AMO Innovation At Every Step

©2007 Advanced Medical Optics, Inc. All Rights Reserved. AMO, the AMO logo, iLASIK and the iLASIK logo are trademarks of Advanced Medical Optics, Inc.

Advanced CustomVue, the Advanced CustomVue logo, CustomVue, STAR S4 IR, the STAR S4 IR logo, Treat with Certainty, VISX, VRR, VSS, WaveScan, the WaveScan logo

and WaveScan WaveFront are trademarks of VISX, Incorporated. IntraLase is a trademark of IntraLase Corp. Mkt Doc 685 Rev. A

Advanced Medical Optics, Inc. • 3400 Central Expressway, Santa Clara, CA • 95051 USA • 1 [800] 246-VISX • 1 [408] 773-2020 • www.amo-ilasik.com

The Pinnacle Of Innovation — VISX™ Technology

The Advanced CustomVue™ Treatment Using VISX™ TechnologyIs Essential To The iLASIK™ SolutionMillions of LASIK candidates have been waiting for the most advanced LASIK technology … They’ve

been waiting for the iLASIK procedure: AMO’s innovative combination of IntraLase™ technology with

the Advanced CustomVue treatment using VISX technology.

The iLASIK technology solution will help you grow your refractive practice by:

• Providing an integrated platform featuring advanced technology at every step

• Driving demand for the iLASIK procedure by actively targeting all segments of “Generation i”

• Giving physicians a committed partner that is making an unmatched investment in LASIK

Combined AdvantagesOne company, one integrated LASIK platform and one committed refractive partner — that’s how we

defi ne the iLASIK solution. Our “forward-thinking” strategy, combining all the best LASIK technology,

delivers the potential for long-term clinical advantages and ergonomic improvements, while spelling

the end of the “a la carte” assemblage of system components in the laser suite.

It’s Time To Meet “Generation i”Increasing the success of your practice means increasing the overall size of the LASIK category. Growing

LASIK and growing your practice is the ultimate objective of the iLASIK solution. We’ll help you reach

out to “Generation i” — the dynamic group of prospects spanning Generation Y, Generation X and

Baby Boomers — by speaking their language and taking the mystery and confusion out of laser vision

correction. Your marketing conversation with consumers just got a whole lot easier — it begins with the

iLASIK procedure.

The “i” Changes Everything

References:1. Data submitted to the FDA for the CustomVue High Myopia Study. Data on File.

2. Dai GM, Gross E, Liang J. System performance evaluation of refractive surgical lasers: a mathematical approach. Appl Opt. 2006;45(9):2124-34.

3. The Advanced CustomVue Monovision procedure clinical trial data. Data on fi le.

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The Advanced CustomVue™ procedure provides the broadest range of custom wavefront-guided

laser vision correction:

• Myopia (with or without astigmatism)

• High myopia (up to -11 D, with or without astigmatism)

• Mixed astigmatism

• Hyperopia (with or without astigmatism)

• Monovision for presbyopic patients with low-to-moderate myopia, with or without astigmatism

Clearer Night Vision

Clinical studies for all indications submitted to the FDA showed higher participant satisfaction with

night vision after the Advanced CustomVue procedure than before with glasses or contact lenses.

The Most AdvancedLaser Vision Correction Technology Available Today*

Patient Satisfaction with Vision at Night1

CustomVue™ High Myopia

WaveScan WaveFront™ System

*As determined by the Market Scope 2007 Annual Refractive Surgeon Survey.

“VISX™ Advanced CustomVue seems to be, in my hands at least, better

than other customized ablations, because Fourier versus Zernike

provides the higher resolution, and Iris Registration provides the perfect

match between the measured and the treated areas.”

— Prof. Dr. Michael C. Knorz

FreeVis LASIK Zentrum Universitätsklinikum Mannheim, Germany

Iris Registration automatically aligns the treatment plan to match the location of the

wavefront error when measured at the WaveScan WaveFront™ System.

Preop BSCVA to Postop UCVA

58503_Visx.1.indd 258503_Visx.1.indd 2 11/2/07 7:29:03 AM11/2/07 7:29:03 AM

A new level of precision may be predictably achieved by linking the

advanced refractive information of the WaveScan WaveFront™ System

with the STAR S4 IR™ Excimer Laser System, providing accurate

alignment and centration for every patient.

