OCT-guided Femtosecond Laser for LASIK and Presbyopia Treatment

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "OCT-guided Femtosecond Laser for LASIK and Presbyopia Treatment"

Transcription

1 Shinagawa LASIK Center OCT-guided Femtosecond Laser for LASIK and Presbyopia Treatment Minoru Tomita, MD, Ph.D 1) Executive Medical Director at Shinagawa LASIK Center, Tokyo, Japan 2) Clinical Professor at the Department of Ophthalmology, Wenzhou Medical College, Wenzhou, China Financial Disclosure Dr. Tomita is a consultant for SCHWIND Eye-Tech-Solutions, Ziemer Ophthalmic Systems AG, and AcuFocus Inc.

2 Shinagawa LASIK Center in Tokyo, JAPAN 1,149,036 Femto LASIK cases since being established in Shinagawa LASIK Center in Tokyo with 5 branch clinics. We have a total of 131 doctors. Our clinics perform approx. 70% of the LASIK procedures in Japan.

3 Laser Systems at Shinagawa LASIK Center FEMTO LDV, Crystal Line & Z6 (9 units) (Ziemer, Switzerland) 23 Units IntraLase FS60 & ifs (AMO, USA) Refractive Suite (Alcon, US) 1 Unit AMARIS (SCHWIND, Germany) Visx star S4 IR (AMO, USA) 14 Units ALLEGRETTO Wave Eye-Q (Alcon, USA) 13 Units 19 Units Other procedures also available: Surface ablation (PRK, LASEK, EpiLASIK) Intrastromal corneal ring segments Phakic IOLs Multi-focal IOLs KAMRA Intracorneal Inlays CK (Conductive Keratoplasty) 3 Units

4 Customer FS Laser Preference at Shinagawa IntraLase FS60 or ifs 2.8% FS % Ziemer FEMTO LDV, Crystal Line & Z6 97.2% Data obtained : August 2013 LASIK using Ziemer FEMTO LDV is the choice for 97% of our patients. Although the price is higher, patients are choosing the benefits of Crystal Line, or Z6 Technology.

5 Total LASIK Surgeries using FEMTO LDV systems: Monthly and Accumulated Accumulated Monthly Number Since we started using FEMTO LDV in February 2009 through February 2013, the number of eyes treated using either FEMTO LDV or Crystal Line has reached 470,796.

6 Purpose 1) To evaluate the safety and efficacy of an Optical Coherence Tomography (OCT) guided femtosecond laser (Ziemer Z6) in Sub-Bowman s LASIK and corneal inlay implantation. 2) To report and evaluate the clinical outcomes of Sub Bowman s LASIK and corneal inlay implantation using Ziemer FEMTO LDV Z6. 3) To evaluate the benefits of this new OCT-Guided femtosecond laser.

7 What will we need in the Future? The Optical Coherence Tomography (OCT) is necessary for refractive surgeons desiring the safest and most efficient surgeries. The latest Z Model now provides this OCT guidance! The OCT guidance is used for : Sub Bowman s LASIK Corneal inlay implantation Corneal ring segment implantation Corneal transplantation 1) Lamellar keratoplasty (LKP) 2) Deep lamellar keratplasty (DLKP) 3) Penetrating keratoplasty (PKP) OCP interface

8 Why is OCT guidance needed? There are RISKS for surgeons while performing Sub-Bowman s LASIK, and corneal inlay implantation for post-lasik eyes. 1) Sub-Bowman s LASIK : button holes, flap tears 2) Corneal inlay implantation for Post-LASIK eyes : perforation from the new pocket to the original Using the Ziemer Z6 with its new OCT technology, surgeons can now visually verify the depth before and during LASER ablation. *This technology brings greater safety to thin flap and pocket creation!

9 Video: Flap Tear During LASIK Flap Creation

10 Video: Perforation During Pocket Creation

11 Method Corneal Flap / Pocket Ziemer Z6 Lowest pulse energy (nj range) combined with the highest repetition rate (>5 MHz). Small spot technology preserves tissue and is free of edema. Focuses on the x, y, and z axis Enables surgeons to be able to change the flap configuration such as position, diameter, hinge position and length, thickness, side cut angle (30º to 150º), and shape. New features added to Z6! Corneal inlay implantation Corneal ring implantation Corneal transplantation + Built-in OCT system Swept source domain Scans in x, y, and z directions OCT images are captured after suctioning

12 Sub-Bowman s LASIK Sub-Bowman s LASIK surgery was performed on 300 eyes of 152 patients using the OCT guided application that is built in the new Ziemer Z6. Refractive correction was performed using Schwind AMARIS 750S. Target flap thickness was μm. Preoperative data : (Operations conducted: September-October 2012) Patients Age Sub-Bowman s LASIK Patients 300 eyes of 152 patients ± 7.69 years UDVA (Snellen) 20/250 CDVA (Snellen) 20/12.5 MRSE (D) -4.41

13 OCT Image: Sub-Bowman s LASIK Pre-OP Bowman s Layer Estimated LASIK Flap Line Vertical OCT-Scan Post-OP Bowman s Layer LASIK Flap For Sub-Bowman s LASIK, we confirm a 30 μm distance between Bowman s layer and the estimated flap line before laser disruption.

14 Visual Acuity : Sub-Bowman s LASIK Achievement (%) 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 14.3% 11.3% 88.7% 89.7% 0.0% 0.0% 0.0% 20/10 or better Cumulative UDVA (Snellen) 20/16 or better 98.7% 96.7% 20/20 or better Pre-Op (n=300) 1W (n=300) 3M (n=300) For UDVA, 96.7% of the eyes achieved 20/20 or better at 3 months postoperatively.

15 MRSE : Sub-Bowman s LASIK Cumulative MRSE (D) Achievement (%) 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 92.7% 100% 91.0% 72.3% 70.0% 0.0% 0.3% 2.0% ±0.25 ±0.50 ± % Pre-Op (n=300) 1W (n=300) 3M (n=300) For MRSE, 91.0% of the eyes achieved results within ±0.50 D and 97.7% of the eyes achieved results within ±1.00 D at 3 months postoperatively.

