The recent updates about corneal collagen crosslinkingAmr Mounir
油
This concentrated presentation describes the recent advances in the topic of corneal collagen cross linking with interaction with the most recent publications about this topic.
Higher fluence, irradiation profiles, epi on slideshareMichael Mrochen
油
cornea, cross linking, trans epithelium, riboflavin, high intensity, short treatment time, clinical results, Theo Seiler, Eberhard Spoerl, Arthur Cummings, Michael Mrochen
Trans epithelial versus epithelium-off corneal cross-linking for the treatmentAbada Fida
油
Trans-epithelial versus epithelium-off corneal cross-linking for progressive keratoconus: A randomized controlled trial compares the two procedures. The study found that transepithelial CXL was less effective at halting keratoconus progression after 1 year compared to epithelium-off CXL. While transepithelial CXL was safe with no complications, 23% of cases showed continued progression after 1 year versus stabilization in the epithelium-off group accompanied by a 1.5 diopter flattening of the cornea on average. The epithelium-off procedure resulted in a demarcation line and changes to the cornea indicative of a cross-linking effect that were not present with the transep
This document discusses various techniques for corneal collagen crosslinking (CXL), a procedure to strengthen the cornea using riboflavin and UV light. It describes the pathogenesis of keratoconus and history of CXL. The standard Dresden protocol involves epithelial removal followed by riboflavin drops and 30 minutes of UV light exposure. Variations discussed include accelerated CXL, hypo-osmolar CXL for thin corneas, transepithelial CXL, and contact lens-assisted CXL. The document provides details on riboflavin solutions, irradiation parameters, and indications and contraindications for CXL.
This document discusses corneal crosslinking, a procedure proposed in 2000 by Dr. Theo Seiler to strengthen the cornea. It involves applying riboflavin drops to the cornea, then exposing it to UVA light, which causes photopolymerization of corneal fibers. This increases the rigidity of collagen and resistance to deformation by creating new covalent bonds between collagen fibers. The procedure is used to treat keratoconus and keratectasia following LASIK to stabilize the cornea. It may also help treat resistant bacterial ulcers and reduce edema and hyperopia. Potential disadvantages include lack of long-term data and minimal improvement in vision, with risks of infiltrates, scarring and endothelial damage in rare cases
Collagen cross linking (CXL) aims to strengthen the cornea through the formation of covalent bonds between collagen fibers. The standard Dresden protocol uses riboflavin and UV light over 30 minutes. Newer accelerated protocols reduce treatment time but increase UV intensity. Trans-epithelial CXL leaves the epithelium intact but appears less effective. Combining CXL with refractive treatments like PRK can improve outcomes for keratoconus. Future areas of research include techniques to speed up CXL like flashlinking and methods to enhance riboflavin penetration such as iontophoresis.
One way to optimize Corneal Cross linking (CXL) !! DiyarAlzubaidy
油
Ophthalmology Lectures: Corneal crosslinking is the only way approved to stop progression of Keratoconus,,let's review the old & new methods of crosslinking
This document discusses corneal collagen cross linking (C3R), a treatment for keratoconus. It begins by describing keratoconus and its symptoms. It then discusses the original C3R protocol developed by Seiler and Spoerl, which involves removing the corneal epithelium, soaking the cornea in riboflavin, and exposing it to UV light. Modifications to the protocol aim to reduce complications by using higher irradiance for less time, different riboflavin delivery methods, and leaving the epithelium intact. Studies show C3R increases corneal collagen bonds and rigidity while halting keratoconus progression in most cases. Contraindications and post-op care are also outlined
This document discusses the history and process of corneal collagen cross-linking. It began as a treatment for keratoconus in the 1990s in Dresden, Germany using riboflavin and UV light. The process increases the stiffness of the cornea by inducing the formation of covalent bonds within and between collagen fibrils. Variations discussed include accelerated techniques, use with thin corneas, and applications for other conditions like post-LASIK ectasia and corneal ulcers. Complications can include haze, infections, and endothelial damage.
