VISX CustomVue vs' LADAR CUSTOMCORNEA: A comparison of advanced surface ablation visual outcomes

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VISX CustomVue vs. LADAR CUSTOMCORNEA A
comparison of advanced surface ablation visual
outcomes
Christopher Kurz, Capt, USAF, MC, FS Charles
Reilly, LtCol, USAF, MC, SFS
Wilford Hall Medical Center San Antonio, TX
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PURPOSE/ STUDY DESIGN

• To compare the visual outcomes of the first two
  custom ablation systems to receive FDA approval
• VISX CustomVue
• LADARVision System
• Numerous studies have compared these custom
  ablation systems using LASIK procedures
• No known study to date has compared these two
  custom ablation systems using surface ablation
  techniques
• Retrospective review of data from the Warfighter
  Refractive Surgery Database
• Group 1 (LVC)
• All custom PRK and LASEK eyes treated with the
  LADARVision System at Wilford Hall Medical Center
  from March 2005 through September 2006
• Group 2 (CV)
• Each eye from Group 1 was matched by age, pre-op
  manifest spherical equivalent and cylinder with
  eyes treated with the VISX CustomVue procedure
  during the same time period
• No normogram adjustments were made for either
  group
• Manifest and uncorrected visual acuities were
  collected at the 1, 3, 6, and 12 month
  post-operative periods

• Surface Ablation is an off-label use of the FDA
  Approved Custom Ablation Systems

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Diopters of MRSE
Diopters of MRSE
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CONCLUSIONS

• Both laser systems provide safe and reliable
  reduction of dependence on spectacle correction
  with advanced surface ablations on patients with
  myopia
• By 3 months, 88 of the CV group and 90 of the
  LVC group had UCVA of 20/20 or better
• At 12 months this rises to 95 for the CV group
  and 100 for the LVC group
• By 3 months, both groups had an average MRSE
  within 1/8 D of plano which remained out to 12
  months
• The CV group had almost double the number of
  patients with 20/15 or better UCVA than the LVC
  group at 1, 3, and 6 months post-op
• At 1 month, the CustomVue procedure appears to
  undercorrect at both lower and higher refractive
  errors, this trend was not seen at 3, 6 ,or 12
  months post-op
• At 1 and 3 months, the LADARVision Sytem tended
  to overcorrect at higher refractive errors, this
  trend was not seen at 6 and 12 months
• Between 1 3 months, both groups showed a
  hyperopic drift of about 1/5 D
• CV group ended up within 1/8 D of plano on the
  minus side
• LVC group ended up within 1/8D of plano on the
  plus side

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REFERENCES

• 1 Awwad ST, Haithcock KK, Oral D, Bowman RW,
  Cavanagh HD, McCulley JP.
• A comparison of induced astigmatism in
  conventional and wavefront-guided myopic
• LASIK using LADARVision4000 and VISX S4
  platforms.
• J Refract Surg. 2005 Nov-Dec21(6)S792-8.
• PMID 16329382 PubMed - indexed for MEDLINE
• 2 Awwad ST, El-Kateb M, Bowman RW, Cavanagh HD,
  McCulley JP.
• Wavefront-guided laser in situ keratomileusis
  with the Alcon CustomCornea and
• the VISX CustomVue three-month results.
• J Refract Surg. 2004 Sep-Oct20(5)S606-13.
• PMID 15523984 PubMed - indexed for MEDLINE
• 3 Slade S.
• Contralateral comparison of Alcon CustomCornea
  and VISX CustomVue
• wavefront-guided laser in situ keratomileusis
  one-month results.
• J Refract Surg. 2004 Sep-Oct20(5)S601-5.
• PMID 15523983 PubMed - indexed for MEDLINE

• 7 Netto MV, Ambrosio R Jr, Shen TT, Wilson SE.
• Wavefront analysis in normal refractive surgery
  candidates.
• J Refract Surg. 2005 Jul-Aug21(4)332-8.
• PMID 16128329 PubMed - indexed for MEDLINE
• 8 Twa MD, Lembach RG, Bullimore MA, Roberts C.
• A prospective randomized clinical trial of laser
  in situ keratomileusis with
• two different lasers.
• Am J Ophthalmol. 2005 Aug140(2)173-83.
• PMID 16023065 PubMed - indexed for MEDLINE
• 9 Jun RM, Cristol SM, Kim MJ, Seo KY, Kim JB,
  Kim EK.
• Rates of epithelial ingrowth after LASIK for
  different excimer laser systems.
• J Refract Surg. 2005 May-Jun21(3)276-80.
• PMID 15977885 PubMed - indexed for MEDLINE
• 10 Duffey RJ, Leaming D.
• US trends in refractive surgery 2003 ISRS/AAO
  survey.

13 Duffey RJ, Leaming D. US trends in
refractive surgery 2004 ISRS/AAO Survey. J
Refract Surg. 2005 Nov-Dec21(6)742-8. No
abstract available. PMID 16329367 PubMed -
indexed for MEDLINE 14 Gailitis RP.
Comparison of LASIK outcomes with the Alcon
LADARVision4000 and the VISX STAR S2 excimer
lasers using optimized nomograms. J Refract Surg.
2005 Nov-Dec21(6)683-90. PMID 16329359
PubMed - indexed for MEDLINE 15 Awwad ST,
Bowman RW, Cavanagh HD, McCulley JP.
Wavefront-guided LASIK for myopia using the LADAR
CustomCornea and the VISX CustomVue. J Refract
Surg. 2007 Jan23(1)26-38. PMID 17269241
PubMed - in process 16 Thomas JW, Mitra S,
Chuang AZ, Yee RW. Electron microscopy of
surface smoothness of porcine corneas and acrylic
plates with four brands of excimer laser. J
Refract Surg. 2003 Nov-Dec19(6)623-8. PMID
14640426 PubMed - indexed for MEDLINE 17
Wachler BS, Hiatt JA. Understanding pre-market
approval and labeling differences of two
leading customized ablation platforms a call for
reform at the FDA. J Refract Surg. 2004
Sep-Oct20(5)S588-92. PMID 15523980 PubMed -
indexed for MEDLINE