Challenging Refractive Surgery Cases. Vance Thompson, MD, FACS Refractive and Cataract Surgery Vance Thompson Vision Sioux Falls, South Dakota
|
|
- Felicity Deborah Hubbard
- 8 years ago
- Views:
Transcription
1 Challenging Refractive Surgery Cases Vance Thompson, MD, FACS Refractive and Cataract Surgery Vance Thompson Vision Sioux Falls, South Dakota
2 Financial Disclosures Research/consulting: Alcon AMO B & L AcuFocus Avedro Wavetec Zeiss Meditec Calhoun Vision Forsight/Nexis Vision Euclid LRG
3 The Psychology of Refractive Surgery A consideration in any situation where the patient is not happy with their vision Staff needs to be trained on how to handle these situations Patient and caring staff and doctor
4 Handling Patients Who Need An Enhancement The key to success of a refractive surgery practice
5 You can t count on the refraction being accurate when the best corrected vision is reduced.
6 Reduced BCVA Clinical Example Myopic 6 months after myopic LASIK Pre-op Mrx: -6.00D 20/20 6 mo po Mrx: X /30 slit lamp exam:. smooth flap What next?
7
8 You can t count on the refraction being accurate when the best corrected vision is reduced.
9 Reduced BCVA Clinical Example Myopic 6 months after myopic LASIK Pre-op Mrx: -6.00D 20/20 6 mo po Mrx: X /30 slit lamp exam:. smooth flap What next? treatment: treat island postop: Mrx: -.25 UCVA:20/20
10 1994 Case #1 Hyperopic Astigmatism 22 yo Caucasian male presents OD Mrx: X 21 20/25+2 OS Mrx: X /40+2 Small central congenital lens opacities very similar between the two eyes Amblyopic Recommendation: No Surgery
11 1999 Case #1 Hyperopic Astigmatism 27 yo Caucasian male presents OD Mrx: X 21 20/25+2 OS Mrx: X /40+2 Small central congenital lens opacities very similar between the two eyes Amblyopic Recommendation: No Surgery
12 2002 Case #1 Hyperopic Astigmatism 30 yo Caucasian male presents OD Mrx: X 21 20/25+2 OS Mrx: X /40+2 Small central congenital lens opacities very similar between the two eyes Amblyopic Recommendation: No Surgery
13 2006 Case #1 Hyperopic Astigmatism 34 yo Caucasian male presents OD Mrx: X 21 20/25+2 OS Mrx: X /40+2 Small central congenital lens opacities very similar between the two eyes Amblyopic Recommendation: No Surgery
14 2009 Case #1 Hyperopic Astigmatism 37 yo Caucasian male presents OD Mrx: X 21 20/25+2 OS Mrx: X /40+2 Small central congenital lens opacities very similar between the two eyes Amblyopic (OD dominant)
15 2009 Case #1 Hyperopic Astigmatism 37 yo Caucasian male presents OD Mrx: X21 20/25+2 OS Mrx: X162 20/40+2 Small central congenital lens opacities very similar between the two eyes Amblyopic (OD dominant) Really hoping to do something now even if I don t get a full correction I would like to lessen my prescription
16 Topography asfa asfadfghfgh
17 Topography asfadfghfgh
18 asfadfghfgh Wavefront
19 asfadfghfgh Wavefront
20 2009 Hyperopic Astigmatism 37 yo Caucasian male presents OD Mrx: X21 20/25+2 OS Mrx: X162 20/40+2 Small central congenital lens opacities very similar between the two eyes Amblyopic (very OD dominant) Really hoping to do something now even if I don t get a full correction I would like to lessen my prescription At age 37 he was not sure if he was ready for a lens based option Recommendation:
21 asfadfghfgh
22 asfadfghfgh
23 2009 Hyperopic Astigmatism 37 yo Caucasian male presents OD Mrx: X21 20/25+2 OS Mrx: X162 20/40+2 Small central congenital lens opacities very similar between the two eyes Amblyopic Pupils in low light: 7 mm
24 2009 Hyperopic Astigmatism 37 yo Caucasian male presents OD Mrx: X21 20/25+2 OS Mrx: X162 20/40+2 Small central congenital lens opacities very similar between the two eyes Amblyopic Pupils in low light: 7 mm VISX Custom LASIK performed 1/2009
25 2009 Hyperopic Astigmatism Was myopic for awhile: 1 week OD UCVA: 20/50 Mrx: X 85 20/25 OS UCVA: 20/50 Mrx: X 3 20/40 For awhile he was pretty happy Post op 1 year he was OD X87 and OS X168 He continued to be frustrated
26 2009 Hyperopic Astigmatism Was myopic for awhile: 1 week OD UCVA: 20/50 Mrx: X 85 20/25 OS UCVA: 20/50 Mrx: X 3 20/40 For awhile he was pretty happy Post op 1 year he was OD X87 and OS X168 He continued to be frustrated Went for full correction enhancement We did a lift flap and laser with WL dialing in full correction
27 Hyperopic Astigmatism Post op he was OD 20/25 and OS 20/30 and fairly happy again Over the next year he became more frustrated with glare and halos One year post enhancement he still had the same vision but very frustrated with nighttime. Gas permeable contact lens over-refraction helped a little bit but not much.
