toric iols do we need them? frank goes [email protected] escrs 2011
TRANSCRIPT
TORIC IOL’S
OR FEMTOLASIK AS A REDO TOOL OR INCISION MODULATION TRY TO
AVOID THE NEED OR A COMBINED APPROACH OF
BOTH PRINCIPLES
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SURGERYIOL CHOICE
IOL POWER CALCULATION
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OUR EXPERIENCE
MOSTLY LASER CORRECTION VISUMAX FEMTOLASIK SINCE 2 YEARSBUT
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-12 SF -4.5 cyl. AXIS 135 OD-11 SF -3.5 cyl.axis 75 OS
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HOW TO APPROACH CASE I
ARTIFLEX TORIC
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OPHTEC ARTIFLEX TORIC ENCLAVATION NEEDLE AND SPATULA
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ANIMATIE
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VERY HAPPY PATIENT
UNCORRECTED OD O.9 20/22OS O.9 20/22
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CANDIDATE MULTIFOCAL IOL ????????
CASE II
OD SF+6 cyl -5.5 axis 85°0S SF +5.5 cyl -6 axis 95°
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TECNIS MF OO
HIGHLY MOTIVATED TO BECOME SPECTACLE FREE
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1.TEMPORAL INCISION PLACEMENT
2.SECOND INCISION OPPOSITE SIDE
3.LARGER INCISION4.FOLLOWED BY LASIK 00
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A VERY HAPPY PATIENT
SPECTACLE FREE FOR DISTANCE AND FOR NEAR
VERY BUSY BUSINESSMANON THE PLANE AT LEAST ONCE A
WEEK
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CASE III
OD +6 CYL -6 AXIS 115OS +6 CYL -6 AXIS 95ACRILISA TORIC OD 20.5 +5.5 DOS 20.5 +6.5 D
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CARL ZEISS AT LISA toric 909M
World first toric multifocal MICS IOL Flagship product for CZM
absolutely unique AT LISA toric 909M combines the excellent
optical performance of AT LISA and reliable
astigmatsim correction of AT TORBI™ 709M
in one iol Carl Zeiss calculates the power of AT LISA
toric 909M for optimal surgery outcome
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PREOP
PREOP POSTOP OD UCVA 0.2 0.6 BCVA 0.9/sf.+5 cyl -6 axis 115 0.9/ -0.5 cyl.-1 axis 120
OS UCVA 0.2 0.7 BCVA 0.8/sf+6 cyl.-6 axis 95 0.9/ -1 axis 65
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Wanted Improvement !!!!!! FEMTOLASIK OO
ENDPOINT UCVA
OD 1.0OS 1.0
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OUR EXPERIENCE FEMTOLASIK AS A TOUCH UP AFTER PREVIOUS REFRACT
IVE LENS SURGERY
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REASON FOR TOUCH UP WITH LASIK
Patient dissatisfactionDiscuss beforehand to pay or not to payWhen Improvement possibleExclude all other pathology
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PRE POST LASIK UCVA47 EYES
0
10
20
30
40
50
60
70
80
90
PRE
POST
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PRE POST LASIK BCVA47 EYES
8,1
8,2
8,3
8,4
8,5
8,6
8,7
PRE
POST
LOSS GAIN OF LINES OF BCVA
LOSS OF MORE THAN ONE LINE:not one eye
GAIN OF MORE THAN ONE LINE: 4 eyes
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INDICATION
Refractive outcome different from plano.Sf.Eq.Myopia in 60%Sf.Eq.hyperopia in 40%Astigmatism > 1 dptr. in 64% of the eyes
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When Astigmatism was present it was
Against the rule in 70%
With the rule in 30%
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TORIC IOL’S
No doubt for important astigmatism
Minor deviations sometimes better predictability with
Femtolasik
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Thanks for the Attention
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