Left eye
Arc 1 Axis
Arc 2 Axis
Incision 1
Arc 1 Length
Arc 2 Length
Incision 2
Patient information
Date of birth
Date
Month
Year
Patient ID
Notes
Eye
PRE-OP BCVA
PRE-OP UCVA
Refraction
Sphere
Cylinder
Axis
Parameters
Tunnel
Inner diameter
Outer diameter
Depth
Outer cut
Diameter
Depth
Inner cut
Diameter
Depth
NON-FEMTO
Segment width
Segment depth
Surgeon
CUSTOMIZATIONS
INTRAOPERATIVE PLAN
Patient initials
DATE OF BIRTH
00 / 00 / 0000
PATIENT ID
LEFT OR RIGHT EYE
LEFT
Surgeon name
Channel
Width
Inner diameter
Outer diameter
Implant 1
Central axis
Cw limit
ccw limit
Implant 2
Central axis
Cw limit
ccw limit
Some notes