CustomVue vs Conventional LASIK: one year study David Chao-Kai Chang M.D. M.P.H. Nobel Eye Clinic, Taipei, Taiwan 台灣諾貝爾眼科醫院 張朝凱醫師 Lady & Gentleman, good afternoon, now I’ll talk about CustomVue versus conventional LASIK, this is a one year study 2006年中國上海COOC會議

Introductions WFG-LASIK More predictable outcome Less induction of HOA Better night vision To compare outcomes of LASIK using conventional Visx S4 and CustomeVue wavefront system in Taiwan We know wavefront guided LASIK is more predictable, less induce HOA and has better night vision, so I will present our experiences in Taiwan to compare the outcomes of conventional LASIK and CustomeVue wavefront guided LASIK 2006年中國上海COOC會議

Patients Recruitment period  July 1 2004 – June 30 2005 Conventional LASIK (VISX S4) 1360 subjects  2685 eyes CustomeVue LASIK ( Wavescan Version 3.5) 262 subjects  500 eyes Patients were enrolled between July 1 2004 and June 30 2005, so 2685 eyes having conventional LASIK and 500 eyes having CustomeVue LASIK were enrolled in this prospective study. 2006年中國上海COOC會議

Pre-OP Data Conventional CustomeVue (n= 2685) (n=500) Age 27.3y/o 28.5y/o M:F 3.3:6.7 3.8:6.2 MRSE -6.28±1.18 -6.59±1.4 Cyl -0.63± 0.42 -0.75±0.45 WRSE NE -6.32±1.5 These are preoperative data including age, gender, spherical equivalent, cylinder and spherical aberrations. There is not significant difference between age, gender, SE and cylinder 2006年中國上海COOC會議

Results UCVA BCVA MRSE Wavefront HOA Contrast Sensitivity F/U time: at 1day, 1 week, 1、3 、6 、12 month (Since July 1 2004 to June 30 2005) UCVA BCVA MRSE Wavefront HOA Contrast Sensitivity Postoperatively, patients were followed at 1 day, 1week and at 1,3,6,12 months. Postoperative examinations included UCVA, BCVA, manifest refraction, contrast sensitivity and wavescan measurement. However, follow-up data at 12 months were available for 19% conventional eyes and 16% customeVue eyes 2006年中國上海COOC會議

Part1 UCVA-Conventional This figure illustrates UCVA for conventional eyes at 1,3,6,12 months, at 12 months, 87% of eyes were equal or above 20/20. 87% of eyes achieved 20/20 UCVA at 12 Month Follow-Up 2006年中國上海COOC會議

94% of eyes achieved 20/20 UCVA at 12 Month Follow-Up Part1 UCVA-CustomeVue This figure illustrates UCVA of CustomeVue eyes at 1,3,6,12 months, at 12 months, 94% of eyes were equal or above 20/20 94% of eyes achieved 20/20 UCVA at 12 Month Follow-Up 2006年中國上海COOC會議

Part2 Post-OP UCVA vs Pre-OP BSCVA - Conventional This figure illustrates comparison between post-op UCVA ant pre-OP BCVA in conventional eyes 2006年中國上海COOC會議

Part2 Post-OP UCVA vs Pre-OP BSCVA - CustomeVue This figure illustrates comparison between post-OP UCVA and Pre-OP BSCVA in CustomeVue eyes 2006年中國上海COOC會議

Part2 Loss BCVA Loss of ≧ 2 lines BCVA 1 mon 0.62% 0 3 mon 0.55% 0.3% Conventional CustomeVue Loss of ≧ 2 lines BCVA 1 mon 0.62% 0 3 mon 0.55% 0.3% 6 mon 0.37% 0 12 mon 0.35% 0 BCVA≦ 20/25 1 mon 0.57% 0 3 mon 0.48% 0.3% 6 mon 0.36% 0 12 mon 0.35% 0 In CustomeVue group, no eyes lost more than 2 lines of BCVA or BCVA were worse than 20/25 at 12 months. 2006年中國上海COOC會議

Part3 MRSE-Conventional This figure shows the attempted versus achieved results of conventional eyes at 1.3.6.12 months. 2006年中國上海COOC會議

Part3 MRSE-CustomeVue This figure shows attempted versus achieved results of CustomeVue group at 1,3,6,12 months 2006年中國上海COOC會議

Part4 Change in HOA (µ) Conventional LASIK CustomeVue LASIK The CustomeVue treatments had a significant lower mean increase in high order aberration than the conventional treatments. Conventional LASIK CustomeVue LASIK 2006年中國上海COOC會議

Part5 CS-Conventional Contrast sensitivity were obtained by Vistech 6500 preoperatively and 6, 12 monts 2006年中國上海COOC會議

Part5 CS-CustomVue Contrast sensitivity were more stable in CustomeVue eyes 2006年中國上海COOC會議

Discussion We will discuss some issues 2006年中國上海COOC會議

Issue 1 – Stability Better vision obtained UCVA ≧20/16 at 1、3、6、12 months F/U CustomeVue LASIK ＞Conventional LASIK Better vision stability 87% of conventional group achieved 20/20 UCVA at 12 months F/U 94% of CustomeVue group achieved 20/20 UCVA at 12 months F/U Issue I, stability: in this study, CustomeVue eyes had better vision obtained and better vision stability 2006年中國上海COOC會議

Issue 2 - Safety In CustomeVue group at 3 month F/U Loss of ≧ 2 lines BCVA: 0.3% BCVA≦ 20/25 : 0.3% Flap complications were the causes CustomeVue LASIK is safe! Some flap problem must be overcome! Issue 2, safety: at 3 months, loss of BCVA in CustomeVue eyes only had 0.3 %, flap complication were the causes, so it’s safety! 2006年中國上海COOC會議

Issue 3 - Predicability MRSE ± 0.50D (12 months) Conventional: CustomeVue = 76% :84% MRSE ± 1.0 D (12 months) Conventional: CustomeVue = 92% :95% Not significant Some undercorrection was found by CustomeVue Nomogram building is important! Issue 3, predicability The attempted versus achieved results at 12 months between conventional eyes and CustomeVue eyes were not significant, in the meantime, some undercorrection was noted for CustomeVue eyes. 2006年中國上海COOC會議

Issue 4 - Visual Quality CustomeVue group had a significant improvement in post-op UCVA compared with pre-op BCVA CustomeVue group had a significant lower mean increase in HOA than conventaional group CustomeVue LASIK really has better visual quality Higher patient satisfaction ! Issue 4, Visual quality, 73% of CustomeVue eyes had better post-op UCVA than their pre-op BCVA, and we also found customeVue eyes had lower mean increase in HOA, so Custome LASIK really has better vision quality and patients satisfication. 2006年中國上海COOC會議

Issue 5 - Scopotic Complains Contrast sensitivity is more stable in CustomeVue group Less HOA increase in CustomeVue group CustomeVue LASIK less induce scopotic problems However, pupil diameter is another important factor ! Issue 5, Scopotic Complains, CustomeVue eyes had more stable contrast sensitivity and less increase HOA , however, pupil diameter is more important factor! 2006年中國上海COOC會議

Thanks for your attentions! 2006年中國上海COOC會議