A virtual ophthalmology waiting room for interactive CME activities: A new patient with a first-degree relative recently diagnosed with glaucoma and a new patient being evaluated for potential LASIK surgery. (Source: Modern Medicine)

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CONCLUSION: The described method permits real-time in vivo mapping of the SEP, thus providing the necessary basis for statistically robust conclusions concerning morphometric plexus alterations. PMID: 20813752 [PubMed - in process] (Source: The British Journal of Ophthalmology)

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(Source: Dishler Laser)

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All 12 TLC Laser Eye Centers in Southern California are changing their names to NVISION Laser Eye Centers. The name change accompanies the sale of TLC Vision's interest in the 12 centers to Medical Director Dr. Tom Tooma to become a separate LASIK brand. The new brand will operate as NVISION Laser Eye Centers and will have the same 12 Southern California locations, same surgeons and staff. In fact, the only thing that will change is the name to reflect additional eye care services now available for Southern California residents... (Source: Health News from Medical News Today)

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In modern cataract surgery, the precision by which the target refraction is achieved still remains unsatisfactory in many cases. Potential reasons include interindividual differences in wound healing, a postoperative shift of the anatomical position of the lens or previous refractive laser surgery. A system that allows for postoperative adjustment of target refraction would be highly beneficial. The light-adjustable lens (LAL, Calhoun Vision, Inc., Pasadena, CA) potentially represents such a system where refractive power is adjusted postoperatively using photosensitive silicone molecules and irradiation with ultraviolet (UV) light. Based on the principle of photochemistry and diffusion and using a well-defined spatial and temporal UV irradiance profile, the LAL is modified to add or subtra...

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TLC LASIK Centers Accused of Performing Procedures on Patients With Pre-Existing Conditions (Source: Health News: CBSNews.com)

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Perhaps an unusual post for a LASIK blog, but we find ourselves increasingly discovered in the world from our website and more importantly from this blog.  At any instant in time there are a myriad of people in front of a computer screen, much like the one you are reading now.  They are using their eyes, their vision, to see that screen and to see the world beyond it.  Our job at Dishler Laser Institute is to make that vision as clear as possible without the need for glasses or contact lenses. How people find us is through this internet along with the conventional "old school" referral patterns which bring new patients to doctors.  On the internet side, there are two powerful forces at work that measure the popularity we achieve and their names remind me ...

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Conclusion Crosslinking in patients with iatrogenic keratectasia stabilised the UCVA and BCVA as well as the maximum k-readings in our cohort. It seems to be a safe and promising procedure to stabilise the refraction and the corneal topography, and thus to stop the progression of visual loss, thereby avoiding or delaying disease progression and keratoplasty. PMID: 20679077 [PubMed - as supplied by publisher] (Source: The British Journal of Ophthalmology)

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Conclusion  Corneal spherical aberration and Z64 increased with corresponding increases in the internal spherical aberration and Z64 following LASIK. This may be an active compensatory mechanism of the internal optics to change, in order to reduce the effect of induced corneal HOA. Content Type Journal ArticleCategory Refractive SurgeryDOI 10.1007/s00417-010-1459-xAuthors Colm McAlinden, University of Ulster School of Biomedical Sciences Cromore Road Coleraine BT52 1SA UKJonathan E. Moore, University of Ulster Cathedral Eye Clinic 25-51 York Street Belfast BT15 1ED UK Journal Graefe's Archive for Clinical and Experimental OphthalmologyOnline ISSN 1435-702XPrint ISSN 0721-832X (Source: Graefe's Archive for Clinical and Experimental Ophthalmology)

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After struggling in the first two quarters of 2010, LCA-Vision, a Lasik provider, is closing its Birmingham location. (Source: bizjournals.com Health Care:Health Insurance headlines)

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(Source: Dishler Laser)

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People with certain vision problems had spectacles for centuries, and then came Lasik surgery. For several decades, people with hearing loss due to noise, viral infections or aging have had hearing aids to help maintain an aural tie to the world. After... (Source: OrlandoSentinel: Medical Research)

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Photorefractive keratectomy, laser epithelial keratomileusis (LASEK) and Epi-LASIK are all variants of a similar type refractive surgery involving laser on the surface of the cornea and differ mainly in management of the epithelium. Although laser in situ keratomileusis (LASIK) is currently the most popular form of refractive surgery, LASEK is the procedure of choice in some patients. We highlight potential complications of LASEK and how these may be managed. Following laser refractive surgery, corneal thickness is reduced, which has implications for intraocular pressure measurement and glaucoma screening and management. This is particularly important following surface laser procedures where no evidence of previous surgery may be visible. In the event that cataract surgery is required at a...MedWorm Sponsor Message: Watch the new MedWorm demo and find out how to get all the very latest, relevant, organized information daily!

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In the consultation section of the January issue, the refractive surgical problem involved a patient who was operated on for a pterygium but the surgeon did not know that laser in situ keratomileusis (LASIK) had been performed 10 years previously. The LASIK flap was excised during surgery, and irregular astigmatism and corneal scarring developed. The patient's visual acuity deteriorated to 20/100. (Source: Journal of Cataract and Refractive Surgery)

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(Source: Dishler Laser)MedWorm Sponsor Message: Watch the new MedWorm demo and find out how to get all the very latest, relevant, organized information daily!

