IsoBeam D200 no touch for presbyopia, emmetropia presbyopia

  • View
    128

  • Download
    6

Embed Size (px)

DESCRIPTION

presbyopia treatment for emmetropia by center no touch technique to perform the surgery, and compared Kera IsoBeam D200 and Zeiss MEL80 presbyopia results performance through the wound healing period. presbyopia new method to treat emmetropic presbyopia. no touch on center cornea for emmetropia presbyopia.

Text of IsoBeam D200 no touch for presbyopia, emmetropia presbyopia

Correction of Presbyopia with Kera No-touch technique

Jae Chan Kim M.D., Ph.D.,

Department of Ophthalmology Chung-Ang University

Refractive regression : major challenge after refractive surgeryWhy?Inconsistensy of wound healing after refractive surgery Refractive regression process predominate in regions of greater tissue removal (William J Dupps Jr, etc. Experimental eye research 2006) Disruption of epithelium over central cornea in PRK amplifies the wound healing response and accounts for higher rates of regression and haze (R.R Mohan, etc. Exp. Eye 2003)

Concept :Refractive regression : major challenge after refractive surgeryEnhanced early wound healing improves final visual outcome by inhibition of regression?

Preservation of central corneal epithelium in corneal ablation surgery lead to shortening of early wound healing time decrease of refractive regression

No-touch surgery in presbyopia ?Object: emmetropia c mild hyperopia * Dual flying spothomogenous energy delivery

* Smooth ablation c no ridgeeffective corneal ablation

* Small beam size :0.44mm & Random projection delicate ablation & more accurate treatmentsInventor : George huang Ph.D. Idea from Jae Chan Kim M.D.Woo chan Park M.D., Byung moo Min M.D.

Center - Distance vision : Spherical curvature No-touch zone(3.5~4.2mm) Paracentral& Peripheral - Near VisionDoughnut shape1.Fa r 2. Near

Corneal ablation method & Concept of early wound healing

Ablation zone

: Aspherical curvature Epithelial migration

Central epithelium ; more faster than Peripheral epithelium

Bidirectional wound healing

Materials & Measurements 10 patients, 12 eyes M:F = 6 : 4, 51.2 years old (43-60) Emmetropia c mild hyperopia(SE 1.25D) - mean S.E. : 0.78D

December, 2007~ June,2008 F/U: postoperative 1, 4, 30days Measurements - Far and near uncorrected visual acuity- DOF, depth of focus - Topography (Humphrey ATLAS, Zeiss) - Aberrometer (WASCA aberrometer, Zeiss) - Contrast sensitivity (CSV-1000E, Vector vision) - Rate of corneal wound healing

Result: Corneal epithelial wound healing ratePostop. Postop.15hrs POD#4

Total ablationS.E 0.75 Ablation depth 39Mm

Postop.

Postop.15hrs

POD#4

No-touchS.E 0.5 Ablation depth 35Mm

Postop.

Postop.15hrs

POD#4

Comparison of corneal epithelial wound healing days*wound healing days5 4 3 2 1 0MEL80

4.5days

1.3daysno- touch

Significant at P