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Several strategies can help surgeons improve LASIK outcomes
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LOS ANGELES — There are several techniques and strategies that can help improve outcomes after LASIK surgery, according to a speaker here.
“One, be wary of presbyopic patients. If we had our ideal patient, we’d pick someone who is 30 years old. The presbyopic patients, you have to deal with the counseling of the readers, trying to figure out what to do with distance, middle, intermediate, and that borderline process of trying to decide on natural lens replacement vs. LASIK,” David R. Hardten, MD, said at Refractive Subspecialty Day preceding the American Society of Cataract and Refractive Surgery meeting.
Second, Hardten suggested using a cycloplegic wavefront scan from a diagnostic standpoint instead of a therapeutic standpoint. The test is easy to perform, and the scan can offer surgeons additional data to improve outcomes.
Third, Hardten stressed educating patients about ocular surface disease. Often, patients will blame their dry eye on factors other than ocular surface disease, so if they experience dry eye after surgery, they will blame the LASIK surgery instead of ocular surface disease for their symptoms, he said.
“I work hard to educate them, treat and manage it, but the biggest thing is helping them understand that what they have will not be cured by your refractive surgery,” he said.
Surgeons should also resist LASIK in patients with epithelial basement membrane dystrophy. Patients with epithelial basement membrane dystrophy who undergo LASIK can develop an epithelial growth or ingrowth, which can slow recovery.
Lastly, Hardten suggested using high-resolution wavefront scans and topography-guided treatment for each patient. This technology allows for wavefront treatment plans to be created for difficult eyes, he said.
“These technologies continue to advance for imaging for our eyes and being able to treat them, so take advantage,” he said. – by Robert Linnehan
Reference:
Hardten DR. Five pearls in five minutes for improving LASIK outcomes. Presented at: American Society of Cataract and Refractive Surgery annual meeting; May 5-9, 2017; Los Angeles.
Disclosure: Hardten reports he is a member of the speakers bureau for Allergan, AMO and Oculus; receives research funding from Calhoun Vision, CXL-USA and HumanOptics; has investment interests in ESI Inc. and OSD; and receives a royalty or other financial gain from TLCV.