2006 年中國上海 COOC 會議 Six Months International Experience with New Iris Registration Technology & its Impact on Clinical Outcomes 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

2006 年中國上海 COOC 會議 Purpose  To evaluate clinical outcomes based on implementing automated iris registration technology with CustomVue Wavefront- guided ablation

2006 年中國上海 COOC 會議 Methods Methods  Six months Retrospective Study  Wavefront analysis: Hartmann Shack Aberrometer (Wavescan, VISX, Sunnyvale, CA, U.S.A)  Excimer laser: VISX Star S4  M2 microkeratome (U.S.A.)  F/U time: 1 day, 1 week, 1, 3, 6, 12 months

2006 年中國上海 COOC 會議 Patient’s Characteristics eyes age M/F eyes age M/F General group w/ IR /52 w/o IR /42 High astigmatism group (astigmatism>1.5D) w/ IR /28 w/o IR /21

2006 年中國上海 COOC 會議 Part1 General group: pre-op data with IR without IR with IR without IR 152 eyes 121 eyes 152 eyes 121 eyes MR X117 。 X112 。 MRSE WR X116 。 X110 。 WRSE MRSE>-6D 55% 77% Cyl>-0.5D 81% 81% RMS 8.86 μ 9.26μ

2006 年中國上海 COOC 會議 Post OP UCVA > 20/16

2006 年中國上海 COOC 會議 Post OP UCVA > 20/20

2006 年中國上海 COOC 會議 Post OP UCVA < 20/25

2006 年中國上海 COOC 會議 Pre_OP BCVA & Post_OP UCVA Comparison Between IR & Non IR

2006 年中國上海 COOC 會議 single eye did CV with IR and the other one did CV without IR UCVA UCVA IR>Non-IR IR=Non-IR IR Non-IR IR=Non-IR IR<Non-IR 1 day 18% 67% 14% 3 month 25% 64% 1%

2006 年中國上海 COOC 會議 Post-OP UCVA > 20/16 (HIGH ASTIG.)

2006 年中國上海 COOC 會議 Part2 High astigmatism group: Pre-OP data with IR without IR with IR without IR 83 eyes 65 eyes 83 eyes 65 eyes MRDC WRDC MRDC>2.0D 50% 43% MRDC>2.5D 30% 27% HOA 9.44 μ 9.98 μ

2006 年中國上海 COOC 會議 Post-OP UCVA > 20/20 (HIGH ASTIG.)

2006 年中國上海 COOC 會議 Post-OP UCVA < 20/25 (HIGH ASTIG.)

2006 年中國上海 COOC 會議 Pre-OP BCVA & Post-OP UCVA Comparison Between IR & Non IR (High Astig Group)

2006 年中國上海 COOC 會議 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-IR IR=Non-IR IR<Non-IR 1 day 20.8% 70.8% 8.3% 3 month 33.3% 66.7% 0

2006 年中國上海 COOC 會議 Pre-OP BCVA & Post-OP Cylinder Comparison: CV without IR

2006 年中國上海 COOC 會議 Pre-OP & Post-OP Cylinder Comparison: with IR Group

2006 年中國上海 COOC 會議 Part3 Cyclotorsional Eye Motion Study 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%

2006 年中國上海 COOC 會議 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: 2.03º Mean excyclotorsion of OS per patient: 1.89º

2006 年中國上海 COOC 會議 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 年中國上海 COOC 會議