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CENTRO OFTALMOLOGICO GUSTAVO TAMAYO BOGOTA COLOMBIA

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 MD. Member of the Advisory Board for AMO Inc.

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CENTRO OFTALMOLOGICO GUSTAVO TAMAYO BOGOTA COLOMBIA

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

  2. DISCLOSURES FOR GUSTAVO TAMAYO MD • Member of the Advisory Board for AMO Inc. • Member of the Advisory Board PRESBIA Corp. • Member of the Advisory Board EYEGENICS Corp. • Member of the Speakers Group for AVEDRO • Member of speakers group of KERAMED • Patent holder of a Presbyopia treatment

  3. LASIK XTRA • A new concept: KXL at the time of a LASIK surgery. • There is no doubt any surgery involving the creation of a flap will decrease the strength of the cornea. • Microkeratomes decrease the corneal strenghth two times more than Femtosecond flaps (own published studies). • If the addition of KXL does not change the final result: WHY NOT?

  4. LASIK XTRA • Very short procedure: one minute soaking time and one minute fifteen seconds UV. • Does not change the normal LASIK procedure itself. • Same ablation, same handling of the flap. • In my own cases we did not detect any change in the refractive result. • No complications added at all to the normal regular procedure of LASIK.

  5. INCORPORATING LASIK XTRA INTO STANDARD LASIK SURGERY • Avedro’s VīBex Riboflavin is applied to the flap bed: • Isotonic • 0.1% riboflavin • 20% Dextran T500 • pH 7.0 Following excimer laser ablation in the flap bed The flap is repositioned and the cornea is then exposed to 30mW/cm2 UVA for 2 minutes

  6. LASIK XTRA ADVANTAGES • Can be carried out with Intralase or with Microkeratome flap. • Do not change the regular procedure. • Easy and simple for Doctor and Patient. • Do not change the final result of the ablation. • Can also be used regardless of the thickness of the flap, depth of ablation or type of Excimer Laser.

  7. LASIK XTRA DISADVANTAGES • Slows down the procedure for a couple of minutes. • Increases the cost.

  8. LASIK XTRA INDICATIONSSTRONG CONSIDERATIONS • ABSOLUTELY CONTRAINDICATED IN THE PRESENCE OF ECTASIA. • ABSOLUTELY NOT INDICATED WHEN DEVELOPMENT OF ECASIA IS WARRANTED. • In such a case I prefer Surface Ablation plus Accelerated Cross Linking.

  9. LASIK XTRA INDICATIONS • Young patients for Lasik (under 24 years of age). • Patients with severe ocular allergies, due to the risk of heavy rubbing. • Completely normal corneas, with no one sign of Keratoconus, but family history. • Thin corneas with complete normal preoperative evaluation (Risk of ectasia has been ruled out). • High myopes (large resections)

  10. LASIK XTRA INDICATIONS • Retreatments, particularly if the thickness of the flap is not known. • Unexpected thick flap. • Irregular flaps with different thickness. • FINALLY IN ALL LASIK CASES: IF IT DOES NOT CHANGE THE RESULT WHY NOT???

  11. LASIK XTRA: Predictable Visual Outcomes Retrospective Comparison of 66 Lasik eyes to 42 LASIK eyes treated for myopia • Mean age: 26.55 in the Lasik Xtra cohort and 27.28 in the LASIK cohort • Mean preoperative MRSE was -2.97 D (Lasik Xtra), and -2.25 D (LASIK). • No adjustment was made to the excimer laser treatment nomogram to account for aCXL, which was performed immediately following stromal ablation

  12. LASIK XTRA: Predictable Visual Outcomes Retrospective Comparison of 66 Lasik eyes to 42 LASIK eyes treated for myopia • Mean UCVA at 1 Day Post-Op 20/21 Lasik Xtra vs 20/20 LASIK • Mean UCVA at 1 Week Post-Op 20/20 Lasik Xtra vs 20/20 LASIK • Mean UCVA at 1 Month Post-Op 20/18 Lasik Xtra vs 20/20 LASIK

  13. LASIK XTRA: Predictable Visual Outcomes Retrospective Comparison of 66 Lasik eyes to 42 LASIK eyes treated for myopia • Mean MRSE at 1 Week Post-Op +0.17 Lasik Xtra vs -0.73 LASIK • Mean MRSE at 1 Month Post-Op +0.49 Lasik Xtra vs +0.17 LASIK

  14. LASIK XTRA: Predictable Visual Outcomes UCVA 1 Day Post Operative

  15. LASIK XTRA: Predictable Visual Outcomes UCVA 1 Month Post Operative

  16. LASIK XTRA EXAMPLE # 1 PREOPERATIVE POSTOPERATIVE

  17. LASIK XTRA EXAMPLE # 2 PREOPERATIVE POSTOPERATIVE

  18. LASIK XTRA EXAMPLE # 2 POSTOPERATIVE PREOPERATIVE

  19. CONCLUSION LASIK XTRA • No need to change nomogramfor LASIK procedures (Femto or microkeratome). • No change in the final results when compared to same procedures without KXL. • No haze or loss of lines of BCVA. • Time for surgery is increased only few more minutes. • Follow up only one year and one eye retreatment in 100 eyes. • Lifting the flap was very easy (surgeon was not aware of the KXL at the time of relifting).

  20. Gracias

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