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Visx accelerates R&D efforts to maintain market position
by Michael Moretti
Due in part to successful industry marketing efforts, the concepts of wavefront technology, scanning spot lasers, eye trackers, and customized laser vision correction (LVC) treatments have captured the imagination of refractive surgeons. While some of this technology is available internationally, domestic surgeons are just beginning to acquire a taste for it.
LVC providers in corporate and private-practice settings realize that they can improve clinical results, patient satisfaction, and increase procedure volume by offering the latest diagnostic and surgical advancements. In the highly competitive LVC marketplace, where corporate laser in-situ keratomileusis discounters are grabbing major market share and driving patient fees downward, refractive surgeons are desperately looking for ways to survive and prosper. Offering the latest technology is one way for them to attract patients and maintain premium pricing. Although wavefront analysis technology is not yet commercially available, this concept is arguably the most popular trend in refractive surgery. Scientific sessions dedicated to the discussion of wavefront analysis are abundant, as ophthalmologists try to understand how this complex and sophisticated optical technology will benefit their patients.
Wavescan
Visx, of Santa Clara, Calif., claims to hold a leadership position in the emerging field of wavefront technology. This company, which boasts the largest installed base of excimer lasers in the United States, introduced a stand-alone device, called the WaveScan Wavefront Analysis System, at the American Society for Cataract and Refractive Surgery meeting in Boston last month. The system received 510(k) clearance from the Food and Drug Administration on May 3; the company expects commercial availability later this year. Thomas McKay, Visx marketing manager of refractive products, said the company’s biggest advantage is timing. “We are closer than anyone else in the industry to commercializing wavefront technology. We have also miniaturized the wavefront device so that it’s the size of a corneal topographer and, therefore, small enough to fit into a physician’s office. Through our partnership with 20/10 Perfect Vision, we have perfected the technology … by using mirrors mounted on a microchip as well as other state-of-the-art improvements.”
The WaveScan uses adaptive optics mounted on microchips to create thousands of micro-mirrors that refract bundles of light rays. This gives the system’s mirrors the ability to flex and change for each light ray, focusing it precisely on the retina. “More mirrors means the device is more precise, faster, and accurate than other systems that only use one deformable mirror that is large, bulky, and expensive,” McKay said. “WaveScan also features a unique closed-loop design, allowing the patient to see his or her corrected vision in real time by viewing an eye chart within the system. This allows the sphere, cylinder, and even higher-order aberrations to be corrected dynamically, with the patient being able to appreciate having their vision corrected to better than 20/20 — or perhaps even to 20/10.” The process of capturing the wavefront analysis for the patient and the data it represents will bear the trade name WavePrint, analogous to a “fingerprint of the eye.”
VISX Star S3
In addition to WaveScan, Visx introduced the Star S3 excimer laser system at ASCRS, also recently approved by the FDA. Although Visx has been quiet about its laser research and development program in the past, management has adopted a new strategy in response to recent changes in the market. Visx spent more than $16 million on development projects in 1999 and wants to aggressively promote its new products. The Star S3 laser has an active eye tracker that uses dual side-mounted infrared cameras to compensate for X, Y, and Z movement of the eye during surgery. No dilation or preoperative imaging is required, since the device tracks on the natural pupil, eliminating the need for pupil dilation or pre-imaging. “Tracking on the natural pupil maintains the added benefits of the LASIK ‘wow factor’ of immediate gratification for the patient, since they can see clearly immediately after the surgery without impeding patient throughput,” McKay said. “Our tracker stops the treatment in response to large eye movement. However, the laser only pauses momentarily and then picks up where it left off after the eye comes back into position. …” Unlike other trackers, Visx allows the surgeon to maintain full control at all times. Since refractive surgeons are embracing the idea of small-spot scanning for custom ablations, Visx’s approach to custom ablation will involve a variable-spot scanning smart-beam technique that will be available through an upgrade to the Star S3. This method uses the best qualities of wider beam and smaller-spot scanning, McKay said. “Star S3 quickly removes most of the corneal tissue with the wide beam for the majority of the refractive portion of the treatment. The smaller beam then polishes with a 1-mm to 0.8-mm spot to complete the wavefront-guided portion of the treatment. This Wavefront Polish will remove irregularities, higher-order aberrations, etc. Our competitive advantage is that we have the fastest treatment times and the ablation remains the smoothest, while removing the least amount of tissue. There’s no lost treatment time due to varying the beam size, unlike others whose treatment times remain two to three times as long, due to the beam size remaining small throughout the procedure.”
About the Author - Michael Moretti
Michael Moretti is a medical laser industry analyst and the editor of Medical Laser Insight. For a sample issue of this monthly report, please e-mail your request to