This is a supplement to EyeWorld Magazine.
Issue link: https://supplements.eyeworld.org/i/307020
New wavefront-guided system incorporates the best Hartman-Shack aberrometer available, with additional exciting technologies to come O ptical Express is continu- ally investing in the best refractive technologies for our patients. There are several exciting develop- ments in laser vision correction, with advanced wavefront diagnos- tics and topography-guided abla- tions coming soon. Overall, I firmly believe we will see even better out- comes with these new technologies and start seeing results that bring us beyond the 20/20 baseline of our current devices. We recently had the opportu- nity to explore a new wavefront diagnostic device. We began evaluating the iDesign aberrometer (Abbott Medical Optics, AMO, Santa Ana, Calif.), part of the iDesign Advanced WaveScan Studio, in a few of our U.K. and Japanese clinics in mid-2012 to see how the results compared with those of the WaveScan (AMO). While I had my doubts that the new technology could match the outcomes of our fine-tuned and consistently good LASIK using the WaveScan, the re- sults were so impressive we decided to incorporate the iDesign into all of our clinics by the summer of 2013. We were already producing customized ablations and individu- alized treatments based on the unique aspects of each eye, however the iDesign further improves that aspect of laser vision correction. It's a significant incre- mental improvement in customized treatments using a better diagnostic device. It works by taking five meas- urements (wavefront aberrometry, autorefraction, topography, keratometry, and pupillometry) in a single capture sequence. The Hartmann-Shack sensor has a higher resolution and a higher dynamic range (sphere range from –16 D to +12 D, cylinder up to 8 D, and higher order aberrations RMS [root mean square] up to 8 microns). It can provide absolute registration of eye motion and pupil shift. Overall, the amount of data that we are capturing is much greater, and this is reflected in our outcomes. What we found After rolling out the device in all of our clinics, we (Optical Express) undertook a large-scale comparison. We analyzed 8,905 eyes (4,721 patients) with low-to-moderate myopia that underwent LASIK with the iDesign in the U.K. and retrospectively compared results to 27,290 matched eyes (14,589 patients) that underwent LASIK with the WaveScan just before the iDesign rollout. The iDesign group had surgery between May 30, 2012 and August 24, 2013, while the WaveScan group underwent surgery between January 1, 2012 and June 18, 2013. There were slightly more women in each group than men, and the average age was about the same (33.8 years in the iDesign group and 34.6 years in the WaveScan group). by Steve Schallhorn, MD Better diagnostics leads to better outcomes "Both advanced wavefront and topography- guided ablations have their benefits, and I believe the future of visual outcomes for our patients is beyond 20/20." Steve Schallhorn, MD 12 Figure 1. Intended cylinder correction Figure 2: 1 month UCVA rates of WaveScan vs. advanced wavefront technology May 2014