Complications of Combined Topography-Guided Photorefractive Keratectomy and Corneal Collagen Crosslinking in Keratoconus

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Complications of Combined Topography-Guided Photorefractive Keratectomy and Corneal Collagen Crosslinking in Keratoconus"

Transcription

1 Complications of Combined Topography-Guided Photorefractive Keratectomy and Corneal Collagen Crosslinking in Keratoconus Michelle Cho, M.D. 1 Anastasios John Kanellopoulos, M.D 1,2 New York University School of Medicine, Department of Ophthalmology, New York, NY 1 Laservision.gr Institute, Athens, Greece 2

2 Financial Disclosure I have no financial interests or relationships to disclose.

3 Keratoconus Rabinowitz Y. Keratoconus. Surv Ophthalmol. 1998;42:

4 Collagen Crosslinking Wollensak G, Spoerl E, Seiler T. Stress-strain measurements of human and Porcine corneas after riboflavin-ultraviolet A-induced cross-linking. J Cat Refract Surg 2003;29:

5 Combined topography-guided PRK and CXL: The Athens Protocol

6 Combined tgprk CXL superior to sequential procedure for visual rehabilitation of KCN and ectasia One procedure Less PRK-associated scarring Increased riboflavin and UVA light penetration No need to remove cross-linked cornea Underscore refraction

7 Combined topography-guided PRK and CXL: The Athens Protocol PTK tgprk MMC CXL

8

9 Kanellopoulos AJ. Comparison of sequential vs same-day simultaneous collagen cross- Linking and topography-guided PRK for treatment of keratoconus. J Refract Surg 2009;25:S812-8.

10 JRS Sept 2009

11 Prospective cohort study Private clinical facility in Athens, Greece 412 keratoconic eyes Inclusion criteria: Diagnosis of progressive keratoconus Progressive corneal steepening of at least 1.00 D in keratometry Exclusion criteria: CCT 350 µm; Other ocular disease Mean follow up: 35 months ± 18 months (range 14 to 72 months)

12 Early Complications Postoperative pain Delayed epithelial healing Salzmann-like epithelial scarring

13 Pain POD# 1 % patients % patients with pain Pain Pain Scale 1- None 2- Mild 3- Moderate 4- Severe

14 Delayed epithelial healing

15 Delayed epithelial healing % cases Day % cases with delayed epithelial healing

16 Salzmann-like scarring

17 Management Lubrication Bandage contact lens Autologous serum administration Surgical removal

18 Late Complications Subepithelial corneal scar (2.9%, n = 12) Stromal haze (3.8%, n = 16) Ectatic progression (1.7%, n = 7)

19 Subepithelial corneal scar

20 Subepithelial corneal scar and haze

21 Stromal haze

22 Management of Ectatic progression Repeat combined topography-guided PRK and CXL Penetrating keratoplasty

23 Other Complications Infectious keratitis Corneal melt

24 Corneal melt

25 Unknown potential risks Ocular surface disease Conjunctival squamous cell carcinoma Endothelial toxicity Cataracts Poor glaucoma management

26 Summary Combined topography-guided PRK and CXL is a promising technique to halt the progression of keratoconus and provide improved functional vision. Early complications are postoperative pain, delayed epithelial healing, and Salzmann-like scarring. Late complications are subepithelial corneal scarring, stromal haze, and ectatic progression.

27 References Rabinowitz Y. Keratoconus. Surv Ophthalmol. 1998;42: Wollensak G, Spoerl E, Seiler T. Stress-strain measurements of human and porcine corneas after riboflavin-ultraviolet A-induced cross-linking. J Cat Refract Surg 2003;29: Kanellopoulos AJ. Comparison of sequential vs same-day simultaneous collagen cross-linking and topography-guided PRK for treatment of keratoconus. J Refract Surg 2009;25:S Krueger RR, Kanellopoulos AJ. Stability of simultaneous topography-guided photorefractive keratectomy and riboflavin/uva cross-linking for progressive keratoconus: case reports. J Refract Surg 2010;26:S Kanellopoulos AJ, Binder PS. Management of corneal ectasia after LASIK with combined, sameday, topography-guided partial transepithelial PRK and collagen cross-linking: the Athens Protocol. J Refract Surg 2011;27: Kanellopoulos AJ. Simultaneous collagen cross-linking (CXL) and topography-guided PRK (tprk) for keratoconus (KCN). Surgical techniques in ophthalmology: corneal surgery. Garg A, Alio JL. New Delhi: Jaypee Brothers Medical Publishers Ltd,

