Kiev Conference March 2 , 2013 Ken Kopp, FCLSA Paragon Vision Sciences Mesa, Arizona USA Translation : Dr. Andrey Kovalev

Paragon Vision Sciences Worldwide distributor of gas permeable materials since 1975 Over 400 authorized laboratory customers in all continents. Entered the finished lens market with overnight Corneal Refractive Therapy (CRT) lens in June of 2002. Added the RG-4 traditional Ortho K design for the US market in 2008 CRT Dual Axis design launched in 2009 CRT Software offered in 2012 Large diameter GP materials and finished lenses in 2012 SilOWet, silicone hydrogel material , introduced in 2013

Core Products/HDS Family Just to quickly review the HDS family of materials….. HDS and HDS 100 are approved for up to 7 day continuous wear – Paragon Thin is a daily wear material for excellent stability for thinner spherical GP designs. And the most recent daily wear offering of HI-1.54 offers the highest index of refraction to achieve higher adds for multifocals and thinner specialty GP designs. Large diameter GP blanks up to 21.8 mm – HDS100 only

Core Products/Fluoroperm Family Not to forget Paragon’s Fluoroperm family of materials that have proven to be reliable performers over the years. FL 60 , 92, and 151 are approved for overnight wear whereas FL 30 is for daily wear only. UV available in all FluoroPerm materials

Core Products/Other GP Materials Optacryl – Dk 14 FSA 38 – Dk 38 FSA 52 - Dk 52 Paraperm O2/EW O2 – Dk 16 EW – Dk 50 UV absorber is available in some materials. Check with your laboratory.

Core Products/Silicone Hydrogel SilOWet™ – a premium soft lens material that has the following properties; 60 Dk at 35○ C Lucifilcon A (non-ionic) Water content 69% @ 20○ C Modulus – 0.13 The SilOwet material is currently in the FDA approval process and we hope to receive approval for distribution in May of this year.

Paragon Corneal Reshaping Products * Jumping from the material side of the business to the finished lens offerings. The standard CRT spherical design has been FDA approved since 2002 for myopia up to 6.00 D and with or without 1.75 D of astigmatism. The CRT Dual Axis design was introduced in 2009 as an augment for corneas with higher amounts of corneal astigmatism. The RG-4 traditional four-curve corneal reshaping design was licensed by Paragon and introduced in 2008. This product is only available in North America at this time. *Currently available in North America only 7

Introducing the CRT Software Package The CRT Software was introduced in 2012 to offer the ability to observe the design choice based on the spectacle Rx and elevation data from the pre-treatment topography.

CRT Initial Lens Selector The traditional lens selection has been taken from this initial lens selector “slide ruler”. The two data pieces that are used are the spherical manifest refraction and the flat keratometry reading. Sliding the arrow to the flat K reading and locate the manifest refraction sphere (MRS) to the right, the suggested lens parameter will be shown. This data was not from a computer algorithm but compiled from hundreds of successful patient fits over 3 years time. The accuracy of the slide ruler and the new software for initial lens selection is between 80-90 %. Once the lens is on the eye, the performance is evaluated via patient follow-up examinations.

Software Design Assist for Initial Lens Selection Accuracy This is the screen for the spherical CRT design. The parameter offerings are the Base Curve, Return Zone Depth, Landing Zone Angle, and diameter choices. All of the parameter choices can be adjusted to maximize the tear pattern for the initial lens parameter selection.

CRT Software Features Import patient files from the topographer Candidate selection for a specific design Ability to manipulate parameters for optimum tear patterns Electronic ordering (international distributors pending)

Compatibility Links Keratron Scout/Piccalo Medmont Studio 4/5 Oculus EasyGraph/Keratograph Humphrey Atlas 900 Series, CZM Atlas Model 9000, Tomey versions 1-4, and Pentacam files can be imported to the CRT software but not linked directly to the unit.

CRT Design Choice

Simulated Tear Pattern With Initial Lens Parameters - CRT

Simulated Tear Pattern With Initial Lens Parameters – CRT DA

Incomplete/Apical Astigmatic Pattern The Spherical and Dual Axis CRT designs have the same FDA approval for astigmatism….up to 1.75 D. The shape of the astigmatic pattern from the pre-treatment topography can be an important factor as to which design is best to begin with. An Apical pattern with 1.75 D of astigmatism, seen in the upper left hand picture, that is enclosed in the 6 mm treatment zone can be successful using the standard spherical design. A optimum tear pattern and centration is achieved as shown in the upper right hand picture. The image at the bottom shows the desired tear layer under the lens using this design on the cornea that is astigmatic but successful with the spherical design.

Limbus-to-Limbus Astigmatic Pattern This astigmatic pattern taken from the pre-treatment map shows the steeper meridian extending from limbus-to-limbus. The spherical CRT design does not allow the appropriate peripheral alignment in the steeper meridian. The result is a decentered lens and inadequate peripheral bearing in all meridans.

CRT Dual Axis on Astigmatic Eye This is a CRT Dual Axis lens on the same cornea that shows the limbus-to-limbus astigmatic pattern. The design offers a peripheral alignment for the flat and steep meridians of the cornea and allows the proper tear pattern for proper centration and complete treatment.

Freedom to Alter Tear Pattern for Optimum Appearance Change all parameters – BC/RZD/LZA/Diameter Rotate Dual Axis design to observe tear pattern changes Reset button to return to original settings and/or click OK to begin ordering sequence or return to the home page

Paragon Software Summary Compatible with multiple topographers Specific design selection for CRT/Dual Axis/RG4 Variable simulated tear patterns Electronic Ordering

Large Diameter GP Lens Designs

ICD 16. 5 is a lens design created by Dr ICD 16.5 is a lens design created by Dr. John Mountford, Patrick Caroline, and Randy Kojima. Paragon recently licensed the product to offer the marketplace to their distributors for manufacture. NormalEyes 15.5 is a lens design created by Dr. Jerry Legerton and Dr. Bill Meyers for Paragon Vision. The nomenclature is the same as the Paragon CRT lens. (BC/RZD/LZA). This product is manufactured by Paragon Both lens designs; vault the cornea and the limbus while resting on the sclera. incorporate the use of an tangent periphery to match the angle of the limbal/scleral junction. are manufactured from Paragon HDS100 material.

Thank you for your attention Thank you for your continued support of Paragon products and if you have any questions, please see me after.