Xe BSS SC Mes An 02-2004

Ophthalmic Echography
Standardized - A scan
USER MANUAL
Version : S 5.XX
See GENERAL PURPOSE USER MANUAL
for complete information.
0459
XE BSS SC MES AN FEBRUARY 2004
QUANTEL MEDICAL SA
Head Office : 21, rue Newton, Z.I. du Brezet
63039 - Clermont-Ferrand cedex 2 - FRANCE
Tel : +33 (0) 473 745 745 - Fax : +33 (0) 473 745 700
E-mail :contact@quantel-medical.fr
Web site :www.quantel-medical.com
USER MANUAL
WARNINGS AND CAUTIONS

QUANTEL MEDICAL cannot be held responsible for any damage or injury which results
from a failure to follow, or incorrect use of, the instructions contained in this manual.
See General purpose User Manual for guarantee conditions.
CAUTION :
Federal USA law restricts this device to sale by or on the order of a physician.
WARNING :
This device is not intended for foetal use : see following page.
WARNING :
Do not use a 3-pin adaptor to accommodate an ungrounded 2-pin wall receptacle. See
chapter 1-3 (In general purpose User Manual).
WARNING :
Disconnect AC power before cleaning the case : see chapter 2-7 (In general purpose
User Manual).
WARNING :
Some persons are extremely allergic to isopropyl alcohol :
see chapter 2-7 (In general purpose User Manual).
CAUTION :
How to prevent patient-to-patient transfer of infection :
See following page
CAUTION :
The probes must be connected (or disconnected) ONLY when the unit is switched OFF.
All connectors are key coded to prevent improper installations. Do not force the
connectors.
CAUTION :
To preserve the finish of the case, avoid the use of abrasive cleaners. If possible, clean
spots before they dry.
Rev. 02 / 2004 P -3
USER MANUAL
WARNINGS AND CAUTIONS

WARNING :
TISSUE EXPOSURE TO ULTRASOUND ENERGY :
The "Cinescan S" combined unit of B and A scan systems is designed for use in
ophthalmology only.
While QUANTEL MEDICAL is not aware of any reports of adverse effect from using
ophthalmologic ultrasound B-scan, diagnostic-A scan and biometry, even at FDA pre-
enactment levels, no other use is intended or implied.
The system controls limit the output energy to within the parameters specified for its
intended purpose.
No control of ultrasound energy is available to the user other than the duration of
exposure.
Considering the current concern for possible unknown hazards, and despite the
extremely low output intensities used in ultrasound B scan, biometry and Diagnostic A-
scan, QUANTEL MEDICAL recommends that patient exposure time during
measurement or diagnostic be minimized.
Warning : This device is not intended for foetal use.
CAUTION :
HOW TO PREVENT PATIENT-TO-PATIENT TRANSFER OF
INFECTION :
Between two patients the probe must be cleaned to prevent patient-to-patient transfer of
infection :
The probe may be cleaned using Cidex liquid disinfectant, usually found in hospitals.
Other FDA-cleared disinfectants may also be used.
The Standardized A-scan probe can be immersed
Do not immerse the connector.
Do not autoclave the probe or the cable.
After the cleaning, rinse the end of probe thoroughly with clean water to remove all
traces of the liquid used.
Follow the instructions on the label of commercial disinfectants.
The surface should then be dried with a lint-free cloth.
See also Chapter 6 on the General Purpose USER MANUAL for complete information.
P-4 Rev. 02 / 2004

USER MANUAL
TABLE OF CONTENTS
Page Rev.
02-2004
WARNINGS AND CAUTIONS P-3
TABLE OF CONTENTS P-5 X
1- SETUP
1-1- SETUP the unit to your own configuration P-7 X
2- USER FILE
2-1- Accessing the user file P-8
2-1-1- IOL File P-9
3- TISSUE SENSITIVITY
3-1- "T" Gain determination P - 11 X
4- FUNCTIONS
4-1- Accessing the STANDARDIZED A-scan functions P - 14
4-2- Cineloop screen P - 16 X
4-3- Unfrozen Cineloop screen P - 17 X
4-4- Frozen Cineloop screen P - 18 X
4-4-1- Cineloop record P - 19
5- GAIN DISPLAY
5-1- Relative Gain display P - 20
5-2- Gain adjustment P - 20
5-3- Switching back to "T" Gain P - 21
6- ZOOM DISPLAYS
6-1- Micro-Second scale P - 22
6-2- 'Shift in Zoom' P - 22
7- BIO-2 ; QUANT-I & ANGLE KAPPA

7-1- Biometry with 2 markers P - 23 X
7-2- Quantitative-I P - 24 X
7-3- Angle Kappa and adjustment P - 25 X
8- LINE OF COMMENTS
8-1- Accessing the comments line P - 27 X
8-2- Printing example P - 28
Rev. 02 / 2004 P -5
USER MANUAL
TABLE OF CONTENTS
Page Rev.
02-2004
9- SAVE and RECALL
9-1- Function keys P - 29
9-2- Memory : 10 A-Scans per eye P - 29
10- AUTOMATIC PRINTING P - 30
11- A1 FUNCTION
11-1- Purpose P - 31
11-2- Accessing the A1 Function P - 31
11-3- Tracking Screen P - 32
11-4- Results Displayed P - 33
12- QUANTITATIVE-II
12-2- Accessing the QUANT-II function P - 35
12-3- Tracking and Results P - 36
12-4- Results Displayed P - 39
13- PROFILE
13-2- Accessing the PROFILE program P - 42 X
13-3- Set of comments P - 43
13-4- Multiple printings of PROFILE screens P - 43
13-5- Single printing plates P - 44
13-5-1- Right eye printing in a single image P - 44
13-5-2- Left eye printing in a single image P - 45
14- AXIAL-LENGTH
14-1- Accessing Axial-length with 5 markers P - 46
14-2- The Immersion Technique P - 47
14-3- The Contact Technique P - 49
14-4- Image capture P - 50
14-5- Frozen A-Scans P - 51
14-6- Using the Track-Ball for markers P - 52
14-7- Recalling the A-Scans P - 53
14-8- Biometry calculation results P - 54
14-9- Stat-2 Calculation P - 55
14-10- Printing Biometry pages P - 56
14-10-1- Video printer P - 56
14-10-2- Parallel PC standard printer P - 57
VALIDATION SHEET P - 58 X
P-6 Rev. 02 / 2004

USER MANUAL
1- SETUP
1-1 SETUP THE UNIT TO YOUR OWN CONFIGURATION
Feb / 08 / 2004
QUANTEL MEDICAL Time : 11:55:24
Cinescan S Version 5.xx
To come back to the first page, B-SCAN STANDARDIZED A-SCAN IOL CALCULATION
press the [ESC ] function key.
User
#1 User 1
#2 User 2
#3 User 3
#4 User 4
#5 User 5
On the First-Page choose F1
to access the SETUP file :
F1 Gral SETUP F2 T-S Determ F3 F4 USER Setup
Use the [Tab] arrow to select the field to be modified
SETUP
Parallel output : not used
Serial output to PC : not used Resolution : medium
Keyboard : Qwerty Cherry Lines in video : 525 In most of the fields, use
Position of marker N°1 in contact : +0.00mm the horizontal arrows to
modify the selected field
Language : English Day : Feb/08/2004 Time : 17:12:59
B probe Factor Centering Factor Centering
10Mhz Slow 300 00 Fast 300 00
BHF long focus 30° 300 00 50° 300 00
F1 Hours F2 Minutes F3 F4
To escape from the SETUP file : Press the [ESC] key to come back to
the First-Page.
Rev. 02 / 2004 P -7
USER MANUAL
2- USER FILE
2-1 ACCESSING THE USER FILE
On page one, select a User with Tab key, then press "F4 User".
User : User1
Adress : Adresse0
User file sreen :
Velocity (m/s) Cor.:1620 A.C.:1532 L:1641 V:1532
Dense/long:1641 PMMA:2718 Acrylic:1946 Silicone:1050
These are the default
values of velocity : Mode: Manual Technique: Immersion
DYN:60 TGC:00 GAIN:80
A.C. : Ant. chamber

L : Lens
V : Vitreous DEFAULT I.O.L. CALCULATION
Reference 1 Reference 8
Dense : Dense cataract. SRK-T AME.:0.00 SRK-T AME.:0.00
A=115.00 A=119.08
F1 IOL FILE F2 F3 F4
Some fields contain a selection of choices : scroll them with the horizontal keys
Mode : (freezing mode) - Manual ; Auto and Auto+save.

