1 Welcome letter from Dr.Edward Perraut, Jr. MD

2 Our Surgivision Results with the Allegretto Wave Eye-QBy: Edward Perraut, Jr. MD

3 Wave-Front Guided vs. Wave-Front Assisted Lasers

4 Patient Education is Key

By: Ron Schwartz, O.D.

By: Alisa Brill

5 Lasik ProMarketing Update

6 Questions and Answers

1Welcome to Lasik Pro’s First Optometric Newsletter

By: L. Edward Perraut, Jr. MD

Welcome to our newsletter, which we intend to be a series of informative articles, which we hope will be helpful to you and your staff in providing laser vision services to your patients. We will present articles aimed at everyone from physicians to man-agers, technicians and assistants.

At Lasik Pro, our goal is to provide the highest quality of Laser Vision Correction service in a per-sonal private practice setting and to do so in a cost effective manner without corporate overhead.

I am extremely proud of the accomplishments we have made in the very short time of our existence. We have remodeled our Frederick location and moved our practice to a beautiful new location in Charlottesville. Our goal is to create a warm, com-fortable yet contemporary place for our patients to come and our staff to work.The Allegreto Wave Eye-Q and the Oculus Penta-cam in both offices, give us all the tools we need to give your patients the best possible outcomes. We hope that you will visit one day in the near future to see a surgery day so you can experience our excellent patient care.

I am very proud of our staff. We have two in-credible clinical optometrists; Dr. Ron Schwartz in Frederick, MD and Dr. Suzanne Matricinno in Charlottesville, VA. Christina Blair and Liz Bromberger are my amazing surgical techs that I have worked with for years. Debbie Schwartz in Frederick, MD and Mary Draughdrill in Charlot-tesville, VA are our wonderful, welcoming Patient Coordinators. Alisa Brill rounds out our team as our Practice Manager.

Thank you all for your support during this amazing journey.

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Our Surgivision Results with the Allegretto Wave Eye-QBy: L. Edward Perraut, Jr. MD

During my last 12 years performing LVC, I have had the opportunity to work with some of the finest excimer lasers offered in our industry. I have had terrific results with all of them.

When it came time to decide on purchasing an excimer laser for my new practice, I decided to go with the latest technology and the last to pass through the FDA trials: The Allegretto Wave Eye-Q.

Besides the wide range of treatment; up to a -12.00D to +6.00D with cylinder correction to a 6.00D, the speed of the laser is phenomenal. The eye tracker also is the fastest and monitors the eye with three infrared lights.

Of course the most important thing is the results. The Allegretto Wave Eye-Q comes with a software

program called Surgivision. All patients are en-tered into a national databank and are analyzed by surgivision and used to refine our nomogram.

The nomogram is continuously upgraded by our surgivision and used to refine our nomogram. The nomogram is continuously upgraded by surgivision. Each patient’s data are entered into the system prior to surgery and a surgeon spe-cific treatment plan is generated for that patient which is unique to that patient at that location.

Our most recent report from Surgivision is presented for your review below:

3Wave-Front Guided vs.

Wave-Front Assisted LasersBy: Ron Schwartz, OD

I have been asked many times about the differ-ences between Wave Front Guided and Wave Front Assisted Lasers, the speed of the lasers and the outcomes.

Most of you know that our surgeon, Dr. Perraut has used both types of lasers during the 45,000+ proce-dures that he has performed. Dr. Perraut reviewed the pros of each laser, studied his results achieved with both systems and without any reservations made the decision that he preferred the results with the Allegretto EyeQ system, especially since they increased the energy level to 400 Hertz (which makes it the fastest laser available in the US.) for his Lasik Pro offices.

I recently read an article that was published in The Ophthalmology Times in August 2010 about the myth that the speed of the laser has no effect on pa-tient outcomes and comfort. Dr. Michael Mrochen and Dr. Arthur B. Cummings wrote this article. I would like to share some of this article with you. If you have any questions, feel free to call Dr. Perraut or myself.

The Myth:The Speed of the Laser has not effect on patient outcomes and comfort.In laser eye treatments, we are trying to reshape the cornea to a theoretically superior profile. The real ques-tion is how optimally clinical data about the eye can be translated to the laser in order to achieve this theoreti-cal profile via precise tissue ablation.

In order to deliver more spots without increasing the total treatment time, a higher repetition rate is needed. With the optimization of the WaveLight4 Allegretto Wave Lasers, the treatment time for a given dioptric correction at a given optical zone diameter can be minimized in comparison with other laser platforms currently available. The interactions of spot size, repeti-tion rate, and total energy delivered to the cornea have been examined in several studies, indicating how these elements of corneal ablation affect the tempera-ture results of LASIK treatments.

The Temperature Factor The temperature of the cornea during ablation can influ-ence the hydration of the cornea, and the changes in the hydration are not uniform across the affected area. Since corneal hydration influences corneal thickness and tissue response to photo ablation, and thus, the predictability of the patient outcomes, temperature is a critical factor in the results of treatment. The more control you have over these factor, the more control you can have over the pre-dictability of your clinical results.

