Laser benefits outweigh drawbacks

The excimer laser can be used to treat spherical equivalent errors ranging from –14 to +5 D, and surgeons have the option of using a wavefront-optimized ablation profile (Wavefront Optimized) or performing a wavefront-guided treatment (A-CAT) using data from a diagnostic device (Allegro Analyzer, Alcon Laboratories).

The excimer laser was installed in late 2008 at the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami. The efficacy, safety, and predictability results being achieved are impressive, said Dr. Culbertson, holder of the Lou Higgins Distinguished Chair in Ophthalmology and professor, Bascom Palmer Eye Institute.

Overall, during the course of the year, only a single enhancement procedure was performed (<1%), whereas prior to acquiring the laser, all patients were told that they faced a 5% chance of needing a second procedure, he said.

In addition, problems with glare and halos at night are reduced relative to experience with other excimer laser platforms, especially considering eyes receiving higher corrections. Dr. Culbertson attributed the latter safety benefit to the wavefront-optimized ablation profile that assures a prolate cornea.

Two other excimer lasers are in use at the institute (VISX STAR S4 IR, Abbott Medical Optics; MEL 80, Carl Zeiss Meditec).