Gaurav Prakash, MD

El desajuste ciclotorsional entre el patrón de ablación de LASIK y el ojo puede provocar una hipocorrección residual postoperatoria. Para contrarrestar esto, el ajuste en base al reconocimiento del iris del haz de ablación de la córnea se ha incorporado en muchas plataformas de láser. La mayoría de las plataformas de láser recientes con reconocimiento del iris poseen una instalación para el reconocimiento del iris de preablación.

O desalinhamento ciclotorsional entre o padrão de ablação da LASIK e o olho pode causar hipocorreção residual pós-cirúrgica. Para evitar isso, o alinhamento do feixe de ablação à córnea com base no reconhecimento da íris foi incorporado em muitas plataformas de laser. A maioria das plataformas de laser recentes com reconhecimento da íris tem instalações para reconhecimento da íris pré-ablação.

In recent years, LASIK outcomes have improved with the use of better algorithms, ablation profiles, and preoperative and intraoperative iris recognition. Despite these advancements, some post-LASIK patients still have significant visual symptoms and poor uncorrected visual acuity and require an enhancement procedure. 

The corneal epithelium plays an important role in the optics of the eye. The thickness of the epithelium variably contributes to the optical power of the cornea. The corneal epithelium influences tear film instability and is associated with local irregularities of the corneal topography created after excimer ablation surgeries. Anterior segment optical coherence tomography has been used in recent years to evaluate corneal epithelial thickness. We evaluated the repeatability, inter-user and intra-user, of Fourier domain OCT to measure epithelial thickness.

Birth injuries to the eye occur due to placement of the forceps blade across the globe and orbit, leading to blunt trauma to Descemet’s membrane. This often results in a transient increase in IOP, leading to rupture of Descemet’s membrane, which heals later by scarring, leading to high astigmatism and often resistant amblyopia. We report a case of an adult who presented to us with bilateral birth trauma scars, amblyopia and high cylinder and underwent sub-Bowman keratomileusis with successful 1-year follow-up.

Cyclotorsional misalignment between the LASIK ablation pattern and the eye can result in postoperative residual undercorrection. To counter this, iris recognition-based alignment of the ablation beam to the cornea has been incorporated in many laser platforms. Most of the recent laser platforms with iris recognition have a facility for pre-ablation iris recognition.

Femtosecond laser-assisted sub-Bowman’s keratomileusis has emerged in recent years with good visual and refractive outcomes and a good biomechanical profile. The current technology available to create a sub-Bowman’s flap with a 60-kHz femtosecond laser has been shown to be satisfactory in terms of visual outcomes and architectural profile regarding planarity and predictability.

An anterior staphyloma, as seen in Figure 1, is a challenging entity.

Accurate assessment of central and paracentral corneal thickness is essential in varied clinical settings. Correct assessment of central thickness is required in glaucoma evaluation and as indirect evidence of functionality of endothelial cells.

Amar Agarwal Pseudophakic bullous keratopathy with an anterior chamber IOL, as seen in Figure 1, is one of the leading causes of full thickness penetrating keratoplasty and IOL exchange. It presents a unique surgical challenge because of a previous complicated surgery, compromised aqueous drainage, unhealthy wound configuration and a deficient posterior capsule. Therefore, both the corneal transplant and the IOL exchange should be optimized to aim at a lesser “open-sky” time, easier intraoperative procedures, earlier wound healing and maximum postoperative preservation of the donor endothelial cells. In this column, we describe a new triple procedure: femtosecond laser-assisted PK, anterior chamber IOL explantation and fibrin glue-assisted sutureless IOL implantation in the posterior chamber for the management of pseudophakic bullous keratopathy with an anterior chamber IOL. The unique benefits of femtosecond laser and glued IOL could be adjunctive and provide enhanced results in cases undergoing PK and IOL exchange.