My ladarvision 4000 alcon

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Patients with astigmatism up to WaveFront Mapping WaveFront Mapping technology is a tremendous breakthrough in laser vision correction and has the ability to produce better visual results than traditional LASIK laser vision correction.

If you want to see a difference in your vision, call Dr. During my consultation with Dr. Boothe, I realized that he is the best fit for me. I know that he is a perfectionist and will do a great job on my eyes. I trusted him. One drawback to the Ladarvision excimer laser is that it operates at 60Hz, meaning more time is needed to complete ablations on patients with high myopia.

Also, the laser needs to be calibrated frequently to maintain a proper energy level prior to ablation. Although the internal changes of the laser's components have decreased the frequency for gas-bottle exchanges, the rate could be improved. Furthermore, although I have adapted to the working space under the laser distance from the patient's head to the bottom of the laser head above him , it could be enhanced. Currently, a floppy disk is used to transfer the wavefront maps to the laser.

In my opinion, a USB drive is preferable, and wireless transmission is ideal for this function. Although registration with the Ladarvision is excellent, it is a little labor intensive. Automating the limbal registration marking process would be an improvement. The Ladar operates at Hz, thus cutting ablation time in half compared with the version. It has an extremely stable Tuilaser cavity Coherent, Inc. Also, this laser has more working space under its head. The new system incorporates a USB drive, which is also upgradeable to wireless, for transferring wavefront data.

Last, the Ladar is equipped with an automated limbal blood vessel registration, so surgeons will not need to mark the limbus. The MEL 80 has three important advantages that make it extremely effective. It is extraordinarily fast at Hz. The eye tracker is equally quick and maintains perfect centration throughout the ablation by means of an ultrarapid iris registration camera. Also, the laser's Gaussian flying spot provides a smooth ablation with prolate optimization, which maintains the natural outer curvature of the corneal surface and thereby minimizes induced spherical aberration.

My patients are extremely pleased with their results. The most pleasant surprise with the MEL 80 is its ability to treat hyperopia. I decided that LASIK was not ideal for patients with hyperopia because of the slower healing and aggravation of dry eye. However, even higher degrees of hyperopia are amenable to correction with the MEL I have treated up to 6. This therapy range for the MEL 80 changes the landscape for hyperopes by providing a viable option for patients who want excellent uncorrected distance vision but do not mind wearing reading glasses.

The ergonomics of operating the MEL 80 is different from that of other lasers I have used. The patient's head is closer to the surgeon's lap. Also, the illumination needs to be a bit lower in order for the tracker to capture the pupillary image. It is a reliable Hartmann-Shack sensor with great sensitivity. If I were in the market for an excimer laser today, I would give very strong consideration to the MEL It represents the latest generation of excimer lasers and reproducibly delivers optimal results, even in the higher ranges of hyperopia.

The biggest problem with this technology is its current lack of FDA approval. That said, treating myopia and myopic astigmatism is easy with this user-friendly device. The opportunity for the surgeon to select whatever optical and transitional zone desired is a big advantage and allows him to tailor the procedure to a variety of patient parameters. Currently, the optical zone can be set as wide as 6. However, a transition zone greater than 8mm is excessive in my opinion.

Wide transition zones on the Nidek laser seem to mitigate nighttime visual symptoms for all but the highest myopic treatments. The utilization of optical and transitional zone adjustments allows the delivery of treatments that optimize the postoperative wavefront characteristics by reducing the induction of spherical aberration.

For astigmatic treatments, the optical zone is not truncated, which produces great visual results with a full optical zone diameter. The Hz eye tracker centers easily and follows patients' eye movements well. The EC is equipped with a combination of active and passive tracking. The laser will shut down if there is eye movement of more than 0. Furthermore, the laser's cross-hair aiming system demonstrably indicates the proper alignment of the eye with the laser for the surgeon.

In my experience, when the laser is placed in a room with efficient air filtration and humidity control, the optical lenses and mirrors are long lasting, and the laser needs very little maintenance. Hyperopia and hyperopic astigmatism should be FDA approved soon, with excellent results from the clinical trials.

The hyperopic treatments will have an optical zone of 7mm and a transition zone of 9mm. Once the laser is approved in the US to treat hyperopia, surgeons may take advantage of this modality.

This instrument is a wonderful device for diagnostic applications and will allow integration for optimized aspheric treament zones and customized aspheric treatment zones. FDA trials for the customized treatments should begin very soon, although far too late for many users. The economic advantages of the Nidek laser are obvious; there are no click fees, and that is a great benefit for any surgeon, particularly those with smaller surgical volumes who cannot negotiate volume-based lower rates with the other excimer laser manufacturers.

Enhancements without fees are another plus. In my experience, the Nidek EC is a reliable instrument that delivers unsurpassed results, especially for a surgeon willing to develop his own nomograms. The platform is an absolute workhorse and is highly reliable. Its broad range of features offers ease of use as well as excellent results. An additional advantage of the Planoscan software is that, for astigmatic treatments, the specified treatment zone defines the short, rather than long, axis of treatment.

This specification provides for a larger effective optical zone and better results when coupled with the laser's generous blend zones. Unfortunately, this benefit has been misunderstood and the laser misrepresented as a tissue-hungry device.

In fact, other systems have now adopted this same strategy in their customized treatment algorithms. This integration means that at least 50 of my patients no longer need to be dilated to receive customized ablations.

The potential for topography-linked as well as wavefront treatments is obvious. I have neither experienced any difficulty tracking pseudophakic patients, nor have I heard of tracking problems with the Intralase Intralase Corp. Perhaps the most significant criticism I have about this laser is its inability to treat mixed astigmatism without a multicard solution. I wish that the platform had a phototherapeutic keratectomy modality and laser-scrape option to facilitate surface ablations.

Other shortcomings such as iris registration and customized hyperopic treatments are already being addressed. The ultrafast Hz head has received FDA approval.

Further refinements to the Technolas, such as customized hyperopic ablations and aspheric treatments, are anticipated for the end of this year.

Both of these technological improvements are needed. Because not everyone is a candidate for customized treatments, aspheric ablation is another part of a series of advances launching later this year.

The package will replace Planoscan and integrate aspheric ablation into customized and standard treatment algorithms. Results with aspheric ablation in other countres outside of the US suggest that this procedure is ideal for patients who are not candidates for existing customized treatments. Although perhaps not as good as truly customized treatments, these aspheric, wavefront-enhanced ablations will be superior to current conventional laser treatments, in my opinion.

A remote diagnostics package will also be offered soon in the US for the maintenance of the Zywave and Technolas systems. Overall, Technolas is a solid performer, and I am very satisfied with the tool, its capabilities and features, and, most importantly, its results.

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