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This study seeks to further understand the incidence of epithelial ingrowth after primary and flap-lift retreatment LASIK. Special attention was paid to procedures and patient variables that could influence the formation of epithelial ingrowth. (Source: Optometry - Journal of the American Optometric Association)MedWorm Sponsor Message: Watch the new MedWorm demo and find out how to get all the very latest, relevant, organized information daily!

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Authors: Titiyal JS, Agarwal T, Jhanji V, Sharma N PMID: 20530185 [PubMed - as supplied by publisher] (Source: The British Journal of Ophthalmology)

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Conclusion: There was a greater decrease in IOP measurement after LASIK by rebound tonometry, showing this method was more affected by surgery.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

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What to expect after the eye surgery (Source: Surgery News - Doctors Lounge)

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Before opting for laser eye surgery, you need to make sure you know what the procedure will entail and how it will work for you, writes FIONA REDDAN (Source: The Irish Times - Health)

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People with certain vision problems had spectacles for centuries, and then came Lasik surgery. For several decades, people with hearing loss due to noise, viral infections or aging have had hearing aids to help maintain an aural tie to the world. After... (Source: OrlandoSentinel: Medical Research)

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SAN DIEGO, March 10, 2010 (GLOBE NEWSWIRE) -- OccuLogix, Inc., dba TearLab Corporation ("TearLab") (Nasdaq:TEAR) (TSX:TLB), announced today that TLCVision Corporation, North America's premier eye care services company, will be incorporating the TearLab(tm) Osmolarity System ("TearLab System") in eight of its U.S. refractive surgery centers to study Dry Eye Disease ("DED") symptoms as they relate to LASIK surgery. (Source: Medical News (via PRIMEZONE))

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Health-care can be divided into three groups.  Thing you have to do like go to the emergency room when something bad happens, things you should do, like have a yearly physical, and the things you elect to do, like having LASIK vision correction.  There has been much said in the recent health-care debate and newly passed legislation about the first two categories, and despite my strong beliefs in this area, I want to concentrate on the last category, those things that you can have if you want them. LASIK in this sense is in the same realm as plastic surgery.  No one really needs cosmetic facial surgery, but many people have this to improve their self esteem.  Likewise, no one really needs LASIK to improve their vision, but many have this also as a way to improve their vi...MedWorm Sponsor Message: Watch the new MedWorm demo and find out how to get all the very latest, relevant, organized information daily!

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We present a technique and small consecutive case series for the use of nonabsorbable tube ligatures with postoperative suture lysis. This technique has the advantages of providing predictable control of postoperative intraocular pressure (because the ligature can be lysed at any time) and eliminating the need to pull a tube rip cord. There may also be a potential for thinner blebs and lower long-term intraocular pressure if the ligatures are left in place for longer periods. (Source: Archives of Opthalmology)MedWorm Sponsor Message: Watch the new MedWorm demo and find out how to get all the very latest, relevant, organized information daily!

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(Source: Dishler Laser)

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Conclusions  Both Epi-LASIK and LASIK show their own characteristics in increased higher-order aberration at smaller and larger pupil sizes, and may create different effects on optical quality for photopic (smaller pupil) and scotopic conditions (larger pupil). We speculate that the visual performance in the Epi-LASIK group may be better than in the LASIK group for the larger pupil size. Content Type Journal ArticleCategory Refractive SurgeryDOI 10.1007/s00417-010-1394-xAuthors Xiaoyan Yang, Tianjin Medical University Tianjin Eye Hospital, Clinical College of Ophthalmology No 4, Gansu Rd, Heping District Tianjin 300020 ChinaYan Wang, Tianjin Medical University Tianjin Eye Hospital, Clinical College of Ophthalmology No 4, Gansu Rd, Heping District Tianjin 300020 China...

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Conclusions Myopic correction by epi-LASIK surgery with all four methods showed stable visual results in terms of the 1-year postoperative clinical outcomes. Haziness levels revealed that treatment with 0.02% MMC was less effective than expected. Overall, the off-flap method offered faster visual recovery and less postoperative pain than the on-flap method. (Source: British Journal of Ophthalmology)

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Dr. Angela Nahl of La Jolla LASIK Institute recently became the first San Diego LASIK surgeon to perform refractive surgery on a patient using the new Ziemer Z-LASIK technology. The patient, who happens to be a physician, reported only minor discomfort and tested with 20/20 vision following the ten minute procedure. During LASIK, the surgeon cuts a flap in the patient's cornea, performs laser treatment and replaces the flap. Over the last eight years, the quality of results and speed of healing have been improved as lasers such as the IntraLase have replaced fine blades... (Source: Health News from Medical News Today)MedWorm Sponsor Message: Watch the new MedWorm demo and find out how to get all the very latest, relevant, organized information daily!

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The May issue of Ophthalmology, the journal of the American Academy of Ophthalmology, includes a surprising, first report on increasing rates of age-related macular degeneration (AMD) among Asians, and describes an innovative "bypass" laser surgery that may help many people with central retinal vein occlusion (CRVO) avoid serious vision loss. Are Asians as Vulnerable to AMD as Caucasians? A major review by Tien Yi Wong, MD, MPH, PhD, and Singapore Eye Research Institute colleagues concludes that Asians may be just as susceptible to age-related macular degeneration as Caucasians... (Source: Health News from Medical News Today)

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Authors: Liu A, Manche EE The authors report anterior segment optical coherence tomography (OCT) imaging findings in a case of central toxic keratopathy following laser in situ keratomileusis (LASIK) surgery for low hyperopia. OCT imaging 1 month after surgery demonstrates that the flap thickness is maintained and the location of stromal tissue loss is just posterior to the flap in the stromal bed in the affected area. This corresponds to the clinical observation of interface opacity extending posteriorly into the stroma as first described by Sonmez and Maloney1 in their initial description of the syndrome. Follow-up OCT imaging 3 months later revealed interval decrease in stromal thinning. The etiology of this syndrome is unknown. PMID: 20429496 [PubMed - as supplied by publisher]...

