Eyeworld

EW CORNEA 31 Superficial keratectomy should be used for significant trauma in the cornea with a large area of involve- ment. Superficial keratectomy in- volves debridement of the epithelium and anterior portion of the basement membrane. "By scraping the epi cells off of the anterior portion with a spatula, you can remove any of the abnor- mal tissue and allow the epithelium to grow back over the more normal basement membrane that's left be- hind," Dr. Rubenstein said. The surface of the cornea may be anesthetized at the slit lamp or with a minor operating microscope while the patient is lying down. The surgeon then uses a blunt spatula to remove the corneal epithelium or any irregularities of the basement membrane that can be seen under the epithelium. "Often when you're scraping a cornea with a blunt spatula, you can feel where the irregularities are," Dr. Rubenstein said. "You should scrape across the surface until it is smooth." Some surgeons add a treatment with a diamond-dusted burr drill bit to the superficial removal of the basement membrane. "The diamond burr further helps to remove the abnormal base- ment membrane and provide a clean slate under the posterior basement membrane for the new epithelial cells to heal on," Dr. Rubenstein said. "Usually (the epithelium) is fairly easy to remove," Dr. Yoo said. "It's loose, which is why the patient is having problems in the first place. After removing the epithelium, I take the diamond burr and gently burr the Bowman's layer to give it a little more of a textured surface so when the new epithelium grows over, it has a better likelihood of sticking and not eroding." Dr. Yoo said superficial keratectomy has an advantage over PTK: price. "Logistically, it's less expensive than the laser and can be done in an office setting," she said. Still, Dr. Rubenstein said he uses PTK often. "Some people might feel it's overkill, but I think it provides a very effective treatment," he said. "It provides a smooth surface when you use the laser as your polishing de- vice, and it also seems to have an ex- tremely low recurrence rate." EW Editors' note: Dr. Rubenstein has no financial interests related to this article. Dr. Yoo has financial interests with Abbott Medical Optics (Santa Ana, Calif.) and Carl Zeiss Meditec (Dublin, Calif.). Contact information Rubenstein: 312-563-2305, jonathan_rubenstein@rush.edu Yoo: 305-326-6322, syoo@med.miami.edu THE BEST OF BOTH WORLDS Only the GALILEI G2 merges the Placido and Dual Scheimpflug Technologies into a single measurement. The combined data provide highly accurate values for surgical evaluation and planning, leading to unrivalled clinical results Move to the next level of accuracy in Anterior Segment Tomography Call 1- 866-708-4490 or visit www.ziemergroup.com for further information about how GALILEI G2 can improve outcomes for your patients for surgical evaluation and planning, leading to unrivalled clinical results into a single measurement. The combined data provide highly accurate values Only the GALILEI G2 merges the Placido and Dual Scheimpflug T for surgical evaluation and planning, leading to unrivalled clinical results into a single measurement. The combined data provide highly accurate values Only the GALILEI G2 merges the Placido and Dual Scheimpflug T T THE BES for surgical evaluation and planning, leading to unrivalled clinical results into a single measurement. The combined data provide highly accurate values echnologies Only the GALILEI G2 merges the Placido and Dual Scheimpflug T H WORLDS T OF BO T Ridge Street, Alton, IL 62002, USA 1 32 Ziemer USA, Inc. about how GALILEI G2 can improve outcomes for your patients 866- - 1 Call Ridge Street, Alton, IL 62002, USA about how GALILEI G2 can improve outcomes for your patients .ziemergroup.com for further information 708-4490 or visit www 866- about how GALILEI G2 can improve outcomes for your patients .ziemergroup.com for further information September 2011

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