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Keith H. Carlson, MD MMM FACS Emmett F Carpel, MD

Initial LASEK Outcomes Using the LADAR6000 CustomCornea Excimer Laser by Experienced VISX S4 CustomVue Users. Keith H. Carlson, MD MMM FACS Emmett F Carpel, MD. LADAR6000 Initial Experience. Purpose:

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Keith H. Carlson, MD MMM FACS Emmett F Carpel, MD

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  1. Initial LASEK Outcomes Using the LADAR6000 CustomCornea Excimer Laser by Experienced VISX S4 CustomVue Users Keith H. Carlson, MD MMM FACS Emmett F Carpel, MD

  2. LADAR6000 Initial Experience • Purpose: • Record initial the LASEK outcomes of 4 experienced Visx surgeons as each transitioned to a new laser platform- the Alcon LADAR6000

  3. LADAR6000 Initial Experience • Methods: • 4 VISX users each with 10 yrs experience • Utilizing a standard 20 % alcohol assisted LASEK procedure • All treatments over 5D of myopia, had Mitomycin C .2mg/ml for 30-40 seconds • Standard training and credentialing in LADAR6000 use

  4. LADAR6000 Initial Experience • Methods: • All LADAR treatments were custom ablations from patient specific Ladarwave • Appropriate offsets were applied to each CustomCornea operative plan • A goal of plano was attempted with each ablation • Patient data was recorded at 6 months

  5. LADAR6000 Initial Experience • Results: • Number of eyes: 42 • Age: Mean- 46yrs Range- 26-65yrs • Mean Preop correction: -4.17D +/-.41 • Mean Postop correction: +.31D +/- .11 • Mean Visual Acuity without correction: 20/30

  6. LADAR6000 Initial Experience • Results: • Uncorrected Visual Acuity • 20/20 – 48% • 20/25 – 69% • 20/30 – 83% • 20/40 – 86% • Less than 20/40 – 14%

  7. LADAR6000 Initial Experience • Results: • A distinctive fine reticular haze was noted in nearly half of patients at 6 months (48%). This was graded at +1 and seen best in sclerotic scatter. • Loss of best corrected visual acuity of one or more lines at 6 months: 4.8% • No topographical areas of central islands were noted.

  8. LADAR6000 Initial Experience • Conclusion: • Initial outcomes by experienced VISX users at 6 months was poorer than that typically seen on a Visx custom platform • 20/40 uncorrected visual acuity was less than 90% • Atypical reticular stromal haze occurred in 48% of patients despite use of Mitomycin C • Loss of one or more lines of best corrected visual acuity was 4.8% • These data in LASEK appear to be more aberrant than any “learning curve” issues would indicate • Other studies evaluating these platforms with LASIK show variable results.¹ ²

  9. LADAR6000 Initial Experience • Bibliography: • 1. Moshirfar M, et al, “Prospective randomized trial of wavefront-guided laser in situ keratomileusis with CustomCornea and CustomVue laser systems”, JCSR 33(10):1727-33, 2007 Oct. • 2. Awwad ST, et al, “ Wavefront guided LASIK for myopia using the LADAR CustomCornea and VISX CustomVue”, JRS 23(1):26-38, 2007 Jan.

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