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LASIK pearls help lessen postop pain, striae
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Applying a long-term anesthetic to the stromal bed after cutting the flap in LASIK will help eliminate postoperative pain, according to the surgeon credited with the discovery of topical anesthesia for cataract surgery.
Richard A. Fichman, MD, said if striae are seen in the corneal flap after ablation, he squeezes them out with a Murocel (Bausch & Lomb) dot. If striae are present at 1 day postop, Dr. Fichman performs the technique again at the slit lamp.
“These simple techniques have really helped my patients,” Dr. Fichman said. “Postop pain, tearing and striae have been all but eliminated in my practice.”
Dr. Fichman applies 0.75% bupivacaine to the stromal layer after flap creation; he said this is effective for eliminating postop pain and tearing of the eye. He told Ocular Surgery News he “stumbled onto this technique by happenstance” while trying to find a method of reducing patients’ awareness of the laser on the corneal surface.
“I put a drop of two of Marcaine (bupivacaine, Cooke-Waite) on the stromal layer, let it sit for 15 seconds and then wipe it off,” Dr. Fichman said. He has been using this method for about 6 months, he said.
For more details on Dr. Fichman’s techniques, see the July 1 issue of Ocular Surgery News.