Therapeutic Femtosecond Laser-Assisted Lamellar Keratectomy for Multidrug-Resistant Nocardia Keratitis.

Purpose: To describe the novel use of femtosecond laser technology for therapeutic resection of infectious foci in a case of multidrug-resistant Nocardia asteroides keratitis.

Methods: A 30-year-old man presented with a corneal infiltrate. Cultures were taken, and fortified vancomycin and tobramycin were initiated.

Femtosecond laser-assisted cataract surgery in a patient with posterior chamber phakic intraocular lens.

We describe a case of modified femtosecond laser settings for cataract extraction in a patient with a posterior chamber phakic intraocular lens (PIOL), to avoid incomplete treatment patterns and treatment displacement. Modification of laser settings (increased depth for the capsulotomy, increased vertical spot spacing for the capsulotomy and increased anterior and posterior capsule safety margins for lens fragmentation) seems to make femtosecond laser-assisted cataract surgery feasible in patients with posterior chamber PIOLs, as complete treatment patterns are achieved.

Calculation of ophthalmic viscoelastic device-induced focus shift during femtosecond laser-assisted cataract surgery.

Purpose: To assess if a change in refractive index of the anterior chamber during femtosecond laser-assisted cataract surgery can affect the laser beam focus position.

Methods: The index of refraction and chromatic dispersion of six ophthalmic viscoelastic devices (OVDs) was measured with an Abbe refractometer. Using the Gullstrand eye model, the index values were used to predict the error in the depth of a femtosecond laser cut when the anterior chamber is filled with OVD.

Operating times of experienced cataract surgeons beginning femtosecond laser-assisted cataract surgery.

Purpose: To compare the time a patient spent in the operating room during femtosecond laser-assisted with that during traditional cataract surgery.

Setting: Academic tertiary referral center.

Design: Retrospective review.

Avoiding Negative Dysphagia Outcomes.

Dysphagia in adults affects their quality of life and can lead to life-threatening conditions. The authors draw on both 30 years of experience as clinicians and also on expert testimony in adult, dysphagia-malpractice cases to make five recommendations with the aim of preventing dysphagia-related deaths. They discuss the importance of informed consent documents and suggest the following nursing actions to reduce these often unnecessary tragedies: consider the importance of diet status; understand and follow speech-language-pathologists' recommendations; be familiar with the dysphagia assessment; be responsive to the need for an instrumental assessment; and ensure dysphagia communication is accurate and disseminated among healthcare professionals.

Femtosecond laser-assisted technique for performing bag-in-the-lens intraocular lens implantation.

We describe a technique for femtosecond laser-assisted bag-in-the-lens (BIL) intraocular lens (IOL) implantation. Anterior capsulotomy and lens division into small pieces are performed by the laser. A fluid-filled interface makes it possible to re-dock the laser to the eye for posterior capsulotomy after the eye has been opened for lens aspiration without complications.

Comparison of IOL power calculation methods and intraoperative wavefront aberrometer in eyes after refractive surgery.

Purpose: To compare preoperative methods for calculating intraocular lens (IOL) power versus the intraoperative wavefront aberrometer in eyes with a history of refractive surgery.

Methods: A retrospective study of 46 eyes (33 patients) with previous refractive surgery that underwent subsequent cataract surgery was conducted. Suggested IOL power predicted by ORange intraoperative wavefront aberrometer (WaveTec Vision Systems, Inc.

Complications of femtosecond laser-assisted re-treatment for residual refractive errors after LASIK.

Purpose: To report complications of femtosecond laser-assisted re-treatment by the creation of side cuts within the old flaps for residual refractive error after primary LASIK in two patients.

Methods: Case report.

Results: Three eyes of two patients had complications with a circumferential sliver of stromal tissue displaced during surgery due to overlap of old and new side cuts.

Femtosecond laser-assisted retreatment for residual refractive errors after laser in situ keratomileusis.

Purpose: To study the utility of creating an additional side cut within the old laser in situ keratomileusis (LASIK) flap using a femtosecond laser to reduce the incidence of epithelial ingrowth in patients having retreatments for residual refractive errors after LASIK.

Setting: Bascom Palmer Eye Institute, Miller School of Medicine, Miami, Florida, USA.

Design: Comparative case series.

Sources of medical error in refractive surgery.

Purpose: To evaluate the causes of laser programming errors in refractive surgery and outcomes in these cases.

Methods: In this multicenter, retrospective chart review, 22 eyes of 18 patients who had incorrect data entered into the refractive laser computer system at the time of treatment were evaluated. Cases were analyzed to uncover the etiology of these errors, patient follow-up treatments, and final outcomes.

Optical patient interface in femtosecond laser-assisted cataract surgery: contact corneal applanation versus liquid immersion.

Purpose: To compare 2 optical patient interface designs used for femtosecond laser-assisted cataract surgery.

Setting: Optimedica Corp., Santa Clara, California, USA, and Centro Laser, Santo Domingo, Dominican Republic.