16 KAMRA Corneal Inlay Implantation using FEMTO LDV Z6

17 KAMRA Corneal Inlay 8,400 holes ( 5 to 11 micron) 3.8mm Total diameter 1.6mm Aperture Made from Polyvinylidene Fluoride (PVDF) 5 microns Thick

18 With Inlay Inlay KAMRA Corneal Inlay (-cont.) The central aperture increases the depth of field. The patient is able to achieve improved vision for near and intermediate with minimal affect on distance vision. (Data source : AcuFocus, Inc.) Presbyopia Lens cannot accommodate Several published reports showed the KAMRA intracorneal inlay is an effective method for the treatment of presbyopia ) Yilmaz et al, Intracorneal inlay to correct presbyopia:long-term results Jul;37(7): ) Seyeddain et al, Small-aperture corneal inlay for the correction of presbyopia: 3-year follow-up. J Cataract Refract Surg Jan;38(1): ) Waring GO 4 th, Correction of presbyopia with a small aperture corneal inlay. J Refract Surg Nov;27(11): ) Tomita et al, Simultaneous corneal inlay implantation and laser in situ keratomileusis for presbyopia in patients with hyperopia, myopia, or emmetropia: sixmonth results. J Cataract Refract Surg Mar;38(3):

19 Post-LASIK Corneal Inlay Implantation Corneal inlay implantation was performed on 300 eyes of 300 Post- LASIK patients with pocket creation using the OCT guided application that is built in the new Ziemer Z6. Preoperative data : (Operations conducted: June ~ September 2012) Post-LASIK Patients Patients 300 eyes of 300 patients Age ± 5.35 years UDVA (Snellen) 20/16 UNVA (Jaeger) MRSE (D) J6

20 How OCT Guidance Works

21 OCT Image: Post-LASIK Corneal Inlay Implantation Pre-OP Bowman s Layer Original LASIK Flap Estimated Pocket Line Post-OP Vertical OCT-Scan Bowman s Layer Original LASIK Flap Pocket For pocket creation, we confirmed a safe distance between the original LASIK flap and the estimated pocket line before laser disruption.

22 Post-LASIK KAMRA Inlay Implantation: Surgical Video

23 Post-LASIK KAMRA Inlay Implantation OCT-Scan Image showing that the previous LASIK flap was made at a depth of 100 μm and the new pocket at a depth of 200 μm. *The OCT (Casia SS-1000, Tomey Corporation, Nogoya, Japan) was used.

24 Visual Acuity (UDVA) of the Implanted Eye: Post-LASIK Corneal Inlay Implantation Cumulative UDVA (Snellen) Achievement (%) 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 93.0% 81.3% 77.7% 20/16 or better 95.3% 96.7% 93.3% 87.0% 91.7% 85.3% 20/20 or better 20/30 or better Pre-Op (n=300) 1M (n=300) 3M (n=300) Mean UDVA was 20/20 at 3 months postoperatively. For UDVA, 85.3% of the eyes achieved 20/20 or better at 3 months postoperatively.

25 Visual Acuity (UNVA) of the Implanted Eye: Post-LASIK Corneal Inlay Implantation Cumulative UNVA (Jaeger) Achievement (%) 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 37.3% 6.0% 46.0% J1 or better 67.3% 61.3% 11.3% J2or better 81.0% 74.7% 16.7% J3 or better 89.7% 85.7% 23.7% J4or better 96.0% 91.7% 34.3% J5 or better Pre-Op (n=300) 1M (n=300) 3M (n=300) Mean UNVA was J2 at 3 months postoperatively. For UNVA, 81.0% of the eyes achieved J3 or better at 3 months postoperatively.

26 Conclusion 1) Using the OCT guided system, surgeons are able to visualize and confirm safe surgical parameters for thin flap and corneal pocket. 2) The clinical outcomes of Sub Bowman s LASIK and corneal inlay implantation using Ziemer FEMTO LDV Z6 were excellent. 3) Using OCT, surgeons are able to prevent intraoperative complications and increase the safety and accuracy of corneal surgery.

What now, when Presbyopia sets in? Minoru Tomita, MD, PhD Executive Director Shinagawa LASIK Center, Tokyo, JAPAN

What now, when Presbyopia sets in? Minoru Tomita, MD, PhD Executive Director Shinagawa LASIK Center, Tokyo, JAPAN What now, when Presbyopia sets in? Minoru Tomita, MD, PhD Executive Director, Tokyo, JAPAN Financial disclosure Travel expenses for the ASCRS meeting were paid by Ziemer and AcuFocus, Inc. Presbyopia:

More information

Comparison Combined LASIK Procedure for Ametropic Presbyopes and Planned Dual Interface for Post-LASIK Presbyopes Using Small Aperture Corneal Inlay

Comparison Combined LASIK Procedure for Ametropic Presbyopes and Planned Dual Interface for Post-LASIK Presbyopes Using Small Aperture Corneal Inlay Comparison Combined LASIK Procedure for Ametropic Presbyopes and Planned Dual Interface for Post-LASIK Presbyopes Using Small Aperture Corneal Inlay Minoru Tomita, MD, PhD 1,2 1) Shinagawa LASIK, Tokyo,

More information

Medical Director, Shinagawa LASIK Center, Tokyo, Japan Adjunct Professor, Department of Ophthalmology, Wenzhou Medical College, Wenzhou, China

Medical Director, Shinagawa LASIK Center, Tokyo, Japan Adjunct Professor, Department of Ophthalmology, Wenzhou Medical College, Wenzhou, China Medical Director,, Tokyo, Japan Adjunct Professor, Department of Ophthalmology, Wenzhou Medical College, Wenzhou, China Financial disclosure: Ziemer Group AG, Switzerland AcuFocus, CA Schwind Eye-Tech-Solutions,

More information

Shinagawa LASIK Center. Examination rooms

Shinagawa LASIK Center. Examination rooms Examination rooms Since was established in October 2004 and from that time through March 2010 we have performed over 700,000 cases. in Tokyo (70% of operations) and 3 branch clinics in Osaka, Nagoya, and

More information

Cross-Linking with Refractive Surgery: Pros and Cons

Cross-Linking with Refractive Surgery: Pros and Cons Cross-Linking with Refractive Surgery: Pros and Cons Raj K. Rajpal, M.D. Medical Director and Founder See Clearly Vision Group Mclean, Virginia Clinical Associate Professor Georgetown University Washington,

More information

Curtin G. Kelley, M.D. Director of Vision Correction Surgery Arena Eye Surgeons Associate Clinical Professor of Ophthalmology The Ohio State

Curtin G. Kelley, M.D. Director of Vision Correction Surgery Arena Eye Surgeons Associate Clinical Professor of Ophthalmology The Ohio State Curtin G. Kelley, M.D. Director of Vision Correction Surgery Arena Eye Surgeons Associate Clinical Professor of Ophthalmology The Ohio State University Columbus, Ohio Refractive Errors Myopia (nearsightedness)

More information

Financial Disclosure. LASIK Flap Parameters IntraLase Microkeratome 6/9/2008. Femtosecond LASIK Flaps: What Could We Customize Yesterday?