Technique : - Contact (probe in contact with cornea)
- Immersion (using a water bath interface with a scleral shell).
Then the probe does not touch the cornea.
Default settings on the B scan image after an "Erase data" on Patient File :
Each user may adjust its own parameters :
DYN : Dynamic displayed : 30 to 90 dB.
TGC : Time Gain Control = -30 dB to 0.
Gain : 20 to 105 dB
Default IOL Calculation : 2 columns for the 2 calculations in the IOL screen.
(These 2 settings with IOL Reference, Formula and Constant used will be taken by
default when the unit is switched on and after erasing Patient data).
Choose a reference inside the user IOL file.
AME : 0.00 : desired ametropia for post operative refraction (-20 to +20 D).
P-8 Rev. 02 / 2004

USER MANUAL
2- USER FILE
2-1-1 IOL File
In the previous screen, select the F1 key. The following table is displayed :
It shows the default parameters of the references.
The user can modify the values of these constants and then personnalize the IOL
file.
Reference 1 Ant
ACDb= 3.21 A= 115.00 SF= -0.48 ACD= 3.21 Note : A, SF and ACD have
Haigis/Default a0 = -0.60 a1 = 0.40 a2 = 0.10 arithmetic relations :
when one of them is
Reference 2 Ant changed the 2 others are
ACDb= 3.39 A= 115.30 SF= -0.31 ACD= 3.39 calculated.
Haigis/Default a0 = -0.41 a1 = 0.40 a2 = 0.10
Note : The ACDb is the
Reference 3 Ant Ant. Ch. depth given by the
ACDb= 3.68 A= 115.80 SF= -0.02 ACD= 3.68 IOL manufacturer. This
Haigis/Default a0 = -0.10 a1 = 0.40 a2 = 0.10 one is used for Binkhorst-II
Formula. It is independant
Reference 4 Ant and not calculated from the
ACDb= 4.15 A= 116.60 SF= 0.43 ACD= 4.15 A constant.
Haigis/Default a0 = 0.40 a1 = 0.40 a2 = 0.10
Reference 5 Post
ACDb= 4.91 A= 117.90 SF= 1.17 ACD= 4.91
Reference 6 Post
ACDb= 5.26 A= 118.50 SF= 1.51 ACD= 5.26
Reference 7 Post
ACDb= 5.37 A= 118.70 SF= 1.62 ACD= 5.37
Reference 8 Post
ACDb= 5.60 A= 119.08 SF= 1.84 ACD= 5.60
The Haigis default values (a0 ; a1 and a2) are also calculated from the A constant.
All the parameters can be modified within the input limits.
See the chapter IOL Formulae in the General Purpose User Manual for more details.
Rev. 02 / 2004 P -9
USER MANUAL
2- USER FILE
The IOL file has a factory setting. It can be modified as required line by line :
Use the vertical arrows to select one IOL from the table (Ref #1 to #8).
Inside the selected IOL, Use the [ TAB ] Key to jump from one field to the other :
* "Reference" : IOL Reference from the manufacturer. Use the Keyboard
* "A/P" : To modify the Anterior / Posterior field, just press the horizontal arrows .
* "ACDb" : is the Post. Op. Ant. Chamber Depth given by the IOL manufacturer.
ACDb is used by the BINKHORST-II formula.
NOTE : This value is entered manually with the Keyboard. It is not calculated
from the other values.
The following 3 constants have relations between them. When one is entered the others
are re-calculated from the entered value :
* "A " : A constant usualy given by the manufacturer for the SRK formulas.
A = ( SF + 65,60 ) / 0,5663
A = 109,49 + (1,71358 x ACD)
* "SF" : Surgeon factor calculated for the Holladay Formula :
SF = ( A x 0.5663 ) - 65.60
S.F. = (ACD x 0,9704) - 3,595
* "ACD" : Ant Ch. Depth calculated for the Hoffer-Q Formula.
ACD = (Sf + 3.595) / 0.9704
ACD = [ ((A x 0,5663) - 65,60) + 3,595 ] / 0,9704
Haigis constants default values :

a0 is calculated from the A constant : a0=(0.62467 x A) -72.434
a1 = 0.40
a2 = 0.10
To escape from the IOL file : press [ ESCape ] key.
P - 10 Rev. 02 / 2004
USER MANUAL
3-1 "T" GAIN DETERMINATION
Wait 15 minutes after Switching ON Feb / 08 / 2004 Time : 11:55:24
QUANTEL MEDICAL
the instrument before determining T.S. Cinescan S Version 5.xx
(Tissue Sensitivity) B-SCAN STANDARDIZED A-SCAN IOL CALCULATION
NOTE : It is always possible to come User

back to this page by pressing "ESC"
#1 User 1
key. #2 User 2
#3 User 3
#4 User 4
#5 User 5
On first page, press F2 to access the
Tissue Sensitivity determination.
F1 Gral SETUP F2 T-S Determ F3 F4 USER Setup
The Tissue Sensitivity " T Gain " is determined for the whole system :
[ Cinescan “S” unit + Probe ] with the Tissue model.
Another probe with the same unit may have a different T Gain.
After any change of unit or probe, this procedure must be completed.

Probe position for Tissue sensitivity determination.
Maintain the probe

vertically
Std-A Probe - Set the probe vertical on the tissue

model.
The contact must be done with a drop
Put a drop of water.
of water
Adjust the gain with the Track-Ball or
vertical arrows.
Note 1 : the picture cannot be frozen.

Tissue Model
Rev. 02 / 2004 P - 11
USER MANUAL
AUTO Mode :
- Keep the probe vertical. Press T.S. (dB) T=77.4dB AVG: 77.8 80.0 76.6 77.4 76.8 76.3 76.9
[F1: Auto T] and wait during the automatic

measurement.
- After this, the average of the 10
measures is calculated and displayed (ex :
77.8dB).
- Press [F2: Store] to validate this average
wich will be displayed on the right side of
the line : AVG: 77.8.
- This procedure may be done 7 times
(see example). F1 Auto T F2 Store F3 Results F4 Enter T
- Press [F3: Results] to access table of

results : Result of Automatic Tissue Sensitivity Determination
#1 #2 #3 #4 #5 #6 #7
Average dB 77.8 80.0 76.6 77.4 76.8 76.3 76.9
77.6 78.4 76.6 77.2 78.2 76.5 76.1
[F1 Return] : return to the previous screen. 77.4 79.6 77.4 77.2 76.4 76.1 76.9
77.8 80.3 76.6 77.8 77.3 76.4 77.0
77.6 80.6 76.8 77.3 77.4 76.1 76.3
[F2 Erase all] : erase all value of the table. 77.6 81.3 75.7 77.0 77.0 76.5 77.0
77.8 81.5 76.0 77.8 76.1 76.1 77.0
78.0 81.7 76.0 77.8 76.1 76.3 77.4
[F3 Ignore / Include] : allow to ignore or 77.6
78.4
77.6
81.7
77.2
77.0
77.4
77.6
77.0
76.3
76.3
76.5
77.2
77.5
include a serial of 10 measures (1
column). TOTAL AVERAGE T = 77.4dB
[F4 Enter T] : validate the 'TOTAL F1 Return F2 Erase all F3 Ignore F4 Enter T
AVERAGE T= XX.XdB' value.
P - 12 Rev. 02 / 2004
USER MANUAL
MANUAL Mode :
T.S. (dB) T=74.0dB AVG:
The Gain modifies the picture from the

Tissue Model (use vertical arrows or
The gain is too low
TrackBall).
In the left picture the Gain is too low.
The right pattern must be a linear

decrease.
F1 Auto T F2 Store F3 Results F4 Enter T
The gain is too high

In the left picture the Gain is too high.
- When the right Gain is found (left

picture) press [F4: Enter T] to validate
The gain is correct
the Gain as the reference T.
The program will then switch to the First-
Page automatically.
Note : The "T" value will be stored and

safe-guarded when the unit is switched
off. Then this procedure is not necessary
each time the unit is switched ON.
Rev. 02 / 2004 P - 13
USER MANUAL
4- FUNCTIONS
4-1- ACCESSING THE STANDARDIZED A-SCAN FUNCTIONS
Select Key F6 :
Escape B A EYE PATIENT B SAVE PRINT RECALL

FUNCTIONS ON SCREEN 10 HF PC
Screen MHz OD-OS
Prt Sc Pause
Escape F1 F2 F3 F4 F5 F6 F7 F8 F9 F10 F11 F12
Sys Rq Break
If the Tissue Sensibility is not determined, then the following screnn is display :
Tissue Sensibility has to be determined

Use the Tissue Model (TM),
See F2 in the First Page
Press any key to continue...
Follow the procedure described in the previous chapter.
P - 14 Rev. 02 / 2004
USER MANUAL
4- FUNCTIONS
Before accessing the A-scan screen, an intermediate screen asks you to choose the
eye to be explored :
Choose the eye to be examined.
This is important since once the acquisition is finished it will be impossible to
change it.
Please, Choose the eye
F1 RIGHT F2 F3 F4 LEFT
Rev. 02 / 2004 P - 15
USER MANUAL
4- FUNCTIONS
4-2- CINELOOP SCREEN
The Cineloop screen is the basic screen from which all the functions are available.
BASIC STRUCTURE :
CINELOOP Non-FROZEN IMAGE CINELOOP FROZEN IMAGE
Cineloop RIGHT ORBIT T= 77.5 dB Cineloop RIGHT #200/200 ORBIT T= 77.5 dB
Freeze
with
Pedal
Functions which are not concerned UnFreeze

by the Cineloop with
Pedal
F6
=
Review #1 to #10
A1 QUANT-II Gain = T AXIAL Length Fix Gain A-scan only Bio2 Q-I K PROFILE
ESCAPE
F1 F2 F3 F4 F1 F2 F3 F4
ESCAPE
Functions with no Cineloop Save to the Save to the Save as ...

