Presby LASIK Topographies

Transcription

1 Presby LASIK Topographies SurgiVision Consultants, Inc. DataLink kforum June 1, 2009 Not for Distribution

2 Introduction Case review of presby LASIK procedures performed with the WaveLight Eye Q Laser Presentation for private review by members of the SurgiVision Consultants, Inc. Forum, only Not for distribution or publication

3 Methods One surgeon, one laser, LASIK with the IntraLase for all cases Inclusion criteria Consecutive cases Postop data beyond D1 recorded One patient lost to follow up due to incarceration after surgery Procedure Summary: 2 Ablations Myopic ablation with a target of either or D sphere using a mm OZ Cylinder treated in myopic procedure Hyperopic treatment for plano target using a 6.0 mm OZ

4 Results Topos and data from last available visit, as noted

5 Preop OD X /15 1 M PO X /15 UCVA 20/15 Near: J1+ Patient RC / OD 44 yo WM

6 Preop OS X /15 1 M PO Plano 20/15 UCVA 20/15 Near: J1+ Patient RC / OS 44 yo WM

7 Preop OD /15 6 M PO Plano 20/15 UCVA 20/15 Near: J5 Patient MK / OD 51 yo WM

8 Preop OS /15 6 M PO Plano 20/15 UCVA 20/15 Near: J3 Patient MK / OS 51 yo WM

9 Preop OD X 81 20/15 3M PO Plano X 90 20/20 UCVA 20/20 Near: J3 Patient JC / OD 59 yo WM

10 Preop OS X 81 20/15 Plano X 89 20/15 3 M PO UCVA 20/20 Near: J4 Patient JC / OS 59 yo WM

11 Preop OD X 81 20/20 6 M PO /20 UCVA 20/25 Near: J1 Patient AS / OD 47 yo WM

12 Preop OS X 92 20/20 6 M PO X 85 20/15 UCVA 20/20 Near: J3 Patient AS / OS 47 yo WM

13 Preop OD X /15 6 M PO 0.50 Sphere 20/15 UCVA 20/20 Near: J1 Patient ES / OD 54 yo WM

14 Preop OS /15 6 M PO 0.50 Sphere 20/15 UCVA 20/15 Near: J2 Patient ES / OS 54 yo WM

15 Near Vision Summary 25% 20% % Eyes 20% 20% 20% 20% 15% 10% 10% 10% 5% 0% Near Acuity (Jaeger)

16 Other Results No patients complained of significant night driving problems Transient dry eyes were commonly reported The scotopic pupil size in all these patients was 5 mm or greater This precluded analysis of any reduced effect with smaller pupils

17 Search for Correlations The procedure works by inducing spherical aberration in the central 2 to 3 mm of the cornea Optical effect of this is limited, therefore results can be expected to be less effective in eyes with lower residual accommodation dti Induced spherical aberration can be expected to increase with larger treatment amounts The following correlations test these assumptions

18 Patient Age v. Postop Near Acuity 6 Correlation of 0.41 is significant and suggests that the procedure is best limited y = 0.192x to younger patients (age 55 or less) R² =

19 Preop Spheroequivalent vs. Postop Near Acuity P o s t o p N e a r J y = 0.78x x R² = J a e g e r A c u i t y Preop Spheroequivalent (D) Trend suggests in increased effect with larger treatment amounts, both plus and minus

20 Observations This is a small case series take caution not to over interpret the findings Results suggest efficacy is related to patient age and preop refractive error Results rely on patient accommodative ability Higher ablation a amounts lead to increased easedspherical aberration and effect Lack of vocalized night driving complaints is encouraging Since procedure works by creating spherical aberration, diminished mesopic vision is inevitable

21 Thank You Please submit and comments or suggestions to the forum: