An Essential Instrument for Ophthalmic Surgeons

The decision to purchase capital equipment is never an easy one, particularly when the chief decision-maker is the sole owner of the practice, as I am. Cost is an important factor to consider, but the deciding factor for me is value. Will this equipment enable me to deliver state-of-the-art care? Will it enhance the patient’s experience? Will it add efficiencies to my practice? Will it last and stand the test of time?

All of these considerations came into play when I was evaluating OCTs to add to my practice. After extensive research, I chose Topcon Healthcare’s Maestro2 Robotic OCT Fundus Camera. Here are the Maestro2 features that impressed me early on and continue to add value to my practice every day.

Innovative Technology

The ability to acquire an OCT scan and a color fundus photograph in one sitting is certainly advantageous for any busy practice. Performing these functions using sophisticated robotic technology takes efficiency to the next level. With a single touch, the Maestro2 automatically aligns, focuses, and optimizes image quality. It can capture widefield scans that encompass the macula and the optic disc as well as anterior segment photographs and OCT scans.

Excellent Image Quality

The Maestro2 captures exceptional images, far better than those produced by any other OCT I’ve used to date, and data acquisition is much faster than anything we’ve had in our office. The true-color fundus images are not only high quality, but also clinically useful. With the Maestro2, I can view a 3D reconstruction of the surface of the macula, and I can also view the visual cuts at a very high resolution and scroll through them. I also find the integrated anterior segment camera and OCT very useful for imaging the angle and the cornea.

A Wealth of Essential Information

The Maestro2 generates an extensive array of reports. The 12mm x 9mm 3D Wide Report encompasses the macula and the optic nerve and includes a 45° true-color fundus photograph, optic disc metrics, ETDRS macular, and retinal ganglion cell/RNFL thickness maps with reference data. The Maestro2’s 12x9 scan also produces the Hood Report for glaucoma structure and function analysis, as well as various trend reports that facilitate monitoring a patient’s status over time, whether it’s their nerve or retina.

The capability to simultaneously capture an OCT image and a fundus photograph provides me a reference point for seeing pathology on the OCT. Particularly for my glaucoma patients, it’s nice to be able to track their optic nerves. It also enables me to see major diseases in the retina. For example, I can see a hemorrhage or exudate at the same time the OCT is being captured. There’s no need for a separate photograph, which is a real time-saver.

In addition to cataract and refractive surgery, my practice also encompasses corneal transplantation. The Maestro2 is an invaluable aid for monitoring patients postoperatively. For example, if the cornea of a post partial corneal transplant patient remains edematous, Maestro2 provides the information I need to verify the location of a graft separation. I also rely on data from the Maestro2 to monitor thin corneal ulcers and document the level of loss over time. The Maestro2 provides the relevant clinical data that I need to make well-informed treatment decisions and provide optimal care for my patients (Figure).

Fast and Intuitive

With previous generations of OCTs from other manufacturers, the emphasis was on highly-trained technicians. The patient would sit across from the tester, who would visualize the retina and bring it into focus manually. Contrast this with the Maestro2, which aligns the patient and focuses and captures the images automatically. It’s easy to learn and operate, and image capture is consistently fast and accurate.

My technicians love the Maestro2, so much so that we now have a Maestro2 in each of my offices. Not only does the Maestro2 streamline our workflow, but it also captures high-quality images quickly and on the first try. This significantly lowers the stress level for my staff. In fact, the Maestro2 is so easy to use that I can easily step in and operate it myself if my technicians are busy. This has helped out my staff and improved morale.

I also like that the Maestro2 has a small form factor. It can be placed against a wall facing out, so that it takes up less space than other OCTs, and the tester and the patient can be on the same side of the device, reducing the footprint by half.

Improved Patient Experience

The Maestro2 is a brief test for most patients, and that, in itself, increases their comfort. They don’t have to sit in awkward positions for prolonged periods and experience multiple flashes in their eyes while images are captured.

The Maestro2 is also beneficial for educating patients. With the included IMAGEnet6 software, I can set up viewing in my examination room and pull up 3D images, raw data, and reports to share with patients and family members.

Interestingly, I’ve found that patients do take notice when we upgrade our equipment. They often marvel at the robotics of the Maestro2. One of my patients is a former engineer and commented on how the Maestro2 is futuristic. He was impressed with how the Maestro2 automatically positions itself and the feedback sounds it makes as it glides into place.

Beyond their fascination with the technology, patients are impressed that we’re investing in the practice in order to provide the best possible care for them. In this day and age, patients are no longer surprised by high tech, they expect it.

Advanced Technology That’s Versatile and Reliable

The OCT is the workhorse imaging device in most ophthalmologists’ offices, and as such, we expect our OCT machines to perform reliably over the long term. Topcon has been in the eye care industry for decades—I’ve been using their products ever since I was a resident—and the company has a reputation for quality, so when I was in the market for a new OCT machine, it was only natural that I considered a Topcon product.

The Maestro2 checked off all of the boxes to meet the needs of my medium-sized practice. Despite its compact size, it is packed with features that quickly perform multiple tasks with ease. I feel Topcon went above and beyond to build a machine that provides so much functionality at an affordable price point.

I would add that I’ve received great support from Topcon as we integrated the Maestro2 into my office and learned how to use it most effectively. The company is sensitive to the needs of ophthalmologist-owned practices.

Many products are available in the marketplace, but I believe the Maestro2 is a well-designed machine that consistently performs at a high level. I would encourage anyone considering adding an OCT to their practice to seriously look at the Maestro2. The quality of the product, its versatility, ease of use, efficiency, and reliability enable me to maintain focus on my patients and provide optimal care.