LASIK and LASIK Complications

Transcription

1 LASIK and LASIK Complications System requirement: Windows XP or above Power DVD player (Software) Windows Media Player version 10.0 or above Quick time player version 6.5 or above Accompanying DVD ROM is playable only in Computer and not in DVD player. Kindly wait for few seconds for DVD to autorun. If it does not autorun then please follow the steps: Click on my computer Click the drive labelled JAYPEE and after opening the drive, kindly double click the file JAYPEE

2 DVD CONTENTS 1. Customized LASIK Ashok Garg (India) 2. LASIK Surgery in Small Eyes John Chang (USA) 3. LASIK without Speculum Roberto Pinelli (Italy) 4. LASIK in a Severe Case of Nistagmus Roberto Pinelli (Italy)

3 LASIK and LASIK Complications Editor Roberto Pinelli MD Scientific Director Istituto Laser Microchirurgia Oculare Italy President Italian Refractive Surgery Society JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD New Delhi Ahmedabad Bengaluru Chennai Hyderabad Kochi Kolkata Lucknow Mumbai Nagpur

4 Published by Jitendar P Vij Jaypee Brothers Medical Publishers (P) Ltd B-3 EMCA House, 23/23B Ansari Road, Daryaganj, New Delhi , India Phones: , , , Rel: , Fax: , [email protected] Visit our website: Branches 2/B, Akruti Society, Jodhpur Gam Road Satellite Ahmedabad , Phones: , Rel: Fax: , [email protected] 202 Batavia Chambers, 8 Kumara Krupa Road, Kumara Park East Bengaluru , Phones: , , Rel: , Fax: , [email protected] 282 IIIrd Floor, Khaleel Shirazi Estate, Fountain Plaza, Pantheon Road Chennai , Phones: , , Rel: Fax: , [email protected] /1-3, 1st Floor, Balaji Building, Ramkote Cross Road Hyderabad , Phones: , , Rel: Fax: , [email protected] No. 41/3098, B & B1, Kuruvi Building, St. Vincent Road Kochi , Kerala, Phones: , , [email protected] 1-A Indian Mirror Street, Wellington Square Kolkata , Phones: , , Rel: , Fax: [email protected] Lekhraj Market-III, B-2, Sector-4, Faizabad Road, Indira Nagar Lucknow , Phones: , , [email protected] 106 Amit Industrial Estate, 61 Dr SS Rao Road, Near MGM Hospital, Parel Mumbai , Phones: , , Rel: Fax: , [email protected] KAMALPUSHPA 38, Reshimbag, Opp. Mohota Science College, Umred Road Nagpur (MS), Phone: Rel: , Fax: [email protected] LASIK and LASIK Complications 2008, Roberto Pinelli All rights reserved. No part of this publication and DVD ROM should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editor and the publisher. This book has been published in good faith that the materials provided by contributors is original. Every effort is made to ensure accuracy of material, but the publisher, printer and editor will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only. First Edition: 2008 ISBN Typeset at JPBMP typesetting unit Printed at Ajanta Offset

5 Dedicated to My wife Elena, My two little twins Chiara e Francesco and to the Staff of ILMO (Istituto Laser Microchirurgia Oculare) for their incredible support

