Diadenosine polyphosphates after laser in situ keratomileusis and photorefractive keratectomy refractive techniques

Size: px
Start display at page:

Download "Diadenosine polyphosphates after laser in situ keratomileusis and photorefractive keratectomy refractive techniques"

Transcription

1 Diadenosine polyphosphates after laser in situ keratomileusis and photorefractive keratectomy refractive techniques Gonzalo Carracedo, 1 Isabel Cacho, 2 Juan Sanchez-Naves 2 and Jesus Pintor 3 1 Department of Optics II (Optometry and Vision), Faculty of Optics, Universidad Complutense de Madrid, Madrid, Spain 2 Instituto Balear de Oftalmologı a, Palma de Mallorca, Spain 3 Department of Biochemistry and Molecular Biology IV, Faculty of Optics, Universidad Complutense de Madrid, Madrid, Spain ABSTRACT. Purpose: To study the concentrations of diadenosine polyphosphates in the ocular surface after and. Methods: Sixty-one patients (30 males and 31 females) with ages ranging from 20 to 63 (34.04 ± 9.13 years) were recruited in Balear Institute of Ophthalmology, Palma de Mallorca, Spain. was performed in 92 eyes of 46 patients and in 25 eyes of 15 patients. Variations in the levels of diadenosine polyphosphate (Ap 4 A and Ap 5 A), Schirmer I (Jones test), TBUT, corneal staining together with the Dry Eye Questionnaire to evaluate discomfort and dryness were studied. All tests were performed at the preoperative visit and at 1-day, 2-week, 1-month and 3-month postoperative visits. Results: Ap 4 A showed a 5 and 3.5 fold increase at the 1-day visit for and, respectively. patients continued having higher statistically significant concentrations (p = 0.01) all over the follow-up. Ap 5 A showed no significant differences at any visit. Tear volume decreased during the 3 months in. The cases had a normal volume at 1 month. TBUT in increased at the 1-day visit (p = 0,002) and decreased from the 2 weeks onwards and for the, decreased by a 35% at the 1-day visit and kept reduced for a month. Discomfort only increased at the 1-day visit (p = 0.007). Dryness frequency was similar in all visits. Conclusions: Ap 4 A levels only are increased in refractive surgery patients during the first day after the surgery. This increasing suggests that Ap 4 A may help accelerating the healing process. Key words: dinucleotides dry eye wound healing Acta Ophthalmol. 2014: 92: e5 e11 ª 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd. doi: /aos Introduction Laser in situ keratomileusis () and photorefractive keratectomy () are safe and effective refractive surgery methods producing similar refractive outcomes. Both techniques produce changes in ocular surface increasing dry eye sensation (Nejima et al. 2005; Toda 2008). In, debridement of corneal epithelium and stromal ablation damages the corneal sensory nerves. On the other hand, in, the lamellar flat cut induces sensory deprivation by severing deeper stromal nerve. This nerve ablation strongly suggests several ocular surface problems including tear function (Perez-Santonja et al. 1999). Several studies relate differences depending on refractive surgery technique used regarding the associated dry eye. It seems that produces stronger eye dryness than. Patients submitted to refractive surgery present a decrease in tear secretion, blink rate, corneal and conjunctival epithelial integrity and conjunctival goblet cell density when compared with normal individuals. These alterations decrease tear film stability and may lead to dry eye symptoms during the first year after surgery (Benitez-del-Castillo et al. 2001; Rodriguez-Prats et al. 2007). The Dry Eye Workshop proposed to diagnose dry eye combining the use of a validated questionnaire regarding symptoms, a test to evaluate ocular surface damage, the measurement of tear instability and tear secretion, and tear hyperosmolarity (listed] 2007). However, it is necessary to be aware that the diagnosis of dry eye is difficult due to the poor correlation between dry eye signs and symptoms (Nichols et al. 2004). Analytical techniques are providing valuable information about new e5

2 components in tears that may have important biochemical and physiological functions (Peral et al. 2008). Among these new tear components, diadenosine polyphosphate emerge as interesting compounds due to their intracellular and extracellular physiological actions. In the tear film, it is known that diadenosine tetraphosphate (Ap 4 A) and diadenosine pentaphosphate (Ap 5 A) concentrations rise in patients with dry eye symptoms and Sjo gren s syndrome, suggesting the possibility that these compounds could be objective markers to score dry eye (Peral et al. 2006; Carracedo et al. 2010). Moreover, a single-dose topical application of the dinucleotide Ap 4 Ain rabbits can stimulate tear secretion, giving this compound a secretagogue action (Pintor et al. 2002a,b). Another role of this dinucleotide on the ocular surface Ap 4 A is improving the rate of corneal wound healing in New Zealand white rabbits (Pintor et al. 2004). Due to the involvement of diadenosine polyphosphates in the ocular surface physiopathology, it is a matter of interest to investigate a possible relationship of this substance in refractive surgery patients. With this aim, the present experimental work describes variations in the levels of diadenosine polyphosphate (Ap 4 A and Ap 5 A), during 3 months after and. Furthermore, we examined tear secretion and its stability, corneal staining and discomfort and dryness symptoms, which may be related during dry eye. Methods The study was conducted in compliance with good clinical practice guidelines, informed consent regulations and the tenets of the Declaration of Helsinki (WMA, 2008). The study was approved by the Balear Institute of Ophthalmology IRB. All of the subjects enrolled in the study were adults older than 18 years who were able to give informed consent. Patients Sixty-one patients (30 men and 31 women) with ages ranging from 20 to 63 (average ± 9.13 years) were recruited. was performed in 92 eyes of 46 patients and in 25 eyes of 15 patients. More detailed demographic characteristics of the population being sampled are shown in Table 1. We followed the inclusion and exclusion criteria for dry eye and did not include any cases or severe dry eye or Sjo gren s syndrome at the preoperative visit. Patients were subjected to a complete preoperative ophthalmic examination including the tests for this study. Postoperative visits were scheduled at 1 day, 2 weeks, 1 and 3 months after surgery. Surgery procedures All surgeries were performed by the same surgeon (J.S.N) using the Technolas 217 flying spot excimer laser system, version V (BAUSCH & LOMB, Irvine, CA, USA). Laser parameters included the following: wavelength of 193 nm, radiant exposure (Fluence) of 160 mj cm 2, pulse repetition rate of 50 Hz, average ablation depth pulse of 0.25 lm on the cornea and an ablation zone diameter from 6.5 to 7 mm with a transition zone of 0.5 mm. For all eyes, preoperative manifest refraction was selected as the target correction. For cases, the XP automated microkeratome (BAUSCH & LOMB, Irvine, CA, USA) was used to create a superior-hinged corneal flap (120 or 140 lm head plates). These patients were prescribed topical antibiotic and steroid drops (Tobradex, Alcon, Fort Worth, TX, USA) every 6 hr for 5 days. Artificial tears (Oculotec, Novartis, Basel, Switzerland) were also prescribed a minimum of four times per day. In cases of severe symptoms signs, patients were changed to other artificial tears containing hyaluronic acid (Hyaback, Thea, Barcelone, Spain). Artificial tears were prescribed for a minimum of 6 weeks but as long as needed. The technique was only applied to patients who had up to a maximum of )3.00 dioptres. Only BSS solution was used to soften the epithelial cell layer and then a blade to scrape and remove it. After, Tobradex drops were prescribed and tapered during a month (reducing from 4 times day during the first week to 3, 2 and finally 1 time day during the fourth week). Artificial tears were prescribed following the same criteria than that used for patients. Finally, a bandage contact lens was applied straight after the surgery and worn for 5 days. Trials Tear secretion was measured using the Schirmer I test (Jones test) with anaesthesia. The tear collection was always performed following van Bijsterveld criteria (van Bijsterveld 1969). The Schirmer strip (Tear Flo, HUB pharmaceuticals, Rancho Cucamonga, CA, USA) was placed on the temporal tarsal conjunctiva of the lower lid for 5 min with the eyes closed. The volume of tears, as millimetres of moistened strip, was recorded and the Schirmer strips were placed in Eppendorf tubes containing 500 ll of ultrapure water, then the samples were frozen until the high-pressure liquid chromatography (HPLC) analysis was performed (Peral et al. 2006). After Schirmer I test (Jones test) with anaesthesia, fluorescein was applied to evaluate TBUT and corneal staining. In order to warrant repeatability of the staining procedure, a solution was prepared using a 10% concentration of sodium fluorescein diluted in saline (NaCL 0.9%). For each application, a micropipette with 5 ll of diluted fluorescein solution was applied in the inferior conjunctival sac, and 20 seconds later, TBUT was analysed using a chronograph to record the time to break after the patient was asked to blink twice and remain with the eyes open. The cornea Table 1. Demographic information of the population enrolled in the study. Parameter Total Number of eyes (patients) 117 (61) 92 (46) 25 (15) Mean age (years) ± SD ± ± ± 9.85 Age range (years) [20, 63] [20, 61] [24, 63] Gender (male female) [30, 31] [22, 26] [8, 5] Mean spherical equivalent (D) ± SD )2.06 ± 2.42 )2.21 ± 2.6 )1.35 ± 0.88 Range of spherical equivalent (D) [)6.38, 5.63] [)6.38, 5.63] [)2.50, 0.88] e6

