Laser Vision Correction for Myopia, Myopic Astigmatism, Hyperopia and Hyperopic

Astigmatism with CustomVis Solid State Laser (213nm)

THE ROYAL AUSTRALIAN AND NEW ZEALAND THE ROYAL AUSTRALIAN AND NEW ZEALAND COLLEGE OF OPHTHALMOLOGISTSCOLLEGE OF OPHTHALMOLOGISTS

24 – 28 NOVEMBER, 200724 – 28 NOVEMBER, 2007

Dr. Ian AndersonDr. Ian Anderson

Dr. Paul van SaarloosDr. Paul van Saarloos

Dr. Gabriel MarinDr. Gabriel Marin

Dr. Tarak PujaraDr. Tarak Pujara

PurposePurpose

To evaluate the clinical efficiency, predictability and To evaluate the clinical efficiency, predictability and safety of a new high speed, 0.6 mm Gaussian shaped safety of a new high speed, 0.6 mm Gaussian shaped flying spot, 213nm solid state laser for the correction flying spot, 213nm solid state laser for the correction of myopia, myopic astigmatism, hyperopia, hyperopic of myopia, myopic astigmatism, hyperopia, hyperopic astigmatism in laser in situ keratomileusis (LASIK).astigmatism in laser in situ keratomileusis (LASIK).

All Lasiks performed at eight international sites.All Lasiks performed at eight international sites.

Compare these results to personal results using Compare these results to personal results using Advanced Surface Ablation ( PRK, Lasek & eppi-Advanced Surface Ablation ( PRK, Lasek & eppi-lasek)lasek)

Data collection done by ophthalmic assistant.Data collection done by ophthalmic assistant.

CustomVis™ Pulzar™ Z1

  

Solid State Laser Source

Diode-pumped Nd:YAG laser

Three non-linear crystals generate the 213nm wavelength

Eliminates need for toxic gases and storage

Energy efficient; no high voltage requirements

Low maintenance

UV Spectrum

BSS Transmission (%)

Depth (µm)

100

50

0

250 500 750 (Dair et al., 2001)

213nm has a significantly higher

transmission through 0.9% NaCl and BSS

than 193nm

(Jain et al., 2004; unpublished data)

UV Wavelengths (220nm – 190nm)

0.9% NaCl Transmission

213nm

193nm

213nm transmits 1620 times more than 193nm in 0.9%NaCL

ZCAD Treatment PlanningZCAD Treatment Planning

ChoicesChoices Optical Zone/ Treatment zoneOptical Zone/ Treatment zone Blend type :-Blend type :-tissue saving, refractive, lineartissue saving, refractive, linear

Treatment :- Treatment :- Standard, Topography, WavefrontStandard, Topography, Wavefront

ReviewReview Post operative topographyPost operative topography Post op Residual thickness mapPost op Residual thickness map

LASIK PatientsLASIK Patients 436 eyes with myopia up to -14.5 D and astigmatism 436 eyes with myopia up to -14.5 D and astigmatism

up to -5.5 D.up to -5.5 D.

195 eyes with hyperopia up to +6 D and mixed 195 eyes with hyperopia up to +6 D and mixed astigmatism up to -6.5 D.astigmatism up to -6.5 D.

All Underwent Laser Vision Correction at eight All Underwent Laser Vision Correction at eight different sites.different sites.

All cases were followed for minimum 3 months.All cases were followed for minimum 3 months.

All data were collected by Ophthalmic Assistants All data were collected by Ophthalmic Assistants and were evaluated by all surgeons.and were evaluated by all surgeons.

Surface Ablation PatientsSurface Ablation Patients

62 Eyes with myopia up to -6D and 62 Eyes with myopia up to -6D and astigmatism up to -4Dastigmatism up to -4D

Majority with abnormal corneasMajority with abnormal corneas Less than 500micronsLess than 500microns Irregular astigmatismIrregular astigmatism Scarring, RK, PKScarring, RK, PK Recurrent ErosionsRecurrent Erosions Very Large pupilsVery Large pupils

Lasik

Myopia and Myopic Astigmatism (SE ≥ -15D)

With minimum 3 months follow-up (n=436)

Note: The graph has some overlapping points

LASIK Visual Results

Myopia and Myopic AstigmatismMyopia and Myopic AstigmatismAttempted vs Achieved CorrectionAttempted vs Achieved CorrectionUCVAUCVA

Lasik

Hyperopia and Mixed Astigmatism

Post-Op UCVAAt latest follow-up of 3 months (n=195)

UCVA Attempted Vs Achieved

SummarySummary Myopia/ Astigmatism Myopia/ Astigmatism LasikLasik SurfaceSurface

LASIK LASIK 84%84% ((95%)95%)were were ± 0.5 D and ± 0.5 D and 98%98% (100%) (100%) were ± 1 D of intended correctionwere ± 1 D of intended correction

Uncorrected Visual Acuity 6/6 in Uncorrected Visual Acuity 6/6 in 74%74% (75%) (75%) and and 6/12 was achieved in 6/12 was achieved in 88%88% (98) (98) of eyes.of eyes.

BSCVA was improved by 1 line in 22 eyes and no BSCVA was improved by 1 line in 22 eyes and no eye lost over 1 line of BSCVA.eye lost over 1 line of BSCVA.

Hyperopia/ AstigmatismHyperopia/ Astigmatism

68% were ± 0.5D and 88% were ± 1D of intended 68% were ± 0.5D and 88% were ± 1D of intended correctioncorrection

86% of 195 Hyperopic cases had 6/6 UCVA post 86% of 195 Hyperopic cases had 6/6 UCVA post operatively.operatively.

ConclusionsConclusions

The Clinical Data supports the safety, predictability The Clinical Data supports the safety, predictability and effectiveness of the PULZAR Z1 Solid State and effectiveness of the PULZAR Z1 Solid State Refractive Laser (213nm) for the correction of a Refractive Laser (213nm) for the correction of a whole range of refractive treatments including high whole range of refractive treatments including high myopia, hyperopia and mixed astigmatism using myopia, hyperopia and mixed astigmatism using both Lasik and Surface Ablation.both Lasik and Surface Ablation.

CustomVis™ Pulzar Z1 laser system is a good CustomVis™ Pulzar Z1 laser system is a good alternative to conventional Excimer systems.alternative to conventional Excimer systems.

Thank YouThank You

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