Short and long term complications of combined. Protocol) in 412 keratoconus eyes (2 7 years follow up)

Short and long term complications of combined. Protocol) in 412 keratoconus eyes (2 7 years follow up) Short and long term complications of combined topography guided PRK and CXL (the Athens Protocol) in 412 keratoconus eyes (2 7 years follow up) Anastasios John Kanellopoulos, MD Director, Laservision.gr

More information

Short and long term complications of combined. Protocol) in 412 keratoconus eyes (2 7 years follow up)

Short and long term complications of combined. Protocol) in 412 keratoconus eyes (2 7 years follow up) Short and long term complications of combined topography guided PRK and CXL (the Athens Protocol) in 412 keratoconus eyes (2 7 years follow up) Anastasios John Kanellopoulos, MD Director, Laservision.gr

More information

Keratoconus. Progressive bilateral ectasia. Onset puberty. Prevalence 1:2000. 20% progress to transplantation. Pathogenesis unclear

Keratoconus. Progressive bilateral ectasia. Onset puberty. Prevalence 1:2000. 20% progress to transplantation. Pathogenesis unclear Keratoconus Progressive bilateral ectasia Onset puberty Prevalence 1:2000 20% progress to transplantation Pathogenesis unclear Increased pepsin and catalase Decreased collagen crosslinking cf normal Conventional

More information

(Mazzotta et al, 2007) Human corneal rigidity increases 329 % (Wollensak, 2006)

(Mazzotta et al, 2007) Human corneal rigidity increases 329 % (Wollensak, 2006) Simultaneous PRK and CXL Corneal Crosslinking (CXL): UV-A light, 365 nm, causes riboflavin, 0.1 %, to release oxygen radicals which create new cross-linking bonds between collagen lameller fibres and within

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

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

CXL With the Epithelium on or off: Which Is Better?

CXL With the Epithelium on or off: Which Is Better? CXL With the Epithelium on or off: Which Is Better? Transepithelial CXL Is Gaining Ground By Roy S. Rubinfeld, MD, and the CXL-USA Study Group At its simplest, corneal collagen cross-linking (CXL) is a

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 (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

Διαθλαζηικη Χειροσργικη 2014

Διαθλαζηικη Χειροσργικη 2014 Διαθλαζηικη Χειροσργικη 2014 Επιθηλιο Femto Κεραηοκωνος Διαζσνδεζη Κολλαγονοσ Anastasios John Kanellopoulos, MD Professor: NYU Medical School, New York, NY LaserVision.gr Eye Institute, Athens, Greece

More information

BY A. JOHN KANELLOPOULOS, MD

BY A. JOHN KANELLOPOULOS, MD Sequential Versus Simultaneous CXL and Topography-Guided PRK Simultaneous treatment appears to provide superior rehabilitation of keratoconus. BY A. JOHN KANELLOPOULOS, MD * Editor s note: The following

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

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

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

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

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

Original Article Corneal Collagen Cross Linking Pak Armed Forces Med J 2015; 65(1): 105-9

Original Article Corneal Collagen Cross Linking Pak Armed Forces Med J 2015; 65(1): 105-9 Original Article Corneal Collagen Cross Linking Pak Armed Forces Med J 2015; 65(1): 105-9 COMPARISON OF RAPID AND CONVENTIONAL CORNEAL COLLAGEN CROSS LINKING IN PATIENTS HAVING KERATOCONUS Intisar ul Haq,

More information

CENTRO OFTALMOLOGICO GUSTAVO TAMAYO BOGOTA COLOMBIA LASIK XTRA GUSTAVO TAMAYO MD CLAUDIA CASTELL MD PILAR VARGAS MD

CENTRO OFTALMOLOGICO GUSTAVO TAMAYO BOGOTA COLOMBIA LASIK XTRA GUSTAVO TAMAYO MD CLAUDIA CASTELL MD PILAR VARGAS MD CENTRO OFTALMOLOGICO GUSTAVO TAMAYO BOGOTA COLOMBIA LASIK XTRA GUSTAVO TAMAYO MD CLAUDIA CASTELL MD PILAR VARGAS MD From: BOGOTA LASER REFRACTIVE INSTITUTE Bogota, Colombia DISCLOSURES FOR GUSTAVO TAMAYO

