Speed and Spot size
–500 Hz ablation rate
–1.4 seconds per diopter ablation
–0.68 mm Gaussian laser beam

Why speed matters
• Reduces stromal dehydration
• Reduces exposure to temperature and humidity factors
• Improves patient fixation time
• Improves patient comfort throughout

The significance of a Gaussian beam profile

The treated surface of the patient's cornea is reshaped smoothly with a Gaussian beam like the WaveLight EX500. Flat-top beam lasers leave a rough, notched surface on the cornea.

One of the most innovative features of our new LASIK system is our adoption of CONTOURA Vision, a highly sophisticated eye-mapping technology. CONTOURA Vision precisely maps up to 22,000 elevation points on each of your eyes. We can now capture these images of the irregularities of your eye and add this to your unique LASIK correction plan. Some of these irregularities may indicate that you have been seeing smears, halos, and glares even with your glasses and contacts. The treatment of these "Higher Order Aberrations" may take patients beyond the vision afforded them by their glasses and contacts, giving them improvement of contrast and clarity beyond 20/20. Patients typically see much better than they are used to on the first day and enjoy continual improvement over 12 months.

Our patients tell us that they are now experiencing vision with unprecedented clarity, color, and dimension.

WaveLight was the first company to introduce high-speed laser vision correction in the United States. Now, the WaveLight EX500 takes the technology one step further with the fastest excimer laser system available today in the U.S. Thanks to the incredible power of the laser, many people can have their vision corrected in as little as eight seconds, some even more quickly. At the same time, the WaveLight EX500 with CONTOURA Vision delivers superior results, with less risk of side effects.

Perfect Pulse Technology™ ensures safe and precise work at high speed. Each ultra-thin laser pulse is used to sculpt the corneal surface of the eye with the utmost accuracy. The high-speed eye tracker follows the eye’s fastest movements, checking the eye’s positions 500 times per second while ensuring an accurate placement of each laser pulse on the cornea. In addition, an integrated crossline projector provides the surgeon with an exact alignment of the eye’s position, making the WaveLight® EX500 one of the safest, most effective optical lasers currently available.

You can have peace of mind that the amount of energy in the laser has been calibrated to exactly the right level. After the beam has been created, it passes through three checkpoints on its way to your eye. At each of these points, the energy level is checked and adjusted if necessary, ensuring that the beam is perfectly attuned at its destination.

The WaveLight® EX500 laser is essentially a precise, controlled beam of energy. The laser employs a proprietary overlapping method to ensure accurate laser placement and thermal control, and is one of the ways that WaveLight® EX500 is able to achieve a rounder, more natural corneal surface than many other lasers used for vision correction.

The eye tracker is 10 times faster than your eye so you need not worry that your procedure will be affected by any eye movement you might accidentally make. Due to the remarkable speed of both the eye and the WaveLight EX500, the laser beam needs to be constantly and minutely adjusted to the position of the eye at any given time. Every two to three milliseconds, the eye’s location is measured and the WaveLight EX500 automatically aligns. Just before the pulse is released, a second check is made to confirm that the eye has not moved. This happens 500 times every second, once for every laser pulse. If, at any time, the eye moves too quickly to be measured or moves out of range, the laser will stop and wait for the eye to move back into position.

Being infrared, the illumination sources cannot cause thermal heating. The illumination sources are independent, meaning that the tracker will continue to work even if one of the pods is covered by the surgeon's hand or a sterile drape, and the gooseneck shape of the illumination pods prevents backscattering of surgery.

Currently, the WaveLight EX500 is the fastest vision correction laser for LASIK available in the United States. At 500 laser bursts per second, it takes only about 1.4 seconds of treatment to correct one diopter. Of course, spending less time under the laser means less stress and discomfort for the patient. More significantly, this means greater accuracy as well, due to less drying of the cornea during treatment, the chief cause of overcorrection.

Patients with myopia (nearsightedness) can determine their approximate treatment time on the chart below:

The WaveLight® EX500 with CONTOURA® Vision eye-mapping is capable of producing some of the largest available optical zones. The optical zone refers to the portion of the cornea that has been corrected by the laser. A larger optical zone is especially important for night vision and for patients with very large pupils. If a patient’s pupil is larger than the optical zone, he or she may experience poor peripheral vision, poor night vision, and a higher than normal incidence of “halos” and glare. In the past, this has been one of the biggest drawbacks to conventional laser correction surgery, so if you have previously been told your pupils are too large for LASIK, see Dr. Winthrop for a free LASIK consultation to see if you may indeed be a candidate.

