By Leslie Goldberg, Assistant Ed i to r
Marco’s 3-D Wave: Improved Efficiency
and Precision in Refractive Care
arco’s 3-D Wave provides users with an
instrument that can
effectively evaluate a
patient’s total visual system. The
3-D Wave allows users to obtain
refraction, corneal topography,
pupillometry (photopic and
mesopic), optical path difference
mapping and wave f ront analysis all
with a single device. Additionally,
the 3-D Wave provides doctors with
a way to evaluate patients comprehensively, perform refractive and
cataract surgery screening, evaluate
postoperative complaints and determine pathology diagnoses.
Measuring both low- and highorder aberrations (HOA) on a single
axis, the 3-D Wave gives users the
power to diagnose patient complaints that simply would not be
diagnosed before. The 3-D Wave has
a dynamic spatial skiascopy wavefront aberrometer that can achieve a
wavefront-guided HOA reading.
3-D Wave Clinical Uses
Christopher Larson, M.D., of
Larson EyeCare in Sh e b oygan, Wis.,
has been using the 3-D Wa ve since
2003. Dr. Larson purchased the system primarily to help in diagnosing
patients with HOAs. The device
also assists him in performing wavefront studies on anyone that has a
need for LASIK surgery. “It is a nice
way to help determine who gets
conventional LASIK and who gets
Cu s t o m v i ew (Ad vanced Medical
Optics [AMO]/Visx, Santa Ana,
Calif.),” says Dr. Larson.
112
Dr. Larson also uses the 3-D
Wave on patients postop to see if
there is much change or induced
HOA due to the flaps being made.
(Figure 1) “It is a way to test my
skills and see if I am ending up with
the kind of flaps that I want and the
kind of healing that I want with very
little HOA,” says Dr. Larson.
The system provides Placido
results from the anterior cornea,
posterior cornea or the lens.
Determination of the spherical
aberration of the lens is important
for cataract surgeons.
Getting the Vision Your
Patients Demand
Dr. Larson says the system is
extremely helpful in making decisions about patients
that were not getting the level of
vision that they
wanted. “The 3-D
Wave is a helpful
way of taking a
g roup of postop
Figure 1. A Pre and postop Zernike graph displaying HOA LASIK patients and
corrections performed.
saying, ‘I think that
disc topography as well as dynamic
you could see better if we did the
spatial skiascopy wavefront aberfollowing…’”
ro m e t ry. Dr. Larson explains that
“A decade ago, the first thing we
there can be ve ry subtle problems
would do is a macular study to
on the surface of the cornea and
determine why someone wasn’t seewithin the cornea, or even within
ing well. Now, we spend more time
the lens, creating HOAs that don’t
w o rking on the cornea. You can see
show up on any Placido disc or any the macula, and know what vision
other corneal topography.
it is capable of producing. It is very
“ Something has to be used to
h a rd with the cornea — using a slit
help to define this occurrence,” says
lamp to determine to say ‘with this
Dr. Larson. “This machine uses
cornea, I should be seeing 20/20 or
dynamic sciascopy (automated
20/30.’ With the 3-D Wa ve, yo u
retinoscopy) and optical path differ- can get a good look at the cornea
ence measurements, and comes up
and you can start making some corwith a mathematical equation show- relations as to how this disease
ing that light is focused better at this translates into this level of vision,
point than at this point.” (Figure 2) and you can say ‘I think I know
Additionally, the interaction of
what your problem is and we don’t
various maps on the 3-D Wa ve
need to do an angiogram or
allows the practitioner to determine OCT,’“ says Dr. Larson. “With the
if the patient’s optical complaint
3-D Wave, I can tell whether the
N OV E M B E R 20 0 6 • O P H TH A L MO LO GY M A N A G E M E N T
A Sh ows pre- and post-posterior capsular opacification
(PCO) effects
A Evaluates postop IOL tilt,
decentration, multifocal
optics
A Assesses contact-lens
candidates for soft- vs.
Figure 2. This difference map shows the decentration of the IOL in the patient's visual
hard-lens wear
system and the correction after IOL lens exchange was performed.
A Evaluates corneal aberrations
d i s t o rtion is coming from the
little puzzled by something, they do
secondary to certain lid and ocular
cornea or from the human lens or
an autorefraction using the 3-D Wave s u rface pathologies
f rom a lens implant.”
and it is ve ry accurate.”
A Monitors progress and visual
effects from va rying ocular pathologies and surgeries
Additional Benefits
Applications of the 3-D Wave
Dr. Larson says that the 3-D
A Evaluates all eyes not corA Assesses pre- and post-corneal
Wave is easy to use. “My staff has a
rectable to 20/20
re f r a c t i vesurgery patients
w o n d e rful understanding of it. It also
A Di f f e rentiates corneal from
A Evaluates postop refractive
takes some of the intuitiveness out of
lenticular aberrations
s u r g e ry complaints (halo, glare). OM
the equation,” he says. “The staff is
A C o m p a res objective to subjecFor more information in the
all trained in retinoscopy. They are
tive point spread function (PSF)
3-D Wave, contact Marco at
able to put patients into a room and
A Assesses cataract patients’
(800) 874-5274 or visit their Web
p e rform a full refraction. If they are a symptoms and “quality” of vision
site at www.marco.com.
Place ad here and delete box rule:
If ad is a three-side bleed delete folio
O P H T H A L M O LO GY M A N A GE M E N T • N OVE M B E R 2 0 0 6
113