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THE ROYAL AUSTRALIAN AND NEW ZEALAND COLLEGE OF OPHTHALMOLOGISTS 24 – 28 NOVEMBER, 2007

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

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THE ROYAL AUSTRALIAN AND NEW ZEALAND COLLEGE OF OPHTHALMOLOGISTS 24 – 28 NOVEMBER, 2007

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  1. 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 OPHTHALMOLOGISTS24 – 28 NOVEMBER, 2007 Dr. Ian Anderson Dr. Paul van Saarloos Dr. Gabriel Marin Dr. Tarak Pujara

  2. Purpose • To evaluate the clinical efficiency, predictability and safety of a new high speed, 0.6 mm Gaussian shaped flying spot, 213nm solid state laser for the correction of myopia, myopic astigmatism, hyperopia, hyperopic astigmatism in laser in situ keratomileusis (LASIK). • All Lasiks performed at eight international sites. • Compare these results to personal results using Advanced Surface Ablation ( PRK, Lasek & eppi-lasek) • Data collection done by ophthalmic assistant.

  3. CustomVis™ Pulzar™ Z1

  4. 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

  5. UV Spectrum (Jain et al., 2004; unpublished data) 213nm transmits 1620 times more than 193nm in 0.9%NaCL 213nm 0.9% NaCl Transmission 193nm BSS Transmission (%) 100 50 UV Wavelengths (220nm – 190nm) 0 250 500 750 Depth (µm) 213nm has a significantly higher transmission through 0.9% NaCl and BSS than 193nm (Dair et al., 2001)

  6. ZCAD Treatment Planning • Choices • Optical Zone/ Treatment zone • Blend type :-tissue saving, refractive, linear • Treatment :- Standard, Topography, Wavefront • Review • Post operative topography • Post op Residual thickness map

  7. LASIK Patients • 436 eyes with myopia up to -14.5 D and astigmatism up to -5.5 D. • 195 eyes with hyperopia up to +6 D and mixed astigmatism up to -6.5 D. • All Underwent Laser Vision Correction at eight different sites. • All cases were followed for minimum 3 months. • All data were collected by Ophthalmic Assistants and were evaluated by all surgeons.

  8. Surface Ablation Patients • 62 Eyes with myopia up to -6D and astigmatism up to -4D • Majority with abnormal corneas • Less than 500microns • Irregular astigmatism • Scarring, RK, PK • Recurrent Erosions • Very Large pupils

  9. Lasik Myopia and Myopic Astigmatism (SE ≥ -15D) With minimum 3 months follow-up (n=436) Note: The graph has some overlapping points

  10. LASIK Visual Results

  11. Myopia and Myopic AstigmatismAttempted vs Achieved CorrectionUCVA

  12. Lasik Hyperopia and Mixed Astigmatism Post-Op UCVAAt latest follow-up of 3 months (n=195) Attempted Vs Achieved UCVA

  13. Summary • Myopia/ Astigmatism LasikSurface • LASIK 84%(95%)were ± 0.5 D and 98%(100%) were ± 1 D of intended correction • Uncorrected Visual Acuity 6/6 in 74%(75%) and 6/12 was achieved in 88%(98) of eyes. • BSCVA was improved by 1 line in 22 eyes and no eye lost over 1 line of BSCVA. • Hyperopia/ Astigmatism • 68% were ± 0.5D and 88% were ± 1D of intended correction • 86% of 195 Hyperopic cases had 6/6 UCVA post operatively.

  14. Conclusions • The Clinical Data supports the safety, predictability and effectiveness of the PULZAR Z1 Solid State Refractive Laser (213nm) for the correction of a whole range of refractive treatments including high myopia, hyperopia and mixed astigmatism using both Lasik and Surface Ablation. • CustomVis™ Pulzar Z1 laser system is a good alternative to conventional Excimer systems.

  15. Thank You Ride for Youth

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