Eyeworld

55 EW REFRACTIVE February 2018 OCT image analysis showed that the depth and location of the incisions were consistent with the preoper- ative surgical plan. The laser-gen- erated incisions within the graft button presented precise geometry and reliable depth of incision, with a wound healing pattern characterized by epithelial ingrowth and fibrosis. 2 Similarly, a study using Intra- Lase-enabled astigmatic keratecto- my in 37 eyes of 34 patients was effective in reducing high post-PK astigmatism (in eyes with at least 5 D astigmatism) and significantly improving UCVA and BCVA. The absolute astigmatism was reduced significantly from 7.46 ± 2.70 D preoperatively to 4.77 ± 3.29 D postoperatively. Refraction stabi- lized between 3 and 6 months after surgery. 3 Some drawbacks of LRIs include a high incidence of recurrence of astigmatism and low predictability. Dr. Rocha advised to undercorrect because overcorrections are tough to deal with, while enhancements are not. Other potential disadvantages of LRI include corneal perforations, wound dehiscence, and prolonged instability of corneal topography. "While FLAAK was effective in creating LRIs in post-PK patients, it is important to understand that post-transplant cases do not con- form to routine nomograms," Dr. Rocha said. "I changed my settings from case to case, as well as my opti- cal zones. The donor recipient inter- face creates a new artificial limbus, and if you have a scar contracture, you can have a higher effect from your LRIs, making the result hard to predict. Preop, you want to rule out graft ectasia, dehiscence, and wound contraction. You need to look at the size of centration and work with the laser until you are satisfied with the centration. Check that the patient has regular astigmatism after suture removal, and always examine the photopic and mesopic pupil pre- and postoperatively. I performed LRIs with FLAAK in 12 patients so far. At 6-months post-FLAAK, they have achieved refractive stability. The patients are usually stable with- in 3–6 months." EW References 1. St Clair RM, et al. Development of a nomogram for femtosecond laser astigmatic keratotomy for astigmatism after keratoplasty. J Cataract Refract Surg. 2016;42:556–62. 2. Nubile M, et al. Femtosecond laser arcuate keratotomy for the correction of high astig- matism after keratoplasty. Ophthalmology. 2009;116:1083–92. 3. Kumar NL, et al. IntraLase-enabled astigmatic keratotomy for post-keratoplasty astigmatism: on-axis vector analysis. Ophthal- mology. 2010;117:1228–1235. Editors' note: Dr. Rocha has no finan- cial interests related to her comments. Contact information Rocha: karolinnemaia@gmail.com HOW DOES YOUR EMR COMPARE? According to the 2015 ASOA EHR Satisfaction Survey Results* • EYEMD EMR HEALTHCARE SYSTEMS SCORED HIGHER ON OVERALL SYSTEM FUNCTIONALITY THAN ANY OTHER VENDOR! • USERS EXPERIENCE LESS HIDDEN COSTS WITH EYEMD EMR THAN ANY OTHER VENDOR! • USERS ARE MORE LIKELY TO RECOMMEND EYEMD EMR OVER ANY OTHER VENDOR! EyeMD EMR is the complete solution designed specifically for ophthalmologists. It has all the features and functionality you need, and it includes built-in DICOM imaging, diagnostic machine integrations, server monitoring, and no-cost, seamless integration with more than 80 practice management systems. All with no hidden costs! Call 1-877-2-EYE-EMR to schedule your free demo today! OR VISIT EYEMDEMR.COM/COMPARE TODAY TO SEE HOW YOUR EMR COMPARES TO EYEMD EMR! ON E O F T H E F AS TES T GRO W I N G P R I VA TE CO M P A N I ES I N T H E U SA T H R EE YEAR S I N A RO W ! 2015 ASOA EHR Satisfaction Survey Results* 1. EyeMD EMR scored higher on Overall System Functionality than any other vendor. 2. EyeMD EMR users report experiencing less hidden costs than any other vendor. 3. Users are more likely to recommend EyeMD EMR than any other vendor. * Based on recent customer satisfaction survey conducted on behalf of the AAO/AAOE & ASCRS/ASOA. Survey results represent opinion only, and are not in any way intended for use as a ranking tool. https://www.aao.org/eyenet/article/what-do-ophthalmologists-think-of-their-ehrs www.EyeMDEMR.com | (877) 2 EYE EMR WE ARE THE IN EMR FOR OPHTHALMOLOGY! *Based on HIGH user satisfaction reported on EHR Satisfaction Surveys conducted by AAO™ & ASCRS/ASOA AAO/AAOE & ASCRS/ASOA do not endorse any products. IRREFUTABLE LEADER HOW DOES YOUR EMR COMPARE? ON OVERALL SYSTEM Visit Us At Booth #2802 At The 2018 ASCRS-ASOA Annual Meeting C M Y CM MY CY CMY K

• Blank Page
• Blank Page (1)