3 was divided in five areas to record the grading staining as proposed the Report of the National Eye Institute and Industry-Sponsored Dry Eye Workshop and the Cornea and Contact Lens Research Unit (CCLRU) grading scales was used. We asked the patients to quantify typical symptoms of dry eye: discomfort and dryness. For this, they had to assess the frequency from 0 to 5, being five the maximum. These questions were taken from Dry Eye Questionnaire (DEQ) performed by Begley et al. (2001). Tear processing and HPLC analysis After thawing, the samples were strongly vortexed for 5 min. The strips were carefully rinsed and the liquid in the Eppendorf tube was heated in a 100 C bath for 20 min to precipitate proteins. In order to pellet the proteins, the tubes were centrifuged at 3500 g for 30 min. Diadenosine polyphosphates are not degraded by this treatment as previously demonstrated (15). Supernatants were chromatographed through SEP-PAK Accell QMA cartridges (16). Briefly, 250 ll of the supernatant was passed through the cartridges that were previously equilibrated with 3 ml of ultrapure water. The elution of the nucleotides and dinucleotides was performed by applying 1 ml of a solution containing 0.2 m KCl, 0.1 m HCl. Prior to injection into the HPLC, samples were neutralized with KOH. This eluents were injected at a volume of ll. Determination and quantification of diadenosine polyphosphates were performed by HPLC. The chromatographic system consisted of a Waters 1515 isocratic HPLC pump, a 2487 dual absorbance detector and a Reodyne injector, all managed by the Breeze software from Waters. The column was a Novapack C18 (15 cm length, 0.4 cm diameter) from Waters. The system was equilibrated overnight with the following mobile phase: 0.1 m KH 2 PO 4,2mm tetrabutyl ammonium, 17% acetonitrile, ph 7.5 (12). Detection was monitored at 260 nm wavelength. All the peaks identified as putative dinucleotides were taken for phosphodiesterase treatment. Phosphodiesterase from Crotalus adamanteus, from Sigma (St. Louis, MO, USA; EC ) at a concentration of 1.0 U ml, was incubated at room temperature for 30 min with the corresponding putative dinucleotide. The digestion products were analysed by HPLC. Peaks were transformed into concentrations by means of external standards of known concentrations of diadenosine polyphosphates (Pintor et al. 2002a,b). Statistical analysis Data were analysed by statistical package SPSS, version 15.0 for Windows (SPSS, Inc., Chicago, IL, USA). Sample size calculations were performed with statistical software (Granmo 6.0; Institut Municipal d Investigacio n Medica, Barcelona, Spain). With an accepted two-sided statistical significance threshold of 0.05 and a risk of 0.20, for a standard deviation 0.7 units to the mean and in order to detect a difference of 0.6 units or more, 14 subjects were needed to find statistically significant differences. The values presented are the means ± SEM of the experiments performed. We selected randomly one eye per subject. Normality of distribution was assessed using the Kolgomorov Smirnov test. Parametric test was used to compare the studied groups. Differences between and groups in tears functions test were estimated by the Student s t-test for independent samples. We used the Student s t-test for related samples to assess the differences among different follow-up visits into each group. p < 0.05 was considered statistically significant. Ap4A concentration (μm) Results Diadenosine polyphosphates Ap 4 A increases its concentration in tears in both and surgery in the next day after surgery, being increased 5 and 3.5 fold compared with the preoperative visit, respectively. After 1 month, Ap 4 A continues its increased concentration in patients with statistically significant p value (p = 0.007). For patients, Ap 4 A concentrations returned to baseline levels after 2 weeks, although the samples collected 1 month after the surgery, Ap 4 A showed lower concentrations than before surgery. The significant difference found between and patients in Ap 4 A concentration was obtained 1 month after surgery (p < 0.05). In the case of Ap 5 A, it remained stable during the 3 months of study. (Figs 1 and 2, Table 2). Tear schirmer For patients, tear volume was lower from the day after surgery and so on, being statistically significant after 2 weeks (p < 0.001), with a reduction by 30%. At 3 months, the tear volume decreased around 20% compared with preoperative values (p = 0.01). On the other hand, in surgery, tear volume at first day was 65% higher than the preoperative (p < 0.001), returning to normal values 1 month after the intervention. We found statistically significant differences between and patients during the first 2 weeks (Fig. 3, Table 2). Fig. 1. Concentrations of Ap 4 A during 3-month follow-up, both (46 patients; 92 eyes) and (15 patients; 25 eyes) surgeries. p value <0.05 versus. t-student test. e7