Financial Disclosure. LASIK Flap Parameters IntraLase Microkeratome 6/9/2008. Femtosecond LASIK Flaps: What Could We Customize Yesterday? Financial Disclosure Arturo Chayet, MD Tijuana, BC Mexico Perry S. Binder, MS, MD San Diego CA USA I have the following financial interests or relationships to disclose: AMO/IntraLase Corporation - C Acufocus

More information

Faster recovery of visual acuity at all distances

Faster recovery of visual acuity at all distances news Special issue PresbyMAX Faster recovery of visual acuity at all distances PresbyMAX μ-monovision: The latest technique for treating presbyopia SCHWIND now offers PresbyMAX µ-monovision as a new option

More information

Presbyopia modern surgical treatments. Johan Lønsmann Poulsen, Euroeyes

Presbyopia modern surgical treatments. Johan Lønsmann Poulsen, Euroeyes Presbyopia modern surgical treatments Johan Lønsmann Poulsen, Euroeyes Presbyopia the earliest treatments Reading stones Emperor Nero (37-68 AD) Presbyopia design trends c. 1400s c. 1680-1750 c. 1800 1850

More information

Overview of Refractive Surgery

Overview of Refractive Surgery Overview of Refractive Surgery Michael N. Wiggins, MD Assistant Professor, College of Health Related Professions and College of Medicine, Department of Ophthalmology Jones Eye Institute University of Arkansas

More information

Femtosecond Lasers in LASIK Surgery

Femtosecond Lasers in LASIK Surgery Femtosecond Lasers in LASIK Surgery Dr Chan Tat Keong Senior Consultant Refractive Surgery Service Singapore National Eye Centre Disclosure Speaker has no financial interest in the products to be discussed

More information

Refractive Surgery. Evolution of Refractive Error Correction

Refractive Surgery. Evolution of Refractive Error Correction Refractive Surgery Techniques that correct for refractive error in the eye have undergone dramatic evolution. The cornea is the easiest place to place a correction, so most techniques have focused on modifying

More information

LASIK. Complications. Customized Ablations. Photorefractive Keratectomy. Femtosecond Keratome for LASIK. Cornea Resculpted

LASIK. Complications. Customized Ablations. Photorefractive Keratectomy. Femtosecond Keratome for LASIK. Cornea Resculpted Refractive Surgery: Which Procedure for Which Patient? David R. Hardten, M.D. Minneapolis, Minnesota Have done research, consulting, or speaking for: Alcon, Allergan, AMO, Bausch & Lomb, Inspire, Medtronic,

More information

Richard S. Hoffman, MD. Clinical Associate Professor of Ophthalmology Oregon Health & Science University

Richard S. Hoffman, MD. Clinical Associate Professor of Ophthalmology Oregon Health & Science University Zeiss Mel 80 and Visumax Refractive Laser Systems Richard S. Hoffman, MD Clinical Associate Professor of Ophthalmology Oregon Health & Science University No Financial Interest ZEISS Workstation CRS-Master

More information

Clinic s Logo YOUR Z-LASIK CLINIC. (( Clinic s name ))

Clinic s Logo YOUR Z-LASIK CLINIC. (( Clinic s name )) Clinic s Logo YOUR Z-LASIK CLINIC in (( Location )) (( Clinic s name )) The gentle way to restore sharp vision We have performed surgical vision correction since (( year )) and treated more than (( number

More information

THE BEST OF BOTH WORLDS Dual-Scheimpflug and Placido Reaching a new level in refractive screening

THE BEST OF BOTH WORLDS Dual-Scheimpflug and Placido Reaching a new level in refractive screening THE BEST OF BOTH WORLDS Dual-Scheimpflug and Placido Reaching a new level in refractive screening GALILEI G4 Clinical Applications Corneal Implant Planning The comes with a licensable corneal inlay software

More information

FIRST EXPERIENCE WITH THE ZEISS FEMTOSECOND SYSTEM IN CONJUNC- TION WITH THE MEL 80 IN THE US

FIRST EXPERIENCE WITH THE ZEISS FEMTOSECOND SYSTEM IN CONJUNC- TION WITH THE MEL 80 IN THE US FIRST EXPERIENCE WITH THE ZEISS FEMTOSECOND SYSTEM IN CONJUNC- TION WITH THE MEL 80 IN THE US JON DISHLER, MD DENVER, COLORADO, USA INTRODUCTION AND STUDY OBJECTIVES This article summarizes the first US

More information

Efficacy, precision, accuracy, and safety of the SMILE procedure

Efficacy, precision, accuracy, and safety of the SMILE procedure Efficacy, precision, accuracy, and safety of the SMILE procedure Jesper Hjortdal Clinical professor Head of Corneal & Refractive Surgery Department of Ophthalmology Aarhus University Hospital Denmark Small

More information

LASER VISION C ORRECTION REFRACTIVE SURGERY CENTER

LASER VISION C ORRECTION REFRACTIVE SURGERY CENTER LASER VISION C ORRECTION REFRACTIVE SURGERY CENTER W e l c o m e Throughout our history, physicians at Mass. Eye and Ear have led clinical advances and research that have resulted in the discovery of disease-causing

More information

Consumer s Guide to LASIK

Consumer s Guide to LASIK Consumer s Guide to LASIK A Community Service Project brought to you by Price Vision Group Your Guide To A Successful LASIK Procedure The purpose of this educational guide is to help prospective patients

More information

ALL LASER LASIK. The gentle way to restore sharp vision with the femtosecond laser

ALL LASER LASIK. The gentle way to restore sharp vision with the femtosecond laser ALL LASER LASIK The gentle way to restore sharp vision with the femtosecond laser THE MOST EFFECTIVE BLADELESS METHOD If you re looking for accurate, safe and comfortable laser refractive surgery, Z-LASIK

