PRESBYOND Customized. All distances. Immediate. The moment you bridge the gap to clear vision at all distances. This is the moment we work for.

// PRESBYOND Made By Carl Zeiss PRESBYOND Laser Blended Vision A clear choice for presbyopic patients

PRESBYOND® Laser Blended Vision from Carl Zeiss is an advanced method for treating patients with age-related loss of , also known as . It offers the opportunity to achieve freedom from glasses by combining the simplicity and accuracy of corneal refractive surgery with the benefits of increased depth of field in retaining visual quality. As a surgical solution based on the naturally occurring spherical aberrations of the , PRESBYOND Laser Blended Vision extends the scope of customized ablation beyond the limits of conventional monovision laser methods in several ways.

Whether for its customized treatment profiles, its at all distances, its indications range or its immediate impact, PRESBYOND Laser Blended Vision is a clear treatment choice for the fast growing demographic of presbyopic patients.

PRESBYOND Laser Blended Vision Customized. All distances. Immediate.

PRESBYOND Laser Blended Vision lets you greatly expand your MEL® 80 excimer laser treatment repertoire and your patient base

4 Next-level vision correction beyond conventional monovision

Although similar to conventional monovision laser treatments in terms of the workflow, PRESBYOND® Laser Blended Vision takes customized vision correction a step beyond, particularly with respect to the outcomes.

DISTANCE Conventional monovision PRESBYOND Laser Blended Vision DISTANCE With conventional monovision treatment As a new, physiologically optimized laser No increase Increase in depth methods (both surgical and contact ), treatment method for presbyopic patients, in depth of field the dominant eye is corrected for distance PRESBYOND Laser Blended Vision of field vision to almost plano. The non-dominant represents the next stage in eye care eye, on the other hand, is corrected for excellence. Similar to conventional near vision, usually to be myopic up to monovision, the dominant eye is corrected -3.0 D. Accommodation is thereby often for distance vision to almost plano, whereas diminished. The method aims to achieve the non-dominant eye is corrected to be optimal vision at distance and near range. slightly myopic for near vision to -1.5 D. Following the procedure, the brain must This micro-monovision strategy is further contend with two separate images with enhanced by a decisive difference: an No increase Increase in depth different levels of correction. increase in the depth of field of each eye in depth of field According to scientific studies, only about using a wavefront-optimized ablation of field 60 % of patients are able to successfully profile to create a continuous refractive merge the two images to experience power gradient for the whole optical zone sharp binocular vision at near and distance of the . PRESBYOND Laser Blended NEAR range.1 Patients that tolerate the method Vision is an absolutely individualized NEAR are left with an uncorrected, compromised treatment plan based on preoperative Dominant eye Non-dominant eye Dominant eye Non-dominant eye gap in the intermediate range, the so- spherical aberrations and the functional ±0.0 D up to -3.0 D ±0.0 D -1.5 D called Blur Zone. In addition to the fuzzy age of the eye. As a result, a customized image, it can also cause other side effects fusion of the two images for near and such as reduced contrast sensitivity and distance vision is created for each patient – The unique Blend Zone stereoacuity. Also, it often takes patients a the so-called Blend Zone. Essentially, the Blend Zone makes it easier for the brain to merge the images of both long time to get used to merging the two , thereby achieving true binocular vision. This is a significant advantage over images into one picture. conventional monovision. In addition to excellent near and far vision, PRESBYOND Conventional monovision is a correction Laser Blended Vision patients also experience very good visual acuity and contrast sensitivity in the intermediate range. They adapt faster and most are delighted about method with compromises. For a number not having to wear glasses anymore. Not surprisingly, PRESBYOND Laser Blended of patients, it is not a suitable option. Vision is tolerated by a high number of patients – up to 97 %.1

6 7 Customized

Generally speaking, conventional monovision methods utilize standard ablation profiles. In the case of PRESBYOND® Laser Blended Vision, they are customized for each eye individually because of the increased depth of field.

