anterior VGFI™* irrigation is
unavailable).
28 "Doctor memories backup copy Sound board flash memory has a Press the OK key and call your Alcon
must be replaced. Please call Field problem during a flash write. field service representative.
Service."
29 "The CPU board battery must be re- CPU SRAM battery is getting low Press the OK key and call your Alcon
placed. Please call Field Service." or is dead. field service representative.
"Please install an MPC scissors MPC mode was entered with no Connect an MPC probe.
handpiece." MPC probe connected.
"Please turn on infusion before The treadle was depressed in a Turn infusion on.
aspirating." posterior mode where the treadle
controls aspiration, but infusion is
not currently turned on.
"Diathermy output exceeded upper Diathermy voltage exceeds upper If this mode is needed, cycle system
tolerance. Press OK to continue." tolerance. power.
16.8
* FOR REFERENCE ONLY * 8065750203
Accurus®
101-110 “All surgical modes are not avail- An error in the Air/Fluid module has If any of these modes are needed,
able.” caused the module and all its functions cycle system power.
to shut down.
111-115 “Modes using Vacuum are not An error in vacuum function of Air/ If any of these modes are needed,
available." Fluid module has caused shutdown of cycle system power.
all modes that use vacuum.
116-117 “VFC (Inject) and Prop Scissors An error in proportional pressure func- If any of these modes are needed,
are not available.” tion of Air/Fluid module has caused cycle system power.
shutdown of all submodes that use
proportional pressure.
118 “Vit and Multi-Cut Scissors are An error in pulsed pressure function of If any of these modes are needed,
not available.” Air/Fluid module has caused shutdown of cycle system power.
all submodes that use pulsed pressure.
119 "Anterior surgical modes are not Continuous reflux valve error. Anterior If any of these modes are needed,
available." functions using vacuum are disabled. cycle system power.
120 "Some surgical modes are not Irrigation valve error. Anterior func- If any of these modes are needed,
available." tions using vacuum are disabled, plus cycle system power.
frag and extrude.
121 "Continuous reflux is not available." Continuous reflux valve error. Continuous If continuous reflux is needed,
reflux not available in anterior modes. cycle system power.
122 "Irrigation must be turned off Irrigation valve error. On/off control Pinch irrigation tubing to control
manually." of irrigation is not available in anterior irrigation on/off. Reduce pressure
modes, though irrigation pressure can to zero if no longer required.
still be adjusted.
123 "MPC scissors modes are not MPC drive voltage error. MPC scissors If MPC modes are needed, cycle
available." functions are disabled. system power.
124 "Pincher error. All surgical func- Irrigation/infusion valve error in Com- If any of these modes are needed,
tions are disabled." bined domain has caused the Air/Fluid cycle system power.
module to shut down. All related surgi-
cal functions are not available.
201-207 “Ultrasonic power and Diathermy An error in the US/Diathermy module If either of these modes is needed,
are not available.” has caused that module and all its func- cycle system power.
tions to shut down.
Table 16-3. ERRORS - Errors appear in popups on the display screen. The popup remains displayed until the
operator acknowledges the error condition. The error status remains until system power is turned
OFF/ON. If the error does not affect current active functions, they will remain active.
8065750203
* FOR REFERENCE ONLY * 16.9
Accurus®
211 “Ultrasonic power is not available.” U/S diathermy out of tolerance. If U/S is needed, cycle system power.
212 “Ultrasonic h/p ground fault. U/S h/p ground fault. Replace handpiece with new one.
Please replace handpiece.”
301, 302, 304 Posterior - “Illuminator and Air LPA/Illum communication line failure If this mode is needed, cycle
Pump settings are fixed.” or volts out of tolerance. system power.
303, 306, Posterior - “Air pressure in non- An error in the LPA/Illuminator module Press OK and recycle power.
309-313 adjustable backup mode set at 30 has caused the module and all its func-
mmHg.” tions to shut down.
307 Posterior - “Possible Air Pump An error detected in the low pressure Press gravity, 30 mmHg backup,
error. Press 30 mmHg backup or air source. or ignore.
ignore.”
314 "Air pressure is not available." LPA directional solenoid valve status Press OK and recycle power.
feedback error.
315 “Illuminator is not available.” Bulb temperature fault detected at If the illuminator function is
system initialization. The function is needed, cycle system power.
disabled.
"Overtemp detected. Illuminator Bulb temperature fault detected during If the illuminator function is
will turn off in 3 minutes." run time. The function is disabled after needed, cycle system power.
a 3 minute delay.
316 “Illuminator power fault. Illumi- An error occurred with the LPA/Illumi- If illuminator is dim, increase
nation may be dim.” nator module’s 17 volt supply. intensity. If results not acceptable,
cycle system power.
317 "Auto stopcock failure. Switch LPA auto stopcock solenoid valve No action taken until auto stop-
stopcock manually." status feedback error. cock function implemented.
319 Posterior - “Air Pressure is not An error was detected in the LPA/Il- If the low pressure air source is
available.” luminator module causing the low pres- needed, cycle system power.
sure air source to be turned off.
Anterior - "Disconnect VGFI™*
and use gravity irrigation."
16.10
* FOR REFERENCE ONLY * 8065750203
Accurus®
501 "Power Pole is not available." Power pole was not connected. There Connect the power pole and
was a communication error between the switch to Power Pole mode again.
host and the power pole.
502 "Power pole position is not valid." Likely cause is system was turned Select Calibrate to home the pole
off with rear switch while pole was and reset its position, or select
moving. Power pole does not know its Gravity to switch to Gravity mode.
current position.