Quality of corneal lamellar cuts quantified using atomic force microscopy.

Purpose: To quantify the cut quality of lamellar dissections made with the femtosecond laser using atomic force microscopy (AFM).

Setting: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.

Design: Experimental study.

Epithelial ingrowth after LASIK: clinical characteristics, risk factors, and visual outcomes in patients requiring flap lift.

Purpose: To describe clinical characteristics, risk factors, and visual outcomes in patients requiring flap lift for epithelial ingrowth following LASIK.

Methods: Consecutive, noncomparative, retrospective case series of eyes requiring flap lift for epithelial ingrowth following LASIK from June 2003 through July 2011 at a tertiary care, university-based eye hospital. Main outcome measures were uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) at 1 and 3 months and recurrence of epithelial ingrowth.

Protective effect of LASIK flap in penetrating keratoplasty following blunt trauma.

Penetrating keratoplasty (PKP) often results in large and unpredictable refractive errors following suture removal in the postoperative period. Laser in situ keratomileusis (LASIK) is an effective means of correcting these errors. However, LASIK following PKP is believed to further weaken an already weak graft-host junction and may predispose such eyes to traumatic dehiscence of the graft-host junction.

Femtosecond laser capsulotomy.

Purpose: To evaluate a femtosecond laser system to create the capsulotomy.

Setting: Porcine and cadaver eye studies were performed at OptiMedica Corp., Santa Clara, California, USA; the human trial was performed at the Centro Laser, Santo Domingo, Dominican Republic.

Femtosecond laser-assisted cataract surgery.

Purpose Of Review: In 2010, the US Food and Drug Administration (FDA) cleared femtosecond laser systems for cataract surgery. Available in 2011, this technology has the potential to significantly impact cataract surgery.

Recent Findings: Femtosecond lasers offer surgeons the ability to make very precise cuts in a targeted area without damaging the surrounding tissues.

In vivo structural characteristics of the femtosecond LASIK-induced opaque bubble layers with ultrahigh-resolution SD-OCT.

The authors report in vivo morphology of opaque bubble layers with ultrahigh-resolution anterior-segment optical coherence tomography (UHR-OCT) in 3 patients. Two patients were operated on with a 30-kHz IntraLase femtosecond laser (Abbott Medical Optics, Abbott Park, IL) and one patient was operated on with a 500-kHz VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany). UHR-OCT images from the patient operated on with the 500-kHz femtosecond laser revealed that the opaque bubble layer extended anterior to the flap dissection plane up to Bowman's membrane.

Epithelial ingrowth after Descemet stripping automated endothelial keratoplasty: description of cases and assessment with anterior segment optical coherence tomography.

Purpose: To describe 5 cases of epithelial ingrowth after Descemet stripping automated endothelial keratoplasty (DSAEK) and the use of anterior segment optical coherence tomography (AS-OCT) to describe the areas of ingrowth.

Methods: Five cases with epithelial ingrowth after DSAEK were examined with commercially available AS-OCT and/or a novel custom-built ultrahigh resolution (UHR) AS-OCT. Argon laser photocoagulation was also used to confirm epithelial ingrowth on the iris surface.

Femtosecond laser-assisted cataract surgery with integrated optical coherence tomography.

About one-third of people in the developed world will undergo cataract surgery in their lifetime. Although marked improvements in surgical technique have occurred since the development of the current approach to lens replacement in the late 1960s and early 1970s, some critical steps of the procedure can still only be executed with limited precision. Current practice requires manual formation of an opening in the anterior lens capsule, fragmentation and evacuation of the lens tissue with an ultrasound probe, and implantation of a plastic intraocular lens into the remaining capsular bag.

Long-term results of femtosecond laser-assisted sutureless anterior lamellar keratoplasty.

Purpose: To evaluate the long-term results of femtosecond laser-assisted anterior lamellar keratoplasty (FALK) for anterior corneal pathologies.

Design: Retrospective, noncomparative, interventional case series.

Participants: Thirteen consecutive patients who underwent FALK for anterior corneal pathologies.

Complications of LASIK flaps made by the IntraLase 15- and 30-kHz femtosecond lasers.

Purpose: To describe complications associated with femtosecond laser-assisted flap creation in LASIK surgery. The management and visual outcomes of femtosecond laser complications related to flap creation in LASIK patients are also described.

Methods: All eyes that underwent LASIK with the IntraLase femtosecond laser from September 2003 to June 2006 at a university-based refractive center were included in this retrospective, noncomparative, interventional case series and IntraLase-related LASIK complications are described.

Effect of marking pens on femtosecond laser-assisted flap creation.

Purpose: To compare the ease of the flap lift after central corneal marking with 2 types of marking pens after femtosecond laser-assisted flap creation in laser in situ keratomileusis.

Setting: Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA.

Methods: Porcine eyes were prepared for flap creation with a femtosecond laser (IntraLase).