28 Hyperopic Astigmatism Post op he was OD 20/25 and OS 20/30 and fairly happy Over the next year he became more frustrated with glare and halos One year post enhancement he still had the same vision but very frustrated with nighttime. Gas permeable contact lens over-refraction helped a little bit but not much. Recommendation:
29 Hyperopic Astigmatism Post op he was OD 20/25 and OS 20/30 and fairly happy Over the next year he became more frustrated with glare and halos One year post enhancement he still had the same vision but very frustrated with nighttime. Gas permeable contact lens over-refraction helped a little bit but not much. Recommendation: lens surgery
30 2011 Case #1 S/P Hyperopic Astig LASIK/Cong Cataracts/Amblyopic OS OS: Tecnis Z OD: B&L Model: LI61SE
31 2011 Case #1 S/P Hyperopic Astig LASIK/Cong Cataracts/Amblyopic OS OS: Tecnis Z OD: B&L Model: LI61SE Currently: OD: 20/20-2 Mrx: x 164 (clear) OS: 20/40-1 Mrx: x 105 (clear) But still nighttime glare and halos OD that are very bothersome pilo helps a lot Capsule is relatively clear
32 32
33 2011 Case #1 S/P Hyperopic Astig LASIK / Cong Cataracts / Amblyopic OS / Big Pupils/ Implants/ Glare OS: Tecnis Z OD: B&L Model: LI61SE Currently: OD: 20/20-2 Mrx: x 164 (clear) OS: 20/40-1 Mrx: x 105 (clear) But still nighttime glare and halos OD that are very bothersome pilo helps a lot Recommendations? Gas permeable contacts? Custom enhance? Pupillary cerclage? asfj ad
34 2006 Case #2 29 yo Caucasian female presents Researching her options Failed contact lenses scarring her corneas Spectacle dependent Worsening night time glare OD: x /15-1 OS: x 56 20/15
35
36 Preop Topography OD A;lsdfja;lskdfj sdas;dlka;ds
37 Pre-op Topography OS A;lsdfja;lskdfj sdas;dlka;ds
38 Pre-op Wavefront OD A;lsdfja;lskdfj sdas;dlka;ds
39 Pre-op Wavefront OS A;lsdfja;lskdfj sdas;dlka;ds
40 2006 Case #2 29 yo Caucasian female presents Researching her options Failed contact lenses scarring her corneas Spectacle dependent Worsening night time glare OD: x /15-1 OS: x 56 20/15 Recommendation:
41 2006 Case #2 29 yo Caucasian female presents Researching her options Failed contact lenses scarring her corneas Spectacle dependent Worsening night time glare OD: x /15-1 OS: x 56 20/15 Recommendation: Short option: Custom PRK OU Long option: PTK first then Custom PRK OU
42 2006 Case #2 29 yo Caucasian female presents Researching her options Failed contact lenses scarring her corneas Spectacle dependent Worsening night time glare OD: x /15-1 OS: x 56 20/15 Recommendation: If it helps you in deciding my rough rule of thumb is that if you are not happy with your glasses image you most likely won t be happy with your laser corrected image
43 Scar Removal
44 Post-PTK Wavefront OD A;lsdfja;lskdfj sdas;dlka;ds
45 Pre-op Wavefront Post PTK Pre-op Wavefront Post-PTK Wavefront OD
46 Pre-op Wavefront Post PTK Pre-op Wavefront Post-PTK Wavefront OD
47 Pre-op Wavefront Post PTK Pre-op Wavefront Post-PTK Wavefront OD
48 Post-PTK Wavefront OS A;lsdfja;lskdfj sdas;dlka;ds
49 Pre-op Wavefront Post PTK Pre-op Wavefront Post-PTK Wavefront OD
50 Pre-op Wavefront Post PTK Pre-op Wavefront Post-PTK Wavefront OD
51 Pre-op Wavefront Post PTK Pre-op Wavefront Post-PTK Wavefront OD
52 2006 Case #2 29 yo Caucasian female presents Researching her options Failed contact lenses scarring her corneas Spectacle dependent Worsening night time glare OD: x /15-1 OS: x 56 20/15 Recommendation: Short option: Custom PRK OU Long option: PTK first then Custom PRK OU
53 Case #2 12/12/12 exam asfj ad
54 2013 Case #3 32 yo cauc male Pre-op: OD Mrx: X 6 OS Mrx: X 170
55 2013 Case #3 32 yo cauc male Pre-op: OD Mrx: X 6 OS Mrx: X 170 CTT
56 2013 Case #3 32 yo cauc male Pre-op: OD Mrx: X 6 OS Mrx: X 170 CTT CustomVue LASIK OU 2010 elsewhere
57 Case #3
58 As;lfjlksjdf;lajsd;kfja;fj;lkj;lskjdf;alsdf
59 2013 As;lfjlksjdf;lajsd;kfja;fj;lkj;lskjdf;alsdf Case #3
60 2013 Case #3
61 2013 Case #3
62 2013 Case #3 Recommendation?
63 How does this refraction look?
64 Case #3 post high myopia/cyl LASIK with residual cyl and HOA s
65 2013 As;lfjlksjdf;lajsd;kfja;fj;lkj;lskjdf;alsdf Case #3
66 Handling Challenging Cases The key to success of a refractive surgery practice Thank You!
67 Refractive cases Sonia H. Yoo, MD Professor of Ophthalmology University of Miami Miller school of Medicine Miami, Florida Financial Disclosures: Alcon, Allergan, Bausch and Lomb, Carl Zeiss Meditec, Optimedica, Transcend Medical
68 CASE #1 22-year-old male complaining of blurry vision in the left eye LASIK OU February 2012 LASIK retreatment OS June 2012
69 Preoperative evaluation, February 2012 Refraction: OD: (-0.75) 51 OS: (-0.50) 93 Pachymetry: OD: 518µ OS: 532µ Uneventful LASIK procedure on February 2 nd 2012
70 Operative report, February OD 2012 OS
71 Postoperative evaluation PO Week 1: OD: (-0.75) 94 OS: (-1.00) 138 PO Month3: OD: (-0.75) 105 OS: (-0.75) 144 LASIK Retreatment OS June 2012
72 OS Operative report, June 2012
73 Clinical evaluation, August 2012 Refraction: - OD: plano (+0.75) 10 20/20 - OS: (+1.00) /400 - Slitlamp examination clear corneas Patient complaining of blurry vision in the left eye
