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    WFG diagnostic capabilities take entire optical system into account

    One-step treatment may eliminate irregularity, correct refractive error at same time


    One of the largest WFG data sets published to date is from Optical Express, a commercial optical surgical provider in the United Kingdom. The population includes 8,905 eyes treated between May 30, 2012 and Aug. 24, 2013.

    The mean preoperative sphere was -2.80 and the mean preoperative cylinder was -0.81. One month after WFG LASIK, 100% of eyes had 20/40 or better uncorrected visual acuity, 95% were 20/20 or better, and 84% were 20/16 or better.

    Dr. Manche reported similar results in a study of the first 78 eyes treated at Stanford after WFG was approved for use by the FDA. The manifest sphere was -4.80, the manifest cylinder 0.66, and the manifest SEQ -4.47.

    One month after surgery, 100% of eyes were 20/32 or better, 96.2% were 20/20 or better, and 44.9% were 20/16 or better. Results at 4 months were similar.

    The predictability of the WFG system was even more impressive, Dr. Manche added.

    All of the eyes were within 1 D of the intended target at 1 month; 97.4% were within 0.5 D, and 85.9% were within 0.25 D. Predictability was even stronger 4 months after surgery; 98.5% were within 0.5 D, and 90.9% within 0.25 D of the intended target.

    “Of all the laser systems I have used in my career, this one has the best predictability I have ever seen,” Dr. Manche said. “It really does have an advantage over our older technology in clinical practice.”


    Data from Egypt

    Published data from the Horus Vision Correction Center, Alexandria, Egypt (data courtesy of Mohamed Shafik Shaheen, MD, PhD) using the iDesign system shows excellent results in highly aberrated eyes that might not be treatable using older technology or could not be treated in a single step. A study group of 22 eyes in 18 patients included a dozen eyes with keratoconus, 4 eyes with prior keratotomy, and 6 eyes with irregularities following LASIK.

    Before surgery, 80% of eyes had best-corrected distance visual acuity of 20/50 or worse. After surgery, all eyes had uncorrected visual acuity of 20/50 or better, 90% were 20/40 or better, 40% were 20/25, and 10% were 20/20 or better. Ten percent gained at least 1 line of visual acuity and 90% gained 2 or more lines.

    “Many of these eyes gained 5 and 6 lines of corrected visual acuity,” Dr. Manche said. “In many cases, WFG allows for one-step treatment, eliminating irregularity and correcting refractive error at the same time.”



    Edward E. Manche, MD

    E: [email protected]

    This article was adapted from Dr. Manche’s presentation during Refractive Subspecialty Day at the 2016 meeting of the American Academy of Ophthalmology. He is a consultant to and has received grant support from Johnson & Johnson Vision (formerly Abbott).

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