Treat With Certainty™

• Fourier technology captures approximately 240 data points

(over a 7 mm pupil) — 25-times more precise than standard

measurements for glasses or contact lenses

• The Fourier algorithm delivers the highest resolution of the

wavefront error available today by utilizing 100% of the available

data to design the optimal treatment

• Iris Registration (IR) uses multiple matching reference points

from the iris to capture and compensate for torsional angle,

as well as pupil centroid shift

• IR provides greater alignment accuracy with sub-fl ap iris imaging

• IR also allows for instant re-registration in the event of

intraoperative cyclotorsional movement

Even the slightest shift between eye

alignment and treatment alignment

can prevent optimum outcomes.

Variable Spot Scanning (VSS™) And Variable Repetition Rate (VRR™) Technologies

VSS technology, available only from AMO, ensures the intricate shapes reconstructed

by the Fourier wavefront algorithm are precisely ablated.

VRR technology delivers proprietary algorithms that vary the laser’s

pulse rate. By continually changing the size and placement of the beam,

VRR technology provides:

• The ability to deliver Fourier shapes with optimized ablation

time while ensuring minimal thermal impact on the cornea

• More accurate reconstruction of wavefront profi le and intricate ablation shapes

• Faster treatment times

• Smoother ablation profi les

Combined, VSS and VRR technologies:

• Minimize thermal effects and optimize clinical results

• Achieve the ideal treatment speed by mixing the pulse sizes,

distribution and repetition rate

• Provide potentially better overall outcomes, including

night vision quality

This theoretical simulation of VSS and VRR technologies, when compared to the alternative

Small Spot Scanning (SSS) ablation, shows improved precision and accuracy, or decreased fi tting

error, across the above ablation profi les.

STAR S4 IR™ Laser

VSS Simulation Results2

Fitting Error Comparison

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VISX™ Wavefront-guided LASIK for Correction of Myopic, Hyperopic, and Mixed Astigmatism and Wavefront-guided Monovision LASIK for Presbyopic Myopes (CustomVue™ LASIK Laser Treatment)

Statements regarding the potential benefi ts of wavefront-guided LASIK (CustomVue) are based upon the results of clinical trials. These results are indicative of not only the CustomVue treatment but also the care of the clinical physicians, the control of the surgical environment by those physicians, the clinical trials’ treatment parameters and the clinical trials’ patient inclusion and exclusion criteria. Although many clinical trial patients after the CustomVue procedure saw 20/20 or better and/or had or reported having better vision during the day and at night, compared to their vision with glasses or contact lenses before the procedure, individual results may vary. You can fi nd information about the clinical trials below and in the Professional Use Information Manuals for the VISX STAR S4™ Excimer Laser System and WaveScan WaveFront™ System (CustomVue Treatments).

As with any surgical procedure, there are risks associated with the CustomVue treatment. Before treating patients with the CustomVue procedure, you should carefully review the Professional Use Information Manual, complete the Physician CustomVue Certifi cation Course, provide your patients with the Patient Information Booklet for CustomVue LASIK Laser Treatment, and discuss the risks associated with this procedure and questions about the procedure with your patients.

WAVEFRONT-GUIDED LASIK INDICATIONS AND INTENDED USES:The VISX STAR S4 Excimer Laser System and WaveScan WaveFront System are approved to perform wavefront-guided laser assisted in-situ keratomileusis (LASIK) treatments for the reduction or elimination of low to moderate myopic astigmatism up to -6.00 D MRSE, with cylinder between 0.00 and -3.00 D in patients 21 years of age or older; and in patients with documented evidence of a change in manifest refraction of no more than 0.50 D (in both cylinder and sphere components) for at least one year prior to the date of pre-operative examination.