4 Ap5A concentration (μm) Tear break-up time Fig. 2. Concentrations of Ap 5 A during 3-month follow-up, both (46 patients; 92 eyes) and (15 patients; 25 eyes) surgeries. t-student test. Table 2. Comparisons between baseline and different follow-up visits in and patients Test Visit p Value p value Ap 4 A mean (SEM) Pre-operative (0.027) (0.036) 1 day (0.199) (0.105) weeks (0.097) (0.015) month (0.109) (0.006) months (0.076) (0.019) Ap 5 A mean (SEM) Pre-operative (0.026) (0.054) 1 day (0,026) (0.026) weeks (0.008) (0.017) month (0.003) months (0.027) Schirmer (mm) mean (SEM) Pre-operative (2.76) (1.69) 1 day (2.66) (0.81) < weeks (3,11) < (1.41) month (3.34) (1.38) months (2.66) (1.36) BUT mean (SEM) Pre-operative (0.64) (1.67) 1 day (2.11) (0.67) weeks (2,65) (0.80) month (1.79) (1.13) months (1.81) (1.07) Corneal staining mean (SEM) Discomfort mean (SEM) Dryness mean (SEM) Pre-operative 0.52 (0.22) 0.57 (0.07) 1 day 1.03 (0.20) (0.1) weeks 1.07 (0.23) (0.1) month 0.65 (0.19) (0.09) months 0.49 (0.17) (0.11) Pre-operative 1.43 (0.14) 1.46 (0.33) 1 day 1.93 (0.12) (0.26) weeks 1.50 (0.10) (0.17) month 1.35 (0.09) (0.20) months 1.08 (0.08) (0.18) Pre-operative 1.21 (0.13) 1.31 (0.29) 1 day 1.47 (0.12) (0.14) weeks 1.64 (0.09) (0.21) month 1.24 (0.07) (0.21) months 1.24 (0.07) (0.22) p < p < Comparison post-operative with pre-operative values. In the case of, TBUT increased slightly next day (p = 0.011), but 2 weeks later, no significant differences with preoperative values were observed. At 3 months, patients showed TBUT values lower than preoperative visit, although it was not statistically significant. TBUT values decreased around 35% the day after surgery. One month after surgery still remained not statistically reduced in tear break-up time. Figure 4 shows a downward trend in patients, whereas in the, TBUT tends to return to initial values. Significant differences have been shown between the two surgeries in the preoperative, next day and 3 months after the surgery (Table 2). Corneal staining Corneal staining was similar in both surgeries, the first 2 weeks being significantly increased (p < 0.05) and returning to initial values 1 month after the surgery (Table 2). Symptoms We evaluated the frequency of two typical dry eye symptoms such as discomfort and dryness. In the case of discomfort, it increased the day after surgery (for both and ), being significant in (p = 0.005) but returning to preoperative values 2 weeks after the surgery. Three months after the surgical procedures, the discomfort frequency decreased, being statistically significant for (p = 0.022). Dryness frequency was similar after surgery than that of preoperative data in both surgical procedures. However, it was statistically significant in at 2 weeks (Table 2). Discussion Nucleotides and dinucleotides are important tear molecules in normal and pathological conditions (Peral et al. 2006; Guzman-Aranguez et al. 2007; Carracedo et al. 2010). The possible changes of these substances on patients submitted to refractive surgery have not yet been investigated. With this aim, we have evaluated the dinucleotide concentrations before and along 3-month postrefractive surgery follows up. Patients selected for this study were operated using two different techniques: and. Independently of the way the surgery has been performed, there was an increase in Ap 4 A levels. Ap 5 A concentration remained stable, with values e8

5 Tear secretion (mm) Fig. 3. Schirmer test with anaesthesia during 3-month follow-up, both (46 patients; 92 eyes) and (15 patients; 25 eyes) surgeries. t-student test. Tear break up time (seconds) Fig. 4. Tear break-up time (TBUT) during 3-month follow-up, both (46 patients; 92 eyes) and (15 patients; 25 eyes) surgeries. p value <0.05 versus. t-student test. lower than those measured at the preoperative stage. As indicated in other studies, Ap 4 A has the ability to accelerate corneal epithelial cell migration. In contrast, a high concentration of Ap 5 A performs the opposite effect of decreasing cell migration (Mediero et al. 2008). Moreover, we have measured Ap 4 A and Ap 5 A concentrations after intraocular collamer lens (ICL) surgery where the damage in the corneal epithelium is minimal. Both dinucleotides levels had a slightly increasing, but it was not statistically significant the day after the surgical procedure (unpublished data). Altogether, these results strongly suggest that the high concentrations of Ap 4 A found the next day of the surgery may help accelerating the healing process as described in animal models (Guzman-Aranguez et al. 2007). Patients undergoing showed elevated concentrations of Ap 4 A during the 3-month follow-up of the study (compared with the preoperative), although it was only statistically significant 1 month after the surgery. Ap 4 A concentration was roughly 2 3- folds lower than that found in patients with symptomatic dry eye and normal lacrimation or patients with Sjo gren s syndrome and normal lacrimation (Carracedo et al. 2010). The diadenosine polyphosphates Ap 4 A and Ap 5 A are released from corneal epithelium due to the shear force produced by the movement of the upper eyelid during the blinking process. The rise in the levels of both diadenosine polyphosphates is concomitant with the increase in the blinking frequency (Pintor et al. 2002a,b) and therefore, the decrease of corneal sensitivity after the surgery could be a factor affecting the release of the Ap 4 A and Ap 5 A (Collins et al. 1989). The tear volume for these patients decreased from the first day after surgery, being statistical significant until 2 weeks. These results are consistent with others that measure tear volume (Siganos et al. 2002) and are linked to a decrease in corneal sensitivity caused by the damage of corneal sensory nerve fibres (Patel et al. 2001; Belmonte et al. 2004). Concerning, these patients showed Ap 4 A concentrations similar to preoperative values from 2 weeks after the surgery. Tear volume in patients increased significantly the first day after surgery but returned to baseline in 1 month, and these results were similar to those found by other authors (Siganos et al. 2000; Lee et al. 2002). The increase of Ap 4 A the day after the surgery could be caused by the corneal epithelial debridement. It would be reasonable to think that higher concentrations of these dinucleotides should be expected, but it is probable that the use of the contact lens affects the dinucleotides concentration, reducing their levels because the shear stress due to the blinking should be less intense. In addition to dinucleotide concentrations and tear secretion, we also assessed TBUT and corneal staining. We observed no significant differences in TBUT in patients during the 3 month of study. Some authors report a reduction in TBUT in and patients (Toda et al. 2001; Konomi et al. 2008), whereas others found no significant differences in or in (Nejima et al. 2005; Mian et al. 2009). Our findings of increased corneal staining during the first 2 weeks in and match with previous findings described by other authors (Toda et al. 2001). There are some studies that indicate an increase in symptoms after and surgery. These works report that dryness and foreign body sensation were the most common ones (Hovanesian et al. 2001; Solomon et al. 2004). In our study, we have found low frequency of symptoms after refractive surgery for both and. These previous studies used different questionnaires to assess the frequency and intensity of a large number of symptoms, and this may be one of the reasons for the differences between those works and ours in which the DEQ is used. It is known that 10% decrease in relative humidity produces 30% of tear evaporation and that this fact e9