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Preoperative retinal straylight, which increased as a function of spherical equivalent refraction, decreased after LASEK refractive surgery. Preoperative increases due to contact lens wear disappeared as well after the procedure. (Source: Investigative Ophthalmology)

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Authors: Srinivasan S, Herzig S The femtosecond laser is gaining popularity as a safe and effective alternative to the microkeratome for creating corneal flaps during LASIK. Rarely, gas bubble formation in the anterior chamber during laser flap creation can interfere with the eye tracking and iris registration software during the subsequent excimer laser ablation. Surgical steps to ensure successful eye tracking and iris registration in such cases are described in this report. PMID: 20415292 [PubMed - as supplied by publisher] (Source: Ophthalmic Surgery, Lasers and Imaging : the Official Journal of the International Society for Imaging in the Eye)

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(Source: Dishler Laser)

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Conclusions: The planar configuration of the femtosecond laser flap did not offer any advantage in corneal high-order aberrations or visual acuity through 3 years after LASIK. Corneal high-order aberrations remain stable through 3 years after LASIK. (Source: American Journal of Ophthalmology)

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Conclusions  The neo–basement membrane components underlying the ingrown cells in human corneas with epithelial ingrowth after LASIK appear to be partially disassembled. Epithelial-stromal interaction over time may be related to prolonged wound healing remodeling, which calls into question the stability of the flap. (Source: Archives of Opthalmology)MedWorm Sponsor Message: Watch the new MedWorm demo and find out how to get all the very latest, relevant, organized information daily!

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25 Centers Across the US Are the First to Adopt the Latest FDA Approved Technology for Laser Vision Correction ST. LOUIS, MO--(HSMN NewsFeed) - In 1985 a haunting close up photo of an Afghan refugee girl appeared on the cover of National Geographic Maga... Devices, Ophthalmology, FDATechnolas Perfect Vision, Advanced Control Eyetracking, LASIK, astigmatism (Source: HSMN NewsFeed)

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CONCLUSION: LASIK is a safe and effective alternative method for correcting myopic anisometropia facilitating treatment of amblyopia, only considerd in children with spectacles or contact lens intolerance, with more improved visual acuity and binocular vision. PMID: 20373894 [PubMed - in process] (Source: Current Eye Research)MedWorm Sponsor Message: Watch the new MedWorm demo and find out how to get all the very latest, relevant, organized information daily!

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Authors: Lasek-Nesselquist E, Welch DM, Sogin ML Giardia duodenalis is an intestinal parasite of many vertebrates. The presence of G. duodenalis in the marine environment due to anthropogenic and wildlife activity is well documented, including the contributions from untreated sewage and storm water, agricultural run-off, and droppings from terrestrial animals. Recently, studies have detected this protistan parasite in the feces of marine vertebrates such as whales, dolphins, seals and shore birds. To explore the population biology of G. duodenalis in marine life, we determined the prevalence of G. duodenalis in two species of seal (Halichoerus grypus, Phoca vitulina vitulina and Phoca vitulina richardsi) from the east and west coasts of the USA, sequenced two loci from G. duodenalis-po...

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Conclusion This is a well-conducted Cochrane review, which carried out a thorough search for all suitable trials comparing laser eye surgery with phakic intraocular lenses for moderate to severe short-sightedness. Both techniques achieved the same success rate for the proportion of people who had 20/20 vision 12 months after surgery. People given phakic lenses were less likely to have a loss in their ‘best spectacle corrected visual acuity’ after treatment. However, on two occasions, cataracts developed after phakic lens surgery. The main drawback to this review is that there is limited research currently available, and the reviewers could only include three trials, treating 228 eyes. This reduces the statistical power for detecting accurate differences between the treatments, particul...

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A new type of procedure for correcting short-sightedness could be safer than laser eye surgery, according to a new scientific review. (Source: the Mail online | Health)

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Conclusions. Topical administration of T1225 oil-based azithromycin eyedrops was well tolerated in both unmanipulated hen corneas and those treated with corneal refractive surgery (PRK and LASIK). T1225 demonstrated a potent antibiotic effect after LASIK treatment. PMID: 20544676 [PubMed - as supplied by publisher] (Source: European Journal of Ophthalmology)

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In this study, the authors initially described the corneal posterior shape by elevation and created a detailed evaluation reference database determining the shape of the corneal posterior surface in normal human eyes. Moreover, the authors retrospectively studied the data on corneal posterior elevation changes after LASIK and epi-LASIK for myopia and myopic astigmatism and evaluated the changes along four districts at center, paracenter, midperiphery, and periphery. (Source: Investigative Ophthalmology)

