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    Advances in refractive accuracy gain traction through technologic evolutions

    Focused heavily on topography-guided ablations, CXL, and introduction of Symfony lens

    Take Home:

    A look at how crosslinking applications, topography-guided ablations, along with the introduction of the Symfony lens, dominated refractive surgery this past year.


    The emphasis this year was on crosslinking applications, topography guided-ablations, and introduction of the Symfony lens.


    This past year saw advances made and increased research performed to expand the use of crosslinking in refractive surgery.

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    “Collagen crosslinking (CXL) is continuing to evolve. There has been continued progress with the technology and we hope for FDA approval of crosslinking for treating keratoconus and corneal ectasia in the near future,” said Peter Hersh, MD, professor of ophthalmology at Rutgers New Jersey Medical School, Newark, and Director, Cornea and Laser Eye Institute—Hersh Vision Group, Teaneck, NJ.

     A New Drug Application was resubmitted by Avedro, of which he is medical monitor, in September for using CXL to treat keratoconus and corneal ectasia. A potential FDA decision is expected in March 2015, according to Dr. Hersh.

    In Europe, new work is being conducted in topography-guided crosslinking techniques for keratoconus. The topography-guided crosslinking device can pattern the ultraviolet dose to the topography of the cone in these patients. The device (Avedro KXL II unit) has an eye-tracking mechanism by which it locks onto the eye.

    “Besides changing the 2-dimensional shape of the incoming ultraviolet light, the unit also can pattern the dosing, i.e., it can administer a greater dose to the steeper areas of the cone and topographically follow it out from there,” Dr. Hersh explained.

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