6 triggers dry eye symptoms. Low relative humidity conditions (office environment, air-conditioned cars, airplane cabins and extreme hot or cold weather) negatively impact the tear film. On the contrary, an increase in humidity points to a more stable tear film, and, thus, more protection against dryness (McCulley et al. 2006). It is possible that environmental conditions, high relative humidity, in the geographic area where we conducted the study, could have caused a lower frequency of symptoms. It would be interesting to conduct further studies with refractive surgery patients on different environmental conditions to support this hypothesis. Refractive surgery causes nerve damage that decreases corneal sensitivity, and this hypoesthesia would decrease the symptoms. However, it has been reported that during the first 7 9 days after surgery, corneal sensitivity could increase, probably due to a local inflammatory reaction (Gallar et al. 2004).This decrease of sensitivity did not recover until 3 months to 1 year from surgery (Perez-Santonja et al. 1999; Benitez-del-Castillo et al. 2001). During this period of hypoesthesia, nerve endings that were damaged have been repaired and have grown back to innervate the entire corneal surface as originally. This growth is often abnormal, creating microaneuromas that transmit wrong signals or overreacted stimuli which may not exist or that are too mild to cause dryness, called dysesthesia (Gallar et al. 2004). Therefore, symptoms that relate to refractive surgery patients after 3 months, such as sensation of dry eye, do not necessarily reflect a real discomfort and may be due to dysesthesias provoked by a very slight dryness (Toda et al. 2006). There is only a recent study where tear film osmolarity has been measured after refractive surgery, finding an increase at 12 month post. Maybe a limitation of this study would be a period of the study. It would have been interesting to followup these patients for periods longer than 6 months, evaluating tear film osmolarity, in order to see whether or not they develop dry eye and assess potential dysesthesias. In this study, we did not evaluate tear osmolarity because the aim was not only to evaluate dry eye and dinucleotides levels relationship, but also its relationship with wound healing, where dinucleotides have a main role (Pintor et al. 2004). In conclusion, the levels of Ap 4 A are increased in refractive surgery patients during the first day after the surgery. This dinucleotide release may help in the wound healing process. During the first months, these patients do not show dry eye. In this sense, it is necessary to be aware that the diagnosis of dry eye could be misinterpreted. Disclosure The authors do not have any financial interest on the materials and instruments used in this study. References Begley CG, Chalmers RL, Mitchell GL et al. (2001): Characterization of ocular surface symptoms from optometric practices in North America. Cornea 20: Belmonte C, Acosta MC & Gallar J (2004): Neural basis of sensation in intact and injured corneas. Exp Eye Res 78: Benitez-del-Castillo JM, del Rio T, Iradier T, Hernandez JL, Castillo A & Garcia-Sanchez J (2001): Decrease in tear secretion and corneal sensitivity after laser in situ keratomileusis. Cornea 20: van Bijsterveld OP (1969): Diagnostic tests in the Sicca syndrome. Arch Ophthalmol 82: Carracedo G, Peral A & Pintor J (2010): Diadenosine polyphosphates in tears of Sjogren syndrome patients. Invest Ophthalmol Vis Sci 51: Collins M, Seeto R, Campbell L & Ross M (1989): Blinking and corneal sensitivity. Acta Ophthalmol (Copenh) 67: Gallar J, Acosta MC, Moilanen JA, Holopainen JM, Belmonte C & Tervo TM (2004): Recovery of corneal sensitivity to mechanical and chemical stimulation after laser in situ keratomileusis. J Refract Surg 20: Guzman-Aranguez A, Crooke A, Peral A, Hoyle CH & Pintor J (2007): Dinucleoside polyphosphates in the eye: from physiology to therapeutics. Prog Retin Eye Res 26: Hovanesian JA, Shah SS & Maloney RK (2001): Symptoms of dry eye and recurrent erosion syndrome after refractive surgery. J Cataract Refract Surg 27: Konomi K, Chen LL, Tarko RS, Scally A, Schaumberg DA, Azar D & Dartt DA (2008): Preoperative characteristics and a potential mechanism of chronic dry eye after. Invest Ophthalmol Vis Sci 49: Lee BH, McLaren JW, Erie JC, Hodge DO & Bourne WM (2002): Reinnervation in the cornea after. Invest Ophthalmol Vis Sci 43: McCulley JP, Aronowicz JD, Uchiyama E, Shine WE & Butovich IA (2006): Correlations in a change in aqueous tear evaporation with a change in relative humidity and the impact. Am J Ophthalmol 141: Mediero A, Guzman-Aranguez A, Crooke A, Peral A & Pintor J (2008): Corneal re-epithelialization stimulated by diadenosine polyphosphates recruits RhoA ROCK and ERK1 2 pathways. Invest Ophthalmol Vis Sci 49: Mian SI, Li AY, Dutta S, Musch DC & Shtein RM (2009): Dry eyes and corneal sensation after laser in situ keratomileusis with femtosecond laser flap creation Effect of hinge position, hinge angle, and flap thickness. J Cataract Refract Surg 35: Nejima R, Miyata K, Tanabe T, Okamoto F, Hiraoka T, Kiuchi T & Oshika T (2005): Corneal barrier function, tear film stability, and corneal sensation after photorefractive keratectomy and laser in situ keratomileusis. Am J Ophthalmol 139: Nichols KK, Nichols JJ & Mitchell GL (2004): The lack of association between signs and symptoms in patients with dry eye disease. Cornea 23: Patel S, Perez-Santonja JJ, Alio JL & Murphy PJ (2001): Corneal sensitivity and some properties of the tear film after laser in situ keratomileusis. J Refract Surg 17: Peral A, Carracedo G, Acosta MC, Gallar J & Pintor J (2006): Increased levels of diadenosine polyphosphates in dry eye. Invest Ophthalmol Vis Sci 47: Peral A, Dominguez-Godinez CO, Carracedo G & Pintor J (2008): Therapeutic targets in dry eye syndrome. Drug News Perspect 21: Perez-Santonja JJ, Sakla HF, Cardona C, Chipont E & Alio JL (1999): Corneal sensitivity after photorefractive keratectomy and laser in situ keratomileusis for low myopia. Am J Ophthalmol 127: Pintor J, Carracedo G, Alonso MC, Bautista A & Peral A (2002a): Presence of diadenosine polyphosphates in human tears. Pflugers Arch 443: Pintor J, Peral A, Hoyle CH, Redick C, Douglass J, Sims I & Yerxa B (2002b): Effects of diadenosine polyphosphates on tear secretion in New Zealand white rabbits. J Pharmacol Exp Ther 300: Pintor J, Bautista A, Carracedo G & Peral A (2004): UTP and diadenosine tetraphosphate accelerate wound healing in the rabbit cornea. Ophthalmic Physiol Opt 24: Rodriguez-Prats JL, Hamdi IM, Rodriguez AE, Galal A & Alio JL (2007): Effect of suction ring application during on goblet cell density. J Refract Surg 23: Siganos DS, Popescu CN, Siganos CS & Pistola G (2000): Tear secretion following e10

Dry eye after LASIK for myopia: Incidence and risk factors

Dry eye after LASIK for myopia: Incidence and risk factors Shoja:Shoja 30-01-2007 16:32 Pagina 1 European Journal of Ophthalmology / Vol. 17 no. 1, 2007 / pp. 1-6 Dry eye after LASIK for myopia: Incidence and risk factors M.R. SHOJA, M.R. BESHARATI Department

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

Laser-Assisted In Situ Keratomileusis for Patients With Dry Eye

Laser-Assisted In Situ Keratomileusis for Patients With Dry Eye CLINICAL SCIENCES Laser-Assisted In Situ Keratomileusis for Patients With Dry Eye Ikuko Toda, MD; Naoko Asano-Kato, MD; Yoshiko Hori-Komai, MD; Kazuo Tsubota, MD Objective: To evaluate the efficacy and

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

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

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

Vision Correction Surgery Patient Information

Vision Correction Surgery Patient Information Vision Correction Surgery Patient Information Anatomy of the eye: The eye is a complex organ composed of many parts, and normal vision requires these parts to work together. When a person looks at an object,

More information

TABLE OF CONTENTS: LASER EYE SURGERY CONSENT FORM

TABLE OF CONTENTS: LASER EYE SURGERY CONSENT FORM 1 BoydVision TABLE OF CONTENTS: LASER EYE SURGERY CONSENT FORM Risks and Side Effects... 2 Risks Specific to PRK... 3 Risks Specific to LASIK... 4 Patient Statement of Consent... 5 Consent for Laser Eye

More information

PHOTOREFRACTIVE KERATECTOMY (PRK) HAS BECOME

PHOTOREFRACTIVE KERATECTOMY (PRK) HAS BECOME Comparison of Corneal Nerve Regeneration and Sensitivity Between LASIK and Laser Epithelial Keratomileusis (LASEK) SEUNG JAE LEE, MD, JIN KUK KIM, MD, KYUNG YUL SEO, MD, EUNG KWEON KIM, MD, PHD, AND HYUNG

