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Schirmer test

Q: I saw a patient today for the first time who is an internist has been treated for dry eye for years.  She really looked to me more like chronic inflammatory OSD due to blepharitis and possible allergy with Rosace, plugging of the glands, loss of lashes, conjunctivochalsis etc.  She had no plugs in but

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Skewed topography

Q: 27 year old woman wants Lasik. MR -5.75 +0.50 x 95 20/20 – 5.25+0.50 x 85 20/20 Pachs 574 OD, 599 OS Topographies attached. What concerns me is the skewed topography left eye. Would you recommend: 1. No refractive surgery 2. PRK 3. Lasik Thanks, David Atlanta, GA A: Hi David In general, if

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25g needle bending

Q: When McLean originally published this technique (Ophthalmology, 1986), it was with a regular, non-bent 20g needle. The advantage of using such a large needle is that there is zero chance of perforating. When Peter Laibson discussed this technique at the AAO, he suggested maybe using a smaller (i.e. 25g) needle. With that, unbent, folks

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SMILE

Q: I will put my $0.02 here for what it’s worth. In theory the structural integrity from SMILE should be better but independent in vivo research is needed. Dan Reinstein is a consultant for Zeiss. SMILE has a lot of attractive features but sadly my evaluation from peers who used it and abandoned it is

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He’s performed 1,000 PRKs, 5,000 LASIKs, 10,000 epiLASEKs, 15,000 LASEKs – more than any surgeon in the US

He got LASIK in his right eye & LASEK in his left eye, so is UNIQUELY qualified to tell you the +/-‘s of BOTH procedures – from BOTH a Surgeon’s & Patient’s point-of-view!

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