503 "Power pole did not reach com- Time out expired for pole to reach its Select Ignore to leave pole where
manded position." destination. it is. Retry to command it to its
setpoint, or Calibrate to home it,
then go to its set point.
906 “Footswitch detents may be ir- A 24 volt error was detected in the host Depress the treadle to test the
regular.” module. This may cause the footswitch detents (only if in U/S mode). If
detents to seem irregular. unacceptable, cycle system power.
8065750203
* FOR REFERENCE ONLY * 16.11
Accurus®
401, 402, 405 Front Panel fault detected. System is put into a safe state. The operator must cycle power. Call Alcon
Field Service.
903 - 905 Host fault detected. System is put into a safe state. Call Alcon Field Service.
907 - 930
N/A Host POST failure. System will not complete initialization. Call Alcon Field Service.
Table 16-4. FAULTS - Faults appear across the display screen. Faults are the most severe system status conditions,
and require that system power be recycled. To help troubleshooting, record information displayed
on the fault screen before recycling power.
16.12
* FORLastREFERENCE
page of this section
ONLY * 8065750203
Accurus®
SECTION SEVENTEEN
OPTIONAL ACCESSORIES
General Information
The Accurus® Cart with IV Pole is used to support and transport all models of the
Accurus® console, and in addition it is designed to carry the Eyelite® laser console.
The IV Pole is available in either manual or power adjustment models. Throughout
the section of the manual, all information pertains to both models except when noted
otherwise.
• EyeLite® Laser
• Footswitches for the Accurus® and EyeLite® systems
• Remote Control
• Ultrasonic handpieces
• Scissors handpiece and tubing
The cart’s four, double wheel caster wheels roll silently and never require lubrication.
All four wheels swivel, and the two rear wheels are the locking type.
The Accurus® cart accommodates infusion/irrigation by both the I/V Pole gravity
method and the gas forced infusion/irrigation method (VGFI™*, AVGFI, or CVGFI).
Figure 17-1 THE MOBILE CART (Power IV Pole model shown) - The mobile cart, shown here with the Accurus®
system mounted in position on the top, offers system mobility for the surgical staff. The retractable
drop panel on the front of the cart is shut in this illustration, hiding and protecting the EyeLite® laser.
8065750203
* FOR REFERENCE ONLY * 17.1
Accurus®
The Eyelite® laser sits on a flat, enclosed shelf under the Mayo tray. The shelf can
serve as a storage area in case no EyeLite® is used.
The Accurus® power cord, compressed air hose, and footswitch cable are secured
to the back of the cart with cable raceways. When moving the cart from room to
room there are cable cleats to wind the Accurus® and EyeLite® power cords, and the
Accurus® air hose.
The Accurus® and EyeLite® footswitch cables exit the systems and enter the bottom
drawer at the rear of the cart. The front of the drawer is notched for the cables so the
drawer can be shut when the footswitches are removed for use; when not in use the
footswitches and cables are stored in the drawer.
Locking
Collar
Cable Raceways
Footswitches Drawer
Cable Cleats
Figure 17-2. MOBILE CART COMPONENTS - The mobile cart has several features to facilitate the OR staff during
ophthalmic surgery. The front and rear views show the cart with the Power IV Pole while the inset
view shows the Manual IV Pole.
17.2
* FOR REFERENCE ONLY * 8065750203
Accurus®
Cart Features
Writing Tablet
A retractable tablet on top of the cart slides left or right for a nurse to use as a writing
station. When not in use the tablet can be secured in the closed position so it does not
protrude in either direction. The tablet cannot be completely pulled out and removed.
Mayo Tray
To accommodate surgical procedures the cart contains a reusable and autoclavable
Mayo instrumentation tray. When extended from the front of the cart, the Mayo tray
is adjustable from 32 to 38 inches above the floor.
There is a drawer on the front of the cart to store the Accurus® and EyeLite®
footswitches/cables. The front of the drawer is notched so the cables can exit the cart
when removing a footswitch for use, and the drawer can be shut. There is another
drawer located at the back of the cart for storing handpieces and the remote control.
Power IV Pole
The power IV pole, equipped with two hooks to accommodate infusion/irrigation
fluid, rises and descends at the push of the Accurus® system's infusion/irrigation global
function buttons. Setting a desired fluid pressure automatically establishes power IV
pole bottle heights that produce specific fluid pressures (5 mmHg to 85 mmHg).
The pole is connected to the Accurus® console via a cable from the cart's rear panel.
The global function LED readout on the Accurus® console provides a readout of the
selected hydrostatic pressure, and the readout blinks while the pole is moving.
NOTES: In the event that the power IV pole hits an obstruction, such as another
piece of equipment or the ceiling, the motor will stall in a safe manner. If there
is a power outage the IV pole will remain extended and will not lose its original
location when power is restored.
The power IV pole will halt movement in the event the user activates MPC
scissors cutting and/or attempts to load/eject the cassette. The IV pole will resume
movement when scissors cutting is stopped or the cassette is loaded/ejected.
See sections three, seven, and eleven in this manual for details of power pole operation
using the Accurus® front panel up/down arrow buttons and graphical user interface.
WARNING!
Keep hands away from IV pole during movement to prevent inadvertent pinching.
8065750203
* FOR REFERENCE ONLY * 17.3
Accurus®
Manual IV Pole
The Manual IV pole, equipped with two hooks to accommodate infusion/irrigation fluid,
can be manually adjusted to accommodate specific fluid pressures (5 mmHg to 85
mmHg). It can reach various heights by loosening the locking collar around the pole,
adjusting the bottle hanger to the desired height, then tightening the locking collar.
