July 15, 2003
LASIK Pearl :Avidance of Flap Complication
Review of Ophthalmology July 2003
Of course, the best way to manage complications is to never have them. You can come closer to this goal by taking certain steps.First, dampen the surgical gauze around the patient’s eye. This decreases the number of fibers that can break loose from the dressing and settle at the stromal interface. After applying the microkeratome’s suction ring, put pressure on both sides of the ring to set it in place for about two or three seconds. This makes an indentation in the conjunctiva, helps achieve better suction and avoids the eye drifting under the microkeratome. Also use a pneumotonometer to ensure that the intraocular pressure is at least 80 mmHg prior to proceeding with the cut. With Hansatome slightly decenter the ring in that direction. Since the flap is not completely circular, this will ensure ample stroma to ablate and won’t hit the hinge with the laser.Another tip with the Hansatome: Make sure the pole on which the keratome sits is tilted a little temporally. This allows the keratome to fit better, because, as you bring it in with your other hand to set it on the pole, it’s never completely vertical. You’ll find it fits in with less manipulation.
Posted by mehdi khanlari at July 15, 2003 11:37 PM