More information

Postrefractive surgery dry eye Guilherme G. Quinto, Walter Camacho and Ashley Behrens

Postrefractive surgery dry eye Guilherme G. Quinto, Walter Camacho and Ashley Behrens Postrefractive surgery dry eye Guilherme G. Quinto, Walter Camacho and Ashley Behrens The Wilmer Ophthalmological Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Correspondence

More information

Case Report Laser Vision Correction on Patients with Sick Optic Nerve: A Case Report

Case Report Laser Vision Correction on Patients with Sick Optic Nerve: A Case Report Case Reports in Ophthalmological Medicine Volume 2011, Article ID 796463, 4 pages doi:10.1155/2011/796463 Case Report Laser Vision Correction on Patients with Sick Optic Nerve: A Case Report Ming Chen

More information

Comparison Between the Visian ICL, LASIK, and PRK

Comparison Between the Visian ICL, LASIK, and PRK Deciding on the vision correction procedure that s right for you is an important one. The table below provides a general comparison of the major differences between Visian ICL, LASIK and PRK. It is NOT

More information

The Changes of Tear Status after Conventional and Wavefront-Guided IntraLASIK

The Changes of Tear Status after Conventional and Wavefront-Guided IntraLASIK Original Article The Changes of Tear Status after Conventional and Wavefront-Guided IntraLASIK Say Kiang Foo 1, Sharanjeet-Kaur 2, Faudziah Abd Manan 2, Aloysius Joseph Low 3 Submitted: 19 Oct 2010 Accepted:

More information

Dr. Booth received his medical degree from the University of California: San Diego and his bachelor of science from Stanford University.

Dr. Booth received his medical degree from the University of California: San Diego and his bachelor of science from Stanford University. We've developed this handbook to help our patients become better informed about the entire process of laser vision correction. We hope you find it helpful and informative. Dr. Booth received his medical

More information

Excimer Laser Eye Surgery

Excimer 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 information

Many patients have taken advantage of the fast and relatively

Many patients have taken advantage of the fast and relatively Preoperative Characteristics and a Potential Mechanism of Chronic Dry Eye after LASIK Keiko Konomi, 1,,3 Li-Li Chen, 1,, Rachel S. Tarko, 1 Amy Scally, 5 Debra A. Schaumberg, 1,,6 Dimitri Azar, 1,,7 and

More information

Many patients have taken advantage of the fast and relatively

Many patients have taken advantage of the fast and relatively Preoperative Characteristics and a Potential Mechanism of Chronic Dry Eye after LASIK Keiko Konomi, 1,,3 Li-Li Chen, 1,, Rachel S. Tarko, 1 Amy Scally, 5 Debra A. Schaumberg, 1,,6 Dimitri Azar, 1,,7 and

More information

Confocal Microscopy of Corneal Stroma and Endothelium After LASIK and PRK

Confocal Microscopy of Corneal Stroma and Endothelium After LASIK and PRK Confocal Microscopy of Corneal Stroma and Endothelium After LASIK and PRK Javad Amoozadeh, MD; Soheil Aliakbari, MD; Amir-Houshang Behesht-Nejad, MD; Mohammad-Amin Seyedian, MD; Bijan Rezvan, DDS; Hassan

More information

Refractive Surgery. Common Refractive Errors

Refractive 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 information

Blepharoplasty is one of the most frequently

Blepharoplasty is one of the most frequently COSMETIC Blepharoplasty in the Post Laser In Situ Keratomileusis Patient: Preoperative Considerations to Avoid Dry Eye Syndrome Bobby S. Korn, M.D., Ph.D. Don O. Kikkawa, M.D. David J. Schanzlin, M.D.

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

LASIK SURGERY OUTCOMES, VOLUME AND RESOURCES

LASIK SURGERY OUTCOMES, VOLUME AND RESOURCES MOH Information Paper: 2006/17 LASIK SURGERY OUTCOMES, VOLUME AND RESOURCES By Dr. Ganga Ganesan 1 I INTRODUCTION LASIK stands for Laser-Assisted In Situ Keratomileusis and is a surgical procedure that

More information

Life Science Journal 2014;11(9) http://www.lifesciencesite.com. Cross cylinder Challenging cases and their resultswith Nidek Quest (EC-5000)

Life Science Journal 2014;11(9) http://www.lifesciencesite.com. Cross cylinder Challenging cases and their resultswith Nidek Quest (EC-5000) Cross cylinder Challenging cases and their resultswith Nidek Quest (EC-5000) Gamal Mostafa Abo El Maaty, Mohamed Elmoddather, Mahmoud Ibrahem Ghazy, Mohamed Al-Taher Ophthalmology Department, Faculty of

More information

Keratorefractive Surgery for Post-Cataract Refractive Surprise. Moataz El Sawy

Keratorefractive 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 information

Lipid tear deficiency in persistent dry eye after laser in situ keratomileusis and treatment results of new eye-warming device

Lipid tear deficiency in persistent dry eye after laser in situ keratomileusis and treatment results of new eye-warming device J CATARACT REFRACT SURG - VOL 31, SEPTEMBER 2005 Lipid tear deficiency in persistent dry eye after laser in situ keratomileusis and treatment results of new eye-warming device Mario A. Di Pascuale, MD,

More information

Information and consent for patients preparing for refractive surgery LASIK Laser Eye Center Kubati

Information and consent for patients preparing for refractive surgery LASIK Laser Eye Center Kubati 1. General information Not long ago, the WHO - World Health Organization has described ametropy (medical term for diopter) as a category of disability creating a solution to the needs of many with ametropy

More information

Bladeless LASIK and PRK

Bladeless LASIK and PRK Bladeless LASIK and PRK Bladeless LASIK and PRK The specialists at North Shore-LIJ Laser Vision Correction understand how valuable your sight is to you, which is why we use the safest, most advanced technology

More information

LASIK Eye Surgery Report

LASIK Eye Surgery Report LASIK Eye Surgery Report LASIK eye surgery can be a liberating experience for people hoping to reduce or eliminate their dependence on glasses and contact lenses. Most patients do not realize how evolved

More information

Preserving the Cornea for the Future

Preserving the Cornea for the Future Supplement to February 2015 Sponsored by STAAR Surgical Preserving the Cornea for the Future Highlights From the Visian ICL Experts Meeting 2014 Why I Chose the Visian Phakic Posterior Chamber Lens for

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

Consumer s Guide to LASIK

Consumer 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 information

Epi-LASIK Surgery. The procedure of choice for surface ablation.

