Intacs microthin prescription inserts (Addition Technology. Original Article

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Intacs microthin prescription inserts (Addition Technology. Original Article"

Transcription

1 Original Article Efficacy of Intacs Intrastromal Corneal Ring Segment Relative to Depth of Insertion Evaluated with Anterior Segment Optical Coherence Tomography Hassan Hashemi 1,2, Alireza Yazdani-Abyaneh 2, Amirhushang Beheshtnejad 2, Mahmood Jabbarvand 2, Ahmad Kheirkhah 2, Seyed Reza Ghaffary 2 ABSTRACT Aim: To evaluate the effect of implantation depth of Intacs microthin prescription inserts (Addition Technology Inc, Fremont, California) on visual and topographic outcomes in patients with post- laser-assisted in situ keratomileusis (LASIK) ectasias. Settings and Design: Retrospective, observational case series. Materials and Methods: In this case series, 16 eyes of 12 patients were evaluated. All cases were post-lasik ectasia that had undergone intrastromal corneal ring segment (ICRS) implantation. The planned insertion depth was 70% of stromal thickness using a manual dissector. At least 12 months postoperatively, all eyes underwent Visante (Carl Zeiss Meditec) AS-OCT to determine insertion depth. Cases were categorized into 3 groups based on the measured implantation depth: 40-59% thickness; 60-79% thickness; and 80% thickness. Visual, refractive and topographic outcomes were evaluated relative to implantation depth. Results: The lowest improvement in the study parameters ocurred when the implantation depth was 80%. In this group, uncorrected visual acuity (UCVA) and best spectacle corrected VA (BSCVA) improved less than 0.5 lines. Manifest refractive spherical equivalent (MRSE) and mean keratometry (Km) change was less than 0.5 diopters (D). The greatest improvements were observed with implantation depth of 60-79% where UCVA and BSCVA increased by 4.5 and 2.5 lines respectively, and MRSE and Km changed by approximately 2.00 D. Less improvement was found when ICRS were implanted between 40-59% of stromal thickness. Conclusion: Implantation of ICRS greater than 80% of stromal thickness may have no effect on visual and topographic status. Access this article online Website: DOI: / Quick Response Code: Key words: Intacs implantation depth, Laser-assisted in situ Keratomileusis, optical coherence tomography, post lasik Ectasia, visual Acuity INTRODUCTION Intacs microthin prescription inserts (Addition Technology Inc, Fermont, California) were first developed for the correction of myopia from -1.0 to -3.0 diopters (D). 1,2 These intrastromal corneal ring segments (ICRS) are a 150 degree polymethyl methacrylate segment, hexagonal in cross-section, which are inserted deep into the stroma. ICRS implanation stretches the cornea peripherally resulting in central corneal flattening. 3,4 Colin et al. 5 were the first to implant ICRS for keratoconus. Subsequently, several authors reported on ICRS implantation for keratoconus, 6-23 post-lasik ectasia and pellucid marginal degeneration However, to the best of our knowledge, there are no reports on the effect of insertion or implantation depth 1 Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran, 2 Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran Corresponding Author: Dr. Hassan Hashemi, Noor Eye Hospital, No 96, Esfandiar Blvd., Vali asr Ave. Tehran, , Iran Middle East African Journal of Ophthalmology, Volume 20, Number 3, July - September 2013

2 of ICRS on the outcome. In this study we evaluate the outcome of Intacs ICRS implantation relative to the insertion depth as measured with anterior segment optical coherent tomography (AS-OCT). MATERIALS AND METHODS In this retrospective study, we reviewed the records of all patients who underwent Intacs ICRS implantation for post-lasik ectasia between 2006 and To be included all patients had to have greater than 1 year postoperative follow up. The Institutional Review Board of the Eye Research Center, Farabi Eye Hospital approved this study. All surgeries were performed by an experienced surgeon (H.H). In all cases, 0.45 mm thick segments were implanted. A single segment was implanted for decentered cones, and double segments were implanted for central cones. Surgeries were performed with tetracaine as topical anesthesic. First, the geometric center of the cornea was marked with a blunt Sinskey hook. Then, using a circular marker, the 7.0 mm optical zone and the incision position in the flat meridian were marked. A 0.9 mm vertical incision was made with a calibrated diamond knife to a depth of 70% of the corneal thickness at the insertion location as measured preoperatively using the Pentacam rotating scheimflug camera (Oculus Gmbh, Wetzlar, Germany). After inspecting whether the depth of incision was adequate, a pocketing hook was applied to the base of the incision to create a pocket on either side taking care they were made to an equal level. After placing the vacuum centering guide, the corneal separator was inserted, and the clockwise and counterclockwise dissections were made. Next, the ICRS segment was manually introduced through the incision into the tunnel and advanced until the end was approximately 1.5mm from the incision. Finally, the incision was closed with a 10-0 nylon suture. After surgery, antibiotic and steroid eye-drops four times a day were prescribed, and the suture was removed after six weeks. Patient evaluation The following preoperative and postoperative data were evaluated: uncorrected visual acuity (UCVA); best spectacle corrected visual acuity (BSCVA); manifest refractive spherical equivalent (MRSE); refractive cylinder (RC); steep keratometry reading (K1), flat keratometry reading (K2), mean keratometry (K m =[K1+K2]/2), topographic cylinder (TC=K1-K2) from the EyeSys Corneal Analysis System (EyeSys Technologies, Houston, Tx, USA). UCVA and BSCVA were converted to logmar for statistical analysis. AS-OCT was performed postoperatively using the Visante (Carl Zeiss Meditec, Jena, Germany) to determine the depth at which Intacs segments were implanted into the cornea. The depth of implanted segment was measured at the middle of its length. The stromal thickness was measured over (S1) and under (S2) the segment. Intacs depth was calculated as S1/(S1+S2), and the result was multiplied by 100 to determine the percent of stromal depth at which the ICRS had been inserted. If the two segments had been implanted, then the results of superior and inferior segments were averaged. The cases were categorized into 3 groups based on the measured depth of implantation: 40-59%, 60-79%, and 80% thickness depths. There were no cases with less than 40% implantation depth. Visual, refractive, and topographic outcomes were compared among the three groups. Statistical analysis Data were analyzed with the Statistical Package for Social Sciences software for windows (version 16.0, IBM Inc., Armonk, NY, USA). The Wilcoxon rank-sum test was used to compare preoperative and postoperative values of UCVA, BSCVA, MRSE, RC, K1, K2, K m, and TC. A p value less than 0.05 were statistically significant. RESULTS Sixteen eyes of 12 patients were evaluated. The mean age of the patients was ± 9.2 years (range, 25 years to 54 years) and the male/female and right/left eye ratios were 1:1. Mean follow up time was 23.8 ± 9.11 m (range, 12 m to 24 m). Based on AS-OCT measurements, we had 3 cases (18.8%) in the 40-59% thickness group, 9 cases (56.2%) in the 60-79% thickness, group and 4 cases (25.0%) in the 80% stromal thickness group. Results of the preoperative and last postoperative visits are summarized in Table 1. Table 1: Mean (± standard deviation) values and changes of visual, refractive, and topographic variables before and after surgery in the entire study cohort Preoperative Postoperative Change p value UCVA (logmar) 0.93 (0.43) 0.61 (0.40) 0.32 (0.42) BSCVA (logmar) 0.38 (0.33) 0.21 (0.18) 0.17 (0.25) MRSE (diopter) 4.25 (2.75) 2.67 (1.69) 1.57 (2.43) RC (diopter) 2.73 (1.90) 2.53 (1.11) 0.20 (1.63) K m (diopter) (4.05) (3.90) 1.63 (1.94) TC (diopter) 2.79 (1.76) 2.47 (1.44) 0.32 (1.55) UCVA: Uncorrected Visual Acuity; BSCVA: Best Spectacle Corrected Visual Acuity; MRSE: Manifest Refractive Spherical Equivalent; RC: Refractive Cylinder; K m : mean keratometry; TC: Topographic Cylinder Middle East African Journal of Ophthalmology, Volume 20, Number 3, July - September