74 Topography, August 2012
75 What to do now? LASIK enhancement? PRK? Contact lenses? Other options?
76 What about IOL surgery to rescue refractive surgery disasters?
77 CASE #2 78 year-old-man Complaining of decreased vision and glare OU for several months Medicines: Flomax for BPH
78 January 2012 Refraction: OD = x 85 20/25 OG = x 95 20/30 Scheduled for CE OS first
79 Topography
80 Acrysof Toric calculator OS
81 IOL power calculation TORIC IOL OU - OD: SN6 AT7 16.5D - OS: SN6 AT9 16D
82 POD#1 CE OS Jan /25 OS without correction! Slitlamp examination: small piece of retained cortex IOP: 24 mmhg
83 POM#2 February 2012 OS: 20/25 but complaining of blurry and double vision Slitlamp: retained cortex IOP controlled by Cosopt (11mmHg) Cortical lens fragment removal
84 POD#1 cortex removal March 2012 Refraction OS : Plano x115 20/60 IOL axis on meridian 45 instead of meridian 100
85 How would you manage this refractive surprise? Contact lens? Arcuate keratotomy? IOL reposition? Immediately? When the IOP is controlled without medication? When the AC is quiet?
86 IOL reposition OS POD#1 IOL reposition OS 20/20 without correction!
87 What about OD? March 2012: CE with ruptured capsule, anterior vitrectomy What IOL to use? Sulcus IOL: MA60AC 16.5D POW#1: 20/50 OD Slitlamp exam: corneal edema IOP: 12 mmhg (Cosopt)
88 POM#1 CE OD April 2012 UCVA OD 20/60 OD= x 95 20/20 OS= 20/20 without correction What to do now?
89 Topography OD Pachymetry 574 µ OD
90 After refractive stabilization (4 months later) Femtosecond laser assisted arcuate keratotomy (FAK)
91 Topography July 2012 POD#1 post FAK UCVA 20/200 Refraction OD x135 20/25
92 Topography September 2012 POM#2 post-ak UCVA 20/100 Refraction OD x135 20/25
93 Case #3 35-year-old male Complaining of dependency on glasses Has never tried contact lenses
94 Refractive evaluation Manifest Refraction: - OD = /20 - OS = x 75 20/20 Cyclopegic refraction: - OD = OS = x 65 Pupill diameter: 5mm OU Dominant eye: OD Slitlamp ex., IOP and fundus: WNL
95 Preop topography OD U/S PACHY = 543 µ
96 Preop topography OS U/S PACHY = 501 µ
97 Preop topography OD
98 Preop topography OS
99 LASIK OU Refractive surgery 7/12/2001 Targeted for distance in both eyes Flap: 130 µ, Mora CB microkeratome VISX conventional treatment : - OD = OS = x 65 Uneventful surgery
100 Postoperative evaluation POD#1 : UCVA OD: 20/20 (-1) and OS: 20/20 (-2) POY#3 (2004): UCVA 20/20, 20/25 with refraction OD = plano and OS = x40 POY#6 (2007): - UCVA 20/25, 20/40-2 with refraction OD = -1.0sph and OS = x 35 - BSCVA 20/20, 20/20
101 To retreat or not to retreat That is the question!
102 itrace February 2012
103 Pentacam April 2012
104 Anterior segment OCT Residual stromal bed = 285 microns
105 Anterior segment OCT 2012
106 How would you retreat?
107 Thank you for your attention
Incision along Steep Axis
Toric IOL An option or a must? ~ 15% cataract surgical patients >1.5 D Options: spectacles, CLs, Incision along steep axis, LRI, AK, toric IOL, Excimer Laser or a combination Walter J. Stark, MD Professor
More information5/24/2013 ESOIRS 2013. Moderator: Alaa Ghaith, MD. Faculty: Ahmed El Masri, MD Mohamed Shafik, MD Mohamed El Kateb, MD
ESOIRS 2013 Moderator: Alaa Ghaith, MD Faculty: Ahmed El Masri, MD Mohamed Shafik, MD Mohamed El Kateb, MD 1 A systematic approach to the management of Keratoconus through the presentation of different
More informationLASIK. Complications. Customized Ablations. Photorefractive Keratectomy. Femtosecond Keratome for LASIK. Cornea Resculpted
Refractive Surgery: Which Procedure for Which Patient? David R. Hardten, M.D. Minneapolis, Minnesota Have done research, consulting, or speaking for: Alcon, Allergan, AMO, Bausch & Lomb, Inspire, Medtronic,
More informationVISX Wavefront-Guided LASIK for Correction of Myopic Astigmatism, Hyperopic Astigmatism and Mixed Astigmatism (CustomVue LASIK Laser Treatment)
CustomVue Advantage Patient Information Sheet VISX Wavefront-Guided LASIK for Correction of Myopic Astigmatism, Hyperopic Astigmatism and Mixed Astigmatism (CustomVue LASIK Laser Treatment) Statements
More informationFIRST EXPERIENCE WITH THE ZEISS FEMTOSECOND SYSTEM IN CONJUNC- TION WITH THE MEL 80 IN THE US
FIRST EXPERIENCE WITH THE ZEISS FEMTOSECOND SYSTEM IN CONJUNC- TION WITH THE MEL 80 IN THE US JON DISHLER, MD DENVER, COLORADO, USA INTRODUCTION AND STUDY OBJECTIVES This article summarizes the first US
More informationefocus Anterior Segment Case Management Tips on Cornea, External Diseases, Cataract and Lens patient management
Issue 038 November 2010 efocus Excellence in Co-Managed Care PACIFIC V I S I O N I N S T I T U T E Life in Focus 415.922.9500 www.pacificvision.org Anterior Segment Case Management Tips on Cornea, External
More informationCornea and Refractive Surgery Update
Cornea and Refractive Surgery Update Fall 2015 Optometric Education Dinner Sebastian Lesniak MD Matossian Eye Associates Disclosures: None Bio: Anterior Segment and Cornea Surgery Fellowship Wills Eye
More informationCurtin G. Kelley, M.D. Director of Vision Correction Surgery Arena Eye Surgeons Associate Clinical Professor of Ophthalmology The Ohio State
Curtin G. Kelley, M.D. Director of Vision Correction Surgery Arena Eye Surgeons Associate Clinical Professor of Ophthalmology The Ohio State University Columbus, Ohio Refractive Errors Myopia (nearsightedness)
More informationRetreatment by Lifting the Original Laser in Situ Keratomileusis Flap after Eleven Years
Retreatment by Lifting the Original Laser in Situ Keratomileusis Flap after Eleven Years Hassan Hashemi, MD 1,2 Mehrdad Mohammadpour, MD 3 Abstract Purpose: To describe a case of successful laser in situ
More informationLong-Term Outcomes of Flap Amputation After LASIK
Long-Term Outcomes of Flap Amputation After LASIK Priyanka Chhadva BS, Florence Cabot MD, Anat Galor MD, Sonia H. Yoo MD Bascom Palmer Eye Institute, University of Miami Miller School of Medicine Miami
More informationThe pinnacle of refractive performance.
