| Glenn - USAEyes.org 2004-12-28, 7:15 pm |
| Progress with LASIK related problems could be considered positive
news. Most certainly positive news to those who have the problem.
While there has been much noise in this newsgroup about the rare
complication ectasia, new treatments have been developed for this
LASIK related problem of the cornea bulging forward because of
weakness. These techniques can be used for naturally occurring
keratoconus as well.
Here are a few paragraphs from a recent article. The full item is at
http://www.revophth.com/index.asp?page=1_634.htm
~~~~~~~~~~~
Possible Hope for Post-LASIK Ectasia
Walt Bethke, Managing Editor
One of the most disheartening, and downright scary, complications of
LASIK is corneal ectasia, since it’s a condition that will get
progressively worse and take the patient’s vision with it. Some
surgeons, however, are trying novel techniques on patients with
post-LASIK ectasia, and say the results show promise. Here’s a
discussion of how these emerging methods may help these eyes.
The Latest on Intacs Beverly Hills, Calif., surgeon Brian Boxer
Wachler has used Addition Technology’s Intacs on 40 patients with
post-LASIK ectasia, based on data from studies of Intacs for either
keratoconus or ectasia.
Riboflavin and UV Light Surgeons are also trying a combination
treatment of riboflavin and ultraviolet light to strengthen the
cornea.
The work was pioneered by European surgeons who performed a
prospective, nonrandomized study in which 23 eyes of 22 patients with
moderate or advanced progressive keratoconus with a K value from 48 to
72 D received a central corneal abrasion, then drops of riboflavin.4
The eyes were then exposed to 370-nm wavelength (UVA) light at 3mW/cm2
for 30 minutes. The follow-up ranged from three months to four years.
Glaucoma Drops Finally, for a handful of LASIK patients whose ectasia
was caught very early, which is usually a month or less after it
appears, Dr. Boxer Wachler has used glaucoma drops to decrease the
intraocular pressure with the hope of decreasing the deformity in the
cornea. He got the idea after listening to a paper on changes in
corneal shape induced by changes in IOP by Peter Pinsky, PhD, of
Stanford, at the 5th International Congress of Wavefront Sensing and
Optimized Refractive Corrections this past February. “I connected the
dots to develop the use of glaucoma drops for early ectasia reversal,”
he says. There haven’t been any controlled studies of the technique,
however.
~~~~~~~~~~~~~~~~~~~~~~
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAEyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
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