2006 年中國上海 COOC 會議 Six Months International Experience with New Iris Registration...
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2006 COOC年中國上海 會議
Six Months International Six Months International Experience with New Iris Experience with New Iris
Registration Technology & its Registration Technology & its Impact on Clinical OutcomesImpact on Clinical Outcomes
David Chao-Kai Chang M.D. M.P.H. David Chao-Kai Chang M.D. M.P.H. Nobel Eye Clinic, Taipei, TaiwanNobel Eye Clinic, Taipei, Taiwan
台灣諾貝爾眼科醫院台灣諾貝爾眼科醫院張朝凱醫師張朝凱醫師
2006 COOC年中國上海 會議2006 COOC年中國上海 會議
PurposePurpose
To evaluate clinical outcomes based on implTo evaluate clinical outcomes based on implementing automated iris registration technolementing automated iris registration technology with CustomVue Wavefront-guided ablatiogy with CustomVue Wavefront-guided ablation on
2006 COOC年中國上海 會議2006 COOC年中國上海 會議
MethodsMethods
Six months Retrospective StudySix months Retrospective Study Wavefront analysis: Hartmann Shack Wavefront analysis: Hartmann Shack
Aberrometer Aberrometer ((Wavescan, VISX, Wavescan, VISX, Sunnyvale, CA, U.S.A) Sunnyvale, CA, U.S.A)
Excimer laser: VISX Star S4 Excimer laser: VISX Star S4 M2 microkeratome (U.S.A.)M2 microkeratome (U.S.A.) F/U time: 1 day, 1 week, 1, 3, 6, 12 monthsF/U time: 1 day, 1 week, 1, 3, 6, 12 months
2006 COOC年中國上海 會議2006 COOC年中國上海 會議
Patient’s CharacteristicsPatient’s Characteristics
eyes age M/Feyes age M/F
General group General group
w/ IR 152 28.3 25/52 w/ IR 152 28.3 25/52
w/o IR 121 27.4 19/42w/o IR 121 27.4 19/42
High astigmatism group (astigmatism>1.5D)High astigmatism group (astigmatism>1.5D)
w/ IR 83 25.7 15/28 w/ IR 83 25.7 15/28
w/o IR 65 24.5 13/21w/o IR 65 24.5 13/21
2006 COOC年中國上海 會議2006 COOC年中國上海 會議
Part1 General group: pre-op dataPart1 General group: pre-op data
with IR without IRwith IR without IR 152 eyes 121 eyes152 eyes 121 eyes
MR -5.66-1.23X117MR -5.66-1.23X117 。 。 -5.83-1.26X112-5.83-1.26X112 。。 MRSE -6.27 -5.39 MRSE -6.27 -5.39 WR -5.81-1.36X116WR -5.81-1.36X116 。 。 -5.37-1.39X110-5.37-1.39X110 。。
WRSE -6.49 -6.52WRSE -6.49 -6.52MRSE>-6D 55% 77%MRSE>-6D 55% 77%Cyl>-0.5D 81% 81%Cyl>-0.5D 81% 81%RMS 8.86RMS 8.86μ μ 9.26μ9.26μ
2006 COOC年中國上海 會議2006 COOC年中國上海 會議
1.4
33.2
41.637.5
30.2
4.9
24.7 26.1 25.5
17.8
05
1015202530354045
Pre_OP BCVA Post_OP@1monthUCVA
Post_OP@3 monthUCVA
Post_OP@6 monthUCVA
Post_OP@12months UCVA
IR NONIR
Post OP UCVA > 20/16
2006 COOC年中國上海 會議2006 COOC年中國上海 會議
78.4 79.5
90.5 90.587.7
80.377
85.8 86.884.5
70
75
80
85
90
95
Pre_OP BCVA Post_OP@1monthUCVA
Post_OP@3monthUCVA
Post_OP@6 monthUCVA
Post_OP@12months UCVA
IR NONIR
Post OP UCVA > 20/20
2006 COOC年中國上海 會議2006 COOC年中國上海 會議
14.9 13.710.4 9.5 8.710.9 11.6 10.2 8.9 9
0
10
20
30
40
50
Pre_OP BCVA Post_OP@1monthUCVA
Post_OP@3month UCVA
Post_OP@6month UCVA
Post_OP@12month UCVA
IR NONIR
Post OP UCVA < 20/25
2006 COOC年中國上海 會議2006 COOC年中國上海 會議
5%
72%
86%
33%
86%
42%
91% 90%
38%
91% 91%
0.3
0.88 0.89
0%
20%
40%
60%
80%
100%
Pre_OP 1 month 3 month 6 months 12 months
IR 20/ 16 or better NONIR 20/ 16 or better IR 20/ 20 or betterNONIR 20/ 20 or better IR 20/ 25 or better NONIR 20/ 25 or better
Pre_OP BCVA & Post_OP UCVA Comparison Between IR & Non IR
2006 COOC年中國上海 會議2006 COOC年中國上海 會議
single eye did CV with IR and the other one did CV without IR
UCVAUCVA
IR>Non-IR IR=Non-IR IR<Non-IRIR>Non-IR IR=Non-IR IR<Non-IR
1 day 1 day 18%18% 67%67% 14% 14%
3 month 3 month 25%25% 64%64% 1% 1%
2006 COOC年中國上海 會議2006 COOC年中國上海 會議
1
28.2
39.2 41.338.5
2.6
24.2 25.530.7
27.5
05
1015202530354045
Pre_OP BCVA Post_OP@1monthUCVA
Post_OP@3 monthUCVA
Post_OP@6monthUCVA
Post_OP@12months UCVA
IR NONIR
Post-OP UCVA > 20/16 (HIGH ASTIG.)