3 Table 2: Mean (±standard deviation) change (preoperative versus postoperative) in visual, refractive, and topographic variables relative to the depth of Intacs insertion Intacs depth 40-59% 60-79% 80-99% Total UCVA (logmar) 0.30 (0.43) 0.46 (0.46) 0.02 (0.09) 0.32 (0.42) BSCVA (logmar) 0.11 (0.20) 0.25 (0.30) 0.02 (0.17) 0.17 (0.25) MRSE (diopter) 1.50 (0.75) 2.11 (3.11) 0.43 (0.82) 1.57 (2.43) Km (diopter) 1.87 (0.67) 2.08 (2.40) 0.43 (0.71) 1.63 (1.94) RC (diopter) (1.52) 0.86 (1.81) (0.14) 0.20 (1.63) TC (diopter) (0.64) 0.68 (1.94) 0.32 (0.35) 0.32 (1.55) UCVA: Uncorrected Visual Acuity; BSCVA: Best Spectacle Corrected Visual Acuity; MRSE: Manifest Refractive Spherical Equivalent; RC: Refractive Cylinder; Km: mean keratometry; TC: Topographic Cylinder a b Figure 1: Preoperative (a) and postoperative (b) topography of a patient right eye with post-lasik ectasia that was implanted with a single intrastromal corneal ring segment Refractive and topographic outcome Overall, MRSE and K m decreased by 1.57 ± 2.43 D and 1.6 ± 1.94 D respectively (p <0.05). The outcome was best when the ICRS were implanted to 60-79% of the stromal thickness; MRSE and K m change was 2.11 ± 3.11 D and 2.08 ± 2.40 D, respectively. When the ICRS were implanted into 80-99% of stromal depth, they had little to no effect [Table 2]. RC and TC did not show clinically or statistically significant changes as a result of surgery; overall RC and TC changes were 0.20 ±1.6 3 D and 0.32 ± 0.32 D, respectively (p >0.05, both cases). Astigmatism did not show clinically significant changes after ICRS implantation relative to depth of implantation (p >0.05; Table 2). Figure 2: Anterior segment optical coherence tomography of the right eye Visual outcome Overall, UCVA changed by 0.32 ± 0.42 logmar which is approximately a gain of 3 Snellen lines. BSCVA increased by 0.17 ± 0.25, which correlates a gain of 1.5 Snellen lines. Best outcomes were observed in the 60-79% thickness group. Table 2 presents the visual outcomes relative to insertion depth. DISCUSSION Several authors have demonstrated that ICRS implantation in post-lasik ectasia can improve UCVA and BCVA by approximately 70% However, to the best of our knowledge, there are no reports evaluating the effect of implantation depth in the corneal stroma on the postoperative outcome after ICRS. 236 Middle East African Journal of Ophthalmology, Volume 20, Number 3, July - September 2013

4 a Figure 3: Preoperative (a) and postoperative (b) topography of the same patient left eye b CONCLUSION The corneal stromal depth at which ICRS are implanted may be an important determinant of visual and topographic outcomes after surgery. Implanting ICRS too deep in the stroma (deeper than 80% stromal depth), may have no effect on the corneal curvature. The best stromal depth is 60-79%, and insertion in the stromal depth of 40-59% may have a lower effect. REFERENCES Figure 4: Anterior segment optical coherence tomography of the left eye. As demonstrated in Table 2, UCVA, BSCVA, MRSE, and Km improved most significantly when the ICRS were implanted at 60-79% thickness, but there was little or no effect when the ICRS was implanted deeper than 80%. Results in the 40-59% thickness group were not as favorable as the 60-79% thickness group. Figure 1 shows the preoperative and postoperative topography of an eye with post-lasik ectasia treated with a single ICRS inferiorly. AS-OCT showed a depth of 61% of stromal thickness [Figure 2]. Some steepening right above the Intacs that might lead to central flattening was observed. Figure 3 shows the topography of the same patient s left eye which underwent implantation of a single ICRS inferiorly. However, this segment was inserted at 83% thickness [Figure 4]. No curvature change occurred over the ICRS and thus, no central flattening was expected. Corneal topography at 24 months postoperatively demonstrated no significant changes in keratometric power. 1. Schanzlin DJ, Asbell PA, Burris TE, Durrie DS. The intrastromal corneal ring segments; phase II results for the correction of myopia. Ophthalmology 1997;104: Burris TE. Intrastromal corneal ring technology: Results and indications. Curr Opin Ophthalmol 1998;9: Burris TE, Ayer CT, Evensen DA, Davenport JM. Effects of intrastromal corneal ring size and thickness on corneal flattening in human eyes. Refract Corneal Surg 1991;7: Burris TE, Baker PC, Ayer CT, Loomas BE, Mathis ML, Silvestrini TA. Flattening of central corneal curvature with intrastromal corneal rings of increasing thickness: An eyebank eye study. J Cataract Refract Surg 1993;19 Suppl: Colin J, Cochener B, Savary G, Malet F. Correcting keratoconus with intracorneal rings. J Cataract Refract Surg 2000;26: Shetty R, Kurian M, Anand D, Mhaske P, Narayana KM, Shetty BK. Intacs in advanced keratoconus. Cornea 2008;27: Ertan A, Ozkilic E. Effect of age on outcomes in patients with keratoconus treated by Intacs using a femtosecond laser. J Refract Surg 2008;24: Ertan A, Kamburoglu G. Intacs implantation using femtosecond laser for management of keratoconus: Comparison of 306 cases in different stages. J Cataract Refract Surg 2008;34: Shabayek MH, Alió JL. Intrastromal corneal ring segment implantation by femtosecond laser for keratoconus correction. Ophthalmology 2007;114: Zare MA, Hashemi H, Salari MR. Intracorneal ring segment implantation for the management of keratoconus: Safety and efficacy. J Cataract Refract Surg 2007;33: Middle East African Journal of Ophthalmology, Volume 20, Number 3, July - September