Epi-LASIK Surgery. The procedure of choice for surface ablation. Epi-LASIK Surgery The procedure of choice for surface ablation. powered by Moria Preservation of Corneal Biomechanical Integrity, minimizing the risks of ectasia Post-LASIK CH decrease (Reichert ORA) 0-1

More information

Your one stop vision centre Our ophthalmic centre offers comprehensive eye management, which includes medical,

Your one stop vision centre Our ophthalmic centre offers comprehensive eye management, which includes medical, sight see OLYMPIA EYE & LASER CENTRE Your one stop vision centre Our ophthalmic centre offers comprehensive eye management, which includes medical, At the Olympia Eye & Laser Centre, our vision is to improve

More information

ALL LASER LASIK. The gentle way to restore sharp vision with the femtosecond laser

ALL LASER LASIK. The gentle way to restore sharp vision with the femtosecond laser ALL LASER LASIK The gentle way to restore sharp vision with the femtosecond laser THE MOST EFFECTIVE BLADELESS METHOD If you re looking for accurate, safe and comfortable laser refractive surgery, Z-LASIK

More information

Corneal Collagen Cross-Linking (CXL) With Riboflavin

Corneal Collagen Cross-Linking (CXL) With Riboflavin Dr. Paul J. Dubord, MD, FRCSC Clinical Professor Department of Ophthalmology and Visual Sciences University of British Columbia Patient Information Guide Corneal Collagen Cross-Linking (CXL) With Riboflavin

More information

Straylight values 1 month after laser in situ keratomileusis and photorefractive keratectomy

Straylight values 1 month after laser in situ keratomileusis and photorefractive keratectomy ARTICLE Straylight values 1 month after laser in situ keratomileusis and photorefractive keratectomy Jeroen J.G. Beerthuizen, MD, FEBOphth, Luuk Franssen, MSc, Monika Landesz, MD, PhD, Thomas J.T.P. van

More information

1-1 INDIAN OIL CORPORATION - REFRACTIVE SURGERY CENTRE ( LASIK) SANKARA NETHRALAYA (JKCN BRANCH) NO 21, PYGROFTS GARDEN ROAD, CHENNAI 6

1-1 INDIAN OIL CORPORATION - REFRACTIVE SURGERY CENTRE ( LASIK) SANKARA NETHRALAYA (JKCN BRANCH) NO 21, PYGROFTS GARDEN ROAD, CHENNAI 6 1-1 1-2 How do we see? Eye Structure (Normal) The eye is like a camera. In a camera, light passes through a lens system back onto the film. The cornea and lens are at the front of the eye (anterior chamber)

More information

Consent for LASIK (Laser In Situ Keratomileusis) Retreatment

Consent for LASIK (Laser In Situ Keratomileusis) Retreatment Consent for LASIK (Laser In Situ Keratomileusis) Retreatment Please read the following consent form very carefully. Please initial at the bottom of each page where indicated. Do not sign this form unless

More information

...You Need to know about

...You Need to know about What......You Need to know about LASIK Our Eyes Eyes are the windows to our world. They are so important to us that for many years we have looked for better ways to fix visual problems and improve our

More information

Ocular Surface Syndrome after LASIK

Ocular Surface Syndrome after LASIK Alaa Atef Ghaith, MD Professor of Ophthalmology Alexandria University Ocular Surface Syndrome after LASIK Up to 33% of eyes Multifactorial entity which causes distress to the patients and physicians 1

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

PATIENT CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK)

PATIENT 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 information

The ophthalmic division of the trigeminal nerve innervates. Corneal Reinnervation after LASIK: Prospective 3-Year Longitudinal Study

The ophthalmic division of the trigeminal nerve innervates. Corneal Reinnervation after LASIK: Prospective 3-Year Longitudinal Study Corneal Reinnervation after LASIK: Prospective 3-Year Longitudinal Study Martha P. Calvillo, 1 Jay W. McLaren, 1 David O. Hodge, 2 and William M. Bourne 1 PURPOSE. To measure the return of innervation

More information

Alexandria s Guide to LASIK

Alexandria 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 information

C L I N I C A L A N D E X P E R I M E N T A L OPTOMETRY ORIGINAL PAPER. Dry eye after LASIK: Comparison of outcomes for Asian and Caucasian eyes

C L I N I C A L A N D E X P E R I M E N T A L OPTOMETRY ORIGINAL PAPER. Dry eye after LASIK: Comparison of outcomes for Asian and Caucasian eyes C L I N I C A L A N D E X P E R I M E N T A L LASIK induced dry eye Albietz, Lenton and McLennan OPTOMETRY ORIGINAL PAPER Dry eye after LASIK: Comparison of outcomes for Asian and Caucasian eyes Clin Exp

More information

The cornea is richly innervated by nerve fibers of the ophthalmic. Reinnervation in the Cornea after LASIK

The cornea is richly innervated by nerve fibers of the ophthalmic. Reinnervation in the Cornea after LASIK Reinnervation in the Cornea after LASIK Bong Hwan Lee, 1 Jay W. McLaren, 1 Jay C. Erie, 1 David O. Hodge, 2 and William M. Bourne 1 PURPOSE. Nerve fibers in the cornea are disrupted by photorefractive

More information

Comparison of Dry Eye and Corneal Sensitivity between Small Incision Lenticule Extraction and Femtosecond LASIK for Myopia

Comparison of Dry Eye and Corneal Sensitivity between Small Incision Lenticule Extraction and Femtosecond LASIK for Myopia Comparison of Dry Eye and Corneal Sensitivity between Small Incision Lenticule Extraction and Femtosecond LASIK for Myopia Meiyan Li 1, Jing Zhao 1, Yang Shen 1, Tao Li 1,LiHe 1, Hailin Xu 1, Yongfu Yu

More information

Laser Vision Correction: A Tutorial for Medical Students

Laser Vision Correction: A Tutorial for Medical Students Laser Vision Correction: A Tutorial for Medical Students Written by: Reid Turner, M4 Reviewed by: Anna Kitzmann, MD Illustrations by: Steve McGaughey, M4 November 29, 2011 1. Introduction Laser vision

More information

LASER VISION C ORRECTION REFRACTIVE SURGERY CENTER

LASER VISION C ORRECTION REFRACTIVE SURGERY CENTER LASER VISION C ORRECTION REFRACTIVE SURGERY CENTER W e l c o m e Throughout our history, physicians at Mass. Eye and Ear have led clinical advances and research that have resulted in the discovery of disease-causing

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

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

To date, several million patients have been treated worldwide. So why not discover the benefits The Eye Hospital can bring to your life.

To date, several million patients have been treated worldwide. So why not discover the benefits The Eye Hospital can bring to your life. L a s e r E y e S u r g e r y I N F O R M A T I O N 1 Welcome Imagine the freedom of being able to do away with glasses and contact lenses. You too, may be suitable for laser eye surgery, freeing you from

More information

Clinic s Logo YOUR Z-LASIK CLINIC. (( Clinic s name ))

Clinic s Logo YOUR Z-LASIK CLINIC. (( Clinic s name )) Clinic s Logo YOUR Z-LASIK CLINIC in (( Location )) (( Clinic s name )) The gentle way to restore sharp vision We have performed surgical vision correction since (( year )) and treated more than (( number

More information

Common visual problems in older LASIK patients

Common visual problems in older LASIK patients 丘 子 宏 LASIK 手 術 後 的 視 覺 Visual acuity:the measurement of high contrast Snellen acuity but not other functions under different condition Quality of vision: measure the visual functions in variable condition

More information

1801 West End Avenue Suite 1150 Nashville, TN 37203, USA Office: 615.321.8881 Fax: 615.321.8874

1801 West End Avenue Suite 1150 Nashville, TN 37203, USA Office: 615.321.8881 Fax: 615.321.8874 1801 West End Avenue Suite 1150 Nashville, TN 37203, USA Office: 615.321.8881 Fax: 615.321.8874 T he purpose of this consent form is to educate you on the bladeless (Intralase) LASIK procedure. It is not

More information

U.S. Food and Drug Administration

U.S. Food and Drug Administration U.S. Food and Drug Administration Notice: Archived Document The content in this document is provided on the FDA s website for reference purposes only. It was current when produced, but is no longer maintained

More information

Managing Post-Operative Complications for LASIK and PRK

Managing Post-Operative Complications for LASIK and PRK Managing Post-Operative Complications for LASIK and PRK LASIK Flap Complications Epithelial defects o Cause Basement membrane dystrophy Recurrent erosion syndrome Dry eyes Trauma PRK as alternative Pre-treat