Wavefront-guided LASIK for correction of low to moderate myopic astigmatism is an elective procedure with the alternatives including but not limited to eyeglasses, contact lenses, photorefractive keratectomy (PRK), conventional LASIK, and other refractive surgeries. Approval of the low to moderate myopic astigmatism application is based on a clinical trial of 351 eyes (189 primary and 162 secondary). Of all eyes treated, 318 were evaluated for effectiveness with 98.8% accountability at 3 months, 277 eyes with 96.9% accountability at 6 months, 102 eyes with 95.3% accountability at 9 months, and 86 eyes with 95.6% accountability at 12 months. The studies found that of the 277 eyes eligible for the uncorrected visual acuity (UCVA) analysis of effectiveness at 6 months, 100% were corrected to 20/40 or better, and 95.8% were corrected to 20/20 or better in 71 spherical myopia eyes; and 99.5% were corrected to 20/40 or better, and 93.2% were corrected to 20/20 or better in 206 astigmatic myopia eyes. The study showed that at the 3 month stability time point: there was a loss of ≥ 2 lines of best corrected vision that can be obtained with spectacles in 1 of 239 astigmatic myopia eyes and there was no loss of ≥ 2 lines of best corrected vision in 79 spherical myopia eyes; there was 1 of 239 astigmatic myopia eyes with best spectacle corrected visual acuity (BSCVA) worse than 20/25 and none in 79 spherical myopia eyes with BSCVA worse than 20/25. During the course of study, no eye lost >2 lines of BSCVA and no eye had a BSCVA worse than 20/40.

The VISX STAR S4 IR™ Excimer Laser System with VSS™ Technology and WaveScan WaveFront System are approved to perform wavefront-guided laser assisted in-situ keratomileusis (LASIK) treatments for the reduction or elimination of high myopic astigmatism from -6.00 D to -11.00 D MRSE, with cylinder between 0.00 and -3.00 D in patients 21 years of age or older; and in patients with documented evidence of a change in manifest refraction of no more than 1.00 D (in both cylinder and sphere components) for at least one year prior to the date of pre-operative examination.

Wavefront-guided LASIK for correction of high myopic astigmatism is an elective procedure with the alternatives including but not limited to eyeglasses, contact lenses, photorefractive keratectomy (PRK), conventional LASIK, and other refractive surgeries. Approval of the application is based on a clinical trial of 184 eyes. Of all eyes treated, 180 were evaluated for effectiveness with 97.8% accountability at 3 months, 178 eyes with 96.7% accountability at 6 months, 170 eyes with 96.5% ac-countability at 9 months, and 107 eyes with 93.9% accountability at 12 months. The studies found that of the 178 eyes eligible for the uncorrected visual acuity (UCVA) analysis of effectiveness at 6 months, 98.3% were corrected to 20/40 or better, 97.2 % were corrected to 20/32 or better, and 84.3% were corrected to 20/20 or better without spectacles or contact lenses. The study showed that of 83 spherical and 101 astigmatic eyes, no eyes lost 2 or more lines of best corrected vision that can be obtained with spectacles (BSCVA) and none of the eyes had BSCVA worse than 20/40.

The VISX STAR S4 Excimer Laser System and WaveScan WaveFront System are approved to perform wavefront-guided laser assisted in-situ keratomileusis (LASIK) treatments for the reduction or elimination of hyperopic astigmatism up to 3.00 D MRSE, with cylinder between 0.00 and 2.00 D in patients 21 years of age or older; and in patients with documented evidence of a change in manifest refraction of no more than 1.00 D (in both cylinder and sphere components) for at least one year prior to the date of pre-operative examination.

Wavefront-guided LASIK for the correction of hyperopic astigmatism is an elective procedure with the alternatives including but not limited to eyeglasses, contact lenses, photorefractive keratectomy (PRK), conventional LASIK, and other refractive surgeries. Approval of the hyperopic astigmatism application is based on a clinical trial of 144 eyes (74 primary and 70 secondary). Of all eyes treated, 134 were evaluated for effectiveness with 98.5% accountability at 3 months, 131 eyes with 97.0% accountability at 6 months, 118 eyes with 90.8% accountability at 9 months, and 27 eyes with 87.1% accountability at 12 months. The studies found that of the 131 eyes eligible for the uncorrected visual acuity (UCVA) analysis of effectiveness at 6 months, 97.3% were corrected to 20/40 or better, and 66.2% were corrected to 20/20 or better in 74 spherical hyperopia eyes; and 93.0% were corrected to 20/40 or better, and 56.1% were corrected to 20/20 or better in 57 astigmatic hyperopia eyes. The study showed that at the 6 month stability time point: there was no loss of ≥ 2 lines of best corrected vision that can be obtained with spectacles in either 63 astigmatic hyperopia eyes or 74 spherical hyperopia eyes; none of the 63 astigmatic hy-peropia eyes or 74 spherical hyperopia eyes had best spectacle corrected visual acuity (BSCVA) worse than 20/25. During the course of study, one of 63 eyes with astigmatic hyperopia lost >2 lines of BSCVA at 1 month, no eyes with spherical hyperopia lost >2 lines of BSCVA, and no eye had a BSCVA worse than 20/40.

