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    Managing LASIK complications

    From preop to postop dryness and IOP, stay on track

    A U.S. patent was granted to Gholam A. Peyman, MD, in June 1989 for a method of modifying the corneal curvature of the eye. The surgical procedure involved cutting a flap in the cornea, pulling the flap back to expose the corneal bed, ablating the exposed surface and then replacing the flap. The current procedure of laser assisted in-situ keratomileusis (LASIK) was not FDA approved until 1999.

    More from Dr. Bloomenstein: The latest tool for photo-refractive comanagement

    LASIK is now part of the vernacular and is recognized worldwide with millions of  procedures performed and still tens of thousands performed annually in the U.S.. The satisfaction of LASIK has been reported to be as high as 94 to 98 percent,1 a rating on Rotten Tomatoes that would warrant a blockbuster! However, this is still surgery, and with every success there is the potential of a complication. Thus, in order to stay focused on this awesomesauce—yes another word added to the dictionary—procedure, a reminder of how to handle the infrequent complication is warranted.

    Related: Will the SMILE procedure replace LASIK?

    LASIK patient evaluation

    The evaluation of a LASIK patient is the first step in the process of avoiding and managing complications. The evaluation is designed to root out these outliers who would not benefit from this procedure. In fact, I look at that examination to prove why the patient should not have LASIK surgery as opposed to finding reasons why he should. We know that a cornea can be thinned only so much before it succumbs to ectasia. Thus, the corneal thickness needs to be commensurate with the amount of tissue ablated to obtain the desired correction. Thus the refractive error is a slightly moving target comparable to the corneal thickness. Topography needs to be symmetrical and void of any signs of ecstatic disorder. This vetting process must also include a cerebral component, justifying that the patient has a clear understanding of what the procedure will accomplish. Yes, I am specifically referring to those low myopic presbyopes.

    Next: Post-LASIK patient recovery and care

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      LASIK, although considered a surgery is less invasive and more convenient. To be able to enjoy its full benefits, a patients must first understand the procedures, benefits and downside of LASIK. Patients must first remember that LASIK is not for everyone, they need to undergo an eye exam and consider the risk and benefits of a LASIK surgery as it may lead to dry eyes syndrome, over or under correction. Also, consider finding the right surgeon who will perform the surgery as it plays an important role in the success of your treatment. If you are anywhere near Sun City in Arizona, who else would be the best eye doctor to perfom LASIK, the inventor himself Dr. Peyman who heads the Arizona Retinal Specialists (arizonaretinalspecialists.com). You are ensured that you get the best eye health care when you are in the hands of a world renowned ophthalmologist.

    Optometry Times A/V