Dr Menard Nov 14
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The document provides several case studies for discussion and consideration of treatment options. A 27-year-old female with night vision issues post LASIK is presented, with options to counsel monitoring or retreatment. A 54-year-old male status post LASIK with a monovision prescription in one eye experiences blurry distance vision and is happy with near vision; options consider retaining the current prescription or retreating the eye for full distance correction. Additional case studies examine options for epithelial ingrowth removal, cataract surgery for developing cataracts, and YAG capsulotomy for posterior capsule opacification following cataract surgery. The specialists welcome seeing any patients to discuss case findings and treatment recommendations.
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As the only member of his graduating class to specialize in Refractive Surgery, and now an recognized authority, Dr. Chynn is frequently invited back to Harvard to give updates on the State of the Art in Refractive Surgery.
This slide show presentation was given to 100 eye surgeons who flew in from across the country to learn the latest advances in glaucoma, retina, cataract surgery--and laser vision correction (from Dr. Chynn).
The title of his talk reflects the movement in the US and worldwide from leading surgeons that is called "Back to the Surface." This means that surgeons are moving away from LASIK and IntraLase, to avoid flap complications and the # 1 problem causing lawsuits (iatrogenic keratoconus, or KC), and back to the surface.
For some doctors, this means going back to the original procedure, PRK, which has a lot of pain, delayed healing, and scarring.
For Dr. Chynn, this means performing an Advanced Surface Ablation, which is either a LASEK or epiLASEK. These are more advanced than PRK because they do not hurt, healing and recovery is quick, and there is no haze or scarring.
For example, Dr. Chynn performs over 1,000 LASEKs and epiLASEKs per year--he performed his last PRK in 1999.
Obviously, he moved away from PRK to LASIK, then to IntraLase, and now back to the safer LASEK and epiLASEK procedures.
View the following slide show to find out more, and call us with your questions--better yet, come in and meet with our MDs!
Acular soft contact lenses after refractive surgery. Post lasik hyperopia tre...
Brief talk on acular and soft contact lenses after refractive surgery. not mine but shared with me by a friend. thought it was informative
6 Month Results of Topography Guided Repair
This study evaluated the 6-month results of wavefront-guided custom ablation using the MEL80 CRS-Master II system in 48 eyes of 32 patients. The system uses topography and wavefront data to create an ideal postoperative corneal surface. Results found that the procedure was safe, with no eyes losing 2 lines of vision and 31% gaining 1 line. It was also effective, with 80% of eyes within ±1.00 D of the intended correction and improved uncorrected visual acuity. Higher order aberrations and spherical aberration were reduced post-operatively along with improved contrast sensitivity, especially in eyes that had below normal levels pre-operatively. The combined topography and wavefront approach helped regularize
Prospective Evaluation of Near and Intermediate Visual Outcomes with Monofoca...
This document presents the results of two studies - MAST 1 and MAST 2 - evaluating the nanoFLEX monofocal intraocular lens (IOL) implanted during cataract surgery. In MAST 1, the nanoFLEX IOL provided average distance-corrected near visual acuity of 20/50 and intermediate acuity of 20/24. MAST 2 found the nanoFLEX offered similar near vision to other monofocal IOLs but significantly better intermediate vision, demonstrating it can provide an effective alternative to multifocal or accommodating IOLs. The conclusion is that the nanoFLEX lens offers patients good near and excellent intermediate vision in a cost-effective monofocal IOL.
Evaluation of Visual Outcomes of Monovision Patients Bilaterally Implanted wi...
This study evaluated outcomes of 63 patients who underwent cataract surgery with implantation of a nanoFLEX monofocal intraocular lens (IOL) using a blended vision technique. Results showed excellent distance vision, good intermediate and near vision, high rates of spectacle independence, and high patient satisfaction. Near vision outcomes were comparable to multifocal IOLs but with reduced cost and risk. The nanoFLEX IOL and blended vision technique provide an effective option for presbyopia correction.
Subjective refraction
The document describes the procedures for performing subjective refraction to determine a patient's distance and near visual prescription. It involves first establishing the patient's best corrected and uncorrected visual acuity. The examiner then determines the patient's best vision sphere and estimates their astigmatism before refining the prescription with trial lenses to account for cylinder power and axis. Verification steps like binocular balance and range of clear vision are also mentioned. Near addition is calculated based on the patient's near point of focus and amplitude of accommodation. The document provides guidance on techniques, tools, and considerations for optimizing subjective refraction outcomes.
Subjective Refraction-1
This document provides instructions for performing subjective refraction using both distance and near vision tests. It discusses evaluating visual acuity with current prescriptions, estimating spherical and astigmatic errors, determining best sphere and refining the prescription. Tables are included showing relationships between visual acuity, refractive error and calculating residual sphere. Procedures for spherical correction using letter charts and duochrome tests are outlined. LogMAR and Snellen visual acuity charts are also described.
Anterior Segment Company Showcase - Encore Vision
Anterior Segment Company Showcase - Encore Vision at OIS@AAO 2016.
