Maximizing Outcomes with LRIs
Eric Donnenfeld, MD, employs the DONO nomogram and places a modified Dell marker (Donnenfeld marker, Accutome, Malvern, PA) to the cornea and marks the axis and length of the incision. A drop of blink Tears (AMO, Santa Ana, CA) has a viscoelastic effect which significantly reduces the risk of an abrasion. Next, he grasps the episclera at the limbus with a 0.12-caliber forceps approximately 180 degrees away from the intended site of the incision. He applies a diamond blade—usually preset to 0.6 mm—to the cornea and holds it in place for a second to ensure that it has achieved the desired depth. The incision is then extended towards the caliber to the required length to correct the targeted amount of cylinder.
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