Lasik Refractive Surgery Dr Vidushi Sharma Dr Suresh Pandey, SuVi Eye Kota India


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Slide 1 : Refractive Surgery Dr. Vidushi Sharma MD (AIIMS), FRCS (UK) Dr Suresh K Pandey, MS, ASF (USA) SuVi Eye Institute & Visx Custom Vue Lasik Laser Center, Kota, Rajasthan, India Website: www.suvieye.com E-mail: suvieye@gmail.com Phone +91 744 2406744, +91 9351412449
Slide 2 : Refractive Surgery Many efforts historically to get rid of glasses Ancient Chinese slept with sandbags on their eyes to flatten the cornea In eighteenth century, Dr. J. Ball made an eye cup with small spring-mounted mallet that struck the cornea through the closed eyelid
Slide 3 : Refractive surgery Cornea based Lens based Cornea has a power of 43 to 45 D compared to lens with about 15 D
Slide 4 : Cornea based Incisional – RK, AK Laser based – PRK, LASIK Variations like EpiLAISK, Lasek etc. Development of femtosecond laser INTACS Conductive Keratoplasty – Holmium laser or radiofrequency probe
Slide 5 : Radial Keratotomy Popularized in USSR by Fyodorov
Slide 6 : Radial Keratotomy Based on observations during removal of glass pieces and corneal rupture
Slide 7 : Radial and Astigmatic Keratotomy LRIs used in conjunction with phaco surgery
Slide 8 : Laser based Excimer laser used in chip manufacturing, micromachining etc. Blum, Srinivasan and Wynne discovered the use of excimer laser on biological tissue Excimer laser causes ablation rather than cutting or burning material
Slide 9 : Excimer Laser Used to reshape the cornea
Slide 10 : PRK Epithelium removed from the centre of cornea Laser to reshape Slower healing, more pain and discomfort, more regression, corneal haze Useful in thin corneas
Slide 11 : LASIK Creation of a flap Laser on the stromal bed Flap repositioned
Slide 12 : Lasik Refractive Surgery
Slide 13 : LASIK
Slide 14 : LASIK Microkeratome Excimer machine Custom treatments (Wavefront analysis)
Slide 15 : Microkeratome Used to create a flap Many advancements
Slide 16 : Microkeratome Nasal or superior hinged flap
Slide 17 : Laser Solid state -213 nm Excimer laser – 193 nm Broad beam Flying spot Slit and spot Variable spot Tracking systems
Slide 18 : Excimer Laser
Slide 19 : Wave Front Analysis
Slide 20 : Wavefront analysis
Slide 21 : Wavefront analysis
Slide 22 : Higher order aberrations Some patients benefit
Slide 23 : Work up Extensive pre – LASIK work-up essential Corneal thickness, topography, retinal examination etc. Night vision – glare, starbursts, haloes in some cases Dryness needing eyedrops
Slide 24 : Starbursts and haloes Newer softwares, blend zones etc. reduce these problems
Slide 25 : Variations of LASIK Surface ablation – PRK Advanced surface ablation LASEK Epi-LASIK (E-LASIK) Sub-Bowman’s Keratomileusis (SBK) Femtosecond laser (All laser LASIK)
Slide 26 : Femtosecond Laser (Intralase) Used to create the flap
Slide 27 : Intralase flap
Slide 28 : Intralase (Blade Free LASIK)
Slide 29 : INTACS® Intrastromal Corneal Ring Segments
Slide 30 : INTACS Earlier used to correct low myopia Now approved for Keratoconus Reversible
Slide 31 : INTACS
Slide 32 : Lens based Refractive Surgery ICLs Prelex – refractive lens exchange
Slide 33 : ICL (Implantable Collamer Lens) Phakic intraocular lens or Implantable Contact lens
Slide 34 : Precautions Only for suitable candidates Other diseases can still develop Regular Retina check Falsely low IOP specially after LASIK Problems in night vision with larger pupils Will need reading glasses after 40 like others
Slide 35 : Complications Relatively very safe Advancements have made complications rare Flap related complications – loss of flap, partial cut, free flap, wrinkles etc. Infection, Inflammation Under or overcorrection Dry Eyes
Slide 36 : Myopic LASIK (Video)
Slide 37 : Hyperopic LASIK (Video)
Slide 38 : Myopic LASIK (Video)
Slide 39 : Team SuVi Eye Kota, Rajasthan, India
Slide 40 : THANK YOU
Slide 41 : Refractive Surgery Dr. Vidushi Sharma MD (AIIMS), FRCS (UK) Dr Suresh K Pandey, MS, ASF (USA) SuVi Eye Institute & Visx Custom Vue Lasik Laser Center, Kota, Rajasthan, India Website: www.suvieye.com E-mail: suvieye@gmail.com Phone +91 744 2406744, +91 9351412449

 



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