Visx Star 4 Laser

The Right Laser System For More Patients

The STAR S4 IR® Excimer Laser System is designed to bring Advanced CustomVue® laser vision correction to life. Featuring VSS technology (Variable Spot Scanning) and VRR (Variable Repetition Rate) pulse-packing algorithm, both proprietary to AMO, the STAR S4 IR® Excimer Laser reduces thermal effects on the cornea, allowing you to perform the Advanced CustomVue® procedure quickly and effectively, while maximizing patient safety.

Using the STAR S4 IR® Excimer Laser System, surgeons can deliver the broadest range of wavefront-guided laser vision correction treatments to patients. In fact, more than 94 percent of eligible candidates in the U.S., and more than 99.75 percent outside the U.S., may potentially benefit from the Advanced CustomVue® procedure.*

STAR S4 IR<sup>®</sup> Excimer Laser


  • Delivers benefits of Iris Registration (IR).
  • Conserves tissue by optimizing treatment times and minimizing thermal effects on the cornea.
  • Minimizes additional time for wavefront-guided custom treatment over conventional treatment.
  • Eliminates the need for dilation; laser tracks on the natural pupil.
  • Maximizes practice efficiency and workflow through ease of use and ergonomics.
  • Adjusts for intra-patient (XYZ) movement with ActiveTrak to further improve treatment accuracy.

From The WaveScan® System To The STAR S4 IR® Excimer Laser System

Optimal results require precise alignment of the laser treatment. By linking diagnostic wavefront information with the treatment itself during the Advanced CustomVue® procedure, IR provides a much higher level of alignment accuracy and precision, giving the surgeon confidence that the treatment will be placed in the correct location.

During treatment delivery, IR:

  • Finds and unwraps the iris in preoperative and operative images.
  • Selects prominent reference points.
  • Applies a set of sophisticated algorithms to find multiple matching reference points for each iris.
  • Calculates the ablation torsional angle from multiple matching reference points, and adjusts the treatment positioning prior to ablation.
  • Automatically checks the solution quality to help prevent false matches.

Optimal Outcomes With Iris Registration (IR)

A patient’s pupil center will move relative to the outer iris boundary in different environments. To minimize the impact of this movement, IR:

  • Records the outer iris boundary at the WaveScan® system and laser.
  • References the WaveScan® system pupil center to the outer iris boundary.
  • Records the pupil center relative to the outer iris boundary and compares it under the laser to the WaveScan® system reading.
  • Centers the laser ablation over the WaveScan® system pupil center.

VSS and VRR technologies

VSS And VRR: Safety And Speed

The STAR S4 IR® Excimer Laser System features VSS technology (Variable Spot Scanning) and VRR (Variable Repetition Rate) pulse-packing algorithm, both proprietary to AMO. The VSS technology produces variable beam sizes from as small as 0.65 mm up to 6.5 mm, while VRR varies the laser’s repetition rate from 6 Hz to 20 Hz. By continually changing the size and placement of the laser beam, the STAR S4 IR® Excimer Laser rapidly delivers the precise ablation pattern required, significantly reducing ablation time. This capability minimizes thermal effects on the cornea and allows you to perform the procedure as quickly as possible.

Additional Benefits

  • Optimizes laser spot size, placement and repetition rate based on pulse-packing algorithm.
  • Enables wide range of beam sizes for more precise shapes.
  • Reduces thermal effects on the cornea, allowing the fastest and safest treatment speed.

Eye Tracking

ActiveTrak 3-D Active Eye Tracking

ActiveTrak 3-D Active Eye Tracking with automatic centering is the first FDA-approved tracker in the industry to track eye movements along the X, Y and Z axes. These features facilitate the accurate performance of the Advanced CustomVue® procedure.

IntraLase® FS Laser

The Technology Behind LASIK Success

How does AMO’s IntraLase® FS Technology contribute to LASIK success? By delivering biomechanical superiority, excellent visual acuity, and unmatched safety. This innovative technology is also well suited for creating uniquely shaped corneal incisions for corneal transplant surgery.