following free following free Choose the # n
#n #n
F4
#1 to # 10
Freeze / Unfreeze A-scan Bio2 Q-I K PROFILE
Selection with
with Pedal Only # n Screen Screen
Save / Recall
F4
Note : After saving one A scan, the [Esc] key will return to the frozen Cineloop.
An other A scan may be saved.
P - 16 Rev. 02 / 2004
USER MANUAL
4- FUNCTIONS
4-3- UNFROZEN CINELOOP SCREEN
These functions do not need the Cineloop record :
F1 : To access A1 function.
CINELOOP Non-FROZEN IMAGE
F2 : To access Quantitative-II program. Cineloop RIGHT ORBIT T= 77.5 dB
F3 : To come back to the Tissue Sensitivity

Gain (T) or T+9dB if you are already at T Gain.
F4 : To enter the AXIAL-LENGTH Functions which are not concerned

by the Cineloop
measurement program.
A1 QUANT-II Gain = T AXIAL Length
F1 F2 F3 F4
ESCAPE
Functions with no Cineloop
The Zoom control : the zoom must be chosen in the unfrozen Cineloop, once the image
is frozen the zoom cannot be changed to be able to replay the sequence with the right
speed.
Press [Alt] key to choose Zoom : Alt Ctrl
'ORBIT' (80 µs) - 'EYE' (40 µs) - '20µs' ZOOM

Eye / Orbit SHIFT ZOOM
See chapter 6-2- for the possible shifts in 'EYE' and '20µS' depth expansions.
Rev. 02 / 2004 P - 17
USER MANUAL
4- FUNCTIONS
4-4- FROZEN CINELOOP SCREEN
CINELOOP FROZEN IMAGE
Cineloop RIGHT #200/200 ORBIT T= 77.5 dB
F6
=
Review #1 to #10
Fix Gain A-scan only Bio2 Q-I K PROFILE
ESCAPE
F1 F2 F3 F4
Save to the Save to the Save as ...

following free following free Choose the # n
#n #n
F4
#1 to # 10
Freeze / Unfreeze A-scan Bio2 Q-I K PROFILE
Selection with
with Pedal Only # n Screen Screen
Save / Recall
F4
F1 : To fix the Gain or to be able to vary it.
F2 : To access the A-scan only.
F3 : To access the following functions :

- Bio2 : the BIOMETRY / 2 Markers.
- QI : the QUANTITATIVE-I calculation.
- K : the Angle Kappa calculation.
F4 : To access PROFILE screen (Orbit expansion only).
F6 : A-scan = review #1 to #10 without saving any picture, just to review the
saved A-scans
P - 18 Rev. 02 / 2004
USER MANUAL
4- FUNCTIONS
4-4-1- Cineloop record :
The Cineloop will help the user to replay the sequence and to select the best image to
be saved for evaluation purposes : from the Cineloop record, the images will be saved
on the 10 available memories : #1 to #10 for each eye by using the 3 following screens :
- A scan Only : The A-scan is saved without any matker.
It is possible to add comments and print the result.
- Bio2 QI-K : 2 markers select a field and evaluate the distance ;

Quantitative-I gives the global reflectivity in % and
Angle Kappa indicates the attenuation angle.
- ORBITAL PROFILE : evaluation of the orbital muscle thickness.
The Cineloop is a powerfull tool that offers to the user a memorized sequence of the 4
seconds preceding the freezing action (the 4 seconds are divided in 200 frames of
20ms). Then, the user can review all the sequence in a loop and also choose one by one
the frames of the sequence.
After the acquisition is done by pressing the pedal, the Cinescan S indicates the
number of frames on the top of the screen.
The displayed image is the last one memorized (example #150/150).
To review the whole sequence :
Pressing the two buttons of the TrackBall, or press [Pg Dn] key starts the automatic
image sequence.
To review the images one by one :
Press the right or the left button of the TrackBall.
If you keep pushing one button the
sequence will be displayed in slow
Home
motion (5 images / seconde). START #
Cine Loop
Pg UP
CLEAR
Pg Dn
LOOP
Right button
End
STOP # increasing
Left button Scan number
decreasing
Scan number
Important :
A new acquisition (pressing the pedal) will erase the previous sequence.
Consequently, all the images which are not saved will be lost.
Rev. 02 / 2004 P - 19
USER MANUAL
5- GAIN DISPLAY
5-1- RELATIVE GAIN DISPLAY
The Gain is displayed in a relative way by reference to the tissue sensitivity Gain.
Examples :
The tissue sensitivity Gain is : 76,5 dB

so the display is :
LEFT ORBIT T = 76,5 dB
Instead of displaying G=85.5dB, when the Gain is greater than "T" by 9dB,
the display will be :
LEFT ORBIT T + 9,0 dB
Instead of displaying g=66.5dB, when the Gain is lower than "T" by 10dB,
the display will be :
LEFT ORBIT T - 10,0 dB
5-2- GAIN ADJUSTMENT

The Gain can be controlled either using the vertical arrows or the Track-Ball.
Gain control : START #
With vertical arrows Cine Loop

End
ift
or CLEAR
with the Track-Ball, moving

the ball vertically. LOOP
STOP #
The Gain is adjustable also on a frozen Standardized

A-Scan image but it is locked / unlocked by pressing
[F1 Fix Gain / Vary gain].
The Gain is fixed on a frozen Axial length A-scan image.
P - 20 Rev. 02 / 2004
USER MANUAL
5- GAIN DISPLAY
5-3- SWITCHING BACK TO "T" GAIN
During the eye examination, with a non-frozen picture, for any Gain and any
position of the probe, you may see what would be the echogram at "T Gain" and
then come back to the previous Gain.
From any Gain displayed : "T - Xo dB"
- PRESS the SPACE BAR and the Gain comes back at "T" GAIN :
example : "T=78.0 dB"
- PRESS again the SPACE BAR and the Gain comes back to the previous
Gain : "T - Xo dB".
From the "T Gain" :
In the same way, you may see what would be the echogram at
"T + 9dB" Gain and then come back to the "T Gain".
-When the displayed Gain is "T" :

the Function Key F3: Displays : " Gain = T+9 "
-When the displayed Gain is "T + 9 dB" :

the Function Key F3: Displays :" Gain = T "
Note : when you are at "T + 9.0dB" the above procedure with the SPACE BAR works
also to shift back to "T Gain".
Rev. 02 / 2004 P - 21
USER MANUAL
6- ZOOM DISPLAYS
6-1- MICRO-SECOND SCALE
The scale displayed below the echogram is in micro-seconds (µs).
Screens displayed in "ORBIT", "EYE" and "20µS" mode :
Cineloop LEFT ORBIT T=77.4dB Cineloop LEFT EYE T=77.4dB Cineloop LEFT 20µs T=77.4dB
F1 A1 F2 Quant II F3 Gain = T+9 F4 Axial Length F1 A1 F2 Quant II F3 Gain = T+9 F4 Axial Length F1 A1 F2 Quant II F3 Gain = T+9 F4 Axial Length
The scale is displayed assuming a medium speed of 1550 m/s.
6-2- 'SHIFT IN ZOOM'

In "EYE " and "20µs" mode, the display is done for 40 µs and 20 µs but the full
80 µs image is still memorized.
So, it is possible to shift within the 80 µs stored in memory.
Use both keys [Ctrl + Horizontal arrows] to move the displayed portion :
Alt Ctrl
ZOOM
Eye / Orbit SHIFT ZOOM
[ Ctrl + RIGHT arrow ] will shift the picture towards the Right.
[ Ctrl + LEFT arrow ] will shift the picture towards the Left.
Inside the #1 to #10 memories the shift is always possible, frozen or not.
In Cineloop, the shift is available on unfrozen screens.
P - 22 Rev. 02 / 2004
USER MANUAL

7-1- BIOMETRY WITH 2 MARKERS
As shown previously, the "Bio-2" function is only available when the picture is frozen :
When pressing the function Key F3 : [Bio2 QI-K] in Cineloop, the transfer is done to
the first free memory (#1 to #10).
Bio2 Q-I K LEFT #1 EYE T=77.4dB A-scan LEFT #1 EYE T=77.4dB
Velocity (m/s) : 1550 Distance= 15.25mm Quant-I= 42%
AVG Height= 35%
F1 Vary Gain F2 Markers F3 Velocity F4 A-scan Only F1 Vary Gain F2 F3 F4 Bio2 Q-I K
Two Gates (over-lighted) are shown and the selected one is blinking.
F2 : is used to select the other Gate.
F3 : will select the Velocity field to change the speed. When the velocity field is
selected enter the new value with the keyboard : (Possible range : 500 to 4 000 m/s).
To QUIT the Speed field : press [ESC] or [Enter].
F4 : go to "A-scan only" screen (from "A-scan only" go to "Bio2 Q-I K" screen also).
The selected marker can be moved with the horizontal arrows.