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Conclusions  The number of monocytes/macrophages in the TM increases substantially after SLT and monocytes augment both outflow facility and SCE conductivity. Clinical Relevance  These findings indicate that the innate immune system in general and monocytes in particular play an important role in aqueous outflow homeostasis. The recruitment of monocytes in increased numbers after SLT likely plays a role in lowering the intraocular pressure after this procedure. The intracameral introduction of autologous monocytes harvested from a vein could have therapeutic potential as a cell-based individualized treatment of glaucoma. (Source: Archives of Opthalmology)

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Conclusions  FT with Rondo microkeratome was significantly influenced by the mean preoperative K reading. First treated eye was significantly thicker than the fellow left eye, while both were significantly lower than the recommended 130 μm thickness. Gaining basic experience of Rondo microkeratome required an average of 90 flaps/surgeon. Content Type Journal ArticleCategory Refractive SurgeryDOI 10.1007/s00417-010-1433-7Authors Eleftherios I. Paschalis, Laser Ophthalmos Eye Clinic Zipari Kos Island Dodecanisa PO BOX 6447 85300 GreeceAntonis P. Aristeidou, Papanikolaou Hospital Thessaliniki GreeceNikitas C. Foudoulakis, Patision General Hospital Athens GreeceLambros A. Razis, Laser Ophthalmos Eye Clinic Zipari Kos Island Dodecanisa PO BOX 6447 85300 Greece ...

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Conclusions: The 3 techniques increase the wavefront aberrations of the cornea and change the relative contribution of coma-like and spherical-like aberrations. For a large aperture (> 5 mm), corneal refractive therapy induces more spherical-like aberrations than standard and custom LASIK. However, no clinically or statistically significant differences existed for narrower apertures. Standard and custom LASIK did not display statistically significant differences regarding higher-order aberrations. (Source: American Journal of Ophthalmology)

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Authors: Kohnen T, Klaproth OK Non-corrected residual refractive errors after cataract extraction and implantation of an artificial intraocular lens (IOL) lead to limited visual acuity or suboptimal usage of enhanced optical properties of IOLs, such as bifocal implants, which are dependent on postoperative emmetropia. In addition to the established corneal procedures for correction of ametropia (excimer laser surgery or limbal relaxing incisions) sulcus supported pseudophakic supplementary IOLs can also be implanted. These IOLs have been designed to deal with the problem associated with sulcus implantation, such as pigment dispersion glaucoma, intralenticular opacification or iris capture. Other possible fields of application of these lenses are the correction of higher astigmatism aft...

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Authors: Rhim JH, Kim JH, Yeo EJ, Kim JC, Park SC Excess caveolin-1 has been reported to play a role in age-dependent hyporesponsiveness to growth factors in vitro. We, therefore, hypothesize that caveolin-1-dependent hyporesponsiveness to growth factors in aged corneal epithelial cells might be responsible for delayed wound healing in vivo. In order to test this hypothesis, corneal wound healing time was evaluated by vital staining using fluorescein after laser epithelial keratomileusis (LASEK). We compared wound healing times in young, middle age, and elderly patients. We also examined caveolin-1 levels and other aging markers, such as p53 and p21, in the corneal epithelium. Elderly patients generally had higher caveolin-1 levels in the corneal epithelia than young patients. There we...

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Conclusions  Improvements in Pelli-Robson CS scores were observed during the first year after IVR/IVB in eyes with mCNV. Content Type Journal ArticleCategory Retinal DisordersDOI 10.1007/s00417-010-1341-xAuthors Sarah Moussa, The Ludwig Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery Vienna AustriaSiamak Ansari-Shahrezaei, The Ludwig Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery Vienna AustriaEva Smretschnig, The Ludwig Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery Vienna AustriaStefan Hagen, The Ludwig Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery Vienna AustriaKerstin Steindl-Kuscher, The Ludwig Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery Vienna AustriaIlse Kre...

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[Abstract unavailable] Language: Eng... (Source: SafetyLit: All (Unduplicated))MedWorm Sponsor Message: Watch the new MedWorm demo and find out how to get all the very latest, relevant, organized information daily!

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Title: Health Tip: Recovering From LASIKCategory: Health NewsCreated: 3/17/2010 10:10:00 AMLast Editorial Review: 3/18/2010 (Source: MedicineNet Eyesight General)

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Conclusions: Monovision is a valid option for myopic patients with presbyopia who are considering LASIK. Good distance and near UCVAs can be obtained with this procedure. (Source: American Journal of Ophthalmology)

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Conclusions. The authors describe an accurate and reliable setup to measure and record in vivo real-time changes in IOP measurement from the anterior chamber during laser surgery. Femtosecond laser flap creation exerts less extreme IOP fluctuations with improved chamber stability but requires more procedure time than does microkeratome. (Source: Investigative Ophthalmology)

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NEW YORK (Reuters Health) - Two forms of laser vision correction sometimes used as an alternative to LASIK seem to have similar results for people with nearsightedness, a new research analysis finds. (Source: Reuters: Health)

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Authors: Fernandes M, Reddy P, Shah SG PMID: 20733029 [PubMed - as supplied by publisher] (Source: The British Journal of Ophthalmology)

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We are beginning to envision a future where refractive cataract surgery can achieve LASIK-like outcomes. Medscape Ophthalmology (Source: Medscape Today Headlines)

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Authors: Nettune GR, Pflugfelder SC ABSTRACT Symptoms of tear dysfunction after laser in situ keratomileusis (LASIK) occur in nearly all patients and resolve in the vast majority. Although dry eye complaints are a leading cause of patient discomfort and dissatisfaction after LASIK, the symptoms are not uniform, and the disease is not a single entity. Post-LASIK tear dysfunction syndrome or dry eye is a term used to describe a spectrum of disease encompassing transient or persistent post-operative neurotrophic disease, tear instability, true aqueous tear deficiency, and neuropathic pain states. Neural changes in the cornea and neuropathic causes of ocular surface discomfort may play a separate or synergistic role in the development of symptoms in some patients. Most cases of early post-...MedWorm Sponsor Message: Watch the new MedWorm demo and find out how to get all the very latest, relevant, organized information daily!

