Surgical intraoperative manegement of astigmatism, opposite clear corneal incisions. Clinica Rementeria | http://www.cirugiaocular.com

1. - Dra. Alba Coronado
- Dra. Beatriz Puerto
- Dr. Jorge García
- Dra. MªJose Merino
- Dr. Carlos Veiga
- Dra. Fé Moreno
- Dra. Andrea Sanz
- Dr. Fco.Javier Hurtado
Dr. Laureano A-Rementería

2. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
MAIN INCISION
GETTING SMALLER
LESS INDUCED ASTIGMATISM
NO SENSE TO MARK STEEPEST AXIS
MAIN INCISION AT MOST CONFORTABLE AXIS
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

3. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
OPPOSITE CLEAR CORNEAL INCISIONS
EASY
NO EXPENSIVE MATERIAL
PREDICTABLE IN LOW ASTIGMATISM
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

4. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
WE TRY TO REDUCE THE PREVIOUS
ASTIGMATISM TROUGH CLEAR
CORNEAL INCISIONS AT THE STEEPEST
AXIS
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

5. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
WE MARK WITH YAG LASER AT THE SLIT
LAMP
IT CAN BE DONE THE DAY BEFORE
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

6. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

7. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

8. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

9. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
WITH THE RULE
1-2 D 2 INCISIONS at 9mm
2-3 D 2 INCISIONS at 7mm
+ 3 D NOT INDICATED
2.5mm diamond blade
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

10. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

11. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

12. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

13. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
AGAINST THE RULE
1-2 D 2 INCISIONS at 7mm
2-3 D 2 INCISIONS at 6mm
+ 3 D NOT INDICATED
2.5mm diamond blade
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

14. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

15. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

16. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

17. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

18. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
0
1
2
3
4
5
6
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 61 63 65 67 69 71 73 75 77 79 81 83 85 87 89 91 93 95 97
PREOP CORNEAL ASTIGMATISM
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

19. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
POSTOP CORNEAL ASTIGMATISM
0
1
2
3
4
5
6
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59 61 63 65 67 69 71 73 75 77 79 81 83 85 87 89 91 93 95 97
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

20. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
AVERAGE
1,58
0,91
0,63
0,00
0,20
0,40
0,60
0,80
1,00
1,20
1,40
1,60
1,80
PREOP POSTOP TEORICO POST
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

21. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
% PATIENTS BELOW 1 Dp.
18
71
88
0
10
20
30
40
50
60
70
80
90
100
PREOP POSTOP TEORICO POST
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

22. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
DIFFERENCES ACCORDING TO THE
ORIENTATION OF CORNEAL ASTIGMATISM
2,02
1,11
0,91
1,48
0,84
0,50
1,41
0,82
0,59
0,00
0,50
1,00
1,50
2,00
2,50
PREOP POST TEORICO POST
DIRECTO
INVERSO
OBLICUO
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

23. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
COMPARISON BETWEEN
SUBJECTIVE PREOPERATIVE ASTIGMATISM AND
CORNEAL PREOPERATIVE ASTIGMATISM
ACCORDING TO THEIR PREOPERATIVE ORIENTATION
1,11
0,84 0,82
0,45
0,87
0,82
0,00
0,20
0,40
0,60
0,80
1,00
1,20
DIRECTO INVERSO OBLICUO
CORNEAL
SUBJETIVO
SURGICAL INTRAOPERATIVE MANAGEMENT OF ASTIGMATISM
OPPOSITE CLEAR CORNEAL INCISIONS

24. MINIINCISIONANDOCCI
MINIMALINVASIVECATARACTSURGERY–ALICANTE2010
CONCLUSSIONS
• OPPOSITE CLEAR CORNEAL INCISIONS ARE
VERY PREDICTABLE IN CORNEAL
ASTIGMATISM UP TO 2 DIOPTERS.
• PATIENTS TOLERATE BETTER THE RESIDUAL
ASTIGMATISM BETTER WITH OF THE RULE.
• THE PRECISION IN THE AXIS OF THE INCISION
IS IMPORTANT.
• WE CAN HAVE MORE MULTIFOCAL PATIENTS.
• OUR PERCENTAGE OF TOUCH UP WITH LASER
DECREASES.

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www.cirugiaocular.com
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FOR YOUR ATTENTION