5 11. Kymionis GD, Siganos CS, Tsiklis NS, Anastasakis A, Yoo SH, Pallikaris AI, et al. Long-term follow-up of Intacs in keratoconus. Am J Ophthalmol 2007;143: Alió JL, Shabayek MH, Artola A. Intracorneal ring segments for keratoconus correction: Long-term follow-up. J Cataract Refract Surg 2006;32: Alió JL, Shabayek MH, Belda JI, Correas P, Diez Feijoo E. Analysis of results related to good and bad outcomes of Intacs implantation for keratoconus correction. J Cataract Refract Surg 2006;32: Ertan A, Kamburoglu G, Bahadir M. Intacs insertion with the femtosecond laser for the management of keratoconus. Oneyear results. J Cataract Refract Surg 2006;32: Colin J. European clinical evaluation: Use of Intacs for the treatment of keratoconus. J Cataract Refract Surg 2006;32: Kanellopoulos AJ, Pe LH, Perry HD, Donnenfeld ED. Modified intracorneal ring segment implantations (Intacs) for the management of moderate to advanced keratoconus. Efficacy and complications. Cornea 2006;25: Hellstedt T, Mäkelä J, Uusitalo R, Emre S, Uusitalo R. Treating keratoconus with Intacs corneal ring segments. J Refract Surg 2005;21: Kwitko S, Severo NS. Ferrara intracorneal ring segments for keratoconus. J Cataract Refract Surg 2004;30: Miranda D, Sartori M, Francesconi C, Allemann N, Ferrara P, Campos M. Ferrara intrastromal corneal ring segments for severe keratoconus. J Refract Surg 2003;19: Siganos CS, Kymionis GD, Kartakis N, Theodorakis MA, Astyrakakis N, Pallikaris IG. Management of keratoconus with Intacs. Am J Ophthalmol 2003;135: Boxer Wachler BS, Chandra NS, Chou B, Korn TS, Nepomuceno R, Christie JP. Intacs for keratoconus. Ophthalmology 2003;110: Ruckhofer J, Stoiber J, Twa MD, Grabner G. Correction of astigmatism with short arc-length intrastromal corneal ring segments. Ophthalmology 2003;110: Colin J, Cochener B, Savary G, Malet F, Holmes- Higgin D. Intacs inserts for treating keratoconus. One year results. Ophthalmology 2001;108: Carrasquillo KG, Rand J, Talamo JH. Intacs for keratoconus and post-lasik ectasia: Mechanical versus femtosecond laserassisted channel creation. Cornea 2007;26: Uceda-Montanes A, Toma s JD, Alio JL. Correction of severe ectasia after LASIK with intracorneal ring segments. J Refract Surg 2008;24: Kymionis GD, Tsiklis NS, Pallikaris AI, Kounis G, Diakonis VF, Astyrakakis N, et al. Long-term follow-up of Intacs for post- LASIK corneal ectasia. Ophthalmology 2006;113: Sharma M, Boxer Wachler BS. Comparison of single-segment and double-segment Intacs for keratoconus and post-lasik ectasia. Am J Ophthalmol 2006;141: Polkroy R, Levinger S, Hirsh A. Single Intacs segment for postlaser in situ keratomileusis keratectasia. J Cataract Refract Surg 2004;30: Gu ell JL, Velasco F, Sa nchez SI, Gris O, Garcia-Rojas M. Intracorneal ring segments after laser in situ keratomileusis. J Refract Surg 2004;20: Kymionis GD, Siganos CS, Kounis G, Astyrakakis N, Kalyvianaki MI, Pallikaris IG. Management of post-lasik corneal ectasia with Intacs inserts; One-year results. Arch Ophthalmol 2003;121: Siganos CS, Kymionis GD, Astyrakakis N, Pallikaris IG. Management of corneal ectasia after laser in situ keratomileusis with INTACS. J Refract Surg 2002;18: Lovisolo CF, Fleming JF. Intracorneal ring segments for iatrogenic keratectasia after laser in situ keratomileusis or photorefractive keratectomy. J Refract Surg 2002;18: Alio JL, Salem TF, Artola A, Osman AA. Intracorneal rings to correct corneal ectasia after laser in situ keratomileusis. J Cataract Refract Surg 2002;28: Piñero DP, Alio JL, Uceda-Montanes A, El Kady B, Pascual I. Intracorneal Ring Segment Implantation in Corneas with Post- Laser In Situ Keratomileusis Keratectasia. Ophthalmology 2009;116: Piñero DP, Alió JL, El Kady B, Pascual I. Corneal aberrometric and refractive performance of 2 intrastromal corneal ring segment models in early and moderate ectatic disease. J Cataract Refract Surg 2010;36: Ertan A, Bahadir M. Management of superior pellucid marginal degeneration with a single intracorneal ring segment using femtosecond laser. J Refract Surg 2007;23: Ertan A, Bahadir M. Intrastromal ring segment insertion using a femtosecond laser to correct pellucid marginal corneal degeneration. J Cataract Refract Surg 2006;32: Mularoni A, Torreggiani A, Di Biase A, Laffi GL, Tassinari G. Conservative treatment of early and moderate pellucid marginal degeneration: A new refractive approach with intracorneal rings. Ophthalmology 2005;112: Barbara A, Shehadeh-Masha our R, Zvi R, Garzozi HJ. Management of pellucid marginal degeneration with intracorneal ring segments. J Refract Surg 2005;21: Akaishi L, Tzelikis PF, Raber IM. Ferrara intracorneal ring implantation and cataract surgery for the correction of pellucid marginal corneal degeneration. J Cataract Refract Surg 2004;30: Kymionis GD, Aslanides IM, Siganos CS, Pallikaris IG. Intacs for early pellucid marginal degeneration. J Cataract Refract Surg 2004;30: Rodriguez-Prats J, Galal A, Garcia-Lledo M, De la Hoz F, Alió JL. Intracorneal rings for the correction of pellucid marginal degeneration. J Cataract Refract Surg 2003;29: Cite this article as: Hashemi H, Yazdani-Abyaneh A, Beheshtnejad A, Jabbarvand M, Kheirkhah A, Ghaffary SR. Efficacy of Intacs Intrastromal Corneal Ring Segment Relative to Depth of Insertion Evaluated with Anterior Segment Optical Coherence Tomography. Middle East Afr J Ophthalmol 2013;20: Source of Support: Nil, Conflict of Interest: None declared. 238 Middle East African Journal of Ophthalmology, Volume 20, Number 3, July - September 2013

Efficacy of Intacs Intrastromal Corneal Ring Segments in Patients with Post-LASIK Corneal Ectasia

Efficacy of Intacs Intrastromal Corneal Ring Segments in Patients with Post-LASIK Corneal Ectasia Efficacy of Intacs Intrastromal Corneal Ring Segments in Patients with Post-LASIK Corneal Ectasia Amirhushang Beheshtnejad, MD 1 Alireza Yazdani-Abyaneh, MD 2 Hassan Hashemi, MD 3,4 Mahmoud Jabbarvand,

More information

KERATOCONUS IS A BILATERAL, ASYMMETRIC, CHRONIC,

KERATOCONUS IS A BILATERAL, ASYMMETRIC, CHRONIC, Comparison of and Intacs for Keratoconus and Post-LASIK Ectasia MUNISH SHARMA, MD, AND BRIAN S. BOXER WACHLER, MD PURPOSE: To evaluate the efficacy of single-segment Intacs and compare with double-segment

More information

Corneal aberrometric and refractive performance of 2 intrastromal corneal ring segment models in early and moderate ectatic disease

