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  This table compares and contrasts the advantages and disadvantages of most currently available laser systems in the United States. Better features are highlighted in "GREEN", less desirable in "YELLOW" and least desirable features in "PINK". 
   
 
VISX STAR S4 IR
WAVELIGHT
ALLEGRETTO
BAUSCH & LOMB
LADAR VISION 4000/6000
NIDEK EC 5000
Customized Wavefront Treatments
Yes - Widest FDA approval of any laser system worldwide
Limited
Limited
Limited
No
Wavefront
Resolution
Fourier algorithm
offers highest
resolution of
wavefront errror
Zernicke
algorithm
interpolates and
smoothes data
artificially
Zernicke
algorithm
interpolates and
smoothes data
artificially
Zernicke
algorithm
interpolates and
smoothes data
artificially
Zernicke
algorithm
interpolates and
smoothes data
artificially
Active 3-D Eye Tracking
Yes
No - 2-D only
No - 2-D only
No - 2-D only
No - 2-D only
Iris Registration
Yes - Centers
& aligns
treatment
independent of
pupil center migration
& eye cyclorotation

No - Manual
marking only -
less accurate
and subjective

No - Manual
marking only -
less accurate
and subjective
No - Manual
marking only -
less accurate
and subjective
No - Manual
marking only -
less accurate
and subjective
Compensates for
pupil migration
during physiologic
pupil dilation
Yes - centers
and aligns
treatment independent
of pupil
migration
No
No
No -
Pharmacologic
pupil
dilation required
for tracking
creates potential
for centering error
No
Requires
peri-operative
use of eye drops
that impair
healing
No
No
Yes
Yes
No
Size of Laser Beam
Small and large
spot for rapid
treatment and
optimized to
reduce thermal
injury to tissue
Small spot only
but very high
speed reduces
tissue dehydration
during laser
photoablation
Small spot onlY
- slows treatment
and allows for
tissue dehydration
during laser
photoablation
Small spot only
- slows treatment
and allows for
tissue dehydration
during laser
photoablation
Scanning slit
Thermal Damage to Cornea
Variable spot
scanning and
variable rep rate
reduces thermal
effects
Higher speed
and excellent beam
characteristics may
reduce thermal
load to tissue

High speed
and small spot
can be prone to
thermal and
drying effects

High speed
and small
Gaussian spot
prone to thermal
and drying effects
Scanning slit
creates heat
that damages
tissue
Physician choice
Largest market
share in the US
and growing rapidly
(VISX invented
laser vision
correction)
Limited physician
acceptance to
date
Limited physician
acceptance to
date
Shrinking physician
acceptance &
numerous post
market complaints
at FDA (see FDA
MAUDE database)
6000 is currently
recalled by the FDA
Shrinking
physician
acceptance due
to aging
platform
Safety in
conservation
of corneal
tissue
Conservative
leaving good
residual for
strength
Conservative
leaving good
residual for
strength
Aggressive
system that
is often tissue
"hungry"
Aggressive
system that
is often tissue
"hungry"
Conservative
leaving good
residual for
strength
Enhancement
Rate
Low - Typically
less than 5%
Low - Typically
less than 5%
Insufficient Data
Available for
Comparison
Many centers
report high rates
of retreatments
from overcorrection
Higher reported
rates due to
aging platform
   
   
 
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