IntraLase<sup>®</sup> FS Laser

How IntraLase® Fits Within LASIK

There’s Only One IntraLase® FS Laser System

Increasingly, successful LASIK procedures have one thing in common — they use AMO’s IntraLase® FS Laser System. IntraLase® FS Technology clearly delivers clinical advantages to enhance your practice.

  • Our 4th-generation laser is designed as a primary laser for LASIK procedures and advanced corneal surgery procedures
  • 60 kHz performance delivers microkeratome speed and laser precision
  • Better biomechanical stability vs. a microkeratome (1)
  • Lower induced high-order aberrations vs. a microkeratome (2)
  • Better refractive outcomes vs. a microkeratome (2)

One Million Reasons And Counting

At a nearly unprecedented level, LASIK has become a trusted way for people to improve their functional vision. And judging by the numbers, the IntraLase® Method, using AMO’s IntraLase® FS Technology, has become an integral part of today’s advanced LASIK procedure. With well over 1 million procedures completed to date, IntraLase® FS Technology is clearly in the DNA of your successful practice. This seemingly genetic link between IntraLase® FS Laser System and your LASIK practice exists because:

  • Patients want all-laser LASIK, and we’re the all-laser pioneers
  • Surgeons believe in the safety, effectiveness and profitability profile of the IntraLase® FS laser
  • The future of refractive surgery hinges on the innovative application of scientific breakthroughs, and IntraLase® FS Technology is at the forefront

Biomechanically Superior Flap Creation

Maintaining the integrity of the corneal biomechanics is a critical element in the success of the refractive procedure — and only AMO IntraLase® FS Laser System delivers unmatched control over flap diameter, depth, centration and morphology, resulting in an unprecedented combination of potential advantages, including:

  • Controlled Flap Structure
  • Precisely centered, accurately sized flaps; programmable hinge placement1
  • Flap dimensions designed based on patient factors, such as corneal thickness, steepness, diameter and pupil position
  • Precise control of flap dimensions helps avoid the peripheral lamellar structure, vital to the biomechanical stability of the cornea2
  • Uniform Flap Thickness
  • Uniformly thin, planar flaps3
  • Smooth, evenly hydrated, stromal morphology4
  • Reproducible flap thicknesses with profiles that are significantly superior to those achieved by mechanical means (p<0.001)4
  • Maximized residual stromal beds
  • Superior Visual Outcomes
  • Rapid visual recovery
  • Day 1: UCVA 20/16 or better in 70% of patients (n=199)5
  • Month 1: Increased contrast sensitivity at all spatial frequencies vs. baseline (n=88)6
  • Better quality of vision
  • Eyes treated with the IntraLase® FS Laser System had fewer visual disturbances (haze, glare, sensitivity), less pain, and less dryness than a microkeratome6

Faster Visual Acuity Than Surface Treatments

In a recent study (Sub-Bowman’s Keratomileusis with IntraLase® FS Laser System vs. PRK), IntraLase® treated eyes demonstrated clinically and statistically better visual acuities (uncorrected and best corrected) through one month postop compared to surface treatment.1

  • Uncorrected Vision
  • Through one week postop, eight times more IntraLase® eyes achieved 20/20 or better uncorrected vision compared to PRK eyes1
  • Superiority continued at one month, where 45% more IntraLase® eyes achieved 20/20 or better uncorrected vision compared to PRK eyes1
  • Best Corrected Vision
  • Clinically and statistically significant improvement through one month with LASIK with the IntraLase® Method over PRK when comparing baseline BCVA and postop BCVA1
  • At one month, more than twice as many IntraLase® eyes showed BCVA gain compared to PRK eyes1

Precision Technology For A Safer LASIK Experience

By replacing the blade commonly used for corneal flap creation with a femtosecond laser, AMO® has made LASIK eye surgery safer than ever before. The IntraLase® FS Laser System delivers micron-level accuracy 100% greater1,2 than a microkeratome for more accurate and consistent flap thickness — which is critical for a successful LASIK outcome.

Retrospective analysis comparing LASIK results with IntraLase® FS Technology versus the two leading microkeratomes demonstrated that IntraLase® FS Laser System performed better in three areas important to LASIK results and safety: flap thickness, induced astigmatism, and cell injury.3 There are fewer flap-related complications with the IntraLase® Method:*4

  • Minimal risk of sight-threatening events (free caps, globe penetration, buttonhole flaps, decentered flaps, and/or incomplete cuts)
  • No risk of corneal abrasion
  • Reduced risk of dry eye

*Only the IntraLase® FS Laser System can be used to perform the IntraLase® Method.