There is growing evidence of an inflammatory factor in the pathogenesis of keratoconus.
Could corneal cross-linking make any difference on its expression?
Cxl for the treatment of bullous keratopathy in dogsFrank FAMOSE
油
This document discusses bullous keratopathy (BK), a condition causing corneal edema, ulceration, and vision loss. It describes current treatments for BK like topical drugs and corneal grafts, which often have poor results. The document then reviews how corneal collagen cross-linking (CXL) has been used in humans to treat BK by strengthening the cornea and reducing edema, with over 30 publications since 2007 reporting temporary relief and improved vision. Finally, it outlines two veterinary case studies that found CXL resolved ulceration in dogs with BK within a week, though edema returned over six months.
Intracorneal ring segments, such as INTACS, are thin plastic rings that are implanted into the corneal stroma to flatten the cornea and reduce myopia. They are placed in a lamellar channel using either a mechanical or laser procedure. Thicker rings provide greater flattening and myopia correction. Potential risks include visual disturbances and complications requiring removal. Intracorneal rings have been used off-label to treat conditions like post-LASIK ectasia and keratectasia with some success in improving vision.
This document describes a new procedure called Keraflex, which combines corneal molding using microthermal keratoplasty and accelerated corneal collagen crosslinking. Keraflex uses microwave energy applied in a ring pattern to the peripheral cornea to induce central corneal flattening for the treatment of myopia and keratoconus. It is a minimally invasive procedure that does not require flap creation. The document provides details on the Keraflex procedure and equipment, as well as preclinical research demonstrating the biomechanical effects and safety profile of combining microthermal keratoplasty with accelerated crosslinking.
This document discusses various corneal laser surgeries and procedures. It describes corneal cross-linking, which uses UV light and riboflavin to increase corneal stiffness and halt keratoconus progression. It is less invasive than corneal transplantation. Intrastromal corneal rings are also discussed, which are implanted in the corneal stroma to decrease steepening and astigmatism in keratoconus. Refractive surgeries like PRK, LASIK, and SMILE are outlined that use lasers to reshape the cornea. Preoperative evaluation, cryotherapy, and potential complications of procedures are summarized as well.
Available options for keratoconus managementAmr Mounir
油
This document discusses various treatment options for managing keratoconus, including glasses, hard contact lenses, corneal collagen cross-linking (CXL), intracorneal ring segments, and keratoplasty. It provides details on the types of intracorneal rings (e.g. kerarings and myoring) and guidelines for when each treatment option is most appropriate based on the severity and progression of the condition, the patient's age, and corneal parameters. Key points emphasized are that keratoconus is a progressive disease, treatment requires customization for each patient, and the goal is to delay or avoid keratoplasty through stabilization and regularization of the cornea.
2013 Co-Management Management of complications Dr. MalikFocusOttawa
油
SBK Intralase complications can be divided into three categories: flap, interface, and biomechanical. The most common complication is diffuse lamellar keratitis (DLK), a sterile inflammatory reaction that develops within 48 hours and is treated with topical steroids. Epithelial ingrowth involves the presence of corneal epithelium in the interface and is treated by lifting and scraping the flap. Dry eye is another common complication caused by surgical destruction of nerve endings, but most cases resolve within three months with treatment. Managing complications early and accurately is key to achieving good visual outcomes.
PRK ..... Is it a good alternative to lasik ????Amr Mounir
油
This presentation try to answer the recent debatable question about which is better LASIK or PRK , when to choose each of them and how to exclude complications of both procedures.
Tissue adhesives are increasingly being used as an alternative to sutures in ophthalmic surgery due to their ease of use and reduced postoperative discomfort. The document discusses various types of tissue adhesives including synthetic cyanoacrylate derivatives and biologic fibrin-based adhesives. It provides details on the uses of tissue adhesives in conditions like corneal thinning, perforations, and glaucoma surgery. Application techniques and postoperative management are also outlined. While well-tolerated, potential complications including infection, infiltration, and cataract formation are noted.