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7 CONTRIBUTORS Ashok Garg MD Medical Director Garg Eye Institute and Research Center India Brian Boxer Wachler MD Director of Boxer Wachler Vision Institute Los Angeles, CA USA Colin CK Chan MD The Eye Institute Chastwood, NSW Australia E Scaffidi MA Clinical Psychologist Vision Psychology Service Istituto Laser Microchirurgia Oculare Brescia, Italy J Gaytán-Melicoff MD Cornea and Refractive Surgery Department Institut de Microchirurgia Ocular Barcelona, Spain JL Güell MD Cornea and Refractive Surgery Department Institut de Microchirurgia Ocular Barcelona, Spain JS Chang MD Consultant Ophthalmologist Hong Kong Sanatorium and Hospital Director of GHC Refractory Surgery Center Assistant Professor, Chinese University of Hong Kong Louis E Probst MD Scientific Director TLC Laser Eye Center, Chicago IL Madison, WI USA M Gordon MD Founder and Director Gordon Binder and Weiss Vision Institute, USA Ming Wang MD, PhD Medical Director Wang Vision Institute Nashville, USA Ralph Chu MD Founder and Medical Director Chu Vision Institute, USA Roberto Pinelli MD Scientific Director Istituto Laser Microchirurgia Oculare Italy President Italian Refractive Surgery Society S Pascucci MD Founder and Medical Director Eye Consultants of Bonita Spring Bonita Spring FL USA Sanjay Chaudhary MS Chaudhary Eye Center and Laser Vision New Delhi India Shawna L Hill OD Staff Doctor Wang Vision Institute Nashville, USA Terry Kim MD Associate Professor of Ophthalmology Associate Director Corneal and External Disease Service and Refractive Surgery Service Duke University School of Medicine Durham NC USA Tracy Swartz OD, FAAO, MS Clinical Operations Manager Wang Vision Institute Nashville, USA

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9 FOREWORD It is my honor and pleasure to write the Foreword for this wonderful reference and textbook entitled LASIK and LASIK Complications. Dr Roberto Pinelli, a world renowned pioneer and leader in refractive surgery, has brought together some of the most prominent and star-studded personalities in ophthalmology, all of whom are willing to share their experience in LASIK techniques and complications with us. There are numerous chapters wherein each expert has provided instruction in, and the nuances to, his/her own LASIK technique. Complicated cases as well as the detailed medical/surgical approach that led to a successful final outcome, are also presented. In addition to these medically oriented chapters, there are some other chapters that serve as a blueprint for the successful operation of a refractive surgery center, not unlike Dr Pinelli s Istituto Laser Microchirurgia Oculare (ILMO) in Brescia, Italy. These chapters include tips for effective internal and external marketing; how to understand and react to local market forces; insights into the psyche of the refractive surgery patient; and guidelines for proper front desk and technical procedures. Lastly, Dr Pinelli has provided a look at the future by describing both his own PML procedure (Presbyopic Multifocal LASIK), and how best to provide skills transfer to our peers and junior colleagues. Dr Pinelli has done an enormous service to the refractive surgery community by compiling this unique book, filled with his own invaluable contributions and those of our distinguished and experienced colleagues. In the final analysis, we learn the most from analyzing our failures, and those of the few brave and honest souls who are willing to share their experience with us. As I often tell my residents and fellows: The most common way to have good judgement is to have had, at one time, bad judgement; we learn best from our mistakes. Marguerite McDonald MD FACS Clinical Professor of Ophthalmology NYU School of Medicine New York Adjunct Clinical Professor of Ophthalmology Tulane University Health Sciences Center New Orleans, Louisiana Ophthalmic Consultants of Long Island Lynbrook, New York

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11 PREFACE I had LASIK in my eyes at the Gordon-Binder-Weiss Vision Institute in San Diego; Michael Gordon, MD performed it with excellent ability. Ten years after the operation, I am still a very happy patient. LASIK technique has not only gained popularity and acceptance in the world, but it seems to confirm, along time, its efficacy and safety. Quick recovery, absence of pain and outstanding outcomes are the reasons of the continuous success of LASIK treatment. Also the Presby-LASIK is now entering in the chapter of presbyopia correction with elegance and scientific evidence, for the treatment of emmetropespresbyops, myop-presbyops and hyperopic-presbyops. Finally, the creation of a thin-flap (using mechanical microkeratome or femtosecond laser) has recently gained wide acceptance among the scientific world and the general population. This book shows the LASIK personal techniques of worldwide experts (Section 2), including a series of clinical cases of LASIK complications and their solution (Section 3). In this way the reader can have a complete overview of the whole world of LASIK in order to become confident with his surgical technique of refractive surgery. Roberto Pinelli