Individualized ablations PRESBYOND Laser Blended Vision is a truly customized approach for treating presbyopic patients. It incorporates preoperative wavefront data to fine-tune the depth of field for each eye individually. The functional age of the eye is also factored in. In result, a personalized ablation profile is created for optimized target refraction. The mono‑ vision component can be pre-adjusted for the patient’s tolerance level. Also, different optical zone sizes can be selected to account for the patient’s pupil size.

Ideal for a growing demographic As an optimized laser method for age-related loss of accommodation, PRESBYOND Laser Blended Vision is ideally suited for serving the needs of patients 40–60 years of age – a fast-growing demographic group interested in sophisticated options. It is also one of the least invasive methods for addressing presbyopia.

Familiar procedure Following the same workflow as established LASIK procedures, PRESBYOND Laser Blended Vision combines the convenient binocular treatment planning of the CRS-Master® » PRESBYOND Laser Blended Vision provides the most natural form of presbyopic with the proven comfort and workflow of the MEL® 80 correction, including 97 % of all refractive errors with preservation of contrast excimer laser from Carl Zeiss. sensitivity, night vision and stereoacuity; it is easily enhanced, adjusted and even reversed, if needed. It’s the Olympic Gold medalist in presbyopic surgery. » Prof. Dan Reinstein, London Vision Clinic, United Kingdom, August 2012

8 9 All distances

Strictly in terms of the visual outcomes, PRESBYOND® Laser Blended Vision transcends conventional monovision methods by offering clear sight at all distances: near, intermediate and far. Better yet, virtually all patients are freed from the need to wear reading glasses.1-4, 6

Outstanding visual acuity By customizing each eye individually, PRESBYOND Laser Blended Vision provides excellent visual acuity for near and distance vision. Unlike conventional monovision methods, PRESBYOND Laser Blended Vision also offers good inter‑ mediate vision in the Blend Zone. According to clinical studies, there is virtually no loss of contrast sensitivity and stereoacuity is maintained. Also, side effects such as multiple images in one eye are almost eliminated.

An all-natural approach PRESBYOND Laser Blended Vision is a physiological solution and a true binocular method for treating presbyopic patients.

Wide indication range PRESBYOND Laser Blended Vision is a proven and effective method for treating indications ranging from -8.0 D to +2.0 D, including emmetropic and astigmatic presbyopic patients (up to 2.0 cyl).

» I have been impressed by the very high patient tolerance rate for PRESBYOND Laser Blended Vision which is much higher than what we see for conventional monovision methods. » Christian de Courten, MD, MV Sante Vision, Switzerland, July 2012

10 Immediate

What also clearly sets PRESBYOND® Laser Blended Vision apart from other laser techniques is the immediate positive impact it offers patients and refractive surgeons alike – visually for the former, economically for the latter.1–4

Appropriate for most patients A key advantage of PRESBYOND Laser Blended Vision is that it is proven to be tolerated by more patients than conventional monovision. It is effective for treating up to 97 %1 of all presbyopia-related forms of impairment as compared to only 59–67 % for conventional monovision. Even presbyopic patients with and can be treated. In fact, it has the potential to achieve a far greater success rate than any comparable treatment.1,5

A competitive edge PRESBYOND Laser Blended Vision allows refractive practices already using a MEL® 80 excimer laser and CRS-Master® from Carl Zeiss to significantly expand their LASIK repertoire and increase the patient base. For most patients, a positive effect is that they can read without glasses the very same day. As such, PRESBYOND Laser Blended Vision offers a decisive competitive advantage over LASIK practices only specializing in monovision treatment methods.

» Zeiss Laser Blended Vision is the answer to the missing platform in LASIK refractive surgery for myopic, hyperopic and even emmetropic patients. » Andrew Taylor, MD. F.R.C.S.C., LASIK Eye Surgery Niagara Falls, Canada, January 2012