Introducing! The pinnacle of refractive performance. REFRACTIVE SURGERY sets a new standard in LASIK outcomes More than 98% of patients would choose it again. 1 It even outperformed glasses and contacts
More informationMinimally Invasive Surgery: Femtosecond Lasers and Other Innovative Microsurgical Techniques
Minimally Invasive Surgery: Femtosecond Lasers and Other Innovative Microsurgical Techniques Julio Narváez MD Associate Professor of Ophthalmology Loma Linda University Non-Refractive Applications of Femtosecond
More informationProviding Optimal Optics For Your Astigmatic Cataract Patients. While the cornea remains relatively stable and prolate throughout life
Providing Optimal Optics For Your Astigmatic Cataract Patients David I. Geffen, OD, FAAO Why keep the crystalline lens? While the cornea remains relatively stable and prolate throughout life Unless we
More informationTechniques for Enhancing Cataract Surgery Patients with Residual Refractive Error. Director of Cornea Center For Excellence In Eye Care Miami, FL
Techniques for Enhancing Cataract Surgery Patients with Residual Refractive Error William Trattler, MD Director of Cornea Center For Excellence In Eye Care Miami, FL 1 Financial Disclosures Consulting
More informationLASIK complications and their management ESCRS Munich 9.2003
LASIK complications and their management ESCRS Munich 9.2003 A. John Kanellopoulos, M.D. Associate Professor NYU Medical School Director, LaserVision.gr Eye Institute Case report 1 2 years s/p PK LASIK
More informationComparison of Residual Stromal Bed Thickness and Flap Thickness at LASIK and Post-LASIK Enhancement in Femtosecond Laser-Created Flaps
Comparison of Residual Stromal Bed Thickness and Flap Thickness at LASIK and Post-LASIK Enhancement in Femtosecond Laser-Created Flaps Lingo Y. Lai, MD William G. Zeh, MD Clark L. Springs, MD The authors
More informationLASIK/PRK following previous eye Surgery
AAO Chicago 2010 LASIK/PRK following previous eye Surgery A. John Kanellopoulos, MD Associate Clinical Professor, NYU Medical School Director: Laservision.gr Eye Institute, Athens, Greece www.brilliantvision.com
More informationWhen To Laser, When To Implant, When To Do Both
When To Laser, When To Implant, When To Do Both Scott MacRae, MD Professor of Ophthalmology Professor of Visual Sciences StrongVision Refractive Surgery Center University of Rochester Eye Institute Refractive
More informationInitial clinical experience with the FS200 Femto and EX500 excimer
Initial clinical experience with the FS200 Femto and EX500 excimer lasers for LASIK ASCRS, San Diego 2011 A. John Kanellopoulos, MD Professor NYU Medical School, NY Director, Laservision.gr Institute,
More informationCustomVue Treatments for Monovision in Presbyopic Patients with Low to Moderate Myopia and Myopic Astigmatism
CustomVue Treatments for Monovision in Presbyopic Patients with Low to Moderate and Myopic Introduction Pre-Operative Examination Surgical Technique 1 2 IMPORTANT INFORMATION CustomVue Monovision treatments
More informationCommon Co-management Questions
Issue 037 efocus Innovation. Leadership. Passion for Perfection 415.922.9500 --- www.pacificvision.org Common Co-management Questions Top questions recently asked by optometrists co-managing refractive
More informationREFRACTIVE SURGERY DECISION MAKING: CANDIDATE SELECTION WITH CASE REPORTS
REFRACTIVE SURGERY DECISION MAKING: CANDIDATE SELECTION WITH CASE REPORTS DAVID I. GEFFEN, OD, FAAO ANDREW MORGENSTERN, OD, FAAO JIM OWEN, OD, FAAO DEMOGRAPHICS 81 Y/O FEMALE COMPLAINS OF POOR VA OU, WORSE
More informationREFRACTIVE SURGERY REVISITED. Sightline Ophthalmic Associates February 22, 2015 Louis J. Phillips, OD, FAAO
REFRACTIVE SURGERY REVISITED Sightline Ophthalmic Associates February 22, 2015 Louis J. Phillips, OD, FAAO INTRODUCTION History Of Laser Vision Correction And Optometry s Involvement. The Western Pennsylvania
More informationInformed Consent for Refractive Lens Exchange (Clear Lens Replacement)
Mark Packer, M.D. Informed Consent for Refractive Lens Exchange (Clear Lens Replacement) This surgery involves the removal of the natural lens of my eye, even though it is not a cataract. The natural lens
More informationPremium IOL Implantation Calculations in Post-LASIK Cataract Eyes Using ASCRS IOL Calculator
Premium IOL Implantation Calculations in Post-LASIK Cataract Eyes Using ASCRS IOL Calculator Sahiba K Chailertborisuth, Saneha K. C. Borisuth, Navaneet S.C. Borisuth, MD, PhD Virdi Eye Clinic & Laser Vision
More informationWHAT IS A CATARACT, AND HOW IS IT TREATED?