In parallel, the Track-Ball can be used more efficiently.
- Select the marker with the RIGHT button.
- Press the LEFT button and turn the ball simultaneously.
Note : when tranferring the A-scan from Cineloop to Bio2, the gain is fixed to be able to
adjust the marker position more easilly.
START #
Cine Loop
CLEAR
To move the LOOP

marker :
Press Left button STOP #
when rotating Right button : press here
the ball to SELECT a new marker = F2
Rev. 02 / 2004 P - 23
USER MANUAL

7-2- QUANTITATIVE - I
The same screen as BIO-2 provides this quantification.
An absolute conditions to get the QUANT- I result : To be at "T Gain"
The purpose is to evaluate the reflectivity by measuring the surface covered by
the echoes between the 2 markers.
This value is expressed in percentage :
Quant-I = 100% if all the echoes are saturated between the markers.
Example with a tissue model :
The Gain is at "T".
Bio2 Q-I K LEFT #1 ORBIT T=77.4dB So the result of Quantitative-I is
Velocity (m/s) : 1550 Distance= 33.91mm Quant-I= 61% displayed.
AVG Height= 42%
The Average Height (AVG Height)

is always displayed for any Gain.
The 2 Gates
F1 Fix Gain F2 Markers F3 Velocity F4 A-scan Only
AVG Height : Quant- I :

the calculation gives the surface limited by the calculation gives the surface limited
the echoes (pics and valleys). mainly by the pics of the echoes.
Bio2 Q-I K LEFT #1 ORBIT T=77.4dB Bio2 Q-I K LEFT #1 ORBIT T=77.4dB
Velocity (m/s) : 1550 Distance= 33.91mm Quant-I= 61% Velocity (m/s) : 1550 Distance= 33.91mm Quant-I= 61%
AVG Height= 42% AVG Height= 42%
Quant-I
AVG Height
F1 Fix Gain F2 Markers F3 Velocity F4 A-scan Only F1 Fix Gain F2 Markers F3 Velocity F4 A-scan Only
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USER MANUAL

7-3- ANGLE KAPPA AND ATTENUATION
In the "Bio2 Q1 K" screen, set the 2 Gates over-lighted to determine the field for
calculation.
The Angle Kappa is the quantification angle of the attenuation in the ORBIT
screen.
The attenuation is also mentioned in dB/mm.
The calculation is a linear regression from all the pics and valleys situated between
the 2 Gates.
2 conditions to obtain Angle Kappa :

- ORBIT screen
- AVG Height value is 50% ±1%.
Bio2 Q-I K LEFT #1 ORBIT T=77.4dB
AVG Height= 33%
Automatic adjustment : press "K" key

on keyboard.
An automatic setting will adjust the gain
to get AVG = 50%, then the program
calculates automatically Angle Kappa.
F1 Vary Gain F2 Markers F3 Velocity F4 A-scan Only
Bio2 Q-I K LEFT #1 ORBIT T +5.3dB

Velocity (m/s) : 1550 Distance= 31.88mm
KAPPA= 49.94° ATT= 1.45dB/mm AVG Height= 50%
F1 Vary Gain F2 Markers F3 Velocity F4 A-scan Only
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USER MANUAL

Display of the linear regression segment in ORBIT screen :
When the Angle Kappa is displayed, the Bio2 Q-I K LEFT #1 ORBIT T +5.3dB
Keyboard key : "K" allows to display the Velocity (m/s) : 1550 Distance= 31.88mm
KAPPA= 49.94° ATT= 1.45dB/mm AVG Height= 50%
segment from the linear regression
calculation.
When the segment is displayed

pressing “K” again, will come back to
the A-scan.
Note : Both pictures may be printed.
Note : this is not possible in EYE and F1 Vary Gain F2 Markers F3 Velocity F4 A-scan Only
20µs screen.
ATTENUATION IN THE "EYE" and "20µs" screen

Because of the dilatation in the Horizontal axis, the angle is not preserved, so the
attenuation is only displayed in dB/mm.
For the same reason, the "K" Key is not active in EYE and 20µs.
Bio2 Q-I K LEFT #1 EYE T +5.3dB Bio2 Q-I K LEFT #1 20µs T +5.3dB
Velocity (m/s) : 1550 Distance= 31.88mm Velocity (m/s) : 1550 Distance= 31.88mm
ATT= 1.45dB/mm AVG Height= 50% ATT= 1.45dB/mm AVG Height= 50%
F1 Vary Gain F2 Markers F3 Velocity F4 A-scan Only F1 Vary Gain F2 Markers F3 Velocity F4 A-scan Only
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USER MANUAL
8- LINE OF COMMENTS
8-1- ACCESSING THE COMMENTS LINE
In the "Bio2 QI-K" screen, a line of comments can be added to the picture on a
frozen image :
Fn Alt Insert Delete Alt Ctrl
On a frozen image press

the function key [Insert] :
Then the following will appear on the

screen : Bio2 Q-I K LEFT #1 ORBIT T=77.4dB
AVG Height= 33%
The right part of the line is selected
(35 characters) and a cursor is ready to
enter the data from the keyboard.
This part is designed to contain the data

concerning this particular picture (#1).
The left part of the line (20 characters)

will be common to the same eye and will
be displayed on all the 10 stored F1 Vary Gain F2 Markers F3 Velocity F4 A-scan Only
images.
It just needs to be entered once on one of the 10 pictures.
To switch from one part of the line to the other : Press the [TAB] Key or the
[Enter] Key
To Escape from the comments line press [ESC] key.

Other functions are not available before escaping from the comments line.
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USER MANUAL
8- LINE OF COMMENTS
8-2- PRINTING EXAMPLE
Example printed on a video printer :
Bio2 Q-I K LEFT #1 ORBIT T=77.4dB

AVG Height= 33%
Video Test QM
Common part to Picture

the Left eye comments
µS
Quantel Medical Cinescan S V:5.xx

Oct/09/2002
- "µs" : This symbol indicates that the visualized scale is in micro-seconds.

Note : In B-mode the visualized scale is in mm.
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USER MANUAL
9- SAVE AND RECALL

9-1- FUNCTION KEYS
These 2 functions can be used whether the picture is frozen or not :

Screen MHz OD-OS
Prt Sc Pause
Sys Rq Break
The 10 saved A-scans (#1 to #10) may be post-processed :

- the gain is adjustable
- the zoom set may be changed
- the markers set for measurement
9-2- MEMORY : 10 A-SCANS PER EYE

Up to 10 A-Scans may be stored for each eye.
It is possible to store pictures for both eyes and to print them afterwards.
The [SAVE] key scrolls the pictures from #1 to #10.
The [RECALL] key scrolls the pictures from #10 to #1.
For the printing see following chapter.
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USER MANUAL
10- AUTOMATIC PRINTING

10- AUTOMATIC PRINTING
A special function ables the user to automatically print all the stored pictures for
one eye :
The only condition is to have a SONY video printer :
The B-SCAN uses the printer remote control : the special cable must be
connected.
The program knows the number of frozen pictures for the current eye.
When pressing the [PRINT] key :

Screen MHz OD-OS
Prt Sc Pause
Sys Rq Break
The following screen appears :
Do you want to print all stored images?
F1 NO F2 F3 F4 YES
F4 : YES : the program starts processing the first picture and initiate the printing, it
processes the second one, initiate the printing ... etc ...
F1 : NO : Only the current picture will be printed.
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USER MANUAL
11- A1 FUNCTION
11-1- PURPOSE
The intention is to determine the nature of a tissue by analysing the reflectivity of its
maximized echo, when the exploration line is perpendicular to this tissue.
In this application, the purpose is to differentiate a Retinal detachment and a Vitreous
Membrane.
11-2- ACCESSING THE A1 FUNCTION

This function is available in the unfrozen "Cineloop" screen : " F1 = A1 "
"Eye", "Orbit" or "20µs" mode can be selected in the A1 screen.
Example :
Cineloop LEFT ORBIT T=77.4dB A1 LEFT ORBIT T=77.4dB
F1 A1 F2 Quant II F3 Gain = T+9 F4 Axial Length F1 <= F2 => F3 <=> F4
"F1 : A1" will access the A1 Function. For the “A1” Function, the Gain is set at
the Tissue Sensitivity Gain
When the user accesses the “A1” Function, the Gain is set at the Tissue
Sensitivity Gain and cannot be changed.
A segment is displayed at 75% of the saturation.
This echo is characterized by :