Corneal aberrometric and refractive performance of 2 intrastromal corneal ring segment models in early and moderate ectatic disease ARTICLE Corneal aberrometric and refractive performance of 2 intrastromal corneal ring segment models in early and moderate ectatic disease David P. Piñero, MSc, Jorge L. Alió, MD, PhD, Bassam El Kady,

More information

Case Reports Post-LASIK ectasia treated with intrastromal corneal ring segments and corneal crosslinking

Case Reports Post-LASIK ectasia treated with intrastromal corneal ring segments and corneal crosslinking Case Reports Post-LASIK ectasia treated with intrastromal corneal ring segments and corneal crosslinking Kay Lam, MD, Dan B. Rootman, MSc, Alejandro Lichtinger, and David S. Rootman, MD, FRCSC Author affiliations:

More information

Intacs for keratoconus Yaron S. Rabinowitz

Intacs for keratoconus Yaron S. Rabinowitz Intacs for keratoconus Yaron S. Rabinowitz Purpose of review The use of Intacs as a therapeutic modality in contact lens intolerant patients with mild to moderate keratoconus is increasingly gaining acceptance

More information

Single-Segment and Double-Segment INTACS for Post-LASIK Ectasia. Received: 8 Mar. 2013; Accepted: 8 Oct. 2013

Single-Segment and Double-Segment INTACS for Post-LASIK Ectasia. Received: 8 Mar. 2013; Accepted: 8 Oct. 2013 ORIGINAL ARTICLE Single-Segment and Double-Segment INTACS for Post-LASIK Ectasia Hassan Hashemi 1, Ali Gholaminejad 1, Kazem Amanzadeh 1, Maryam Hashemi 2, and Mehdi Khabazkhoob 3 1 Noor Ophthalmology

More information

NEW SURGICAL APPROACHES TO THE MANAGEMENT OF KERATOCONUS AND POST-LASIK ECTASIA

NEW SURGICAL APPROACHES TO THE MANAGEMENT OF KERATOCONUS AND POST-LASIK ECTASIA NEW SURGICAL APPROACHES TO THE MANAGEMENT OF KERATOCONUS AND POST-LASIK ECTASIA BY Bryan U. Tan MD, Tracy L. Purcell PhD, Luis F. Torres MD PhD, AND David J. Schanzlin MD* ABSTRACT Purpose: The objective

More information

INTRASTROMAL CORNEAL RING SEGMENTS

INTRASTROMAL CORNEAL RING SEGMENTS CLINICAL POLICY INTRASTROMAL CORNEAL RING SEGMENTS Policy Number: VISION 026.6 T2 Effective Date: April 1, 2013 Table of Contents CONDITIONS OF COVERAGE... COVERAGE RATIONALE BENEFIT CONSIDERATIONS BACKGROUND...

More information

Management of Unpredictable Post-PRK Corneal Ectasia with Intacs Implantation

Management of Unpredictable Post-PRK Corneal Ectasia with Intacs Implantation Management of Unpredictable Post-PRK Corneal Ectasia with Intacs Implantation Mohammad Naser Hashemian, MD 1 Mahdi AliZadeh, MD 2 Hassan Hashemi, MD 1,3 Firoozeh Rahimi, MD 4 Abstract Purpose: To present

More information

INTRASTROMAL CORNEAL RING SEGMENTS

INTRASTROMAL CORNEAL RING SEGMENTS MEDICAL POLICY INTRASTROMAL CORNEAL RING SEGMENTS Policy Number: 2014T0486J Effective Date: February 1, 2014 Table of Contents COVERAGE RATIONALE... BENEFIT CONSIDERATIONS... BACKGROUND... CLINICAL EVIDENCE...

More information

Long-term follow-up of intrastromal corneal ring segments in keratoconus

Long-term follow-up of intrastromal corneal ring segments in keratoconus ARTICLE Long-term follow-up of intrastromal corneal ring segments in keratoconus Leonardo Torquetti, MD, PhD, Rodrigo Fabri Berbel, MD, Paulo Ferrara, MD, PhD PURPOSE: To report the long-term follow-up

More information

THE IMPLANTATION OF SMALL ARC-LIKE POLYMETHYL

THE IMPLANTATION OF SMALL ARC-LIKE POLYMETHYL One-Year Results of Intrastromal Corneal Ring Segment Implantation (KeraRing) using Femtosecond Laser in Patients with Keratoconus EFEKAN COSKUNSEVEN, GEORGE D. KYMIONIS, NIKOLAOS S. TSIKLIS, SERIFE ATUN,

More information

TREATMENT OF KERATOCONUS WITH INTACS INTRASTROMAL RINGS ICI (7 MM) AND ISK (6 MM). UP TO 3 YEARS IN 72 EYES.

TREATMENT OF KERATOCONUS WITH INTACS INTRASTROMAL RINGS ICI (7 MM) AND ISK (6 MM). UP TO 3 YEARS IN 72 EYES. TREATMENT OF KERATOCONUS WITH INTACS INTRASTROMAL RINGS ICI (7 MM) AND ISK (6 MM). UP TO 3 YEARS IN 72 EYES. Manuel Ignacio Vejarano Restrepo, MD Head Department of Cornea and Refractive Surgery Medical

More information

Evaluation of intrastromal corneal ring segments for treatment of post-lasik ectasia patients with a mechanical implantation technique

Evaluation of intrastromal corneal ring segments for treatment of post-lasik ectasia patients with a mechanical implantation technique Original Article Evaluation of intrastromal corneal ring segments for treatment of post-lasik ectasia patients with a mechanical implantation technique Zeki Tunc, Firat Helvacioglu, Sadik Sencan Aim: To

More information

Keratoconus is one of the most challenging corneal

Keratoconus is one of the most challenging corneal 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 information

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE INTERVENTIONAL PROCEDURES PROGRAMME Interventional procedure overview of corneal implants for keratoconus Keratoconus is a disease of the cornea which

More information

INTACS Inserts Using the Femtosecond Laser Compared to the Mechanical Spreader in the Treatment of Keratoconus

INTACS Inserts Using the Femtosecond Laser Compared to the Mechanical Spreader in the Treatment of Keratoconus INTACS Inserts Using the Femtosecond Laser Compared to the Mechanical Spreader in the Treatment of Keratoconus Yaron S. Rabinowitz, MD; Xiaohui Li, MD; Teresa S. Ignacio, MD; Ezra Maguen, MD ABSTRACT PURPOSE:

More information

Intracorneal Ring Segments Implantation Followed by Same-day Topography-guided PRK and Corneal Collagen CXL in Low to Moderate Keratoconus

Intracorneal Ring Segments Implantation Followed by Same-day Topography-guided PRK and Corneal Collagen CXL in Low to Moderate Keratoconus SURGICAL TECHNIQUE Intracorneal Ring Segments Implantation Followed by Same-day Topography-guided PRK and Corneal Collagen CXL in Low to Moderate Keratoconus Waleed Al-Tuwairqi, MD; Mazen M. Sinjab, MD,

More information

Retreatment 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 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 information

Corneal intrastromal implantation surgery for the treatment of moderate and high myopia

