Presentation from OIS@ASCRS 2016 Rajesh K. Rajpal, MD, Chief Medical Officer Video Presentation: https://www.youtube.com/watch?v=Wbq-D5kwMUk&list=PL1dmdBNnPTZJBhQxPOp0vdNg3s3wtN2yw&index=39

1. The Present and Future of CXL
Rajesh K. Rajpal, MD
Chief Medical Officer

2. Financial Disclosures
• Avedro, Inc: Employee, Investigator, Shareholder

3. United States FDA Approval
Avedro, Inc. received approval from the U.S. Food and
Drug Administration (FDA) for Photrexa Viscous
(riboflavin 5’-phosphate in 20% dextran ophthalmic
solution) 0.146%, Photrexa (riboflavin 5’-phosphate
ophthalmic solution) 0.146%, and the KXL system for
corneal cross-linking for the treatment of progressive
keratoconus on April 15th 2016.
Photrexa Viscous, Photrexa and the KXL System
are the first and only FDA-approved therapeutic
treatment for progressive keratoconus

4. FDA Approved Indication
INDICATION AND USAGE
Photrexa Viscous and Photrexa are photoenhancers
indicated for use with the KXL System in corneal collagen
cross-linking for the treatment of progressive keratoconus.
CONTRAINDICATIONS
None
WARNINGS AND PRECAUTIONS
Ulcerative keratitis can occur. Monitor for resolution of
epithelial defects.
ADVERSE REACTIONS
The most common ocular adverse reactions in any CXL-
treated eye were corneal opacity (haze), punctate
keratitis, corneal striae, corneal epithelium defect, eye
pain, reduced visual acuity, and blurred vision.

5. 5
Brian Roberts – CFO/COO
Steve Blinn – CCO
Rajesh K. Rajpal, MD – CMO
Marc Friedman, PhD – CSO
Senior Management Board of Directors
Robert J. Palmisano
Joe Mandato, PhD
Gil Kliman, MD
Jonathan Silverstein
Avedro Senior Management Team

6. 755 Avedro devices sold worldwide
78 countries with Avedro devices
Avedro’s Approved Countries
Commercial Infrastructure for Growth
SALES & DISTRIBUTION
United States
• 10 member direct sales team
• 6 member direct service team
Outside the United States
• 66 distributors
• 200 sales and service reps
INSTALLED BASE

7. PiXL …
The Future of Refractive CXL

8. PiXL: Photorefractive Intrastromal Cross-linking
UVA patterning is applied
with the Mosaic System
to the center of the
riboflavin-soaked cornea
for myopia correction
PiXL Myopia
Treatment
Goal: induce focal stiffening in the cross-linked regions,
resulting in “bulging” of the cornea in untreated regions in
response to the normal intraocular pressure

9. Prospective Epi-Off Clinical Trial
Ruhr University, Bochum, Germany
A prospective evaluation of the safety and efficacy of the
KXL II system for photorefractive intrastromal cross-
linking (PiXL) for the treatment of Myopia
40 Eyes with Myopia
Follow-up at 1, 3, 6 and 12 Months
Evaluations to include:
• UCVA
• BSCVA
• Autorefraction
• Manifest refraction
• Slit lamp examination
• Intraocular Pressure
Measurement
• Anterior Segment OCT
• Pentacam measurements
• Aberrometry
• Specular Microscopy
Professor H. Burkhard Dick
Matthias Elling, MD
Ruhr University
Bochum, Germany

10. Initial 12 month results demonstrate the stability of the procedure from 3
months, confirming the feasibility of PiXL as a refractive treatment
Prospective Clinical Trial: Stability
Ruhr University, Bochum, Germany
Potential to reduce
recovery time and
speed stabilization
by avoiding
epithelial removal.
12 Month Stability (n=9)

11. Transepithelial PiXL Pilot Study
Dr. Julian Theng and Dr Lim Wee Kiak Eagle Eye Ctr. Singapore
Demographic:
14 myopic eyes (1.62 ± 0.6D)
Post-op checks:
Objective
• Safety – BCVA, ECC, Slit lamp evaluation
• Efficacy – UCVA, manifest Rx, Contrast Sensitivity, Corneal topography
Subjective
• Questionnaire
Sphere Cylinder Treatment Zone
UV
Energy
Treatment Time
-0.50 to -0.75D < -0.50D 4.5mm 10J 11 min 11 sec
-1.00 to -1.50D < -0.50D 4.5mm 15J 16 min 39 sec
Dr. Julian Theng
Medical Director
Eagle Eye Ctr.
Singapore

12. Transepithelial PiXL Pilot Study
Dr. Julian Theng and Dr Lim Wee Kiak Eagle Eye Ctr. Singapore
Mean gain in VA: 0.35 log unit (3.5 snellen lines) Average MRSE reduction: 0.80 ± 0.45D
* MRSE – Manifest Refraction Spherical Equivalent

13. Upcoming Transepithelial PiXL Studies
20+ Healthy Myopic Eyes Per Site
Intended correction:
-0.75 to -2.0D sphere, 0 to 0.75 D cyl
No prior corneal surgery
Investigator-Initiated Pilot Clinical Trials of Transepithelial PiXL
with Supplemental Oxygen for Treatment of Low Myopia
Principal Investigators:
Prof. H. Burkhard Dick
Ruhr University,
Bochum, Germany
Prof. François Malecaze
Hôpital Purpan
Toulouse, France
Prof. Anders Behndig
Umea University Hospital
Umeå, Sweden

14. Avedro Booth 1601