the author has a financial interest in the matter under presentation
DESCRIPTION
The author has a financial interest in the matter under presentation Dr. Rupal Shah, New Vision Laser Centers, India. Results of All-in-One ( AiO ) Femtosecond Laser Surgery for Correction of Myopia and Myopic Astigmatism. All-In-One Femtosecond LASIK. - PowerPoint PPT PresentationTRANSCRIPT
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The author has a financial interest in the matter under presentationDr. Rupal Shah, New Vision Laser Centers, India
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Uses only the femtosecond laser for completing the entire LASIK procedure
No need for an excimer laserPossible only with the VisuMax Laser
from Carl ZeissTwo Procedures
FLEx=Femtosecond Lenticule Extraction SMILE=Small Incision Lenticule Extraction
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All-Femto Lasik Integrated Solution
Benefits and Advantages
Advantages for the patient
Vision correction w/o corneal ablation• Result quality independent of external conditions• High refractive correction with less induced aberration
Fast single-step treatment• Short period of stress and fear• No need to change stations
Potential for minimal-invasive procedure• Better and faster healing (small incisions)• Preserved biomechanical stability of the cornea• Potential for correction of higher myopes• Lower incidence of Dry-Eye syndrome
(to be proven)
Advantages for the surgeon Differentiation from other LVC providers• Uniqueness of AIO procedure (marketing, positioning)
Workflow improvements• Fast bilateral treatment w/o need to change to excimer
higher patient throughput• Less space requirement
Increased profitability • Premium procedure provides higher margin potential
(ex.: Intralase, Wavefront)• Minimal-invasive treatment may increase demand• Only one laser, with the investment, consumables and
service costs for only laser
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683 eyes treated between Aug 2008 and February 2010
Includes eyes treated with both FLEx and SMILE
All consecutive eyes- All eyes treated have been included
Video Illustrates technique of All in One (AiO) Femtosecond Laser Refractive Surgery
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Subject Demographics
Mean Range
Age 25 y 18 y to 50y
MR SEQ -4.56 D ± 2.04 D -0.75 D to -10.38 D
MR Sphere -4.22 D ± 1.95 D -0.50 D to -10.00 D
MR Cylinder -0.68 D ± 0.72 D up to -4.50 D
Pre-operative: 683 eligible eyes (339 OD, 344 OS)
429 female eyes, 254 male eyes
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Postoperative Results
Mean Range
MR SEQ 0.00 D ± 0.26 D 1.00 D to -1.25 D
MR Sphere 0.00 D ± 0.21 D 1.00 D to -1.25 D
MR Cylinder -0.10 D ± 0.26 D up to -1.75 D
6 month 423 eyes
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AiO Safety Change in CDVA
Change in CDVA
13%
54%
8%6%
1%
18%
4%
17%
4%2%
25%
64%
1%4%
33%
57%
11%
<1%2%
31%
58%
8%7%2%2%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
lost > 2 lost 2 lost 1 unchanged gained 1 gained 2 gained > 2
Per
cen
tag
e E
yes
[%]
0.25 (638) 1 (558) 3 (502) 6 (423) 12 (109)month (eye)
@3 month 92% unchanged/gained
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AiO Stability Achieved correction (MR SEQ) over time
Time
-4.49
0.12 0.08 0.04 0.05 0.03
110423502558639683-7.00
-6.00
-5.00
-4.00
-3.00
-2.00
-1.00
0.00
1.00
pre op 1 w 1 m 3 m 6 m 1 y
Highly stable refraction over time!
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R2 = 0.97
0
1
2
3
4
5
6
7
8
9
10
11
12
0 1 2 3 4 5 6 7 8 9 10 11 12
Attempted delta SR equiv. [D]
Achieved [D]
overcorrected
undercorrected
R2 = 0.98
0
1
2
3
4
5
6
7
8
9
10
11
12
0 1 2 3 4 5 6 7 8 9 10 11 12
Attempted delta SR equiv. [D]
Achieved [D]
overcorrected
undercorrected
AiO Refractive Outcome MR SEQ Percent within Attempted@1w and @6m
1 week (639) 6 month (423)
High predictability for early and late follow-ups!
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Refractive outcome - Percentage within Attempted
2%
90%
7%3%
93%
4%
94%
3%<1% 2% 2%2%
97%
1%1%0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
-1.01 to -2.00 -0.51 to -1.00 +- 0.50 +0.51 to +1.00 +1.01 to +2.00
1 w (639) 1 m (558) 3 m (502) 6 m (423) 1 y (110)
AiO Refractive Outcome MR SEQ Percent within Attempted
@1w 99% ± 1.00 D@3m100% ± 1.00 D
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preOP CDVA vs. postOP UDVA - Percentage
67% 69%
43%
22%
44%
<1%
94%
84%
65%
99%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
20/16 orbetter
20/20 orbetter
20/25 orbetter
20/32 orbetter
20/40 orbetter
20/50 orbetter
20/63 orworse
preSCVA (575) 1 d (572) 1 w (537)
month (eyes)
Only 94% are 20/25 or better preOP
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AiO-Astigmatism CorrectionNormalized Double Angle Minus Cylinder – Scatter Plot ►only eyes with myopic astigmatism
preOP (485 eyes with myopic astigmatism)
High predictability in cylinder correction after 1 week!
-5
-4
-3
-2
-1
-0
-1
-2
-3
-4
-5
-5 -4 -3 -2 -1 -0 -1 -2 -3 -4 -5
Mean Cyl -0.95 @ 0.0°CZM-Applikation Gehmlich
0°
45°
90°
135°
1 week (460 eyes with myopic astigmatism)
-5
-4
-3
-2
-1
-0
-1
-2
-3
-4
-5
-5 -4 -3 -2 -1 -0 -1 -2 -3 -4 -5
Mean Cyl -0.02@ 167.2°CZM-Applikation Gehmlich
0°
45°
90°
135°