Corneal intrastromal implantation surgery for the treatment of moderate and high myopia TECHNIQUE Corneal intrastromal implantation surgery for the treatment of moderate and high myopia Albert Daxer, MD, PhD I describe a corneal intrastromal implantation technique that uses a new type of

More information

Implantation of a Complete Corneal Ring in an Intrastromal Pocket for Keratoconus

Implantation of a Complete Corneal Ring in an Intrastromal Pocket for Keratoconus NEW TECHNIQUE Implantation of a Complete Corneal Ring in an Intrastromal Pocket for Keratoconus Haifa Mahmood, MD; R.S. Venkateswaran, OD; Albert Daxer, MD, PhD ABSTRACT PURPOSE: To evaluate the refractive

More information

Simultaneous Topography-guided PRK Followed by Corneal Collagen Cross-linking for Keratoconus

Simultaneous Topography-guided PRK Followed by Corneal Collagen Cross-linking for Keratoconus Simultaneous Topography-guided PRK Followed by Corneal Collagen Cross-linking for Keratoconus George D. Kymionis, MD, PhD; Georgios A. Kontadakis, MD, MSc; George A. Kounis, PhD; Dimitra M. Portaliou,

More information

Refractive, Tomographic and Biomechanical Outcomes after Implantation of Ferrara ICRS in Keratoconus Patients

Refractive, Tomographic and Biomechanical Outcomes after Implantation of Ferrara ICRS in Keratoconus Patients 10.5005/jp-journals-10025-1003 José M Salgado-Borges et al ORIGINAL ARTICLE Refractive, Tomographic and Biomechanical Outcomes after Implantation of Ferrara ICRS in Keratoconus Patients José M Salgado-Borges,

More information

Corporate Medical Policy Implantation of Intrastromal Corneal Ring Segments

Corporate Medical Policy Implantation of Intrastromal Corneal Ring Segments Corporate Medical Policy Implantation of Intrastromal Corneal Ring Segments File Name: Origination: Last CAP Review: Next CAP Review: Last Review: implantation_of_intrastromal_corneal_ring_segments 8/2008

More information

FIRST 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 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 information

Post LASIK Ectasia. Examination: Gina M. Rogers, MD and Kenneth M. Goins, MD

Post LASIK Ectasia. Examination: Gina M. Rogers, MD and Kenneth M. Goins, MD Post LASIK Ectasia Gina M. Rogers, MD and Kenneth M. Goins, MD October 6, 2012 Chief Complaint: Decreasing vision after laser- assisted in- situ keratomileusis (LASIK) History of Present Illness: This

More information

Total Corneal Astigmatism Correction With Limbal Relaxing Incisions Made by Femtosecond Laser System

Total Corneal Astigmatism Correction With Limbal Relaxing Incisions Made by Femtosecond Laser System Total Corneal Astigmatism Correction With Limbal Relaxing Incisions Made by Femtosecond Laser System Pilavas J 2, Nissirios N 1,2, Hatsis A 1,2 1 Long Island Vision Experts, Rockville Centre, NY and 2

More information

POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS DISCLAIMER CODING INFORMATION REFERENCES POLICY HISTORY

POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS DISCLAIMER CODING INFORMATION REFERENCES POLICY HISTORY Original Issue Date (Created): July 1, 2002 Most Recent Review Date (Revised): January 27, 2015 Effective Date: April 1, 2015 POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT

More information

Intrastromal corneal ring segment implantation for high astigmatism after penetrating keratoplasty

Intrastromal corneal ring segment implantation for high astigmatism after penetrating keratoplasty ARTICLE Intrastromal corneal ring segment implantation for high astigmatism after penetrating keratoplasty Pedro Arriola-Villalobos, MD, David Díaz-Valle, MD, PhD, Jose Luis Güell, MD, PhD, María Teresa

More information

Refractive errors, such as residual astigmatism after

Refractive errors, such as residual astigmatism after CLINICAL SCIENCE Intrastromal Corneal Ring Segment Implantation by Femtosecond Laser for the Correction of Residual Astigmatism After Penetrating Keratoplasty Tatiana Moura Bastos Prazeres, MD,* Allan

More information

Long-Term Outcomes of Flap Amputation After LASIK

Long-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 information

INTACS Inserts for Treating Keratoconus

INTACS Inserts for Treating Keratoconus INTACS Inserts for Treating Keratoconus One-year Results Joseph Colin, MD, 1 Béatrice Cochener, MD, 2 Gwenaelle Savary, Orthoptist, 2 Florence Malet, MD, 1 Debby Holmes-Higgin, MS, MPH 3 Objective: To

More information

Laser in situ keratomileusis (LASIK) has been. Retreatment of Hyperopia After Primary Hyperopic LASIK REPORTS

Laser in situ keratomileusis (LASIK) has been. Retreatment of Hyperopia After Primary Hyperopic LASIK REPORTS REPORTS Retreatment of Hyperopia After Primary Hyperopic LASIK Julio Ortega-Usobiaga, MD, PhD; Rosario Cobo-Soriano, MD, PhD; Fernando Llovet, MD; Francisco Ramos, MD; Jaime Beltrán, MD; Julio Baviera-Sabater,

More information

How do we use the Galilei for cataract and refractive surgery?

How 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 information

Ectasia after laser in-situ keratomileusis (LASIK)

Ectasia after laser in-situ keratomileusis (LASIK) Ectasia after laser in-situ keratomileusis (LASIK) 長 庚 紀 念 醫 院 眼 科 蕭 靜 熹 Post-LASIK ectasia A rare complication of LASIK Manhattan jury awarded a former investment banker a record $7.25 million for post-lasik

More information

European clinical evaluation: Use of Intacs for the treatment of keratoconus

European clinical evaluation: Use of Intacs for the treatment of keratoconus J CATARACT REFRACT SURG - VOL 32, MAY 2006 European clinical evaluation: Use of Intacs for the treatment of keraconus Joseph Colin, MD PURPOSE: To evaluate the safety and efficacy of Intacs inserts in

More information

INTACS vs Cross-Linking for Keratoconus

INTACS vs Cross-Linking for Keratoconus INTACS vs Cross-Linking for Keratoconus Tomaso Caporossi MD Policlinico A. Gemelli -Roma Istituto di Oculistica Siena X-Linking: 1 Corso Nazionale Abilitante Keratoconus Non inflammatory progressive corneal

More information

Conductive keratoplasty (CK) utilizes radiofrequency energy. Original Article

Conductive keratoplasty (CK) utilizes radiofrequency energy. Original Article Original Article Comparing the Rate of Regression after Conductive Keratoplasty with or without Prior Laser-Assisted in situ Keratomileusis or Photorefractive Keratectomy Majid Moshirfar, Erik Anderson

More information

Validation of a New Scoring System for the Detection of Early Forme of Keratoconus

Validation of a New Scoring System for the Detection of Early Forme of Keratoconus 10.5005/jp-journals-10025-1019 Alain Saad, Damien Gatinel ORIGINAL ARTICLE Validation of a New Scoring System for the Detection of Early Forme of Keratoconus Alain Saad, Damien Gatinel ABSTRACT Purpose:

More information

5/24/2013 ESOIRS 2013. Moderator: Alaa Ghaith, MD. Faculty: Ahmed El Masri, MD Mohamed Shafik, MD Mohamed El Kateb, MD