4089 TAMIAMI TRAIL NORTH SUITE A103 NAPLES, FL 34103 TELEPHONE (239) 262-2020 FAX (239) 435-1084 DOES THE PATIENT NEED OR WANT A TRANSLATOR, INTERPRETOR OR READER? YES NO TO THE PATIENT: You have the right,
More informationSurgical Advances in Keratoconus. Keratoconus. Innovations in Ophthalmology. New Surgical Advances. Diagnosis of Keratoconus. Scheimpflug imaging
Surgical Advances in Keratoconus Keratoconus Ectatic disorder 1 in 1,000 individuals Starts in adolescence & early adulthood Uncertain cause 20% require corneal transplant Innovations in Ophthalmology
More informationOphthalmic Consultants of Long Island
Case History Improving Cataract and Refractive Surgery Outcomes Through Ocular Surface Optimization 59 year old healthy white female History increased IOP Mother has history of glaucoma Presents for refractive
More informationLASIK/PRK following previous eye Surgery
AAO San Francisco 2009 LASIK/PRK following previous eye Surgery A. John Kanellopoulos, MD Associate Clinical Professor, NYU Medical School Director: Laservision.gr Eye Institute, Athens, Greece www.brilliantvision.com
More informationPRK Wavefront Guided idesign Photorefractive Keratectomy
PRK Wavefront Guided idesign Photorefractive Keratectomy What is PRK? PRK (photorefractive keratectomy) is the same laser procedure as LASIK. Like LASIK it involves the use of the cool energy of an Excimer
More informationMaximizing Surgery Co Management
Maximizing Surgery Co Management Number One Goal Happy Patients! Vandi Rimer, OD Diplomat, American Board of Optometry vrimer@spivack.com 303 740 5475 May 6, 2014 Refractive Surgery from Start to Finish
More informationMy Favorite Practice Altering Therapeutic Cases. Retinal Specialist Results. Case #1 History. Referred to LHEA (my office)
My Favorite Practice Altering Therapeutic Cases Case #1 A complicated case made easy Case #1 History Patient referred from Dallas by brother in law Saw OD first with report of blurry vision OD occurring
More informationThe best way to treat negative
38 EW FEATURE February 2011 Treating, eliminating negative dysphotopsia by Vanessa Caceres EyeWorld Contributing Writer AT A GLANCE Negative dysphotopsia can occur after cataract surgery, even if the surgery
More informationOverview. Addressing Astigmatism with Toric IOL Implantation: Pre-Operative and Operative Considerations. Where are we now? How have we progressed?
Addressing Astigmatism with Toric IOL Implantation: Pre-Operative and Operative Considerations Jason Wang, M.D. Spring Symposium 2012 OMNI Eye Specialists / Spivack Vision Center March 3, 2012 Overview
More informationHow do we use the Galilei for cataract and refractive surgery?
How do we use the Galilei for cataract and refractive surgery? Douglas D. Koch, MD Mariko Shirayama, MD* Li Wang, MD, PhD* Mitchell P. Weikert, MD Cullen Eye Institute Baylor College of Medicine Houston,
More informationPatient Information Booklet Information for patients considering Laser Assisted In-Situ Keratomileusis (LASIK) Surgery
WaveLight EX500 Patient Information Booklet Information for patients considering Laser Assisted In-Situ Keratomileusis (LASIK) Surgery Information for patients considering: LASIK surgery for the elimination
More informationKeratorefractive Surgery for Post-Cataract Refractive Surprise. Moataz El Sawy
Keratorefractive Surgery for Post-Cataract Refractive Surprise Moataz El Sawy Departmentof Ophthalmology, Faculty of Medicine,MenoufiyaUniversity, Egypt mfelsawy@yahoo.co.uk Abstract: Purpose: To evaluate
More informationSurgical Management of Irregular Astigmatism
Peer-Reviewed Literature: Surgical Management of Irregular Astigmatism Editor: Ming Wang, MD, PhD, Clinical Associate Professor of Ophthalmology at the University of Tennessee and Director of the Wang
More informationWavefront-guided Excimer Laser Vision Correction After Multifocal IOL Implantation
Wavefront-guided Excimer Laser Vision Correction After Multifocal IOL Implantation Bettina B. Jendritza, MD; Michael C. Knorz, MD; Steve Morton ABSTRACT PURPOSE: To investigate the use of wavefront-guided
More informationHow To Implant A Keraring
Corneal Remodeling Using the Keraring A variety of thicknesses, arc lengths, and optical zone sizes allows tailoring of the procedure to the individual patient. BY DOMINIQUE PIETRINI, MD; AND TONY GUEDJ
More informationRichard S. Hoffman, MD. Clinical Associate Professor of Ophthalmology Oregon Health & Science University
Zeiss Mel 80 and Visumax Refractive Laser Systems Richard S. Hoffman, MD Clinical Associate Professor of Ophthalmology Oregon Health & Science University No Financial Interest ZEISS Workstation CRS-Master
More informationPriyanka Chhadva, 1 Florence Cabot, 1,2 Anat Galor, 1,3 and Sonia H. Yoo 1,2. 1. Introduction. 2. Case Presentation
Case Reports in Ophthalmological Medicine Volume 2, Article ID 5925, 4 pages http://dx.doi.org/1.15/2/5925 Case Report Long-Term Outcomes of Radial Keratotomy, Laser In Situ Keratomileusis, and Astigmatic
More informationRefractive Surgery. Evolution of Refractive Error Correction
Refractive Surgery Techniques that correct for refractive error in the eye have undergone dramatic evolution. The cornea is the easiest place to place a correction, so most techniques have focused on modifying
More informationSurface Ablation After Corneal
Surface Ablation After Corneal Surgery: Management of Haze Helen K. Wu, MD New England Eye Center Tufts University School of Medicine Boston, MA Financial Disclosures Travel Stipend/Honoraries: IOP Ophthalmics
