Transcript EPI-LASIK after Flap amputation

Augenabteilung am St. Franziskus Hospital Münster
EPI-LASIK
using the
Zyoptix XP EPI Separator
Suphi Taneri
ASCRS Symposium, April 4-9, 2008, Chicago
Travel grant by Bausch & Lomb
Purpose
To evaluate the safety and predictability of EpiLASIK using the Zyoptix XP microkeratome and the
influence of the epithelial flap in laser surface
ablation on visual recovery and pain.
Augenabteilung am St. Franziskus Hospital Münster
Methods
Baseline, n = 8 eyes
Mean
average
Keratometry
(dpt)
Age
(Years)
Corneal
Thickness
(µm)
Sphere
(dpt)
28
520
-1.34
-0.88
-1.78
0.98
43.30
26
2.95
0.65
2.89
0.07
1.07
SD
Cylinder
(dpt)
SE
(dpt)
BCVA
Min
19
483
-6.25
0.0
-6.25
0.8
42.40
Max
48
556
2.75
-1.75
2.38
1.0
45.20
In this prospective, comparative (self-controlled) single center
pilot study 8 eyes that were treated with Epi-LASIK by the same
surgeon using the XP EPI Separator were examined.
Augenabteilung am St. Franziskus Hospital Münster
Results
Epi-Separator Passage
no complications
free flap
Bowman
injury
torn flap
6
2
1
1
Epi-Flap
discarded
repositioned
2
6
Augenabteilung am St. Franziskus Hospital Münster
Results
HE stain of the discarded flap
magnification 200x
Microscopical examination showed complete epithelial separation
Augenabteilung am St. Franziskus Hospital Münster
Results
PAS stain of the discarded flap
magnification 200x
Microscopical examination showed complete epithelial separation
Augenabteilung am St. Franziskus Hospital Münster
Visual recovery
UCVA (decimal)
development of visual acuity
0,90
0,80
0,70
0,60
0,50
0,40
0,30
0,20
0,10
0,00
4th day postoperative
(n = 8)
1st day postoerative
(n=8)
0,43
0,66
0,38
2nd day postoperative (n=6)
Augenabteilung am St. Franziskus Hospital Münster
0,85
3 month postoperative
(n=6)
Healing Process
pain scale (0-10)
development of pain perception
10
9
8
7
6
5
4
3
2
1
0
1st day
postoperative
(n = 8)
2,00
2nd day
postoperative
(n = 8)
4th day
postoperative
(n = 8)
0,88
0,38
Pain perception of the patient: Description of pain on a scale
from 0 (no pain) to 10 (very strong pain)
Augenabteilung am St. Franziskus Hospital Münster
Healing Process
diameter of epithelial defect (mm)
8,00
closing of epithelium
7,67
7,00
6,00
5,00
4,00
1st day
postoperative
(n = 6)
3,00
2,00
1,00
2nd day
postoperative (n = 4)
2,00
4th day
postoperative (n = 8)
0,00
0,00
Augenabteilung am St. Franziskus Hospital Münster
Healing Process
closing of epithelium
n
8
8
7
6
5
4
3
2
1
0
3
0
1st day postoperative
2nd day postoperative
4th day postoperative
visits
Haze at 3 months visit: mean 0,7, range 0-1,5 (Fantes scale 0 – 3)
Augenabteilung am St. Franziskus Hospital Münster
Conclusion
•
Initial results of this ongoing trial indicate a safe and
standardized fashion of performing a surface
ablation using the Zyoptix XP Epi Separator.
• Further results may help to elucidate the role of the
epithelial flap in surface ablation.
Augenabteilung am St. Franziskus Hospital Münster