The bottle hanger can be located on either side of the cart. To remove the bottle
hanger, loosen the collar and lift the bottle hanger to the maximum height until a stop
is felt. Loosen the collar several more turns. Using a little force, pull the bottle hanger
straight out. To reinstall it on the opposite side of the cart, loosen the collar several
turns. Using a little force, push the bottle hanger into the opening until the knurled
end of the bottle hanger is well advanced inside the collar. Adjust it to the correct
height and tighten the collar.
Cleaning
All external console, cart, and pole surfaces are wipeable with a cloth containing a
mild detergent solution, isopropyl alcohol, or a germicidal solution such as Cidex.
!
Caution, or
System Error (yellow), or
System Advisory (green)
17.4
* FOR REFERENCE ONLY * 8065750203
Accurus®
!
®
542-1104-001 REV*
DIODE LASER 660-680 nm - 1mW
EXPOSITION DANGEREUSE
DE L'OEIL OU DE LA PEAU AU
CLASS 4 LASER PRODUCT
542-1053-001 REV --
RAYONNEMENT DIRECT OU DIFFUS
APPAREIL A LASER DE CLASSE 4
IEC 825 - A1:1990, 601-1:1988
LASER RADIATION
AVOID EYE OR SKIN EXPOSURE TO
DIRECT OR SCATTERED RADIATION
CLASS 4 LASER PRODUCT
532-1394-001 REV --
WARNING
L'USAGE DE CE LASER SANS FILTRE MEDECIN
PEUT ENDOMAGER LES YEUX DE L'UTILISATEUR
8065750203
* FOR REFERENCE ONLY * 17.5
Accurus®
Overview
The VideOverlay Parameters System (VOPS) accepts operating parameters from
the Accurus® system and overlays that information onto video accepted from the
microscope camera. The VOPS system then outputs a video signal to a monitor and/or
VCR for retrospective viewing.
There are two possibilities for VOPS setup: Standard and Super VHS. The two
possibilities are described in this section of the manual.
WARNINGS!
To prevent electrical shock, do not remove cover. There are no user-serviceable parts
inside. Refer servicing to qualified service personnel.
The VideOverlay must be plugged into an appropriate wall outlet and be positioned
at least 5 feet (1.5 meters) away from the patient.
The VOPS display is for information purposes only, and is not intended to substitute
for the Accurus® display.
CAUTION
Use only Alcon-supplied cable to connect the VideOverlay to the Accurus®
system. Accurus® and Legacy® cables are not interchangeable.
NOTE: This unit is not a medical device and should be located/stored with other
video equipment (i.e., VCR, monitor, etc.). When connected to the Accurus®
system, the VideOverlay unit does not increase the leakage current of the
Accurus® system.
AT
HE
HD ER
OV
N S
FA TU 5
A +
ST 2
+1
2
-1
-5
POWER SWITCH
ER
W
PO
DISKETTE PORT
T
SE
RE
AL
IC
RG m
SU Sy
ste
rs
ete
m
ra
Pa
ay
v erl
eO
Vid
17.6
* FOR REFERENCE ONLY * 8065750203
Accurus®
COMPOSITE/SVHS SERIAL 1
SWITCH INTERCONNECT
(set to "Composite") (DB-9 CONNECTOR)
VIDEO IN
CONNECTOR
NOT ACCESSIBLE
AC POWER
CONNECTOR
VOLTAGE
SELECT SWITCH 115
NOT USED
1. Ensure power to all systems is off, then attach the AC power cord firmly to the AC
power connector located on the rear panel of the VideOverlay (see Figure 17-6).
2. Plug the other end of the AC power cord into an appropriate wall outlet.
3. Verify the red voltage select switch (i.e., 115 VAC or 230 VAC) located under the
AC power connector is set to the proper line voltage. Note: In Japan set the switch
to 115 VAC; the system will operate properly when set as low as 90 VAC.
5. The VideOverlay is configured for SVHS cables, so Standard setups require RCA
adaptor cables (included with all units). Connect the adaptor cables as follows
(see Figure 17-7):
• Plug an RCA-to-SVHS adaptor cable into the “Video In” connector on the
VideOverlay rear panel.
• Plug the other RCA-to-SVHS adaptor cable into the “Video Out” connector on
the VideOverlay rear panel.
6. Connect an RCA video cable from the microscope camera to the "Video In" RCA-
to-SVHS adaptor cable. NOTE: Older cameras may require an additional
adaptor.
8065750203
* FOR REFERENCE ONLY * 17.7
Accurus®
VIDEO
IN
RCA TO SVHS
ADAPTOR CABLES
VIDEO
OUT
RCA CABLE
115
CAMERA
RCA CABLE
EYE
VIDEOVERLAY
(rear view)
Alcon
Surgical
VIDEO IN
SERIAL PORT
MONITOR VCR !
ACCURUS® CONSOLE
Figure 17-7 VIDEOVERLAY STANDARD INTERCONNECT DIAGRAM - This diagram shows the cabling used when
connecting to a standard video monitor. This cabling requires the use of RCA-to-SVHS adaptor cables.
17.8
* FOR REFERENCE ONLY * 8065750203
Accurus®
7. Connect an RCA cable from the VCR "Video In" connector to the "Video Out"
RCA-to-SVHS adaptor cable.
8. Verify the VCR video output is connected to the Monitor video input.
9. Connect the Alcon Data Cable from the connector marked “Accurus” on the
VideOverlay to the “Serial” port on the back of the Accurus® console. Tighten
connector screws securely.