More informationPatient-Reported Outcomes with LASIK (PROWL-1) Results
Patient-Reported Outcomes with LASIK (PROWL-1) Results Elizabeth M. Hofmeister, MD CAPT, MC, USN Naval Medical Center San Diego Refractive Surgery Advisor for Navy Ophthalmology Assistant Professor of
More informationCataract Surgery after Myopic Refractive Procedures. Ray Guard Eye Center Huang Wei-Jen, MD
Cataract Surgery after Myopic Refractive Procedures Ray Guard Eye Center Huang Wei-Jen, MD Financial Disclosures : * No financial interest on products mentioned Cataract Surgery after Myopic Refractive
More informationIncreasing cost of health care 2010 Prevalence of Cataract Patients: 24.4 M (NEI/NIH) of patients age 40+
7/27/15 Comanaging Modern Cataract Surgery: Guiding patients through Advanced Technology and Optimizing Surgical Outcomes Disclosures: Robert S. Stutman, OD, MBA, FAAO Alcon Speaker s Alliance Select Eye
More informationAccelerated Refractive Performance
Accelerated Refractive Performance Get There at the Speed of WaveLight Designed to accommodate your refractive technology goals now and into the future, the WaveLight Workstation is a faster way to get
More informationBY JOHN F. DOANE, MD, FACS; PERRY S. BINDER, MD, MS; PARAG A. MAJMUDAR, MD; LOUIS E. PROBST, MD; STEPHEN G. SLADE, MD, FACS; AND WILLIAM B
What Is Your Diagnosis? Surgeons discuss their analyses of various topographies of possibly keratoconic cases and converse about their treatment recommendations. BY JOHN F. DOANE, MD, FACS; PERRY S. BINDER,
More informationComparison Combined LASIK Procedure for Ametropic Presbyopes and Planned Dual Interface for Post-LASIK Presbyopes Using Small Aperture Corneal Inlay
Comparison Combined LASIK Procedure for Ametropic Presbyopes and Planned Dual Interface for Post-LASIK Presbyopes Using Small Aperture Corneal Inlay Minoru Tomita, MD, PhD 1,2 1) Shinagawa LASIK, Tokyo,
More informationKerry D. Solomon, MD, is Director of the Carolina Eyecare Research Institute at Carolina Eyecare Physicians in Charleston, S.C.
I think the ideal diagnostic technology for all of us would be a device where we could take a measurement, make an adjustment based on the patient s history, including past surgery, and come up with an
More informationLooking for Keratoconus
07.31.06 Screening for LASIK: Tips and Techniques Surgeons share helpful strategies for identifying which patients are good candidates and which could be trouble. Christopher Kent, Senior Editor Screening
More informationWavefront Analysis of Flap & Laser-induced aberrations in 2-step LASIK. Ann Laurenzi, O.D. Cole Eye Institute Cleveland Clinic Foundation
Wavefront Analysis of Flap & Laser-induced aberrations in 2-step LASIK Ann Laurenzi, O.D. Cole Eye Institute Cleveland Clinic Foundation Co-Authors Maria Regina Chalita, M.D. Samra Waheed, M.D. Meng Xu,
More informationRefracOve Cataract Surgery
Disclosures Advances in Cataract Surgery 2014 Doug Devries, O.D. February 2014 Douglas K. Devries Consultant or Speakers Bureau for Allergan AMO Odyssey Medical Essilor B & L TearLab Nicox Akorn Premium
More informationWVI Co-management Update 2012
WVI Co-management Update 2012 Ming Wang, MD, PhD Clinical Associate Professor of Ophthalmology, UT International President, Shanghai Aier Eye Hospital Director, Wang Vision Institute Attending Surgeon,
More informationCase Report: Fitting of a Mini-Scleral Lens on a Post-RK and Post-LASIK Irregular Cornea
Case Report: Fitting of a Mini-Scleral Lens on a Post-RK and Post-LASIK Irregular Cornea Sonja Iverson-Hill Michigan College of Optometry Senior Intern 1 Case Report: Fitting of a Mini-Scleral Lens on
More informationIs LASIK Good Enough? 75% of flights have a CL wearer 53% of all EVAs have either a spectacle or CL wearer Microbial keratitis has occurred
Optical Correction of Astronauts 21 Sept 27: NASA Approves LASIK 75% of flights have a CL wearer 53% of all EVAs have either a spectacle or CL wearer Microbial keratitis has occurred Staph epi Presbyopia
More informationWhat is the main target for all phaco surgeons?
CORRECTION C O OF ASTIGMATISM DURING CATARACT SURGERY Abdallah dllh K. Hassouna, M.D. Sherein S. Wahba, M.D. Ain Shams University 2009 Main target What is the main target for all phaco surgeons? Main Target
More informationInformed Consent for Refractive Lens Exchange (Clear Lens Replacement)
Drs. Fine, Hoffman and Packer, LLC PHYSICIANS AND SURGEONS, EyeMDs OPHTHALMOLOGY I. Howard Fine, M.D. Richard S. Hoffman, M.D. Mark Packer, M.D. 1550 Oak Street, Suite 5 www.finemd.com Eugene, OR 97401-7701
More informationLasik Xtra in: Hyperopia AK Xtra Clear cornea cataract surgery
Lasik Xtra in: Hyperopia AK Xtra Clear cornea cataract surgery A. John Kanellopoulos, M.D. Clinical Profesor of Ophthalmology New York University School of Medicine, New York, NY, USA Laservision.gr Institute,
More informationExcimer Laser Eye Surgery
Excimer Laser Eye Surgery This booklet contains general information that is not specific to you. If you have any questions after reading this, ask your own physician or health care worker. They know you
More informationLASER VISION CORRECTION SURGERY A GUIDE FOR PATIENTS. Professional care for your eye health
LASER VISION CORRECTION SURGERY A GUIDE FOR PATIENTS Professional care for your eye health Contents About Dr John Males... 1 COMMON QUESTIONS How does an eye work?... 2 What is Myopia (short sightedness)...
