- •Preface
- •Contents
- •Contributors
- •Refractive Errors and Their Treatment
- •History of LASIK
- •Lasers in LASIK
- •Microkeratomes
- •Adjunctive Instrumentation in LASIK
- •Preoperative Considerations
- •LASIK Techniques
- •Microkeratomes and Laser Settings
- •Centration of LASIK Procedures
- •Surgical Caveats for Managing Difficult Intraoperative Situations
- •Bilateral Simultaneous LASIK
- •Visual Outcomes After Primary LASIK
- •Quality of Vision After LASIK
- •LASIK Retreatments
- •LASIK After Penetrating Keratoplasty
- •Bioptics
- •Intraoperative Complications
- •Postoperative Complications of LASIK
- •Optical Aberrations After LASIK
- •The Future of LASIK
- •Index
L A S I K
Fundamentals, Surgical Techniques,
and Complications
edited by
Dimitri T. Azar
Massachusetts Eye and Ear Infirmary
Schepens Eye Research Institute
and Harvard Medical School
Boston, Massachusetts, U.S.A.
Douglas D. Koch
Cullen Eye Institute
Baylor College of Medicine
Houston, Texas, U.S.A.
|
MARCEL DEKKER, INC. |
NEW YORK • BASEL |
|
|
|
Copyright © 2002 by Marcel Dekker, Inc. All Rights Reserved.
Library of Congress Cataloging-in-Publication Data
A catalog record for this book is available from the Library of Congress.
ISBN: 0-8247-0797-4
This book is printed on acid-free paper.
Headquarters
Marcel Dekker, Inc.
270 Madison Avenue, New York, NY 10016 tel: 212-696-9000; fax: 212-685-4540
Eastern Hemisphere Distribution
Marcel Dekker AG
Hutgasse 4, Postfach 812, CH-4001 Basel, Switzerland tel: 41-61-260-6300; fax: 41-61-260-6333
World Wide Web
http://www.dekker.com
The publisher offers discounts on this book when ordered in bulk quantities. For more information, write to Special Sales/Professional Marketing at the headquarters address above.
Copyright © 2003 by Marcel Dekker, Inc. All Rights Reserved.
Neither this book nor any part may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, microfilming, and recording, or by any information storage and retrieval system, without permission in writing from the publisher.
Current printing (last digit): 10 9 8 7 6 5 4 3 2 1
PRINTED IN THE UNITED STATES OF AMERICA
To Nathalie, Alexander, Nicholas, and Lara—for all the joyful moments that we share.
DTA
To my wife, Marcia, who makes it all so much more meaningful—and fun.
DDK
Preface
Dov’é mio figlio? . . . più non lo vedo:
In te più Alfredo–trovar non so
For decades, the majority of ophthalmologists have been embarrassed by and highly suspicious of refractive surgery, at times with good justification. They have been repelled by its tactics in patient recruitment, uneasy about its seemingly cavalier use without longterm data, eager to defend its unsuspecting victims, and deeply concerned that its shortterm benefits are outweighed by its burdensome long-term consequences. And so the words of Germont, uttered pursuant to the most dramatic moment in Verdi’s La Traviata, echo the extreme and oftentimes passionate contempt expressed by so many colleagues and close friends towards academically oriented ophthalmologists who marched among the vanguards of laser refractive surgeons. Their repudiation was not unlike Germont’s scorn of his son Alfredo for offending Violetta and for making himself worthy of disdain:
Where is my son? . . . no more do I see him.
I am unable to see Alfredo in you.