10. Ensure that the monitor and VCR are both on the "video" setting.
11. Turn the VideOverlay power switch to the ON position (see Figure 17-5).
13. Observe the video display on the monitor (see Figure 17-8). If an overlay video
picture does not appear, check the video cable connections. If there seems to be no
communication to the Accurus® system, check the Alcon Data Cable connections.
If the system still does not operate correctly, contact an Alcon Technical Service
Representative.
8065750203
* FOR REFERENCE ONLY * 17.9
Accurus®
Super VHS High Resolution Setup (requires special camera and cables)
1. Ensure power to all systems is off, then attach the AC power cord firmly to the AC
power connector located on the rear panel of the VideOverlay (see Figure 17-6).
2. Plug the other end of the AC power cord into an appropriate wall outlet.
3. Verify the red voltage select switch (i.e., 115 VAC or 230 VAC) located under the
AC power connector is set to the proper line voltage. Note: In Japan set the switch
to 115 VAC; the system will operate properly when set as low as 90 VAC.
5. Connect a SVHS video cable between the microscope camera and the “Video In”
connector on the rear panel of the VideOverlay (see Figure 17-8). NOTE: Do not
use RCA cable.
6. Plug the other SVHS video cable between the “Video Out” connector on the rear
panel of the VideOverlay and the “Video In” connector on the VCR.
7. Verify the VCR video output is connected to the Monitor video input.
8. Connect the Alcon Data Cable from the connector marked “Accurus” on the
VideOverlay to the “Serial” port on the back of the Accurus® console. Tighten
connector screws securely.
9. Ensure that the monitor and VCR are both on the "video" setting.
10. Turn the VideOverlay power switch to the ON position (see Figure 17-5).
12. Observe the video display on the monitor (see Figure 17-8). If an overlay video
picture does not appear on the monitor, check the video connections. If there
seems to be no communication to the Accurus® system, check the Alcon Data
Cable connections. If the system still does not operate, contact an Alcon Technical
Service Representative.
17.10
* FOR REFERENCE ONLY * 8065750203
Accurus®
VIDEO
IN
VIDEO
SVHS OUT
VIDEO CABLE
115
CAMERA
SVHS
EYE VIDEO CABLE
VIDEOVERLAY
(rear view)
Alcon
Surgical
VIDEO IN
SERIAL PORT
MONITOR VCR !
ACCURUS® CONSOLE
Figure 17-9 VIDEOVERLAY SVHS INTERCONNECT DIAGRAM - This diagram shows the cabling used when connecting
to a Super VHS video monitor. This cabling requires the use of SVHS video cables.
8065750203
* FOR REFERENCE ONLY * 17.11
Accurus®
VideOverlay Operation
After the system is connected, operation is straight forward. Nothing else is required.
The system will automatically display the appropriate information onto the video
screen. Table 17-1 shows the possible displayed information.
17.12
* FOR REFERENCE ONLY * 8065750203
Accurus®
Additional Information
• Due to the nature of the interface between the Accurus® console and the VOPS,
information transfer delays up to 1-2 seconds may occur when the Accurus®
console is heavily utilized.
• When the VOPS is powered up, the System Status bar displays the version
number of the software for approximately 5 seconds.
Dimensions
Size: 168mm x 240mm x 399mm (6.6" x 9.5" x 15.7”)
Weight: 15.9 kilo (35 lb.)
Environmental
Altitude: 3050 meter (10,000 ft.)
Temperature: 0° C to 55° C
Relative Humidity: 10% to 90% Without Condensation
Electrical Requirements
115/230 VAC, 50-60 Hz, 6/3 A
Certifications
IEC-950, UL1950, CSA C22.2 No. 950, EN60950,
EN55022 Class B, EN50082-1, FCC Class B.
I/O
Video In: NTSC or PAL, depending on system purchased
Video Out: NTSC or PAL, depending on system purchased
Data In: RS232C data cable from the Accurus® console
8065750203
* FOR REFERENCE ONLY * 17.13
Accurus®
17.14
* FORLast
REFERENCE
page of this section
ONLY * 8065750203
Accurus®
SECTION EIGHTEEN
INDEX
Symbols C
20 cc syringe. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.11, 12.19 Cable from the power IV pole . . . . . . . . . . . . . . . . . . . . . . . . . . 17.2
375/40 U/S and Mackool** handpiece. . . . . . . . . . . . . . 7.14, 11.27 Cannula. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.9, 12.10
5 bar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.4, 4.1, 12.1 Care and maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.1
Cart features. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.3
Cart with IV pole . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.1
A Cart with power I/V pole . . . . . . . . . . . . . . . . . . . . . . . 3.3, 7.3, 11.4
AAMI standards and recommended practices. . . . . . 5.5, 9.4, 13.5 Cassette . . . . . . . . . . . . . . . . . . . . . . 2.2, 2.4, 4.8, 12.9, 16.2, 16.6
About this operator’s manual. . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3 Cassette ejector. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.7
AC power. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.2 Cassette port LEDs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.4
Accessories. . . . . . . . . . . . . . . . . . . . 3.2, 6.1, 7.2, 10.1, 11.2, 14.1 Cassette release level. . . . . . . . . . . . . . . . . . . . . . . . . 5.1, 9.1, 13.1
Accessory equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.4 Cassette removal. . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.1, 9.1, 13.1
AccuPak® Stand Alone Vitreous Probe. . . . . . . . . . . . . . . . . . . 8.16 Cassette design. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2
Accurus® probes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.22, 11.28 Cataract surgery setup screen . . . . . . . . . . . . . . . . . . . . . . . . . . 7.1
Accurus® anterior pak setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.7 Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii, 1.9
Accurus® console. . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1, 17.1, 17.2 Channel selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.3
Accurus® console and EyeLite® laser mounting . . . . . . . . . . . 17.2 Circulating nurse. . . . . . . . . . . . . . . . . . . . . 4.1, 4.8, 8.1, 12.1, 12.8
Accurus® models . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3 Clean key. . . . . . . . . . . . . . . . . . . . . . . 3.2, 4.4, 7.2, 8.4, 11.2, 12.4
Accurus® opening screen. . . . . . . . . . . . . . . . . . . . . . . . . . 4.2, 8.2 Clean membrane peeler cutter (MPC) Scissors . . . . . . . . 5.3, 13.3
Accurus® ophthalmic surgery system. . . . . . . . . . . . . . . . . 1.1, 2.1 Clean the diathermy handpiece. . . . . . . . . . . . . . . . . . 5.4, 9.3, 13.4
