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Trephine for ASA and alternate alcohol

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)

there has been a movement to renaming this procedure epiLASEK rather than epiLASIK, as it is clearly closer to LASEK (ie another ASA or Advanced Surface Ablation procedure) than LASIK, and the former (better) nomenclature is also more clear to the consumer/lay patient (ie they understand it is different than LASIK)

this is also why i have a problem w “bladeless” LASIK, as we all know that many lay patients think that this means there is no flap being cut at all, when in reality it means a flap is being cut with a laser. i do understand the branding/marketing value of this term, as it reduces fear, but i have actually seen a few patients over the last 20 yrs come in w flap dislocations from extreme sports after “bladeless” LASIK, and they were SHOCKED that they had a flap, and said “if my doctor had been more clear/honest w me that i had a flap cut into my cornea w a laser, i would have been more careful and worn eye protection”

long answer to a short question, but i hope it will be helpful and perhaps stimulate discussion!:)

 

No other laser vision correction surgeon in New York….

No other laser vision correction surgeon in New York....

...offers you the opportunity to have a Free Remote Consultation with the surgeon! Ask Dr. Chynn your main question or concern, and will answer, personally, within 2 business days!

Unsure whether you're a good candidate because of a lot of astigmatism? Large pupils? Dry eyes? Maybe you were rejected by LASIK surgeons due to a “thin cornea” or high prescription.

Take advantage of this incredible opportunity to find out if LASEK is an option for you from Dr. Chynn, our famous, cornea fellowship-trained, Columbia & Harvard graduate who’s in MENSA & was the 1st eye surgeon in NY, NJ, CT & PA to get LASIK, & has performed 1,000 PRKs, 5,000 LASIKs, 10,000 LASEKs, and 5,000 epiLASEKs

But please be considerate. Dr. Chynn gets paid $1,000/hour as a consultant for expert networks & expert witness, so please limit yourself to your most pressing question or concern, as he’s doing this for free on a trial basis to help interested patients.

Please include the information below in your email so Dr. Chynn can answer your question specifically.

Age:
Approximate prescription (if known):
Occupation (the more specific the better):
Main barrier or concern:

  • This field is for validation purposes and should be left unchanged.

Tell Dr. Chynn your main barrier so he can help overcome it😉👌

Email us at dr@ParkAvenueLASEK.com
Text us at (212) 691-4221

Contact Dr. Chynn

x

Tell Dr. Chynn your main barrier so he can help overcome it😉👌 Email us at dr@ParkAvenueLASEK.com Text us at (212) 691-4221

No other laser vision correction surgeon in New York….

No other laser vision correction surgeon in New York....

...offers you the opportunity to have a Free Remote Consultation with the surgeon! Ask Dr. Chynn your main question or concern, and will answer, personally, within 2 business days!

Unsure whether you're a good candidate because of a lot of astigmatism? Large pupils? Dry eyes? Maybe you were rejected by LASIK surgeons due to a “thin cornea” or high prescription.

Take advantage of this incredible opportunity to find out if LASEK is an option for you from Dr. Chynn, our famous, cornea fellowship-trained, Columbia & Harvard graduate who’s in MENSA & was the 1st eye surgeon in NY, NJ, CT & PA to get LASIK, & has performed 1,000 PRKs, 5,000 LASIKs, 10,000 LASEKs, and 5,000 epiLASEKs

But please be considerate. Dr. Chynn gets paid $1,000/hour as a consultant for expert networks & expert witness, so please limit yourself to your most pressing question or concern, as he’s doing this for free on a trial basis to help interested patients.

Please include the information below in your email so Dr. Chynn can answer your question specifically.

Age:
Approximate prescription (if known):
Occupation (the more specific the better):
Main barrier or concern:

  • This field is for validation purposes and should be left unchanged.