More informationAgain, thank you for trusting Shady Grove Ophthalmology!
Dear Valued Patient, Thank you for choosing Shady Grove Ophthalmology for your Cataract procedure. Our excellent staff is committed to offering you the highest quality eye care using state of the art technologies.
More informationFor the cover focus on decision-making in refractive surgery in this issue, we asked CRST Europe Editorial
Evaluate This: Surgeon- Submitted Case Presentations A panel of refractive surgery experts proposes treatment plans for a variety of cases. BY SUPHI TANERI, MD; ROBERT EDWARD T. ANG, MD; DETLEF HOLLAND,
More informationVA high quality, complications low with phakic IOL
Page 1 of 5 VA high quality, complications low with phakic IOL Use in keratoconus will continue, one surgeon predicts; another ponders long-term safety Nov 1, 2007 By:Nancy Groves Ophthalmology Times Several
More informationLASIK following previous eye Surgery
AAO Anaheim 2003 Course 584 Nov18th, 2-415PM LASIK following previous eye Surgery A. John Kanellopoulos, MD Associate Clinical Professor, NYU Medical School Director: Laservision.gr Eye Institute, Athens,
More informationRefractive Surgery. Common Refractive Errors
Refractive Surgery Over the last 25 years developments in medical technology and Refractive Surgery allow almost all need for glasses and contact lenses to be eliminated. Currently there are a number of
More informationOverview of Refractive Surgery
Overview of Refractive Surgery Michael N. Wiggins, MD Assistant Professor, College of Health Related Professions and College of Medicine, Department of Ophthalmology Jones Eye Institute University of Arkansas
More informationLASIK Wavefront Guided idesign LASIK with IntraLase
LASIK Wavefront Guided idesign LASIK with IntraLase What is LASIK? LASIK (Laser Assisted In-Situ Keratomileusis), commonly referred to as laser eye surgery or laser vision correction is a safe High Definition
More informationEmil William Chynn, MD, FACS, MBA Park Avenue LASEK 333 Park Avenue South, New York, NY dr@parkavenuelasek.com
Emil William Chynn, MD, FACS, MBA Park Avenue LASEK 333 Park Avenue South, New York, NY dr@parkavenuelasek.com Evolu&on of Refrac&ve Surgery RK, AK (Fyodorov Russia/Ukraine) PRK (Trokel & L Esperance,
More informationOMNI EYE SPECIALISTS. The Intraocular Lens
OMNI EYE SPECIALISTS Intraocular Lens Options In Cataract Surgery Or Refractive Lens Exchange Surgery Your decision to have vision surgery is important and the doctors at Omni Eye Specialists will explain
More informationFemto-LASIK. Pulsewidth: Ultrashort-pulse micro- machining can make sub- wavelength holes. micromachining
All-laser laser LASIK (Femto( Femto-LASIK) Femto-LASIK 台 大 眼 科 王 一 中 IntraLase 2/1 Perfect Vision Ziemer (DaVinci) Carl Zeiss Meditec Pulsewidth: Femtosecond laser (Nd:Glass)) 153 nm (near infrared) Each
More informationConsumer s Guide to LASIK
Consumer s Guide to LASIK A Community Service Project brought to you by Price Vision Group Your Guide To A Successful LASIK Procedure The purpose of this educational guide is to help prospective patients
More informationRefractive Errors & Correction
Super Vision 6 Chapter Lasik is currently the most sophisticated procedure for correction of refractive errors. Lasik is an acronym for Laser Assisted Insitu Keratomileusis. In Lasik, Excimer laser is
More informationCross-Linking with Refractive Surgery: Pros and Cons
Cross-Linking with Refractive Surgery: Pros and Cons Raj K. Rajpal, M.D. Medical Director and Founder See Clearly Vision Group Mclean, Virginia Clinical Associate Professor Georgetown University Washington,
More informationAcknowledgements. National Statistics - Trends. 2014 Monterey Symposium. Hmmmmm.. Part deux. U.S. Statistics.. Or things that make you go hmmm
2014 Monterey Symposium Surgical Options for Presbyopes: Corneal Based and Lens Based Jimmy Jackson, OD, FAAO President InSight Lasik Acknowledgements I have received honoraria from Alcon Laboratories,
More informationEuropa Scleral Case Studies. (877) 533-1509 www.visionary-optics.com 1325 Progress Drive Front Royal, VA 22630
Europa Scleral Case Studies (877) 533-1509 www.visionary-optics.com 1325 Progress Drive Front Royal, VA 22630 Visionary Case Study Doctors Matt Kauffman, OD, FAAO Dr. Matt Kauffman, OD, FAAO, graduated
More informationManagement of Astigmatism in Cataract Surgery
Management of Astigmatism in Cataract Surgery Jonathan B. Rubenstein, M Vice- Chairman and eutsch Family Professor of Ophthalmology irector of Refractive Surgery Rush University Medical Center Financial
More informationMedical Director, Shinagawa LASIK Center, Tokyo, Japan Adjunct Professor, Department of Ophthalmology, Wenzhou Medical College, Wenzhou, China
Medical Director,, Tokyo, Japan Adjunct Professor, Department of Ophthalmology, Wenzhou Medical College, Wenzhou, China Financial disclosure: Ziemer Group AG, Switzerland AcuFocus, CA Schwind Eye-Tech-Solutions,
More informationIrregular astigmatism:
Irregular astigmatism: definition, classification, topographic and clinical presentation Ming X. Wang, MD, PhD Clinical Associate Professor of Ophthalmology of University of Tennessee Director, Wang Vision
More informationUPDATE ON AVEDRO CROSSLINKING STUDIES
UPDATE ON AVEDRO CROSSLINKING STUDIES Peter S. Hersh, M.D. Director, Cornea & Laser Eye Institute CLEI Center for Keratoconus Clinical Professor of Ophthalmology, Rutgers Medical School Visiting Researcher,
More information415.922.9500 www.pacificvision.org
Issue 046 September 2012 efocus Excellence in Co-Managed Care P A C I F I C V I S I O N I N S T I T U T E Life in Focus 415.922.9500 www.pacificvision.org Last month, we held a dinner with the Bay Area
More informationDisclosure. Disclosure. Background. Do Believe Me. Course Objective(s) Thank You. A Survival Guide to Refractive Surgery Recommendations 12/16/2010
A Myope, a Hyperope, an Astigmat and a Presbyope Walk into an Optometry Office.. Disclosure A Survival Guide to Refractive Surgery Recommendations Carl H. Spear, OD, FAAO Pensacola, Florida Consultant
More informationThe vision care specialists
The vision care specialists Imagine a world without glasses and contact lenses. Why not join the millions of people around the world who are already enjoying the life changing benefits of a vision correction
More informationAlexandria s Guide to LASIK
Alexandria s Guide to LASIK A Community Service Project sponsored by: Wallace Laser Center Your Guide To A Successful LASIK Procedure The word LASIK is actually an acronym for Laser Assisted In-Situ Keratomileusis.