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

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

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

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

Lasik Xtra in: Hyperopia AK Xtra Clear cornea cataract surgery

Lasik Xtra in: Hyperopia AK Xtra Clear cornea cataract surgery Lasik Xtra in: Hyperopia AK Xtra Clear cornea cataract surgery A. John Kanellopoulos, M.D. Clinical Profesor of Ophthalmology New York University School of Medicine, New York, NY, USA Laservision.gr Institute,

More 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

Clinical Results of Topography-based Customized Ablations in Highly Aberrated Eyes and Keratoconus/Ectasia With Cross-linking

Clinical Results of Topography-based Customized Ablations in Highly Aberrated Eyes and Keratoconus/Ectasia With Cross-linking Clinical Results of Topography-based Customized Ablations in Highly Aberrated Eyes and Keratoconus/Ectasia With Cross-linking David T.C. Lin, MD, FRCSC; Simon Holland, MD, FRCSC; Johnson C.H. Tan, MBBS,

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

9/15/2013. Naturally-existing Corneal Pathology Forme Fruste Keratoconus Keratoconus Pellucid Marginal Degeneration

9/15/2013. Naturally-existing Corneal Pathology Forme Fruste Keratoconus Keratoconus Pellucid Marginal Degeneration Bill Tullo, OD, FAAO Diplomate Vice-President of Clinical Services TLC Vision 33386-PO 1 Hour Bill Tullo, OD has no financial interests in any of the products or companies discussed in this program Naturally-existing

More information

WILL SURFACE ABLATION TECHNIQUES SURVIVE?

WILL SURFACE ABLATION TECHNIQUES SURVIVE? WILL SURFACE ABLATION TECHNIQUES SURVIVE? There will always be situations in which the original laser approach works best. BY SUPHI TANERI, MD I had the privilege of being trained in refractive surgery

More information

Simultaneous Photorefractive keratectomy (PRK) with Corneal Cross Linking (CXL) For Treatment of Early Keratoconus.

Simultaneous Photorefractive keratectomy (PRK) with Corneal Cross Linking (CXL) For Treatment of Early Keratoconus. Simultaneous Photorefractive keratectomy (PRK) with Corneal Cross Linking (CXL) For Treatment of Early Keratoconus. Mahmoud M Saleh, Ahmed I Galhoom, Mohamed A El-Malah, Abdelgany Ib Abdelgany Department

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

What We Do and Don t Know about Corneal Crosslinking. Roy Rubinfeld, MD

What We Do and Don t Know about Corneal Crosslinking. Roy Rubinfeld, MD What We Do and Don t Know about Corneal Crosslinking Roy Rubinfeld, MD Washington Eye Physicians and Surgeons Chevy Chase, MD Georgetown University Medical Center, Washington Hospital Center, Washington,

More information

Corneal Collagen Crosslinking: An Introduction to the New Paradigm in Keratoconus. Michael Waggoner DO McDonald Eye Associates Fayetteville AR

Corneal Collagen Crosslinking: An Introduction to the New Paradigm in Keratoconus. Michael Waggoner DO McDonald Eye Associates Fayetteville AR Corneal Collagen Crosslinking: An Introduction to the New Paradigm in Keratoconus Michael Waggoner DO McDonald Eye Associates Fayetteville AR Learning Objectives Gain knowledge in: The history of the development

More information

Information and Consent form for Corneal Collagen Cross-Linking

Information and Consent form for Corneal Collagen Cross-Linking Information and Consent form for Corneal Collagen Cross-Linking What is corneal collagen cross-linking? Although current treatments for keratoconus, such as contact lenses and corneal ring implants, can

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

By Dr Waleed Al-Tuwairqi, MD Dr Omnia Sherif, MD Ophthalmology Consultants, Elite Medical & Surgical Center Riyadh -KSA.

