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My travel expenses have been PAID by Moria, S.A. of Antony, France. Comparison of the Texture of Bowman’s Membrane in LASEK, PRK and Epi-LASIK. ASCRS April 3-9, 2009 James S. Lewis, MD Wills Eye Surgical Network, Philadelphia, PA. 30 Consecutive Eyes - PowerPoint PPT Presentation
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Comparison of the Texture of Bowman’s Membrane in LASEK, PRK and Epi-LASIK
ASCRS April 3-9, 2009James S. Lewis, MD
Wills Eye Surgical Network, Philadelphia, PA
My travel expenses have been PAID by Moria, S.A. of Antony, France.
My travel expenses have been PAID by Moria, S.A. of Antony, France.
30 Consecutive EyesScheduled for
Advanced Surface Ablation were Randomized to
Epi-LASIK, PRK and LASEK
1080i Digital HD VIDEO
was captured in each case
video was passed thru a proprietary embossing filter
a representative swatch (like that on the right) was presented to three masked observers
images were graded 1-5
1: Smoothest 5: Roughest
procedureObserver
1Observer
2Observer
3Average Texture
LASEK 2 2.8 3 2.60
PRK 4.1 4 3.9 4.00
Epi-LASIK 1.6 1.3 1.2 1.36
Surgical Details
LASEK was performed with 30 seconds of exposure to a solution of 80 % BSS and 20% medical grade alcohol as described by Massimo Camellin
PRK was performed using a Hyperopic Amoil’s Brush
Epi-LASIK was performed using Moria’s Epi-K™
Motivations
Advanced Surface Ablation preserves the highest amount of corneal structural integrity
Bandage contact lenses, topical Mitomycin, cold BSS, NSAIDs, steroids, oral Vitamin Supplements and more homogeneous Excimer lasers have led to diminished scarring and haze
We strive to determine the smoothest possible surface to apply the refractive correction
Techniques and Alternatives
SEM distorts smoothness data by chemical post-processing
Drying artifacts thwart intraoperative measurement
Photography provides only a single image with variable lighting
EVI: Enhanced Video Imaging using uncompressed digital data and an embossing filter makes smoothness recognition easy
Conclusion
PRK using an Amoil’s brush provided the least smooth refractive surface (4.0 out of 5.0) for Excimer Laser Corneal Sculpting
LASEK produced a Bowman’s Membrane surface scored substantially better than PRK (2.6 out of 5.0)
Epi-LASIK scored a smoothness score of 1.36 out of 5.0
We suggest the best refractive results will arise from the smoothest refractive surface
Thanks
I gratefully acknowledge Massimo Camellin who suggested this study and who is responsible for our new commitment to advanced surface ablation.