Presenter:
Bill Burns, President & CEO
Powered by:
Healthegy
For more ophthalmology innovation
Visit us at www.ois.net
Mr. Dan Gore presentation at the Mediphacos User Meeting 2013
This document summarizes a new clinical pathway for treating keratoconus that begins with inserting intracorneal ring segments (ICRS) for gross shape correction if best corrected distance visual acuity (CDVA) is less than 20/20 and coma is greater than 3μm. Next, collagen cross-linking (CXL) is performed for shape stabilization. Patients with good CDVA then undergo fine shape correction with photorefractive keratectomy (PRK) at least two years post-CXL, while those with poor CDVA receive a phakic intraocular lens for refractive correction. The document then evaluates outcomes for 17 keratoconus patients who underwent ICRS implantation using a femtosecond laser,
iMinds The Conference: Johan de Mey
Spectral imaging and iterative reconstruction techniques are redefining the rules of clinical CT. These new techniques allow for ultra-low dose CT scans at diagnostic quality with up to 95% dose reduction compared to standard CT. They also enable artifact reduction and improved tissue characterization. Spectral imaging using dual energy CT generates multiple datasets that can be used to create material-specific images like iodine and water images, improving detection and characterization of lesions. Iterative reconstruction further reduces image noise improving low dose imaging. Together these techniques are opening new dimensions in CT imaging capabilities.
IWO bijeenkomst - 18 november - Dr. H. Borghs
This document discusses potential pitfalls in bone densitometry and vertebral fracture assessment (VFA).
DXA is considered the gold standard for measuring bone mineral density but is subject to errors from changes in hardware/software, improper patient positioning, artifacts, and inconsistencies in analysis. Regular quality control and cross-calibration between devices is important. VFA performed on DXA scans can detect vertebral fractures but is limited for fractures above D7 and by obliquity of the lumbar spine. Both DXA and VFA require trained technicians to minimize errors and ensure accurate interpretation.
Panel of challenging cases
This document summarizes a panel discussion on challenging cases in corneal refractive surgery. The panel discusses various complex cases involving thin corneas, high corrections, posterior corneal elevation, corneal opacities and dystrophies. For these types of cases, the panel discusses techniques like topography-guided PRK combined with corneal collagen cross-linking and evaluating factors like patient age and corneal biomechanics when determining treatment options. The document also provides examples of case studies presented to the panel and the specific considerations and approaches recommended for each case.
apostila-refrativa-rio-ingles-final-pdf-revisado.pdf
Case Study on the Implant of Ferrara Ring for the treatment of Keratoconus. Jordana Sandes, Md, PhD. For the Course Refrativa RIO 2022
Similar to Dr Menard Nov 14 (13)
Current Trends in Refractive Surgery - Lecture given at Harvard by Emil Chynn...
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Dr Menard Nov 14
- 1. Case Studies Claude Ménard, MD David Edmison, MD John Cheung, MD Wednesday November 14, 2011
- 2. Case Studies When should we intervene? • Retx parameters • Monovision • Epithelial ingrowth • Cataracts, IOL PCO • Other Happy to see any patient.
- 3. Retx – Case Study 27 y.o. female: WGA SBK OU 2009. cc: can’t see clearly at night UCVA: 20/25+2, 20/20-2 Rx: -0.75 20/20 -0.50 20/20+2 Consider counseling and monitoring Rx. Risk vs benefit. 20/40 or +/- 1.00D
- 4. MV – Case Study 54 y.o. male: WGA SBK OU Oct 2011 -1.50 Mv OD cc: blurry at PC dist., great reading UCVA: 20/100-2, 20/20; near J1+ Rx: OD -2.25 20/20 OS -0.25+0.50x90 20/20 Should we retx OD for -1.50 or counsel and stay with current Rx status?
- 5. MV – Case Study 38 y.o. male: STD PRK OU 1996 cc: Blurry right eye UCVA: 20/40+1, 20/20-2 Rx: OD -1.50+0.50x175 20/20 OS PL+0.50x170 20/20 Consider retx OD for distance since he is happy to wear readers now at 53yo. Could do WGA SBK if reasonable pachymetry.
- 6. MV – Case Study 48 y.o. female: WGA PRK OU 2004 (Mv OD) cc: Blurry near vision UCVA: 20/20-1, 20/40 Rx: OD -0.50+0.50x90 20/20 OS +1.00+0.25x95 20/20 Consider retx OS for near since OD is good for Dv. Reversing original Mv. Could do WGA SBK if reasonable pachymetry.
- 7. Epi ingrowth – Case Study 27 y.o. female: WGA SBK OU 2011 cc: none UCVA: 20/20-1, 20/20 Rx: OD -0.25 20/20 OS Plano 20/20 Slit lamp exam reveals peripheral epithelial ingrowth. Do we try and remove ingrowth?
- 8. Cataract – Case Study 62 y.o. female: WGA SBK OU 2008 (Mv OD) cc: Decrease dist acuity OS. UCVA: 20/80, 20/50-1 Rx: OD -2.00+0.25x180 20/25-1 OS -1.25 20/30 1-2+ NS observed (OS>OD). Refer for cataract Sx.
- 9. IOL PCO – Case Study 53 y.o. male: CLE OU 2010 (Mv OS) cc: Decrease dist acuity OD. UCVA: 20/40, 20/200-1 Rx: OD -0.50 20/30-1 OS -2.75+0.50x90 20/25 1-2+ PCO observed (OD>OS). Refer for YAG Caps
- 10. Focus Eye Centre Thank you!