Transcript Bioptic Surgery

Bioptic Surgery
Kangnam Eyence Eye Clinic
Woon Bong Jwa
Biopitcs
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Phakic IOL + LASIK, LASEK
- Zaldivar (1999)
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Excellent option for
- >-19D SE
- significant astigmatism
More reliable refractive results
Decrease the risk of halos
Management of Astigmatism
during & after ICL operation
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Incisional Astigmatic Procedure
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LASIK or LASEK
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Toric ICL
Incisional Astigmatic Procedure
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The change of incisional direction, size
according to astigmatism during ICL op.
Relaxing Incision after ICL op.
Incisional Astigmatic Procedure
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CCI on the direction of WTR
astigmatism by preop. MR, Topo.
Incisional size (by Astigmatism) –
3mm : < 1D
– 3.5mm : < 1.5D
– 4mm : < 2D
– 4.5mm : >2D
Incisional Astigmatic Procedure
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2005. 1 ~ 2005. 2 ICL op. patients
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50 eyes , female : male = 23 : 6 (p)
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Preop. SE : -10.69±3.37D
(-4.5 ~ -20.38D)
Preop. Astigmatism : -1.62 ±1.21D
(-0.5 ~ -6.25D)
Incisional Astigmatic Procedure
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Topical anesthesia
Superior CCI ( 3mm ~ 4.5mm)
ICL insertion to A/C
Rotation of ICL
ICL haptic insertion
Confirm of ICL centration
Irrigation & wound adhesion
Incisional Astigmatic Procedure
Results of Incisional Astigmatic
Procedure during ICL operation
The changes of spherical
equivalent after ICL operation
0
Pre ICL
-0.16
2wks
-0.21
1M
D i op t er s
-2
-4
-10.69
-6
-8
-10
-12
T i m e af t er I C L op .
-0.22
3M
The changes of astigmatism after
incisional astigmatic procedure
2.8
D i op t er s
2.4
2
1.6
1.62
1.2
0.8
0.52
0.4
0
Preop.
2wks
0.41
0.45
1M
3M
T i m e af t er i n ci si on al ast i gm at i c p r ocedur e
The changes of vision after
incisional astigmatic procedure
1.4
NVA
BCVA
D i op t er s
1.2
1
0.8
0.6
0.4
0.2
0
Preop
2wks
1M
3M
T i m e af t er i n ci si on al ast i gm at i c p r ocedur e
The changes of astigmatic amount after
incisional astigmatic procedure
3.5
3mm
3.5mm
4mm
4.5mm
D i op t e r s
3
2.5
2
1.5
1
0.5
0
Pre ICL
2wks
1M
3M
T i m e af t e r i n ci si on al ast i gm at i c p r oce d u r e
Complications during & after
incisional astigmatic procedure
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Scant iris hemorrhage
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Corneal wound leak & dehiscence
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Infection – no
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Crystalline lens touch - no
Conclusions of incisional astigmatic
procedure during ICL operation
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Easy & safe procedure
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Fast recovery of naked vision
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Increased patient’s satisfaction
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No intra & post op. complications
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Stable refractive results
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Effective to 2.0D below astigmatism
Bioptics by LASEK
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2003. 10 ~ 2004. 11 Bioptics patients
43 eyes, female : male = 14 : 4 (p)
Pre ICL SE : -9.49±2.12D (-5.25~-11.25)
Pre ICL Astigmatism : -2.27±1.12D
(-1.00~-4.00)
Post ICL SE : +0.33±0.39D
Post ICL Astigmatism : -2.36±0.71D
Interval to LASEK after ICL operation
: 4.65±2.63m
LASEK procedure (Bioptics)
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Horizontal axis marking
20% alcohol soaking : 15 sec.
Excimer laser ablation (Visx star S4)
Cold saline irrigation
T-lens & 5% NaCl qid
Results of LASEK
after ICL operation
The changes of vision after
LASEK operation (Bioptics)
1.4
D i op t e r s
1.2
NVA
BCVA
1
0.8
0.6
0.4
0.2
0
Pre
ICL
Post
ICL
LASEK LASEK LASEK LASEK
2wks
1M
3M
6M
T i m e af t e r B i op t i cs
The changes of astigmatism
after LASEK operation (Bioptics)
2.5
2.27
2.36
D i op t ers
2
1.5
1
0.73
0.5
0
Pre
ICL
Post
ICL
0.55
0.38
0.27
LASEK LASEK LASEK LASEK
2wks
1M
3M
6M
T i m e af t er B i op t i cs
Complications of LASEK
after ICL operation (Bioptics)
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Striate keratopathy
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Delayed wound healing
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Corneal opacity
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Steroid induced ocular HT - no
– next F/U day
- no
- no
Conclusions of LASEK
after ICL operation (Bioptics)
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Accurate correction results
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Increased patient’s satisfaction
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No intra & post op. complications
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Stable refractive results
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Effective to all ranged astigmatism