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Post Info TOPIC: Topography Results: Artsybashev Keratotomy Technique


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Date: Wed Apr 21 6:24 PM, 2010
Topography Results: Artsybashev Keratotomy Technique
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Henrick,
You read my mind... Excellent questions! Im just curious to know if the pressure is released somewhat in the eye and the flattening of the cone is as a result of that, how would we be assure that the new shape would remain in place.

Secondly, Im very much aware that many doctors have apprehensions differing techiniques in treating certain illness/diseases, but in this of procedure that offeres so much apparent benefit, why is it not as popular as other procedures that appear to be vastly mose invassive.

I'm not in any way questioning the efficacy of this procedure, but admittedly, there appears to be very limited information (eg. Blogs, Etc)available online for Kcers to peruse.

Just curious......

Thanks very much drgoren

-- Edited by DEFPOTEC on Wednesday 21st of April 2010 05:28:03 PM

-- Edited by DEFPOTEC on Wednesday 21st of April 2010 05:59:30 PM

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Date: Thu Apr 22 2:31 AM, 2010
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Thanks for your interest. I have spoken with Dr. Artsybashev and his answers were the following:

1. Is there any collected data of many patient that could give the mean
outcome for VA improvements?

All of the operations have resulted in an improvement in visual acuity. There is an ongoing collection of data and the results will be presented at a conference in the near future.

2. Is there any data about what patients thought about reduction in
ghosting halos and other problems that are hard to measure with a simple
eye chart but still causes alot of problems?

In general these problems have been reduced. This is based on feedback from patients.

3. I am curious about the program to follow postop, did he tell about that?

The program is designed to limit the amount of stress on the eyes during the early recovery period. It is during this time that the incisions are healing. Certain activities such as weight lifting or strenuous exercise should be avoided.

4.  Are other surgeons picking up interest in this technique? Are the risks
high? I mean if the incisions are placed a slight bit wrong the pressure
and reshaping could be totally wrong?

It requires a lot of focus and skill to operate on a keratoconus patient with this method. The cornea is thinner and weaker. There is not much room for error. Perforations must be avoided as they can lead to serious complications. The difficulty of the procedure typically increases with the stage of the keratoconus. A surgeon wanting to learn this procedure would need a significant amount of training.

5. Im just curious to know if the pressure is released somewhat in the eye
and the flattening of the cone is as a result of that, how would we be
assure that the new shape would remain in place.

The incisions are made in a special way so that during the recovery process they strengthen the cornea as they heal. The incisions also target the areas most affected by the disease. There is data showing numerous years of follow-up with stable results.


6. Secondly, Im very much aware that many doctors have apprehensions
differing techiniques in treating certain illness/diseases, but in this
of procedure that offeres so much apparent benefit, why is it not as
popular as other procedures that appear to be vastly mose invassive.

The results of this procedure have not been available until recently.



Regards,

Peter

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Date: Fri May 14 7:33 PM, 2010
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Hi again, I happend to see some mount everest program on discovery channel. One climber had done diamond surgery. He got some serious complication due to that (and the 8000+ heights)

Are there any other potential problems? I dont know if his problems was due to not waiting long enough after the surgery or not.

Have you managed to see any more data about results?

Br Henrik.F



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Date: Sat May 15 3:40 AM, 2010
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Hi Henrik,

The climber you mentioned is Beck Weathers. He survived the 1996 Everest disaster. From what I understand he had radial keratotomy surgery in America approximately one week before flying to Kathmandu for the Everest expedition. He did not inform his doctor about his plans.

There are major differences between Dr. Artsybashev's technique and the RK surgeries that were performed in America. The first video demonstrates the type of surgery that Beck Weathers underwent. I recommend starting at 5:30 in order to see the two perforations at 5:47 and 7:50. The surgeon mentions that the first one was a microperforation. However, this was clearly a macroperforation and a serious complication. Those areas of the cornea remain structurally weaker.

In the second video you can watch Dr. Artsybashev's technique. The surgery is quick, delicate, and without perforations. There is much less trauma on the cornea. With proper care during the recovery period a strong adhesion is formed that allows for stable results.

Video 1: The American Technique



Video 2: The  Artsybashev Technique




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Date: Sat May 15 7:26 PM, 2010
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Thanks really informative, I am getting more and more interested in this method it seems to be easy and straightforward ( for the patient atleast ), with even less recovery period than CXL and from what i seen some real good refractive results.

I got one more question, has radial keratotomy been done on a CXL eyed? Is there any drawback with having it CXLed atfirst? (one of my eyes is CXLed)

Crazy going to extreme altitude one week after such operation, i didnt even go to gym for a week or two after CXL.

Do they calibrate the "cuttingtool" to not cut deeper than desired in the first video? Is Dr Artsybashev doing the same to ensure not cutting through the thin KC cornea?

Cant wait to get more data from Dr Artsybashevs results. I am currently not 100% happy with my situation, as many people with KC :) Personally I feel it limits my social life a little bit, even though i am lucky with one mild/moderate eye left. So it would be worth alot to improve it.

Are you yourself interested in starting this procedure or you are not aiming to be an operating eye doctor? (from what i know at the hospital here only a few do operations, maybe wrong impression :))

Thanks for all information.

/Henrik







-- Edited by Zenke on Saturday 15th of May 2010 06:31:52 PM

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Date: Sun May 16 4:46 PM, 2010
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It is not a problem to operate after CXL. Unlike Intacs, CXL does not increase the difficulty of the operation.

Compared with the first video, Dr. Artsybashev uses a different technique with specialized calibrations and calculations to avoid perforations.

The first step for me is to become an ophthalmologist. I am now in the final year of medical school. To learn this procedure would take years of training, but if I am fortunate enough to earn a spot in ophthalmology it is something I would consider.

Regards,

Peter

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Date: Fri Oct 22 5:22 AM, 2010
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very interesting

Thank you for your informative posts drgoren

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Date: Fri Jan 21 6:08 AM, 2011
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These are the 3D topographic maps from before the operation (left) compared to the 4 month control visit (right).

Keratoconus Stage II - 4-Month Control Visit

Uncorrected visual acuity at 4 month control:

 

OD

OS

4 Month Post-op:

0.7-0.8

0.9-1.0



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