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news
Topics Issue 2/ 2007
Market launch for the SCHWIND AMARIS 1-2
Multi-center LASIK study: Excellent results with the SCHWIND AMARIS 2-3
Innovation offensive: Research & Development achieved technological quantum leaps 4-5
The others must measure against it: Reference doctors rate the SCHWIND AMARIS 6-8
Market launch for the SCHWIND AMARISTotalTech Laser introduced for the first time at the ESCRS 2007
Faster, stronger, more precise: At
the ESCRS Congress (European Society
of Cataract and Refractive Surgeons)
in Stockholm, SCHWIND eye-tech-
solutions presents a new excimer laser
generation, redefining perfection in
refractive corneal surgery. ”With the
SCHWIND AMARIS, we have developed
an all-rounder with unmatched high
performance, thereby offering an extra-
ordinarily high level of accuracy and
the first and only laser to combine all
available state-of-the-art technologies
in one system“, says CEO Rolf Schwind.
The ”TotalTech Laser“ impresses
through a true pulse frequency of
500 Hz and, with two automatically
adapted fluence values, ensures
perfect ablation control. Depending on
the refraction to be corrected, approxi-
mately 80 percent of the corneal
ablation is performed with a high
fluence level, thus speeding up the
treatment. Fine correction takes place
with a low fluence level, improving
the resolution. With this intelligent
process, the laser treatment is signifi-
cantly shortened, especially when
higher refractions are corrected, and
at the same time carried out with
exceptional precision. The correction
of one diopter takes on average less
than 2.5 seconds with the SCHWIND
AMARIS. Thereby, the stroma is pre-
served through thermally optimized
laser pulse distribution.
SCHWIND AMARIS – unmatched high performance
Two automatically adapted fluence values
news
page 2 of 8 Issue 2/2007
Five-dimensional eyetracking
1050 Hz turbo eyetracker
An eyetracker must work at a signifi-
cantly higher frequency than the laser
in order to safely allow a very short
ablation time. The SCHWIND AMARIS’
1050 Hz turbo eyetracker, with a
response time of less than three milli-
seconds, serves to provide unsur-
passed precision in the positioning
of each laser pulse. The extreme speed
and other groundbreaking features,
Innovative particle aspiration system
such as rotation balance, limbus
tracking and static as well as dynamic
cyclotorsion control, ensure exact
compensation of every eye movement,
on into the fifth dimension.
Safe and comfortable
The Treatment Assistant Manager
software module, especially devel-
oped for the SCHWIND AMARIS, guides
through the treatment safely and
comfortably. Each treatment step is
defined: The default settings are set
at levels that are practical for the
surgeon, but can also be changed
or expanded and saved. With the
particle aspiration system, developed
on the basis of comprehensive flow
analysis, energy-reducing particles are
efficiently removed during ablation.
This concept of maximum safety is
completed through the integration of
high-resolution online pachymetry.
Unique ergonomic advantages that
optimize the treatment process are
also included. The laser arm and
the patient bed, for example, can be
swiveled 90°. This makes patient pre-
paration and the combination with
other medical devices easy and com-
fortable. The treatment monitor is
adjustable in any direction – assisting
personnel can work with it comfortably
too.
Excellent results already after only one monthThe first international multi-center LASIK study with the SCHWIND AMARISExcellent visual acuity, extremely high
predictability and low variance in
results: These were substantiated in
one-month results of a recent multi-
center LASIK study in which the new
excimer laser generation SCHWIND
AMARIS was employed for the first
time. The study was carried out on
389 eyes by SCHWIND reference sur-
geons Maria-Clara Arbelaez, MD,
Oman, Ioannis Aslanides, MD, Greece,
Francesco Carones, MD, Italy, Tobias
Neuhann, MD, Germany, as well as
Alena Feuermannova, MD and Pavel
Rozsival, MD, Czech Republic. Treated
patients were myopes, either pure
or with astigmatism, between 18 and
60 years of age. The preoperative
spherical equivalent (SEQ) ranged
from -0.50 D to -8.25 D, and astig-
matism was treated up to -5.00 D.
All patients were corrected with
SCHWIND’s „Aberration-Free“ treat-
ment.
Issue 2/2007 page 3 of 8
Postoperatively, an average SEQ of
- 0.16 with a very low standard
deviation of 0.25 D was observed. In
74 percent of all treated eyes, the
planned refractive result was achieved
within a minimum deviation of ± 0,25
already after one month. 93 percent
were in the range of ± 0.50 D and
100 percent of eyes within ±1.00 D
(see figure 1). High postoperative
stability was already observed after
one week. This very rapid convergence
toward the planned refractive result
implies that the recovery time after
surgery with the SCHWIND AMARIS
is very short.