Recent advances in treatment of DME include:
1) Frequency doubled Nd:YAG and micropulse diode lasers can treat DME with less damage to the retina compared to traditional lasers.
2) Steroid implants like ILUVIEN and Ozurdex have shown benefits for DME, with ILUVIEN maintaining vision gains over 3 years and Ozurdex benefits lasting 6 months.
3) Ranibizumab injections with or without prompt laser provide mean vision improvements of 9-10 letters over 1 year for DME treatment, with sustained benefits over 2 years.
A corneal transplant replaces a damaged cornea with a healthy donor cornea. The cornea is the transparent front layer of the eye. During the surgery, the diseased cornea is removed and replaced with a donor cornea of matching size and shape. Post-surgery care involves protective eyewear, eye drops to prevent infection and reduce inflammation, and follow-up visits to ensure the transplant is successful in restoring vision. Corneal transplants have a high success rate of over 90%, but risks include infection, glaucoma, and rejection of the donor tissue.
One way to optimize Corneal Cross linking (CXL) !! DiyarAlzubaidy
油
Ophthalmology Lectures: Corneal crosslinking is the only way approved to stop progression of Keratoconus,,let's review the old & new methods of crosslinking
This document discusses corneal collagen cross linking (C3R), a treatment for keratoconus. It begins by describing keratoconus and its symptoms. It then discusses the original C3R protocol developed by Seiler and Spoerl, which involves removing the corneal epithelium, soaking the cornea in riboflavin, and exposing it to UV light. Modifications to the protocol aim to reduce complications by using higher irradiance for less time, different riboflavin delivery methods, and leaving the epithelium intact. Studies show C3R increases corneal collagen bonds and rigidity while halting keratoconus progression in most cases. Contraindications and post-op care are also outlined
This document discusses the history and process of corneal collagen cross-linking. It began as a treatment for keratoconus in the 1990s in Dresden, Germany using riboflavin and UV light. The process increases the stiffness of the cornea by inducing the formation of covalent bonds within and between collagen fibrils. Variations discussed include accelerated techniques, use with thin corneas, and applications for other conditions like post-LASIK ectasia and corneal ulcers. Complications can include haze, infections, and endothelial damage.
There is growing evidence of an inflammatory factor in the pathogenesis of keratoconus.
Could corneal cross-linking make any difference on its expression?
Cxl for the treatment of bullous keratopathy in dogsFrank FAMOSE
油
This document discusses bullous keratopathy (BK), a condition causing corneal edema, ulceration, and vision loss. It describes current treatments for BK like topical drugs and corneal grafts, which often have poor results. The document then reviews how corneal collagen cross-linking (CXL) has been used in humans to treat BK by strengthening the cornea and reducing edema, with over 30 publications since 2007 reporting temporary relief and improved vision. Finally, it outlines two veterinary case studies that found CXL resolved ulceration in dogs with BK within a week, though edema returned over six months.
Intracorneal ring segments, such as INTACS, are thin plastic rings that are implanted into the corneal stroma to flatten the cornea and reduce myopia. They are placed in a lamellar channel using either a mechanical or laser procedure. Thicker rings provide greater flattening and myopia correction. Potential risks include visual disturbances and complications requiring removal. Intracorneal rings have been used off-label to treat conditions like post-LASIK ectasia and keratectasia with some success in improving vision.
This document describes a new procedure called Keraflex, which combines corneal molding using microthermal keratoplasty and accelerated corneal collagen crosslinking. Keraflex uses microwave energy applied in a ring pattern to the peripheral cornea to induce central corneal flattening for the treatment of myopia and keratoconus. It is a minimally invasive procedure that does not require flap creation. The document provides details on the Keraflex procedure and equipment, as well as preclinical research demonstrating the biomechanical effects and safety profile of combining microthermal keratoplasty with accelerated crosslinking.