The VISX STAR S4 IR™ Excimer Laser System with VSS™ Technology and WaveScan WaveFront™ System are approved to perform wavefront-guided laser assisted in-situ keratomileusis (LASIK) treatments for the reduction or elimination of naturally occurring mixed astigmatism when the magnitude of cylinder (from 1.0 to 5.0 D) is greater than the magnitude of sphere and the cylinder and sphere have opposite signs; in patients 21 years of age or older; and in patients with documented evidence of a change in manifest refraction of no more than 0.50 D (in both cylinder and sphere components) for at least one year prior to the date of pre-operative examination.

Wavefront-guided LASIK for the correction of mixed astigmatism is an elective procedure with the alternatives including but not limited to eyeglasses, contact lenses, photorefractive keratectomy (PRK), conventional LASIK, and other refractive surgeries. Approval of the mixed astigmatism application is based on a clinical trial of 86 eyes. Of all eyes treated, 86 were evaluated for effectiveness with 100.0% accountability at 3 months, 80 eyes with 95.2% accountability at 6 months, 69 eyes with 86.3% accountability at 9 months, and 63 eyes with 94.0% accountability at 12 months. The studies found that of the 86 eyes eligible for the uncorrected visual acuity (UCVA) analysis of effectiveness at 3 months, 95.3% were corrected to 20/40 or better, 91.9% were corrected to 20/32 or better, and 61.6% were corrected to 20/20 or better without spectacles or contact lenses. The study showed that of 86 astigmatic eyes, one eye temporarily lost 2 lines of best corrected vision that can be obtained with spectacles at 1 month and at 6 months and none of the eyes had best spectacle corrected visual acuity (BSCVA) worse than 20/40.

The STAR S4 IR Excimer Laser System and WaveScan WaveFront System are approved to perform wavefront-guided laser assisted in-situ keratomileusis (LASIK) treatments to achieve monovision by the targeted retention of myopia (-1.25 to -2.00 D) in the non-dominant eye of presbyopic myopes with myopic astigmatism up to -6.00 D MRSE, with cylinder between 0.00 and -3.00 D in patients 40 years of age or older; in patients with documented evidence of a change in manifest refraction of no more than 0.50 D (in both cylinder and sphere components) for at least one year prior to the date of pre-operative examination and with a successful preoperative trial of monovision or history of monovision experience.

Wavefront-guided LASIK for monovision is an elective procedure with the alternatives including but not limited to bifocal, trifocal and progressive eyeglasses, contact lenses, or a combination of refractive surgery and reading glasses. Approval of the monovision application is based on a clinical trial of 159 treated dominant eyes and 137 treated non-dominant eyes of 160 subjects. Of all subjects, 157 were evaluated for effectiveness with 98.1% accountability at 3 months, 158 subjects with 98.8% accountability at 6 months, 152 subjects with 97.4% accountability at 9 months, and 149 eyes with 97.4% accountability at 12 months. The study found that at 6 months, 100% of subjects achieved binocular uncorrected distance visual acuity of 20/40 or better, and 86.7% achieved 20/20 or better. At 6 months 100% of subjects achieved binocular uncorrected near visual acuity of 20/40 or better, and 88.0% achieved 20/20 or better. At 6 months 100% of subject achieved simultaneous binocular uncorrected distance and near visual acuity of 20/40 or better, and 79.7% achieved 20/20 or better. At 6 months 98.7% of subjects achieved binocular uncorrected intermediate visual acuity of 20/40 or better, and 84.8% achieved 20/20 or better. The study showed that at 6 months no eyes lost 2 or more lines of best corrected distance vision that can be obtained with spectacles (BSCVA), and one eye (0.3%) lost 2 lines of best corrected near visual acuity. There were no eyes with best corrected distance or near visual acuity worse than 20/25.