Accurus® probe. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.10, 12.11 Clean the extrusion handpiece . . . . . . . . . . . . . . . . . . . . . 5.3, 13.4
Accurus® system specifications. . . . . . . . . . . . . . . . . . . . . . . . 1.16 Clean the Fragmatome™* handpiece. . . . . . . . . . . . . . . . 5.2, 13.2
Activate button. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.9 Clean the I/A handpiece . . . . . . . . . . . . . . . . . . . . . . . . . . 9.3, 13.3
Advisories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.45, 16.6 Clean the intraocular scissors (IOS) handpiece . . . . . . . . 5.3, 13.3
Air connector. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.7 Clean the phaco handpiece. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.2
Air filter cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.5 Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.1, 9.1, 13.1, 17.4
Air input grate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.7 Coagulation handpieces . . . . . . . . . . . . . . . . . . . . . . . . 3.21, 11.30
Air pressure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.4 Color LCD display and touch screen. . . . . . . . . . . . . . . . . . . . . . 2.2
Air pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.3, 7.3, 11.4 Combined mode screens. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.2
Air supply. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.7, 8.6, 12.7 Combined surgery modes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.8
Alcon customer service. . . . . . . . . . . . . . . . . . . . . . . 6.1, 10.1, 14.1 Combined surgery setup screen. . . . . . . . . . . . . . . . . . . 11.1, 12.2
Alcon Laboratories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i, 1.15 Combined VFC injection/extrusion screen. 3.17, 3.18, 11.25, 11.26
Alcon paks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.8, 8.6, 12.8 Combined viscous fluid injection with extrusion . . . . . . 4.23, 12.29
Alcon Surgical. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i, xiii Common tab set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.28
Alternate fluid pressure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.5 Compressed air connector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.7
Alternate infusion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4 Connector LED's. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.4
Alternate infusion pressure. . . . . . . . . . . . . . . . 3.4, 7.4, 11.4, 11.5 Connectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.4
Anterior accessories and parts . . . . . . . . . . . . . . . . . . . . . . . . . 10.1 Consumable paks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.13, 1.14
Anterior domain key. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.1 Consumables. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.13
Anterior domain surgery modes . . . . . . . . . . . . . . . . . . . . . . . . . 7.7 Continuous Irrigation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.5
Anterior fluid cassette insertion. . . . . . . . . . . . . . . . . . . . . . . . . . 8.7 Corrective action. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.1
Anterior pak setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.7, 8.12 Crating instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.4
Anterior setup and surgery screens. . . . . . . . . . . . . . . . . . . . . . 7.1 Current key . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.21
Anterior surgery screens. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.7 Customer service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.14
Anterior tab set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.23 CVGFI. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.2
Anterior vented gas forced irrigation (AVGFI). . . . . . . . . . . . . . 8.12 CVGFI-F/AX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.15
Anterior VGFI™* cassette pak . . . . . . . . . . . . . . . . . . . . . . . . . 8.14
Anterior vitrectomy. . . . . . . . . . . . . . . . . . . . . . . . 8.16, 7.13, 12.31 D
Auto ranging power supply . . . . . . . . . . . . . . . . . . . . . . . . 2.7, 15.1
Available Yes/No. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4 Default settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.7, 4.4, 11.8
AVGFI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.12 Defaults key. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.21
AVGFI irrigation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.5 Description. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1
DFU. . . . . . . . . . . . . . . . . . . . . . . . 1.9, 4.8, 5.1, 8.6, 9.1, 12.8, 13.1
Diathermy . . . . . . 3.2, 3.6, 4.7, 7.2, 7.6, 8.6, 11.2, 11.7, 12.8, 16.4, 16.5
B Diathermy function. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.11
Battery replacement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.3 Diathermy power. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.20
Biohazards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.13 Diathermy probe connection. . . . . . . . . . . . . . . . . . . . . 4.20, 12.26
Bottle hanger. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.4 Diathermy setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.20, 12.26
Bottle height. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.3 Diathermy/Coagulation handpieces. . . . . . . . . . . 3.24, 7.15, 11.30
Bulb. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.7, 3.6, 7.6, 11.7 Directions for use. . . . . . . . . . . . . . . . . . . . . . . . .1.9, 4.8, 8.6, 12.8
Bulb replacement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1.12, 15.2 Disassembly and cleaning. . . . . . . . . . . . . . . . . . . . . . 5.1, 9.1, 13.1
Bulbs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5 Display windows . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.12
Burnt bulb . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.6, 7.6, 11.7 Disposables. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.15
8065750203
* FOR REFERENCE ONLY * 18.1
Accurus®
D - continued G
Doctor memories window . . . . . . . . . . . . . . . . . . . . . . . . 2.15, 2.16 General Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.1
Doctor memory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.21 General Purpose Timer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.17
Doctor's name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.33 GFX Infusion Line Connection. . . . . . . . . . . . . . . . . . . . . . . . 12.32