By Dr Waleed Al-Tuwairqi, MD Dr Omnia Sherif, MD Ophthalmology Consultants, Elite Medical & Surgical Center Riyadh -KSA. By Dr Waleed Al-Tuwairqi, MD Dr Omnia Sherif, MD Ophthalmology Consultants, Elite Medical & Surgical Center Riyadh -KSA Rome, Italy 2013 بسم الرحمن الرحيم In the name of Allah, Most Gracious, Most Merciful

More information

LASIK or PRK, the identified surgery, is referred to as the Procedure in the following:

LASIK or PRK, the identified surgery, is referred to as the Procedure in the following: At LASIK MD, we strongly believe that you should have all of the necessary information on-hand in order to make an informed decision about your procedure. The content of this consent form is not intended

More information

LASIK/PRK following previous eye Surgery

LASIK/PRK following previous eye Surgery AAO San Francisco 2009 LASIK/PRK following previous eye Surgery A. John Kanellopoulos, MD Associate Clinical Professor, NYU Medical School Director: Laservision.gr Eye Institute, Athens, Greece www.brilliantvision.com

More information

This is the author s version of a work that was submitted/accepted for publication in the following source:

This is the author s version of a work that was submitted/accepted for publication in the following source: This is the author s version of a work that was submitted/accepted for publication in the following source: Zeraid, Ferial M., Jawkhab, Asma A., Al-Tuwairqi, Waleed S., & Osuagwu, Uchechukwu L. (2014)

More information

Review Article Complications of Corneal Collagen Cross-Linking

Review Article Complications of Corneal Collagen Cross-Linking Hindawi Publishing Corporation Journal of Ophthalmology Volume 2011, Article ID 869015, 5 pages doi:10.1155/2011/869015 Review Article Complications of Corneal Collagen Cross-Linking Shikha Dhawan, Kavita

More information

INFORMED CONSENT FOR PHOTOREFRACTIVE KERATECTOMY (PRK)

INFORMED CONSENT FOR PHOTOREFRACTIVE KERATECTOMY (PRK) INFORMED CONSENT FOR PHOTOREFRACTIVE KERATECTOMY (PRK) This information and the Patient Information booklet must be reviewed so you can make an informed decision regarding Photorefractive Keratectomy (PRK)

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

Crosslinking and Long-Term Hyperopic LASIK Stability Initial Clinical Findings in Contralateral Eye Study

Crosslinking and Long-Term Hyperopic LASIK Stability Initial Clinical Findings in Contralateral Eye Study ASCRS 2012 Crosslinking and Long-Term Hyperopic LASIK Stability Initial Clinical Findings in Contralateral Eye Study Jonathan B. Kahn, M.D. 1 and A. John Kanellopoulos, M.D. 1,2 1 New York University School

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

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

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

Photorefractive keratectomy in mild to moderate keratoconus: Outcomes in over 40 year old patients

Photorefractive keratectomy in mild to moderate keratoconus: Outcomes in over 40 year old patients Original Article Photorefractive keratectomy in mild to moderate keratoconus: Outcomes in over 40 year old patients Hamid Khakshoor, Fatemeh Razavi, Alireza Eslampour 1, Arash Omdtabrizi 1 Background:

More information

REFRACTIVE SURGERY NIGHTMARES Dr.ATHIYA AGARWAL

REFRACTIVE SURGERY NIGHTMARES Dr.ATHIYA AGARWAL REFRACTIVE SURGERY NIGHTMARES Dr.ATHIYA AGARWAL POST LASIK INFECTION Infection occurring after photorefractive keratectomy (PRK) may be 1. Secondary to the defect in the epithelium as well as the use of

More information

Excimer Laser Photorefractive Keratectomy for Keratoconus

Excimer Laser Photorefractive Keratectomy for Keratoconus C H A P T E R 1 4 Excimer Laser Photorefractive Keratectomy for Keratoconus Arun C. Gulani, MD; Lee T. Nordan, MD; Noel Alpins, FRANZCO, FRCOphth, FACS; and George Stamatelatos, BSCOptom P atients with

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

LASIK/PRK following previous eye Surgery

LASIK/PRK following previous eye Surgery AAO Chicago 2010 LASIK/PRK following previous eye Surgery A. John Kanellopoulos, MD Associate Clinical Professor, NYU Medical School Director: Laservision.gr Eye Institute, Athens, Greece www.brilliantvision.com

More information

INFORMED CONSENT FOR PHOTOREFRACTIVE KERATECTOMY (PRK)