Again after only one month, more
than 92 percent of treated patients
attained post-operative uncorrected
visual acuity (UCVA) of 20/20 or better.
No single patient eye realized a
visual acuity of less than 20/32. In 99
percent, an UCVA of 20/25 or better
was achieved. More than 32 percent
of study participants even achieved
visual acuity of 20/16 or better (see
figure 2).
Altogether, only very slight scattering
of results was observed and no trend
toward over- or undercorrections
was detected after only one month.
All results were obtained without the
use of individual nomograms.
summed up Dr. Maria-Clara Arbelaez,
Oman, at the presentation of the
multi-center study on the occasion of
the ESCRS 2007 in Stockholm.
„In my opinion, the extraordinary
performance of the SCHWIND AMARIS
decisively contributed to the excellent
clinical results that we have seen so far“,
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news
page 4 of 8 Issue 2/2007
Innovation offensive with the SCHWIND AMARISResearch & Development achieved technological quantum leaps
developed eye model translates linear
detected movements into horizontal
and vertical rotations. Innovation is
also demonstrated by the unique
particle aspiration system, whose
concept is based on comprehensive
flow analysis by SCHWIND. Energy-
reducing particles are efficiently
removed during ablation. In order
to minimize energy losses, the
engineers furthermore developed a
completely enclosed beam path under
vacuum.
From the left: Thomas Klinner, and Thomas Hollerbach, Research & Development department,working on development of the eyetracker camera
The new excimer laser generation,
SCHWIND AMARIS, impresses with a
multitude of groundbreaking inno-
vations. From the very beginning, the
development activities for this ambi-
tious project concentrated on setting
new outstanding technological and
clinical standards in refractive surgery.
SCHWIND engineers with different
specializations, mathematicians and
physicists worked towards a single
goal: To realize the maximum of
today’s technological possibilities and
to integrate the experience gained
through the up to now successful
laser generations from SCHWIND.
The development process started
with a strategic idea management – in
close partnership with internationally
renowned refractive surgeons. Here,
SCHWIND experts acted as ´Trend
Scouts´. “We explored and achieved
long-term sustainable, technological
quantum leaps“, says Thomas Holler-
bach, Head of Research & Develop-
ment department. This included an
comprehensive risk analysis and the
development of sustainable solutions.
The outcome was, for instance, a
unique technique, that safely allows
the realization of significantly shorter
treatment time. Two automatically
adapted fluence values ensure per-
fect ablation control. Depending on
the planned refractive correction,
approximately 80 percent of the cor-
neal ablation is realized with a high
fluence level in order to accelerate
the treatment. The fine correction
takes place with a low fluence level.
Rotation balance
Another groundbreaking development
is the rotation balance in the 5-D
Eyetracker, through which so-called
„eye rolling“ is for the first time
compensated. Therewith, a SCHWIND-
Issue 2/2007 page 5 of 8
High stability
SCHWIND has redefined perfection in
every detail: The SCHWIND AMARIS’
high-end microscope, developed
especially for use with excimer lasers
and with a 14° stereopsis, suits
natural, threedimensional vision and
delivers very good contrast, true
color brilliance and a superior depth
of focus. High flexibility also ranks
among the core characteristics of
the all-rounder. Both the laser arm
and the patient bed can be swiveled
independently.
The entire construction was carried
out three-dimensionally in order to
allow the performance of optimal soft-
ware-supported material and load
analysis from the very beginning. This
ensured – already in the planning
phase – extremely high mechanical
stability of the laser. A team of 20
experts ensured the ideal union of
unequaled cutting edge technology,
ergonomic design and, oriented toward
a requirement of everyday treatment
standards, high user-friendliness. The
complete conception and development
of control and application software
took place in-house. Smaller tasks
such as, for example, the layout deve-
lopment of circuit boards, were out-
sourced to competent external part-
ners. SCHWIND AMARIS’ main control
processor runs on the basis of Debian-
Linux – an operating system that is
also employed in aviation due to its
high stability.