- The Specific Gain used : the Tissue Sensitivity Gain
- The Amplitude : saturated or not. Minimum height : 75% of the saturation level.
- The number of nodules between 10 and 95% of the saturation level.
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USER MANUAL
11- A1 FUNCTION
11-3- TRACKING SCREEN
The echo selected for tracking is designated with a bright horizontal segment.
The selected echo is the first one found on the segment.
A1 LEFT ORBIT T=77.4dB
F1 <= F2 => F3 <=> F4
- The horizontal segment position can be modified with the F1 and F2 function keys.
- The horizontal segment width can be modified with the F3 function keys.
- At the beginning the height of this segment is set at 75% of the saturation level,
which is the minimum threshold considered to apply the A1sign analysis. The
threshold can jump to 97% if the echo becomes higher.
Tracking Software :
The tracking is done during the time the pedal is pressed.
- It compares the selected echo amplitudes during the successive images

- Keeps in memory the image with the highest detected amplitude.
When the pedal is released the software switches to the result page showing the
selected image and the analysis result.
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USER MANUAL
11- A1 FUNCTION
11-4- RESULTS DISPLAYED
The analysis is done from the following table :
A1 di agnos tic support information / Version 3.x x - 4.xx - 5.xx
Condition 1 : The Gain used is the T-GAIN
Condition 2 : The Echo is maximised and the Tracking keeps the image with the
highest amplitude
Height of the Echo
Number of N odules Diagnostic information
(n% of the saturation)
0 Retina +++
1 Retina ++
2 Retina +
> 98 % 3 Equivocal Result
4 Membrane +
5 Membrane ++
>5 Membrane +++
0 ;1 ;2 Equivocal Result
3 Membrane +
>=97 % and <= 98 %
4 Membrane ++
>4 Membrane +++
0 ;1 ;2 Membrane +
>=75 % and < 97 % 3 Membrane ++
>3 Membrane +++
< 75 % The last image is frozen Max Spike Height < 75 %
A1 LEFT ORBIT T=77.4dB
Diagnostic Support Information : Membrane + (>98% 4)

Example :
98%
97%
The selected echo height is above
95%
95%, 97% and 98%.
The number of nodules, between
4 nodules levels 10% and 95% is : 4.
The A1 sign for this echo is :
"Membrane +"
10%
F1 F2 F3 F4
Rev. 02 / 2004 P - 33
USER MANUAL
12- QUANTITATIVE - II
12-1- PURPOSE
Echo amplitudes are only significant if they are maximized, when the exploration
axis is perpendicular to the tissue.
QUANT-II helps the user to find the best echogram maximized in amplitude for one
particular echo. This software will track in a non-frozen picture the selected echo
and store the image where its amplitude has been the highest.
A typical application is the differential diagnosis between a membrane and retina.

Three echograms will be stored containing the 3 maximized echoes :
- Membrane
- Pre-sclera
- Sclera
A following calculation will give the algebraic difference between these 3
amplitudes in dB :
- Diff M-S = Membrane amplitude - Sclera amplitude
- Diff Ps-S = Pre-sclera amplitude - Sclera amplitude
- Diff M-Ps = Membrane amplitude - Pre-sclera amplitude
These values will guide the ophthalmologist to make the right diagnosis.
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USER MANUAL
12-2- ACCESSING THE QUANT-II FUNCTION
As shown previously, the [ QUANT-II ] key function is F2 in the unfrozen Cineloop
screen.
The screen will be as follows : Quant-II LEFT ORBIT T=77.4dB
It is possible to review a previous Quant-II

analysis for the current eye.
Three A-Scans per eye are stored for this

quantification.
The memories are different than the 10
scans storage per eye which are available :
#1 to #10.
For review : Press "F2 : Old" F1 F2 Old F3 New F4
Press : "F3 : New" to erase the old storage and start a new quantification.
After pressing [F3: New], the screen will be as follows :

The first screen is concerning the MEMBRANE.
3 pictures must be recorded with the highest Q-II Membrane LEFT ORBIT T=77.4dB
selected echo obtain by tracking : Diff.: M-S=XX.XdB Diff.: Ps-S=XX.XdB Diff.: M-Ps=XX.XdB
- Membrane - Sclera - Pre sclera.
[F3 : M-> S ->PS ] : To select one of the 3
echoes to track.
The tracking will be done above the horizontal
segment. This line will be adjustable on the
"tracking" page.
[F1: Reset] will erase the displayed image
[F2: Tracking] will start a new tracking. F1 Reset F2 Tracking F3 M=>S=>Ps F4
If the previous image is not erased, the

tracking will try to get a highest echo, if not, the previous image will be kept in memory.
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USER MANUAL
12-3- TRACKING AND RESULTS
Tracking the Membrane : Q-II Membrane LEFT ORBIT T=77.4dB
The segment is used to select the echo for

tracking.
Using F1 and F2, position it on the selected
echo.
The image is NON-frozen, the selection of
the echo must be done keeping the probe in
the right position.
F3 : is used to adjust the segment length.

Pressing several times : 4 lengths are F1 <= F2 => F3 <=> F4
available.
The horizontal segment is adjustable vertically from 5 to 95 %.

The corresponding level is the threshold above which the tracking is done.
The [ + ] and [ - ] Keyboard keys are used to adjust the level.
The tracking will start when PRESSING THE PEDAL and will be active during
the time it is pressed.
Q-II Membrane LEFT ORBIT T=77.4dB
Membrane Tracking Result :
Diff.: M-S=XX.XdB Diff.: Ps-S=XX.XdB Diff.: M-Ps=XX.XdB
After the pedal is released, the screen goes

automatically to the result display.
The calculations are not made because only

the Membrane echogram has been stored :
[F1 : Reset] will erase the displayed image.

[F2 : Tracking] will start a new Tracking of the
membrane. F1 Reset F2 Tracking F3 M=>S=>Ps F4
Note : if F2 is pressed without resetting
first, the program will keep the previous result and try to get an highest echo
amplitude.
[F3 : M->PS->S]will select the following image : Sclera.
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USER MANUAL
Tracking the Sclera :
The Scleral echo will be the highest echo Q-II Sclera LEFT ORBIT T -2.5dB
inside the segment.
Usually the scleral echo has a higher

amplitude and it is necessary to avoid the
saturation. The Gain may be adjusted. It will
be taken in account for the relative amplitude
measurement of the echo.
The tracking is effective during the time the

pedal is pressed.
F1 <= F2 => F3 <=> F4
to the Result display.
Sclera Tracking result : Q-II Sclera LEFT ORBIT T -2.5dB
Diff.: M-S=13.5dB Diff.: Ps-S=XX.XdB Diff.: M-Ps=XX.XdB

The calculation gives the first result : M-S
because only the Membrane (M) and the
Sclera (S) have been processed.
[F1 : Reset] will erase the displayed image.
[F2 : Tracking] will start a new Tracking of the

Pre-Scelra.
Note : if F2 is pressed without resetting
first, the program will keep the previous F1 Reset F2 Tracking F3 M=>S=>Ps F4
result and try to get an highest echo
amplitude.
[F3 : M->PS->S]will select the following image : Pre-Sclera.
Rev. 02 / 2004 P - 37
USER MANUAL
Tracking the Pre-Sclera : Q-II Pre -sclera LEFT ORBIT T +5.5dB
The Pre-Sclera will be the first echo in the

segment.
The tracking is effective during the time the

pedal is pressed.

to the Result display.
F1 <= F2 => F3 <=> F4
Pre-Sclera Tracking Result :
The result Ps-S and M-Ps are now Q-II Pre-sclera LEFT ORBIT T +5.5dB
displayed.
Diff.: M-S=13.5dB Diff.: Ps-S=-11.0dB Diff.: M-Ps=6.5dB
Pressing [F3], the user can scroll the 3

echograms : M; S and Ps.
The calculation results are the same in the 3

pictures.
The 3 echograms can be done again : F1 Reset F2 Tracking F3 M=>S=>Ps F4
- This first result can be kept, just press [F2] to continue the tracking and try to get an
highest level.
- Or Press [F1] to reset the previous echogram before starting a new tracking with [F2]
P - 38 Rev. 02 / 2004
USER MANUAL
12-4- RESULTS DISPLAYED
The analysis is done from the following tables :
Results after the tracking of the Membrane (M) and Sclera (S) :
Result of the difference :

Diagnostic Support
M-S (Amp. Membrane Additional Message
Information
- Amp. Sclera)
1° -13<=M-S<=-5dB R.D. ++
2° -15<M-S<-13dB R.D. +
1) Try to get better M

3° -16<M-S<=-15dB R.D. (+)
2) Try to get the Pre-Sclera

4° -17<M-S<=-16dB Equivocal

5° -18<M-S<=-17dB Membrane (+)
6° -19<M-S<=-18dB Membrane +
7° -20<M-S<=-19dB Membrane ++
8° -35<M-S<=-20dB Membrane +++
Rev. 02 / 2004 P - 39
USER MANUAL
Results after the tracking of the Membrane (M), Sclera (S) and Pre-Sclera (Ps) :
Result of the Result of the

