2006 年中國上海 cooc 會議 six months international experience with new iris registration...

2006 COOC年中國上海會議

Six Months International Six Months International Experience with New Iris Experience with New Iris

Registration Technology & its Registration Technology & its Impact on Clinical OutcomesImpact on Clinical Outcomes

David Chao-Kai Chang M.D. M.P.H. David Chao-Kai Chang M.D. M.P.H. Nobel Eye Clinic, Taipei, TaiwanNobel Eye Clinic, Taipei, Taiwan

台灣諾貝爾眼科醫院台灣諾貝爾眼科醫院張朝凱醫師張朝凱醫師

2006 COOC年中國上海會議2006 COOC年中國上海會議

PurposePurpose

To evaluate clinical outcomes based on implTo evaluate clinical outcomes based on implementing automated iris registration technolementing automated iris registration technology with CustomVue Wavefront-guided ablatiogy with CustomVue Wavefront-guided ablation on


MethodsMethods

Six months Retrospective StudySix months Retrospective Study Wavefront analysis: Hartmann Shack Wavefront analysis: Hartmann Shack

Aberrometer Aberrometer ((Wavescan, VISX, Wavescan, VISX, Sunnyvale, CA, U.S.A) Sunnyvale, CA, U.S.A)

Excimer laser: VISX Star S4 Excimer laser: VISX Star S4 M2 microkeratome (U.S.A.)M2 microkeratome (U.S.A.) F/U time: 1 day, 1 week, 1, 3, 6, 12 monthsF/U time: 1 day, 1 week, 1, 3, 6, 12 months


Patient’s CharacteristicsPatient’s Characteristics

eyes age M/Feyes age M/F

General group General group

w/ IR 152 28.3 25/52 w/ IR 152 28.3 25/52

w/o IR 121 27.4 19/42w/o IR 121 27.4 19/42

High astigmatism group (astigmatism>1.5D)High astigmatism group (astigmatism>1.5D)

w/ IR 83 25.7 15/28 w/ IR 83 25.7 15/28

w/o IR 65 24.5 13/21w/o IR 65 24.5 13/21


Part1 General group: pre-op dataPart1 General group: pre-op data

with IR without IRwith IR without IR 152 eyes 121 eyes152 eyes 121 eyes

MR -5.66-1.23X117MR -5.66-1.23X117 。。 -5.83-1.26X112-5.83-1.26X112 。。 MRSE -6.27 -5.39 MRSE -6.27 -5.39 WR -5.81-1.36X116WR -5.81-1.36X116 。。 -5.37-1.39X110-5.37-1.39X110 。。

WRSE -6.49 -6.52WRSE -6.49 -6.52MRSE>-6D 55% 77%MRSE>-6D 55% 77%Cyl>-0.5D 81% 81%Cyl>-0.5D 81% 81%RMS 8.86RMS 8.86μ μ 9.26μ9.26μ


1.4

33.2

41.637.5

30.2

4.9

24.7 26.1 25.5

17.8

05

1015202530354045

Pre_OP BCVA Post_OP@1monthUCVA

Post_OP@3 monthUCVA

Post_OP@6 monthUCVA

Post_OP@12months UCVA

IR NONIR

Post OP UCVA > 20/16


78.4 79.5

90.5 90.587.7

80.377

85.8 86.884.5

70

75

80

85

90

95


Post_OP@3monthUCVA

Post_OP@6 monthUCVA


IR NONIR

Post OP UCVA > 20/20


14.9 13.710.4 9.5 8.710.9 11.6 10.2 8.9 9

0

10

20

30

40

50


Post_OP@3month UCVA

Post_OP@6month UCVA

Post_OP@12month UCVA

IR NONIR

Post OP UCVA < 20/25


5%

72%

86%

33%

86%

42%

91% 90%

38%

91% 91%

0.3

0.88 0.89

0%

20%

40%

60%

80%

100%

Pre_OP 1 month 3 month 6 months 12 months

IR 20/ 16 or better NONIR 20/ 16 or better IR 20/ 20 or betterNONIR 20/ 20 or better IR 20/ 25 or better NONIR 20/ 25 or better

Pre_OP BCVA & Post_OP UCVA Comparison Between IR & Non IR


single eye did CV with IR and the other one did CV without IR

UCVAUCVA

IR>Non-IR IR=Non-IR IR<Non-IRIR>Non-IR IR=Non-IR IR<Non-IR

1 day 1 day 18%18% 67%67% 14% 14%

3 month 3 month 25%25% 64%64% 1% 1%


1

28.2

39.2 41.338.5

2.6

24.2 25.530.7

27.5

05

1015202530354045


Post_OP@3 monthUCVA

Post_OP@6monthUCVA


IR NONIR

Post-OP UCVA > 20/16 (HIGH ASTIG.)