The concept of “time” in excimer laser treatment encom-passes issues such as the total treatment time. These fac-tors can influence the fixation fatigue experienced by the patient, which affects patient compliance and , ultimately, the predictability of the refractive corrections.

Treatment Time in Laser Eye Surgery The longer the cornea is exposed, the more it dehydrates. The more dehydrated the cornea becomes; the more tissue is going to be ablated. And because the level of dehydration varies across the treatment zone, the more irregular the resulting ablation profile can be.

If a 5-D treatment can be performed in 10 seconds, which is the case with the WaveLight 4D Allegretto Wave Lasers, there is much less time for the cornea to become dehy-drated compared to using a different laser for the same procedure which could take from 30-60 seconds.

Laser Beam QualityJust as a painter chooses a fine brush to paint fine de-tails, we want to use a small laser spot to treat all optical aberrations-including both lower and higher order aberra-tions. The smaller the spot, the more accurate you need to be in order to place it in the right area. But you also have to make the laser faster so that you can use that smaller spot to deliver the same profile in the same amount of ablation time. And when you make the laser faster, you need to make the eye tracker faster, so everything can work together.

Over the years, we have used a number of older genera-tion lasers. Today, I prefer the new generation Wavelight4 Allegretto because of the speed, minimal latency of the eye tracker, quality of the laser bean and the short sealed beam pathway.

By: Michael Mrochen, Phd

The Truth:Shorter treatment times can improve patient comfort and treatment outcomes.

Patient Education is KeyBy: Alisa Brill

I have been very lucky over the years to have met some of the most successful optometrists in the country. Most of them will tell you that the reason for their success over the years is due to educat-ing their patients on all the latest products that can help their visual needs. Simply put, an educated patient will buy more, and also will understand the need to come back for their complete eye exam on schedule.

Patient education is also the key behind a large monthly income from their co-management of LVC. Their patients know that if they are interested in LVC, they will call their optometrist first and not the LVC surgeon.

Here are some methods you can use to educate your patient about LVC:

Advertise that you offer LVC exams. This should be in all your marketing. Your practice can be listed on the Lasik Pro website just call!

When a patient calls for an exam, have your receptionist ask if this is for eyeglasses, con-tact, or an LVC consult.

Brochures for Lasik Pro should always in your waiting room. It will remind them to bring it up to you!

Create “Ask me about LASIK” buttons for your staff members to wear.

Go with your patients to watch their proce-dure then have your picture taken with them and your surgeon. Place it in your waiting room for all to see!

At the end of your exam always mention LVC as an option to those patients you feel could be candidates. List it right along with glasses and contacts.

Educate your staff as to how co-managing LVC increases the bottom line! Create an internal contest with your staff. Offer a prize to the staff member that gets the most patients to speak to you about their candidacy.

Allow your staff to visit Lasik Pro! We enjoy a surgery day with visiting staffs from a referring optometric office.

Have a Lasik seminar in your practice. Dr. Perruat will come to your practice so that your patients can meet him and he will discuss his LASIK procedure with them.

If you are a candidate, consider LASIK for your-self!

Trying new methods to increase awareness of LVC in your office will help your patients know that you can tell them if they are a candidate for LASIK. Lasik Pro will continue to support your efforts to market LVC in your practice by listing your practice on our website and giving you marketing mate-rials to place in your office. Please feel free to contact us at either location to add any additional support or ideas.

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Thank you for your partnership!

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Questions & Answers 6

Question:If a patient is interested in having refractive sur-gery, how do I refer them to your office?

Answer:There are two ways to refer a patient to Lasik Pro. The first way is to perform your complete pre-op exam and then call the office to schedule the patient’s Pentacam and surgery. The second way is to send the patient to us for a Pentacam first. We will schedule the patient and then send them back to you for the pre-op exam.

Question:If the patient lives far away from the Lasik Pro location, is it OK to have the patient take the Pentacam scan on the same day of surgery?

Answer:Absolutely! Finish up your pre-op exam and fax to us. We can call the patient to schedule their proce-dure or you can call us while they are in the office. Just make sure that the patient is aware that there is a small chance that the Pentacam will reveal something that would cancel their procedure.

Question:Where can I get copies of the Pre-Op Treatment sheet, Post-Op sheet and Post-Op Instructions?

Answer:They are attached to this Newsletter!

Question:What Days of the week does Dr. Perraut perform his procedures?

Answer:Dr. Perraut will do anything he can to accom-modate a patient’s schedule. Mondays and Thursday’s are typically our procedure days, however if there is a special conflict, we will help your patient any way we can.

Question:What is the treatment range of the Allegretto Wave Eye-Q?

Answer:-12.00 to +6.00 and up to a +6.00 cylinder!!

Question:Can I send a patient over for just a Pentacam?

Answer:Absolutely! Several of our optometrists are already sending patients over to check for Keratoconus and other corneal diseases. Our surgical techni-cians can perform these for you and then email the results straight to you for your evaluation.