Wavefrontguided lasik for the correction of primary. Nomogram reduction of the programmed input does not mean less tissue is removed. The field of nomography was invented in 1884 by the french engineer philbert maurice docagne 18621938 and used. He proudly performs his refractive surgery procedures at his offices using this laser, a revolutionary tool in laser eye surgery. Wavefrontoptimized laser in situ keratomileusis with the. Striving for perfection i believe surgeons can achieve low enhancement rates by using the appropriate outcomebased nomogram and. The wavelight allegretto eyeq is a flyingspot excimer laser, with a pulse. The nomograms were generated with datagraphmed refractive outcomes software v 3.
On the third line, known as the modified line, i enter the final, nomogram adjusted treatment chosen for the eye. Laser insitu keratomileusis lasik is probably the most popular surgical. Every surgeons nightmare with a new laser involves. The treatment is the first topographyguided lasik to receive fda approval. Treatment of high astigmatism with wavelight allegretto eyeq. Lasik on the allegretto platform in myopic astigmatism eyes showed no.
Lasik improves vision ultimately by changing the shape of the cornea. Nomogram adjustment of laser in situ keratomileusis for myopia and myopic astigmatism with the alcon ladarvision system article in journal of refractive surgery thorofare, n. Once we dialed in our numbers, we had fantastic results with the waverfrontguided surgery, and we have never looked back. When treating hyoperopes with the visx platform, my outcomes were quite. Wavelight is the only laser company that is so confident about its results that provides this web based data analysis program for all of its surgeons. Pamel uses a datalink software which allows him to create his personal nomogram and to compre his results with wavelight allegretto users around the world. Celebrating innovation in the year of presbyopic correction. Pamel has a premier lasik facility and has treated thousands of queens and manhattan lasik eye surgery patients. Although these effects are dependent on laser platform, this study, along with the publications describing the rochester nomogram, 7,8 suggest that at least two laser platforms ladarvision and.
Nomogram large oz optimizes the visual outcome and promotes refractive stability. Crstoday how hyperopia saved my refractive practice. Laser in situ keratomileusis lasik american academy of. Here, several allegretto surgeons discuss the laser, its features, and how to flatten the learning. Pamel uses a datalink software which allows him to create his personal nomogram and to compare his results with wavelight allegretto users around the world. Factors like temperature, humidity, and atmospheric pressure can affect surgical results. Comparison of wavelight allegretto eyeq and schwind.
Datalink is an easytouse, webbased software application that provides surgical planning and outcomes analysis specifically for the allegretto wave excimer laser system. Panelists provide answers to the question, at what point do you apply the nomogram adjustments. I have an allegretto wave eyeq excimer laser alcon, which is the 400hz laser. Alcon has a system in place to help the new allegretto user craft the right nomogram. The wavelight allegretto wave laser was introduced first in europe just over 10 years ago and was then approved by the fda in 2003. Development of an advanced nomogram for myopic astigmatic. The treatment zones available for conventional lasik using the visx star s4 laser for the correction of myopia are 6. Comparison of outcomes of conventional wavelight allegretto.
The history of wavefrontoptimized treatments crsteurope. Efficacy of the wavefront optimized wfo profile in non. The group treated 221 eyes of patients with a mean age. Every surgeons nightmare with a new laser involves what it will do to his outcomes, opines greensboro, n. As stated earlier, the blend zone will extend the treatment zone to a diameter of 8. Topographyguided custom photorefractive keratectomy for. At the center for lasik, we use sophisticated software to track our outcomes and modify future treatments. Lasik fort lauderdale lasik technology center for lasik. Our results are comparable to those reported by han et al. Once the nomogram adjustment was made, the results were spot on.
Results three months postoperatively, 24% of eyes 27111. We perform customvision using the wavelight allegretto wave eyeq excimer laser the fastest and most advanced laser platform available providing exceptional levels of safety and effectiveness. It is performed using the wavelight topolyzer vario diagnostic device, proprietary treatment planning software, and either the allegretto wave eyeq or wavelight ex500 excimer laser systems all alcon. The eyes that underwent conventional lasik had a 0. Wavefront lasers compared allegretto wavelight lasik. Topographyguided procedure raises the bar in laser vision. Evaluation of the efficacy of the allegretto wave and the. Previously established moran laser center wf guided lasik nomograms were followed for both the allegretto and the customvue treatments. Full text treatment of moderatetohigh hyperopia with.
Contoura vision also has lower rates of symptoms associated with lasik, such as light. Custom lasik new york wavelight lasik in manhattan. However, it also increases the depth of tissue ablation. Topographyguided custom photorefractive keratectomy for myopia in primary eyes with the wavelight ex500 platform. Cataract and refractive surgeons can use ibra to collect, analyze and improve their treatment results, leading to higher accuracy and better patient satisfaction. A nomogram from greek nomos, law and gramme, line, also called a nomograph, alignment chart, or abaque, is a graphical calculating device, a twodimensional diagram designed to allow the approximate graphical computation of a mathematical function. Lasik for mixed astigmatism using the allegretto wavestonecipher et al the allegretto software and applied with a single ablation.
