The LASIK industry & the FDA have conspired since LASIK's inception to purposely withhold information vital to the public in making a truly informed LASIK decision. With Lasikdecision.com, The hope is to show you what the industry and FDA would not and did not even think of doing until LASIK casualties started speaking out, and yet, they still did NOTHING.
IOL/IOP Related Studies & Articles PDF Print E-mail
A Correction Formula for the Real Intraocular Pressure After LASIK for the Correction of Myopic Astigmatism - To create a correction formula to determine the real intraocular pressure (IOP) after LASIK considering the altered corneal thickness, corneal curvature, and corneal stability.

Measurement of intraocular pressure after LASIK by dynamic contour tonometry - Changes of corneal properties induced by laser in situ keratomileusis (LASIK) results in low inaccurate intraocular pressure (IOP) readings by Goldmann applanation tonometry (GAT).

Early Transient Visual Acuity Loss After LASIK Due to Steroid-induced Elevation of Intraocular Pressure - To report the clinical course of early transient reduction of uncorrected visual acuity (UCVA) after LASIK surgery resulting from steroid-induced elevation of intraocular pressure (IOP).

Change in IOP measurements after LASIK the effect of the refractive correction and the lamellar flap - To study the relationship between intraocular pressure (IOP) readings after LASIK and the amount of refractive correction.

The AS biometry technique-A novel technique to aid accurate intraocular lens power calculation after corneal laser refractive surgery - IOL calculation for cataract surgery has been shown to be inaccurate after PRK, LASEK, and LASIK. This technique is to determine difference to clinical history method (CHM).

Effect of microkeratome suction during LASIK on ocular structures - To study the effect of microkeratome suction on ocular structures during LASIK.

A predictive model for postoperative intraocular pressure among patients undergoing LASIK - To develop a predictive model based on preoperative variables for estimating postoperative intraocular pressure (IOP) of those eyes undergoing LASIK surgery, to predict the amount of underestimated IOP after LASIK for myopia and myopic astigmatism.

Preventing IOP increase after phacoemulsification and the role of perioperative apraclonidine - To evaluate the effectiveness of prophylactic topical apraclonidine 1% in preventing an intraocular pressure (IOP) rise in the early period after uneventful phacoemulsification with intraocular lens (IOL) implantation.

Accurate intraocular lens power calculation after myopic LASIK, bypassing corneal power - To describe a novel method for calculating intraocular lens (IOL) power after myopic laser in situ keratomileusis (LASIK) without using the inaccuracies of the post-LASIK corneal power.

Angle-supported phakic IOLs withdrawn from the French market  - Angle-supported phakic IOLs will no longer be sold and implanted in France due to an alarming amount of endothelial cell loss found in a significant number of patients 2 to 3 years after implantation.

Ocular Structure Changes During Vacuum by the Hansatome Microkeratome Suction Ring - To evaluate whether the vacuum of a microkeratome suction ring induces ocular structure changes. 

Patients are not informed that IOP measurements after LASIK are not accurate. This can have serious implications for patients. High IOP must be treated in order to avoid permanent vision loss.

"Another concern is that IOL power calculation in eyes with previous refractive surgery is notoriously inaccurate"

SOURCE

Cataract & Refractive Surgery Today

April 2006

Cataract Surgery in Postrefractive Surgery Patients

By Eric D. Donnenfeld, MD

Quote: The potential intraocular side effects of ocular steroids are well known and include a rise in IOP and the formation of cataracts.

SOURCE

EyeWorld February 2006

PredForte

 

Is your intraocular pressure being monitored on the Pred Forte? Patients who are on this drug for more than 10 days require ongoing IOP monitoring because of the very real risk of inducing glaucoma. Tonometry is known to give falsely low IOP readings after LASIK, so other measures to assess glaucoma (like GDx optic nerve fiber analysis) appear indicated. Have you noticed any visual field losses?. Are your visual fields even being assesed?

Check out this info on ophthalmic PredForte:

http://www.drugs.com/PDR/Pred_Forte_Ophthalmic_Suspension.html

Warnings: Prolonged use of corticosteroids may result in glaucoma with damage to the optic nerve, defects in visual acuity and fields of vision, and in posterior subcapsular cataract formation. Prolonged use may also suppress the host immune response and thus increase the hazard of secondary ocular infections.

Various ocular diseases and long-term use of topical corticosteroids have been known to cause corneal and scleral thinning. Use of topical corticosteroids in the presence of thin corneal or scleral tissue may lead to perforation.


Acute purulent infections of the eye may be masked or activity enhanced by the presence of corticosteroid medication.

If this product is used for 10 days or longer, intraocular pressure should be routinely monitored.

