Curbside Consultation in Refractive and Lens-Based Surgery 49 Clinical Questions

Dedication

Acknowledgments

About the Editors

Contributing Authors

Preface

Section I Preoperative Consultation

Question 1 My Patient Has a Systemic Disease. Should I Perform Refractive Surgery?

Yassine J. Daoud, MD and Walter J. Stark, MD

Question 2 Should I Perform Refractive Surgery in Patients With a History of Strabismus?

Gabriela L. Pagano, MD and Ofelia Brugnoli de Pagano, MD

Question 3 My Patient Is a 25-Year-Old Latent Hyperope. His Manifest Refraction Is +2.0 D, but After Cycloplegia It Is +4.0 D. Which Refraction Should I Treat?

Alain Saad, MD and Damien Gatinel, MD

Question 4 What Are the Corneal Pachymetry Thresholds for Performing LASIK, PRK, or No Laser Vision Correction at All?

J. Bradley Randleman, MD

Question 5 After Radial Keratotomy, Should I Perform PRK or LASIK Surgery?

Ramon Coral Ghanem, MD, PhD and Vinícius Coral Ghanem, MD, PhD

Question 6 Are There Special Considerations in the Evaluation and Treatment of Patients With High Astigmatism Seeking Laser Vision Correction?

Afshan Nanji, MD, MPH and Sonia H. Yoo, MD

Question 7 Should I Perform PRK in Patients With Forme Fruste Keratoconus?

Damien Gatinel, MD

Question 8 When Should I Perform Topography-Guided or Aberration-Guided Refractive Surgery?

A.J. Kanellopoulos, MD

Section II Surgical Procedure

Question 9 How Should I Center My Ablation in Patients With a Large Angle Kappa?

Samuel Arba Mosquera, PhD, MSc

Question 10 How Do I Manage Suction Loss During LASIK?

Pravin Krishna Vadavalli, MD and Vardhaman P. Kankariya, MD

Question 11 What Should I Do if My Patient Has a Decentered Flap?

George D. Kymionis, MD, PhD and George A. Kontadakis, MD, MSc

Question 12 How Do I Manage a Buttonhole or Free Cap During LASIK?

Lingmin He, MD, MS and Edward E. Manche, MD

Question 13 Should I Use Mitomycin C With All of My PRK Cases?

Vasilios F. Diakonis, MD, PhD and Vardhaman P. Kankariya, MD

Question 14 What Should I Do About a Large Epithelial Defect That Occurs During LASIK?

Vardhaman P. Kankariya, MD and Vasilios F. Diakonis, MD, PhD

Section III Postoperative Complications

Question 15 How Do I Manage Diffuse Lamellar Keratitis After LASIK? How Does This Differ From Pressure-Induced Interlamellar Stromal Keratitis?

Matthew J. Weiss, MD and Sonia H. Yoo, MD

Question 16 What Should I Do in Case of LASIK Flap Dislocation?

Majid Moshirfar, MD and Jason N. Edmonds, MD

Question 17 When Should I Perform a Second Procedure in Patients With Flap Striae?

Jordon G. Lubahn, MD and William W. Culbertson, MD

Question 18 How Do I Manage Patients With Dry Eyes After LASIK Surgery?

Eric D. Donnenfeld, MD and Matthew J. Schear, DO

Question 19 How Do I Manage Patients With Severe Glare Symptoms After LASIK?

Roberto Zaldivar, MD and Roger Zaldivar, MD

Question 20 How Do I Manage Epithelial Ingrowth After LASIK? What if It Recurs?

Jorge L. Alió, MD, PhD and Alessandro Abbouda, MD

Question 21 How Do I Manage Severe Haze After Photorefractive Keratectomy?

Florence Cabot, MD and Sonia H. Yoo, MD

Question 22 How Do I Detect and Manage Ectasia After LASIK?

Rosane de Oliveira Corrêa, MD; Renato Ambrósio Jr, MD, PhD; and William Trattler, MD

Question 23 After an Incomplete Flap and Aborted LASIK, How and When Do I Manage the Residual Refractive Error? PRK With or Without MMC, LASIK, or Contact Lens?