5/24/2013 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 information

Surgical Advances in Keratoconus. Keratoconus. Innovations in Ophthalmology. New Surgical Advances. Diagnosis of Keratoconus. Scheimpflug imaging

Surgical 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 information

ICRS 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 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 information

Refractive Surgery Ring segments still valuable for keratoconus treatment

Refractive Surgery Ring segments still valuable for keratoconus treatment Refractive Surgery Ring segments still valuable for keratoconus treatment by Michelle Dalton EyeWorld Contributing Editor AT A GLANCE Intrastromal ring segments can stabilize the keratoconic cornea up

More information

Mirko R. Jankov II, MD PhD (1) Efekan Coskunseven, MD (2)

Mirko R. Jankov II, MD PhD (1) Efekan Coskunseven, MD (2) Combined intrastromal corneal rings (KeraRing) and corneal collagen crosslinking (UV-X) in patients with keratoconus which is the right treatment sequence? Mirko R. Jankov II, MD PhD (1) Efekan Coskunseven,

More information

Journal of American Science 2014;10(8) http://www.jofamericanscience.org

Journal of American Science 2014;10(8) http://www.jofamericanscience.org Management of Early Post LASIK Ectasia by using Corneal Collagen Cross-Linking Abdalla M. Elamin MD. Ophthalmology Department, Faculty of Medicine, Al Azhar University, Cairo, Egypt Abstract: Purpose:

More information

Topography guided custom ablation treatment for treatment of keratoconus

Topography guided custom ablation treatment for treatment of keratoconus Symposium: Keratoconus Topography guided custom ablation treatment for treatment of keratoconus Rohit Shetty, Sharon D Souza, Samaresh Srivastava 1, R Ashwini Keratoconus is a progressive ectatic disorder

More information

Keratoconus Detection Using Corneal Topography

Keratoconus Detection Using Corneal Topography Keratoconus Detection Using Corneal Topography Jack T. Holladay, MD, MSEE, FACS ABSTRACT PURPOSE: To review the topographic patterns associated with keratoconus suspects and provide criteria for keratoconus

More information

Comparison 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 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 information

Collagen cross-linking should be done separately. Canan Asli Utine, MD, MSc, FICO Yeditepe University, Istanbul, Turkey

Collagen cross-linking should be done separately. Canan Asli Utine, MD, MSc, FICO Yeditepe University, Istanbul, Turkey Collagen cross-linking should be done separately Canan Asli Utine, MD, MSc, FICO Yeditepe University, Istanbul, Turkey Collagen cross linking 1st established tx addressing the pathophysiology of corneal

More information

Corneal Collagen Cross-Linking for Ectasia after LASIK and Photorefractive Keratectomy

Corneal Collagen Cross-Linking for Ectasia after LASIK and Photorefractive Keratectomy Corneal Collagen Cross-Linking for Ectasia after LASIK and Photorefractive Keratectomy Long-Term Results Olivier Richoz, MD, 1 Nikolaos Mavrakanas, MD, 1 Bojan Pajic, MD, PhD, 1 Farhad Hafezi, MD, PhD

More information

California Optometric Association Home February 2012

California Optometric Association Home February 2012 California Optometric Association CE @ Home February 2012 Contact Lens Fitting for Keratoconic Patient with Intrastromal Corneal Ring Segments (Intacs) Dr. Jennifer Hsieh graduated and completed her residency

More information

REFRACTIVE AND THERAPEUTIC OPHTHALMOLOGY PROCEDURES

REFRACTIVE AND THERAPEUTIC OPHTHALMOLOGY PROCEDURES REFRACTIVE AND THERAPEUTIC OPHTHALMOLOGY PROCEDURES Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan.

More information

Keratoconus surgery: what works best and why-

Keratoconus surgery: what works best and why- Keratoconus surgery: what works best and why-./-0&1#-!"#$%%&'&(%&)*-+,-,23$45&3*-6")$372)2&#/83-9#):5(5$*-.51$#)*-;3$$4$-

More information

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

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 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 information

Alain Saad, MD, Alice Grise-Dulac, MD, Damien Gatinel, MD, PhD

Alain Saad, MD, Alice Grise-Dulac, MD, Damien Gatinel, MD, PhD CASE REPORT Bilateral loss in the quality of vision associated with anterior corneal protrusion after hyperopic LASIK followed by intrastromal femtolaser-assisted incisions Alain Saad, MD, Alice Grise-Dulac,

More information

Corneal collagen crosslinking with riboflavin and ultraviolet A to treat induced keratectasia after laser in situ keratomileusis

Corneal collagen crosslinking with riboflavin and ultraviolet A to treat induced keratectasia after laser in situ keratomileusis ARTICLE Corneal collagen crosslinking with riboflavin and ultraviolet A to treat induced keratectasia after laser in situ keratomileusis Farhad Hafezi, MD, John Kanellopoulos, MD, Rainer Wiltfang, MD,

More information

Comparison of Corneal Power and Intraocular Lens Power Calculation Methods after LASIK for Myopia. Abstract

Comparison of Corneal Power and Intraocular Lens Power Calculation Methods after LASIK for Myopia. Abstract Comparison of Corneal Power and Intraocular Lens Power Calculation Methods after LASIK for Myopia Seyed Mohammad Reza Taheri, MD 1 Azita Kheiltash, MD, MPH 2 Hassan Hashemi, MD 1,3 Abstract Purpose: To

More information

Common Co-management Questions

Common 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 information

MEDICAL POLICY SUBJECT: REFRACTIVE PROCEDURES

MEDICAL POLICY SUBJECT: REFRACTIVE PROCEDURES MEDICAL POLICY REVISED DATE: 12/02/04, 12/02/05, 12/07/06, 12/13/07 PAGE: 1 OF: 6 If the member's subscriber contract excludes coverage for a specific service it is not covered under that contract. In

More information

Intraoperative Complications of Laser in Situ Keratomileusis in Yazd

Intraoperative Complications of Laser in Situ Keratomileusis in Yazd Ophthalmology Research: An International Journal 2(4): 196-203, 2014, Article no. OR.2014.003 SCIENCEDOMAIN international www.sciencedomain.org Intraoperative Complications of Laser in Situ Keratomileusis

More information

THE BEST OF BOTH WORLDS Dual-Scheimpflug and Placido Reaching a new level in refractive screening

THE BEST OF BOTH WORLDS Dual-Scheimpflug and Placido Reaching a new level in refractive screening THE BEST OF BOTH WORLDS Dual-Scheimpflug and Placido Reaching a new level in refractive screening GALILEI G4 Clinical Applications Corneal Implant Planning The comes with a licensable corneal inlay software

More information

CLASSICALLY, THERAPEUTIC. Keratoconus Managed With Intacs. One-Year Results CLINICAL SCIENCES. Samuel Levinger, MD; Russell Pokroy, MD

CLASSICALLY, THERAPEUTIC. Keratoconus Managed With Intacs. One-Year Results CLINICAL SCIENCES. Samuel Levinger, MD; Russell Pokroy, MD CLINICL SCIENCES Keratoconus Managed With Intacs One-Year Results Samuel Levinger, MD; Russell Pokroy, MD Objectives: To describe the visual outcome of keratoconus managed with Intacs implantation (ddition

More information

Corneal ectasia induced by laser in situ keratomileusis. Ioannis G. Pallikaris, MD, PhD, George D. Kymionis, MD, PhD, Nikolaos I.

