Epi-LASIK Surgery

Epi-LASIK
Surgery
The procedure of choice
for surface ablation.
powered by Moria
Preservation of Corneal
Biomechanical Integrity,
The Reichert® Ocular Response
Analyzer device fires a rapid air
pulse at the cornea and records
separate applanation pressure
measurements as the air puff
hits the cornea and bounces
back. The difference between
the two pressure values is
corneal hysteresis (CH). Low CH
demonstrates that the cornea
is less capable of absorbing or
damping the energy of the air
pulse.
Vergés C; ASCRS 2007
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
-1
-2
-3
50%
45%
40%
35%
30%
25%
20%
15%
10%
5%
0%
Average post-LASIK
CH decrease value
48%
Vergés C; ASCRS 2007
Post-LASIK CH decrease (Reichert® ORA)
minimizing the risks of ectasia
12%
Reduction in Corneal Hysteresis
(6 months postop)
-4
Thin-Flap LASIK
Epi-LASIK with Moria Epi-K™
-5
(flap discarded)
Eyes
Post-LASIK Decrease in Corneal Hysteresis
(6 months postop)
Fewer Induced
Higher Order Aberrations
Changes in Higher order Aberrations (HoA)
6 months follow-up
Vergés C; ASCRS 2007
0.8
0.73
Thin-Flap LASIK
Epi-LASIK with Moria Epi-K™
(flap discarded)
Mechanical PRK with brush
RMS error in microns
0.7
0.5
0.4
0.3
0.28
0.25
0.2
0.1
Laser-assisted PRK
0
0.06
Spherical aberrations
0.07
0.03
Coma
HoA
Faster Healing
than All Other Surface Ablation Procedures
Alcohol-assisted PRK
•Use of alcohol on the cornea potentially
inducing inflammation.
•Devitalized cells pushed to center of the
cornea, releasing cytokines.
•Pseudodendrites typically visible for one week
or more and retard healing.
•Painful procedure.
•Average healing time: 7 days.
•Some patients require 10 days or longer.
Mechanical PRK with a brush
•80% of irregular edges with mechanical PRK
with a brush.
•Average healing time: 5 days.
•Some patients require 7 days or longer.
Epithelium and Bowman’s membrane
after alcohol removal1
Epithelium and Bowman’s membrane
after mechanical PRK with a brush2
Epi-LASIK with Moria Epi-KTM
•100% of regular and clean-edges with
2
Epi-LASIK using Moria Epi-KTM .
•Very smooth surface.
•Epithelium adjacent to removed sheet is fully
adherent and not traumatized by alcohol or
brush debridment.
•Cornea thus re-epithelializes quickly.
•Several suction ring sizes to customize
epithelial flap dimensions
•Average healing time: 42 hours to 3½ days 3
•Bandage contact lens removed sooner for a
better experience for patient
Epithelium and Bowman’s membrane
after use of Moria Epi-KTM 1
Milne HL. Refractive Surgery Returns to the Surface. Cataract and Refractive Surgery Today. 2006; 6 (10): 41-44.
Vergés C. Presented at the annual meeting of ASCRS in San Diego, USA in April 2007.
3
Michell R. Cornea epithelial healing rates after advanced surface treatment Epi-LASIK refractive surgery.
Paper presented during ASCRS 2010 (Boston, MA), ARVO 2010 (Fort Lauderdale, FL) and ESCRS Fall 2010 (Paris, France).
