Eyeworld

41 EW FEATURE August 2015 Keratorefractive surgery Contact information Coleman: Stephen@colemanvision.com Cummings: abc@wellingtoneyeclinic.com McDonnell: Pmcdonn1@jhmi.edu in regularizing the cornea. "With topography-guided ablations, phy- sicians have the ability to make the optical zone size any size in 0.1 mm increments," he explained, adding that it is not necessary to use quarter diopter increments as it is with wavefront-optimized; with topog- raphy-guided, the refraction can be entered in 1/100ths. With topog- raphy-guided procedures, the final asphericity can also be controlled by adjusting the Q-value target. Dr. Cummings described the results from the topography-guided trial in the U.S. that led to the FDA approval of the WaveLight Allegret- to Wave Eye-Q (Alcon, Fort Worth, Texas). These indicated that at 3 months, 93% of eyes were 20/20 or better, 69% were 20/16 or better, and 32% were 20/12.5 or better. These results highlight the power of regularizing the cornea during laser refractive surgery. From a clinical perspective, he thinks that primary topography- guided LASIK with its very good outcomes has the potential to get patient referrals going again. "LASIK has taken a bit of a beating in the last few years," he said. "Now we might suddenly find that's changed with better outcomes." Also, Dr. Cummings said the approach can be used to repair results of LASIK cases gone awry. "When people start seeing the value of topo-guided as a repair tool, it will take the worry away from patients who currently aren't having LASIK done for fear of some sight-damaging complica- tions," he said. Going forward, Dr. Cummings thinks there is one more import- ant technology in the wings—ray tracing. This does what topogra- phy-guided LASIK can do but also includes refractive modeling of the eye, he explained. All of the other technologies irrespective of their diagnostics apply the data to a generic eye (Gullstrand model). Ray tracing uses a virtual model of the patient's own eye as represented by data points from devices providing corneal, wavefront, biometric, and refractive data, he said, adding that the results will likely be even more accurate. But the advent of this is still a couple of years away. EW Editors' note: Dr. Cummings has financial interests with Alcon. Dr. McDonnell has financial interests with Allergan (Dublin, Ireland) and GrayBug (Baltimore). Dr. Coleman has no finan- cial interests related to this article. SAFE r1BUFOUFE1VSJPO¡1SPDFTTHFOUMZEFIZESBUFT BOEUFSNJOBMMZTUFSJMJ[FTUIFBNOJPUJDNFNCSBOF XIJMFQSFTFSWJOHFTTFOUJBMHSPXUIGBDUPST QSPUFJOTBOEDZUPLJOFT EFFECTIVE rFZFTTVDDFTTGVMMZUSFBUFEXJUIPVUBOZ BEWFSTFFGGFDUT r1SPWFO1VSJPO¡5FDIOPMPHZSFUBJOTNPSFFTTFOUJBM HSPXUIGBDUPSTQSPUFJOTBOEDZUPLJOFTUIBO PUIFSQSPEVDUT SIMPLE r&BTJMZBQQMJFEPOUPBESZDPSOFBBOEDPWFSFEXJUI BCBOEBHFDPOUBDUMFOT r1FSGPSNFEEVSJOHBCSJFGPGGJDFWJTJUXJUIPVUUIF OFFEGPSUBQJOHUIFFZFTIVU COMFORTABLE r8FMMUPMFSBUFECZQBUJFOUT r/PGPSFJHOCPEZTFOTBUJPO WELL REIMBURSED r$PWFSFEJOUIFPGGJDFFOWJSPONFOUVOEFS$15DPEF $BMMPVSGSFFIPUMJOFUPEFUFSNJOFUIF SFJNCVSTFNFOUJOZPVSBSFB EXTENDED SHELF LIFE rZFBSTIFMGMJGFBUSPPNUFNQFSBUVSF r/PTQFDJBMIBOEMJOHTIJQQJOHSFRVJSFE INSTRUMENTS BIOLOGICS DEVICES 4-54r-535-3545rXXXLBUFOBDPN Why not help your patients today with IOP AmbioDisk ™ ? HELP FOR YOUR PATIENTS WITH Ocular Surface Disorders Do you treat patients with ocular surface issues? Do you see patients with corneal erosions or epithelial defects? Have you ever considered using IOP AmbioDisk to help your patients?

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