Keratorefractive Excimer Procedures

By George Waring IV, MD
Senior Editor, Refractive Surgery

The number of keratorefractive surgical options continues to grow with advances in research and technology. The myriad of keratorefractive eponyms can make differentiating the different procedures challenging.

When considering corneal excimer refractive surgery, the primary decision is whether a patient is a candidate, and the most common contraindication is the presence of risk factors for development or exacerbation of ectasia. If a patient is considered a non-candidate for a flap based procedure, however is still a candidate for a surface ablation, the choice of surface ablation procedure is often predicated upon surgeon’s preference.

Over the last few years, we have learned more about corneal biomechanics and LASIK flap optimization with femtosecond technology. Thin flap LASIK, also known as Sub-Bowman’s Keratomileusis, combines the quick recovery of a flap based procedure with increased safety.1 Patients who were once considered borderline candidates for a traditional thick flap based procedure may indeed now be candidates for a thin-flap LASIK.2

In this edition in the Refractive Surgery section of Pearls in Ophthalmology, Renato Ambrosio Jr., MD provides a clear review and summary of the different keratorefractive excimer procedures available today.


References

1. Durrie DS, Slade SG, Marshall J. Wavefront-guided Excimer Laser Ablation Using Photorefractive Keratectomy and Sub-Bowman’s Keratomileusis: A Contralateral Eye Study. J Refract Surg. 2008;24:S77-84.
   
2. Waring IV GO, Durrie DS. Emerging trends for procedure selection in contemporary refractive surgery: consecutive review of 200 cases from a single center. J Refract Surg. 2008 Apr;24(4):S419-23.