CONTRAINDICATIONS:Wavefront-guided LASIK is contraindicated in patients with collagen vascular, autoimmune or immunodefi ciency disease, signs of keratoconus or abnormal corneal topography, patients taking isotretinoin (Accutane®*) or amiodarone hydrochloride (Cordarone® †) or are pregnant or nursing.

WARNINGS:Wavefront-guided LASIK is not recommended in patients who have diabetes, a history of Herpes simplex or Herpes zoster keratitis, signifi cant dry eye that is unresponsive to treatment, or severe allergies. For the treatment of low to moderate myopic astigmatism, lower uncorrected visual acuity may be anticipated in the treatment of higher degrees of myopia with and without astigmatism (>-5.0 D MRSE).

PRECAUTIONS:The safety and effectiveness of wavefront-guided LASIK surgery has ONLY been established with an optical zone of 6 mm and an ablation zone of 8 mm for myopic astigmatism, and an optical zone of 6 mm and an ablation zone of 9 mm for hyperopic and mixed astigmatism. Long term risks of wavefront-guided LASIK beyond 12 months have not been studied. The safety and effectiveness of the STAR S4 Excimer Laser System have NOT been established for wavefront-guided treatment of low to moderate myopic astigmatism in patients: whose WaveScan™ wavefront diameter is less than 6 mm, for treatments greater than 6 diopters of MRSE or with greater than 3 diopters of astigmatism and for retreatment with CustomVue LASIK. The safety and effectiveness of the STAR S4 Excimer Laser System have NOT been established for wavefront-guided treatment of high myopic astigmatism in patients: whose WaveScan™ wavefront diameter is less than 5 mm, for treatments greater than -11 diopters of MRSE or with greater than 3 diopters of astigmatism. The safety and effectiveness of the STAR S4 Excimer Laser System have NOT been established for wavefront-guided treatment of hyperopic astigmatism in patients: whose WaveScan wavefront diameter is less than 5 mm; for treatments greater than 3 diopters of MRSE or with greater than 2 diopters of astigmatism and for retreatment with CustomVue LASIK. The safety and effectiveness of the STAR S4 IR™ Excimer Laser System have NOT been established for wavefront-guided treatment of mixed astigmatism in patients: whose WaveScan wavefront diameter is less than 5 mm, for treatments greater than 5 diopters or less than 1 diopter of astigmatism and for retreatment with CustomVue LASIK.

Although the WaveScan WaveFront System measures the refractive error and wavefront aberrations of the human eyes, including myopia, hyperopia, astigmatism, coma, spherical aberration, trefoil, and other higher order aberrations through sixth order, in the clinical studies for low to moderate myopic astigmatism, hyperopic astigmatism and mixed astigmatism, the average higher order aberration did not decrease after CustomVue treatment. In the clinical studies for high myopic astigmatism, the average higher order aberration increased after CustomVue treatment.

It is possible, after wavefront-guided LASIK treatment, that patients will fi nd it more diffi cult than usual to see in conditions such as very dim light, rain, snow, fog, or glare from bright lights at night. Visual performance possibly could be worsened by large pupil sizes or decentered pupils. Pupil size should be evaluated under mesopic illumination conditions.

The use of Percentage Nomogram Adjustment should be based upon careful consideration of patient and surgeon information, in addition to environmental conditions surrounding the surgery. The simultaneous use of the Percentage Nomogram Adjust-ment and the Physician Adjustment has not been studied in controlled investigations, and should not be attempted until the accuracy of the Nomogram setting has been verifi ed for the same laser, treatment conditions and type of treatment. Therefore, the combined simultaneous use of the Percentage Nomogram Adjustment and the Physician Adjustment is not recommended without careful analysis of postoperative refractive results.

ADVERSE EVENTS AND COMPLICATIONS:The clinical trial for low to moderate myopic astigmatism showed that the following adverse events or complications occurred in at least 1% of the 351 eyes at any interval up to 6 months post-treatment: infl ammation of the cornea under the fl ap (1.4%); double or ghost images (1.4%); and scratch on the surface of the eye (1.4%). The following subjective symptoms frequency rated “often or always” were increased in the effectiveness cohort at 6 months post-treatment on 258 eyes compared with pre-treatment on 332 eyes: dryness (9% vs. 6%); fl uctuation of vision (3% vs. 2%); glare (4% vs. 2%) and halos (7% vs. 5%).