The ophthalmological peer-reviewed publications and textbooks prior to the late 1980s reflected this disinterest in or hostility toward refractive surgery. Unfortunately, in the pre-LASIK era, there were relatively few high-quality peer-reviewed reports on refractive surgery. Criticisms of the scientific rigor with which clinical studies were conducted were often justified, which, in turn, discouraged academically bound graduates of ophthalmology training programs from dedicating their careers to this subspecialty. Comprehensive textbooks of ophthalmology in the pre-LASIK era also kept refractive surgery at arm’s length, relegating it to a minor chapter on the topic. Refractive surgery was viewed as an outlier of great potential but little practical merit in mainstream ophthalmology. But this has all changed with the advent of LASIK!
v
vi |
Preface |
This book is the first in a series dedicated to Refractive Surgery by Marcel Dekker, Inc. It will most certainly be judged by many as just another LASIK book. While there is abundant coverage of the topic in other books, this volume has several unique features. Its coverage of LASIK is relatively comprehensive, in that it is not limited to LASIK history, surgical techniques, complications, and their management. New aspects of lasers, optics, refraction, diagnostics, and instrumentation are combined with the science and general principles of LASIK, and indications for its use. Although not meant to be encyclopedic, key references abound. They are intended to serve as a guide to the literature on the topic. Thus, this book is not so much a chronicle of LASIK, as an attempt to serve as a source of information relevant to clinical practice.
We are indebted to the students, residents, and colleagues who have made valuable contributions to this book. Several have included original work and analysis in their chapters. It is evident that the authors have attended diligently to their assignments. We are grateful for their effort in integrating the sometimes limited information in peer-reviewed literature with the knowledge derived from their clinical experiences and interactions with colleagues. We hope that this has resulted in a text that is both clinically relevant and as ev- idence-based as possible.
We thank Dr. Geoffrey Greenwood and Elizabeth Curione of Marcel Dekker, Inc., for their commitment to this project and Drs. Tsubota, Boxer Wachler, Hoang-Xuan, Ang, and Gatinel for their assistance in future books in this series. Special thanks go to Leona Greenhill, for her editorial assistance, and to Rhonda Harris, who managed this project with care and precision. Her attention to detail and her dedication have enabled us to work coherently in the face of adversity.
We take the opportunity to acknowledge the pioneering surgeons and researchers in the field of refractive surgery. Their work and vision have provided the basis not only for current refractive developments that we can offer to our patients, but also for future advances to be made by the next generation of thoughtful contributors to this important field.
Dimitri T. Azar
Douglas D. Koch
Contents
Preface |
v |
|
Contributors |
xi |
|
1. |
Refractive Errors and Their Treatment |
1 |
|
Liane Clamen Glazer and Dimitri T. Azar |
|
2. |
History of LASIK |
21 |
|
Ioannis Pallikaris and Thekla Papadaki |
|
3. |
Lasers in LASIK: Basic Aspects |
39 |
|
Rodrigo Torres, Robert T. Ang, and Dimitri T. Azar |
|
4. |
Microkeratomes |
57 |
|
Sandeep Kakaria, Thanh Hoang-Xuan, and Dimitri T. Azar |
|
5. |
Adjunctive Instrumentation in LASIK |
71 |
|
