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Bioptic Surgery

Bioptic Surgery. Kangnam Eyence Eye Clinic Woon Bong Jwa. Biopitcs. Phakic IOL + LASIK, LASEK - Zaldivar (1999) Excellent option for - >-19D SE - significant astigmatism More reliable refractive results Decrease the risk of halos.

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Bioptic Surgery

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  1. Bioptic Surgery Kangnam Eyence Eye Clinic Woon Bong Jwa

  2. Biopitcs • Phakic IOL + LASIK, LASEK- Zaldivar (1999) • Excellent option for - >-19D SE - significant astigmatism • More reliable refractive results • Decrease the risk of halos

  3. Management of Astigmatism during & after ICL operation • Incisional Astigmatic Procedure • LASIK or LASEK • Toric ICL

  4. Incisional Astigmatic Procedure • The change of incisional direction, size according to astigmatism during ICL op. • Relaxing Incision after ICL op.

  5. Incisional Astigmatic Procedure • CCI on the direction of WTRastigmatism by preop. MR, Topo. • Incisional size (by Astigmatism) – 3mm : < 1D – 3.5mm : < 1.5D – 4mm : < 2D – 4.5mm : >2D

  6. Incisional Astigmatic Procedure • 2005. 1 ~ 2005. 2 ICL op. patients • 50 eyes , female : male = 23 : 6 (p) • Preop. SE : -10.69±3.37D (-4.5 ~ -20.38D) • Preop. Astigmatism : -1.62 ±1.21D (-0.5 ~ -6.25D)

  7. Incisional Astigmatic Procedure • Topical anesthesia • Superior CCI ( 3mm ~ 4.5mm) • ICL insertion to A/C • Rotation of ICL • ICL haptic insertion • Confirm of ICL centration • Irrigation & wound adhesion

  8. Incisional Astigmatic Procedure

  9. Results of Incisional Astigmatic Procedure during ICL operation

  10. The changes of spherical equivalent after ICL operation

  11. The changes of astigmatism after incisional astigmatic procedure

  12. The changes of vision after incisional astigmatic procedure

  13. The changes of astigmatic amount after incisional astigmatic procedure

  14. Complications during & after incisional astigmatic procedure • Scant iris hemorrhage • Corneal wound leak & dehiscence • Infection– no • Crystalline lens touch- no

  15. Conclusions of incisional astigmatic procedure during ICL operation • Easy & safe procedure • Fast recovery of naked vision • Increased patient’s satisfaction • No intra & post op. complications • Stable refractive results • Effective to 2.0D below astigmatism

  16. Bioptics by LASEK • 2003. 10 ~ 2004. 11 Bioptics patients • 43 eyes, female : male = 14 : 4 (p) • Pre ICL SE : -9.49±2.12D (-5.25~-11.25) • Pre ICL Astigmatism : -2.27±1.12D (-1.00~-4.00) • Post ICL SE : +0.33±0.39D • Post ICL Astigmatism : -2.36±0.71D • Interval to LASEK after ICL operation : 4.65±2.63m

  17. LASEK procedure (Bioptics) • Horizontal axis marking • 20% alcohol soaking : 15 sec. • Excimer laser ablation (Visx star S4) • Cold saline irrigation • T-lens & 5% NaCl qid

  18. Results of LASEK after ICL operation

  19. The changes of vision after LASEK operation (Bioptics)

  20. The changes of astigmatism after LASEK operation (Bioptics)

  21. Complications of LASEK after ICL operation (Bioptics) • Striate keratopathy– next F/U day • Delayed wound healing- no • Corneal opacity- no • Steroid induced ocular HT- no

  22. Conclusions of LASEK after ICL operation (Bioptics) • Accurate correction results • Increased patient’s satisfaction • No intra & post op. complications • Stable refractive results • Effective to all ranged astigmatism

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