This document discusses various corneal laser surgeries and procedures. It describes corneal cross-linking, which uses UV light and riboflavin to increase corneal stiffness and halt keratoconus progression. It is less invasive than corneal transplantation. Intrastromal corneal rings are also discussed, which are implanted in the corneal stroma to decrease steepening and astigmatism in keratoconus. Refractive surgeries like PRK, LASIK, and SMILE are outlined that use lasers to reshape the cornea. Preoperative evaluation, cryotherapy, and potential complications of procedures are summarized as well.
Available options for keratoconus managementAmr Mounir
油
This document discusses various treatment options for managing keratoconus, including glasses, hard contact lenses, corneal collagen cross-linking (CXL), intracorneal ring segments, and keratoplasty. It provides details on the types of intracorneal rings (e.g. kerarings and myoring) and guidelines for when each treatment option is most appropriate based on the severity and progression of the condition, the patient's age, and corneal parameters. Key points emphasized are that keratoconus is a progressive disease, treatment requires customization for each patient, and the goal is to delay or avoid keratoplasty through stabilization and regularization of the cornea.
2013 Co-Management Management of complications Dr. MalikFocusOttawa
油
SBK Intralase complications can be divided into three categories: flap, interface, and biomechanical. The most common complication is diffuse lamellar keratitis (DLK), a sterile inflammatory reaction that develops within 48 hours and is treated with topical steroids. Epithelial ingrowth involves the presence of corneal epithelium in the interface and is treated by lifting and scraping the flap. Dry eye is another common complication caused by surgical destruction of nerve endings, but most cases resolve within three months with treatment. Managing complications early and accurately is key to achieving good visual outcomes.
PRK ..... Is it a good alternative to lasik ????Amr Mounir
油
This presentation try to answer the recent debatable question about which is better LASIK or PRK , when to choose each of them and how to exclude complications of both procedures.
Tissue adhesives are increasingly being used as an alternative to sutures in ophthalmic surgery due to their ease of use and reduced postoperative discomfort. The document discusses various types of tissue adhesives including synthetic cyanoacrylate derivatives and biologic fibrin-based adhesives. It provides details on the uses of tissue adhesives in conditions like corneal thinning, perforations, and glaucoma surgery. Application techniques and postoperative management are also outlined. While well-tolerated, potential complications including infection, infiltration, and cataract formation are noted.
Recent advances in treatment of DME include:
1) Frequency doubled Nd:YAG and micropulse diode lasers can treat DME with less damage to the retina compared to traditional lasers.
2) Steroid implants like ILUVIEN and Ozurdex have shown benefits for DME, with ILUVIEN maintaining vision gains over 3 years and Ozurdex benefits lasting 6 months.
3) Ranibizumab injections with or without prompt laser provide mean vision improvements of 9-10 letters over 1 year for DME treatment, with sustained benefits over 2 years.
A corneal transplant replaces a damaged cornea with a healthy donor cornea. The cornea is the transparent front layer of the eye. During the surgery, the diseased cornea is removed and replaced with a donor cornea of matching size and shape. Post-surgery care involves protective eyewear, eye drops to prevent infection and reduce inflammation, and follow-up visits to ensure the transplant is successful in restoring vision. Corneal transplants have a high success rate of over 90%, but risks include infection, glaucoma, and rejection of the donor tissue.
Radial keratotomy, photorefractive keratectomy, laser in-situ keratomileusis, and small incision lenticule extraction are some of the main refractive surgery procedures discussed in the document. These procedures use laser beams, incisions, or intraocular lenses to reshape the cornea and correct refractive errors like myopia, hyperopia, and astigmatism. The document provides details on how each procedure is performed, the types of refractive errors they can treat, potential risks and complications, and expected recovery times. It also discusses factors considered for different correction options and evaluates patients for suitability before performing refractive eye surgery.
