Eyeworld Supplements

2 Other features I've found partic- ularly useful: a heads-up display that allows the surgeon to look through the microscope and have all the nec- essary information available. The system provides real-time feedback on how well tracked the patient is and the progress of the ablation. The online pachymetry allows surgeons to have immediate access to residual stromal bed depths. All of this infor- mation in addition to patient identi- fiers and laterality are digitally viewed through the oculars during surgery. The system comes standard with the IBRA, an intuitive treat- ment guidance program that pro- vides real-time data analysis to the surgeon while building the surgical nomogram. The other half of the refractive suite includes the WaveLight FS200 femtosecond laser, which, at 200 kHz, is the fastest femtosecond laser in the U.S. That particular femtosecond laser can create flaps in approximately 6 seconds† with full customization capabilities. Patient response The advantages of this technology aren't just noticeable to surgeons; patients are really responding to it. Our Generation Y or Millennials are responding to the speed that this laser offers. Patients have told me it took less time for me to correct their sight with the WaveLight EX500 Laser than it did for them to put in their contact lenses. This type of phraseology is powerful for word-of- mouth advertising and has helped boost our refractive volume. The WaveLight Refractive Suite is, in my mind, the most advanced technology available today because of its speed and its noticeable effect on patient outcomes. It is an ad- vanced form of LASIK and can be a valuable tool for any surgeon look- ing to expand his or her refractive practice. *Trademarks are the property of Alcon, a Novartis company. †Based on typical treatment parameters; Alcon data on file. Dr. Waring is assistant professor of ophthal- mology and director of refractive surgery, MUSC Storm Eye Institute, Charleston, S.C. He can be contacted at 843-792-8861. EW San Francisco 2013 Sunday, April 21, 2013 2 WaveLight continued from page 1 Please refer to pages 7 and 8 for important safety information about the Alcon products described in this supplement. The WaveLight EX500 Laser provides 25 cm under the microscope. Source: George O. Waring, IV, MD translates to approximately 1.4 seconds per diopter.† This high repetition rate reduces the amount of time for flap and stromal bed dehydration, and in theory, should result in quicker recovery times. We observe a similar quick recovery rate with intraocular surgery with proper technique and less manipulation of the eye. In my practice, we have observed the speed of recovery using this laser, and patients have even commented on their quick recovery. The WaveLight EX500 Laser de- livers not only a great patient experi- ence, but a surgeon's "wow factor." When I look at these patients imme- diately postop under the slit lamp, I am often seeing results I'd expect to see clinically at one week postop. There is minimal edema, swelling, inflammation, dryness—the eyes look pristine. Dealing with "extremes" My advice to surgeons using a new laser is to start conservatively until there's a good sense of how the laser performs using their own techniques and under the conditions of the operating room environment. In my experience, developing a sur- geon-specific nomogram usually takes a few hundred cases. Because I had some experience with this laser outside the U.S., I felt comfortable performing cases in the refractive extremes for myopia, hyperopia, and astigmatism my first day of surgery. I have treated anywhere between +5.00 D to –10.00 D of spherical correction, and up to 6.00 D of cylinder, gaining a line of best cor- rected visual acuity in the majority of these extreme cases. My prelimi- nary outcomes data has been quite encouraging, with my correlation coefficients (programmed target versus my achieved outcome) to be 0.96 and 0.97 for spherical equiva- lent and cylinder treatments, respec- tively. Overall advances The WaveLight EX500 Laser also fea- tures a 1050 Hz, multidimensional eye tracker synchronized at 500 Hz, which follows the eye's movements for precision and safety. This tracker features a 2 millisecond latency time and can track all pupil sizes, from 1.5 mm to 8 mm. The tracker self- regulates, meaning it will slow the laser down as needed. The laser has a large working distance, with 25 cm under the microscope allowing for comfortable surgery and easy handoff of instru- ments from your technician. Alcon Sunday_SF2103 8pages-DL2_Layout 1 4/20/13 8:12 PM Page 2

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