INFORMED CONSENT FOR PHOTOREFRACTIVE KERATECTOMY (PRK) 1550 Oak St., Suite 5 1515 Oak St., St Eugene, OR 97401 Eugene, OR 97401 (541) 687-2110 (541) 344-2010 INFORMED CONSENT FOR PHOTOREFRACTIVE KERATECTOMY (PRK) This information is to help you make an informed

More information

I have read and understood this page. Patient Initials

I have read and understood this page. Patient Initials INFORMED CONSENT FOR PHOTOREFRACTIVE KERATECTOMY (PRK) AND ADVANCE SURFACE ABLATION (ASA) This information and the Patient Information booklet must be reviewed so you can make an informed decision regarding

More information

Diego Fernando Suárez Sierra, MD Fellow Cornea and Refractive Surgery Fellow Lens and Ocular Surface Vejarano Laser Vision Center

Diego Fernando Suárez Sierra, MD Fellow Cornea and Refractive Surgery Fellow Lens and Ocular Surface Vejarano Laser Vision Center Corneal crosslinking with riboflavin and ultraviolet light before or after subepithelial keratectomy laser-assisted (LASEK) in patients with thin corneas. Diego Fernando Suárez Sierra, MD Fellow Cornea

More information

Keratometric Changes after Corneal Collagen Cross linking for Keratoconus

Keratometric Changes after Corneal Collagen Cross linking for Keratoconus Original Article ISSN (O):2395-2822; ISSN (P):2395-2814 Keratometric Changes after Corneal Collagen Cross linking for Keratoconus Muhemmed Swadique 1, Priya S 2, Sanju TS 3 1 Associate Professor, Dept.

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

Irregular astigmatism can occur naturally or due to

Irregular astigmatism can occur naturally or due to Combined Topography- Guided Transepithelial PRK and CXL in Patients With Keratoconus The combined procedure strengthens the cornea and regularizes the anterior surface. BY MIRKO R. JANKOV II, MD, PHD;

More information

Keratoconus Lasers, Lenses & Boomerangs (the journey, missing links, and management & treatment options) Moderator: Jan P G Bergmanson, OD, PhD

Keratoconus Lasers, Lenses & Boomerangs (the journey, missing links, and management & treatment options) Moderator: Jan P G Bergmanson, OD, PhD 2014 AAO CCLRT Section Symposium Keratoconus Lasers, Lenses & Boomerangs (the journey, missing links, and management & treatment options) Moderator: Jan P G Bergmanson, OD, PhD Recurrent Keratoconus: Does

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

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

Medical Director, Shinagawa LASIK Center, Tokyo, Japan Adjunct Professor, Department of Ophthalmology, Wenzhou Medical College, Wenzhou, China

Medical Director, Shinagawa LASIK Center, Tokyo, Japan Adjunct Professor, Department of Ophthalmology, Wenzhou Medical College, Wenzhou, China Medical Director,, Tokyo, Japan Adjunct Professor, Department of Ophthalmology, Wenzhou Medical College, Wenzhou, China Financial disclosure: Ziemer Group AG, Switzerland AcuFocus, CA Schwind Eye-Tech-Solutions,

More 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

Ophthalmology Symposium

Ophthalmology Symposium Thursday 22, January 2015 T1A Cornea and Refractive Surgery Course: Abdulhameed Al Ghamdi, MD 17:00 18:00 Corneal Topography A-Z 18:00 18:20 Prayer and Break T2A Cornea and Keratoconus Course: Serene Jouhargy,

More information

Complication and failure rates after corneal crosslinking

Complication and failure rates after corneal crosslinking ARTICLE Complication and failure rates after corneal crosslinking Tobias Koller, MD, Michael Mrochen, PhD, Theo Seiler, MD, PhD PURPOSE: To evaluate the complication rate of corneal crosslinking (CXL)

More information

Elsevier Editorial System(tm) for Journal of Cataract & Refractive Surgery Manuscript Draft

Elsevier Editorial System(tm) for Journal of Cataract & Refractive Surgery Manuscript Draft Elsevier Editorial System(tm) for Journal of Cataract & Refractive Surgery Manuscript Draft Manuscript Number: Title: Keratoconus exacerbation after cross-linking and surface ablation - a case report Article

More information

Page: 1 of 6. Corneal Topography/Computer-Assisted Corneal Topography/ Photokeratoscopy