Experience expert keratoconus treatment in Dubai with Dr. Rahul Raghav's premier contact lens clinic. Our specialists offer advanced care using the latest technologies, including scleral lenses and hybrid contact lenses, to restore clear vision and comfort. Trust our expertise for personalized solutions that improve your quality of life.
Indication of combined cataract & glaucoma surgery .pptxMdShahjahanSiraj2
油
Combined cataract and glaucoma surgery can provide benefits of reduced costs, stress, and risks compared to staged surgeries. However, it also carries risks like increased inflammation and complications affecting the success of both procedures. The choice depends on factors like glaucoma severity and damage, medications, prior surgeries, and surgeon expertise. Successful outcomes require minimizing these risks through techniques like two-site surgeries and addressing challenges like poor dilation.
A cornea transplant is a highly effective procedure for restoring vision in individuals with damaged or diseased corneas. With advancements in surgical techniques and post-operative care, the success rates of corneal transplants continue to rise, offering new hope to patients worldwide.
Femtosecond lasers are being touted as the next great leap forward in cataract surgery but, as with any radical change to our practices, many questions remain: Does this technology truly improve cataract surgery? Is the refractive accuracy better? Is the safety profile significantly elevated compared to existing technologies? Are there additional complications or issues with using this laser?
1. Keratoplasty, or corneal transplantation, involves replacing part or all of a damaged cornea with donor corneal tissue.
2. There are several types of keratoplasty procedures including penetrating keratoplasty (full thickness), lamellar keratoplasty (partial thickness), DSAEK, and DMEK.
3. Keratoplasty is indicated for conditions such as corneal opacity, dystrophy, infection, trauma, ectasia, and refractive errors. Careful donor preparation, surgical technique, and postoperative management are required for successful outcomes. Complications can include rejection, infection, and recurrence of the underlying condition.
Femtosecond lasers can be used to assist with cataract surgery by performing three key steps: creating a precise capsulotomy, fragmenting the lens, and making incisions. The laser uses ultrashort pulses to precisely cut tissue with minimal collateral damage. During femtosecond laser-assisted cataract surgery (FLACS), the laser performs several pre-operative steps, then the surgeon completes phacoemulsification and lens implantation manually. Potential advantages include more reproducible incisions and capsulotomies, decreased ultrasound energy, and reduced stress on zonules, but the procedure takes more time and has a higher cost than conventional cataract surgery.
This document discusses the various techniques used in refractive surgeries to correct vision, including steps for evaluating patients and determining suitability. It describes the history and evolution of refractive surgeries. The main techniques covered are corneal-based procedures like LASIK, PRK, and SMILE as well as lenticular procedures using phakic intraocular lenses. For LASIK specifically, it outlines the surgical technique and potential complications. Contraindications for refractive surgeries are also stated.
Optometry's Role in Laser Vision Correctioncoakleylincoln
油
Although optometrists do not perform laser vision correction here in the United States, they can still provide a valuable role in this procedure that is gaining unprecedented popularity.
Although optometrists do not perform laser vision correction here in the United States, they can still provide a valuable role in this procedure that is gaining unprecedented popularity.
This document discusses various eye care services including cataract surgery, glaucoma, laser vision correction, corneal transplantation, and medical tourism in India. It provides details on procedures like cataract surgery techniques, types of intraocular lenses, corneal transplantation types, LASIK, and Epi-LASIK. It also summarizes why medical tourism is growing in India due to lower costs, world-class facilities, and Arman Healthcare which assists foreign patients with treatment planning and arrangements.
This document discusses cataracts and cataract surgery. It provides an overview of cataract anatomy, symptoms, and surgery. It describes the risks factors for developing cataracts and recommendations for cataract screening and treatment. The document then focuses on how using a femtosecond laser during cataract surgery can improve precision for steps like corneal incisions, anterior capsulotomy, and lens fragmentation compared to traditional manual techniques. This precision is said to allow for more consistent outcomes and reduced risks.