More information

CLINICAL SCIENCES. Subbasal Nerve Density and Corneal Sensitivity After Laser In Situ Keratomileusis

CLINICAL SCIENCES. Subbasal Nerve Density and Corneal Sensitivity After Laser In Situ Keratomileusis CLINICAL SCIENCES Subbasal Nerve Density and Corneal Sensitivity After Laser In Situ Keratomileusis Femtosecond Laser vs Mechanical Microkeratome Sanjay V. Patel, MD; Jay W. McLaren, PhD; Katrina M. Kittleson,

More information

Laser in situ keratomileusis in patients with corneal guttata and family history of Fuchs endothelial dystrophy

Laser in situ keratomileusis in patients with corneal guttata and family history of Fuchs endothelial dystrophy J CATARACT REFRACT SURG - VOL 31, DECEMBER 2005 Laser in situ keratomileusis in patients with corneal guttata and family history of Fuchs endothelial dystrophy Majid Moshirfar, MD, Vahid Feiz, MD, Michael

More information

Pre-Operative Laser Surgery Information

Pre-Operative Laser Surgery Information Pre-Operative Laser Surgery Information Contact 1800 10 20 20 Our Facility The Canberra Eye Laser Centre has always been at the forefront of refractive technology employing the most up to date equipment

More information

Richard S. Hoffman, MD. Clinical Associate Professor of Ophthalmology Oregon Health & Science University

Richard 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 information

Short-term Corneal Endothelial Changes after Laser-assisted Subepithelial Keratectomy

Short-term Corneal Endothelial Changes after Laser-assisted Subepithelial Keratectomy The Journal of International Medical Research 2010; 1484 1490 [first published online as 38(4) 9] Short-term Corneal Endothelial Changes after Laser-assisted Subepithelial Keratectomy J ZHOU, S LU, J DAI,

More information

Acknowledgements. Dry Eye Update. Dry Eye. Dry Eye. Dry Eye. 2014 Monterey Symposium

Acknowledgements. Dry Eye Update. Dry Eye. Dry Eye. Dry Eye. 2014 Monterey Symposium 2014 Monterey Symposium Update Jimmy Jackson, OD, FAAO President InSight Lasik Acknowledgements I have received honoraria from Alcon Laboratories, Inc for speaking engagements. I have received research

More information

Femtosecond Lasers in LASIK Surgery

Femtosecond Lasers in LASIK Surgery Femtosecond Lasers in LASIK Surgery Dr Chan Tat Keong Senior Consultant Refractive Surgery Service Singapore National Eye Centre Disclosure Speaker has no financial interest in the products to be discussed

More information

refractive surgery a closer look

refractive surgery a closer look 2011-2012 refractive surgery a closer look How the eye works Light rays enter the eye through the clear cornea, pupil and lens. These light rays are focused directly onto the retina, the light-sensitive

More information

Anterior Lamellar Keratoplasty With a Microkeratome: A Method for Managing Complications After Refractive Surgery

Anterior Lamellar Keratoplasty With a Microkeratome: A Method for Managing Complications After Refractive Surgery Anterior Lamellar Keratoplasty With a Microkeratome: A Method for Managing Complications After Refractive Surgery Farhad Hafezi, MD; Michael Mrochen, PhD; Franz Fankhauser II, MD; Theo Seiler, MD, PhD

More information

Patient information Alexander Ionides Moorfields Eye Hospital

Patient information Alexander Ionides Moorfields Eye Hospital Wavefront guided laser refractive surgery - 2014 Laser refractive surgery is a way of reshaping of the cornea to correct myopia, hypermetropia ( long-sightedness ) and astigmatism. The re-shaping of the

More information

Michael J. Collins, Jr., M.D., F.A.C.S. Professional Background

Michael J. Collins, Jr., M.D., F.A.C.S. Professional Background Michael J. Collins, Jr., M.D., F.A.C.S Main Office: Fort Myers Office 6900 International Center Blvd. Fort Myers, FL 33912 (239) 936-4706 Fax: (239) 225-6775 www.collinsvision.com Professional Background

More information

Congratulations! You have just joined the thousands of people who are enjoying the benefits of laser vision correction.

Congratulations! You have just joined the thousands of people who are enjoying the benefits of laser vision correction. Dear Valued Patient, Thank you for choosing Shady Grove Ophthalmology for your laser vision correction procedure. Our excellent staff is committed to offering you the highest quality eye care using state

More information

MAZAHERI LASIK METHOD FOR VISUAL ENHANCEMENT TECHNICAL FIELD OF THE INVENTION. [0001] The present invention is directed, in general, to

MAZAHERI LASIK METHOD FOR VISUAL ENHANCEMENT TECHNICAL FIELD OF THE INVENTION. [0001] The present invention is directed, in general, to MAZAHERI LASIK METHOD FOR VISUAL ENHANCEMENT TECHNICAL FIELD OF THE INVENTION [0001] The present invention is directed, in general, to a surgical procedure and, more particularly, to surgical procedure

More information

Descemet s Stripping Automated Endothelial Keratoplasty (DSAEK)

Descemet s Stripping Automated Endothelial Keratoplasty (DSAEK) Descemet s Stripping Automated Endothelial Keratoplasty (DSAEK) John D. Goosey, MD Introduction DSAEK is a corneal transplant technique where the unhealthy, diseased, posterior portion of a patient s cornea

More information

Our Commitment To You

Our Commitment To You SYSTEM SUPPORT Quality-crafted, the system boasts dependability with high efficiency and low gas usage. We provide responsive service and maintenance contract options, supported by our nationwide direct

More information

Patient-Reported Outcomes with LASIK (PROWL-1) Results

Patient-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 information

FOR MORE INFORMATION VISIT WWW.Z-LASIK.NET

FOR MORE INFORMATION VISIT WWW.Z-LASIK.NET FOR MORE INFORMATION VISIT WWW.Z-LASIK.NET Dougherty Laser Vision 9100 Wilshire Blvd, Suite #265E Beverly Hills, CA 90210 323-466-7337 1821 E Daily Drive Camarillo, CA 93010 805-987-5300 4353 Park Terrace

More information

Curtin 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 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 information

PRK Wavefront Guided idesign Photorefractive Keratectomy

PRK 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 information

Associated Eye Surgeons

Associated Eye Surgeons Associated Eye Surgeons 45 Resnik Road, Suite 301 Plymouth, MA 02360 Henry J Kriegstein MD, FACS Board Certified Lois M. Townshend, MD, FRCSC Board Certified Kristin S. Kenney, OD LASIK CONSENT FORM I.

More information

Effect of Preoperative Keratometric Power on Intraoperative Complications in LASIK in 34,099 Eyes

Effect of Preoperative Keratometric Power on Intraoperative Complications in LASIK in 34,099 Eyes Effect of Preoperative Keratometric Power on Intraoperative Complications in LASIK in 34,099 Eyes J. Carlos Albelda-Vallés, MD; Clara Martin-Reyes, MD; Francisco Ramos, MD; Jaime Beltran, MD; Fernando

More information

IDENTIFY DRY EYE AN IN-OFFICE TEST TO AID IN DRY EYE DIAGNOSIS. 85% Sensitivity, 94% Specificity 1. This brochure is for use in Canada only.

IDENTIFY DRY EYE AN IN-OFFICE TEST TO AID IN DRY EYE DIAGNOSIS. 85% Sensitivity, 94% Specificity 1. This brochure is for use in Canada only. IDENTIFY DRY EYE AN IN-OFFICE TEST TO AID IN DRY EYE DIAGNOSIS 85% Sensitivity, 94% Specificity 1 IDENTIFY DRY EYE WITH INFLAMMADRY InflammaDry is the first and only rapid, in-office test that detects

More information

Financial Disclosure. LASIK Flap Parameters IntraLase Microkeratome 6/9/2008. Femtosecond LASIK Flaps: What Could We Customize Yesterday?

