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John Josephson MD, and Karanveer Saini
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Post-LASIK corneal ectasia can present significant challenges during cataract and refractive procedures. This patient, who had LASIK surgery 22 years ago, was diagnosed with moderate keratoconus and sought options for refractive correction, as their best-corrected visual acuity (BCVA) was limited to 20/100-1. Corneal tissue addition keratoplasty (CTAK) was recommended as a viable option, and the patient elected to proceed with the surgery.
The procedure began with channel creation using the Ziemer FemtoSecond Laser at a depth of 250 microns. However, during the channel creation, it became apparent that the depth was insufficient, as the LASIK flap lifted with ease. For the patient's safety, the procedure was immediately aborted. This issue was communicated to Peter Hersh, MD, who is the founder of CTAK and a leading expert in corneal surgery. Dr. Hersh contributed to the development of a revised surgical plan, which included increasing the channel depth to 400 microns, utilizing anterior segment OCT to better assess the corneal architecture. Two months later, the procedure was reattempted, this time with the LASIK flap remaining securely in position during the tissue insertion at 400 microns. The video below provides a detailed explanation of each step taken during the process and the rationale behind the adjustments made.
Posted: 1/02/2025
John Josephson MD, and Karanveer Saini
Post-LASIK corneal ectasia can present significant challenges during cataract and refractive procedures. This patient, who had LASIK surgery 22 years ago, was diagnosed with moderate keratoconus and sought options for refractive correction, as their best-corrected visual acuity (BCVA) was limited to 20/100-1. Corneal tissue addition keratoplasty (CTAK) was recommended as a viable option, and the patient elected to proceed with the surgery.
The procedure began with channel creation using the Ziemer FemtoSecond Laser at a depth of 250 microns. However, during the channel creation, it became apparent that the depth was insufficient, as the LASIK flap lifted with ease. For the patient's safety, the procedure was immediately aborted. This issue was communicated to Peter Hersh, MD, who is the founder of CTAK and a leading expert in corneal surgery. Dr. Hersh contributed to the development of a revised surgical plan, which included increasing the channel depth to 400 microns, utilizing anterior segment OCT to better assess the corneal architecture. Two months later, the procedure was reattempted, this time with the LASIK flap remaining securely in position during the tissue insertion at 400 microns. The video below provides a detailed explanation of each step taken during the process and the rationale behind the adjustments made.
Posted: 1/02/2025
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