Robert T. Ang and Dimitri T. Azar |
|
6. |
LASIK Indications, Contraindications, and Preoperative Evaluation |
91 |
|
Richard E. Braunstein, Marc Winnick, and Kenneth A. Greenberg |
|
7.Preoperative Optical Considerations in LASIK: Refractive Errors,
Monovision, and Contrast Sensitivity |
101 |
Balamurali K. Ambati, Leon Strauss, and Dimitri T. Azar |
|
8. Corneal Topography and LASIK Applications |
111 |
Li Wang, Douglas D. Koch, Dimitri T. Azar, Robert T. Ang, |
|
and Rengin Yildirim |
|
vii
viii |
|
Contents |
9. Wavefront Technology and LASIK Applications |
139 |
|
|
Naoyuki Maeda |
|
10. |
Preoperative Considerations: Diagnosis, Classification, |
|
|
and Avoidance of Keratoconus Complications |
153 |
|
Paul Chung-Shien Lu and Dimitri T. Azar |
|
11. |
Corneal Stability and Biomechanics After LASIK |
163 |
|
Esen Karamursel Akpek, Rana Altan-Yaycioglu, and Walter J. Stark |
|
12. |
LASIK Techniques |
175 |
|
Dimitri T. Azar, Kathryn Colby, and Douglas D. Koch |
|
13. |
Microkeratomes and Laser Settings |
189 |
|
William J. Lahners and David R. Hardten |
|
14. |
Centration of LASIK Procedures |
199 |
|
Marsha C. Cheung, Chun Chen Chen, and Dimitri T. Azar |
|
15. |
Surgical Caveats for Managing Difficult Intraoperative |
|
|
Situations |
229 |
|
Samir G. Farah and Dimitri T. Azar |
|
16. |
Bilateral Simultaneous LASIK: Advantages, Disadvantages, |
|
|
and Surgical Caveats |
243 |
|
David R. Hardten, Elizabeth A. Davis, Richard L. Lindstrom, |
|
|
and William J. Lahners |
|
17. |
Postoperative Management Protocols for Uncomplicated |
|
|
LASIK Procedures |
255 |
|
Melanie A. R. Graham and Dimitri T. Azar |
|
18. |
Visual Outcomes After Primary LASIK |
265 |
|
Samir G. Farah and Dimitri T. Azar |
|
19. |
Quality of Vision After LASIK |
277 |
|
Patrick C. Yeh and Dimitri T. Azar |
|
20. |
LASIK for Hyperopia, Hyperopic Astigmatism, and Presbyopia |
285 |
|
Neal A. Sher |
|
21. |
LASIK Retreatments |
297 |
|
Ayman F. El-Shiaty and Brian S. Boxer Wachler |
|
22. |
LASIK Following Radial Keratotomy and Photorefractive |
|
|
Keratectomy |
313 |
Natalie A. Afshari and Dimitri T. Azar
Contents |
ix |
|
23. |
LASIK After Penetrating Keratoplasty |
319 |
|
Glenn C. Cockerham and Natalie A. Afshari |
|
24. |
Bioptics: Combined LASIK and Phakic Intraocular Lens Surgery |
329 |
|
José L. Güell, Mercedes Vázquez, Fortino Velasco, and Felicidad Manero |
|
25. |
LASIK and Intrastromal Corneal Ring Segments (ICRS) |
335 |
|
Jonathan D. Primack, Samir G. Farah, and Dimitri T. Azar |
|
26. |
Intraoperative Complications |
351 |
|
Li Wang, Manjula Misra, and Douglas D. Koch |
|
27. |
Postoperative Complications of LASIK |
365 |
|
Samir G. Farah, Jae Bum Lee, and Dimitri T. Azar |
|
28. |
Optical Aberrations After LASIK |
387 |
|
Samir A. Melki, Cinthia E. Proano, and Dimitri T. Azar |
|
29. |
Posterior Segment Complications of LASIK |
397 |
|
Ron Afshari Adelman and Natalie A. Afshari |
|
30. |
Management of Topographical Irregularities Following LASIK |
403 |
|
Jeffrey Johnson, Roselyn Jeun, and Dimitri T. Azar |
|
31. |
LASIK and TopoLink for Irregular Astigmatism |
421 |
|
Michael C. Knorz |
|
32. |
Management of Flap Complications in LASIK |
431 |
|
Manolette R. Roque, Samir A. Melki, Dimitri T. Azar, and Emily Yeung |
|
33. |
Management of Interlamellar Epithelium |
463 |
|
Nan Wang and Douglas D. Koch |
|
34. |
Management of Infections, Inflammation, and Lamellar |
|
|
Keratitis After LASIK |
477 |
|
Bilal F. Khan, Margaret Chang, Sandeep Jain, Kathryn Colby, |
|
|
and Dimitri T. Azar |
|
35. |
The Future of LASIK |
491 |
|
Nan Wang and Douglas D. Koch |
|
Index |
495 |
|