Low service costs
Another requirement in construction
and hardware has been to make it
easy to maintain as well. The laser
control system was modularly built
and is distributed among several con-
trol units. Correspondingly, upgrades
are easy to perform: They require
only on a small scale exchange or
modification of parts. The laser head
can be swiveled and must not be
removed for maintenance. Such well
thought-out concepts keep the amount
of work and service costs low. An
important part of the development
process is made up of validation and
documentation. Thanks to rapid and
successful integration, the laser could
be brought into series production
within only a short time. The result:
The SCHWIND AMARIS carries the
European CE-mark, as well as the
certification of other international
safety standards and can therefore
be immediately used virtually word-
wide.
Thomas Bader, Research & Development, constructs a flow analysis for the particleaspiration system
Swivelinglaser arm
news
page 6 of 8 Issue 2/2007
After performing more than 37,000
excimer laser refractive surgeries with
different excimer lasers, including the
latest 10.000 cases done with the
SCHWIND ESIRIS, which gave me the
answer to treat simple and very com-
plex cases using the SCHWIND-CAM
platform, such as ”Aberration-Free”
based treatments, ocular wavefront
based treatments and corneal wave-
front based treatments with excellent
results: I was recently able to perform
550 consecutive cases with the new
generation SCHWIND AMARIS excimer
laser and would like to say what this
name means to me:
Intelligent – There are built-in fea-
tures that make this machine very
smart and user friendly, with software
that guides you step by step. There is
a high resolution stereoscopic micro-
scope, slit focusing illumination,
integrated online pachymetry (OCP)
and a slit lamp.
Safe – The knowledge, the experience
and the results obtained previously
with the SCHWIND-CAM software, are
used and built into the SCHWIND
AMARIS profiles. This means minimal
need for nomograms and no surprises
with the results.
My results with the SCHWIND AMARIS
are amazing so far! More than
amazing! Previously, our re-treatment
rate was 2%. With the new system, we
can already see with the early results,
that it is far lower.
Contact: Maria Clara Arbelaez, MDMedical DirectorMuscat Eye Laser CenterMuscat, Oman – Phone +968 24691414Email: [email protected]
The others must measure against itReference doctors rate the SCHWIND AMARIS
Advanced – The SCHWIND AMARIS
is a super fast excimer laser with a
0.54 mm SuperGaussian profile at true
500 Hz repetition rate and automatic
fluence adjustment (high and low
fluence levels accordingly with the
planned correction), with a 1050 Hz
turbo eyetracker considering static
and dynamic cyclotorsion (5D) and
detection of both iris and limbus.
Multifunctional – On the same system
I have the possibility to perform
”Aberration-Free” treatments, ocular
wavefront treatments, corneal wave-
front treatments and pachymetry-
assisted lamellar corneal surgeries.
Anatomic design that makes it very
easy to use and handle, all controls
are well placed and easy to reach
and manipulate. The laser arm can
be swiveled 90°, giving space for the
patient and for other instruments in
the operating room.
Reliable – The particle aspiration
system gives a totally stable climate
around the eye that makes the system
fully independent from the environ-
mental conditions and air flow.
Maria Clara Arbelaez, MD
Issue 2/2007 page 7 of 8
I had the opportunity to use five different
laser platforms in my career. SCHWIND
AMARIS opens up a new dimension in
safety and quality and fulfills highest
expectations both in patient care and
clinical demands – redefining, what
state-of-the-art in contemporary re-
fractive surgery is. We now have a
laser platform of a totally new genera-
tion available, that includes unparal-
leled, highly sophisticated technology
both on theoretical and practical level.
You work with a 500 Hz repetition rate
and a 1050 Hz Eyetracker, which is the
absolute theoretical and safe match
regarding a state of the art machine.
This makes this system not only safe
but as well significantly shortens treat-
ment time precluding most potential
problems – especially in high ametro-
pias - where every single detail plays a
major role for the final outcome. Due
to the laser beam profile a very smooth
ablation is achieved, which leads to a
very quick healing in surface treat-
ments. The SCHWIND AMARIS combi-
nes high speed with relatively less
energy compared to competitor laser
systems. That makes the system safe
and effective. It’s definitely a new era:
The system has taken care of tracking
and cyclotorsion problems and it
moved all safety features to a higher
quality stage. The SCHWIND AMARIS
addresses the needs of high-volume sur-
geons and of medium-volume surgeons
as well: It optimizes the workflow and
it’s easy to follow - you are guided
through the process and therefore also
not very experienced surgeons will find
it easy to use. SCHWIND AMARIS, apart
from being an excellent primary treat-
ment platform, due to its unique charac-
teristics in combination with the highly
precise corneal wavefront analysis is
also an invaluable retreatment tool and
completes a comprehensive package
for any competitive refractive surgeon.