A comparison of different lasers used for lasik eye surgery, explaining. Like most modern technologies, excimer lasers have seen significant improvements through the. The nomogram adjustment typically involves reducing treatment power. We use proprietary algorithm to calculate accurate laser performance profiles from the global reference database or your own. It is better to have a large oz with surface ablation than have lasik with a reduced oz in younger patients. To describe wavefrontguided wfg lasik for the primary treatment of low to moderate levels of myopia and astigmatism and to examine the evidence on the safety and effectiveness of the procedure in comparison with conventional lasik. This nomogram advises the surgeon to reduce the astigmatic correction by 25%. We also compared this data to the food and drug administration custom lasik study on 340 eyes done in an equivalent fashion. The laser software used the nomogram adjusted manifest refraction data to determine the treatment plan for prk. To help with this, alcons made available the datalink service that was developed by guy kezirians firm surgivision. For all patients, the programmed treatment consisted of cycloplegic spherical correction with manifest astigmatic power and axis.
In 1990, pallikarisperformed the first lasik procedure, using the excimer. Md, msee, and i developed for the refractive surgery consultant elite software. There are no limitations on nomogram adjustments with the allegretto wave. A nomogram adjustment to a lower refractive error that becomes the laser input.
The excimer laser is the device that is responsible for making that change in the shape of the cornea in order to provide the eye with a proper focus. Recent software upgrades on the intralase femtosecond laser allow a. The allegretto wave excimer laser software version. To implement and apply the nomogram, we use software designed and developed by dr. Pdf aspheric profile versus wavefrontguided ablation. In ourhands, outcomes and enhancement rates with the allegretto wave have been outstanding and we can unreservedly recommend this technology to our patients and colleagues. With the ability to better predict outcomes with the allegretto, surgeons can treat hyperopes just as easily as myopes.
The mean postoperative mrse for allegretto wave lasik was 0. Hyperopic treatment requires a treatment zone of 9. Then, my technician and i look at the contoura vision maps. A few months later, i started using datalink, the online data tracking and nomogram software designed specifically for the allegretto. Lasik for mixed astigmatism using the allegretto wave. At long last, american surgeons are getting access to topographyguided ablationa technology that has been available outside the united states for several yearsand many of the surgeons using it are. After lasik, excess corneal flattening reduces the quality of the optical performance of the eye and increases aberrations. The first step during lasik surgery is to create a thin flap of tissue on the front of the eye to expose the inner tissue of the cornea where the actual resculpting is performed to improve your vision. This excimer laser system is approved in the united states to perform lasik laserassisted in situ keratomileusis treatment. The 1999 announcement by theo seiler, md, phd, that he had performed lasik based on aberrometry data rather than a refraction set off a frenzy of research and development. A users guide this technology promises to improve many patients vision, but surgeons need to start slowly. Wavefrontoptimized laser in situ keratomileusis with the allegretto wave eyeq excimer laser and the femto ldv crystal line femtosecond laser. However, it has become less with advanced planoscan.
Customvision is a refinement of lasik using advanced nomograms and wavefront imaging technology combined with topography measurements to achieve high contrast vision. The full text of this article hosted at is unavailable due to technical difficulties. For the refractive surgeon, the target of the wavefront marketing that also exploded around that same time, the situation can be confusing. In addition, fda has approved the wavelight allegretto wave eyeq excimer laser system, when used with the wavelight allegro topolyzer and topographyguided treatment planning software for topographyguided lasik treatments for the reduction or elimination of up to 9. The software developed by venkiteshwar and macrae controls how the laser beam dances around the surface of the cornea during a lasik procedure, allowing the surgeon to sculpt the cornea into just the right shape so that it produces as flawless an image as possible. Stahls trademarked customvision technology uses exclusive nomograms to. Adding contoura vision, topographyguided lasik to the refractive. Once the nomogram has been adapted, we hope to obtain even better andor more predictable results. For the allegretto eyeq, the wellington nomogram provided by the company was used for spherical correction.
The cartesian coordinates of the corneal vertex were manually entered into the software program. Brian stahl to customize an individual treatment plan for each patient. Wave excimer laser and tcat software topography guided. Millennialeye optimizing outcomes with contoura vision. For the refractive surgeon, the target of the wavefront marketing that also exploded around that same time. Wavelight allegretto wave eyeq excimer laser system and the allegro topolyzer. Treatment of moderatetohigh hyperopia with the wavelight allegretto 400 and ex500 excimer laser systems manoj motwani,1 ronald pei1,21motwani lasik institute, san diego, 2precision outcome consultants, fresno, ca, usapurpose. Topographyguided treatment of irregular astigmatism laserfocus. Ingenieurburo pieger gmbh, wendelstein, germany using a minimum of 50 eyes for each wavefront platform with a minimum followup of 3 months.
Our tracking software calculates the best treatment for each individual patient based on outcomes from many previous patients. Pamel was one of the first new york lasik surgeons to adopt the newest technology in custom lasik surgery, the allegretto wavelight laser. Nomogram adjustment of laser in situ keratomileusis for. Excimer laser systems, including the wavelight allegretto wave, the. The nomogram adjustment typically involves reducing treatment power by up to 10%15% for higher degrees of myopic correction. Attempted ablations were modified according to the s001 wellington nomogram for the wavefront optimised protocol. Lasik results from the wavelight allegretto wave fda clinical trials show that wavefrontoptimized profiles in treatments based on phoropter refractions outperform the custom results with the ladarvision and visx s4 lasers, without the added costs of the aberrometer, higher clickfees, increased exam time and staff training. Excimer laser surgery, excimer laser surgery crstoday. Ziemer femto ldv laser alllaser lasik with the ziemer femto ldv. Previous nonclinical study for lasik was conducted for the allegretto device in the original pma submission p020050.