Transcript Document

Clinical results of Hyperopic Wavefront
LASIK with the
Bausch & Lomb Zyoptix platform
Dr Haralabos Eleftheriadis, M.D
Ultralase Clinic Bristol UK
Financial Interest:
Travelling Grants received from Bausch & Lomb
ASCRS Symposium 2009, San Francisco, April 3-8,
Purpose
To study the visual and refractive results of hyperopia and
compound hyperopic astigmatism treated with LASIK using
the wavefront Bausch & Lomb (B&L) Zyoptix platform and
flaps created with the femtosecond IntraLase laser
ASCRS Symposium 2009, San Francisco, April 3-8,
Methods 1
• Hyperopic patients undergoing wavefront LASIK with the
B&L Zyoptix platform were studied prospectively
• Flaps were created with the femtosecond IntraLase laser
• Data were collected at months 1, 2, 3, 6 and at the time of
discharge
ASCRS Symposium 2009, San Francisco, April 3-8,
Methods 2
• Studied parameters were uncorrected visual acuity (UCVA),
best-corrected visual acuity (BCVA), manifest refraction as
well as safety, efficacy and predictability
• Only eyes with preoperative manifest spherical equivalent
(MSE) of ≤+4.00 dioptres (D), BCVA of ≥20/20 and target
refraction of emmetropia were included in this study
• Results at the time of discharge are presented below as mean ±
standard deviation and range
ASCRS Symposium 2009, San Francisco, April 3-8,
Results 1
• 114 eyes (56 right eyes)
• 59 patients (33 male)
• Age 52±7 years (range 38 to 65)
• Preoperative MSE +2.11±0.82 D (range +0.75 to +4.00)
• Preoperative Sphere: +2.47±0.87 D (range +1.00 to +4.25 D)
• Preoperative Cylinder: -0.70±0.40 D (range -0.25 to -2.50 D)
• Time of discharge: 8.3±3 months (range 3 to 22)
ASCRS Symposium 2009, San Francisco, April 3-8,
Results 2
Cumulative LogMAR Visual Acuity at Discharge
100
100
89
100
98
74
80
% of Eyes
96
56
60
Preop
Postop
40
23
20
11
1
0
-0.2
-0.1
0
+0.1
+0.2
+0.3
+0.4
Efficacy Index at Discharge 95.8%
ASCRS Symposium 2009, San Francisco, April 3-8,
Results 3
Changes in Lines of LogMAR BCVA at Discharge
100
% of Eyes
80
60
46
37
40
20
12
1
5
0
-3
-2
-1
0
+1
+2
Safety index at Discharge 98%
ASCRS Symposium 2009, San Francisco, April 3-8,
Results 4
Postoperative Spherical Equivalent Refraction at Discharge
100
±0.50 D: 88%
% of Eyes
80
±1.00 D: 99%
60
46
42
40
20
1
3
-1.49 to -1.00
-0.99 to -0.50
8
0
-0.49 to 0
+0.1 to +0.50
+0.51 to +1.00
ASCRS Symposium 2009, San Francisco, April 3-8,
Results 5
Defocus Spherical Equivalent at Discharge
98
100
99
100
84
% of Eyes
80
≤0.5 D: 84%
60
≤1.00D: 98%
40
20
0
≤0.5
≤1
≤1.5
≤2
ASCRS Symposium 2009, San Francisco, April 3-8,
Results 6
Attempted vs Achieved SE at Discharge
5
4.5
OVERCORRECTED
Achieved Correction (D)
4
3.5
3
Y=-0.110+1.093*X, R2=0.88
2.5
2
1.5
UNDERCORRECTED
1
0.5
0
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
Attempted Correction (D)
ASCRS Symposium 2009, San Francisco, April 3-8,
Results 7
Evolution of Spherical Equivalent
5
Spherical Equivalent
4
3
2
1
0
-1
Preop
1 Month
2 Months 3 Months
6 Months
9 Months 12 Months
Discharge
3 eyes (2.6%) required enhancement procedures
ASCRS Symposium 2009, San Francisco, April 3-8,
Conclusions
• Wavefront guided LASIK for hyperopia and compound
hyperopic astigmatism with the Zyoptix Bausch & Lomb
platform and flaps created with the IntraLase femtosecond
laser is
 Highly effective
 Very safe refractive procedure
• It yields very accurate visual and refractive results
ASCRS Symposium 2009, San Francisco, April 3-8,