the royal australian and new zealand college of ophthalmologists 24 – 28 november, 2007
DESCRIPTION
Laser Vision Correction for Myopia, Myopic Astigmatism, Hyperopia and Hyperopic Astigmatism with CustomVis Solid State Laser (213nm). THE ROYAL AUSTRALIAN AND NEW ZEALAND COLLEGE OF OPHTHALMOLOGISTS 24 – 28 NOVEMBER, 2007. Dr. Ian Anderson Dr. Paul van Saarloos Dr. Gabriel Marin - PowerPoint PPT PresentationTRANSCRIPT
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(Jain et al., 2004; unpublished data)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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