1 / 35

Epi-LASIK with Moria Epi-K: Compared to PRK, LASEK, and LASIK

Intra-stromal vs. Sub-epithelial Ablation. LASIK flap presents biomechanical problems for optimal ablationHinge contributes to irregularity and may increase comaPost-op dryness may cause irregular healingLoss of stretch effect when cutting collagenSurface treatment has certain unique biochemical healing risksApoptosis with scarring and irregular collagen formationSlower healing characterized by pain and early poor acuity.

tino
Download Presentation

Epi-LASIK with Moria Epi-K: Compared to PRK, LASEK, and LASIK

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. Epi-LASIK with Moria Epi-K: Compared to PRK, LASEK, and LASIK Barrie D. Soloway, MD, FACS Director, Vision Correction Assistant Professor, Ophthalmology New York Eye and Ear Infirmary

    2. Intra-stromal vs. Sub-epithelial Ablation LASIK flap presents biomechanical problems for optimal ablation Hinge contributes to irregularity and may increase coma Post-op dryness may cause irregular healing Loss of stretch effect when cutting collagen Surface treatment has certain unique biochemical healing risks Apoptosis with scarring and irregular collagen formation Slower healing characterized by pain and early poor acuity

    3. Epi-LASIK: a marriage of two technologies Compared to other surface methods, a viable epithelial flap may: Decrease post-op pain Restore good acuity faster Decrease the formation of post/op healing haze Compared to LASIK, a viable epithelial flap may improve custom wavefront surgery results: Decrease the irregularity caused by the LASIK flap hinge Decrease the adverse biomechanical effects of cutting collagen in LASIK Decrease the effects of the LASIK flap being larger than the resultant bed and microstriae

    4. Purpose of this Study To compare 4 refractive surgical treatments, LASIK with thin flaps Epi-LASIK PRK with Mechanical epithelium removal and Trans-epithelial PRK Analyzing the efficacy and safety.

    5. MATERIAL AND METHODS Prospective study 80 eyes, 20 eyes per group. Equivalent demographic date with NSSD Age: 23-48 years SE: -2 to -9 D (astigm < 3 D) Pachymetry > 500 mirons Standard inclusion-exclusion criteria

    6. MATERIAL AND METHODS Topical anesthesia Allegreto 400 Q Wave Light (Q adjusted) LASIK: M2 90 SU, flaps 83 – 127 µ Epi-LASIK: MORIA Epi-K, removing the epithelium PRK (MtMC 0.02% 15 sec every 50 µ ablation) Mechanical with brush Trans-epithelial PRK : Allegreto PTK 9.5 mm, 50 µ

    7. MATERIAL AND METHODS Corneal Hysteresis Discomfort, Visual recovery Wavefront testing

    8. MATERIAL AND METHODS Cold BSS at start and end of surgery Acuvue ® contact lens soaked with Lidocaine 1%, during surgery Acular ®, Tobradex ®, TID. PF artificial tears

    9. LASIK Results - FLAP THICKNESS M2 SU-90 Ultrasound intra-op. 94.63 µ (sd 14.8) Range 81 – 124 µ Ratio Intended/Achieved (I/A): 1.06

    10. LASIK Results Flap Diameter > 9 mm Ratio I/A: 1.28 HINGE: Ratio I/A: 1.42

    11. LASIK Results FLAP DECENTRATION: 1 Case (1.2 mm) IRREGULARITIES OF THE EDGE: None FLAP STRIAE: 3 cases with micro-striate during the first 7 days not requiring repair

    12. RESULTS: Epi-LASIK DIAMETER 8.7 mm (sd 0.3) Range 8.2 – 9,3 mm Defined edges: 100% cases Decentration 2 cases (enlarged manually without problems)

    13. RESULTS: PRK Manual epithelial removal Diameter Adjusted Irregular edges: 80% Trans-epithelial laser removal Diameter Adjusted Irregular edges: 40%

    19. Epi-LASIK surgical procedure with Epi-KTM

    20. Why Epi-LASIK procedure ? 1. Faster healing than PRK 2. Faster visual recovery: “WOW” factor 3. Treatment of a wider range of patients 4. Differentiate yourself !

    21. Faster healing

    22. Faster visual recovery

    23. Better visual acuity

    24. Faster visual recovery

    25. Faster visual recovery

    26. Faster visual recovery than PRK

    27. The 5-minute Epi “Wow” factor “At 5 minutes: Most patients see 20/40 or better. Many see 20/20 or better.”

    28. With Epi-LASIK you can treat an additional range of patients: who do not accept post-op pain who want faster visual recovery than LASEK or PRK who view PRK/LASEK as an old-fashioned procedure who are looking for the latest technology available Epi-LASIK allows to ask for premium prices Epi-LASIK allows to: Differentiate yourself from centers doing PRK or LASEK

    29. Epi-LASIK: with or without the flap ? Both techniques give good outcomes Most surgeons today are discarding the flap

    30. Safety and design features: Metal separator Applanation plate Variable speed Disposable plastic head with integrated cleaver Why the Moria Epi-KTM ?

    31. Why Epi-LASIK over LASIK? The trend is to go back to the surface To minimize the risk of ectasia To treat a wider range of patients Visual outcomes: similar or superior to the femtosecond technology

    33. Why this return to the surface? Patients requests The post-LASIK risks of ectasia

    34. To minimize the risks of ectasia Lower risk of ectasia than with PRK Corneal biomechanics is not compromised like in LASIK Post-LASIK cases of ectasia are more and more reported and published:

    35. Patients looking for safety first Patients with dry eye syndrome Patients with thin corneas (<500 microns) Patients that have active life styles or occupations where flap dislodgement is a possibility Patients who don’t want their eyes cut and that have been turned off by the pain and long visual recovery of PRK/LASEK

    36. Thank you for your attention

More Related