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TLC LASIK Centers Accused of Performing Procedures on Patients With Pre-Existing Conditions (Source: Health News: CBSNews.com)

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In reference to the article describing histological examination of epi-LASIK flaps, we report a unique postoperative problem. A 22-year-old man had epi-LASIK in both eyes after standard refractive surgery evaluation. The refractive error was −2.00 diopters sphere (DS) in each eye. Intraoperatively, the patient squeezed his eyes as the epikeratome was creating the epithelial flap. The epithelial flaps appeared thin and were spontaneously amputated. The laser was delivered as usual, and bandage contact lenses were placed. Epithelial healing was uneventful. (Source: Journal of Cataract and Refractive Surgery)

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Conclusions  All burns initially appear as equivalent square-edged, columnar foci of hyperreflectivity in the outer retina. Pascal 20-millisecond burns progressively reduce in size, and this suggests a novel healing response localized to the JI/OSP and apical retinal pigment epithelium. The higher-fluence 100-millisecond burns develop larger defects due to thermal blooming and collateral damage. (Source: Archives of Opthalmology)

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Conclusion  The topical use of latanoprost increases MMP-1 and MMP-9 and decreases TIMP-1 on the ocular surface. Clinical Relevance  The use of topical latanoprost might not be recommended in patients with keratoconus or after laser-assisted in situ keratomileusis. (Source: Archives of Opthalmology)

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Ophthalmologica 2010;224:325–331 (DOI:10.1159/000313834) (Source: Ophthalmologica)

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Conclusion: Flap thickness did not affect visual or refractive outcomes with a mechanical microkeratome with either blade type.Financial Disclaimer: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

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We report a case of Mycobacterium abscessus keratitis after elective laser in situ keratomileusis in a 19-year-old woman. The infection started 3 weeks after uneventful surgery, and the patient received multiple antimicrobial treatments without response. A corneal scrape isolate showed an acid-fast bacterium that was subsequently confirmed by culture to be M abscessus. Prompt treatment of oral moxifloxacin 400 mg twice daily and hourly topical amikacin 2.5% was started. Recovery occurred within the first week of treatment, with complete resolution 3 weeks after presentation. The final uncorrected distance visual acuity was 6/9. We comment on other reports of post-LASIK keratitis caused by M abscessus, the in vitro sensitivity to antibiotic agents described in the literature, and the use of...

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A 48-year-old man with a history of myopic laser in situ keratomileusis (LASIK) had selective laser trabeculoplasty (SLT) for the treatment of glaucoma in the right eye. He subsequently developed grade 2 diffuse lamellar keratitis (DLK). He then elected to have SLT in the left eye and developed grade 1 DLK. To our knowledge, this is the first report of bilateral consecutive late postoperative DLK following SLT after LASIK.Financial disclosure: Neither author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

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We would like to make several comments about the article by Nishimura et al. Forward movements of the cornea measured by slit scan or similar devices after myopic laser in situ keratomileusis (LASIK) or photorefractive keratectomy have been reported by many authors. This phenomenon can be explained by the steepening of the posterior cornea caused by postoperative changes in the magnification ratio. Postoperative differences in the corneal thickness measurement by ultrasound and by slit scan or similar devices can be explained by the same hypothesis. (Source: Journal of Cataract and Refractive Surgery)MedWorm Sponsor Message: Watch the new MedWorm demo and find out how to get all the very latest, relevant, organized information daily!

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We are grateful for Nawa's interest in our article. However, we think the comments are very similar to his comments about a previous article; in those, he suggested that we should consider the magnification effect by the cornea. According to his suggestion, we asked Oculus (the manufacturer of Pentacam) about this. As shown in the authors' reply, the manufacturer answered that the Pentacam corrected for the magnification effect with ray tracing. We fully understand Nawa's point and agree with him that the difference in accuracy of the correction methods may partly influence the results. However, without a gold standard for measurement of the corneal curvature, thickness, and anterior chamber depth after refractive surgery, we believe no one can provide an answer to this question. We hope f...

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Conclusions  There were no adverse outcomes (CRT, visual acuity, or visual field) from using multispot SS-PRP vs single-spot MS-PRP at 12 weeks postlaser, and treatment times were significantly shorter for multispot SS-PRP. Pascal SS-PRP was as effective as MS-PRP in the treatment of PDR. Application to Clinical Practice  Twenty-millisecond Pascal SS-PRP may be safely and rapidly performed in 1500 burns with a similar efficacy to conventional MS-PRP. Trial Identifier  Research and Development Office PIN R00037, Central Manchester University Hospitals Foundation Trust. (Source: Archives of Opthalmology)

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Conclusion: In spite of an excellent visual outcome, WFO Lasik induces significant higher order aberrations. Large ablation zones reduce the induction of spherical aberration. (Source: Indian Journal of Ophthalmology)MedWorm Sponsor Message: Watch the new MedWorm demo and find out how to get all the very latest, relevant, organized information daily!

