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Laser System Summaries

VISX Star S4 IR – VISX is the American company that invented laser vision correction in 1986. With every major technological advancement available today including custom-wavefront driven treatments, Fourier reconstruction of wavefront data, 3-dimensional eye tracking, and the only available system of automated registration to insure that each laser spot is placed at precisely the right location, the flagship VISX Star S4 IR laser continues to lead the industry in technological innovation and physician preference.

The WaveLight Allegretto is currently in second place behind VISX. It is a well-respected, German-made laser that appeals to many Arizona LASIK surgeons because its per procedure royalty fee is lower than most of the competition and because it offers a “wavefront optimized” treatment mode that can approximate the results of a true wavefront-driven custom treatment with less work. However, the Allegretto does not offer Fourier reconstruction, it only offers 2-dimensional eye tracking and it does not offer any form of automated registration to precisely align the treatment. Furthermore, a comparative study recently showed that VISX Star S4 IR custom-wavefront treatments reduce visual aberrations better than the Allegretto's wavefront optimized mode. Consequently, the Allegretto remains a distant second to VISX.

Bausch and Lomb – The B&L laser was quite popular overseas in the 1990's. However, it was slow in obtaining FDA approvals and lacks the latest technological innovations, most notably automated registration. With the large lead held by VISX and the current status of the WaveLight Allegretto as the preferred alternative, it is unlikely that the B&L laser will play more than a small role in the future.

Alcon LadarVision – Alcon's LadarVision went head-to-head with VISX through the mid to late 1990's until VISX ultimately won out. For a time, LadarVision also had an advanced method for registration, but the system was recalled by the FDA for performance issues. This was a significant setback for the LadarVision platform and perhaps the main reason that Alcon recently purchased the WaveLight company. Consequently, most LadarVision lasers are now being replaced by WaveLight Allegretto systems.

NIDEK – The NIDEK EC 5000 is the only commonly used laser that lacks custom-wavefront technology. As such, it occupies the bottom rung on the technology ladder. Since NIDEK is the only laser company that does not charge a per-procedure royalty fee, its lasers are found almost exclusively in corporate discount chains that drive patient volume through cut-rate pricing. However, with no custom-wavefront technology, limited implementation of 2-D eye trackers, and no automated registration, patients who desire premium quality must look elsewhere.

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