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LASIK. Aravind Eye Hospital, Tirunelveli. Introduction. Technological explosion in field of refractive surgery 25 years later, 20 different refractive surgical techniques - Lasik currently most widely used. Indications. Myopia (-1-to-15D) Hypermetropia (+1-to+8D)
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LASIK Aravind Eye Hospital, Tirunelveli
Introduction Technological explosion in field of refractive surgery 25 years later, 20 different refractive surgical techniques - Lasik currently most widely used
Indications Myopia (-1-to-15D) Hypermetropia (+1-to+8D) need for modification of current algorithms & better ablation profile to improve predictability Astigmatism: - range from – 0.5 D. - in mixed astig may not be possible to correct in a single ablation
Pre Operative assessment Patient selection - Vital importance - patient education - practical knowledge of procedure - preshyopic age group
Patient selection Criteria Above 18 years of age Stable refraction for atleast for one year Refusal to use glass or Contact Lens Contact lens intolerance Absence of corneal pathology Realistic expectation from the procedure Properly obtained informed consent
History Stability of Refraction - stable atleast for preceding year - 18 years or Older - change in spherical equivalent should not be more than 0.50D over 12 months
Contact Lens - Reversible changes in refractive status of eye - Discontinue CL atleast 2 weeks in soft lens & 4 weeks in RGP / hard lens users.
Clinical Examination Uncorrected and best corrected visual acuity Manifest and cycloplegic refraction Fundus examination Slit lamp examination Keratometry and axial length Corneal topography Pachymetry Pupil size IOP Specular microscopy Glare & contrast sensitivity
Instruments Laser machine Eye tracking system Foot switches Micro keratome Power supply New blade Suction ring
Patient Preparation Some surgeons prefer to sedate Eye cleaned with 5 % povidone iodine solution Broad spectrum antibiotic Patient, head must be parallel to floor and the chin & forehead should be at the same level Patient cornea is perpendicular to laser beam Topical anaesthesia drops applied 10 minutes prior to surgery and just before inserting speculum Eye Drape.
Post operative management SIL after an hour Steroids for 1 week Tear supplements
Complications following Lasik though rare can be sight threatening Demand for safety Knowledge experience careful use and maintanence of microkerotome can reduce incidence of these complications Conclusion