More informationManaging Astigmatism in your Cataract Practice
Managing Astigmatism in your Cataract Practice KAREN S. BACHMAN, COMT, COE, OCS THE EYE INSTITUTE OF UTAH Disclaimer Ms. Bachman: Member of Alcon Speakers Alliance Mr. Larson: Employee of Corcoran Consulting
More informationPseudo-accommodative Cornea (PAC) for the Correction of Presbyopia
Pseudo-accommodative Cornea (PAC) for the Correction of Presbyopia Alaa El Danasoury, FRCS Magrabi Hospitals & Centers Surgical options for the Correction of Presbyopia Monovision Reversal of Presbyopia:
More informationBy Dr Waleed Al-Tuwairqi, MD Dr Omnia Sherif, MD Ophthalmology Consultants, Elite Medical & Surgical Center Riyadh -KSA.
By Dr Waleed Al-Tuwairqi, MD Dr Omnia Sherif, MD Ophthalmology Consultants, Elite Medical & Surgical Center Riyadh -KSA Rome, Italy 2013 بسم الرحمن الرحيم In the name of Allah, Most Gracious, Most Merciful
More informationTHE NVISION ANSWER BOOK
THE NVISION ANSWER BOOK LASIK CATARACTS TABLE OF CONTENTS LASIK: CO-MANAGEMENT WITH NVISION 1 Role of the Optometrist 2 LASIK: Process Overview 3 Process Details 4 Pre-Surgical Evaluation 5 & 6 Post-Procedure
More informationICRS implantation with the Femto LDV laser in stabilized KC patients: 6 months results
ICRS implantation with the Femto LDV laser in stabilized KC patients: 6 months results Jérôme C. VRYGHEM, M.D. Brussels Eye Doctors Brussels, Belgium No financial interest! A lot of KC patients show interest
More informationInsert to October 2013 THE COMPLETE PICTURE. Experiences with the ALADDIN system. Sponsored by Topcon
Insert to October 2013 THE COMPLETE PICTURE Experiences with the ALADDIN system Sponsored by Topcon THE COMPLETE PICTURE Advantages of The Aladdin How this all-in-one optical biometer edged out the IOLMaster
More informationHow To Treat Eye Sight Problems With Eye Care
Dealing With The Refractive Surprise Richard S. Hoffman, MD Clinical Associate Professor of Ophthalmology Casey Eye Institute Oregon Health and Science University No Financial Interest Why The Surprise?
More informationLASIK and Refractive Surgery. Laser and Lens Vision Correction Options
LASIK and Refractive Surgery Laser and Lens Vision Correction Options For over 30 years, The Eye Institute of Utah has been giving people vision for life... Dr. Andrew Lyle, vision pioneer and founder
More informationEUROPEAN JOURNAL OF PHARMACEUTICAL AND MEDICAL RESEARCH www.ejpmr.com
ejpmr, 2015,2(3), 436-440 EUROPEAN JOURNAL OF PHARMACEUTICAL AND MEDICAL RESEARCH www.ejpmr.com Tumram et al. SJIF Impact Factor 2.026 Research Article ISSN 3294-3211 EJPMR CLINICAL OUTCOME OF TORIC IOL
More informationPATIENT CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK)
INTRODUCTION: You have been diagnosed with myopia (nearsightedness) or hyperopia (farsightedness) with or without astigmatism, or astigmatism alone. Myopia is a result of light entering the eye and focusing
More informationREFRACTIVE ERROR AND SURGERIES IN THE UNITED STATES
Introduction REFRACTIVE ERROR AND SURGERIES IN THE UNITED STATES 150 million wear eyeglasses or contact lenses 2.3 million refractive surgeries performed between 1995 and 2001 Introduction REFRACTIVE SURGERY:
More informationINTRACOR. An excerpt from the presentations by Dr Luis Ruiz and Dr Mike Holzer and the Round Table discussion moderated by Dr Wing-Kwong Chan in the
INTRACOR An excerpt from the presentations by Dr Luis Ruiz and Dr Mike Holzer and the Round Table discussion moderated by Dr Wing-Kwong Chan in the 1 Dr Luis Ruiz Presbyopia treatment with INTRACOR Luis
More informationInformed Consent for Refractive Lens Exchange (Clear Lens Extraction)
Informed Consent for Refractive Lens Exchange (Clear Lens Extraction) This form is designed to ensure that you have all the information you need to make a decision about whether or not you wish to undergo
More informationThe cataract laser technology of tomorrow is here for you today.
The cataract laser technology of tomorrow is here for you today. See inside to learn about all your exciting new options See better. Live better. Thanks to new advancements, this is a great time to have
More informationRefractive errors are caused by an imperfectly shaped eyeball, cornea or lens, and are of three basic types:
Tips on Lasik Eye Surgery If you re tired of wearing glasses or contact lenses, you may be considering Lasik eye surgery one of the newest procedures to correct vision problems. Before you sign up for
More information