QUATERA 700 – Sticking with Stability; Suited to You
Dr. Omar Shakir, MD, MBA, founded his practice seven years ago. Since then, he’s transitioned from several systems in pursuit of delivering premium cataract surgery experiences and outcomes to patients. However, this cycle ended after experiencing the ZEISS QUATERA 700 a year ago. Instead of continuing to canvas the market, Dr. Shakir made the QUATERA 700 the exclusive platform for cataract surgery conducted in his practice. But what exactly sets it apart from everything else?
“The big thing that makes QUATERA stand out is the QUATTRO pump,” Dr. Shakir highlights. “It’s where the magic lies.” The ZEISS-patented QUATTRO pump has a push-pull mechanism similar to the four-chamber system of the heart, with sensors tightly linking the pump’s infusion and aspiration chambers to keep the fluid influx and efflux rates the same. This ultimately leads to instantly noticeable enhanced anterior chamber stability. “During my first minutes of trialling the system, I noticed the massive difference in stability compared to the machine I was coming from; that’s what sold it to me,” recalls Dr. Shakir. “It's so rare for a new technology to really hit the mark immediately in the surgeon's hands, but the QUATERA was very comfortable right there and then. I felt that it would benefit me and my patients.”
QUATERA’s stability is exemplified by its virtual elimination of post-occlusion surges. “As you increase the vacuum, the post-occlusion break times and compensation remain constant, even at high vacuum limits,” Dr. Shakir explains. “Even when operating at low intraocular pressures (IOPs), such as at physiologic IOP, you'll still really see no change when setting different vacuums, which is definitely not usually the case.” He also points to the QUATERA 700’s ability to maintain IOP as aspirational flow rates increase,1 something, in Dr. Shakir’s experience, its competitors fail to do. “When you look at most other systems out there, the fidelity of the IOP degrades as you increase aspiration,” he says. “When using those machines, it's often not even evident because they report the IOP to be within the proper range, which would be disproved if it was measured. But with the QUATERA, there's compensation built in that actually edges up the IOP slightly; it remains steady, even at very high flow rates, up to 100 ml/min.”
However, its customizability has solidified the QUATERA 700’s place in Dr. Shakir’s workflow. “This is an incredibly customizable system; the user interface offers sliders for adjusting almost anything,” he explains. “It really lets you tailor the feel to the point that you can replicate any type of system that you want, be it a vacuum-based system or a more stable, slower, peristaltic system.” And Dr. Shakir has been taking full advantage of this. “After every surgical day, I digest my cases and continually dial in my system over time and within my own knowledge of the machine,” he says. “It really lets me optimize things so my patients consistently receive better post-operative day one outcomes.”
MICOR 700 – Revolutionary Results at Your Fingertips
Over the course of his career, Dr. Seth Pantanelli, MD, MS, has seen numerous technologies come and go. Still, nothing seemed capable of surpassing the dominance of phacoemulsification for cataract extraction—until he was introduced to the ZEISS MICOR 700. “This is a device that I got involved with very early—I was one of the first six surgeons to use MICOR, over three years ago—and since then, I’ve performed over 400 cases,” he explains. “After the first 250, we began a prospective clinical trial comparing MICOR to phacoemulsification and found that MICOR uses about half the amount of fluid per case and that these cases were, on average, between 45 and 60 seconds faster.”
However, what was most impressive to Dr. Pantanelli was the post-operative, day-one vision achieved through MICOR, which was better than that achieved using phacoemulsification. “I struggled to believe it at first, but I had objective data demonstrating that there must be less central corneal edema, leading to better vision through the cornea with MICOR than for phaco,” he explains. “Despite my initial surprise, it was readily clear to me that the proof is in the pudding.”
Understanding the technology behind the MICOR 700 gives insight into Dr. Pantanelli’s results. Like phacoemulsification, the MICOR 700 is minimally invasive. However, with its dramatically reduced oscillation rate (40Hz versus phacoemulsification’s 20,000Hz), the MICOR 700 generates less ocular thermal stress. “Although the design of the MICOR 700 particularly lends itself to softer nuclei, I have used it on 4+ NS, hand motion, LP cataracts,” Dr. Pantanelli says. “It’s true that these cases take longer—something also true of phaco—but with phaco, as a case goes on, the temperature inside the eye and at the wound rises. With MICOR, unbelievably, the eye temperature does not rise.”
Its safety profile also enhances the MICOR 700’s results. “If you look at a real close-up photo of the MICOR handpiece, you'll notice that the edge is not sharp, like a phaco needle, but rounded,” Dr. Pantanelli highlights. In his hundreds of cases, Dr. Pantanelli has only ever experienced two posterior capsule (PC) tears. These rare instances and these low rates have further demonstrated MICOR’s safety. “Both times I experienced a PC tear, something incredible happened,” he recalls. “Instead of the hole expanding and blowing open, as happens with phaco due to the pumping of fluid through the ragged edges created by the phaco needle, the tear remained small, and I was able to put a one-piece lens in the capsular bag. These are the only times that I’ve ever been able to do that; it just blew me away.”
These results, alongside the MICOR 700’s flexibility and minimal footprint, solidified Dr. Pantanelli’s decision to use it for most of his premium IOL patients. “I really believe that the MICOR 700 is a revolutionary device,” he says. “I’ve used lots of medicines and gadgets over the last decade, and this is really one of the only devices that’s changed how I perform cataract surgery and has made me a better surgeon.”