Corneal ectasia induced by laser in situ keratomileusis. Ioannis G. Pallikaris, MD, PhD, George D. Kymionis, MD, PhD, Nikolaos I. Corneal ectasia induced by laser in situ keratomileusis Ioannis G. Pallikaris, D, PhD, George D. Kymionis, D, PhD, Nikolaos I. Astyrakakis, OD ABSTRACT Purpose: To identify factors that can lead to corneal

More information

Refractive Surgery Issue. Inlays and Presbyopia: On the Horizon P. 24. Crack a SMILE or Raise a Flap? P. 30. LASIK Xtra: Who Should Get It? P.

Refractive Surgery Issue. Inlays and Presbyopia: On the Horizon P. 24. Crack a SMILE or Raise a Flap? P. 30. LASIK Xtra: Who Should Get It? P. MULTIMODAL IMAGING OF PLACOID DISORDERS P. 42 WILLS RESIDENT CASE SERIES P. 67 NTG: THE NOCTURNAL BLOOD PRESSURE FACTOR P. 54 WISE CHOICES FOR OCULAR DIAGNOSES P. 50 NEW WAYS TO DETECT KERATOCONUS P. 58

More information

EUROPEAN JOURNAL OF PHARMACEUTICAL AND MEDICAL RESEARCH www.ejpmr.com

EUROPEAN 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 information

Keratoconus is described in the literature as a corneal

Keratoconus is described in the literature as a corneal Cornea Intracorneal Ring Segment in Keratoconus: A Model to Predict Visual Changes Induced by the Surgery Pablo Peña-García, 1 Alfredo Vega-Estrada, 1,2 Rafael I. Barraquer, 3,4 Neus Burguera-Giménez,

More information

Refractive Surgery. Evolution of Refractive Error Correction

Refractive 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 information

VA high quality, complications low with phakic IOL

VA 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 information

Overview of Refractive Surgery

Overview 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 information

Comparing Femtosecond Lenticule Extraction (FLEx) and Femtosecond Laser In-situ Keratomileusis (LASIK) for Myopia and Astigmatism

Comparing Femtosecond Lenticule Extraction (FLEx) and Femtosecond Laser In-situ Keratomileusis (LASIK) for Myopia and Astigmatism Original Article Philippine Journal of OPHTHALMOLOGY Comparing Femtosecond Lenticule Extraction (FLEx) and Femtosecond Laser In-situ Keratomileusis (LASIK) for Myopia and Astigmatism Tina Marie Saban-Roa,

More information

Artisan Phakic Intraocular Lens for the Correction of Severe Myopic Astigmatism

Artisan Phakic Intraocular Lens for the Correction of Severe Myopic Astigmatism Artisan Phakic Intraocular Lens for the Correction of Severe Myopic Astigmatism Hassan Hashemi, MD 1,2 Mansour Taherzadeh, MD 1 Mehdi Khabazkhoob, MSc 1 Abstract Purpose: To determine and evaluate the

More information

OCT-guided Femtosecond Laser for LASIK and Presbyopia Treatment

OCT-guided Femtosecond Laser for LASIK and Presbyopia Treatment Shinagawa LASIK Center OCT-guided Femtosecond Laser for LASIK and Presbyopia Treatment Minoru Tomita, MD, Ph.D 1) Executive Medical Director at Shinagawa LASIK Center, Tokyo, Japan 2) Clinical Professor

More information

Collagen Cross-linking combined with PRK and LASIK

Collagen Cross-linking combined with PRK and LASIK Collagen Cross-linking combined with PRK and LASIK./*0&1#*!"#$%%&'&(%&)2*+,* +$345"%*,46$57&62*8")$694)4&#/:6*;#)%4#45"%*?6&@$))&62*ABC*8"#:&#$*+$345"%*D51&&%2*AB!"#$%%&'&(%&)*+,!

More information

Transepithelial Crosslinking vs. Corneal Pocket Crosslinking. Christoph Kranemann MD Anna Yu OD

Transepithelial Crosslinking vs. Corneal Pocket Crosslinking. Christoph Kranemann MD Anna Yu OD Transepithelial Crosslinking vs. Corneal Pocket Crosslinking Christoph Kranemann MD Anna Yu OD Rome 2013 We have no financial interests in this presentation. Corneal collagen cross linking Creates new

More information

LASIK SURGERY IN AL- NASSIRYA CITY A CLINICOSTATISTICAL STUDY

LASIK SURGERY IN AL- NASSIRYA CITY A CLINICOSTATISTICAL STUDY Thi-Qar Medical Journal (TQMJ): Vol(4) No(4):1(14-21) SUMMARY: LASIK SURGERY IN AL- NASSIRYA CITY A CLINICOSTATISTICAL STUDY Dr. Ali Jawad AL- Gidis (M.B.Ch.B., D.O., F.I.C.O.)* Background: LASIK which

More information

ABLATION-RELATED COMPLICATIONS FOLLOWING

ABLATION-RELATED COMPLICATIONS FOLLOWING Topographically Supported Customized Ablation for the Management of Decentered Laser In Situ Keratomileusis GEORGE D. KYMIONIS, MD, PHD, SOPHIA I. PANAGOPOULOU, BSC, IOANNIS M. ASLANIDES, MD, PHD, SOTIRIS

More information

VISX Wavefront-Guided LASIK for Correction of Myopic Astigmatism, Hyperopic Astigmatism and Mixed Astigmatism (CustomVue LASIK Laser Treatment)

VISX 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 information

Corneal collagen crosslinking for keratoconus and corneal ectasia: One-year results

Corneal collagen crosslinking for keratoconus and corneal ectasia: One-year results ARTICLE Corneal collagen crosslinking for keratoconus and corneal ectasia: One-year results Peter S. Hersh, MD, Steven A. Greenstein, Kristen L. Fry, OD, MS PURPOSE: To evaluate 1-year outcomes of corneal

More information

Comparison 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 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 information

The pinnacle of refractive performance.