Everything a General Practitioner needs to know about Laser Vision Correctionpresmedaustralia
油
This document summarizes an ophthalmic education event on refractive surgery. It defines refractive surgery as procedures that alter how the eye focuses light to improve vision and reduce dependence on glasses or contacts. The most common refractive surgeries are LASIK, PRK, and lens-based procedures like cataract surgery. LASIK involves creating a corneal flap with a laser and then sculpting the exposed corneal tissue with an excimer laser to correct vision. Risks include over/undercorrection, dry eyes, halos, and infections. The document reviews the LASIK procedure step-by-step and presents clinical cases and the provider's 2013 results, which showed over 96% of LASIK patients achieving good unaided distance vision.
This document provides an overview of corneal transplantation techniques from their origins to recent advances. It discusses:
- The first corneal transplant in 1905 and subsequent developments like operating microscopes, finer sutures, and corticosteroids which improved outcomes.
- Why lamellar keratoplasty fell out of favor for decades due to interface irregularities causing poor vision, but has made a comeback as techniques improve vision.
- Recent advances like Descemet's Stripping Endothelial Keratoplasty (DSAEK) and Deep Anterior Lamellar Keratoplasty (DALK) which replace less of the cornea and have benefits like quicker recovery time and less rejection risk compared to
Optimization in Pharmaceutical Formulations: Concepts, Methods & ApplicationsKHUSHAL CHAVAN
油
This presentation provides a comprehensive overview of optimization in pharmaceutical formulations. It explains the concept of optimization, different types of optimization problems (constrained and unconstrained), and the mathematical principles behind formulation development. Key topics include:
Methods for optimization (Sequential Simplex Method, Classical Mathematical Methods)
Statistical analysis in optimization (Mean, Standard Deviation, Regression, Hypothesis Testing)
Factorial Design & Quality by Design (QbD) for process improvement
Applications of optimization in drug formulation
This resource is beneficial for pharmaceutical scientists, R&D professionals, regulatory experts, and students looking to understand pharmaceutical process optimization and quality by design approaches.
Dr. Vincenzo Giordano began his medical career 2011 at Aberdeen Royal Infirmary in the Department of Cardiothoracic Surgery. Here, he performed complex adult cardiothoracic surgical procedures, significantly enhancing his proficiency in patient critical care, as evidenced by his FCCS certification.
BIOMECHANICS OF THE MOVEMENT OF THE SHOULDER COMPLEX.pptxdrnidhimnd
油
The shoulder complex acts as in coordinated fashion to provide the smoothest and greatest range of motion possible of the upper limb.
Combined motion of GH and ST joint of shoulder complex helps in:
Distribution of motion between other two joints.
Maintenance of glenoid fossa in optimal position.
Maintenance of good length tension
Although some amount of glenohumeral motion may occur while the other shoulder articulations remain stabilized, movement of the humerus more commonly involves some movement at all three shoulder joints.
At Macafem, we provide 100% natural support for women navigating menopause. For over 20 years, we've helped women manage symptoms, and in 2024, we're proud to share their heartfelt experiences.
Non-Invasive ICP Monitoring for NeurosurgeonsDhaval Shukla
油
This presentation delves into the latest advancements in non-invasive intracranial pressure (ICP) monitoring techniques, specifically tailored for neurosurgeons. It covers the importance of ICP monitoring in clinical practice, explores various non-invasive methods, and discusses their accuracy, reliability, and clinical applications. Attendees will gain insights into the benefits of non-invasive approaches over traditional invasive methods, including reduced risk of complications and improved patient outcomes. This comprehensive overview is designed to enhance the knowledge and skills of neurosurgeons in managing patients with neurological conditions.
