The LASIK Handbook

INTRODUCTION BASIC LASIK (R. Feder and A. Cirino): Patient Evaluation: Psycho-Social Factors / Anatomical Factors / Evaluation / Discussing the Risks of Surgery. Surgical Planning: What Correction Should Be Entered into the Laser's Computer? / What Is the Appropriate Treatment Zone? / What Will Be the Maximum Ablation Depth? / What Is the Appropriate Flap Thickness? / What Is the Appropriate Flap Diameter? The Procedure: Preoperative Medication / Marking the Patient / Setting the Oculars / Environmental Conditions in the Laser Suite / Preoperative Checklist / Microkeratome / Excimer Laser / Prep, Drape, and Speculum Insertion / Patient Positioning / Ring Placement / Flap Positioning / Flap Thickness / The Laser Ablation / Flap Repositioning / Immediate Postoperative Evaluation EQUIPMENT (R. Feder, M. Macsai, S. Rosenfeld, M. Vrabec, P. Majmudar, C. Kraff and J. Rubenstein): Corneal Topography: Available Systems / Keratoconus Detection. The Microkeratomes: Two-Piece Microkeratome / One-Piece Microkeratome (Nidek) / Manual versus Automated Microkeratomes. Femtosecond Laser for LASIK Flap Creation: Laser Physics / Patient Selection / Technique / Further Considerations of the Femtosecond Laser. The Lasers: The Bausch and Lomb Technolas Platform / VISX Star S4 Platform / The LADARVision(R) System / Nidek Excimer Laser Corneal Surgery System THE ROLE OF MITOMYCIN-C IN KERATOREFRACTIVE SURGERY (P. Majmudar): Treatment of Existing Corneal Haze with Mitomycin-C. Prophylactic Treatment with Mitomycin-C RETREATMENT OF PATIENTS AFTER PRIMARY REFRACTIVE SURGERY (M. Rosenberg): Indications. Common Postoperative Vision Problems: Asymmetry of Visual Acuity / Night Vision Symptomology / Oblique Astigmatism / Unrecognized Anisometropia / Asthenopia in Uncorrected Pre-Presbyopic Patients. Evaluation. Surgical Techniques for Retreatment: Standard Excimer Laser Retreatment beneath a Previously Made LASIK Flap / Simple Surface Retreatment after Primary Surface Ablation / Limbal Relaxing Incisions / LASIK Retreatment in Patients Having Undergone Prior Surface Treatment / Surface Retreatment in Patients Having Undergone Prior LASIK / Custom Surface or LASIK Retreatment of Patients with Prior Conventional Treatment LASIK COMPLICATIONS AND MANAGEMENT (C. Rapuano): Intraoperative Complications: Shredded Flap / Buttonhole Flap / Short or Decentered Flap with an Edge in Laser Treatment Zone / Free Cap / Interface Debris / Epithelial Loosening or Defect / Limbal Bleeding / Poorly Adherent Flap. Postoperative Complications: Flap Displacement / Infection / Diffuse Lamellar Keratitis / Pressure-Induced Stromal Keratitis / Microstriae / Macrostriae / Dry Eye Syndrome/Neurotrophic Epitheliopathy / Glare/Halos / Epithelial Ingrowth / Corneal Ectasia / Central Islands ALTERNATIVES TO LASIK REFRACTIVE SURGERY (L. Gans): Surface Ablation: PRK/ LASEK/ EPI-LASIK. Incisional Procedures: Astigmatic Keratotomy and Limbal Relaxing Keratotomy / Radial Keratotomy. Thermal Procedures: Conductive Keratoplasty / Holmium LTK. Augmentation Procedures: Keratophakia / Epikeratoplasty / Orthokeratology / Lens Implantation. Advanced Technology Intraocular Lenses: Toric Intraocular Lenses / Multifocal Intraocular Lenses / Accommodative Intraocular Lenses / Phakic Intraocular Lenses / Bioptics CASE SECTION (R. Feder, A. Cirino, M. Macsai, S. Rosenfeld, M. Vrabec, P. Majmudar, C. Kraff, J. Rubenstein, M. Rosenberg, C. Rapuano and L. Gans): Preoperative Decision-Making. Intraoperative Decision-Making. Postoperative Decision-Making SELF-ASSESSMENT TEST (R. Feder) CONCLUSION APPENDIX: MANUFACTURER CONTACT INFORMATION