More information

Non-surgical Presbyopia correction

Non-surgical Presbyopia correction Non-surgical Presbyopia correction Presbyopia is the decreasing age-related ability of the eye to focus on objects at close distances! The rate of decline in near visual work is faster compared to 100

More information

Evolution of Refractive Surgery 2003

Evolution of Refractive Surgery 2003 Evolution of Refractive Surgery 2003 Daniel S. Durrie, MD Overland Park, Kansas USA Surgical Options 1. corneal curvature 2. change the lens 3. add a lens Evolution of Refractive Surgery Evolution of Refractive

More information

Femto-LASIK. Pulsewidth: Ultrashort-pulse micro- machining can make sub- wavelength holes. micromachining

Femto-LASIK. Pulsewidth: Ultrashort-pulse micro- machining can make sub- wavelength holes. micromachining All-laser laser LASIK (Femto( Femto-LASIK) Femto-LASIK 台 大 眼 科 王 一 中 IntraLase 2/1 Perfect Vision Ziemer (DaVinci) Carl Zeiss Meditec Pulsewidth: Femtosecond laser (Nd:Glass)) 153 nm (near infrared) Each

More information

The Laser Eye Center s surgeons are sub-specialized in both cornea and refractive surgery, and are among the region s most experienced surgeons.

The Laser Eye Center s surgeons are sub-specialized in both cornea and refractive surgery, and are among the region s most experienced surgeons. Laser Eye Center 1 About Us The Laser Eye Center at AUBMC is a state-of-the-art, continuously updated facility with a mission to provide high-precision refractive surgery to correct visual errors. Staffed

More information

FEMTO LDV Z MODELS THE POWER OF ONE. The ONE FEMTO PLATFORM for cornea, presbyopia, and cataract* Supplement to September 2012

FEMTO LDV Z MODELS THE POWER OF ONE. The ONE FEMTO PLATFORM for cornea, presbyopia, and cataract* Supplement to September 2012 Supplement to September 2012 FEMTO LDV Z MODELS THE POWER OF ONE The ONE FEMTO PLATFORM for cornea, presbyopia, and cataract* *The Ziemer FEMTO LDV Z Models are FDA cleared and CE marked and available

More information

The POwer OF One The One FemTO PlaTFOrm FOr COrnea, PresbyOPia and CaTaraCT

The POwer OF One The One FemTO PlaTFOrm FOr COrnea, PresbyOPia and CaTaraCT The Power of One The One Femto Platform for Cornea, Presbyopia and Cataract Time to listen, passion to design, power to build A partnership for the future Technology is rapidly changing and it is important

More information

Refractive Surgery. Common Refractive Errors

Refractive Surgery. Common Refractive Errors Refractive Surgery Over the last 25 years developments in medical technology and Refractive Surgery allow almost all need for glasses and contact lenses to be eliminated. Currently there are a number of

More information

Innovations in Refractive Surgery

Innovations in Refractive Surgery Innovations in Refractive Surgery Edward E. Manche, MD Byers Eye Institute Stanford University School of Medicine Financial Interest Disclosures AMO D Best Doctors A Calhoun Vision R Avellino Laboratories

More information

NEW HORIZONS IN CORNEAL SURGERY VERSATILE FEMTOSECOND LASER WORKSTATION WE FOCUS ON PERFECTION

NEW HORIZONS IN CORNEAL SURGERY VERSATILE FEMTOSECOND LASER WORKSTATION WE FOCUS ON PERFECTION NEW HORIZONS VERSATILE FEMTOSECOND IN CORNEAL LASER WORKSTATION SURGERY WE FOCUS ON PERFECTION ADVANCED FEMTOSECOND LASER TECHNOLOGY COMMITTED TO VERSATILITY > ONE SYSTEM FOR ALL FEMTO-APPLICATIONS > ANATOMICALLY

More information

Comparison of Residual Stromal Bed Thickness and Flap Thickness at LASIK and Post-LASIK Enhancement in Femtosecond Laser-Created Flaps

Comparison of Residual Stromal Bed Thickness and Flap Thickness at LASIK and Post-LASIK Enhancement in Femtosecond Laser-Created Flaps Comparison of Residual Stromal Bed Thickness and Flap Thickness at LASIK and Post-LASIK Enhancement in Femtosecond Laser-Created Flaps Lingo Y. Lai, MD William G. Zeh, MD Clark L. Springs, MD The authors

More information

Supplement to September 2013 FEATURED AUTHORS:

Supplement to September 2013 FEATURED AUTHORS: Supplement to September 2013 SHAPING THE FUTURE With SCHWIND AMARIS 1050RS and PresbyMAX Hybrid FEATURED AUTHORS: Minoru Tomita, MD, PhD María Clara Arbelaez, MD Michiel H.A. Luger, MD Pierre Baudu, MD

More information

Small aperture corneal inlay for the correction of presbyopia: visual results and complications

Small aperture corneal inlay for the correction of presbyopia: visual results and complications UPDATE/REVIEW Small aperture corneal inlay for the correction of presbyopia: visual results and complications Javier Tomás-Juan, OD, MSc 1 ABSTRACT: Small aperture corneal inlay is one of the surgical

More information

Minimally Invasive Surgery: Femtosecond Lasers and Other Innovative Microsurgical Techniques

Minimally Invasive Surgery: Femtosecond Lasers and Other Innovative Microsurgical Techniques Minimally Invasive Surgery: Femtosecond Lasers and Other Innovative Microsurgical Techniques Julio Narváez MD Associate Professor of Ophthalmology Loma Linda University Non-Refractive Applications of Femtosecond

More information

FOR MORE INFORMATION VISIT WWW.Z-LASIK.NET

FOR MORE INFORMATION VISIT WWW.Z-LASIK.NET FOR MORE INFORMATION VISIT WWW.Z-LASIK.NET Dougherty Laser Vision 9100 Wilshire Blvd, Suite #265E Beverly Hills, CA 90210 323-466-7337 1821 E Daily Drive Camarillo, CA 93010 805-987-5300 4353 Park Terrace

More information

Excellent outlook for your eyes: With SCHWIND AMARIS technology

Excellent outlook for your eyes: With SCHWIND AMARIS technology Excellent outlook for your eyes: With SCHWIND AMARIS technology Laser surgery for the eyes Comfortable, fast and safe The SCHWIND laser eye procedure When performing laser procedures, eye surgeons apply