Part2 High astigmatism group: Pre-OP dataPart2 High astigmatism group: Pre-OP data

with IR without IRwith IR without IR 83 eyes 65 eyes 83 eyes 65 eyes

MRDC -2.0 -1.92MRDC -2.0 -1.92WRDC -2.14 -2.02 WRDC -2.14 -2.02 MRDC>2.0D 50% 43%MRDC>2.0D 50% 43%MRDC>2.5D 30% 27%MRDC>2.5D 30% 27%HOA 9.44HOA 9.44μ μ 9.989.98μμ


68.275.4 80

85 83.272.6 74.5 75.2

83.5 82.7

0102030405060708090


Post_OP@3 monthUCVA

Post_OP@6 monthUCVA

Post_OP@12 monthUCVA

IR NONIR

Post-OP UCVA > 20/20 (HIGH ASTIG.)


16.4

24.1

11.3 10.1 9.8

18.313.7 12.4 11.3 11.2

0

10

20

30

40

50

Pre_OP BCVA Post_OP@ 1 monthUCVA

Post_OP@3 monthsUCVA

Post_OP@6 monthUCVA


IR NONIR

Post-OP UCVA < 20/25 (HIGH ASTIG.)


1%

68%

82%

28%

75% 76%

39%

80%

89%

0.41

0.850.9

0.39

0.83

0.9

0%

20%

40%

60%

80%

100%

Pre_OP 1 month 3 month 6 month 12 month

IR 20/ 16 or better NONIR 20/ 16 or better IR 20/ 20 or betterNONIR 20/ 20 or better IR 20/ 25 or better NONIR 20/ 25 or better

Pre-OP BCVA & Post-OP UCVA Comparison Between IR & Non IR (High Astig Group)


single eye did CV with IR and the other one did CV without IR

(High Astigma Group)(High Astigma Group) UCVA UCVA IR>Non-IR IR=Non-IR IR<Non-IRIR>Non-IR IR=Non-IR IR<Non-IR

1 day 1 day 20.8%20.8% 70.8%70.8% 8.3% 8.3%

3 month 3 month 33.3%33.3% 66.7%66.7% 0 0


Pre-OP BCVA & Post-OP Cylinder Comparison: CV without IR

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

>3.0D 3D~2D 2D~1D 1D~0.5D0.5D~0.25D 0 D

Post_OP

Post_OP@1 month

Post_OP@3 month

Post_OP@6 month

Post_OP@12 month


Pre-OP & Post-OP Cylinder Comparison: with IR Group

0%

5%

10%

15%

20%

25%

30%

35%

>3.0D 3D~2D 2D~1D 1D~0.5D0.5D~0.25D 0 D

Pre_OP

Post_OP@1 month

Post_OP@3 month

Post_OP@6 months

Post_OP@12 months


Part3 Cyclotorsional Eye Motion Study

31%

26%

19%

13%

4%6%0°~1°

1°~2°

2°~3°

3°~4°

4°~5°

>5°

Angle of rotation:Angle of rotation:

0°~1° : 31%0°~1° : 31%

1°~2° : 26%1°~2° : 26%

2°~3° : 19%2°~3° : 19%

3°~4° : 13%3°~4° : 13%

4°~5° : 6%4°~5° : 6%

>5° : 4%>5° : 4%


Part4 Cyclotorsional Eye Motion Study

(OD,OS)= (CW,CCW) : 9.8%(OD,OS)= (CCW,CW) : 52.8%(OD,OS)= (CW,CW) : 12.2%(OD,OS)= (CCW,CCW) : 25.2%Mean excyclotorsion of OD per patient: 2.03ºMean excyclotorsion of OS per patient: 1.89º

9.8%

52.8%

12.2%

25.2%

CW,CCW

CCW,CW

CW,CW

CCW,CCW


Conclusions Cyclotorsional registration is essential All CV guided treatment provide excellent clinical

results. But the CV with IR technology is a more efficient and precise LVC treatment.

IR can produce best vision than is possible with non-IR treatment especially for high astigmatism patient.

Automated iris registration optimizes clinical outcomes through alignment of wavefront map and laser ablation in this study and further investigations are developing

2006 COOC年中國上海會議

2006 年中國上海 cooc 會議 six months international experience with new iris registration...

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