Eyeworld

SUMMER 2024 | EYEWORLD | 43 R I WISH I HAD … About the physicians Y. Ralph Chu, MD Founder and Medical Director Chu Vision Institute Bloomington, Minnesota Edward Manche, MD Director of Cornea and Refractive Surgery Professor of Ophthalmology Byers Eye Institute Stanford University School of Medicine Stanford, California Jod Mehta, MD Distinguished Professor of Clinical Innovation in Ophthalmology Singapore National Eye Centre Executive Director Singapore Eye Research Institute Singapore by Liz Hillman Editorial Co-Director with current platforms. There appears to be less regression, and there are amazing results." The Teneo is not the only laser moving LASIK forward. Dr. Chu also said that Carl Zeiss Meditec is conducting a trial that will introduce hyperopia and hyperopic astigmatism correc- tion to its platform as well. Dr. Chu is also an investigator on the MEL 90 platform (Carl Zeiss Meditec) Phase 3 clinical trial. "I think that in the U.S., the introduction of new lasers has been limited because of the incredible investment that it takes to get through the FDA regulatory process. … The fact that Bausch + Lomb and other companies are investing in the next generation is important," Dr. Chu said. "It's not just about lasers getting faster; there is so much that is continuously being learned by laser engineers and how to deliver the energy and laser profiles. I think the delivery systems do matter. I think the software changes matter, and you can see that in the patient results." Lenticule advancements While Carl Zeiss Meditec has maintained the U.S. lenticule extraction market with SMILE (small incision lenticule extraction), other tech- nologies for lenticule extraction for refractive results are in development. T he future of corneal refractive surgery is in the works. EyeWorld checked in on various technologies in the pipeline with physicians in the know. "There is constant innovation," Y. Ralph Chu, MD, said of the field of corneal refractive surgery. He acknowledged that this innovation is a big investment for companies within the U.S. regulatory environment, but "it's exciting to see that investment and that these things are coming close to fruition in the U.S." LASIK for hyperopia with astigmatism Dr. Chu spoke about the work being done by Bausch + Lomb to perform LASIK for hyperopia with astigmatism with the Technolas Teneo laser platform. Dr. Chu, who is involved in Phase 3 trials for the technology in the U.S., said "the results look amazing with this technology." "Patients and surgeons are happy. The plat- form represents an advancement over current technology, so that's exciting for us," he said. The Teneo laser received FDA approval for myopia and myopic astigmatic correction in Jan- uary 2024, with the company stating in a press release that it has an eye tracker that operates at 1,740 Hz and a high-speed laser that operates at 50 Hz (about 1.2 seconds per diopter). It also has a small footprint. Outside the U.S. where the Teneo is in use for treatment of myopia, hyperopia, astigma- tism, and presbyopia, Dr. Chu said it has been shown to have a faster rate of ablation and a high-speed tracker. It remains under investiga- tion in the U.S. for these other indications. Dr. Chu said his hope for newer lasers incorporating hyperopia correction is that it will remain stable over time. "Hyperopia tends to regress over time, and in the higher ranges of farsightedness, some of the visual results in the past were limited. That's why a lot of surgeons either held off on doing hyperopic treatments or looked toward lens replacement surgeries be- cause of quality of vision," he said. "With some of these newer platforms that are under inves- tigation, we're starting to see amazing results, even with patients with higher degrees of far- sightedness that we weren't necessarily treating Corneal refractive surgery: the future wish list continued on page 44 Intraoperative view of semi-automated manual adjustment of the lenticule following suction application Source: Jod Mehta, MD

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