At night and in dark conditions, the pupil becomes larger to permit the maximum amount of light to enter the eye. Laser eye correction needs to take this fact into account. If the optical zone is smaller than the size of the pupil at its largest, there is a good chance that the patient will experience poor night vision or problems with glare and halos around bright objects such as oncoming headlights. The WaveLight® EX500 with CONTOURA® Vision is able to produce a larger optical zone, virtually eliminating glare and night vision problems associated with older-generation lasers.

Finding the eye’s right treatment position and avoiding displacements caused by cyclotorsion is one of the most important factors in obtaining an excellent refractive outcome. The WaveLight® EX500’s integrated cross line projector provides the surgeon an exact alignment of the eye’s position. The target diode which generates a red light cross hair on the patient’s face, illustrating the correct position in coordination with the manual marks. With the WaveLight® EX-500, a surgeon can also treat difficult cases or patients with a high cyclotorsion value up to 15% and still produce excellent results. This was demonstrated by the FDA clinical trials having a cornering predictability from ± 0.5 D.

This information pertains to all WaveLight® Excimer Laser Systems, including the WaveLight® ALLEGRETTO WAVE®, the ALLEGRETTO WAVE® Eye-Q, and the WaveLight® EX500.

Caution: Federal (U.S.) law restricts the WaveLight® Excimer Laser Systems to sale by or on the order of a physician. Only practitioners who are experienced in the medical management and surgical treatment of the cornea, who have been trained in laser refractive surgery (including laser calibration and operation) should use a WaveLight® Excimer Laser System.

Indications: FDA has approved the WaveLight® Excimer Laser Systems for use in laser-assisted in situ keratomileusis (LASIK) treatments for nearsightedness (myopia), farsightedness (hyperopia), and astigmatism, including mixed astigmatism. Astigmatism occurs if the shape of your eye causes light to bend and distort as it passes through your lens. With astigmatism, objects tend to appear blurry or unfocused. Mixed astigmatism occurs if you have symptoms of nearsightedness and farsightedness at the same time.

The WaveLight® Excimer Laser Systems are approved for the following specific LASIK treatments and ranges:

• Reduction or elimination of nearsightedness of up to – 12.00 diopters of sphere and up to 6.00 diopters of astigmatism at the spectacle plane.
• Reduction or elimination of farsightedness up to + 6.00 diopters of sphere and up to 5.00 diopters of astigmatism at the spectacle plane, with a maximum manifest refraction spherical equivalent of + 6.00 diopters.
• Reduction or elimination of naturally occurring mixed astigmatism of up to 6.00 diopters at the spectacle plane.
• Wavefront-guided reduction or elimination of nearsightedness of up to – 7.00 diopters of sphere and up to 3.00 diopters of astigmatism at the spectacle plane. Wavefront-guided LASIK treatment takes into account small, complex imperfections in the shape of your eye that can affect your vision. Wavefront-guided LASIK is more highly customized than traditional LASIK procedures.
• In addition, the WaveLight® ALLEGRETTO WAVE® Eye-Q Excimer Laser System, when used with the WaveLight® ALLEGRO Topolyzer® and topography-guided treatment planning software, is approved for topography-guided LASIK treatments for the reduction or elimination of up to -9.00 diopters of nearsightedness, or for the reduction of elimination of nearsightedness with astigmatism with up to -8.00 diopters of nearsightedness and up to 3.00 diopters of astigmatism.
• The WaveLight® Excimer Laser Systems are only indicated for use in patients who are 18 years of age or older (21 years of age or older for mixed astigmatism), who have documented evidence that their refraction did not change by more than 0.50 diopters during the year before their preoperative examination.
• Alternatives to LASIK: LASIK is just one option for correcting your vision. Alternative options include eyeglasses, contact lenses, photorefractive keratectomy surgery (PRK), and other refractive surgeries. Be sure to talk to your doctor to find out if LASIK is appropriate for your condition.

Contraindications: If you have any of the following situations or conditions, you should not have LASIK because the risk is greater than the benefit:

• You are pregnant or nursing. These conditions may cause temporary and unpredictable changes in your cornea and a LASIK treatment would improperly change the shape of your cornea.
• You have a collagen vascular, autoimmune or immunodeficiency disease, such as rheumatoid arthritis, multiple sclerosis, lupus or AIDS. These conditions affect the body’s ability to heal.
• You show signs of keratoconus or any other condition that causes a thinning of your cornea. This condition can lead to serious corneal problems during and after LASIK surgery. It may result in need for additional surgery and may result in poor vision after LASIK.
• You are taking medications with ocular side effects, such as Isotretinoin (Accutane*) for acne treatment or amiodarone hydrochloride (Cordarone*) for normalizing heart rhythm, because they may affect the accuracy of the LASIK treatment or the way your cornea heals after LASIK. This may result in poor vision after LASIK.
• You show symptoms of severe dry eye. If you have severely dry eyes, LASIK may increase dryness. This may or may not go away. This dryness may delay healing of the flap or interfere with the surface of the eye after surgery.
• Your corneas are too thin. If your corneas will be too thin after your doctor has cut a flap and performed the LASIK treatment, you cannot have LASIK.
• You have recurrent corneal erosion. This condition can lead to serious corneal problems during and after LASIK surgery.
• You have advanced glaucoma. It is unknown whether LASIK is safe and effective for you.
• You have uncontrolled diabetes. LASIK may be risky for you because your diabetes may interfere with the healing of your eyes.