Invasive systems are commonly used for monitoring intracranial pressure (ICP) in traumatic brain injury (TBI) and are considered the gold standard. The availability of invasive ICP monitoring is heterogeneous, and in low- and middle-income settings, these systems are not routinely employed due to high cost or limited accessibility. The aim of this presentation is to develop recommendations to guide monitoring and ICP-driven therapies in TBI using non-invasive ICP (nICP) systems.
Stability of Dosage Forms as per ICH GuidelinesKHUSHAL CHAVAN
油
This presentation covers the stability testing of pharmaceutical dosage forms according to ICH guidelines (Q1A-Q1F). It explains the definition of stability, various testing protocols, storage conditions, and evaluation criteria required for regulatory submissions. Key topics include stress testing, container closure systems, stability commitment, and photostability testing. The guidelines ensure that pharmaceutical products maintain their identity, purity, strength, and efficacy throughout their shelf life. This resource is valuable for pharmaceutical professionals, researchers, and regulatory experts.
Best Sampling Practices Webinar USP <797> Compliance & Environmental Monito...NuAire
油
Best Sampling Practices Webinar USP <797> Compliance & Environmental Monitoring
Are your cleanroom sampling practices USP <797> compliant? This webinar, hosted by Pharmacy Purchasing & Products (PP&P Magazine) and sponsored by NuAire, features microbiology expert Abby Roth discussing best practices for surface & air sampling, data analysis, and compliance.
Key Topics Covered:
鏝 Viable air & surface sampling best practices
鏝 USP <797> requirements & compliance strategies
鏝 How to analyze & trend viable sample data
鏝 Improving environmental monitoring in cleanrooms
・ Watch Now: https://www.nuaire.com/resources/best-sampling-practices-cleanroom-usp-797
Stay informedfollow Abby Roth on LinkedIn for more cleanroom insights!
Acute & Chronic Inflammation, Chemical mediators in Inflammation and Wound he...Ganapathi Vankudoth
油
A complete information of Inflammation, it includes types of Inflammation, purpose of Inflammation, pathogenesis of acute inflammation, chemical mediators in inflammation, types of chronic inflammation, wound healing and Inflammation in skin repair, phases of wound healing, factors influencing wound healing and types of wound healing.
Flag Screening in Physiotherapy Examination.pptxBALAJI SOMA
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Flag screening is a crucial part of physiotherapy assessment that helps in identifying medical, psychological, occupational, and social barriers to recovery. Recognizing these flags ensures that physiotherapists make informed decisions, provide holistic care, and refer patients appropriately when necessary. By integrating flag screening into practice, physiotherapists can optimize patient outcomes and prevent chronicity of conditions.
Cardiac Arrhythmia definition, classification, normal sinus rhythm, characteristics , types and management with medical ,surgical & nursing, health education and nursing diagnosis for paramedical students.
Intacs and corneal collagen cross linking, two new but effective procedures
2. What is Intacs ?
Intacs and Corneal Collagen.
Post-operative care.
Intacs and CK- the combined surgery.
Corneal Collagen Cross-linking procedure or
CXL.
The procedure.
Conclusion.
3. Intacs is the trademark name for micro-thin
prescription insertswhich were previously used as a
form of refractive surgery in the treatment of low
levels of myopia or nearsightedness, but has
recently received FDA approval for keratoconus.
4. Keratoconus Intacs is a single day procedure performed in
the OPD section. Eyes are numbed by putting anesthetic
drops, and lid holder is applied to the eye to prevent
blinking.
Surgeon creates a thin channel within the cornea to insert
Intacs with the help of high-speed Femtosecond Laser beam.
Then, one or two Intacs, are inserted as per requirement.
5. Then, one or two Intacs, are inserted as per requirement.
Individual shape of the cornea decides the requirement of
one or more intacs.
Surgeons insert intacs into the outermost edge of the cornea
keeping the center portion untouched.
As the procedure ends, surgeon places a contact lens
bandage, puts drops on the eyes and uses a plastic shield to
keep the eye safe.
