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iTrace Dynamic Laser Refraction: Clinical Application Joe S. Wakil, M.D. Chairman, Tracey Technologies, LLC and EyeSys Vision, Inc. Speaker has a Financial Interest Why Dynamic Ray Tracing? Because… the Eye is NOT a Telescope! Pupil Size: Effects Refraction (ex. Night Myopia) Accommodatio Refraction is NOT a FIXED Number! n: Effects Refraction (Instrument Myopia) Tear Film: Effects Quality of Vision (Aberrations) Where are the Sources of Aberrations? How do they change with Surgery? Cornea: Astigmatism (Irreg.), Sph & other HOA Lens: Aberrometer/Wavefront Technologies • Hartmann-Shack Lenslet Array • Tscherning Aberrometer • Differential Skiascopy • Ray Tracing Features: -Rapid, point by point, IR measurement - no data confusion -Pupillometry with autotracking/capture -Programmable sampling (256 pts.) in any pupil up to 8mm -Open Field Fixation – avoid instrument myopia and measure Accommodation -Corneal Topography integration – Post LASIK Post LASIK Post LASIK Keratoconu s Normal Normal Near Fixation Accommodating IOL Change due to Accommodation Far Fixation Advantages of Ray Tracing Aberrometry Combined with Corneal Topography - iTrace • Robust dynamic range to measure highly irregular eyes including immediately postop • Multi-Zone Refraction in seconds to measure variations in refraction from normal night myopes to post-op results saving chair time • Able to separate Corneal from Lenticular (internal ocular) sources of aberrations with EyeSys Corneal Topography • Improved Diagnostic Wavefront to help in patient selection including Custom LASIK and IOL procedures Conclusion The Tracey iTrace brings a new standard of care in completely assessing vision in terms of quality of vision and corneal topography to progress visual correction through surgery to its ultimate goals.