"New Solid-State Refractive Surgery Laser System Emerges
Irving J. Arons Spectrum Consulting
Over the years, there have been several attempts to develop and market solid-state lasers for use in refractive surgery. Some of the earlier attempts in the late 1980s were the nanosecond and picosecond YAGs (or YLFs) that operated in the near infrared (IR) or at green wavelengths. Phoenix Laser Systems (Alfred Sklar) and Intelligent Surgical Lasers (Josef Bille) attempted to take advantage of photodisruption (with the Phoenix YAG) and fast pulsed near IR (ISL) to vaporize tissue, in performing intrastromal ablation within the cornea without affecting the corneal surface. The results, however, were not very good or reproducible, and after rabbit tests, few human experiments were ever tried.
Later, in the early 1990s, other companies tried to develop solid-state lasers that emulated the excimer in operating at deep UV wavelengths. Two of these were the LaserHarmonic quintupled YAG (JT Lin) from LaserSight and the LightBlade, which I believe was an argon-pumped Ti Sapphire system (Shui Lai) from Novatec. Neither system made it to the market, as the LaserSight system never got beyond the experimental stage, and the Novatec system, after some human clinical trials, simply ran out of funding.
More recently, TELCO of Australia, renamed Q-Vis, has shown its version of a quintupled YAG, first called Eye-Q, but now renamed the Q-Vis Quantum 213, operating at 213 nm. The laser has entered into human clinical trials, and even began the long path toward U.S. FDA approval. These trials were begun in the United States in July 2000. Late in 2001, the company learned that some of the test results with its earlier model of the Quantum caused significant undercorrections and the FDA testing was halted until corrections in both engineering and its algorithms could be changed. At this year's ASCRS meeting, the company said that the engineering corrections had been made and that clinical trials were recommencing in Australia and possibly Canada. No information about re-starting clinicals in the U.S. was supplied.
Intralase (Ronald Kurtz), based on the earlier concepts from ISL, but using femtosecond pulses rather than picosecond, is attempting to revitalize the concept of intrastromal ablation. Only time will tell if this company is any more successful than was ISL (or Phoenix).
And now, another Australian company, CustomVis, founded by Dr. Paul van Saarloos, who was a co-founder of Q-Vis, and the inventor of its Quantum solid-state laser (and also the Atlas corneal topography system sold by the Humphrey division of Carl Zeiss Meditec), has come forward with its own version of a solid-state system, the CustomVis Custom Corneal Reshaping System, specifically designed for customized ablation. With both public (Australian Government grants) and private financial backing, Dr. van Saarloos hopes to bring a new solid-state approach to solve the custom ablation puzzle. He has combined a new solid-state, diode-pumped, quintupled YAG laser, operating at 213 nm with solid-state scanning and eyetracking to deliver "better" custom outcomes for patients.
The new CustomVis Custom Corneal Reshaping System is composed of the Pulzar small spot (0.6 mm), fast pulse (300 Khz), solid-state laser, combined with an analog-based EX1 5 Khz gaze tracker, that locks onto the limbus and monitors both eye movement and gaze direction with a closed-loop 1 Khz response time. The diagnostic system utilizes an Orbscan topography device for measuring surface abnormalities, and will, in the future, possibly use the Tracey VFA (visual function analyzer) wavefront diagnostic for higher order aberrations, along with a LASEK surgery approach to minimize flap aberrations. (Presentations on this new approach to custom ablation surgery will be given at this Fall's ISRS meeting, preceding the AAO, in Orlando.)
By proper registration of the wavefront and topography data, along with minimizing the problems of centration and cyclorotation and intraoperative eye and gaze tracking, along with utilizing LASEK to avoid flap problems, the company hopes to minimize all potential problems and deliver superior results.
Early patient trials with the system were conducted at the Laser Sight centers of Australia in mid-September, and the first results will be presented at the upcoming ISRS meeting. If the results with this integrated system prove to be as good as anticipated, perhaps we will have found a solid-state solution to the custom surgery puzzle."
The question is what do QVL own in the way of patents and technologies etc, and what can the new management team do to increase value for shareholders, (read themselves)?
an interesting footnote, two of my older relos had laser corrective surgery, not sure where, now they can see!! There is certainly a big future in the technology, I mean, who wants to wear glasses/contacts if they don't have to?
