EyeWorld Asia-Pacific September 2019 Issue

&RQWRXUD TM LV D EL PRGDO WUHDWPHQW VKDYLQJ R΍ SHDNV DQG VWHHSLQJ WKH ȵDWWHU DUHDV RI FRUQHD SURYLGLQJ RSWLPDO FRUQHDO FXUYDWXUH ΖW LV VWDWLF reproducible, provides better peripheral GDWD DQG LV QRW D΍HFWHG E\ DJH SXSLO size and corneal opacity. 7DEOH 3UH UHTXLVLWHV IRU &RQWRXUD TM Vision • High quality topography is essential • Good correlation between topographic and refractive astigmatism is necessary • $EODWLRQ SURȴOHV RI 7 &$7 DQG ZDYH IURQW optimized should be compared • 8VH RI VDPH WDUJHW 4 YDOXH DV SUH RSHUDWLRQ YDOXH WR LV HVVHQWLDO • Proper patient alignment under the laser needs to be ensured 0DQDJLQJ 7RSRJUDSK\ JXLGHG 7UHDWPHQWV LQ WKH &OLQLFV Dr. Ryu Ik Hee 2 &OLQLFDO 6FLHQFH %HKLQG &RQWRXUD TM Dr. Dandapani Ramamurthy Prof. Zhang Fengju Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, China 'U 'DQGDSDQL5DPDPXUWK\ Chairman, The Eye Foundation, India 'U $UWKXU &XPPLQJV Consultant Eye Surgeon, Wellington Eye Clinic Consultant Ophthalmologist and Head of the Department of Ophthalmology Beacon Hospital, Ireland Dr. Ryu Ik Hee Chief Director, B&VIIT Eye Center, Seoul, South Korea said Dr. Dandapani Ramamurthy. Dr. Ramamurthy shared his personal views and recommendations on pre-requisites to achieve optimal refractive and visual outcome with Contoura TM Vision (Table 1). The Contoura TM Vision is a topography-guided treatment on eyes that utilizes a placido ring based topographical system (Topolyzer VARIO or Allegro Topolyzer). The patient’s eye is imaged and analyzed using 22 rings and 22,000 unique elevation points on the cornea. This data is sent to the surgical planning computer WR FUHDWH DQ LQGLYLGXDOL]HG DEODWLRQ SURȴOH following which a Wavelight ® EX500 or Excimer Laser automatically adjusts laser pulse placement to match the topography-guided treatment. Contoura TM Vision is performed either on EX500 or EYE-Q in conjunction with Topolyzer VARIO with the help of T-CAT software. The software calculates treatment plan combining manifest refraction data and corneal irregular shapedata fromtopographer. A minimum of 4 examinations are imported and the system calculates the median (corneal radius and asphericity), following which the HOAs are FDOFXODWHG DQG ȴQDOO\ WKH VSKHUH DQG DVWLJPDWLVP estimation by the surgeon is added. “During Contoura TM , the elevated parts of the cornea are depressed, and the surrounding areas around the depressed parts are elevated. This bi- modal treatment results in reduced consumption of tissue and more regularization of the cornea” 7DEOH &RQVLGHUDWLRQ IRU .HUDWRFRQXV using Wavelight Oculyzer TM $QWHULRU ȵRDW FULWHULD • 1RUPDO YDOXHV wP RU wP • 6XVSLFLRXV IURP wP WR wP • .&1 ! wP 3RVWHULRU ȵRDW FULWHULD • 1RUPDO YDOXHV wP • 6XVSLFLRXV IURP wP WR wP • .&1 ! wP With an experience of more than 1000 procedures using the Contoura TM Vision, Dr. Ryu Ik Hee shared his insights and provided valuable guidance on managing topography-guided treatments in clinical practice. Topography-guided Contoura TM Vision is ideal for patients who need customized procedures, LQFOXGLQJ WKRVH ZLWK LUUHJXODU WRSRJUDSK\ ȴQGLQJV (superior or inferior steepening), and those with astigmatism by manifest refraction of >2D or when index of height decentralization (IHD) > 0.01, which LV WKH PRVW VLJQLȴFDQW YDOXH GXULQJ VFUHHQLQJ Abnormal topo map as seen from the Wavelight ® Oculyzer TM , should be considered suspicious for keratoconus (Table 2). ȊΖ FRQVLGHU DQWHULRU ȵRDW FULWHULD ! wP DQG SRVWHULRU ȵRDW FULWHULD ! wP VXVSLFLRXV IRU keratoconus (KCN) eliminating laser refractive surgery”, explained Dr. Ryu.