Michael C. Knorz, MD

Question 24 A Patient Had LASIK 10 Years Ago and Wants Retreatment for Residual Refractive Error. How Should I Proceed?

Sumitra S. Khandelwal, MD and Elizabeth A. Davis, MD, FACS

Section IV Refractive Cataract Surgery

Question 25 If a Patient Has Had Previous Corneal Refractive Surgery, What Type of IOL Would You Choose? Does It Matter if It Was Myopic or Hyperopic Corneal Refractive Surgery?

Edward C. Lai, MD and Jessica B. Ciralsky, MD

Question 26 What Is Your Routine Testing for Patients Who Are Receiving a Refractive IOL?

Preeya K. Gupta, MD and Jay J. Meyer, MD, MPH

Section V Astigmatism Correction

Question 27 What Is Your Algorithm for Choosing When to Perform a Corneal Incisional Astigmatic Correction vs Toric IOL vs Laser Refractive Surgery?

Francesco Carones, MD

Chapter 28 Can I Use a Toric IOL in a Patient With Keratoconus? How About in a Patient With EBMD, Fuchs', or Other Corneal Dystrophies?

Mahshad Darvish-Zargar, MD CM, MBA, FRCSC and Edward J. Holland, MD

Chapter 29 If the K Measurements Differ Between Different Methods, Which One Should I Use?

Nienke Visser, MD and Rudy M.M.A. Nuijts, MD, PhD

Chapter 30 Is Posterior Corneal Astigmatism Important When Planning Cataract Surgery?

Zaina Al-Mohtaseb, MD; Bruna V. Ventura, MD, MS; Li Wang, MD, PhD; and Douglas D. Koch, MD

Chapter 31 How Do I Determine My Surgically Induced Astigmatism?

Alex Mammen, MD and Deepinder K. Dhaliwal, MD, LAc

Chapter 32 What Is the Best Way to Mark the Eye for a Toric IOL?

Kevin M. Miller, MD

Chapter 33 If a Patient Has Residual Astigmatism After I Implant a Toric IOL on Postoperative Day 1, What Should I Do?

John P. Berdahl, MD

Chapter 34 My Astigmatic Keratotomy Results Are Unpredictable. How Can I Improve Them?

R. Bruce Wallace III, MD, FACS

Section VI Presbyopia Correction

Chapter 35 Do You Implant Multifocal IOLs in a Patient With Mild Macular Disease Such as Mild Non-Proliferative Diabetic Retinopathy or a Few Drusen?

Uday Devgan, MD, FACS, FRCS(Glasg)

Chapter 36 Do You Implant a Multifocal IOL in Patients With PXF or Other Zonular Abnormalities?

Kim-Binh Mai, MD and Bonnie An Henderson, MD

Chapter 37 Describe Your Approach in Counseling a Patient Regarding the Premium IOL Choices. Do You Delegate the Responsibility?

Richard L. Lindstrom, MD; Sumitra S. Khandelwal, MD; David R. Hardten, MD; and Sherman Reeves, MD

Chapter 38 What Are the Indications for Monovision vs Other Presbyopia-Correcting IOL Options? How Much Anisometropia Is Advisable With Monovision With Monofocal IOLs?

Wei Boon Khor, MBBS, FRCSEd and Natalie Afshari, MD, FACS

Chapter 39 How Do You Choose Between a Multifocal and an Accommodating IOL?

Jay S. Pepose, MD, PhD

Chapter 40 Is a Monocular Implantation of a Multifocal IOL Tolerated?

Kimiya Shimizu, MD, PhD and Yoshihiko Iida, MD, PhD

Chapter 41 Is Checking for Eye Dominance Important? If so, Why, and What Is Your Method?

Jae Yong Kim, MD, PhD

Chapter 42 Do You Consider Pupil Size When Choosing a Presbyopia-Correcting IOL? Why or Why Not?

Roger F. Steinert, MD

Chapter 43 How Do You Center a Multifocal IOL, and Is It Important?

Richard Tipperman, MD

Chapter 44 How Do You Manage an Unhappy Multifocal Patient Who Is Experiencing Halos and Glare?