The clinical trial for high myopic astigmatism showed that the following adverse events or complications occurred in at least 1% of the 184 eyes at one or more postoperative examinations up to 6 months post-treatment: epithelium in the interface (1.1%); peripheral corneal epithelial defect at 1 month or later (2.2%); corneal edema between 1 week and 1 month post-operatively (2.7%) and double vision (or “ghost images”) in the operative eye (6.0%). The following subjective symptoms were reported as present “often or always” by a higher percentage of subjects 6 months after treatment than before treatment: dryness (10.8% vs. 9.3%); halos (21.6% vs. 15.4%); and ghosting or shadowing of images (2.8% vs. 1.1%).

The clinical trial for hyperopic astigmatism showed that the following adverse events or complications occurred in at least 1% of the 144 eyes at any interval up to 6 months post-treatment: cells growing under the fl ap (2.1%); feeling of something in the eye (1.4%); double or ghost images (11.3%); and scratch on the surface of the eye (2.1%). The following subjective symptoms rated “often or always” were increased in the effectiveness cohort at 6 months post-treatment on 131 eyes compared with pre-treatment on 136 eyes: dryness (17% vs. 6%); blurry vision (10% vs. 7%); fl uctuation of vision (14% vs. 6%); halos (10% vs. 5%); double or ghost images (7% vs. 3%).

The clinical trial for mixed astigmatism showed that the following adverse events or complications occurred in at least 1% of the 86 eyes at one or more postoperative examinations up to 3 months post-treatment: miscreated fl ap (1.2%); cells growing under the fl ap (4.7%); and double vision (or “ghost images”) in the operative eye (8.1%). The following subjective symptoms were reported as present “often or always” by a higher percentage of subjects 3 months after treatment than before treatment: dryness (22% vs. 6%); halos (20% vs. 13%).

The clinical trial for monovision showed that the following adverse events or complications occurred in at least 1% of the 296 treated eyes of 160 subjects: diffuse lamellar keratitis (4.1% of eyes), epithelium in the interface (1.0% of eyes) and ghost images or diplopia (17.5% of subjects). No subjects with diplopia reported the diplopia as occurring “often” or “always”. Ghost images were reported as occurring “often” by four subjects and “always” by one subject. The following subjective symptoms were reported as present “often or always” by a higher percentage of subjects 6 months after treatment than before treatment: dryness (11% vs. 6%); glare (4% vs. 3%); halos (10% vs. 8%); and ghosting (4% vs. 2%).

VISX, WaveScan, CustomVue, STAR S4, STAR S4 IR, VSS, WaveScan WaveFront and the Advanced CustomVue logo are trademarks of VISX, Incorporated. The AMO logo is a trademark of Advanced Medical Optics, Inc.* Accutane® is a registered trademark of Hoffmann-La Roche Inc.† Cordarone® is a registered trademark of Sanofi -Synthelabo, Inc.

© July 2007 Advanced Medical Optics, Inc.

Building On A LegacyOf Innovation

Monovision Treatment For Presbyopic Myopia PatientsThe Advanced CustomVue™ procedure is the fi rst and only FDA-approved wavefront-guided

monovision treatment to correct both near and distance vision in presbyopic patients with low-to-

moderate myopia, with or without astigmatism.

“We fi nally have the option to

provide presbyopic patients

with near vision correction

that matches the accuracy

and quality of vision we

routinely achieve for distance

correction. The Advanced

CustomVue Monovision

procedure sets a new standard

for visual outcomes and

patient satisfaction.”

— Douglas D. Koch, MD

Baylor Vision

Texas, USA

At 12 months:

• 99% of study participants achieved binocular near

UCVA of 20/25 or better

• 97% achieved binocular distance UCVA of 20/25 or better

• 86% of study participants achieved 20/20 or better for

both uncorrected near and uncorrected distance

visual acuity

• 98% of study participants expressed satisfaction with

their results

Advanced CustomVue Monovision3

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

0%

20/25 or Better20/40 or Better

20/20 or Better

Preop 6 Months 12 Months

86% of study participants achieved

binocular simultaneous 20/20 or

better for both uncorrected near and

uncorrected distance visual acuity.

Simultaneous UCDVA and UCNVA

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