Warnings: If you have any of the following conditions, you should have LASIK only if your doctor evaluates the seriousness of your condition and believes the benefit of having LASIK is greater than the risk:

• Systemic diseases likely to affect wound healing. If you have a systemic disease such as a connective tissue disease, severe atopic disease or are immunocompromised, LASIK may be risky for you because it may affect the ability of your eyes to heal.
• Diabetes. If you have diabetes and depend on insulin, LASIK may be risky for you because your diabetes may interfere with the healing of your eyes.
• History of Herpes simplex or Herpes zoster infection that has affected your eyes. If you have had a Herpes simplex or a Herpes zoster infection that affected your eyes, or have an infection now, LASIK is more risky for you.
• Symptoms of significant dry eye. If you have severely dry eyes, LASIK may increase dryness. This may or may not go away. This dryness may delay healing of the flap or interfere with the surface of the eye after surgery.
• Severe allergies. If you have severe allergies and take medicines for them, LASIK is more risky for you. These medicines may change the wetness level in your eye. If the medication changes the moisture of your eye, the accuracy of your refractive results may be affected, and topography-guided LASIK is more risky for you.
• History of glaucoma, increased pressure inside your eyes, have been diagnosed with ocular hypertension, or are being followed for possible glaucoma, because it is unknown whether LASIK is safe and effective for you.
• Your doctor is unable to obtain preoperative topography maps that are of good enough quality to use for planning a topography-guided LASIK treatment. Poor quality topography maps may affect the accuracy of the topography-guided LASIK treatment and may result in poor vision after topography-guided LASIK.
• Taking the medication isotretinoin (Accutane*) for acne treatment, because this may affect the accuracy of the LASIK treatment or the way your cornea heals after LASIK. This may result in poor vision after LASIK.

Precautions: If any of the following conditions or situations apply to you, you should discuss them with your doctor:

• Your nearsightedness, farsightedness, astigmatism or mixed astigmatism is getting better or worse. If your eyes are unstable, the right amount of treatment cannot be determined. This may result in poor vision after LASIK.
• You have an eye disease. It is unknown whether LASIK is safe and effective under this condition.
• You have had a prior eye injury or eye surgery. If your eyes are injured or you have had surgery, it is unknown whether LASIK will weaken the cornea too much. This may result in poor vision after LASIK.
• You have a corneal abnormality (e.g., scar, irregular astigmatism, infection, etc.). An abnormal corneal condition may affect the accuracy of the LASIK treatment or the way your cornea heals after LASIK. This may result in poor vision after LASIK.
• You take medicines that might make it harder for wounds to heal, such as sumatriptan succinate (Imitrex*) for migraine headaches. It is unknown whether LASIK is safe and effective for people who take these medicines.
• You are younger than 18 years of age (21 years for mixed astigmatism). It is unknown whether LASIK is safe and effective for you.
• Your doctor may modify the wavefront-calculated ablation program in order to give you a treatment that does not fully correct distance vision. You should discuss the risks in depth with your doctor for any LASIK corrections that do not fully correct for distance vision, especially if performed only in one eye.
• You have a cataract or other problem with the lens or vitreous of your eye. It is unknown whether LASIK is safe and effective under this condition.
• You have any problems with the iris (colored part) of your eye or have had previous surgery on this part of your eye. The eyetracker on the laser may not work properly and LASIK may not be safe and effective for you.
• You are taking prescription or over-the-counter medications that may affect the ability of your eye to heal after surgery, including certain types of cancer drugs (antimetabolites).
• Your doctor plans to use a treatment zone with the laser < 6.0 millimeters or > 6.5 millimeters in diameter. It is unknown whether LASIK with these treatment zones is safe and effective for you.
• Your nearsightedness is worse than – 12.00 diopters, or with astigmatism that is worse than 6.00 diopters. It is unknown whether LASIK is safe and effective for you.
• Your farsightedness is worse than + 6.00 diopters, or with astigmatism that is worse than 5.00 diopters. It is unknown whether LASIK is safe and effective for you.

FDA Summary of Safety and Effectiveness