Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Z(4,0) (OSA)
1.18 µm
• Biomechanics
Peripheral Stromal
Thickening
Central Flattening
Roberts C. The cornea is not a piece of plastic.
• Increases central
ablation depth
• No “Free Lunch”
y = -0.059x - 0.0136
0.6
) R² = 0.6444
A
S
O 0.5
,
m
µ
(
t 0.4
n
ie
ic
ff 0.3
e
o
C 0.2
)
0
,
4
(
Z 0.1
n
i
e
g 0.0
n
a
h
C -0.1
-0.2
0.00 -1.00 -2.00 -3.00 -4.00 -5.00 -6.00 -7.00 -8.00 -9.00 -10.00
• “Q-slider”
– (WaveLight)
• Wavefront-guided ablation
– Includes pre-op spherical aberration
– Effect dependent on pre-op spherical aberration
-7.13 D Corrected
-9.00 D Corrected
Pre Op Post Op
Rx Treated
OD -6.50 -1.25 x 178
OS -8.25 -1.50 x 17
OD
Peripheral Stromal
Thickening
Central Flattening
Roberts C. The cornea is not a piece of plastic.
y = 0.9958x - 0.5106
) -13 R² = 0.9291
s
r
e
t
p-12
o
i
D
(
t -11
n
e
l
a
v
i -10
u
q
E -9
l
a
c
ir
e -8
h
p
S
d -7
e
v
e
i
h -6
c
A
-5
-6 -7 -8 -9 -10 -11 -12 -13 -14
Pre-release online
Pachymetry 509 µm
• Patients
– Myopia SEQ -9.51 㫧 1.32 D -8.00 up to -14.50 D
– Myopia max merid -10.18 㫧 1.48 D -8.00 up to -16.00 D
– Cylinder -1.32 㫧 1.10 D up to -6.25 D
– 220 eyes
– 1 year follow up
• Retreatments
– 45% eyes treated as “two-stage”
– Enhancement rate (non two-stage): 35%
) y = 1.0726x + 0.8394
s
r
e
t
-13 R² = 0.8759
p
o
i
D
(
t -12
n
e
l
a
v
i -11
u
q
E
l
a
c
ir -10
e
h
p
S -9
d
e
v
e
i
h -8
c
A
-7
-7 -8 -9 -10 -11 -12 -13 -14
Attempted Spherical Equivalent (Diopters)
30%
25%
s 25%
e
y
E 20%
e 15%
g 15% 13%
a
t
n
e 10%
c
r 7%
e
P 5% 3%
0% 1% 1%
0%
-2.00 -1.50 -1.00 -0.50 -0.13 0.14 +0.51 +1.01 +1.51
To - To - To - To - To To To To To
1.51 1.01 0.51 0.14 0.13 +0.50 +1.00 +1.50 +2.00
Accuracy 0% 3% 15% 33% 25% 13% 7% 1% 1%
Accuracy of Spherical Equivalent
n=176
Efficacy: Monocular UCVA
100% 99% 99% 99%
100% 97%
90%
83%
80%
s
e
y
E 60%
e 47%
g
a
t
n 40%
e 28%
c
r
e
P 20%
11%
1%
0%
20/12.5 20/16 20/20 20/25 20/32 20/40 20/63
Pre BSCVA 1% 28% 83% 100%
Efficacy 11% 47% 90% 97% 99% 99% 99%
Monocular UCVA
60%
52%
s 40%
e
y 40%
E
e
g
a
t
n
e 20%
c
r
e
P N=4
6%
2%
0.0% 0.0%
0%
Loss 3 or No Gain 2 or
Loss 2 Loss 1 Gain 1
More Change More
Safety 0.0% 0.0% 2% 40% 52% 6%
) 0.00
D
(
t
n
e
l -2.00
a
v
i
u
q
E -4.00
l
a
c
ir
e -6.00
h
p
S
-8.00
-10.00
-12.00
3 Mo 6 Mo 12 Mo 24 Mo