Control console default light is on when powering on
This may occur if the RED emergency stop button at the lower right corner of the control console front panel has been pushed in. Power off, pull emergency stop button out, then power on again.
Control console shows default despite previous action
Do not use console. Contact vendor.
The suction cup is deformed or damaged
Do not use unit.
The push rod is not in its pre-set location
Do not attempt to reset push rod. Do not use unit.
No audible click is heard and felt by the surgeon when the Zepto tip is elongated using the finger slider
Do not use unit.
The roller dispenser is not pushing OVD/BSS to release Zepto off the capsule
After capsulotomy, Zepto is designed to be released from the capsule by using the roller dispenser to push OVD/BSS back into the suction cup and float Zepto off the capsule. If this release mechanism does not work, release may be achieved by first disconnecting the suction tubing from the isolator and then moving the roller dispenser back to its original position. A syringe filled with BSS is then connected to the suction tubing and BSS is introduced slowly by pushing on the syringe plunger with the surgeon observing through the microscope. Zepto release is confirmed when OVD/BSS is observed exiting the corneal incision (or if air bubbles are observed in the eye in the case where the suction line was not properly filled with BSS during initial device set-up).
Iris tissue is interfering with Zepto withdrawal from the eye
A second instrument may be used through the sideport to hold down and move iris tissue away from the Zepto tip. In addition, OVD may be introduced through the sideport to push down and separate iris tissue from the Zepto tip.
I am having incomplete capsulotomies, what’s happening?
Good apposition of the bottom edge of the nitinol capsulotomy ring with the lens capsule is essential. Check that the push rod is all the way out and full suction is being delivered. After maximum suction is achieved, wait 5-7 more seconds before delivering the capsulotomy energy. The tendency is to be too quick. Develop a consistent steady pace as you go through the steps for zepto use.
I got an anterior capsule tear after removing Zepto from the eye
This is typically caused by inadequate release of zepto from the capsule. Make sure sufficient time is allowed for the OVD and BSS to be pushed back into the zepto suction cup to float it off the capsule completely. Look for some OVD/BSS escaping from the corneal incision as this will indicate that Zepto is off the capsule and ready to be removed from the eye.
A tear developed later in surgery, what happened?
Zepto’s unique capsulotomy edge is slightly ‘rolled-up’ and has been demonstrated to be 2-4X stronger than the capsulotomy edges created by CCC or by femtosecond laser. (Thompson et al 2016 PDF). This strong rolled-up edge is produced by a combination of the way energy is delivered in the presence of suction. Inadequate suction, for example resulting from the push rod being left inside the neck or a kink in the suction line, will prevent full suction and the strong rolled up edge may not form. Adequate suction is the key to success with Zepto.