Bioptic Surgery

Kangnam Eyence Eye Clinic Woon Bong Jwa

Biopitcs Phakic IOL + LASIK, LASEK - Zal

divar (1999) Excellent option for - >-19D SE - significant astigmatism More reliable refractive results Decrease the risk of halos

Management of Astigmatism during & after

ICL operation

Incisional Astigmatic Procedure

LASIK or LASEK

Toric ICL

Incisional Astigmatic Procedure

The change of incisional direction, size according to astigmatism during ICL op.

Relaxing Incision after ICL op.

CCI on the direction of WTR astigmatism by preop. MR, Topo.

Incisional size (by Astigmatism) – 3mm : < 1D

– 3.5mm : < 1.5D – 4mm : < 2D – 4.5mm : >2D

Incisional Astigmatic Procedure

2005. 1 ~ 2005. 2 ICL op. patients 50 eyes , female : male = 23 : 6 (p) Preop. SE : -10.69±3.37D (-4.5 ~ -20.38D) Preop. Astigmatism : -1.62 ±1.21D

(-0.5 ~ -6.25D)

Incisional Astigmatic Procedure

Topical anesthesia Superior CCI ( 3mm ~ 4.5mm) ICL insertion to A/C Rotation of ICL ICL haptic insertion Confirm of ICL centration Irrigation & wound adhesion

Incisional Astigmatic Procedure

Incisional Astigmatic Procedure

Results of Incisional Astigmatic Procedure during ICL operation

The changes of spherical equivalent after ICL operation

-10.69

-0.16 -0.21 -0.22

-12

-10

-8

-6

-4

-2

0

Pre ICL 2wks 1M 3M

T ime after ICL op.

Dio

pte

rs

1.62

0.52 0.41 0.45

0

0.4

0.8

1.2

1.6

2

2.4

2.8

Dio

pte

rs

Preop. 2wks 1M 3MT ime after incisional astigmatic procedure

The changes of astigmatism after incisional astigmatic procedure

0

0.2

0.4

0.6

0.8

1

1.2

1.4

Dio

pte

rs

Preop 2wks 1M 3M

T ime after incisional astigmatic procedure

NVA BCVA

The changes of vision after incisional astigmatic procedure

0

0.5

1

1.5

2

2.5

3

3.5

Dio

pte

rs

Pre ICL 2wks 1M 3M

T ime after incisional astigmatic procedure

3mm3.5mm4mm4.5mm

The changes of astigmatic amount after incisional astigmatic procedure

Complications during & after incisional astigmatic procedure

Scant iris hemorrhage

Corneal wound leak & dehiscence

Infection – no

Crystalline lens touch - no

Easy & safe procedure

Fast recovery of naked vision

Increased patient’s satisfaction

No intra & post op. complications

Stable refractive results

Effective to 2.0D below astigmatism

Conclusions of incisional astigmatic procedure during ICL operation

Bioptics by LASEK 2003. 10 ~ 2004. 11 Bioptics patients 43 eyes, female : male = 14 : 4 (p) Pre ICL SE : -9.49±2.12D (-5.25~-11.25) Pre ICL Astigmatism : -2.27±1.12D (-1.00~-4.00) Post ICL SE : +0.33±0.39D Post ICL Astigmatism : -2.36±0.71D Interval to LASEK after ICL operation : 4.65±2.63m

Horizontal axis marking

20% alcohol soaking : 15 sec. Excimer laser ablation (Visx star S4) Cold saline irrigation T-lens & 5% NaCl qid

LASEK procedure (Bioptics)

Results of LASEK after ICL operation

0

0.2

0.4

0.6

0.8

1

1.2

1.4

Dio

pte

rs

PreICL

PostICL

LASEK2wks

LASEK1M

LASEK3M

LASEK6M

T ime after Bioptics

NVABCVA

The changes of vision after LASEK operation (Bioptics)

2.27 2.36

0.730.55

0.38 0.27

0

0.5

1

1.5

2

2.5

Dio

pte

rs

PreICL

PostICL

LASEK2wks

LASEK1M

LASEK3M

LASEK6M

T ime after Bioptics

The changes of astigmatism after LASEK operation (Bioptics)

Striate keratopathy – next F/U day

Delayed wound healing - no

Corneal opacity - no

Steroid induced ocular HT - no

Complications of LASEK after ICL operation (Bioptics)

Conclusions of LASEK after ICL operation (Bioptics)

Accurate correction results

Increased patient’s satisfaction

No intra & post op. complications

Stable refractive results

Effective to all ranged astigmatism