6. Intacs are made from a contact lens-like material, and the
shape is like two small crescents.
Insertion of intacs makes the cornea flat, and it reduces the
irregular astigmatism and asymmetries of cornea caused by
Keratoconus.
Surgeons have found it useful for cross- linking of corneal
collagen and vision improvement as well.The procedure also
corrects without glasses or contact lenses.
7. Vision improvement happens immediately after the
procedure, but there may be fluctuations initially. Patients
can resume work within one or two days with a few
restrictions.
Doctors look at the improvement during the follow-up
period and perform additional procedures if required.
It can be changing size and position of intacs, adding
supplementary procedures like Conductive Keratoscopy
or CK.
8. Cornea improves in a majority of cases, but there can be a
need of contact lenses or spectacles.
In rare cases, there are secondary problems like insertion of
intacs or infection during corneal healing.
Surgeons take the decision of removing intacs in some
extreme cases. All these complications are discussed with
patients before surgery.
9. Eye specialists are always in search of innovative procedures
for treating eye problems. It has been observed that in a few
cases, it is possible to combine Conductive Keratoplasty
with Intacs procedure.
It can be performed in a single session or back-to-back
depending on the situation. It is a revolutionary approach to
correct Keratoconus.
10. Since CK is a procedure of correcting the shape of the cornea
by shrinking the collagen, it allows excellent reshaping of a
keratoconus cornea when combined with Intacs procedure.
It can be done along with Intacs or when the sutures get
removed.
It is not a recognized procedure by FDA and the clinic has to
take approval for it.
12. Since CK is not an approved procedure for correcting
Keratoconus (though it is approved for correcting
farsightedness), patients have to select it as an offline
procedure.
In a few cases, Intacs may act as a supplementary procedure
for correcting severe nearsightedness through LASIK or
LASEK/PRK procedures.
So far, clinical trials have shown quite satisfactory and
enthusiastic results.
13. CXL is a relatively new and experimental procedure
performed in a few countries of Europe.
It is still under observation and research is being done to
assess its effectiveness and safety in correcting problems like
Keratoconus or Corneal Ectasia after LASIK surgery.
14. It is a procedure performed with the primary goal of
strengthening and stiffening the corneal fibers so that
progression of Keratoconus can be prevented.
It also decreases the cone steepness in some cases.Though
the safety and effectiveness are still points of research, initial
results show that it is quite effective.
15. Surgeons put anesthesia drops to prevent pain and
discomfort. A lid retainer is installed to prevent blinking.
The surgical procedure starts with removing of surface
epithelial cells of the cornea.
Riboflavin drops put for 30 minutes so that cross-linking
effect gets enhanced and the rest of the eye from exposure
to Ultraviolet exposure.
16. Patients are told to look at a source of UV light (365 microns
of wavelength and 3mW/cm2 power) for half an hour.A soft
contact lens bandage is applied.
Anti-inflammatory drops and antibiotic drugs are prescribed
for two weeks. Contact lenses are placed for a week so that
the healing process can be improved.
17. Intacs procedure is one of the prominent and important
procedures for correcting Keratoconus.
It is equally effective in making the eyes tolerant of contact
lenses. It avoids the possibility of corneal transplant up to a
large extent.
It avoids the possibility of corneal transplant up to a large
extent.
18. Improving vision correction with glasses or contact lenses is
other applications.
Some patients achieve a fantastic correction while some
need additional corrections.
Many specialty hospitals and eye treatment centers offer it,
but it is very important to check the proficiency and
expertise of the doctors.
19. Cure Sight Laser Centre
Contact Us:
3rd Floor, Dev Complex,
Parimal Garden Cross Road,
Ahmedabad, Gujarat
Timing : 10.00 AM to 5.00 PM
Contact No. : +91 9825 00 7494
Email Id : info@curesight.com
Website : http://www.curesight.com