12 Technical data

A perfect combination: CRS-Master MEL 80 Laser data CRS-Master and MEL 80 Dimensions Max. 1060 x 420 x 1510 mm Type ArF excimer laser (W x D x H) Wavelength 193 nm Weight Max. 110 kg Frequency 250 Hz Input voltage Aiming beam diode 650 nm (laser class 1 according with table 120, 230 V AC ± 10 % IEC 60825-1) without table 100, 120, 230 V AC; adjustable, single phase Device data Input current Max. 6.3 A Weight of MEL 80 290 kg incl. gas cylinder Rated frequency 50/60 Hz Weight of patient 232 kg Ambient conditions Temperature +15 . . . +30 °C supporting system Relative humidity 30 . . . 75 % Dimensions (Laser, W x D x H) 800 x 1550 x 1490 mm Non condensing Air pressure 700 . . . 1060 hPa Dimensions including patient 1800 x 3140 x 1490 mm supporting system (W x D x H) Data backup CD/DVD Power supply 100 V AC; 50/60 Hz; 17.5 A Data transfer USB flash memory drive (USB memory stick) 120 V AC; 50/60 Hz; 14.6 A Data printout Via network connection with Ethernet cable 208, 220, 230, 240 V AC; and optional network isolator 50/60 Hz; 7.9 A Approval CE mark as per Medical Device Approval CE mark as per Medical Device Directive 93/42/EEC Directive 93/42/EEC Gas supply Integrated ArF-Premix cylinder 10 l References

Claims made in this document are supported by Equipment information provided in the following publications: Surgical microscope OPMI® pico with integrated video camera 1. Reinstein DZ, Couch DG, Archer TJ. LASIK for Hyperopic Astigmatism and Active eye tracker Infrared, pupil and limbus Presbyopia Using Micro-monovision With the Carl Zeiss Meditec MEL 80. tracking, 1050 frames per J Refract Surg. 2009;25(1):37-58. second (fps)

2. Reinstein DZ, Archer TJ, Gobbe M. LASIK for Myopic Astigmatism and CCA+ (plume removal system) Integrated in device Presbyopia Using Non-Linear Aspheric Micro-Monovision with the Carl Zeiss Meditec MEL 80 Platform. J Refract Surg. 2011;27(1):23-37. Spot scanning parameters Beam dimensions 0.7 mm FWHM 3. Reinstein DZ, Carp GI, Archer TJ, Gobbe M. LASIK for the correction of (Full width at half maximum), presbyopia in emmetropic patients using aspheric ablation profiles and a Gaussian beam profile micro-monovision protocol with the Carl Zeiss Meditec MEL 80 and VisuMax. J Refract Surg. 2012 [In Press]. Phototherapeutic keratectomy 4. Reinstein DZ, Archer TJ, Gobbe M. Stereoacuity after Corneal Presbyopic ® Area ablation Programmed PTK shaping PRESBYOND Laser Blended Vision is an optional software LASIK in Myopic, Hyperopic and Emmetropic Patients. ESCRS Annual Meeting, upgrade for the CRS-Master® from Carl Zeiss. It forms a Vienna, September 2011. perfect fit with the MEL® 80 excimer laser, expanding the 5. Evans BJ. Monovision: a review. Ophthalmic Physiol Opt. VISIBLE AND INVISBLE repertoire of the customized refractive laser corrections LASER RADIATION AVOID EYE 2007;27(5):417-439. OR SKIN EXPOSURE TO DIRECT OR SCATTERED RADITION far beyond the limits of conventional monovision methods. CLASS4LASER PRODUCT ACCORDING 6. Reinstein DZ , Archer TJ, Gobbe M. LASER BLENDED VISION DIN EN 60825-1:2003 UND :2008 193 nm, <2 mJ, 4-7ns FOR PRESBYOPIA CORRECTION. 000000-1429-382-04-GB-Vs01 MWIB Pallikaris I, Plainis S, Charman WN. PRESBYOND and CRS-Master are not intended for Presbyopia: Origins, Effects, and Treatment (pp. 191-196). sale in the United States. © 2012 SLACK Incorporated.

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Publication No: 000000-2000-981 Printed in Germany CZ-VIII/2012 The contents of the brochure may differ from the current status of approval of the product in your country. Please contact our regional representative for more information. Subject to change in design and scope of delivery and as a result of ongoing technical development. Printed on elemental chlorine-free bleached paper. © 2012 by Carl Zeiss Meditec AG. All copyrights reserved.