2006 COOC年中國上海 會議2006 COOC年中國上海 會議
Part2 High astigmatism group: Pre-OP dataPart2 High astigmatism group: Pre-OP data
with IR without IRwith IR without IR 83 eyes 65 eyes 83 eyes 65 eyes
MRDC -2.0 -1.92MRDC -2.0 -1.92WRDC -2.14 -2.02 WRDC -2.14 -2.02 MRDC>2.0D 50% 43%MRDC>2.0D 50% 43%MRDC>2.5D 30% 27%MRDC>2.5D 30% 27%HOA 9.44HOA 9.44μ μ 9.989.98μμ
2006 COOC年中國上海 會議2006 COOC年中國上海 會議
68.275.4 80
85 83.272.6 74.5 75.2
83.5 82.7
0102030405060708090
Pre_OP BCVA Post_OP@1monthUCVA
Post_OP@3 monthUCVA
Post_OP@6 monthUCVA
Post_OP@12 monthUCVA
IR NONIR
Post-OP UCVA > 20/20 (HIGH ASTIG.)
2006 COOC年中國上海 會議2006 COOC年中國上海 會議
16.4
24.1
11.3 10.1 9.8
18.313.7 12.4 11.3 11.2
0
10
20
30
40
50
Pre_OP BCVA Post_OP@ 1 monthUCVA
Post_OP@3 monthsUCVA
Post_OP@6 monthUCVA
Post_OP@12months UCVA
IR NONIR
Post-OP UCVA < 20/25 (HIGH ASTIG.)
2006 COOC年中國上海 會議2006 COOC年中國上海 會議
1%
68%
82%
28%
75% 76%
39%
80%
89%
0.41
0.850.9
0.39
0.83
0.9
0%
20%
40%
60%
80%
100%
Pre_OP 1 month 3 month 6 month 12 month
IR 20/ 16 or better NONIR 20/ 16 or better IR 20/ 20 or betterNONIR 20/ 20 or better IR 20/ 25 or better NONIR 20/ 25 or better
Pre-OP BCVA & Post-OP UCVA Comparison Between IR & Non IR (High Astig Group)
2006 COOC年中國上海 會議2006 COOC年中國上海 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-IRIR>Non-IR IR=Non-IR IR<Non-IR
1 day 1 day 20.8%20.8% 70.8%70.8% 8.3% 8.3%
3 month 3 month 33.3%33.3% 66.7%66.7% 0 0
2006 COOC年中國上海 會議2006 COOC年中國上海 會議
Pre-OP BCVA & Post-OP Cylinder Comparison: CV without IR
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
>3.0D 3D~2D 2D~1D 1D~0.5D0.5D~0.25D 0 D
Post_OP
Post_OP@1 month
Post_OP@3 month
Post_OP@6 month
Post_OP@12 month
2006 COOC年中國上海 會議2006 COOC年中國上海 會議
Pre-OP & Post-OP Cylinder Comparison: with IR Group
0%
5%
10%
15%
20%
25%
30%
35%
>3.0D 3D~2D 2D~1D 1D~0.5D0.5D~0.25D 0 D
Pre_OP
Post_OP@1 month
Post_OP@3 month
Post_OP@6 months
Post_OP@12 months
2006 COOC年中國上海 會議2006 COOC年中國上海 會議
Part3 Cyclotorsional Eye Motion Study
31%
26%
19%
13%
4%6%0°~1°
1°~2°
2°~3°
3°~4°
4°~5°
>5°
Angle of rotation: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 COOC年中國上海 會議2006 COOC年中國上海 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: 2.03ºMean excyclotorsion of OS per patient: 1.89º
9.8%
52.8%
12.2%
25.2%
CW,CCW
CCW,CW
CW,CW
CCW,CCW
2006 COOC年中國上海 會議2006 COOC年中國上海 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 COOC年中國上海 會議