Eyeworld

I THERAPEUTIC REFRACTIVE CORNEAL SURGERY N FOCUS 76 | EYEWORLD | APRIL 2020 Contact Gordon: mgordon786@gmail.com Maloney: info@maloneyshamie.com Price: frankprice@pricevisiongroup.net References 1. Wolle MA, et al. Complications of refractive surgery: ectasia after refractive surgery. Int Ophthalmol Clin. 2016;56:129–139. 2. Eydelman M, et al. Symptoms and satisfaction of patients in the Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL) studies. JAMA Ophthal- mol. 2017;135:13–22. 3. Hays RD, et al. Assessment of the psychometric properties of a questionnaire assessing Patient-Reported Outcomes With Laser In Situ Keratomileusis (PROWL). JAMA Ophthalmol. 2017;135:3–12. 4. Price MO, et al. Three-year longitudinal survey comparing visual satisfaction with LASIK and contact lenses. Ophthalmology. 2016;123:1659–1666. Relevant disclosures Gordon: None Maloney: None Price: Alcon, STAAR Surgical Localized nest of epithelial ingrowth extending in from wound margin at 10:00 Source: Francis Price Jr., MD "Usually in patients who get them later, they had epithelial defects at the time of sur- gery," Dr. Maloney said. "If you're working on a patient and the epithelium begins to slough, you can be sure they've got basement membrane dystrophy and at least recognize the possibility of recurrent erosions later. When recurrent erosions happen, it's usually a month after the procedure and they generally tend to go away." Dr. Maloney said he treats recurrent ero- sion the same way he would for patients who hadn't had LASIK. Facing post-LASIK ectasia Post-LASIK ectasia is estimated to occur in a range of 0.04–0.6% of cases. 1 Better screening methods have reduced incidents of post-LASIK ectasia. In fact, Dr. Price said, screening in some cases, is "too good," screening out too many possible candidates who would have otherwise done well with LASIK. "I think the biggest problem are people who rub their eyes," Dr. Price said. "Most of the people I've had to do crosslinking on who are sent in for post-LASIK ectasia have a histo- ry of rubbing their eyes." As such, Dr. Price said they make a point in his practice of telling patients not to rub their eyes now or later. "Early on, don't rub your eyes because the flap can come off or wrinkle. Thirty years from now don't do hard eye rubbing or pushing on your eyes because the cornea can bulge out," Dr. Price said. "It's important to be proactive and remind them about behavioral things that can cause them to have problems later." continued from page 75

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