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Senthil Sirisha, Rathi Varsha, Garudadri ChandrasekharIndian Journal of Ophthalmology 2010 58(4):333-335A 21-year-old myope presented with decreased vision and corneal edema following vitreoretinal surgery for retinal detachment. While intraocular pressure (IOP) measurement with Goldmann applanation tonometer (GAT) was low, the digital tonometry indicated raised pressures. An interface fluid syndrome (IFS) was suspected and confirmed by clinical exam and optical coherence tomography. A tonopen used to measure IOP through the peripheral cornea revealed elevated IOP which was the cause of the interface fluid. Treatment with IOP-lowering agents resulted in complete resolution of the interface fluid. This case is being reported to highlight the fact that IFS should be suspected when there is L...

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The reliability of using a reference system intrinsic to the cornea has been evaluated in order to characterize corneas of subjects after refractive surgery. Data on 90 eyes operated on by LASIK to correct myopia and astigmatism were considered. The corneal parameters (curvature radii and corneal ... (Source: Journal of the Optical Society of America A)MedWorm Sponsor Message: Watch the new MedWorm demo and find out how to get all the very latest, relevant, organized information daily!

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This surgery is a fast, safe, and cost-effective alternative to glasses and contact lenses. U.S. Pharmacist (Source: Medscape Today Headlines)

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Flap creation is a critical step in laser in situ keratomileusis (LASIK). Efforts to improve the safety and predictability of the lamellar incision have fostered the development of femtosecond lasers. Several advantages of the femtosecond laser over mechanical microkeratomes have been reported in LASIK surgery. In this article, we review common considerations in management and complications of this step in femtosecond laser–LASIK and concentrate primarily on the IntraLase laser because most published studies relate to this instrument.Financial Disclosure: Neither author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes. (Source: Journal of Cataract and Refractive Surgery)

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A patient was treated bilaterally for myopia using laser in situ keratomileusis (LASIK). Preoperatively, there was no known risk factor for ectasia but a 20 μm between-eye difference in central mean corneal thickness was seen on the optical pachymetry map. Two years postoperatively, bilateral ectasia was diagnosed. This case suggests that abstention or surface ablation treatment may be a safer option than LASIK in patients showing central thickness asymmetry between eyes.Financial Disclosure: Neither author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

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A 31-year-old man was referred to us 2 months after bilateral laser in situ keratomileusis (LASIK). On presentation, the corrected distance visual acuity was hand motion in the right eye and 20/25 in the left eye. Slitlamp examination showed a diffuse central stromal infiltrate, flap melting, and hypopyon in the right eye and marked interface opacities with crystal-like edges in the left eye. Flap lift and irrigation were performed. Because of the progressive keratitis, penetrating keratoplasty (PKP) was done in both eyes. Achromobacter xylosoxidans was isolated from both corneal buttons, and therapy was changed to chloramphenicol prednisolone eyedrops 8 times a day and intravenous meropenem 500 mg 3 times a day according to sensitivity testing. Two months after surgery, both transplants r...

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Purpose: To compare visual outcomes, complications, and patient satisfaction after femtosecond laser in situ keratomileusis (LASIK) and conductive keratoplasty (CK).Setting: Private laser clinics, Reading and Southampton, United Kingdom.Methods: In this retrospective consecutive single-surgeon comparative study, presbyopic emmetropia was treated with femtosecond LASIK or CK to achieve monovision by targeting −1.50 diopters (D) of myopia in the nondominant eye after a successful monovision contact lens trial. The CK treatments were performed with a ViewPoint CK system using the light-touch technique. The femtosecond LASIK was performed using an IntraLase FS/FS30 and EC-5000 platform with OPDCAT wavefront treatment.Results: The mean spherical equivalent 12 months postoperatively was −1.6...MedWorm Sponsor Message: Watch the new MedWorm demo and find out how to get all the very latest, relevant, organized information daily!

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Purpose: To compare changes in corneal hysteresis (CH) and the corneal resistance factor (CRF) in myopic and hyperopic laser in situ keratomileusis (LASIK) and evaluate their relationship to the number of photoablative pulses delivered, a surrogate for ablation volume.Setting: Cleveland Clinic Cole Eye Institute, Cleveland, Ohio, USA.Methods: Preoperative and 1-week postoperative Ocular Response Analyzer measurements in eyes that had femtosecond-assisted LASIK were studied retrospectively. Changes in CH and CRF were compared and tested for correlation with the number of excimer laser pulses.Results: Thirteen myopic eyes and 11 hyperopic eyes were evaluated. Preoperative corneal thickness, CH, CRF, programmed correction magnitude, flap thickness, and total number of fixed spot-size photoabl...