1
2
Faster Visual Recovery
than All Other Surface Ablation Procedures
20/25 or Better Vision (UCVA)
Vergés C; ASCRS 2007
90%
80%
80%
70%
Epi-LASIK with Moria Epi-K™
(flap discarded)
60%
Mechanical PRK with brush
50%
Laser-assisted PRK
40%
63%
44%
37%
23%
20%
0%
12%
38%
35%
30%
10%
58%
52%
25%
14%
Day 1
Day 2
Day 3
1 week
20/40 or Better Vision (UCVA)
Legal Driving Limit
Mitchell R; AAO 2006
100%
100%
100%
1 week
1 month
98%
96%
Epi-LASIK with Moria Epi-K™
(flap discarded)
94%
93%
92%
92%
90%
88%
Day 1
Day 3
Vergés C; ASCRS 2007
80%
72%
Epi-LASIK with Moria Epi-K™
(flap discarded)
Mechanical PRK with brush
60%
58%
50%
40%
Laser-assisted PRK
70%
66%
70%
36%
38%
42%
44%
50%
54%
58%
52%
30%
20%
10%
0%
Day 1
Day 2
Day 3
1 week
powered by Moria
Epi-LASIK has changed
greatly from its original form
• Most surgeons now discard the epithelial sheet.
• Moria Epi-KTM the most widely used epikeratome.
• New surgical techniques and pain management regimens.
• Appealing to safety-conscious patients.
• Distinguishing any refractive practice: gold standard for surface ablation.
and achieved impressive results
• More efficient in epithelial flap creation compared to other epikeratomes 4.
• Consistent epithelial separation.
• Preservation of corneal biomechanical integrity minimizing the risks of ectasia.
• Fewer induced higher order aberrations (HoA).
• Faster healing than all other surface ablation procedures.
• Faster visual recovery than all other surface ablation techniques.
• Very effective post-operative pain management.
The Moria Epi-K™ :
The US Epikeratome Market Leader
2005
2010
Moria
Moria
Centurion SES
(Norwood) 19%
51%
VisiJet 10%
70%
Amadeus II
(Ziemer) 20%
VisiJet 19%
Amadeus II
(Ziemer) 11%
US Trends in Refractive Surgery Epikeratome used: 2005 ISRS and 2010 ISRS Survey by Duffey, Leaming, Wexler.
4
Choi SK, Kim JH, Lee D, Lee JB, Kim HM, Tchah HW, Hahn TW, Joo M, Ha CI. Different epithelial cleavage planes produced
by various epikeratomes in epithelial laser in situ keratomileusis. J Cataract Refract Surg. 2008; 34: 2079–2084.
powered by Moria
The optimal design
for safe, reliable epithelial separation time after time.
• Metal separator with proprietary edge geometry specifically for cleaving rather
than cutting.
• Disposable plastic head encases each separator for added safety and
convenience.
• Applanation plate provides yet an additional margin of safety.
• Single-Use suction ring option.
• Large diameter suction ring for hyperopes, flat corneas, wavefront-guided
ablations, and lasers requiring large ablation zones.
• Small diameter suction rings more than adequate for the 6.0-mm optical zone
treatments for myopes.
• Only 10- to 15-sec for the epithelial separation, short suction time
• Ideally paired with the One Use-Plus microkeratome, which shares the same
technology platform.
Non contractual document. MORIA #66043EN-F-02.2013
• Evolution3E console operates Epi-K™, all Moria microkeratomes, and the DSAEK
system.
To obtain more information
MORIA SA
15, rue Georges Besse
92160 Antony
FRANCE
Phone: +33 (0) 1 46 74 46 74
Fax: +33 (0) 1 46 74 46 70
www.moria-surgical.com
MORIA Inc
1050 Cross Keys Drive
Doylestown, PA 18902
USA
Phone: (800) 441 1314
Fax: + 1 (215) 230 7670
www.moria-surgical.com
MORIA JAPAN KK
Inami Bldg. 6F
3-24-2 Hongo Bunkyo-ku
Tokyo 113-0033
JAPAN
Phone: + 81 3 5842 6761
Fax: + 81 3 5842 6762
www.moriajapan.com
MORIA in CHINA
Moria Commercial (China) Co. Ltd
Rm H, I, 6FL, Kai Li Building
N° 432 Huai Hai West Road
Shanghai 200052
CHINA
Phone: + 86 21 5258 5066
Fax: + 86 21 5258 5067
www.moria-surgical.com.cn