Diapositiva 1

1
Optimized Zernike Terms Selection In Customized
Treatments For Laser Corneal Refractive Surgery
6 months experience in state-of-the-art treatments
Maria C. Arbelaez, MD1 Samuel Arba Mosquera,
MSc2,3 Camila Vidal, OD1
1 Muscat Eye Laser Center (Sultanate of Oman)2
Grupo de Investigación en Cirugía Refractiva y
Calidad de Visión (IOBA, Spain)3 SCHWIND
eye-tech-solutions (Germany)Preceptor Jesús
Merayo2
The authors Arbelaez and Vidal have no
proprietary interest in the materials presented
herein Samuel Arba Mosquera is employee at
SCHWIND eye-tech-solutions Part of a Doctoral
Thesis in Sciences of Vision
2
Optimized Zernike Terms Selection in Customized
Treatments for Laser Corneal Refractive Surgery
Arbelaez, MD. and cols

• Goals
• To evaluate the clinical application of two
  methods for minimizing the required ablation
  tissue based upon
• objective minimization of the maximum depth of a
  customized ablation
• objective minimization of the ablation volume of
  a customized ablation
• both based on the Zernike expansion of the
  wavefront aberration

• Materials
• SCHWIND CAM Software Platform (not approved by
  U.S. Food and Drug Administration)
• SCHWIND ESIRIS Excimer Laser (not approved by
  U.S. Food and Drug Administration)
• SCHWIND Ocular Wavefront Analyzer (not approved
  by U.S. Food and Dug Administration)
• SCHWIND Corneal Wavefront Analyzer
• OPTIKON Keratron Scout
• Contrast Sensitivity Tester
• Vision Sciences Research Corporation CST 1800 D

3
Optimized Zernike Terms Selection in Customized
Treatments for Laser Corneal Refractive Surgery
Arbelaez, MD. and cols

• Groups
• 3 groups treated with LASIK technique with 30
  eyes each
• Corneal Wavefront group (CW) Full customized
  correction
• Min Depth group (MD) Optimal Zernike terms
  selection for minimum depth
• Min Volume group (MV) Optimal Zernike terms
  selection for minimum time

CW MD MV
4
Optimized Zernike Terms Selection in Customized
Treatments for Laser Corneal Refractive Surgery
Arbelaez, MD. and cols
5
Refractive Outcomes
Arbelaez, MD. and cols

• Very good refractive
  outcomes from the three groups
• gt 57 in 0.25 D 100 in 1.00 D gt 90 in
  0.50 DEq 100 in 1.00 DEq

Best results for the MV group, but not
statistically significant
6
Predictability
Arbelaez, MD. and cols

• Very high predictability from the three
  groups.
• SEq Cyl

Best results for the MV group, but not
statistically significant
7
Stability Efficacy
Arbelaez, MD. and cols
Very good UCVA postoperative from the three
groups gt 87 UCVA 20/20 or better
Very stable results from the three groups since
the first month follow up
Results for the MD and MV groups better than for
CW group, statistically significant (p lt 0.01)
8
Safety
Arbelaez, MD. and cols
Between 34 and 47 of the treatments gained at
least 1 line of BSCVA No single eye lost even 1
line of BSCVA
Between 30 and 40 of the treatments with
post-op UCVA were better than pre-op BSCVA
Best results for the MV group, but not
statistically significant
9
Contrast Sensitivity
Arbelaez, MD. and cols
Excellent improvement in postoperative contrast
sensitivity for all three groups
Best results for the MV group, but not
statistically significant
10
Comparison
Arbelaez, MD. and cols
MD group saved -4 µm depth in average MV group
saved -3 µm depth in average
MD group saved -3 s time in average MV group
saved -4 s time in average
11
Summary
Arbelaez, MD. and cols
MD group saved -4 µm depth in average MV group
saved -3 µm depth in average
MD group saved -3 s time in average MV group
saved -4 s time in average
12
Optimized Zernike Terms Selection in Customized
Treatments for Laser Corneal Refractive Surgery
Arbelaez, MD. and cols

• Conclusions
• The three groups compared here (CW, MD and MV)
  are Predictable, Safe, Stable and Accurate
• The two minimization techniques compared here
  can be used to reduce the depth and time needed
  for the ablation
• Depth and time were effectively reduced by up to
  a maximum of 25, and by 8 in average
• The performed ablations reduced in depth and
  time did not affect negatively the clinical
  outcomes postoperatively
• The two minimization techniques compared here
  yielded results equivalent to those of the full
  customization group

13
Optimized Zernike Terms Selection in Customized
Treatments for Laser Corneal Refractive Surgery

• Conclusions II What I would choose for
  minimization

Arbelaez, MD. and cols