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In this study, CCT was measured by sequential Scheimpflug imaging, spectral-domain anterior segment optical coherence tomography (AS-OCT), and ultrasound (US) pachymetry.Results: Each of the 3 groups comprised 50 eyes. There were no differences between the 3 groups in age, sex, or intraocular pressure. In normal eyes, CCT was statistically significantly higher by US pachymetry (mean 525.8 μm ± 41.4) [SD] than by Scheimpflug imaging (mean 519.4 ± 40.9 μm) and AS-OCT (mean 517.9 ± 41.5 μm) (both P (Source: Journal of Cataract and Refractive Surgery)

scheimpflug mean eyes imaging optical groups normal domain tomography coherence spectral pachymetry ultrasound situ laser significantly central keratomileusis between measur

Authors: Gorbatov M, Miller J, Yu PK, Cringle SJ, Yu DY New and more precise subretinal surgical techniques would be useful in a range of retinal diseases. The purpose of this study is to determine the feasibility of using fiberoptically delivered ultraviolet laser energy to transect or ablate subretinal tissues. Choroid segments dissected from fresh porcine eyes, with or without the retinal pigment epithelium (RPE), were clamped in a fluid bath. Pulsed fourth harmonic (266 nm) of a Nd:YAG laser radiation was delivered via an optical fiber probe at fluence levels between 0.08 and 0.40 J/cm(2). The tissue was then fixed and sectioned for histological examination. Radiation induced damage was categorized by the degree of tissue disruption and ablation depth. Tissue ablation and the sever...

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The procedure provides better eyesight with less chance of vision loss. For those whose eyes aren't that bad, laser surgery is the best option. Flashy lasers get much of the attention in vision-correcting surgery, but they can't fix severe shortsightedness. For those wearing the thickest glasses, a newer procedure provides better eyesight with less risk of vision loss, according to a recent study. (Source: L.A. Times - Health)

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Conclusions  Our study indicates that there are significant differences in CRT values in patients with vascular PED, due to different segmentation algorithms and a high error rate in automatically set threshold lines. When planning and conducting multicenter studies, one has to be especially aware of the differences in delineating threshold algorithm lines by different SD OCT devices. Content Type Journal ArticleCategory Retinal DisordersDOI 10.1007/s00417-010-1415-9Authors Eva Smretschnig, The Ludwig Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery Juchgasse 25 1030 Vienna AustriaIlse Krebs, The Ludwig Boltzmann Institute for Retinology and Biomicroscopic Laser Surgery Juchgasse 25 1030 Vienna AustriaSarah Moussa, The Ludwig Boltzmann Institute fo...MedWorm Sponsor Message: Watch the new MedWorm demo and find out how to get all the very latest, relevant, organized information daily!

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(Source: Dishler Laser)

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In this article, we use a longitudinal census of laser in situ keratomileusis (LASIK) eye surgeries collected directly from patient charts to examine the learning-by-doing hypothesis in medicine. LASIK surgery has precise measures of presurgical condition and postsurgical outcomes. Unlike other types of surgery, the impact of unobservable underlying patient conditions on outcomes is minimal. Individual learning by doing is identified through observations of surgical outcomes over time, based on the cumulative number of surgeries performed. Collective learning is identified separately, through changes in a group adjustment rule determined jointly by all the surgeons in a structured internal review process. Our unique data set overcomes some of the measurement problems in patient outcomes en...

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In the consultation section of the January issue, the refractive surgical problem was a patient who was operated on for a pterygium without the surgeon knowing that laser in situ keratomileusis (LASIK) had been performed 10 years previously. The LASIK flap was excised during surgery, and irregular astigmatism and corneal scarring developed. The patient's visual acuity deteriorated to 20/100. (Source: Journal of Cataract and Refractive Surgery)MedWorm Sponsor Message: Watch the new MedWorm demo and find out how to get all the very latest, relevant, organized information daily!

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Conclusions: Spherical IOL implantation and conventional myopic LASIK increased ocular peripheral aberrations, causing a significant increase in spherical aberration across the visual field. Laser in situ keratomileusis reversed the sign of the rate of change in coma across the field relative to that in the other groups.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

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Conclusions: The 4-year results indicate that ICRS implantation is effective and safe in the correction of low myopia in patients for whom excimer laser surgery is contraindicated because of abnormal topography, including forme fruste keratoconus. The achieved refractive correction remained stable throughout the follow-up.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

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Conclusion: Deep anterior lamellar keratoplasty using the big-bubble technique effectively restored corneal regularity and thus increased CDVA; however, a high refractive error should be expected postoperatively.Financial Disclosure: Neither author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

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Conclusions  GAT-determined IOP values were significant lower at all time-points after hyperopic LASIK, as well as myopic PRK or LASIK. The Pascal tonometry values remained unaffected for all groups. Content Type Journal ArticleCategory Refractive SurgeryDOI 10.1007/s00417-010-1431-9Authors Antonios P. Aristeidou, Democritus University of Thrace Ophthalmology Department Alexandroupolis GreeceGeorgios Labiris, Democritus University of Thrace Ophthalmology Department Alexandroupolis GreeceAndreas Katsanos, Democritus University of Thrace Eye Institute of Thrace (E.I.T.) Dragana 68100 Alexandroupolis GreeceMichalis Fanariotis, Democritus University of Thrace Eye Institute of Thrace (E.I.T.) Dragana 68100 Alexandroupolis GreeceNikitas C. Foudoulakis, Democritus University...

