Patents

Patent US9956230

Abstract
A new and novel method for determining post-procedural treatment is disclosed herein. In one embodiment, a method for treating a patient following a surgical procedure on at least one eye comprises determining a depth at which the surgical procedure is to be performed or was performed and providing instructions for administering medication for a length of time to the at least one eye of the patient, the length of time-based at least in part upon the depth.

Technical Field of the Invention
The present invention is directed, in general, to a surgical procedure and, more particularly, to a surgical procedure to improve the visual acuity of a patient.

Background of the Invention
There are a number of types of photorefractive surgical procedures now being used for vision correction. Included among these procedures is LASIK (Laser-Assisted In Situ Keratomileusis). LASIK is a procedure used to permanently change the shape of the cornea with an Excimer laser. A flap is cut in the cornea and folded back, revealing the stroma, which is the middle section of the cornea. Pulses from a computer-controlled Excimer laser are used to ablate or vaporize a portion of the interior of the stroma and reshape the corneal tissue. The flap is then replaced over the reshaped area to conform to the new corneal shape.

Some patients, however, are not suitable candidates for LASIK. Those patients that have extremely thin corneas are better served using a procedure other than LASIK. Advanced surface ablations techniques provide a suitable alternative in such cases. These techniques involve the removal of the very surface layer of the cornea, known as the epithelium, and lasering the exposed corneal bed. This keeps the laser from ablating or vaporizing too deep into the tissue of the cornea and reduces the risk of ectasia or destabilization of the cornea.

Both LASIK and the various surface ablation techniques can be grouped under the general umbrella of laser eye surgery, but each is a little different with respect to its advantages and disadvantages. The great advantage of LASIK over a surface ablation technique is that, as soon as the flap created during the LASIK procedure is replaced, the cornea begins to heal and will naturally seal itself to the rest of the cornea. This greatly speeds the overall healing process when compared to surface ablation techniques, which leaves the reshaped area generally more exposed or open. With surface ablation, improvement is more gradual, and the eye may take a few days or even a month or two to stabilize. In general, most surgeons prefer LASIK except for patients with thin corneas, in which case a surface ablation technique is preferred. Patient satisfaction is another reason surgeons prefer LASIK because the patient can quickly see clearly, and his or her anxiety is significantly reduced.

Several potential problems are inherent in LASIK. The three most common problems are: (1) under correction, where not enough tissue is removed during the procedure; (2) overcorrection, where too much tissue is removed during the procedure; and (3) wrinkling of the corneal flap, where a small fold or wrinkle occurs during replacement which causes a small blurry area in the patient's vision. In most cases, each of these problems can be easily corrected with a second surgical procedure. Of course, if the under or over-correction is very slight, the surgeon will most likely advise against any attempt to refine the patient’s vision any further. In fact, many recipients of laser eye surgery, although they may never achieve normal vision, view the procedure as a success if they are able to achieve a significant reduction in their corrective-lens prescription.

Summary of the Invention
To address the above-discussed deficiencies of the prior art, the present invention provides, in one aspect, a new and novel method for performing refractive correction on a patient’s eyes. In one embodiment, the method includes (1) performing a surface ablation corrective procedure on a corneal surface of the patient’s non-dominant eye; and (2) reshaping a corneal stroma of the patient’s dominant eye, where the reshaping includes the making of a lamellar cut in the surface of the dominant eye to create a flap; folding the flap back to reveal an interior section of the corneal stroma and ablating a portion of such interior section, after which the flap is replaced.

Thus this new method introduces the MLasik™ procedure for visual correction. The MLasik™ procedure provides several advantages over existing procedures. For example, by performing a flapless visual corrective procedure on the patient’s non-dominant eye, the risk of any medical complication is significantly reduced. The surgeon has the opportunity to determine if the patient has an epithelial or Bowman membrane disease that could cause in-growth, the determination of which could also militate against a more invasive procedure being performed on the dominant eye. The performance of surface ablation correction on the non-dominant eye also eliminates the potential of diffuse lamellar keratitis (DLK). Surface ablation correction also has less potential for eye dryness than does the more invasive procedure of shaping an interior portion of the corneal stroma. In addition, the surgeon can also provide a slight under-correction in the non-dominant eye to reduce the chance of an over-correction and scarring. On the other hand, the major benefits of shaping the corneal stroma under a folded back flap cut from the cornea are retained with respect to the dominant eye. The patient will be able to see more clearly quickly, and the patient’s anxiety will be reduced. In addition, the chances of bilateral scaring of the eyes are reduced, and the potential of the patient having an adverse steroid reaction is. Also, when the corneal stroma is shaped using a flap technique, the surgery can be more easily enhanced if needed.

As those skilled in the pertinent art will understand, there may be an advantage, such as a medical reason, for using the flap technique to correct the dominant eye's vision before correcting the non-dominant eye’s vision using a surface ablation technique. The scope of the present invention is intended to include correction being performed on the dominant eye using a flap technique before correcting the non-dominant eye using a surface ablation technique.

In one embodiment, a microkeratome or a laser is used to make the lamellar cut in the cornea to form a flap. In another embodiment, the method provides for the surface ablation corrective procedure to result in a slight under-correction of the patient’s vision in the non-dominant eye. In still another embodiment, the method provides for the surgeon to determine whether the patient suffers from epithelial or Bowman membrane disease.

In yet still another embodiment of the invention, the method is further comprised of making a cut to an epithelium depth of the non-dominant eye to create an epithelium flap. This epithelium flap is then folded back prior to performing the surface ablation corrective procedure, after which it is replaced.