More information

Premium IOL Implantation Calculations in Post-LASIK Cataract Eyes Using ASCRS IOL Calculator

Premium IOL Implantation Calculations in Post-LASIK Cataract Eyes Using ASCRS IOL Calculator Premium IOL Implantation Calculations in Post-LASIK Cataract Eyes Using ASCRS IOL Calculator Sahiba K Chailertborisuth, Saneha K. C. Borisuth, Navaneet S.C. Borisuth, MD, PhD Virdi Eye Clinic & Laser Vision

More information

bringing life into focus

bringing life into focus bringing life into focus Our Vision Serves To Enhance Yours Every day, you participate in activities that require focused vision. Whether it s reading a newspaper, driving a car or hitting a golf ball,

More information

Multi-Centre Evaluation of TransPRK outcomes with SCHWIND AMARIS using SmartPulse Technology

Multi-Centre Evaluation of TransPRK outcomes with SCHWIND AMARIS using SmartPulse Technology study 2015 Multi-Centre Evaluation of TransPRK outcomes with SCHWIND AMARIS using SmartPulse Technology David T. Lin, MD, Canada, Paolo Vinciguerra, MD, Italy, Maria C. Arbelaez, MD, Oman, Shady T. Awwad,

More information

ICRS implantation with the Femto LDV laser in stabilized KC patients: 6 months results

ICRS implantation with the Femto LDV laser in stabilized KC patients: 6 months results ICRS implantation with the Femto LDV laser in stabilized KC patients: 6 months results Jérôme C. VRYGHEM, M.D. Brussels Eye Doctors Brussels, Belgium No financial interest! A lot of KC patients show interest

More information

Ophthalmology Department,Tanta University, Egypt

Ophthalmology Department,Tanta University, Egypt Moataz M. Sabry, MD, PhD. Ophthalmology Department,Tanta University, Egypt 1 SHOULD WE ABONDONE MECHANICAL MICROKERATOMES? 2 With Mechanical, LASIK is a one-laser procedure, there s no moving of patient

More information

IBRA Professional. Leading Technology for Refractive Outcome Analysis. Brochure 2015

IBRA Professional. Leading Technology for Refractive Outcome Analysis. Brochure 2015 IBRA Professional Leading Technology for Refractive Outcome Analysis Brochure 2015 Introduction IBRA is the leading all-in-one system for refractive laser and lens surgery outcomes, allowing eye surgeons

More information

LASIK and Refractive Surgery. Laser and Lens Vision Correction Options

LASIK and Refractive Surgery. Laser and Lens Vision Correction Options LASIK and Refractive Surgery Laser and Lens Vision Correction Options For over 30 years, The Eye Institute of Utah has been giving people vision for life... Dr. Andrew Lyle, vision pioneer and founder

More information

Technical specifications. TECHNOLAS Femtosecond Workstation 520F Versatility at its best. Diode Pumped Solid State Laser (DPSSL)

Technical specifications. TECHNOLAS Femtosecond Workstation 520F Versatility at its best. Diode Pumped Solid State Laser (DPSSL) Technical specifications Laser type Pulse duration Wavelength Pulse frequency Supply Power consumption Size Weight System Components Microscope Safety Room conditions Diode Pumped Solid State Laser (DPSSL)

More information

Daniel F. Goodman, M.D. 2211 Bush Street, 2nd Floor San Francisco, CA 94115 Phone: 415-474-3333 Fax: 415-474-3939

Daniel F. Goodman, M.D. 2211 Bush Street, 2nd Floor San Francisco, CA 94115 Phone: 415-474-3333 Fax: 415-474-3939 Daniel F. Goodman, M.D. 2211 Bush Street, 2nd Floor San Francisco, CA 94115 Phone: 415-474-3333 Fax: 415-474-3939 INFORMED CONSENT FOR LASIK (LASER IN SITU KERATOMILEUSIS) and PRK (PHOTOREFRACTIVE KERATECTOMY)

More information

Case Reports Post-LASIK ectasia treated with intrastromal corneal ring segments and corneal crosslinking

Case Reports Post-LASIK ectasia treated with intrastromal corneal ring segments and corneal crosslinking Case Reports Post-LASIK ectasia treated with intrastromal corneal ring segments and corneal crosslinking Kay Lam, MD, Dan B. Rootman, MSc, Alejandro Lichtinger, and David S. Rootman, MD, FRCSC Author affiliations:

More information

refractive surgery a closer look

refractive surgery a closer look 2011-2012 refractive surgery a closer look How the eye works Light rays enter the eye through the clear cornea, pupil and lens. These light rays are focused directly onto the retina, the light-sensitive

More information

Comparison of Retinal Image Quality between SBK and PRK. Allen Boghossian, D.O. Durrie Vision Overland Park, KS

Comparison of Retinal Image Quality between SBK and PRK. Allen Boghossian, D.O. Durrie Vision Overland Park, KS Comparison of Retinal Image Quality between and Allen Boghossian, D.O. Durrie Vision Overland Park, KS Study Design Purpose: To compare optical quality and intraocular scatter between and using double-pass

More information

LASIK Eye Surgery Report

LASIK Eye Surgery Report LASIK Eye Surgery Report LASIK eye surgery can be a liberating experience for people hoping to reduce or eliminate their dependence on glasses and contact lenses. Most patients do not realize how evolved

More information

Uniquely Safe. predictably better for our patients. enhancement, may be significantly reduced.

Uniquely Safe. predictably better for our patients. enhancement, may be significantly reduced. Uniquely Safe Clinical Support: Six different studies verify the improved safety of flap creation with the INTRALASE FS laser when compared to traditional microkeratomes. Clinical studies validate the

More information

REFRACTIVE ERROR AND SURGERIES IN THE UNITED STATES

REFRACTIVE ERROR AND SURGERIES IN THE UNITED STATES Introduction REFRACTIVE ERROR AND SURGERIES IN THE UNITED STATES 150 million wear eyeglasses or contact lenses 2.3 million refractive surgeries performed between 1995 and 2001 Introduction REFRACTIVE SURGERY:

More information

Alain Saad, MD, Alice Grise-Dulac, MD, Damien Gatinel, MD, PhD

Alain Saad, MD, Alice Grise-Dulac, MD, Damien Gatinel, MD, PhD CASE REPORT Bilateral loss in the quality of vision associated with anterior corneal protrusion after hyperopic LASIK followed by intrastromal femtolaser-assisted incisions Alain Saad, MD, Alice Grise-Dulac,

More information

Alexandria s Guide to LASIK

Alexandria s Guide to LASIK Alexandria s Guide to LASIK A Community Service Project sponsored by: Wallace Laser Center Your Guide To A Successful LASIK Procedure The word LASIK is actually an acronym for Laser Assisted In-Situ Keratomileusis.