Diagnostic
difference : M-S difference : Ps-S
Support Additional message
(Amp. Membrane (Amp. Pre-Sclera
Information
- Amp. Sclera) - Amp. Sclera)
-35<=Ps-S<=-15dB R.D. +++
-15<Ps-S<=-14dB R.D. ++
1° -13<=M-S<= -5dB
-14<Ps-S<=-13dB R.D . +
-13<Ps-S<= -5dB Contradiction Try to get better S
-35<=Ps-S<=-15dB R.D. ++
-15<Ps-S<=-14dB R.D . +
2° -15<M-S<-13dB Try to get better echoes :
-14<Ps-S<=-13dB R.D. (+)
1) Sclera ; 2) Membrane
-13<Ps-S<= -5dB Contradiction Try to get better S
-35<=Ps-S<=-15dB R.D . +
Try to get better echoes :

-15<Ps-S<=-14dB R.D. (+)
3° -16<M-S<=-15dB Try to get better echoes :
-14<Ps-S<=-13dB Equivoque

-13<Ps-S<= -5dB Contradiction

-35<=Ps-S<=-15dB R.D. (+)
1) Pre-Sclera ; 2) Membrane

-15<Ps-S<=-14dB Equivoque
4° -17<M-S<=-16dB 1) Pre-Sclera ; 2) Membrane

-14<Ps-S<=-13dB Membrane (+)
-13<Ps-S<= -5dB Membrane +

-35<=Ps-S<=-15dB Contradiction

5° -18<M-S<=-17dB -15<Ps-S<=-14dB Membrane (+)
-14<Ps-S<=-13dB Membrane +
-13<Ps-S<= -5dB Membrane ++
P - 40 Rev. 02 / 2004
USER MANUAL
-35<=Ps-S<=-15dB Contradiction

6° -19<M-S<=-18dB -15<Ps-S<=-14dB Membrane (+)
-13<Ps-S<=-5dB Membrane ++
-35<=Ps-S<=-15dB Contradiction Try to get better Ps
7° -20<=M-S<=-19dB
-13<Ps-S<=-5dB Membrane +++
-35<=Ps-S<=-15dB Contradiction Try to get better Ps
8° -30<=M-S<-20dB
Results after the tracking of the Membrane (M) and Pre-Sclera (Ps) when the
Sclera is impossible to detect :
Result of the difference :

Diagnostic Support
M-Ps (Amp. Membrane Additional message
Information
- Amp. Pre-Sclera)
1° M-Ps<=-6dB Membrane ++
2° -6<M-Ps<-3dB Membrane +
3° -3<=M-Ps<=-2dB Membrane (+) Try to get better Ps
4° -2<M-Ps<=+1dB Equivocal
5° +1<M-Ps<=+3dB D.R. (+) Try to get better M
6° +3<M-Ps<+6dB D.R. +
7° M-Ps>=+6dB D.R. ++
Rev. 02 / 2004 P - 41
USER MANUAL
13- PROFILE
13-1- PURPOSE
To follow some pathologies it is useful to document the thickness of all the extra-
ocular muscles. A profile set of 9 echograms will be printed. Each one is prepared for
a specific echogram. The muscle initials are entered with each scan number and the
name of the muscle to measure is entered inside the right side of the comments line.
To enter a common comment see chapter 7 : Line of comments.
13-2- ACCESSING THE PROFILE PROGRAM

The image acquisition is done in the Cineloop to save the image inside the #1 to #10
memories. After selecting the image inside the Cineloop record, press F4 : Profile.
Cineloop LEFT #200/200 ORBIT T=77.4dB PROFILE LEFT #1 M.R. ORBIT T=77.4dB
Save as # PROFILE Velocity (m/s) : 1550 Distance= 9.88mm

---- #1 M.R.
---- #2 S.R. Medial Rectus
---- #3 S.O.
---- #4 L.R.
---- #5 I.R.
---- #6 I.O.
---- #7 O.N.
---- #8 P.O.
---- #9 L.G.
---- #10
F1 F2 Review F3 F4 Save as F1 Vary Gain F2 Markers F3 Velocity F4 A-scan Only
Frozen Cineloop screen with Frozen picture in PROFILE program :

F4 : PROFILE selected. #1 Medial Rectus and velocity is 1550m/s.
Select the right muscle with vertical arrows Press [save] or [recall] to scroll inside the 9
to save the image in the right field. pictures.
Press [Escape] to come back to Cineloop and be able to make an other acquisition.
The following muscle initials will be displayed in the unfrozen Cineloop screen.
F2 To come back to the saved images ( to review the #1 to #10) without the need
to save an image from the cineloop.
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USER MANUAL
13- PROFILE
13-3- SET OF COMMENTS
The following initials and comments are used for each number :
Number Initials Muscle name in the Comments Line :
#1 M.R. Medial Rectus #6 I.O. Inferior
Oblique
#2 S.R. Superior Rectus #7 O.N. Optic Nerve
#3 S.O. Superior Oblique #8 P.O. Peri-Orbita
#4 L.R. Lateral Rectus #9 L.G. Lacrimal Gland
#5 I.R. Inferior Rectus
13-4- MULTIPLE PRINTINGS OF PROFILE SCREENS

When the print will be selected the program will ask if you want the 9 scans in a
SINGLE print or on 9 different printouts.
How do you want to get

the PROFILE Printout?
F1 Single F2 F3 F4 Multiple
If the answer is "MULTIPLE" you will get the printings for each frozen scan as
follows :
PROFILE LEFT #1 M.R. ORBIT T=77.4dB
Velocity (m/s) : 1550 Distance= 9.88mm
"Comments" Medial Rectus
Printing Example for the scan #1 :
Medial Rectus muscle.
Quantel Medical CineScan S V : 5.xx

DATA NAME PATIENT IDENTIFICATION Oct/09/2002
Echo #10 case :
this one does not take part of the Profile set ( #1 to # 9).
The scan #10 can be used and printed separately.
Rev. 02 / 2004 P - 43
USER MANUAL
13- PROFILE
13-5- SINGLE PRINTING PLATES
13-5-1- RIGHT EYE PRINTING IN A SINGLE IMAGE
If you ask for a Single Image the printing will be as follows :
RIGHT COMMON COMMENTS ( 20 Characters)
#9 L.G. D9= 1.28 mm #2 S.R. D2= 7.32 mm #3 S.O. D3= 3.49 mm
#4 L.R. D4= 5.11 mm #7 O.N. D7= 1.74 mm #1 M.R. D1= 5.11 mm
#6 I.O. D6= 3.25 mm #5 I.R. D5= 6.28 mm #8 P.O. D8= 0.70 mm
Superonasal Index : SNI = 5.31 mm Muscle Index : MI = 5.10 mm

PATIENT NAME DATA......... IDENTIFICATION [ Date ]
Calculations : - Superonasal Index SNI = ( D1+D2+D3 ) / 3

- Muscle Index MI = ( D1+D2+D3+D4+D5+D6 ) / 6
Note : the Index will not be calculated if one of the Distances is missing.
P - 44 Rev. 02 / 2004
USER MANUAL
13- PROFILE
13-5-2- LEFT EYE PRINTING IN A SINGLE IMAGE
If you ask for a Single Image the printing will be as follows :
The arrangement of the echograms is different. If we put the 2 Printouts

side by side, the disposition is symmetrical.
LEFT COMMON COMMENTS ( 20 Characters)
#3 S.O. D3= 3.49 mm #2 S.R. D2= 7.32 mm #9 L.G. D9= 3.55 mm
#1 M.R. D1= 5.11 mm #7 O.N. D7= 1.74 mm #4 L.R. D4= 5.11 mm
#8 P.O. D8= 0.70 mm #5 I.R. D5= 6.28 mm #6 I.O. D6= 3.25 mm
Superonasal Index : SNI = 5.31 mm Muscle Index : MI = 5.10 mm
PATIENT NAME DATA......... IDENTIFICATION [ Date ]
Calculations : - Superonasal Index SNI = ( D1+D2+D3 ) / 3

- Muscle Index MI = ( D1+D2+D3+D4+D5+D6 ) / 6
Note : the Index will not be calculated if one of the Distances is missing.
Rev. 02 / 2004 P - 45
USER MANUAL
14- AXIAL - LENGTH

14-1 ACCESSING AXIAL LENGTH WITH 5 MARKERS
After accessing the standardized-A functions with Key F6,
First : Choose the eye to be examined :
This is important since once the acquisition is finished it will be impossible to
change the selected eye.
Press [F4 : Axial Length], available in "ORBIT", "EYE" and "20µs" unfrozen screen.
The screens displayed might be the following :
LEFT #1 T=77.4dB Phakic Manual Immersion

Non frozen screen :
Example : Technique : Immersion
Mode : Manual 95%
Eye type : Phakic
5%
F1 F2 Type F3 Mode F4 Technique

Frozen screen : Cor. A.C. L V
m/s 1620 1532 1641 1532
A verage=27.55mm #1 :27.44
#2 :27.51
mm 0.56 3.45 3.87 19.56 #3 :28.36
Example : after acquisition in immersion. #4 :28.07
#5 :27.51
#6 :27.51
#7 :26.83
Cornea Lens Retina #8 :28.05
#9 :27.88
#10:27.21
F1 F2 Type F3 Res. screen F4 Markers
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USER MANUAL
14- AXIAL - LENGTH

14-2- THE IMMERSION TECHNIQUE
The immersion technique is realised using a scleral shell filled with Physiologic
serum.
Use [F4 : Technique] to display "IMMERSION" on the top line (right side).
Adjust the Gain to get the top of the echoes within the 2 horizontal lines.
Example : a low gain of T-20 dB allows to see more easily all the structures.
LEFT #1 T -20.0dB Phakic Manual Immersion
95%
The echoes must be

between the 2 lines.
5%
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USER MANUAL
14- AXIAL - LENGTH

IMMERSION BASic for beginners :
The Immersion technique might be difficult for beginners.
The Immersion Basic mode will help by controling the axial position of the
echogram :
LEFT #1 T -6dB Phakic Manual Immersion Bas
82%
Recommended gain : T to T - 6 dB.

