Preexisting Psychiatric and Personality Disorders Can be a Major Source of Dissatisfaction After LASIK

A recent study done at the US Navy Refractive Center in San Diego was performed to determine the source of patient dissatisfaction after LASIK. The study confirmed that the overwhelming majority of patients were satisfied with the results of their LASIK surgery. An important predictor of dissatisfaction was the preexistence of psychiatric and personality disorders. Specifically mentioned was the presence of depression or a negative outlook. This study points out the importance of screening patients for these disorders and for patients to have realistic expectations. http://www.medpagetoday.com/MeetingCoverage/AAO/7323

Measurement of Depth of Intacs

A recent article explores the use of Intacs in keratoconus:

Measurement of Depth of Intacs Implanted Via Femtosecond Laser Using Pentacam
Journal of Refractive Surgery Vol. 25 No. 4 April 2009

Günhal Kamburoglu, MD; Aylin Ertan, MD and Osman Saraçbasi, PhD

Thirty-two eyes of 23 keratoconic patients receiving Intacs intrastromal corneal ring segments implanted by femtosecond laser were included in the study. The depth of intracorneal channel and Intacs segments were measured for 7 predetermined points at 1 week and 1 year postoperatively using Scheimpflug images.
Mean achieved intrastromal channel depth exceeded the intended parameter by 6.5 µm to 69.0 µm. The standard deviation varied between ±13.5 µm and ±44.2 µm. The segment depth decreased at the end of the first postoperative year in all measured points, and the change was statistically significant at the superior, inferior, and temporal sides of the Intacs. The degree of change was not correlated with size of the Intacs, preoperative central corneal thickness, and mean keratometric values.

CONCLUSIONS
Intacs started out deeper than intended and tended to shallow over time. I had one patient who had erosion of their Intac segment into their anterior chamber which may have been a result of deeper than intended placement. This study has important implications for surgeons who perform Intacs in the treatment of keratoconus.

Ride for the Cure Today

Today (Sunday) we are helping sponsor Ride for the Cure. The motorcycle ride begins at C and C Cycles and ends at Scooters Bar and Grill. http://rideforthecure.us for more info. Hope you can join us in helping find a cure for breast cancer. Next week we will be involved in the Fallen Heroes Run. More info to follow.

Treating Epithelial Ingrowth with the YAG Laser

Jorge L. Alió, MD described the use of the YAG laser to treat epithelial ingrowth after LASIK as an alternative to flap lifts in a recent issue of Refractive Eyecare. Early treatment of mild-to-moderate epithelial ingrowth with the Nd:YAG laser promises a simple way to eliminate a vexing problem and, possibly, prevent the development of more serious problems.
Instead of lifting the LASIK flap, refractive surgeons can treat most moderate epithelial ingrowth and restore patients’ lost visual acuity with a laser commonly used after cataract surgery. This low-energy, effective procedure uses the workhorse of ophthalmic lasers to spare patients more invasive surgery and avoid the risks of further complications from a flap lift

Thin Corneas Not a Risk for LASIK

Contrary to the assumption that eyes with thin corneas are poor candidates for LASIK because they are at increased risk of developing postoperative ectasia, scientific evidence fails to support preoperative central corneal thickness (CCT) as an independent risk factor for this complication, said William B. Trattler, MD, at the annual meeting of the American Academy of Ophthalmology. Individuals with thin corneas, however, are at risk for ectasia if an abnormality such as forme fruste keratoconus (FFKC) is found during preoperative topographic analysis, he said.
Time and time again I have seen patients told they are not a candidate for LASIK because of thin corneas. There are multiple studies that show that thin corneas are not an independent risk factor for LASIK and this is just one more report confirming this.

Outdoor Activities Decrease the Risk of Myopia

Spending 2 to 3 hours a day outdoors can significantly lower a child’s risk of developing myopia, according to a new study.
A child’s chances of becoming nearsighted, if he or she has two nearsighted parents, are about six in 10 for children who spend 0 to 5 hours outside a week, but the risk drops to two in 10 when outdoor time exceeds 14 hours a week, according to researchers.
Researchers also said that the critical factor for reducing development of myopia in children seems to be total time spent outdoors; both active and passive outdoor activities equally protected child’s vision.

Botox

Speaking of newer cosmetic uses of drugs, many readers may not be aware that the some of the original uses of Botox also were in ophthalmology. The muscle paralyzing properties were and continue to be used in blepharospasm, a benign but very disturbing forceful lid closing condition. Patients who suffer from blepharospasm experience uncontrolled forceful lid closure/spasms that can be quite debilitating. The injection of botox in and around the eyelids can give relief for approximately 6 months. Now the most common use of Botox is the relaxation of facial wrinkles. Newer indications continue to evolve and Botox has been used for relief of other muscle spasms and contractions, strabismus, severe sweating (hyperhidrosis), and headaches.