By taking this medicine for 6.5 months you are putting yourself at an increased risk for irreversible blindness due to glaucoma. Has your doctor told you this? You need to pin your doctor down regarding what he/she is treating. If not DLK, then what non infectious situation does he/she think he/she is treating. Treating an infectious keratitis with steroids will only worsen the condition.

Also long term topical opthalmic steroids are known to thin the cornea and can lead to corneal perforation.

The AS biometry technique-A novel technique to aid accurate intraocular lens power calculation after corneal laser refractive surgery

Cont Lens Anterior Eye. 2006 Apr 4;

Sambare C, Naroo S, Shah S, Sharma A.

The Ophthalmic Department, Kempston Road, Bedford Hospital, Bedford MK42 9DJ, UK.

Intraocular lens power (IOL) calculation for cataract surgery has been shown to be inaccurate after photorefractive keratectomy (PRK), laser-assisted subepithelial keratectomy (LASEK) and laser in situ keratomileusis (LASIK).

Many techniques exist to calculate corneal power with varying results and require the clinician to be aware of the pitfalls of IOL power calculation in post-refractive eyes. The AS biometry method proposed here is a simple method which does not rely on the calculation of corneal power. This new method is compared to the current gold standard the clinical history method (CHM). Twenty-nine eyes of 15 patients had routine biometry prior to LASIK, LASEK or PRK. The range of pre-operative spherical equivalent refractive error was -5.37 to +4.00diopters. The post-operative refraction was measured at 3-6 months. The IOL power calculation was calculated using the AS biometry method and the CHM. The two methods were compared using the Student's paired t-test and the Bland Altman technique. There was no statistical difference between the AS biometry method and the CHM. The paired Student's t-test comparing the AS biometry method and the CHM showed no statistical difference, t=0.33 with a p-value of 0.75, at a 95% confidence interval. The authors conclude that the AS biometry technique is as accurate as the CHM. The former is a simpler method which avoids many of the pitfalls and confounding factors involved in IOL power calculation following corneal excimer laser surgery. However, like the CHM it requires measurements prior to laser surgery.

IOL power calculation after LASIK is inaccurate

SOURCE

Excerpt:

The topic of IOL implantation after refractive surgery and power calculations arose a few years ago. However, Dr. O'Brien noted that now this situation is arising on a daily basis in practices as the number of refractive procedures increases each year and as the population ages.

"There has been a question of whether laser refractive surgery is accelerating the development of cataract. This is controversial, but I see it more and more often in my practice," he said. Dr. O'Brien is professor of ophthalmology and director of the Refractive Surgery Service, Bascom Palmer Eye Institute, Miami.

The problem, he pointed out, is that the patients who have undergone refractive surgery and then develop cataract are different in mindset from the traditional patient with cataract in that they have extraordinarily high expectations; they want immediate results; and they want no surgical discomfort, sutures, or downtime after the procedure.

"These patients who develop cataract after refractive surgery want a perfect outcome. They are potentially frustrated and angry because their quality of vision has suffered as the result of the refractive surgery, and the results may be unpredictable. Interestingly, incorrect power is the most common reason for IOL explantation. This is the result of our not being able to determine the power as accurately as we would like," he stated and advised exercising extra care with these patients.

"However, as more individuals have refractive surgery, the number of cataract patients with this in their history continues to increase, and calculating IOL power in these eyes can be quite problematic."

SOURCE

Excerpts:

"However, as more individuals have refractive surgery, the number of cataract patients with this in their history continues to increase, and calculating IOL power in these eyes can be quite problematic."

“The problem is that we can’t do nearly as well with people who have had LASIK, which alters the refractive index of the cornea,” he continues. “We’re getting an increasing number of post-LASIK patients, and I consider that I’ve done well if I get within a diopter of the intended outcome.”

"Most of the surgeons we spoke to agree that the uncertain outcomes that still occur with post-refractive surgery patients necessitate warning these patients in advance. “Despite our good outcomes to date, refractive surprises may still occur,” says Dr. Wang. “It’s important to advise patients of the risk of unacceptably high postoperative myopia or hyperopia, and the possible need for glasses, contact lenses, or additional surgery. Additional surgery could mean corneal refractive surgical enhancement, IOL exchange, or a piggyback IOL.”

“Right now our methods are not accurate enough,” agrees Dr. Packer, “especially since these patients have already paid a lot of money to have refractive surgery. Now they have a cataract and they expect a good refractive result. With current outcomes, 40 to 50 percent of these patients could need a piggyback lens to correct residual refractive error so they can be emmetropic. So, we warn all of them that it’s likely that they’ll need a piggyback implant.”