Presentation on theme: "GUSTAVO TAMAYO MD CLAUDIA CASTELL MD"— Presentation transcript:
1GUSTAVO TAMAYO MD CLAUDIA CASTELL MD CENTRO OFTALMOLOGICOGUSTAVO TAMAYOBOGOTA COLOMBIALASIK XTRAGUSTAVO TAMAYO MD CLAUDIA CASTELL MDPILAR VARGAS MDFrom: BOGOTA LASER REFRACTIVE INSTITUTEBogota, Colombia
2DISCLOSURES FOR GUSTAVO TAMAYO MD Member of the Advisory Board for AMO Inc.Member of the Advisory Board PRESBIA Corp.Member of the Advisory Board EYEGENICS Corp.Member of the Speakers Group for AVEDROMember of speakers group of KERAMEDPatent holder of a Presbyopia treatment
3LASIK XTRA A new concept: KXL at the time of a LASIK surgery. There is no doubt any surgery involving the creation of a flap will decrease the strength of the cornea.Microkeratomes decrease the corneal strenghth two times more than Femtosecond flaps (own published studies).If the addition of KXL does not change the final result: WHY NOT?
4LASIK XTRAVery short procedure: one minute soaking time and one minute fifteen seconds UV.Does not change the normal LASIK procedure itself.Same ablation, same handling of the flap.In my own cases we did not detect any change in the refractive result.No complications added at all to the normal regular procedure of LASIK.
5INCORPORATING LASIK XTRA INTO STANDARD LASIK SURGERY Avedro’s VīBex Riboflavin is applied to the flap bed:Isotonic0.1% riboflavin20% Dextran T500pH 7.0Following excimer laser ablation in the flap bedThe flap is repositioned and the cornea is thenexposed to 30mW/cm2UVA for 2 minutes
6LASIK XTRA ADVANTAGESCan be carried out with Intralase or with Microkeratome flap.Do not change the regular procedure.Easy and simple for Doctor and Patient.Do not change the final result of the ablation.Can also be used regardless of the thickness of the flap, depth of ablation or type of Excimer Laser.
7LASIK XTRA DISADVANTAGES Slows down the procedure for a couple of minutes.Increases the cost.
8LASIK XTRA INDICATIONS STRONG CONSIDERATIONS ABSOLUTELY CONTRAINDICATED IN THE PRESENCE OF ECTASIA.ABSOLUTELY NOT INDICATED WHEN DEVELOPMENT OF ECASIA IS WARRANTED.In such a case I prefer Surface Ablation plus Accelerated Cross Linking.
9LASIK XTRA INDICATIONS Young patients for Lasik (under 24 years of age).Patients with severe ocular allergies, due to the risk of heavy rubbing.Completely normal corneas, with no one sign of Keratoconus, but family history.Thin corneas with complete normal preoperative evaluation (Risk of ectasia has been ruled out).High myopes (large resections)
10LASIK XTRA INDICATIONS Retreatments, particularly if the thickness of the flap is not known.Unexpected thick flap.Irregular flaps with different thickness.FINALLY IN ALL LASIK CASES: IF IT DOES NOT CHANGE THE RESULT WHY NOT???
11LASIK XTRA: Predictable Visual Outcomes Retrospective Comparison of 66 Lasik eyes to 42 LASIK eyes treated for myopiaMean age: in the Lasik Xtra cohort and in the LASIK cohortMean preoperative MRSE was D (Lasik Xtra), and D (LASIK).No adjustment was made to the excimer laser treatment nomogram to account for aCXL, which was performed immediately following stromal ablation
12LASIK XTRA: Predictable Visual Outcomes Retrospective Comparison of 66 Lasik eyes to 42 LASIK eyes treated for myopiaMean UCVA at 1 Day Post-Op20/21 Lasik Xtra vs 20/20 LASIKMean UCVA at 1 Week Post-Op20/20 Lasik Xtra vs 20/20 LASIKMean UCVA at 1 Month Post-Op20/18 Lasik Xtra vs 20/20 LASIK
13LASIK XTRA: Predictable Visual Outcomes Retrospective Comparison of 66 Lasik eyes to 42 LASIK eyes treated for myopiaMean MRSE at 1 Week Post-Op+0.17 Lasik Xtra vs LASIKMean MRSE at 1 Month Post-Op+0.49 Lasik Xtra vs LASIK
14LASIK XTRA: Predictable Visual Outcomes UCVA 1 Day Post Operative
15LASIK XTRA: Predictable Visual Outcomes UCVA 1 Month Post Operative
19CONCLUSION LASIK XTRANo need to change nomogram for LASIK procedures (Femto or microkeratome).No change in the final results when compared to same procedures without KXL.No haze or loss of lines of BCVA.Time for surgery is increased only few more minutes.Follow up only one year and one eye retreatment in 100 eyes.Lifting the flap was very easy (surgeon was not aware of the KXL at the time of relifting).