ASA v PRK protocols
Inspired by Emil, I made epithelial flaps for two patient on my last LVC day. One patient 20/20- POD#1 the other 20/30 POD#1 and 20/20 OD and 20/25 OS POW#1 (-3.50 preop MRx). Second patient had discomfort on POD#4; I think it likely was from a very tight CTL fit and not the technique.
Here’s what I did. Thank you for sharing your thoughts and feedback with me.
Gentle superficial trephination with 8.75 mm trephine.
33% etoh for 5 seconds in 9.00 mm well incorporating trephine edges for 360 degrees.
Lifted intact epithelial flap with spatula leaving a perfectly smooth stromal bed with perfect circular epithelial edge for 360 degrees.
I’d concur that it’s important not to panic if you get an IOP spike post ASA and to not then cut the steroid. Had a couple of cases where a Fellow d/c’d the steroid prematurely and then haze started even months postop on higher Rxs
Just add some glaucoma drop and stay the course. Usually I add Alphagan as that helps with night glare too
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