More information

Refractive Surgery Issue. Inlays and Presbyopia: On the Horizon P. 24. Crack a SMILE or Raise a Flap? P. 30. LASIK Xtra: Who Should Get It? P.

Refractive Surgery Issue. Inlays and Presbyopia: On the Horizon P. 24. Crack a SMILE or Raise a Flap? P. 30. LASIK Xtra: Who Should Get It? P. MULTIMODAL IMAGING OF PLACOID DISORDERS P. 42 WILLS RESIDENT CASE SERIES P. 67 NTG: THE NOCTURNAL BLOOD PRESSURE FACTOR P. 54 WISE CHOICES FOR OCULAR DIAGNOSES P. 50 NEW WAYS TO DETECT KERATOCONUS P. 58

More information

Schwind Amaris 500E Cutting edge technology impressively efficient

Schwind Amaris 500E Cutting edge technology impressively efficient Schwind Amaris 500E Cutting edge technology impressively efficient TREAT 2 TREAT Schwind Amaris 500E Cutting edge technology from the technology leader Everything that a patient can expect from corneal

More information

PATIENT CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK)

PATIENT CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK) INTRODUCTION: You have been diagnosed with myopia (nearsightedness) or hyperopia (farsightedness) with or without astigmatism, or astigmatism alone. Myopia is a result of light entering the eye and focusing

More information

Eye Surgery. Laser Eye Surgery and Refractive Surgery

Eye Surgery. Laser Eye Surgery and Refractive Surgery Eye Surgery Laser Eye Surgery and Refractive Surgery Traditional LASIK (Laser-In-Situ-Keratomileusis) Technique is the most practiced surgical procedure for resolving of the eyesight problems with dominating

More information

DEPTH OF FOCUS EXTENDING. Corneal Inlay Experts Discuss Best Practices for Achieving Reliable, Long-Lasting Presbyopia Correction

DEPTH OF FOCUS EXTENDING. Corneal Inlay Experts Discuss Best Practices for Achieving Reliable, Long-Lasting Presbyopia Correction Supplement to May 2014 Sponsored by AcuFocus, Inc. EXTENDING DEPTH OF FOCUS Corneal Inlay Experts Discuss Best Practices for Achieving Reliable, Long-Lasting Presbyopia Correction Contributors Waleed Al-Tuwairqi,

More information

Keratoconus is one of the most challenging corneal

Keratoconus is one of the most challenging corneal Corneal Remodeling Using the Keraring A variety of thicknesses, arc lengths, and optical zone sizes allows tailoring of the procedure to the individual patient. BY DOMINIQUE PIETRINI, MD; AND TONY GUEDJ

More information

One Use-PlusSBK versus LDV Femto Laser Clinical evaluation

One Use-PlusSBK versus LDV Femto Laser Clinical evaluation One Use-PlusSBK versus LDV Femto Laser Clinical evaluation Nikica Gabric, Maja Bohac, Iva Dekaris Eye Clinic Svjetlost Zagreb, Croatia MORIA ONE USE-PLUS SBK MICROKERATOME Automatic linear microkeratome

More information

Retreatment by Lifting the Original Laser in Situ Keratomileusis Flap after Eleven Years

Retreatment by Lifting the Original Laser in Situ Keratomileusis Flap after Eleven Years Retreatment by Lifting the Original Laser in Situ Keratomileusis Flap after Eleven Years Hassan Hashemi, MD 1,2 Mehrdad Mohammadpour, MD 3 Abstract Purpose: To describe a case of successful laser in situ

More information

Laser Vision Correction

Laser Vision Correction Laser Vision Correction Your laser eye surgery questions, answered. At Vision Eye Institute, we understand that the decision whether or not to have laser vision correction isn t easy. You ll have many

More information

Ectasia after laser in-situ keratomileusis (LASIK)

Ectasia after laser in-situ keratomileusis (LASIK) Ectasia after laser in-situ keratomileusis (LASIK) 長 庚 紀 念 醫 院 眼 科 蕭 靜 熹 Post-LASIK ectasia A rare complication of LASIK Manhattan jury awarded a former investment banker a record $7.25 million for post-lasik

More information

MicroScan. Excimer laser system for all types of vision corrections OPTOSYSTEMS LTD.

MicroScan. Excimer laser system for all types of vision corrections OPTOSYSTEMS LTD. MicroScan Excimer laser system for all types of vision corrections OPTOSYSTEMS LTD. МicroScan is a new generation excimer laser system for all types of vision corrections: myopia, hypermetropia, astigmatism.

More information

SCHWIND AMARIS 750S Always innovative

SCHWIND AMARIS 750S Always innovative SCHWIND AMARIS 750S Always innovative TREAT 4 TREAT The SCHWIND AMARIS 750S The absolute best performance from the leader in technology The demands patients are placing on treatment methods and the results

More information

Lasik Xtra in: Hyperopia AK Xtra Clear cornea cataract surgery

Lasik Xtra in: Hyperopia AK Xtra Clear cornea cataract surgery Lasik Xtra in: Hyperopia AK Xtra Clear cornea cataract surgery A. John Kanellopoulos, M.D. Clinical Profesor of Ophthalmology New York University School of Medicine, New York, NY, USA Laservision.gr Institute,

More information

Conductive keratoplasty (CK) utilizes radiofrequency energy. Original Article

Conductive keratoplasty (CK) utilizes radiofrequency energy. Original Article Original Article Comparing the Rate of Regression after Conductive Keratoplasty with or without Prior Laser-Assisted in situ Keratomileusis or Photorefractive Keratectomy Majid Moshirfar, Erik Anderson

More information

New and Improved Femtosecond Laser Applications. Karl Stonecipher, MD Wavefront Congress 2008

