Alcon at APACRS 2024: Formal Introduction of the WaveLight Plus He added his real-world outcomes are “not that surprisingly different from the multicenter trial. In our study, 89% of our patients achieved 20/16; “Analysis of lines of change from preoperative CDVA to month 3 CDVA showed that 46.5% eyes had no change, 40.3% eyes gained 1 line, and 8.0% eyes gained 2 lines of visual acuity. None of the eyes lost 2 or more lines of CDVA compared with preoperative CDVA.” With more than half the patients seeing 20/16 or better, “my touch-up rate has gone down,” Prof. Bala said, adding that most of those are in eyes with higher cylinder. Preoperative higher-order aberrations (HOAs) were 0.308±0.102, and postLASIK they were 0.371±0.135; these increases were not clinically significant.. Additionally, spherical aberration decreased. “This is the first time we are seeing a systematic reduction in spherical aberration, and that is an achievement for engineering technology at a 6mm zone. Remember, this is not at the 4mm zone,” he said. Using one device to redefine refractive surgery Accurate refraction is the most important parameter for a successful laser vision correction (LVC) surgery, and refraction is based on the cycloplegic and the manifest or subjective refraction, with manifest refraction being the gold standard for LVC, co-moderator Prof. Yueguo Chen, MD (China) said. Errors introduced in the subjective refraction (inadvertently from technicians or optometrists and/or patients) can lead to clinically significant refractive surprises. The question becomes, How accurate is the wavefront-based objective refraction and can it replace manifest refraction or be used with a nomogram adjustment? The WaveLight Plus creates the ablation profile by creating a 3D eye model (InnovEyes) and an ablation profile incorporating 2,000 rays of light from the corneal anterior surface to the retina. It then takes into account the geometrical and optical properties of the entire cornea and intraocular segments, he said. In unpublished data on the consistency between the subjective refraction and the objective wavefront refraction in 500 eyes (average age was under 30 years), Dr. Chen found both the wavefront refractive sphere and cylinder (-6.18D and -1D, CHENGDU, China — This year’s APACRS served as the formal launch in Asia of Alcon’s latest refractive device, the WaveLight Plus. Several experts spoke about the device’s attributes, among them its ability to create a 3D eye, which allows surgeons to truly personalize each patient’s treatment. Introducing the WaveLight Plus Co-moderator Chandra Bala, PhD, BSc(Med), MBBS, FRANZCO (Australia) has performed more than 2,000 surgeries with the WaveLight Plus; he recently completed a study (N=400) that showed more than 80% of the patients achieved 20/16 vision or better. An advantage of the WaveLight Plus is its InnovEyes Sightmap, a single, non-contact-ophthalmic diagnostic device designed to capture images of the anterior segment of the eye, which includes the cornea, pupil, anterior chamber and lens. Furthermore, it provides the axial dimensions and is indicated to analyze the optical aberrations of the eye by use of wavefront technology.” “The patient doesn’t get up and move anywhere,” Prof. Bala said. “Everything — refraction, aberrometry, topography — all these metrics are measured in one sitting and they’re aligned to the patient’s corneal vertex.” “No longer do we need to treat their glasses; we’re treating each and every dot on their cornea as an individual dot. It’s truly personalized to their eye,” he said. In his experience, Prof. Bala has only encountered three instances where he could not get the pupil to dilate enough to take a measurement. Real-world results In his real-world study1 of 400 myopic eyes (range ≤-8.25D; astigmatism 0 to -4.25D) that were treated with the WaveLight Plus and having a 3D eye model generated with a customized LASIK ablation profile, Prof. Bala said “in more than half the cases, we were able to achieve 20/12.5. In fact, we were able to get 20/10 in 8% of cases.” Supplement to EyeWorld Asia-Pacific September 2024 In a 400-eye cohort, 89.3% of eyes achieved 20/16 or better uncorrected distance visual acuity after myopic LASIK with the WaveLight Plus.
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