refractive surgery results are perfect provided surgeon is not tempted to operate in contraindicated patients !

1. LASIK DEMYSTIFIED
PRK REVISITED
INDOREDRISHTI.WORDPRESS.COM

3. DR DINESH MITTAL DR SONALEE MITTAL
DRISHTI EYE HOSP VIJAYNAGAR INDORE

4. Eye’s refractive power determined by
1. Power of the cornea
2. Power of the lens
3. Length of the eye
EMMETROPIA
- IMAGE OF
THE OBJECT
BEING
VIEWED IS
FOCUSED
ON RETINA

5. 1. Myopia
- Near-sightedness
- Image is focused
in front of retina
2. Hyperopia
- Far-sightedness
- Image is focused
behind retina

6. LASIK (Laser-assisted in situ keratomileusis)
• Most commonly
performed refractive
surgery
• Excimer laser ablation
of corneal stroma
beneath a hinged
corneal flap created
with a mechanical
microkeratome /
femtosecond laser

7. LASIK STEPS
TOPICAL
ANAESTHESIA
SUCTION
RING
MICROKERAT
OME HEAD
EXCIMER LASER FLAPFLAP PUT BACK

8. NEW
CURVATURE
LASIK

9. ADVANCED SURFACE ABLATIONS

10. REMOVAL OF EPITHELIUM
SPATULA
⓴% ALCHOL
ROTARY BRUSH

12. MUNNERLYN FORMULA

13. PERCENT TISSUE ALTERED PTA

14. PTA SHOULD BE LESS THAN 40 %

15. COMPLICATION LASIK ASA
ECTASIA ***** *
FLAP RELATED ***** NO
HAZE * ***
DRY EYE ** *
INFECTIONS * **
INFLAMMATORY *** *
IRREGULAR
ASTIGMATISM
* *

19. SCREENING
ALGORITHM

21. Refractive surgery trends

22. lasik

23. lasik

24. PREOP TESTING

25. EVALUATION

26. INDICATIONS

27. EXAMINATION

28. EQUIPMENT

29. TOPOGRAPHIC ANALYSIS
Keratometry & Computerized Videokeratography

30. PACHYMETRY
measuring thickness of cornea
ULTRASONIC
PACHYMETRY
Minimum bed
thickness (275µ)

31. TOP ❿ RED FLAGS

32. screening

33. consultation

34. OCULAR DISEASE

35. Visually demanding
occupations

36. Inappropriate expectations

38.  All corneal refractive surgical
procedures reduce corneal
strength to varying degrees
 Excessive corneal
weakening can result in
nonprogressive irregular
astigmatism or progressive
corneal ectasia

39. ECTASIA RISK SCORE SYSTEM

40. TO BE CONTINUED IN PART 2

41. LASIK DEMYSTIFIED
PRK REVISITED
INDOREDRISHTI.WORDPRESS.COM
PART 2

42. DR DINESH MITTAL DR SONALEE MITTAL
DRISHTI EYE HOSP VIJAYNAGAR INDORE

43. TOMOGRAPHY
THANKS TO MAZEN M SINZAB

44. TOMOGRAPHY
• ANTERIOR CURVATURE
( TOPOGRAPHY )
• ANT. & POST. CORNEAL
SURFACE ELEVATION DATA
• REGIONAL CORNEAL
THICKNESS
• BELIN / AMBROSIO DISPLAY
FOR EARLY DETECTION OF
ECTASIA
PENTACAM GOLD STANDARD GIVE ALL ABOVE DATA

45. Topography pattern categories

50. pentacam

75. BFS>8 ANT ; >18 POST

76. DECISION
PRK
NO RISK DO PRK OR LASIK

77. K READINGS

78. K READINGS

79. K READINGS

80. K READINGS

81. K READINGS

82. K READINGS

83. K READINGS

84. K READINGS effect on flap properties

85. TO BE CONTINUED
IN PART 3

86. LASIK DEMYSTIFIED
PRK REVISITED
INDOREDRISHTI.WORDPRESS.COM
PART 3

87. DR DINESH MITTAL DR SONALEE MITTAL
DRISHTI EYE HOSP VIJAYNAGAR INDORE

126. THANKYOU
DR DINESH
DR SONALEE