In AUTO or AUTO + SAVE modes :
The software has a minimum level criteria to control the axial position of the
echogram :
- The top of the echoes must be higher than the horizontal line which is at 82 % of the
saturation level.
- In addition it must recognize the axial-length pattern.
- The slope of the Retinal spike rising edge must be very steep.
- If the Retinal echo is above the horizontal line but the rising edge is not sharp
enough: the buzzer is activated.
When all criteria are OK the picture is frozen.
P - 48 Rev. 02 / 2004
USER MANUAL
14- AXIAL - LENGTH

14-3- THE CONTACT TECHNIQUE
2 types of AUTOMATIC acquisition are available :
- CONTACT BASic : - CONTACT ADVance :
LEFT #1 T -6dB Phakic Manual Contact Bas LEFT #1 T -20dB Phakic Manual Contact Adv
95%
82%
5%
F1 F2 Type F3 Mode F4 Technique F1 F2 Type F3 Mode F4 Technique
Recommended gain : T to T - 6 dB. Recommended low gain : about T- 20 dB.

In AUTO or AUTO + SAVE modes : In AUTO mode :
Note: "Auto + Save" mode is not available
The software has a minimum level criteria
for this technique
to control the axial position of the
echogram : The top of the echoes must be within
- The top of the echoes must be higher the 2 horizontal lines which are at 5%
than the horizontal line which is at 82 % and 95% of the saturation level.
of the saturation level.
For more experienced users, like for the
- In addition it must recognize the axial-
Immersion Technique, the height of the
length pattern.
echoes may not be sufficient criteria :
- The slope of the Retinal spike rising with a lower Gain the user may distinguish
edge must be very steep. the different layers and be able to
- If the Retinal echo is above the appreciate themselves the best position
horizontal line but the rising edge is not of the probe.
sharp enough: the buzzer is activated.
The program :
- checks the echoes are between 5%
When all criteria are OK the picture is
and 95%;
frozen.
- must recognize the axial-length
pattern.
- Then freezes the picture.
Rev. 02 / 2004 P - 49
USER MANUAL
14- AXIAL - LENGTH

14-4- IMAGE CAPTURE
LEFT #1 T -20.0dB Phakic Manual Immersion
The biometry page (non frozen)

appears as follows : 95%
Sub functions F1/F4 are active

as described below.
5%
The chosen parameters are

displayed on the top line of the F1 F2 Type F3 Mode F4 Technique
screen.
Note : The 40µS and 20µS may be shifted within the 80 µS with the "horizontal arrows +
Ctrl" keys.
F2 : Type : selection of the eye type : allows the user to “toggle” the following :
Phakic ; Aphakic ; Dense/Long ; PMMA ; Acrylic ; Silicone.
F3 : Mode : Consecutive selection allows the user to choose between :
MANUAL; AUTO; & [ "AUTO + SAVE" only in CONTACT BASic ].
* MANUAL : FREEZING by the pedal,
storage of scans (up to 10) is also achieved manually by the "SAVE" function Key.
* AUTO - The image is frozen automatically - Storage is achieved manually.
* AUTO + SAVE - Automatic freezing and automatic storage of 10 scans.
F4 : Technique : Consecutive selection allows the user to choose between :
IMMERSION = Where a water bath “stand off” is used :
IMMERSION = thresholds at 5% and 95% (2 lines)
IMMERSION BASic = general threshold at 82% height (1 line)
CONTACT = probe in contact with the cornea.
CONTACT ADVance = thresholds at 5% and 95% (2 lines)
CONTACT BASic = general threshold at 82% height (1 line)
The PEDAL :
On a Non Frozen Picture :
In MANUAL : To freeze the image.
In AUTOMATIC : Inhibits the automatic freezing when it is pressed.
On a Frozen Picture : - Pressing more than 1 second will save the picture.
- A short press will unfreeze the picture.
P - 50 Rev. 02 / 2004
USER MANUAL
14- AXIAL - LENGTH

14-5- FROZEN A-SCANS
Once the image is frozen, the markers are automatically sited :
- In AUTO modes, the markers will always be positioned.
- In MANUAL mode, if the software criteria

are not valid, no markers will be Cor. A.C. L V A verage=27.55mm #1 :27.44
#2 :27.51
positioned. m/s 1620 1532 1641 1532
mm 0.56 3.45 3.87 19.56 #3 :28.36
#4 :28.07
#5 :27.51
#6 :27.51
The frozen image, after an IMMERSION #7 :26.83
#8 :28.05
capture is as follows : Cornea Lens Retina
#9 :27.88
#10:27.21
F1 F2 Type F3 Res. screen F4 Markers
After the A-scan is frozen, no marker is blinking and the horizontal arrows are not active
to modify the marker position.
The user must check the image and the marker positionning.
If needed, press once the Key “F4 : marker” or the Right Button of the Track-Ball to get
the first marker selected to be able to move it.
F2 : Type : Selection of the eye type : allows the user to “toggle” the following :
Phakic ; Aphakic ; Dense/Long ; PMMA ; Acrylic ; Silicone.
F3 : Results Screen : Allows access to the “BIOMETRY RESULTS ” page where the
values of all the measurements taken may be seen :
See the chapter : 14-8- BIOMETRY CALCULATION RESULTS
F4 : MARKERS : Allows the selection of the cursor which may be positioned

subsequently using the horizontal arrows of the keyboard.
The selected marker appears on the screen as a blinking overlight.
See the following chapter to adjust the markers with the Track-Ball :
Rev. 02 / 2004 P - 51
USER MANUAL
14- AXIAL - LENGTH

14-6- USING THE TRACK-BALL FOR MARKERS
If the automatic positioning is not correct, the user can move the markers :
As described in previous chapter, the key F4 : MARKERS is used to select the
marker to be moved.
The selected overlight will be blinking.
In parallel with the horizontal arrows, the Track-Ball can be used to move
the selected overlight.
Procedure to adjust the overlight position :

- Select the marker with the RIGHT button.
- Press the LEFT button with the thumb at the same time as the ball is
turned by.
TO MOVE THE MARKERS ON SCREEN :

PRESS LEFT BUTTON DURING ROTATION OF THE BALL
START #
Cine Loop
CLEAR
Rotating ball. LOOP
STOP #
Left button. Right button : press here

to SELECT a new marker.
P - 52 Rev. 02 / 2004
USER MANUAL
14- AXIAL - LENGTH

14-7- RECALLING THE A-SCANS
To review the stored A-Scans :
Press [RECALL] or [ Shift + Tab ] to scroll from #10 to #1
Press [SAVE] or [ Tab ] or [ Enter ] to scroll from #1 to #10

Screen MHz OD-OS
Prt Sc Pause
Sys Rq Break
It is possible to scroll through all the 10 scans whether they are frozen or not.
Summary :
On a frozen scan :
- " F3 : RESULTS " to go to the RESULTS Table.
- Incorrectly sited markers may be moved.
- The image may be un-frozen (Short press on pedal) to repeat acquisition.
- To Save the image, press the pedal during more than 1 second or press "Save"
On a non-frozen scan :
- Acquisition can begin depending on the acquisition mode selected :
- Manual and Auto : freeze and unfreeze until you save it.
- Auto + Save : acquisition of the available empty scans will begin.
- Technique : Contact Bas - Contact Adv - Immersion - Immersion Bas
Rev. 02 / 2004 P - 53
USER MANUAL
14- AXIAL - LENGTH

14-8- BIOMETRY CALCULATION RESULTS
The BIOMETRY RESULTS page is shown as follows :
LEFT Phakic
The Vertical arrows Average

Cor. A.C. L. V. T.L.
24.60
or [Tab] Key Vitesse 1620 1532 1641 1532 m/s
allow selection of one of the #1 0.57 2.80 4.35 16.85 24.56 mm
#2 0.57 3.03 4.06 17.01 24.66 mm
lines of the table. Stat. 2
#3 0.61 2.95 4.14 16.81 24.51 mm
#4 0.45 3.03 4.14 16.81 24.43 mm 24.67
#5 0.65 3.06 4.06 16.85 24.63 mm
#6 0.57 3.03 4.27 16.89 24.75 mm
#7 0.57 2.95 4.14 17.01 24.66 mm
#8 0.61 2.95 4.23 16.85 24.63 mm
#9 0.49 3.10 3.94 17.04 24.57 mm
#10 0.57 2.99 4.18 16.89 24.63 mm
S.D. 0.09 0.08 0.09 mm

AVG. 3.55 4.15 16.90 24.60 mm
F1 F2 Erase all F3 Ignore F4 Res. choice
F2 : Erase All :
Allows access to the acquisition page after deleting all the scans. The operator
can repeat the acquisition of all echograms.
F3 : Ignore / Include :
Allows the user to remove the set of values on the line shown.
The line number of the removed will then be shown in normal video instead of
reverse video : They will not be taken into account for the calculations.
Note 1 : A line with all numbers at Zero is automatically ignored. The Average
is not taking in account this line unless the user includes it. Even in this case the
printing will ignore it.
Note 2 : The ignored lines will be erased if the user comes back to the Axial-L
acquisition. Then a new acquisition of the ignored scans is possible.
F4 : Result Choice : Selection for the IOL Calculation :"Average" or "Stat-2".