The 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 information

Calculation of intraocular lens (IOL) power for

Calculation of intraocular lens (IOL) power for A New Method of Calculating Intraocular Lens Power After Photorefractive Keratectomy Nicola Rosa, MD; Luigi Capasso, MD; Antonio Romano, MD ABSTRACT PURPOSE: To find a method of calculating intraocular

More information

Combined Corneal Collagen Cross-linking and Mini Asymmetric Radial Keratotomy for the Treatment of Keratoconus

Combined Corneal Collagen Cross-linking and Mini Asymmetric Radial Keratotomy for the Treatment of Keratoconus Original Article Combined Corneal Collagen Cross-linking and Mini Asymmetric Radial Keratotomy for the Treatment of Keratoconus Marco Abbondanza 1, Barmak Abdolrahimzadeh 2, Margherita Guidobaldi 3 1 Head

More information

Femtosecond Laser-Assisted Astigmatism Correction

Femtosecond Laser-Assisted Astigmatism Correction 13 Femtosecond Laser-Assisted Astigmatism Correction Duna Raoof-Daneshvar and Shahzad I. Mian University of Michigan, W.K. Kellogg Eye Center, USA 1. Introduction Femtosecond lasers generate ultrashort

More information

Topographically-guided Laser In Situ Keratomileusis to Treat Corneal Irregularities

Topographically-guided Laser In Situ Keratomileusis to Treat Corneal Irregularities Topographically-guided Laser In Situ Keratomileusis to Treat Corneal Irregularities Michael C. Knorz, MD, Bettina Jendritza, MD Objective: To evaluate the predictability and safety of topographically guided

More information

Medical Policy Vision Surgeries for Refractive Errors

Medical Policy Vision Surgeries for Refractive Errors Medical Policy Vision Surgeries for Refractive Errors Effective Date: April 1, 2016 Subject: Vision Surgeries for Refractive Errors Overview: Vision surgeries are surgical procedures and/or laser treatments

More information

Pentacam HR Criteria for Curvature Change in Keratoconus and Postoperative LASIK Ectasia

Pentacam HR Criteria for Curvature Change in Keratoconus and Postoperative LASIK Ectasia Pentacam HR Criteria for Curvature Change in Keratoconus and Postoperative LASIK Ectasia Robert L. Epstein, MD, MSEE; Yi-Lin Chiu, PhD; Greg L. Epstein, BS ABSTRACT PURPOSE: To determine criteria for keratoconus

More information

Keratoconus is a bilateral, nonsymmetric, and noninflammatory

Keratoconus is a bilateral, nonsymmetric, and noninflammatory CASE REPORT Collagen Cross-Linking (CCL) With Sequential Topography-Guided PRK A Temporizing Alternative for Keratoconus to Penetrating Keratoplasty A. John Kanellopoulos, MD* and Perry S. Binder, MS,

More information

Long-term stability of the posterior cornea after laser in situ keratomileusis

Long-term stability of the posterior cornea after laser in situ keratomileusis ARTICLE Long-term stability of the posterior cornea after laser in situ keratomileusis Joseph B. Ciolino, MD, Stephen S. Khachikian, MD, Michael J. Cortese, OD, Michael W. Belin, MD PURPOSE: To study long-term

More information

ORIGINAL ARTICLES. Anastasios John Kanellopoulos, MD; Perry S. Binder, MS, MD

ORIGINAL ARTICLES. Anastasios John Kanellopoulos, MD; Perry S. Binder, MS, MD ORIGINAL ARTICLES Management of Corneal Ectasia After LASIK With Combined, Same-day, Topographyguided Partial Transepithelial PRK and Collagen Cross-linking: The Athens Protocol Anastasios John Kanellopoulos,

More information

Unilateral Corneal Ectasia after Bilateral LASIK: The Thick Flap Counts

Unilateral Corneal Ectasia after Bilateral LASIK: The Thick Flap Counts 10.5005/jp-journals-10025-1056 Case Report IJKECD Unilateral Corneal Ectasia after Bilateral LASIK: The Thick Flap Counts Bruno Freitas Valbon, Renato Ambrosio Jr, Juliana Glicéria, Rodrigo Santos, Allan

More information

UPDATE ON AVEDRO CROSSLINKING STUDIES

UPDATE 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 information

Current Surgical Options for Visual Rehabilitation in Keratoconus

Current Surgical Options for Visual Rehabilitation in Keratoconus ESCRS EUROTIMES Supplement April 2011 Current Surgical Options for Visual Rehabilitation in Keratoconus Friday 3 September 2010 Hotel Concorde Lafayette Paris, France Sponsors: Jérôme C Vryghem Introduction

More information

INTRODUCTION. Trans Am Ophthalmol Soc 2006;104:402-413

INTRODUCTION. Trans Am Ophthalmol Soc 2006;104:402-413 ORBSCAN II ASSISTED INTRAOCULAR LENS POWER CALCULATION FOR CATARACT SURGERY FOLLOWING MYOPIC LASER IN SITU KERATOMILEUSIS (AN AMERICAN OPHTHALMOLOGICAL SOCIETY THESIS) BY Henry Gelender MD ABSTRACT Purpose:

More information

Introducing TOPOGRAPHY-GUIDED REFRACTIVE SURGERY

Introducing TOPOGRAPHY-GUIDED REFRACTIVE SURGERY Sponsored by Introducing TOPOGRAPHY-GUIDED REFRACTIVE SURGERY Results of the T-CAT Phase III Clinical Trial TOPOGRAPHY-GUIDED REFRACTIVE SURGERY Topography-Guided Custom Ablation Treatments (T-CAT) with

More information

Laser in Situ Keratomileusis versus Laser Assisted Subepithelial Keratectomy for the Correction of Low to Moderate Myopia and Astigmatism

Laser in Situ Keratomileusis versus Laser Assisted Subepithelial Keratectomy for the Correction of Low to Moderate Myopia and Astigmatism Laser in Situ Keratomileusis versus Laser Assisted Subepithelial Keratectomy for the Correction of Low to Moderate Myopia and Astigmatism Seyed Javad Hashemian, MD 1 Hossein Aghaei, MD 2 Alireza Foroutan,

More information

Keratoconus is a common ectatic

Keratoconus is a common ectatic Abstract Keratoconus is a common ectatic disorder occurring in more than 1 in 1000 individuals. The condition typically starts in adolescence and early adulthood. It is a disease with an uncertain cause

More information

LASIK, Epi LASIK and PRK Past present and future

LASIK, Epi LASIK and PRK Past present and future LASIK, Epi LASIK and PRK Past present and future Ioannis G. Pallikaris MD, PhD Institute of Vision and Optics University of Crete Medical School Heraklion Crete Greece Photorefractive Keratectomy Kerr-Muir

More information

Bitoric Laser In Situ Keratomileusis for the Correction of Simple Myopic and Mixed Astigmatism

Bitoric Laser In Situ Keratomileusis for the Correction of Simple Myopic and Mixed Astigmatism Bitoric Laser In Situ Keratomileusis for the Correction of Simple Myopic and Mixed Astigmatism Arturo S. Chayet, MD, 1 Miguel Montes, MD, 1 Laura Gómez, MD, 1 Xavier Rodríguez, MD, 1 Nora Robledo, OD,

More information

Enhancement of femtosecond lenticule extraction for visual symptomatic eye after myopia correction

Enhancement of femtosecond lenticule extraction for visual symptomatic eye after myopia correction Zhao et al. BMC Ophthalmology 2014, 14:68 CASE REPORT Open Access Enhancement of femtosecond lenticule extraction for visual symptomatic eye after myopia correction Jing Zhao, Peijun Yao, Zhi Chen, Meiyan

More information

Comparison of Sequential vs Same-day Simultaneous Collagen Cross-linking and Topography-guided PRK for Treatment of Keratoconus

Comparison of Sequential vs Same-day Simultaneous Collagen Cross-linking and Topography-guided PRK for Treatment of Keratoconus Comparison of Sequential vs Same-day Simultaneous Collagen Cross-linking and Topography-guided PRK for Treatment of Keratoconus Anastasios John Kanellopoulos, MD ABSTRACT PURPOSE: The safety and effi cacy

More information