Safety of Flap Lift Enhancements after IntraLase Lasik

1
Safety of Flap Lift Enhancements after IntraLase
Lasik

• Lewis R Groden, MD (1,2)
• Sunir Joshi, MD (1)
• 1 Department of Ophthalmology, University of
  South Florida, Tampa FL
• 2 LasikPlus Vision Center Tampa, FL
• The authors have no financial interests in this
  presentation

2
Financial Disclosure

• LRG speaker list Allergan
  JohnsonJohnson/Vistakon
• shareholder LCAV (LasikPlus)
• SJ none
• The authors have no financial interests in any of
  the material discussed in this presentation.

3
Purpose

• To determine the safety of performing
  enhancements via flap lift after thin flap
  IntraLase lasik

4
Methods

• Retrospective chart review
• 57 consecutive eyes of 44 IntraLase lasik
  patients who had undergone flap lift enhancements
• Enhancements performed 4 - 13 months post lasik,
  mean 8 months
• Follow-up post enhancement 3 8 months

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Primary IntraLase settings

• Flap depth 100 microns (range 90-120)
• Flap diameter 8.5 mm (myopes)
• 9.0 mm (hyperopes)
• Side cut angle 90 degrees
• Side cut energy 1.00
• Bed energy 0.90
• Spot sep 9
• Line sep 9

6
Flap lift technique

• At slit lamp, Sinskey hook to crack wound
• Under laser microscope, Sinskey hook to unzip the
  wound up to hinge (1200)
• Slade cannula to gently sweep open the flap from
  hinge to 600
• - gentle but firm downward pressure, do not
  pull upward on flap

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Technique Precautions

• Do not enter the pocket while unzipping the
  wound, may get a free cap.
• Do not tug on flap, may get flap buttonhole/tear.
  Gently break adhesions with firm downward
  sweeping motions.

8
Results

• No intra-operative complications
• No peri-operative complications
• No post-operative complications

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Conclusions

• Thin IntraLase flaps can be safely lifted in
  order to perform enhancement procedures