Doctors tab set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.33 Global Function LED Displays. . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2
Drain bag. . . . . . . . . . . . . . 2.2, 3.2, 4.8, 8.7, 8.14, 11.2, 12.9, 16.2 Global Function Up/Down Adjustment Buttons. . . . . . . . . . . . . . 2.2
Global Functions. . . . . . . . . . . . . . . . . . . . . . . . . 2.2, 4.7, 8.6, 12.7
E Global Functions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.5, 7.5, 11.6
Global Functions Keys. . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.5, 11.6
Eject Button. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.4 Global Functions Window. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.14
Electrical Connectors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.4 Global Keys. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.7, 8.6, 12.7
Electrical Requirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.16 Gravity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.7
Electromagnetic emissions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.6 Gravity fed infusion. . . . . . . . . . . . . . . . . . . . . . . . . . . 4.7, 8.6, 12.7
Electromagnetic immunity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.7 Gravity infusion. . . . . . . . . . . . . . . . . . . . . . 3.3, 3.5, 7.3, 11.4, 11.6
Electromagnetic environment . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.8 Ground continuity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.9
Elevated Infusion Timer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.17
EMC Statement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.6 H
Environmental Considerations. . . . . . . . . . . . . . . . . . . . . . . . . . 1.5
Environmental Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.5 Handpieces. . . . . . . . . . . . . . . . . . . . . . . . . . . 6.3, 10.4, 14.3, 14.4
Environmental Limitations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.16 Handpieces and probes. . . . . . . . . . . . . . . . . . . . 3.19, 7.14, 11.26
Equal Potentiality Lug. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.7 Hazardous Substances. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.5
Erase Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.36 Heel switch . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.33, 3.7, 7.7, 11.8
Error Condition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.9 Help. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.1
Error Message. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.9 Horizontal/vertical switches. . . . . . . . . . . . . . . . . 2.8, 3.7, 7.7, 11.8
Errors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.43
Export Tab. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.36
Extract. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.18, 11.26
I
Extrude Mode Surgery Screen . . . . . . . . . . . . . . . . . . . 3.19, 11.24 I/A and Phaco Fluidics Balance Test. . . . . . . . . . . . . . . . . . . . 12.16
Extrusion Handpiece Setup. . . . . . . . . . . . . . . . . . . . . . 4.11, 12.17 I/A Handpiece Setup. . . . . . . . . . . . . . . . . . . . . . . . . . . 8.10, 12.14
Extrusion Line. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.12, 12.17 I/A Handpieces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.4, 10.4, 14.3
Extrusion Screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.19, 11.24 I/A Mode Surgery Screen . . . . . . . . . . . . . . . . . . . . . . . 7.12, 11.18
Eyelite® Laser. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.1 I/A Safety Test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.10
Icons Used with the Accurus® Ophthalmic Surgical System . . 1.18
F IEC 60601-1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.9
F/AX. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.5, 4.15, 11.7, 12.32 IEC Standard. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.4
F/AX global function key. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.15 Illuminator . . . . . . . . . . . . . . . . . . . . . . . . . 4.11, 12.18, 16.4, 16.10
F/AX Infusion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.7, 12.7 Illuminator Adaptors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5
Factory default settings.3.7, 4.4, 4.5, 4.6, 8.4, 8.5, 11.8, 12.4, 12.5 Illuminator Alignment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.2
Faults. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.43, 16.12 Illuminator Bulb Replacement. . . . . . . . . . . . . . . . . . . . . . . . . . 15.2
Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2, 1.3 Illuminator Drawer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5, 15.2
Fiber Optic Illuminator. . . . . . . . . . . . . . . . . . . . . . . . . . 4.12, 12.18 Illuminator Ejector Button . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.7
Fiber Optic Illuminator Setup. . . . . . . . . . . . . . . . . . . . . 4.11, 12.18 Illuminator Exhaust Grate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.6
Fixed Fragmentation Submode. . . . . . . . . . . . . . . . . . . 3.13, 11.18 Illuminator Function. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.12
Fluid Air Exchange (F/AX). . . . . . . . . . . . . . . . . . . . . . . . . 3.5, 11.7 Illuminator Receptacles. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5
Fluid Cassette. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 Illuminators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.7, 8.6, 12.8
Fluid Delivery Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.3 Illuminators (Illum1 & Illum2). . . . . . . . . . . . . . . . . . . . 3.6, 7.6, 11.7
Fluid/Air Exchange . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.7, 12.7 Import Tab. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.35
Fluid/Air Exchange (F/AX) Setup. . . . . . . . . . . . . . . . . .4.15, 12.33 Infusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.3, 3.5, 4.7, 8.6, 12.7
Fluid/Gas Exchange Tubing Set . . . . . . . . . . . . . . . . . . 4.15, 12.33 Infusion cannula . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.9, 12.10
Footpedal Operation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.21 Infusion Setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.9, 12.9
Footswitch. . . . . . . . . . . . . . . . . . . . 2.8, 3.7, 7.7, 11.8, 16.2, 16.11 Infusion tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.4
Footswitch Cables. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.2 Infusion Type. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.3, 7.3, 11.3