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13 ACKNOWLEDGEMENTS Special thanks to Patrizia Signoroni and Anna Koj for the realization of the project. Thanks to Fabrizio Gabas, Ilaria Sireno and Patrizia Portesi for their competent technical and surgical assistance. Thanks to Tiziana Busi, Francesca Loda and Linda Zacchi for the realization of the chapters on our Institute in Section 1. A special thanks to Marguerite McDonald MD, a great friend and a very prestigious colleague, for her precious support in the achievement of this book.

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15 CONTENTS SECTION 1: The Project of Vision: Hypothesis for a Functional Structure 1. The Project of Vision: A New Winning Philosophy... 3 R Pinelli The Vision Institute 3 Structure of the New Vision Institute 4 A Management Hypothesis on Daily Briefing: Contacts Between Medical and Non-medical Staff (Analyzing The Daily Patients Agenda) Highlights on Statistics and Clinical Research R Pinelli External Relations for Surgical and Clinical News 13 Cooperation with National and International Scientific Societies New Operative Tools to Improve the Structure E Scaffidi The Psychology of Vision 18 Evaluation of Patient s Satisfaction Questionnaire Istituto Laser Microchirurgia Oculare Standard of Care R Pinelli Preoperative Phase 35 The Day of Surgery 44 LASIK: Dr Pinelli s Personal Technique 47 The Postoperative Phase 54 SECTION 2: Laser-assisted In Situ Keratomileusis (LASIK): Personal Technique 5. New Frontier of LASIK: Customized PML TM (Presbyopic Multifocal LASIK) Technique R Pinelli 6. LASIK: The Personal Technique Brian Boxer Wachler Dr Brian Boxer Wachler s Personal Technique LASIK: The Personal Technique S Pascucci Dr S Pascucci s Personal Technique My Personal Technique M Gordon Dr M Gordon s Personal Technique LASIK Performance on the Daily Basis Consultation J Gaytán-Melicoff, JL Güell 10. Laser In Situ Keratomileusis: Techniques and Postoperative Management Louis E Probst

16 xvi LASIK and LASIK Complications 11. LASIK (Laser Assisted In Situ Keratomileusis) Sanjay Chaudhary, Ashok Garg Over View (Sanjay Chaudhary) 91 Ocular Pharmacokinetics in LASIK Surgery (Ashok Garg) LASIK Surgery in Small Eyes JS Chang SECTION 3: LASIK Complications 13. Pinelli s LASIK Complications R Pinelli 14. Chu s LASIK Complications Ralph Chu 15. Chan s and Boxer Wachler s LASIK Complications Colin CK Chan, B Boxer Wachler Wavefront Retreatment for Higher Order Aberrations Post-Conventional LASIK 116 Treatment of Post-LASIK Ectasia Guell s LASIK Complications I Guell 17. Garg s and Chaudhary s LASIK Complications Sanjay Chaudhary, Ashok Garg Free Flap 126 Corneal Haze after LASEK with Mitomycin 128 Flap Wrinkles Pascucci s LASIK Complications Stephen Pascucci 19. Wang s LASIK Complications Shawna L Hill, Tracy Swartz, Ming Wang Decentered Ablation Status Post A High Myopic Treatment 135 Refractive Instability Status Post-LASIK 140 Diffuse Lamellar Keratitis (Sands of Sahara) Kim s LASIK Complications Terry Kim Case 1: Recurrent Epithelial Ingrowth Treated with LASIK Flap Suturing 151 Case 2: Treatment of Traumatic LASIK Flap Dislocation and Epithelial Ingrowth with Fibrin... Glue 153 Case 3: Medical and Surgical Treatment of Atypical Mycobacterial Keratitis Following LASIK Chang s LASIK Complications JS Chang Diffuse Lamellar Keratitis 159 Epithelial Ingrowth 161 Index