Page: 1 of 6. Corneal Topography/Computer-Assisted Corneal Topography/ Photokeratoscopy Section: Surgery Effective Date: July 15, 2015 Last Review Status/Date: June 2015 Page: 1 of 6 Corneal Topography/ Photokeratoscopy Description Computer-assisted topography/photokeratoscopy provides a

More information

Collagen Cross Linking in the limelight: The Universal Dream of Keratoconus Treatment

Collagen Cross Linking in the limelight: The Universal Dream of Keratoconus Treatment Collagen Cross Linking in the limelight: The Universal Dream of Keratoconus Treatment Andrew S. Morgenstern, OD FAAO Booz Allen Hamilton Contractor at The Vision Center of Excellence Who We Work For My

More information

REFRACTIVE ERROR AND SURGERIES IN THE UNITED STATES

REFRACTIVE ERROR AND SURGERIES IN THE UNITED STATES Introduction REFRACTIVE ERROR AND SURGERIES IN THE UNITED STATES 150 million wear eyeglasses or contact lenses 2.3 million refractive surgeries performed between 1995 and 2001 Introduction REFRACTIVE SURGERY:

More information

Lasik Xtra Provides Corneal Stability and Improved Outcomes

Lasik Xtra Provides Corneal Stability and Improved Outcomes DOI 10.1007/s40123-015-0039-x REVIEW Lasik Xtra Provides Corneal Stability and Improved Outcomes Rajesh K. Rajpal. Christine B. Wisecarver. Dawn Williams. Sachin D. Rajpal. Rhonda Kerzner. Nick Nianiaris.

More information

Refractive Errors. Refractive Surgery. Eye Care In Modern Life. Structure of the Eye. Structure of the Eye. Structure of the Eye. Structure of the Eye

Refractive Errors. Refractive Surgery. Eye Care In Modern Life. Structure of the Eye. Structure of the Eye. Structure of the Eye. Structure of the Eye Structure of the Eye Eye Care In Modern Life Dr. Dorothy Fan Department of Ophthalmology & Visual Sciences September 2007 Information age > 90% of sensory input Blindness is one of the most fearful disabilities

More information

Collagen Crosslinking and Management of Keratoconus Christopher Chow, M.D. Michigan Cornea Consultants Oakland University William Beaumont School of Medicine May 11, 2012 2 Keratoconus First described

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

Eye Care In Modern Life

Eye Care In Modern Life Eye Care In Modern Life Dr. Dorothy Fan Department of Ophthalmology & Visual Sciences November 2009 dorothyfan@cuhk.edu.hk Structure of the Eye Information age > 90% of sensory input Blindness is one of

More information

VISION PATTERN. What Can you Expect from the ReSTOR procedure?

VISION PATTERN. What Can you Expect from the ReSTOR procedure? RESTOR Presbyopia is the normal aging process that everyone experiences over the age of 40 which affects near vision. This usually results in the need for reading glasses or bifocals. The crystalline lens

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

Topography-guided laser refractive surgery

Topography-guided laser refractive surgery REVIEW C URRENT OPINION Topography-guided laser refractive surgery Simon Holland a,b, David T.C. Lin a, and Johnson C.H. Tan b,c Purpose of review Topography-guided laser refractive surgery regularizes

More information

Sharjah: Al Zahra Private Hospital, Al Zahra square Tel: 06 5619999, Appointments: 06 5167080, 06 5167081

Sharjah: Al Zahra Private Hospital, Al Zahra square Tel: 06 5619999, Appointments: 06 5167080, 06 5167081 Sharjah: Al Zahra Private Hospital, Al Zahra square Tel: 06 5619999, Appointments: 06 5167080, 06 5167081 Email: alzahra@alzahra.com Dubai: Al Zahra Medical Centre, Sheikh Zayed Road Tel: 04 3315000, Appointments:

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

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

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

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

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

Surface Ablation After Corneal

Surface Ablation After Corneal Surface Ablation After Corneal Surgery: Management of Haze Helen K. Wu, MD New England Eye Center Tufts University School of Medicine Boston, MA Financial Disclosures Travel Stipend/Honoraries: IOP Ophthalmics

More information

A.M.Sherif,M.A.Ammar,Y.S.Mostafa,S.A.GamalEldin,andA.A.Osman. Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo 12411, Egypt