Innovative-Shaped Corneal Incisions

IntraLase® enabled keratoplasty gives surgeons the ability to precisely create uniquely shaped corneal incisions — opening a new era in corneal transplantation and delivering the potential for faster healing and improved visual recovery. Leading corneal surgeons have demonstrated that this technology advancement enables:

  • Surgeons to create straight, angled and arcuate incisions within the cornea
  • Multiplanar custom incisions with hermetic sealing properties that require less suture tension
  • Less suture tension can result in less astigmatism1
  • Multiplanar custom incisions provide larger wound surface area for stronger healing
  • Laser resectioning that produces more rapid healing1
  • Earlier suture removal and rapid visual rehabilitation1

Create Customized Incisions With Advanced Edge Profiles
Mushroom incision profile

The mushroom-shaped incision preserves more host endothelium than the traditional trephine approach.1
Top-hat incision profile

The top-hat-shaped incision allows for the transplantation of large endothelial surfaces.1
Zig-zag incision profile

The zig-zag-shaped incision provides a smooth transition between host and donor tissue and allows for a hermetic wound seal.1
Establish Secure Grafts, Requiring Less Suture Tension1
1 week after surgery
1 week after surgery
3 months after surgery
3 months after surgery
6 months after surgery
6 months after surgery
         Early experience indicates that IEK incisions create less irritation, form hermetic wound seals, and produce crystal-clear corneas
        at 1, 3, and 6 months. In addition, all sutures were removed before 6 months vs. 1 year with standard trephine techniques.2

WaveScan WaveFront® System

Registration + Resolution

The AMO WaveScan WaveFront® System leads the industry for outstanding wavefront acquisition and diagnostic capabilities. Fast and powerful, the WaveScan System delivers unprecedented measurement accuracy, enhancing the precision of the Advanced CustomVue™ procedure.

Using AMO Fourier algorithms, WaveScan captures the unique imperfections of each patient’s eye using 100 percent of the available Hartmann-Shack data points for more accurate wavefront error reconstruction. The system provides the highest resolution available for any shape pupil (up to 7 mm), enabling precise, individualized treatment for the broadest range of visual imperfections.

                                                                                                                                         WaveScan WaveFront<sup>®</sup> System

Additional Benefits

  • Personalizes the Advanced CustomVue™ treatment for each patient according to the unique characteristics of his or her eyes.
  • Allows you to link diagnostic information to laser treatment.
  • Advanced features like off-line programming and auto exam selection improve workflow efficiencies.

The WaveScan Promise

Truly Personalized Vision Correction

The WaveScan WaveFront® System uses intuitive software to help physicians determine the appropriate treatment with colorful, 3-D, easy-to-read Acuity Maps® and difference maps. Physicians can choose from single or multiple exams for automated exam selection mode. First, the WaveScan System captures the wavefront, maps the aberrations, and automatically records picture quality for Iris Registration. Then it provides 3-D maps of acuity, higher-order aberrations, and point spread function (PSF), along with the captured eye image. Finally, the design screen provides a visualization of the calculated ablation depth and the eye image. The physician can easily make adjustments that further personalize treatment for the individual patient. By streamlining the steps between treatment design and delivery, the software enables greater practice efficiency.


The AMO Fourier Algorithm

Using 100 percent of the available Hartmann-Shack data points (about 240 points), the AMO Fourier algorithm delivers the highest available resolution of the wavefront error. Fourier algorithms use data from pupils of any shape, and reconstruct all peripheral data (data that lie beyond the circular data) unlike with the use of Zernike reconstruction. No dilation is necessary. The Fourier algorithm provides the most precise measurement of the wavefront error available today, and is equivalent to 20th-order Zernike measurements.

Guided by AMO Fourier algorithms, the WaveScan WaveFront® System — together with the STAR S4 IR™ Excimer Laser System — allows you to calculate and deliver more precise ablation shapes.