Financial Disclosure. LASIK Flap Parameters IntraLase Microkeratome 6/9/2008. Femtosecond LASIK Flaps: What Could We Customize Yesterday? Financial Disclosure Arturo Chayet, MD Tijuana, BC Mexico Perry S. Binder, MS, MD San Diego CA USA I have the following financial interests or relationships to disclose: AMO/IntraLase Corporation - C Acufocus

More information

Wavefront technology has been used in our

Wavefront technology has been used in our Wavefront Customized Ablations With the WASCA Asclepion Workstation Sophia I. Panagopoulou, BSc; Ioannis G. Pallikaris, MD ABSTRACT PURPOSE: WASCA (Wavefront Aberration Supported Cornea Ablation) is a

More information

What is LASIK? The eye and vision errors

What is LASIK? The eye and vision errors What is LASIK? The eye and vision errors The cornea is a part of the eye that helps focus light to create an image on the retina. It works in much the same way that the lens of a camera focuses light to

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

PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012

PREPARED FOR: U.S. Army Medical Research and Materiel Command Fort Detrick, Maryland 21702-5012 AD Award Number: W81XWH-04-2-0008 TITLE: Molecular Solutions to Low Vision Resulting from Battlefield Injuries PRINCIPAL INVESTIGATOR: Darlene A. Dartt, Ph.D. CONTRACTING ORGANIZATION: Schepens Eye Research

More information

Comparison of Two Procedures: Photorefractive Keratectomy Versus Laser In Situ Keratomileusis for Low to Moderate Myopia

Comparison of Two Procedures: Photorefractive Keratectomy Versus Laser In Situ Keratomileusis for Low to Moderate Myopia Comparison of Two Procedures: Photorefractive Keratectomy Versus Laser In Situ Keratomileusis for Low to Moderate Myopia Jae Bum Lee, Jae Sung Kim, Chul-Myong Choe, Gong Je Seong and Eung Kweon Kim Institute

More information

Dry Eye After Clear Cornea Phacoemulsification

Dry Eye After Clear Cornea Phacoemulsification Original Article Philippine Journal of OPHTHALMOLOGY Dry Eye After Clear Cornea Phacoemulsification Peter Mark G. Chao, MD 1 and Ruben Lim-Bon-Siong, MD 1,2 1 Department of Ophthalmology and Visual Sciences

More information

Risks and Limitations of LASIK Procedure

Risks and Limitations of LASIK Procedure Drs. Fine, Hoffman & Packer, LLC 1550 Oak Street, Suite #5 Eugene, OR 97401 541-687-2110 From Drs. Fine, Hoffman, & Packer Risks and Limitations of LASIK Procedure Infection, serious injury, or even death,

More information

LASIK. What is LASIK? Eye Words to Know. Who is a good candidate for LASIK?

LASIK. What is LASIK? Eye Words to Know. Who is a good candidate for LASIK? 2014 2015 LASIK What is LASIK? LASIK (laser in situ keratomileusis) is a type of refractive surgery. This kind of surgery uses a laser to treat vision problems caused by refractive errors. You have a refractive

More information

Rosario G. Anera, PhD, Jose R. Jiménez, PhD, Luis Jiménez del Barco, PhD, Javier Bermúdez, PhD, Enrique Hita, PhD

Rosario G. Anera, PhD, Jose R. Jiménez, PhD, Luis Jiménez del Barco, PhD, Javier Bermúdez, PhD, Enrique Hita, PhD Changes in corneal asphericity after laser in situ keratomileusis Rosario G. Anera, PhD, Jose R. Jiménez, PhD, Luis Jiménez del Barco, PhD, Javier Bermúdez, PhD, Enrique Hita, PhD Purpose: To analyze the

More information

Curriculum Vitae. Irwin Y. Cua, M.D. Present Positions:

Curriculum Vitae. Irwin Y. Cua, M.D. Present Positions: Curriculum Vitae Name: Irwin Y. Cua, M.D. Present Positions: Affiliate Consultant, Vision Laser Center, St. Luke s Medical Center Affiliate Consultant, Section of Cornea and External Disease, St. Luke

More information

ALTERNATIVES TO LASIK

ALTERNATIVES TO LASIK EYE PHYSICIANS OF NORTH HOUSTON 845 FM 1960 WEST, SUITE 101, Houston, TX 77090 Office: 281 893 1760 Fax: 281 893 4037 INFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK) INTRODUCTION This information

More information

Refractive Surgery Education and Informed Consent

Refractive Surgery Education and Informed Consent Refractive Surgery Education and Informed Consent Tripler Army Medical Center Refractive Surgery Center Warfighter Refractive Eye Surgery Program (WRESP) Goals of this Briefing To explain the Warfighter

More information

INFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK)

INFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK) Lasik Center 2445 Broadway Quincy, IL 62301 217-222-8800 INFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK) INTRODUCTION This information is being provided to you so that you can make an informed

More information

Accelerated Refractive Performance

Accelerated 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 information

WAKE FOREST BAPTIST HEALTH EYE CENTER. LASIK Consent Form

WAKE FOREST BAPTIST HEALTH EYE CENTER. LASIK Consent Form 1 WAKE FOREST BAPTIST HEALTH EYE CENTER LASIK Consent Form 1. GENERAL INFORMATION The following information is intended to help you make an informed decision about having Laser In-Situ Keratomileusis (LASIK).

More information

Medicare and Corneal Surgery: Cosmetic versus Functional

Medicare and Corneal Surgery: Cosmetic versus Functional Medicare and Corneal Surgery: Cosmetic versus Functional Riva Lee Asbell INTRODUCTION With the introduction of several new CPT (Current Procedural Terminology) codes for cornea, corneal coding is in the

More information

LASIK: Clinical Results and Their Relationship to Patient Satisfaction

LASIK: Clinical Results and Their Relationship to Patient Satisfaction LASIK: Clinical Results and Their Relationship to Patient Satisfaction Lien Thieu Tat A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy School of Applied Vision

More information

Olympia HSA Medical Series. Laser Eye Surgery A COMPLETE GUIDE FOR CANADIANS

Olympia HSA Medical Series. Laser Eye Surgery A COMPLETE GUIDE FOR CANADIANS Olympia HSA Medical Series Laser Eye Surgery A COMPLETE GUIDE FOR CANADIANS 1 Optimal Healthcare and Life Benefits Olympia s All-in-one Benefits Program HEALTH SPENDING ACCOUNTS Optimize your Health Benefits

More information

Visual Performance After Reduced Blinking in Eyes With Soft Contact Lenses or After LASIK

Visual Performance After Reduced Blinking in Eyes With Soft Contact Lenses or After LASIK Visual Performance fter Reduced linking in Eyes With Soft ontact Lenses or fter LSIK Ikuko Toda, MD; tsushi Yoshida, OD; hikako Sakai, Sc; Yoshiko Hori-Komai, MD; Kazuo Tsubota, MD STRT PURPOSE: To evaluate

More information

INFORMED CONSENT FOR LASIK SURGERY

INFORMED CONSENT FOR LASIK SURGERY IMPORTANT: READ EVERY WORD! This information is to help you make an informed decision about having laser assisted in-situ keratomileusis (LASIK) surgery to treat your nearsightedness, farsightedness and/or

More information