Q: Anyone had issues with poor epithelial healing (or even corneal melts) with Besivance? A: I’ve heard of this but think it’s BS because I’ve done literally 1,900 LASEKs using Besivance so if there was a true association I’d notice it by now as melts would be more common in ASA than in LASIK The …
Q: Was a bit surprised that OMIC has granted liability coverage for same day bilateral cataract surgery. They have suggestions but not underwriter requirements/ restrictions. Certainly a refusal to cover this could have discouraged ophthalmology from going further in that direction. I know same day cataract surgery has been discussed on kera–net with proponents for it. I …
Dr. Chynn on same day bilateral cataract surgery Read More »
I used to use MMC for Rx above -5, then had some late (>3 mo out) haze for -4, and rarely had it for -3 something so i reduced my limit for MMC (since it is really perfectly safe if diluted properly and applied on a sponge) to > -3 this depends where you are, …
Q: a 49 year old presents 2 months ago; she had Lasik in Ecuador early, 2014 and still doesn’t see well her exam shows an interface as to what appears an incomplete flap OU, just nasal to the visual axis and many nests of old epithelial cells in the interface OU also out of the …
Q: The conventional teaching for lid margin disease is to use an antibiotic oint to the lid margins at bedtime along with other therapy. If we continue ointment once alone for a long period, for maintenance, are we not using a subtherapeutic dosage and will this not promote drug resistance. Would it be better to …
Q: I have a 26 yo healthy female (only med is a birth control pill, which she has been on for years) with the following refractive error: Current wear in glasses: OD: -2.50+1.00×83 OS: -1.75+1.25x96Manifest June 2014: OD: -2.25+1.75×80 OS: -1.75+1.50×100Manifest Dec 2014: OD: -2.50+1.00×85 OS: -1.75+1.25×95Her topos from June and December 2014 are attached …
Fluence/mm2/sec but then got bogged down by the math and units and didn’t want to post something I wasn’t confident about I guess we should just say: “Haze can be induced by the (mild) thermal damage caused when the excimer laser photo disrupts covalent bonds of the collagen stroma. This is why techniques such as …
Dr. Chynn on The invention and basic science of the excimer laser Read More »
Q: New pt came to see me earlier this week for a refractive evaluation. 26yo male with past ocular hx of high astigmatism, no family hx of keratoconus. Highly motivated, and understands higher likelihood for enhancement. I was thinking of ASA for him, but wanted some input. BCVA OD: +0.5-4.50×005 20/25 pach 588 BCVA OS: …
Q: Inspired by Emil, I made epithelial flaps for two patient on my last LVC day. One patient 20/20- POD#1 the other 20/30 POD#1 and 20/20 OD and 20/25 OS POW#1 (-3.50 preop MRx). Second patient had discomfort on POD#4; I think it likely was from a very tight CTL fit and not the technique. …
Q: Dear All, I’ve noticed during PRK enhancements over prior PRK, even years later, using a brush, that the epithelium is quite obviously not as adherent over the ablation zone as it generally is during primary PRK’s. This phenomenon would probably not be apparent during alcohol-assisted enhancements, since that method loosens the epithelium before the …
Epithelial Reattachment Following Surface Ablation Read More »