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ASA v PRK protocols

Q:

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.
Chilled BSS.
Lifted intact epithelial flap with spatula leaving a perfectly smooth stromal bed with perfect circular epithelial edge for 360 degrees.

Thank you,
C. H.

A:

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

– See more at: http://parkavenuelasek.com/asa-v-prk-protocols/#sthash.HwuzS4xk.dpuf

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