New and Improved Femtosecond Laser Applications. Karl Stonecipher, MD Wavefront Congress 2008 New and Improved Femtosecond Laser Applications Karl Stonecipher, MD Wavefront Congress 2008 When birds don t fly, neither should you. When cows bunch together in a field, a storm is coming. When ants

More information

TRUSTED LASIK SURGEONS. Eye Conditions Correctable by Refractive Surgical Procedures

TRUSTED LASIK SURGEONS. Eye Conditions Correctable by Refractive Surgical Procedures Eye Conditions Correctable by Refractive Surgical Procedures How does the eye focus? Light rays are focused on to the retina (where the image is relayed to the brain) by the cornea and the lens of the

More information

REFRACTIVE SURGERY OVERVIEW 2007 Lecture notes Professor Charles McGhee PhD FRCOphth

REFRACTIVE SURGERY OVERVIEW 2007 Lecture notes Professor Charles McGhee PhD FRCOphth REFRACTIVE SURGERY OVERVIEW 2007 Lecture notes Professor Charles McGhee PhD FRCOphth Importance of refractive surgery Refractive surgery increasingly popular Essentially healthy eyes with normal visual

More information

Dr. Booth received his medical degree from the University of California: San Diego and his bachelor of science from Stanford University.

Dr. Booth received his medical degree from the University of California: San Diego and his bachelor of science from Stanford University. We've developed this handbook to help our patients become better informed about the entire process of laser vision correction. We hope you find it helpful and informative. Dr. Booth received his medical

More information

5/24/2013 ESOIRS 2013. Moderator: Alaa Ghaith, MD. Faculty: Ahmed El Masri, MD Mohamed Shafik, MD Mohamed El Kateb, MD

5/24/2013 ESOIRS 2013. Moderator: Alaa Ghaith, MD. Faculty: Ahmed El Masri, MD Mohamed Shafik, MD Mohamed El Kateb, MD ESOIRS 2013 Moderator: Alaa Ghaith, MD Faculty: Ahmed El Masri, MD Mohamed Shafik, MD Mohamed El Kateb, MD 1 A systematic approach to the management of Keratoconus through the presentation of different

More information

ReLEx smile Minimally invasive vision correction Information for patients

ReLEx smile Minimally invasive vision correction Information for patients ReLEx smile Minimally invasive vision correction Information for patients Seeing is living Our eyes are our most important sensory organ. The human brain obtains over 80 % of its information via the sense

More information

Corneal-based surgical presbyopic therapies and their application in pseudophakic patients

Corneal-based surgical presbyopic therapies and their application in pseudophakic patients Washington University School of Medicine Digital Commons@Becker Open Access Publications 2016 Corneal-based surgical presbyopic therapies and their application in pseudophakic patients Grace L. Paley Washington

More information

Your Prescription for a New Beginning

Your Prescription for a New Beginning Your Prescription for a New Beginning Now is the time to stop letting poor vision stand in between you and life's most meaningful moments. Surgeons at TLC Laser Eye Centers specialize in the latest vision

More information

Preliminary U.S. FDA Outcomes of SMILE

Preliminary U.S. FDA Outcomes of SMILE Preliminary U.S. FDA Outcomes of SMILE D. REX HAMILTON, MD, MS, FACS HEALTH SCIENCES CLINICAL PROFESSOR OF OPHTHALMOLOGY MEDICAL DIRECTOR, UCLA LASER REFRACTIVE CENTER STEIN EYE INSTITUTE, GEFFEN SCHOOL

More information

Cornea and Refractive Surgery Update

Cornea and Refractive Surgery Update Cornea and Refractive Surgery Update Fall 2015 Optometric Education Dinner Sebastian Lesniak MD Matossian Eye Associates Disclosures: None Bio: Anterior Segment and Cornea Surgery Fellowship Wills Eye

More information

INFORMED CONSENT LASER IN SITU KERATOMILEUSIS (LASIK)

INFORMED CONSENT LASER IN SITU KERATOMILEUSIS (LASIK) Edward C. Wade, M. D Christopher D. Allee, O. D. Ting Fang-Suarez, M. D. Jill Autry, O. D. Mark L. Mayo, M. D. Amanda Bachman, O. D. Randall N. Reichle, O. D Julie Ngo, O. D. INFORMED CONSENT LASER IN

More information

Precision Work on the Human Eye

Precision Work on the Human Eye WHITEPAPER Precision Work on the Human Eye PIEZO-BASED NANOPOSITIONING SYSTEMS FOR OPHTHALMOLOGY BIRGIT BAUER PIEZO-BASED NANOPOSITIONING SYSTEMS FOR OPHTHALMOLOGY PAGE 2 Content Introduction... 3 Precision

More information

TABLE OF CONTENTS: LASER EYE SURGERY CONSENT FORM

TABLE OF CONTENTS: LASER EYE SURGERY CONSENT FORM 1 BoydVision TABLE OF CONTENTS: LASER EYE SURGERY CONSENT FORM Risks and Side Effects... 2 Risks Specific to PRK... 3 Risks Specific to LASIK... 4 Patient Statement of Consent... 5 Consent for Laser Eye

More information

The state-of-the-art LASIK Laser Eye Center. Connie S. McCaa, MD,PhD LASIK Laser Eye Center 4800 Lakeland Drive Flowood, MS 39232 601-933-1080

The state-of-the-art LASIK Laser Eye Center. Connie S. McCaa, MD,PhD LASIK Laser Eye Center 4800 Lakeland Drive Flowood, MS 39232 601-933-1080 The state-of-the-art Connie S. McCaa, MD,PhD LASIK is a proven procedure Connie S. McCaa, MD, PhD, was one of the first ophthalmologists in the United States to be trained in the LASIK procedure. She has

More information

Rediscover quality of life thanks to vision correction with technology from Carl Zeiss. Patient Information

Rediscover quality of life thanks to vision correction with technology from Carl Zeiss. Patient Information Rediscover quality of life thanks to vision correction with technology from Carl Zeiss Patient Information 5 2 It was really w Vision defects: Light that goes astray For clear vision the eyes, cornea and

More information

Correction of refractive eye errors in adults Part II: laser surgery and intraocular lenses

Correction of refractive eye errors in adults Part II: laser surgery and intraocular lenses Correction of refractive eye errors in adults Part II: laser surgery and intraocular lenses C.Obyn, Y. Smit, P. Post, L. Kohn, N. Defourny, W. Christiaens, D. Paulus CA-RVB, 17 th December 2013 2nd part