Contact: Ioannis M Aslanides, MDAssistant Clinical ProfessorWeill Cornell Medical College, New YorkMedical Director Emmetropia Mediterranean EyeInstitute,Crete,Greece – Phone +302810226198Email: [email protected]
I had the opportunity to use seven
different laser systems. I like the
SCHWIND AMARIS, in particular, be-
cause it gives the refractive surgeon
full flexibility regarding the potential
for treatments, whether they be
aberration-free, topography-guided or
wavefront-guided custom ablations.
From my point of view, the extreme
reliability in the interaction of ablation
speed and eyetracker is the most
interesting feature for the surgeon.
For the patients the most obvious
appealing point is that they only have
to stay under the laser for a few
seconds. The minimized treatment
time does not cause any kind of
anxiety because there is not enough
time to develop any kind of worry. That
is the case for high refractions as
well as for low refractions. For lower
corrections, it takes only 3 or 4
seconds; for higher corrections it
takes about 20 seconds – not time
enough for getting them worried.
Although the clinical results with
the SCHWIND AMARIS are still pre-
liminary, I’m impressed by the imme-
diate postoperative “day one” results:
The vast majority of my patients had
a best corrected visual acuity of 20/20
or better. From this we can draw the
conclusion that the recovery time with
the SCHWIND AMARIS is very short.
Furthermore, I like very much the
ergonomics of the new laser. The
positioning of the surgeon is very
Ioannis M Aslanides, MD
Francesco Carones, MD
page 8 of 8 Issue 2/2007
ImprintSCHWIND eye-tech-solutions GmbH & Co. KG · Mainparkstrasse 6-10 · D-63801 Kleinostheim · www.eye-tech-solutions.comEditor: Antje Splittdorf · fon: +49 (0) 60 27 – 5 08-164 · email: [email protected]
good. With other laser systems you are
close to the laser, but many controls
are pretty much far away from your
sitting position. Not with the SCHWIND
AMARIS. You work in a convenient
position almost like in a comfortable
driver seat in a car – all your operatio-
nal controls are very easy to reach
and clearly arranged.
The swiveling laser arm provides
several advantages such as comfor-
table patient preparation. The storing
of the laser arm in the parking position
gives smaller eye clinics the oppor-
tunity to use the space for other
purposes. Moreover, you can use the
same operating room and position for
performing a cataract surgery.
Contact: Francesco Carones, MDMedical DirectorCarones Ophthalmology CenterMilan, Italy – Phone +3902 76318174Email: [email protected]
My general impression: The SCHWIND
AMARIS is an excellent all-rounder as
well as comfortable for both doctor
and patient. I am very content with the
speed of ablation, because sometimes
the patients are not able to fixate on
the light for long time. The results are
so far more than satisfactory. One day
after surgery, all my LASIK-patients
attained a best corrected visual acuity
of 20/20 and 20/16. In the majority of
the patients the uncorrected visual
acuity was the same. It was seen that
the laser facilitates extremely smooth
treatment surfaces, which might con-
tribute to a better postoperative healing
process. The SCHWIND AMARIS is very
userfriendly and optimizes the refrac-
tive surgeon’s workflow. In conclusion,
the fact that I treated my own son with
the SCHWIND AMARIS, seems to be the
most convincing proof that I complete-
ly trust in the all encompassing capa-
bilities of this new laser generation.
Contact: Alena Feuermannova, MDCharles UniversityHradec Kralove, CZ – Phone + 420 49 583 -3336Email: [email protected]
SCHWIND AMARIS fulfills in nearly all
cases the long list of desires and
necessities that have become evident
over the past 15 years. Until now,
the unique combination of all con-
veniences such as iris detection, online
pachymetry, fast eyetracking, super-
fast tissue-saving ablation, diagnostic
slitlamp and swiveling patient bed
was not be found on the market.
Other very interesting and important
integrated innovations, too numerous
to all be listed here, can be discovered
and enjoyed by the SCHWIND AMARIS
user.
A learning phase must be calculated
into the initial process, but it is
short and pleasant. Reasons for the
necessity of every technical innovation
are, besides the significantly improved
safety for patients, the quality, speed
and sustainability of the treatment.
The SCHWIND AMARIS has succeeded
in setting a new standard that other
manufacturers have to measure
against.
Contact: Tobias Neuhann, MDMedical DirectorAaM Augenklinik am MarienplatzMunich, Germany – Phone +89 72 32 41 080Email: [email protected]
Alena Feuermannova, MD
Tobias Neuhann, MD