*PROTOCOL, DRUG REGIMEN AND CONTACT LENS WITHOUT THE FLAP WITH THE MORIA EPI-KTM *Patient Selection Guidelines Inclusion Criteria
• Patients suitable for LASIK or surface ablation with intact Bowman's membrane, • and keratometries between 39 and 48 D.
Exclusion Criteria
• Patients who have had any previous surgery that could have damaged Bowman's membrane, including but not limited to RK,
PRK, LASEK, PTK, LASIK, IntraLASIK, or Epi-LASIK.
• Patients with any pathologies such as pterygium, keratoconus, corneal ulcers, corneal scars etc. that could have damaged
• Patients who have had a foreign body removed. *Guidelines for Suction Ring and Stop Selection For myopic treatments on normal or small eyes (corneal diameter up to 11.5 mm), select the metal –1 ring with the 9.0 stop for all cases, decentering nasally in order to obtain a free cap. To decenter correctly, allow 0.5 mm of sclera to show through the ring.
For hyperopic treatments or treatments requiring a large ablation zone or large eyes (corneal diameter > 11.5 mm), select the metal LD (Large Diameter) ring with the 9.5 stop.
For those using the Single-Use ring, use the –1 size with the 9.5 stop in all cases. **Dr. Milne’s Protocol, Drug Regimen and Contact Lens Intra-op
Instill 1 to 2 drops of Alcaine® (proparacaine, Alcon) as soon as the patient is positioned under the laser.
Instill 2-3 drops of BSS® on cornea and 1-2 drops on separator before Epi-K™ pass.
Just after laser ablation, optional application of mitomycin C (MMC).
• Some surgeons apply MMC 0.02% on the stromal bed for 30 seconds if laser ablation depth is greater than 75 microns with or
Apply frozen weck cell sponge on the stromal bed after the laser ablation or MMC for 20 sec.
Fit an Acuvue® Oasys 8.4 base curve bandage contact lens (Johnson & Johnson). The selection of this specific lens is very critical to prevent pain and to get a fast visual recovery. Zymar® (gatifloxacin, Allergan) 1 drop 4 times a day for 1 week. Pred Forte® (prednisolone acetate, Allergan) 1 drop 4 times a day for 3 or 4 days. When the contact lens is removed, ask the patient to switch to 1 drop twice a day for 2 weeks to 1 months. Corticosteroids like dexamethasone can also be used instead. Xibrom® (bromfenac 0.09%, Ista Pharmaceuticals) 1 drop 4 times a day until the 4th day postop. Vitamin C 1000mg a day for 3 months.
Non contractual document - MORIA #65071A - 07/2007
* These guidelines are recommendations only. Each surgeon must make an independent medical judgment in
choosing the proper technique and procedure for performing Epi-LASIK using the Epi-KTM. Moria is not be responsiblefor the outcome of any Epi-LASIK procedure or any direct, incidental, consequential or exemplary damages suffered byany party as a result of undergoing this surgery.
** Dr. Milne’s Epi-LASIK protocol, drug regimen and contact lens (Columbia, SC, USA) is provided for information only.
Each surgeon must make an independent medical judgment in choosing the proper technique, procedure, protocol, drugregimen and contact lens for performing Epi-LASIK using the Epi-KTM. *PROTOCOL, DRUG REGIMEN AND CONTACT LENS WITH THE FLAP WITH THE MORIA EPI-KTM *Patient Selection Guidelines Inclusion Criteria
• Patients suitable for LASIK or surface ablation with intact Bowman's membrane, • and keratometries between 39 and 48 D.
Exclusion Criteria
• Patients who have had any previous surgery that could have damaged Bowman's membrane, including but not limited to RK,
PRK, LASEK, PTK, LASIK, IntraLASIK, or Epi-LASIK.
• Patients with any pathologies such as pterygium, keratoconus, corneal ulcers, corneal scars etc. that could have damaged
• Patients who have had a foreign body removed. *Guidelines for Suction Ring and Stop Selection Reusable metal rings
For hyperopic treatments or treatments requiring
For myopic treatments on normal or small eyes
a large ablation zone (wavefront-guided, large pupils)
or large eyes (corneal diameter > 11.5 mm)
7.5 stop for average K < 43.5 D, Select the LD 7.5 stop for average K < 43.5 D,
Select the -1 ring with 8.0 stop for average K ≥ 43.5 D (Large Diameter) ring with 8.0 stop for average K ≥ 43.5 D Single Use rings
For myopic treatments on normal or small eyes
For large eyes (corneal diameter > 11.5 mm)
7.5 stop for average K < 43.5 D,
Select the -1 ring with
Select the -1 ring with 8.0 stop for average K ≥ 43.5 D **Protocol, and Dr. Milne’s Drug Regimen and Contact Lens Intra-op
Instill 1 to 2 drops of Alcaine® (proparacaine, Alcon) as soon as
Apply frozen weck cell sponge on the stromal bed after the laser
the patient is positioned under the laser.
Instill 2-3 drops of BSS® on cornea and 1-2 drops on separator before Epi-K™ pass.
Fit an Acuvue® Oasys 8.4 base curve bandage contact lens (Johnson & Johnson).
Reminder of key steps of Dr. Soloway’s My Technique if the epi-
The selection of this specific lens is very critical to prevent pain
• At end of epikeratome pass, instill 2-3 drops of BSS® on
• Touch the flap as little as possible. The less manipulation,
Zymar® (gatifloxacin, Allergan) 1 drop 4 times a day for 1 week.
• Don’t aim for an exact fit. The epithelial flap will be stret-
Pred Forte® (prednisolone acetate, Allergan) 1 drop 4 times a day
ched, causing overlap that is acceptable. Just make sure
for 3 or 4 days. When the contact lens is removed, ask the patient
the flap does not go over the limbus and that there is no
to switch to 1 drop twice a day for 2 weeks to 1 months.
wrinkles in the optical zone. 6 hours postop, it will retract
Corticosteroids like dexamethasone can also be used instead.
• Once the flap is back in place, remove any fluid from the
Xibrom® (bromfenac 0.09%, Ista Pharmaceuticals) 1 drop 4
interface, then allow at least 2-minute dry time of flap prior
times a day until the 4th day postop.
to fitting the contact lens on the eye. Vitamin C 1000mg a day for 3 months.
Just after laser ablation, optional application of mitomycin C (MMC).
• Some surgeons apply MMC 0.02% on the stromal bed for
30 seconds if laser ablation depth is greater than 75
Non contractual document - MORIA #65071A - 07/2007
* These guidelines are recommendations only. Each surgeon must make an independent medical judg-
ment in choosing the proper technique and procedure for performing Epi-LASIK using the Epi-KTM.
Moria is not be responsible for the outcome of any Epi-LASIK procedure or any direct, incidental,conse-
quential or exemplary damages suffered by any party as a result of undergoing this surgery. ** Dr. Soloway's Epi-LASIK technique (New York, NY) and Dr. Milne’s Epi-LASIK drug regimen and
contact lens (Columbia, SC, USA) are provided for information only. Each surgeon must make an
independent medical judgment in choosing the proper technique, procedure, protocol, drug regimen
www.moria-surgical.com
and contact lens for performing Epi-LASIK using the Epi-KTM.
The Unknowing Nose ; With no ability to smell, an anosmiac has difficulty making scents of the world [FINAL Edition] Document Text Go to amazon.com, call up a scratch-and-sniff book titled The Sweet Smell of Christmas and you'll find 55 out of 56 customer reviewers give it aNot bad for a book that's short on plot but long on snootfuls of chemically contrived hot cocoa and candy canes. &#
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