Footswitch Connector. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.7 Inject . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.20, 11.25
Footswitch Functions. . . . . . . . . . . . . . . . . . . . . 2.29, 3.8, 3.9, 3.10 InnoVit® probe. . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.22, 4.10, 12.11
Footswitch Icon. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.17 Installation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.4
Footswitch Tab. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.29 Interference with other devices. . . . . . . . . . . . . . . . . . . . . . . . . . 1.6
Frag 3D Submode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.16, 11.18 Intraocular Scissors (IOS) Handpiece. . . . . . . . . . . . . . 3.20, 11.29
Frag Mode Surgery Screen. . . . . . . . . . . . . . . . . . . . . . 3.15, 11.17 Intraocular Scissors (IOS) Setup. . . . . . . . . . . . . . . . . . 4.18, 12.24
Fragmatome™* Accessory pak. . . . . . . . . . . . . . . . . . . . . . . . . 4.13 IOS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.18, 12.24
Fragmatome™* Handpiece. . . . . . . . . . . . . . . . . . 3.22, 4.13, 11.28 Irrigation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.5
Fragmatome™* Handpiece Tubing Connections . . . . . 4.13, 12.23 Irrigation methods. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.3, 7.3
Fragmatome™* Accessory Pak Setup . . . . . . . . . . . . . . . . . . 12.22 Irrigation ON/OFF control . . . . . . . . . . . . . . . . . . . . . . . . . 7.5, 11.6
Fragmatome™* Handpiece. . . . . . . . . . . . . . . . . . . . . . 3.19, 11.28 Irrigation/Aspiration Handpiece. . . . . . . . . . . . . . . . . . . 7.14, 11.27
Fragmentation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.15, 11.17 IV Pole. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.1, 17.3
Front panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.3
Front panel components. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2
Front panel Display Screens. . . . . . . . . . . . . . . . . . . . . . . . . . . 2.10
Fuse Holders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.7
Fuse Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.7
Fuse Replacement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.2
Fuse Selection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.1
18.2
* FOR REFERENCE ONLY * 8065750203
Accurus®
P R
Pacemakers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.11 Rear Panel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.6
Pak setup procedures. . . . . . . . . . . . . . . . . . . . . . . . . 4.1, 8.1, 12.1 Rear Panel Components. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.6
Paks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1.13, 4.8, 8.6, 12.8 Recycle. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.5
Parts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.1, 10.1, 14.1 Reduced (5 bar). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.4
Patient Eye Level. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16.3, 16.5 Reflux . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.7
PC Card Slot. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.6 Regurgitation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.3, 16.5
Performance figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.16 Remote control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.9
Personal Identification Number (PIN) . . . . . . . . . . . . . . . . . . . . 2.21 Remote Control Battery Replacement. . . . . . . . . . . . . . . . . . . . 15.3
Phaco and I/A Safety Test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.10 Remote Control Channel Selection. . . . . . . . . . . . . . . . . . . . . . 15.3
Phaco 3D submode. . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.11, 11.16 Replace Fuses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.1
Phaco Burst submode. . . . . . . . . . . . . . . . . . . . . . . . . . 7.11, 11.16 Return of the equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.14
Phaco Fixed submode. . . . . . . . . . . . . . . . . . . . . . . . . . 7.11, 11.16
Phaco Handpieces . . . . . . . . . . . . . . . . . . . . . . . . . . 6.4, 10.4, 14.3
Phaco Linear submode. . . . . . . . . . . . . . . . . . . . . . . . . 7.10, 11.15
8065750203
* FOR REFERENCE ONLY * 18.3
Accurus®
S U
Safety Performance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.14 U/S Pulse. . . . . . . . . . . . . . . . . . . . . . . . . . 3.13, 7.10, 11.14, 11.16
Save All key. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.20 Uncrating. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.4
Save Mode key. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.20 Universal precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.5
Scissors. . . . . . . . . . . . . . . . . . . . . . . . . 3.2, 4.18, 11.2, 12.24, 16.4 Up/down adjustment buttons. . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2
Scissors (IOS) Handpiece. . . . . . . . . . . . . . . . . . . . . . . 3.23, 11.29 Up/Down arrow buttons. . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.5, 7.5
Scissors Calibration Screen . . . . . . . . . . . . . . . . . . . . . 3.18, 11.22
Scissors Line Connection . . . . . . . . . . . . . 4.18, 4.19, 12.24, 12.25 V
Scissors mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.17, 11.23
Scissors Mode Surgery Screen. . . . . . . . . . . . . . . . . . . 3.17, 11.23 Vacuum Rise Time. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.25
Scissors: Calibration Screen. . . . . . . . . . . . . . . . . . . . . 3.17, 11.23 Vented Gas Forced Infusion Setup. . . . . . . . . . . . . . . . 4.16, 12.20
Scrub Nurse. . . . . . . . . . . . . . . . . . . . . . . . 4.1, 4.8, 8.1, 12.1, 12.8 Vented Gas Forced Infusion Connection. . . . . . . . . . . . 4.17, 12.21
Select. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.4 Vertical Microscissors . . . . . . . . . . . . . . . . . . . . . . . . . . 4.18, 12.24
Select a Mode of Operation. . . . . . . . . . . . . . . . . . . . . . . . 4.2, 12.2 VFC. . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.2, 4.21, 11.2, 12.27, 16.7
Select Handpiece for Prime / Test. . . . . . . . . . . . . . . . 3.2, 7.2, 11.2 VFC mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.20, 11.25
Selectable Power Supply. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.7 VFC Mode Surgery Screen. . . . . . . . . . . . . . . . . . . . . . 3.20, 11.25
Self-test diagnostics . . . . . . . . . . . . . . . . . . . . . 2.10, 4.2, 8.2, 12.2 VGFI™* infusion. . . . . . . 3.3, 3.5, 4.7, 4.16, 11.3, 11.5, 11.6, 12.20
