Designed for LASIK enhancements
* Allows surgeon to reopen flap incision...
* To lift the flap...
* Ideally at the slit lamp |
 Richard
A. Erdey, MD
Columbus, OH
Complications
arising from LASIK Enhancement constitute a significant
risk factor in cornea surgery today.
Various reports indicate enhancement rates of
between 8% and 20%. These complications include
torn caps, folds, cracks and infection.
However, the most prevalent complication is that
of epithelial defects due to the blunt dissection
normally applied. This gives rise to epithelial
tears and tags which can inadvertently be tucked
under the flap margins upon replacement. This
results in epithelial in-growth and entrapped
epithelium, which have been proven to lead to
stromal melting anterior to the epi-entrapment.
This issue is so significant that some surgeons
are using a second microkeratome pass to raise
the flap. Our new Erdey Flap Elevator will help
manage these concerns. |
This
two ended instrument employs a specially designed miniature
sharpened crescent which easily locates and dissects the original
flap margin, which is commonly one of the more difficult aspects
of the enhancement. Once the flap edge is scored, the Erdey
Elevator end of the instrument is then employed to sharply
dissect the epithelium cleanly along the entire circumference
of the gutter. The sharpened Erdey Flap Elevator, with upswept
facets, is intended to lift and separate, while the radius
assists tracking in the gutter. This action reveals the margin
of the epithelium dynamically and uniquely. The detuned proximal
edges eliminate the tendency to create a false plane.
Designed
to be employed at either the slit-lamp (ideally) or the surgical
microscope (laser optics are notoriously poor, however) the
Erdey Flap Elevator is simple and effective. After the margin
has been cleaved, the patient is taken to the laser and the
flap is then easily lifted. Obviously the stromal adherence
will vary slightly from eye to eye but is easily overcome
since the tenacious epithelial bond has been severed.