The selected result (in reverse video) will be taken for the IOL Calculation, if the
IOL calculation is called from this page.
See following page.
[ ESC ] or [ F6 ]: To quit the Results table and to come back to the selected A-scan.
P - 54 Rev. 02 / 2004
USER MANUAL
14- AXIAL - LENGTH

14-9- STAT-2 CALCULATION
Remarks :
- The longer anterior chamber corresponds to a lower pression on the eye
when the Biometry is done in Contact Technique.
- The smallest vitreous is corresponding to the sharpest retinal echo, so a
probe position perpendicular to the retina.
- The "Stat-2" combines 2 echograms considering the following segments :
[ the longest value of (Cornea + Ant. Chamber + Lens) ]
+ [ the shortest vitreous length ].
Example below :
* the longest value of [Ant. Chamber + Lens ] :
see line #6 : 0.57 + 3.03 + 4.27 = 7.87 mm
* the shortest vitreous length :
see lines #4 : 16.81 mm
In this example : Stat-2 = 7.87 + 16.61 = 24.68 mm
Note : the result may have a difference of 0.01 mm because the unit takes the
numbers with more than 2 decimals for the calculation and then the rounded value is
made after the addition.
LEFT Phakic
Average
Cor. A.C. L. V. T.L.
24.60
Vitesse 1620 1532 1641 1532 m/s
#1 0.57 2.80 4.35 16.85 24.56 mm
#2 0.57 3.03 4.06 17.01 24.66 mm
Stat. 2
#3 0.61 2.95 4.14 16.81 24.51 mm
#4 0.45 3.03 4.14 16.81 24.43 mm 24.67
#5 0.65 3.06 4.06 16.85 24.63 mm
#6 0.57 3.03 4.27 16.89 24.75 mm
#7 0.57 2.95 4.14 17.01 24.66 mm
#8 0.61 2.95 4.23 16.85 24.63 mm
#9 0.49 3.10 3.94 17.04 24.57 mm
#10 0.57 2.99 4.18 16.89 24.63 mm
S.D. 0.09 0.08 0.09 mm

AVG. 3.55 4.15 16.90 24.60 mm
F1 F2 Erase all F3 Ignore F4 Res. choice
Rev. 02 / 2004 P - 55
USER MANUAL
14- AXIAL - LENGTH

14-10- PRINTING BIOMETRY PAGES
14-10-1- VIDEO PRINTER :
To print either one of the 10 echograms or the table of results :
Select the screen and Press the PRINT key :

Screen MHz OD-OS
Prt Sc Pause
Sys Rq Break
The screen displayed will be printed with the addition of the DATE and the
PATIENT NAME.
If the printer connected is a SONY, and if the REMOTE cable is connected the
printing will be performed automatically.
If the REMOTE cable is not connected or if the printer is a different model, follow
the instructions on screen :
in this case, it is necessary to press the PRINT button on the printer.

Cor. A.C. L V Average=27.55mm #1 :27.44
m/s 1620 1532 1641 1532 #2 :27.51
mm 0.56 3.45 3.87 19.56 #3 :28.36
#4 :28.07
#5 :27.51
#6 :27.51
#7 :26.83
#8 :28.05
#9 :27.88
#10:27.21 The symbol "µs"
indicates that the
visualized scale is in
microseconds.
µs Note : In B-mode, the

Quantel Medical Cinescan S V : 5.xx
visualized scale is in
DATA NAME PATIENT IDENTIFICATION Oct/09/2002 millimeters : "mm".
P - 56 Rev. 02 / 2004
USER MANUAL
14- AXIAL - LENGTH

14-10-2- PARALLEL PC STANDARD PRINTER :
PC Standard printer may be connected to the parallel port of the Cinescan S.
In the SETUP screen, " Parallel output " field, select the printer type.
The choice is the following :
- not used - no graphic - H.P. - Epson / Canon - Epson / Canon / HP/P2 -

Screen MHz OD-OS
Prt Sc Pause
Sys Rq Break
When a parallel printer is selected and you press "Print" key, this printer will be
used in the following pages :
- the axial length screen
The printout will have the patient data and the Biometry of both eyes.
- the IOL caculation screen
The printout will have the patient data, the Biometry and the IOL calculation
of both eyes
The others pictures, B-scan or Standardized A-scan will be printed on the video
printer.
Rev. 02 / 2004 P - 57
USER MANUAL
VALIDATION SHEET
SOFTWARE VERSION Version : S 5.xx
Publishing date February 2004
Revision date February 2004
Written by C. TCHA
Checked by J. ABASCAL
Validated by P. QUERO
P - 58 Rev. 02 / 2004

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Ophthalmic Echography

XE BSS SC MES AN FEBRUARY 2004

WARNINGS AND CAUTIONS

See General purpose User Manual for guarantee conditions.

WARNINGS AND CAUTIONS

Warning : This device is not intended for foetal use.

P-4 Rev. 02 / 2004

TABLE OF CONTENTS P-5 X

7- BIO-2 ; QUANT-I & ANGLE KAPPA

10- AUTOMATIC PRINTING P - 30

P-6 Rev. 02 / 2004

1-1 SETUP THE UNIT TO YOUR OWN CONFIGURATION

F1 Gral SETUP F2 T-S Determ F3 F4 USER Setup

Use the [Tab] arrow to select the field to be modified

A.C. : Ant. chamber

Mode : (freezing mode) - Manual ; Auto and Auto+save.

P-8 Rev. 02 / 2004

All the parameters can be modified within the input limits.

* "Reference" : IOL Reference from the manufacturer. Use the Keyboard

Haigis constants default values :

To escape from the IOL file : press [ ESCape ] key.

NOTE : It is always possible to come User

F1 Gral SETUP F2 T-S Determ F3 F4 USER Setup

After any change of unit or probe, this procedure must be completed.

Maintain the probe

Std-A Probe - Set the probe vertical on the tissue

Note 1 : the picture cannot be frozen.

[F1: Auto T] and wait during the automatic

- Press [F3: Results] to access table of

AVERAGE T= XX.XdB' value.

The Gain modifies the picture from the

In the left picture the Gain is too low.

The right pattern must be a linear

F1 Auto T F2 Store F3 Results F4 Enter T

T.S. (dB) T=80.8dB AVG:

The gain is too high

F1 Auto T F2 Store F3 Results F4 Enter T

T.S. (dB) T=77.4dB AVG:

- When the right Gain is found (left

Note : The "T" value will be stored and

Escape B A EYE PATIENT B SAVE PRINT RECALL

Tissue Sensibility has to be determined

Press any key to continue...

Follow the procedure described in the previous chapter.

CINELOOP Non-FROZEN IMAGE CINELOOP FROZEN IMAGE

Cineloop RIGHT ORBIT T= 77.5 dB Cineloop RIGHT #200/200 ORBIT T= 77.5 dB

Functions which are not concerned UnFreeze

Functions with no Cineloop Save to the Save to the Save as ...

These functions do not need the Cineloop record :

F2 : To access Quantitative-II program. Cineloop RIGHT ORBIT T= 77.5 dB

F3 : To come back to the Tissue Sensitivity

F4 : To enter the AXIAL-LENGTH Functions which are not concerned

A1 QUANT-II Gain = T AXIAL Length

Functions with no Cineloop

Press [Alt] key to choose Zoom : Alt Ctrl

'ORBIT' (80 µs) - 'EYE' (40 µs) - '20µs' ZOOM

Cineloop RIGHT #200/200 ORBIT T= 77.5 dB

Save to the Save to the Save as ...

F1 : To fix the Gain or to be able to vary it.

F2 : To access the A-scan only.

F3 : To access the following functions :

F4 : To access PROFILE screen (Orbit expansion only).