A.M.Sherif,M.A.Ammar,Y.S.Mostafa,S.A.GamalEldin,andA.A.Osman. Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo 12411, Egypt Ophthalmology Volume 2015, Article ID 321953, 7 pages http://dx.doi.org/10.1155/2015/321953 Clinical Study One-Year Results of Simultaneous Topography-Guided Photorefractive Keratectomy and Corneal Collagen

More information

The concept of a proactive intervention involving in situ

The concept of a proactive intervention involving in situ CLINICAL SCIENCE Epithelial Remodeling After Femtosecond Laser-assisted High Myopic LASIK: Comparison of Stand-alone With LASIK Combined With Prophylactic High-fluence Cross-linking Anastasios J. Kanellopoulos,

More information

Cornea and Refractive Surgery Update

Cornea and Refractive Surgery Update Cornea and Refractive Surgery Update Fall 2015 Optometric Education Dinner Sebastian Lesniak MD Matossian Eye Associates Disclosures: None Bio: Anterior Segment and Cornea Surgery Fellowship Wills Eye

More 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

Cross-Linking with Refractive Surgery: Pros and Cons

Cross-Linking with Refractive Surgery: Pros and Cons Cross-Linking with Refractive Surgery: Pros and Cons Raj K. Rajpal, M.D. Medical Director and Founder See Clearly Vision Group Mclean, Virginia Clinical Associate Professor Georgetown University Washington,

More 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

Collagen Cross-Linking: The Promise Keeps Growing

Collagen Cross-Linking: The Promise Keeps Growing Page 1 of 9 This Month's Issue CME Programs Archive Newsletter Archive Retina Online Archive Idea Exchange Meetings/CME Calendar of Events About the Review Author Guidelines Contact Us Subscription Services

More information

Consent for Bilateral Simultaneous Refractive Surgery PRK

Consent for Bilateral Simultaneous Refractive Surgery PRK Consent for Bilateral Simultaneous Refractive Surgery PRK Please sign and return Patient Copy While many patients choose to have both eyes treated at the same surgical setting, there may be risks associated

More information

Eye Surgery. Laser Eye Surgery and Refractive Surgery

Eye Surgery. Laser Eye Surgery and Refractive Surgery Eye Surgery Laser Eye Surgery and Refractive Surgery Traditional LASIK (Laser-In-Situ-Keratomileusis) Technique is the most practiced surgical procedure for resolving of the eyesight problems with dominating

More information

Call today at 1 877 702 2020

Call today at 1 877 702 2020 Call today at 1 877 702 2020 VISIAN ICL LASIK is a well known, successful, and accurate laser vision correction procedure which has been FDA approved in the U.S. for 15 years. The majority of patients

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

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

Crosslinking for Keratoconus in Down syndrome

Crosslinking for Keratoconus in Down syndrome Crosslinking for Keratoconus in Down C. Koppen MD, I. Leysen MD, MJ. Tassignon MD, PhD Antwerp University Hospital, Dep of Ophthalmology Antwerp University, Faculty of Medicine Down and the cornea Thinning

More information

Keratoconus. What is keratoconus?

Keratoconus. What is keratoconus? Keratoconus What is keratoconus? Keratoconus is a common bilateral corneal condition, occurring in more than 1 in 1000 people. The condition typically starts in adolescence and early adulthood. Keratoconus

More information

LASIK. Complications. Customized Ablations. Photorefractive Keratectomy. Femtosecond Keratome for LASIK. Cornea Resculpted

LASIK. Complications. Customized Ablations. Photorefractive Keratectomy. Femtosecond Keratome for LASIK. Cornea Resculpted Refractive Surgery: Which Procedure for Which Patient? David R. Hardten, M.D. Minneapolis, Minnesota Have done research, consulting, or speaking for: Alcon, Allergan, AMO, Bausch & Lomb, Inspire, Medtronic,

More 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

Management of Epithelial Ingrowth after LASIK. Helen K. Wu, MD New England Eye Center Tufts University School of Medicine Boston, MA

Management of Epithelial Ingrowth after LASIK. Helen K. Wu, MD New England Eye Center Tufts University School of Medicine Boston, MA Management of Epithelial Ingrowth after LASIK Helen K. Wu, MD New England Eye Center Tufts University School of Medicine Boston, MA Acknowledgements IOP Ophthalmics Staar Surgical Case Presentation 46

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