Separaration distances. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.8 VGFI™* irrigation . . 7.3, 7.4, 8.6, 11.6, 7.3, 11.3, 11.4, 11.6, 12.20
Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.14 VGFI™* Tubing Set. . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.16, 12.20
Settings Restoration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.4 VGFI™*/AVGFI/CVGFI Bottle Hanger. . . . . . . . . . . . . . . . . . . . 17.4
Setup Instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.8, 8.6, 12.8 VideOverlay Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.12
Setup key. . . . . . . . . . . . . . . . . . . . . . . 3.2, 4.4, 7.2, 8.4, 11.3, 12.2 VideOverlay Parameters System (VOPS). . . . . . . . . . . . . . . . . 17.6
Setup procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1, 8.1, 12.1 Viscous Fluid Control (VFC) Setup. . . . . . . . . . . . . . . . 4.21, 12.27
Silicone oil. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.17, 11.25 Viscous Fluid Extraction . . . . . . . . . . . . . . . . . . . . . . . . 4.23, 12.29
Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.6 Viscous Fluid Injection. . . . . . . . . . . . . . . . . . . . . . . . . . 4.21, 12.27
Source air pressure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.4 Viscous Fluid Injection with Extrusion. . . . . . . . . . . . . . 4.23, 12.29
Speaker. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5 Viscous Fluid Injector (VFI) Pak . . . . . . . . . . . . . . . . . . 4.21, 12.27
Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.16 Viscous Fluid Injector Connection. . . . . . . . . . . . . . . . . 4.22, 12.28
Standard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.4 Vit Cut-off Vacuum. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.33
Standby. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.39 Vit Cut-off Setpoint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.13
Standby switch . . . . . . . . . . . . . . . . . . . . . . . . . 2.5, 4.1, 8.1, 12.1 Vit Handpieces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.4
Sterilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.5, 9.4, 13.5 Vit Mode Surgery Screen . . . . . . . . . . . . . . . . . . . 3.11, 7.13, 11.19
Sterilization Temperature and Time Settings. . . . . . . 5.5, 9.4, 13.5 Vit Tab. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.24, 2.26
Stopcock. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.9, 12.10 VIT: Momentary Cut submode. . . . . . . . . . . . . . . . . . . . . . . . . 11.19
Surgeon. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1, 8.1, 12.1 VIT: Proportional Vacuum submode . . . . . . . . . . . . . . . . . . . . 11.20
Surgery key. . . . . . . . . . . . . . . . . . . . . 3.2, 4.4, 7.2, 8.4, 11.2, 12.4 Vitrectomy Dual Proportional submode. . . . . . . . . . . . . 3.13, 11.21
Surgery modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.7, 11.8, 18.3 Vitrectomy mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.12, 11.19
Surgery Screens. . . . . . . . . . . . . . . . . 3.7, 4.4, 7.7, 8.4, 11.8, 12.4 Vitrectomy Momentary Cut submode . . . . . . . . . . . . . . . . . . . . 3.13
Surgery Setup Screens. . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.2, 8.2 Vitrectomy Probe Connections . . . . . . . . . . . . . . . . . . . 4.10, 12.11
Surgical team. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1, 8.1, 12.1 Vitrectomy Probe Setup. . . . . . . . . . . . . . . . . . . . . . . . . 4.10, 12.11
Syringe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.11, 12.19
Vitrectomy Probes. . . . . . . . . . . . . . . . . . . . 2.40, 3.19, 7.15, 11.28
System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.42
Vitrectomy Proportional Vacuum submode. . . . . . . . . . . . . . . . 3.11
System Configurations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3
Vitreoretinal Infusion Settings Screen. . . . . . . . . . . . . . . . 3.3, 11.3
System Error Popup Message. . . . . . . . . . . . . . . . . . . . . . . . . 2.44
Vitreoretinal Surgery Setup Screen. . . . . . . . . . . . . . . . . . . . . . . 3.1
System Fault Screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.10
Voice confirmation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5
System Faults. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.43
Voltage and Fuse Selection. . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.1
System Identification. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3
Volume. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.37
System Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.45
System Information Popup Windows. . . . . . . . . . . . . . . . . . . . 2.45
System Power. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1, 8.1, 12.1 W
System Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.16
Warnings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii, 1.9
Warranty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.15
T Weight. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.16
Wet anterior vitrectomy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.19
Take-Back Systems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.5
Writing tablet. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.3
Tear Down the System . . . . . . . . . . . . . . . . . . . . . . . . 5.1, 9.1, 13.1
Technical Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
Technical Services Department. . . . . . . . . . . . . . . . . . . . . . . . . 1.15
Telephone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i
Tension adjustment knob. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.8
Terms and abbreviations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.17
Test key. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.40, 3.2, 7.2, 11.2
Testing/tuning . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.14, 12.12, 12.22
Timer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.38
Timer Display Keys. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.17
Tip Wrench . . . . . . . . . . . . . . . . . . . . . . . . . 4.13, 8.8, 12.12, 12.22
Title Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.15
Tones. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5
Tones and their Descriptions. . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5
Total Plus® Vitrectomy Pak Setup. . . . . . . . . . . . . . . . . . . 4.8, 12.8
Touch Screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.2, 2.12
Troubleshooting Instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . 16.1
18.4
* FORLast
REFERENCE
page of this section
ONLY * 8065750203