More information

SCHWIND CAM Perfect Planning wide range of applications

SCHWIND CAM Perfect Planning wide range of applications SCHWIND CAM Perfect Planning wide range of applications ORK-CAM PresbyMAX PALK-CAM PTK-CAM 2 SCHWIND CAM the system solution The latest version of the modular SCHWIND CAM represents an even more efficient

More information

Since the mid 1990s, ReVision LASIK and Cataract Surgery Center has helped individuals from the Midwest and around the world enjoy great vision with

Since the mid 1990s, ReVision LASIK and Cataract Surgery Center has helped individuals from the Midwest and around the world enjoy great vision with Refractive Surgery Options Since the mid 1990s, ReVision LASIK and Cataract Surgery Center has helped individuals from the Midwest and around the world enjoy great vision with the latest technologies and

More information

Bladeless LASIK and PRK

Bladeless LASIK and PRK Bladeless LASIK and PRK Bladeless LASIK and PRK The specialists at North Shore-LIJ Laser Vision Correction understand how valuable your sight is to you, which is why we use the safest, most advanced technology

More information

Flight School Applicants Refractive Surgery Fact Sheet

Flight School Applicants Refractive Surgery Fact Sheet Flight School Applicants Refractive Surgery Fact Sheet What: LASIK (Laser in-situ keratomileusis) and PRK(Photorefractive keratectomy) are disqualifying for Army Aviation in accordance with Army Regulation

More information

LASIK Information Kit

LASIK Information Kit LASIK Information Kit www.eyecareinstitute.com 2 About The Eye Care Institute We are eye physicians and surgeons in Louisville, Kentucky and Southern Indiana. In practice since 1984, our eye doctors have

More information

INTRACOR. An excerpt from the presentations by Dr Luis Ruiz and Dr Mike Holzer and the Round Table discussion moderated by Dr Wing-Kwong Chan in the

INTRACOR. An excerpt from the presentations by Dr Luis Ruiz and Dr Mike Holzer and the Round Table discussion moderated by Dr Wing-Kwong Chan in the INTRACOR An excerpt from the presentations by Dr Luis Ruiz and Dr Mike Holzer and the Round Table discussion moderated by Dr Wing-Kwong Chan in the 1 Dr Luis Ruiz Presbyopia treatment with INTRACOR Luis

More information

PresbyMAX For visibly younger eyesight

PresbyMAX For visibly younger eyesight PresbyMAX For visibly younger eyesight Contents 2 3 SCHWIND eye-tech-solutions So you can still read stories aloud tomorrow CONTENTS Presbyopia 4 5 PresbyMAX 6 7 Visual acuity at all distances 8 9 Your

More information

THE GUIDE TO REFRACTIVE LENS EXCHANGE SEE CLEARLY.

THE GUIDE TO REFRACTIVE LENS EXCHANGE SEE CLEARLY. THE GUIDE TO REFRACTIVE LENS EXCHANGE SEE CLEARLY. EVERYBODY WANTS TO SEE CLEARLY Many of us take our sight for granted, whether it s forgetting how often we rely on it to guide us through our day-to-day

More information

Techniques for Enhancing Cataract Surgery Patients with Residual Refractive Error. Director of Cornea Center For Excellence In Eye Care Miami, FL

Techniques for Enhancing Cataract Surgery Patients with Residual Refractive Error. Director of Cornea Center For Excellence In Eye Care Miami, FL Techniques for Enhancing Cataract Surgery Patients with Residual Refractive Error William Trattler, MD Director of Cornea Center For Excellence In Eye Care Miami, FL 1 Financial Disclosures Consulting

More information

Epi-LASIK Surgery. The procedure of choice for surface ablation.

Epi-LASIK Surgery. The procedure of choice for surface ablation. Epi-LASIK Surgery The procedure of choice for surface ablation. powered by Moria Preservation of Corneal Biomechanical Integrity, minimizing the risks of ectasia Post-LASIK CH decrease (Reichert ORA) 0-1

More information

The pinnacle of refractive performance.

The pinnacle of refractive performance. Introducing! The pinnacle of refractive performance. REFRACTIVE SURGERY sets a new standard in LASIK outcomes More than 98% of patients would choose it again. 1 It even outperformed glasses and contacts

More information

WAKE FOREST BAPTIST HEALTH EYE CENTER. LASIK Consent Form

WAKE FOREST BAPTIST HEALTH EYE CENTER. LASIK Consent Form 1 WAKE FOREST BAPTIST HEALTH EYE CENTER LASIK Consent Form 1. GENERAL INFORMATION The following information is intended to help you make an informed decision about having Laser In-Situ Keratomileusis (LASIK).

More information

Refractive Errors & Correction

Refractive Errors & Correction Super Vision 6 Chapter Lasik is currently the most sophisticated procedure for correction of refractive errors. Lasik is an acronym for Laser Assisted Insitu Keratomileusis. In Lasik, Excimer laser is

More information

LASIK & Refractive Surgery

LASIK & Refractive Surgery LASIK & Refractive Surgery LASIK PRK ICL RLE Monovision + + + For over 30 years, The Eye Institute of Utah has been giving people vision for life... The Eye Institute of Utah was the first medical facility

More information

Precision Work on the Human Eye

Precision Work on the Human Eye Precision Work on the Human Eye Piezo-Based Nanopositioning Systems for Ophthalmology Page 1 of 5 Introduction Human beings are visual animals, in other words, they acquire most information visually. It

More information

The «three-in-one» Microkeratome for traditional LASIK, EPI-LASIK, and anterior and posterior Lamellar Keratoplasty

The «three-in-one» Microkeratome for traditional LASIK, EPI-LASIK, and anterior and posterior Lamellar Keratoplasty The «three-in-one» Microkeratome for traditional LASIK, EPI-LASIK, and anterior and posterior Lamellar Keratoplasty Ziemer Group We develop and produce diagnostic and surgical products for the ophthalmic

More information

Refractive Surgery Education and Informed Consent

Refractive Surgery Education and Informed Consent Refractive Surgery Education and Informed Consent Tripler Army Medical Center Refractive Surgery Center Warfighter Refractive Eye Surgery Program (WRESP) Goals of this Briefing To explain the Warfighter

More information