Q:
Emil:
I’d like to try your technique.
Can you share what your preferred trephine for ASA is (vendor, size, catalog #) ?
For yours and the group’s interest: I’ve been using a corneal light protector sponge saturated with 70% Isopropyl alcohol (yep good old rubbing alcohol!) for 12 secs followed by chilled BSS rinse. The epi comes off beautifully but not with a clean outer edge like a trephine.
I think the clean epi removal and ice cold BSS both after alcohol and after ablation are most helpful for pain control. I use Oasys 8.4, NSAIDS for only 2 days, FML tapered over 3-4 months.
Mike
A by Emil Chynn MD:
it’s the same exact thing, ie using a mechanical microkeratome which uses a blunt separator that’s too blunt to go into the cornea, to push off the epithelium in one clean sheet, without needing any EtOH (in most cases), where the surgeon can choose to replace the epithelium or not (about 50% of surgeons do and 50% do not, bc they have observed quicker brand-new epithelium when they stimulate epi regrowth by leaving the area denuded for a few days w a BCL, surprisingly wo any increase in discomfort, and sometimes epi-off is actually more comfortable, probably bc the old epi isn’t dying off and releasing cytokines and other inflammatory mediators)