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Conclusions: Wavefront-guided PRK and wavefront-guided LASIK had similar efficacy, predictability, safety, and contrast sensitivity; however, wavefront-guided PRK induced statistically fewer HOAs than wavefront-guided LASIK at 6 months.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

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Conclusion: Results indicate that the excimer laser platform used in the study may yield greater UV exposure than previous systems; however, the levels did not exceed occupational exposure limits.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

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AMSTERDAM, Netherlands, July 26, 2010 (GLOBE NEWSWIRE) -- Presbia, a leading medical device company that has developed a corneal inlay optical surgical solution for presbyopia, announced today that renowned refractive surgeon Dr. Ronald R. Krueger of Cleveland Clinic has joined its Medical Advisory Board. Dr. Krueger brings more than 26 years of experience in refractive surgery to the advisory board, which is chaired by Prof. Ioannis Pallikaris, M.D., widely regarded as the "father" of LASIK surgery. (Source: Medical News (via PRIMEZONE))

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After struggling in the first two quarters of 2010, LCA-Vision, a Lasik provider, is closing its Birmingham location. (Source: bizjournals.com Health Care:Biotechnology headlines)MedWorm Sponsor Message: Watch the new MedWorm demo and find out how to get all the very latest, relevant, organized information daily!

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Authors: Parfrey LW, Grant J, Tekle YI, Lasek-Nesselquist E, Morrison HG, Sogin ML, Patterson DJ, Katz LA An accurate reconstruction of the eukaryotic tree of life is essential to identify the innovations underlying the diversity of microbial and macroscopic (e.g., plants and animals) eukaryotes. Previous work has divided eukaryotic diversity into a small number of high-level "supergroups," many of which receive strong support in phylogenomic analyses. However, the abundance of data in phylogenomic analyses can lead to highly supported but incorrect relationships due to systematic phylogenetic error. Furthermore, the paucity of major eukaryotic lineages (19 or fewer) included in these genomic studies may exaggerate systematic error and reduce power to evaluate hypotheses. Here, we use ...

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CONCLUSION:The presence of K-structures and ACM may be an index to identify eyes that had a previous refractive surgical procedure (surface ablation or LASIK) and be a health index of Bowman layer and adjacent anterior stroma. PMID: 20672768 [PubMed - as supplied by publisher] (Source: Ophthalmic Surgery, Lasers and Imaging : the Official Journal of the International Society for Imaging in the Eye)

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In this case, inadvertent overcorrection after myopic LASIK led to a significant hyperopic result. The visual rehabilitation of this patient has to address the CDVA as well as the UDVA. (Source: Journal of Cataract and Refractive Surgery)

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Not only was this patient overcorrected, the postoperative topographic maps show that the treatment was decentered (temporally) in both eyes. Primary hyperopic correction of more than 5.00 or 6.00 D with conventional or custom wavefront LASIK, PRK, laser-assisted subepithelial keratectomy, or conductive keratoplasty is very difficult to treat without regression. Although wavefront-guided retreatment for consecutive hyperopia after primary myopic treatment has been reported, most patients had low preoperative hyperopia (range 0.50 to 1.50 D). (Source: Journal of Cataract and Refractive Surgery)

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In this unfortunate situation, this 39-year-old woman has marked overcorrection, visual distortions, and a loss of CDVA after bilateral LASIK for a rather routine refractive error. Although the question posed regards treatment, several points have to be raised about the initial LASIK. (Source: Journal of Cataract and Refractive Surgery)

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This patient with poor-quality vision after myopic LASIK requires careful handling because of the poor refractive outcome. She has become a consecutive hyperope with a large overcorrection in both eyes. The multizone ablation as described is not capable of being performed in the United States with a Visx Star S4 laser. Myopic corrections of less than 6.00 D with this laser are usually 1 zone with a blend in the United States. I admit I am unfamiliar with a 3-zone ablation profile as described. (Source: Journal of Cataract and Refractive Surgery)

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A 39-year-old woman who had bilateral laser in situ keratomileusis (LASIK) 5 months ago presents for poor quality of vision in both eyes. She has no significant systemic history. Before LASIK, the refraction was −5.25 +0.75 × 90 and the corrected distance visual acuity (CDVA) 20/20 in both eyes. The preoperative keratometry (K) readings were 43.50 diopters (D) and 44.37 D in the right eye and 43.62 D and 44.75 D in the left eye. shows the preoperative corneal topography and pachymetry maps. The LASIK procedure was performed with a Visx Star S4 excimer laser (Abbott Medical Optics) using a multizone treatment. The profile was 3 ablations of −3.80 D with a 5.0 mm, 5.5 mm, and 6.0 mm optical zone, respectively. The overcorrection led to bilateral loss of CDVA and visual distortions. (So...MedWorm Sponsor Message: Watch the new MedWorm demo and find out how to get all the very latest, relevant, organized information daily!

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In this case, the most important issue to rule out before further surgical intervention is post-LASIK corneal ectasia. The refraction went from −5.25 +0.75 × 90 in both eyes preoperatively to +6.50 D in the right eye and +7.00 D in the left eye postoperatively. Furthermore, the K values of both corneas decreased by approximately 10.00 D. The refractive and K values show that the ablation in both corneas was to correct approximately −10.00 to −12.00 D. The risk for post-LASIK ectasia in such cases is significant because the attempted correction exceeded 10.00 D (despite the small ablation zones and depth). This patient should be followed for at least 12 months after the refractive surgery to evaluate possible changes in corneal topography, UDVA, and CDVA to rule out ectasia or regres...

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We report a case of visually significant haze after PRK with MMC for residual myopia following LASIK.Financial Disclosure: Neither author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery)

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