EyeWorld Asia-Pacific September 2019 Issue

7KH )HPWRVHFRQG /DVHU )ODS 0DQDJLQJ FRPSOLFDWLRQV Dr. Alnette Lee Tan 7DEOH 7HFKQLTXHV WR PDQDJH ΖQFRPSOHWH )6 )ODS 5HFXW ZLWK WKH VDPH SDUDPHWHUV HQVXULQJ the suction ring is at the exact position of WKH SUHYLRXV SDVV 5HFXW ULJKW DIWHU ZLWK D ELJJHU ȵDS VL]H DQG a deeper level, ensuring not to cut through WKH LQFRPSOHWH LQWHUIDFH 7KH FDQDO VKRXOG EH SXW DW D GL΍HUHQW DQJOH WR SUHYHQW RYHUODS ZLWK WKH SUHYLRXV FDQDO )ROORZLQJ WKH GLVVHFWLRQ of the interface, the circumference of the ȵDS VKRXOG EH VFRXUHG ZLWK D ZLGHU GLDPHWHU to make sure that the second interface is FRPSOHWHG Patient selection is the key aspect of IHPWRVHFRQG ODVHU (\HEDOO PRYHPHQW ORVV RI VXFWLRQ LQFRPSOHWH ȵDSV WHDU\ eye and accidental service setting on laser DUH FRPPRQO\ HQFRXQWHUHG LVVXHV GXULQJ IHPWRVHFRQG ODVHU 7DEOH &OLQLFDO SHDUOV RI IHPWRVHFRQG ODVHU • $OORZV FXVWRPL]DWLRQ RI ȵDS WKLFNQHVV • 3URYLGHV VWURQJ ȵDS KHDOLQJ DQG LV OHVV SURQH WR displacement • Allows customization of position of hinging • (QDEOHV SUHGLFWLRQ RI ȵDS WKLFNQHVV LV SRVVLEOH • $OORZV LQGLYLGXDOL]HG ȵDS FHQWUDWLRQ • 8VHIXO LQ GL΍HUHQW W\SHV RI NHUDWRSODVW\ • Easily cuts through dense corneal scars PLFURELDO NHUDWLWLV %XFNOHU G\VWURSK\ • Minimizes potential intraoperative complications • Provides faster visual and refractive recovery )HPWRVHFRQG ODVHU LV NQRZQ IRU LWV precision, safety, versatility and patient FRPIRUW :LGH DGMXVWPHQW UDQJH RI JHRPHWULHV DQG SDUDPHWHUV DELOLW\ WR FUHDWH WKLQQHU DQG FXVWRP ȵDSV DQG faster visual and refractive recovery are VRPH WKH PRVW LPSRUWDQW DGYDQWDJHV RI IHPWRVHFRQG ODVHU 'XH WR LWV DELOLW\ WR FUHDWH WKLQQHU ȵDSV ELRPHFKDQLFDO LQVXOW IROORZLQJ IHPWRVHFRQG ODVHU LV EHOLHYHG WR EH PLQLPDO 7KH UROH RI FRUQHDO HSLWKHOLXP LQ VXUIDFH DEDODWLRQ Prof Zhai Changbin 9 :KLOH )6 ODVHU KDV SURYLGHG VLJQLȴFDQW LPSURYHPHQW toophthalmic refractive surgery, complications such as patient’s eyeball movement, loss of suction, LQFRPSOHWH ȵDSV WHDU\ H\H DQG DFFLGHQWDO VHUYLFH settings on the machine can be encountered in routine clinical practice. “Patient selection is the key aspect of FS laser” said Dr. Alnette Tan. In order to achieve suction and secure the applanation cone successfully, the patients need to be able to refrain from moving, jerking, or trying to squeeze eyes shut. “Eyeball movement, especially during the last second of side cut can result in an inadequate inferior side cut,” explained Dr. Tan. Loss of suction midway is another issue. Loss of suction can occur due to loose conjunctiva or due to patient movement during the procedure. It can be avoided by using caution while applying the interface and counseling the patient to stay still and avoid jerky movements. The next common complication during FS surgery LV LQFRPSOHWH )6 ȵDSV 'U 7DQ VXJJHVWV WKDW WKHUH DUH ZD\V RI GHDOLQJ ZLWK WKLV FRPSOLFDWLRQ 7DEOH 5). Dr. Tan explained that FS200 has a unique way of managing opaque bubble layer (OBL). By FUHDWLQJ D WXQQHO WR YHQW JDV FUHDWHG GXULQJ ȵDS creation, the Wavelength ® FS200 femtosecond laser minimizes OBL issues, the excimer laser WUHDWPHQW FDQ EH SHUIRUPHG ULJKW DIWHU WKH ȵDS is cut resulting in fast total refractive procedures. ([DPLQDWLRQ RI WKH ȴHOG DQG GU\LQJ WKH DUHDV RI teary eye before applying the suction ring is an important step while performing FS laser. Ȋ'U\LQJ WKHȵXLGDQG UH GRFNLQJ DQG VZHHSLQJ DZD\ any loose or redundant conjunctiva.” added Dr. Tan as an important step to avoid complications. “Corneal wound healing reaction is one of the main determinants of surgical effectiveness and safety. The integrity of the corneal epithelium is necessary to maintain the balance between the epithelium and the stroma. In refractive surgery the integrity and vitality of corneal epithelium is important for the good healing of corneal wounds, avoiding complications and obtaining the best postoperative vision.” - Prof. Zhai Changbin