Our retrospective analysis involved a large cohort of previous LASIK cases. Presented at the SMILE user group meeting held by Carl Zeiss Meditec in New Orleans in November 2017, our findings suggest that SMILE should be applicable to a higher percentage of laser vision correction candidates than originally thought. My fellow researchers and I conducted a straightforward analysis of the preoperative sphere and cylinder in patients who underwent LASIK and met the aforementioned criteria for SMILE. In the United States, small-incision lenticule extraction (SMILE) is approved for the treatment of patients with -1.00 to -8.00 D of myopia, -0.50 D or less of cylinder, and a manifest refraction spherical equivalent of -8.25 D. It is important to speak to the patient calmly during energy delivery, to remind him or her repeatedly not to talk or move, and to provide assurances that everything is going great.
Remove qbserve from dock full#
When you have full applanation, remind the patient not to worry about the pressure, and instruct him or her to avoid talking. If full applanation does not happen immediately, quickly turn off suction, move the focusing lens down a bit farther for more applanation, and then press suction again. Then, press the suction button located on the top of the joystick, at which point 100% applanation should occur. When you are happy with the centration, bring the focusing lens down so that 80% to 90% of the applanation is occurring. If it is, tilt the patient’s head away from the focusing lens a bit more so that his or her nose does not hit the cone. If the readjustments are not getting you closer to the center of the pupil, check to see if the cone is touching the patient’s nose. If he or she is still looking at it but the focusing lens is not centered, readjust it with the joystick while reminding the patient not to look away from the focusing light. If the focusing lens is not on the center of the pupil, double-check that the patient is looking at the fixation light. The goal is for the center of the pupil to be the first place the focusing lens touches the cornea. While the patient fixates on the light, I watch the pupil as I use the joystick to lower the focusing lens onto the cornea. As the focusing lens comes into contact with the cornea, the patient is reminded to look at the blinking Otherwise, the patient’s nose may block the laser-focusing lens from fully applanating the cornea.įigure 3. This positioning will prevent the focusing lens from hitting the patient’s nose when you bring down the lens to contact the cornea. Ideally, the nose will be at the 11-o’clock position, head tilted slightly to the left for the right eye or slightly to the right for the left eye. Adjust the patient’s head so that his or her nose tilts away from the focusing lens (Figure 1).
This positioning provides full exposure and ensures that the upper eyelid does not block the laser focusing lens from centering on the cornea. His or her face is parallel to the floor, or his or her chin is slightly elevated from that position. This should be done in conjunction with step No. 1: Place the lid speculum in the eye to be treated. It is important to speak calmly to the patient during fixation and energy delivery.Although small-incision lenticule extraction is performed in just one step, achieving excellent refractive results requires a thoughtful preoperative protocol for docking the femtosecond laser.MIGS: Restoration of Normal Outflow Aqueous Pathways with ABiC Understanding Technology Advances in Refractive Femtosecond Laser Platforms I’m Just a Great AdapterĮmerging Techniques Meet Continuity of CareĮnsuring Ocular Surface Health Before Laser Vision Correction Newly Approved Glaucoma Therapy Increases Options for Patients and Providersĭisabled, Handicapped? Not Me. Improving Vision and Lives With Cataract SurgeryĬataract Surgery After LASIK Corneal Flap Removal
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