Laura Vickers, MD and Terry Kim, MD

Chapter 45 When Should the Posterior Capsule Be Opened With a YAG? Do You Do It Sooner Rather Than Later, or Wait Until the Last Moment?

Mark Packer, MD, FACS, CPI

Chapter 46 How Would You Treat a +1.50 D Residual Refractive Error in a Patient With a Multifocal IOL? How About ?1.00 D? How About +1.25 D Astigmatism?

Hiroko Bissen-Miyajima, MD, PhD

Chapter 47 After Implantation of an Accommodating IOL, How Would You Treat ?1.5-D Residual Refractive Error, 1.5-D With-the-Rule Astigmatic Error, and 1.5-D Against-the-Rule Astigmatic Error?

Parag Parekh, MD, MPA and Louis D. Skip Nichamin, MD

Chapter 48 What Causes a Z-Syndrome? How Do You Diagnose and Manage It?

Peter A. Rapoza, MD, FACS

Chapter 49 If the Implantation of an Accommodating IOL in the First Eye Did Not Yield Sufficient Uncorrected Near Vision, What Do You Recommend for the Second Eye?

Richard S. Hoffman, MD

Financial Disclosures

Index

Biography

Bonnie An Henderson, MD is a partner at Ophthalmic Consultants of Boston and a Clinical Professor at Tufts University School of Medicine. Dr. Henderson completed her ophthalmology residency at Harvard Medical School, Massachusetts Eye and Ear Infirmary. She graduated from Dartmouth College and from Dartmouth Medical School with high honors. Dr. Henderson specializes in refractive cataract surgery and complex anterior segment surgery. She has authored over 100 articles, papers, book chapters, and abstracts, written/edited 4 textbooks, and has delivered over 250 invited lectures worldwide. Dr. Henderson is the Associate Editor for the Journal of Refractive Surgery and Associate Editor for Eyeworld for the American Society of Cataract and Refractive Surgery. She serves on the editorial advisory board of Eyenet Magazine of the American Academy of Ophthalmology, and serves on the editorial boards of 3 other journals. She serves on a number of committees for the American Academy of Ophthalmology and the American Society of Cataract and Refractive Society. She is a reviewer for eight ophthalmic journals.
Dr. Henderson has been awarded an Achievement Award and Secretariat Award by the American Academy of Ophthalmology, and “Best of” awards from the American Society of Cataract and Refractive Surgery for her research and films. She serves on the Executive Committee and is the President-Elect of the American Society of Cataract and Refractive Surgery for 2017. She serves on the Executive Board of the Massachusetts Society of Eye Physicians and Surgeons, the Executive Board of Women In Ophthalmology, and has served on the Physician Board of Directors at the Massachusetts Eye and Ear Infirmary. She also serves on the Board of Overseers at the Geisel School of Medicine at Dartmouth.
 
Sonia H. Yoo, MD is a Professor of Ophthalmology with a joint appointment in Biomedical Engineering and Associate Medical Director at Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine. Dr. Yoo received her BA at Stanford University and MD at Case Western Reserve University. She completed residency and fellowship at Massachusetts Eye and Ear Infirmary, Harvard Medical School in 1998.
Her areas of clinical practice are cornea, cataract, and refractive surgery. Her areas of research interest are in laser applications in cornea, cataract, and refractive surgery and restoring accommodation. She has authored over 100 book chapters and peer-reviewed journal articles and has been the principle investigator in numerous drug and device trials. Dr. Yoo served as the cornea fellowship director at Bascom Palmer Eye Institute from 2000-2013.
Dr. Yoo is the 2014 program chair of the Refractive Surgery subspecialty day program of the American Academy of Ophthalmology and serves on the Academy’s Practicing Ophthalmologists Curriculum Refractive Management/Intervention Panel for refractive surgery. She is a board member of the American Society of Cataract and Refractive Surgery and is on the board of directors for the Cornea Society. She is a reviewer for numerous peer-reviewed journals. Additionally, she serves on the editorial board of the Cornea Society, the Journal of Refractive Surgery, the Journal of Cataract and Refractive Surgery, and Ophthalmic Surgery, Lasers and Imaging.