Acta Scientific Ophthalmology (ISSN: 2582-3191)

Research Article Volume 4 Issue 11

Management of Post-operative LASIK Patients Before and After COVID-19: New Treatment Protocols

Karl Stonecipher1*, Ben Likins4, Maya Goyal3, Monica Soni1 and Madison Thurmond2

1Department of Clinical Associate Professor of Ophthalmology, University of North Carolina, USA
2Department of Biology, University of North Carolina at Wilmington, USA
3Georgetown University, USA
4Medical University of South Carolina, USA

*Corresponding Author: Karl Stonecipher, Department of Clinical Associate Professor of Ophthalmology, University of North Carolina, USA.

Received: October 04, 2021 ; Published: October 23, 2021

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Abstract

Importance: To discuss a new post-operative (post-op) protocol for patients undergoing laser-assisted in situ keratomileusis (LASIK) seen during the COVID-19 pandemic.

Background: With advances in analytic software for topography-guided LASIK, better visual outcomes and lower rates of post-op complication and the need for enhancement surgery have allowed for safe yet effective ways to manage patients before, during, and after surgery. However, with the present state of practicing in a pandemic the authors propose a new practice pattern to promote efficiency, maintain outcomes, and potentially reduce ophthalmic complications while keeping our patients safe.

Design: A insignificant risk retrospective review of topography-guided LASIK using two separate protocols. The authors used one prior to the pandemic and another during the pandemic with new patient safety guidelines. Comparison of outcomes will be discussed.

Participants: A total of 1,026 eyes from 513 patients were treated with LASIK prior to the pandemic and during the time of COVID-19 were included in the patient population.

Methods: Management of patients with current post- op protocol including in-patient visits at preoperative, one day, one week, one month, three months and twelve months compared with a new protocol including in-patient visits at preoperative, post op one day, three months and twelve months but telehealth visits with subjective questionnaire at one week and one month were utilized during the pandemic as well as patient isolation from other patients were also instituted preoperatively and postoperatively during the pandemic.

Main Outcome Measures: Results included uncorrected visual acuity (UCVA) outcomes for patients in each group as well as total enhancement rates.

Results: No significant differences were seen between UCVA outcomes between groups. The rate of enhancement was also insignificant. Postoperative day 1 UCVA 20/20 or better in individual eyes (OD/OS) was 97% vs 99% in Pre-COVID-19 vs Post-COVID-19 respectively. Postoperative day 1 UCVA 20/15 or better in both eyes (OU) was 81% vs 84%. The enhancement rate at one year in each group was identical at 0.29%.

Conclusion: The application of advanced analytic computer software engine allows for better planning of LASIK and provides an opportunity for a more efficient and safe protocol for management of patients. Reduction in overall diagnostics and the use of telemedicine also provided benefits to patients and similar outcomes, as compared to prior to the pandemic. No patients during the treatment period developed COVID-19 to our knowledge.

Keywords: Laser-assisted In Situ Keratomileusis (LASIK); COVID-19; Telehealth; Telemedicine; Post-operative (post-op) Management; Uncorrected Visual Acuity (UCVA)

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References

  1. Stewart Conor. Number of LASIK Surgeries in the United STATES 2020. Statista (2016).
  2. Stulting RD., et al. “Results of topography-guided laser in situ keratomileusis custom ablation treatment with a refractive excimer laser”. Journal of Cataract and Refractive Surgery1 (2016): 11-18.
  3. Mathew J and Stonecipher K. “Wavefront Optimized versus topography guided corneal ablations with the Wavelight® platform: A summary of visual outcomes”. White Paper. 2020 Alcon Inc. 06/20 US-ALL-2000003.
  4. Awwad ST and McCulley JP. “Wavefront-guided LASIK: recent developments and results”. International Ophthalmology Clinic 3 (2006): 27-38.
  5. Stonecipher K., et al. “Comparing wavefront-optimized, wavefront-guided and topography-guided laser vision correction: clinical outcomes using an objective decision tree”. Current Opinion on Ophthalmology4 (2018): 277-285.
  6. Stulting RD., et al. “Topography-Guided Refractive Astigmatism Outcomes: Predictions Comparing Three Different Programming Methods”. Clinical Ophthalmology 14 (2020): 1091-1100.
  7. Lobanoff M., et al. “Clinical outcomes after topography-guided LASIK: comparing results based on a new topography analysis algorithm with those based on manifest refraction”. Journal of Cataract and Refractive Surgery6 (2020): 814-819.
  8. Stonecipher MK and Stonecipher KG. “Influences on enhancement rates in laser vision correction”. US Ophthalmic Review 9.2 (2016): 107-109.
  9. Carr F., et al. “Restarting cataract surgery during the COVID-19 pandemic; a prospective study analyzing 30-day outcomes after elective cataract surgery in the United Kingdom”. BMC Ophthalmology1 (2021): 167.
  10. Lin PF., et al. “Cataract service redesign in the post-COVID-19 era”. British Journal of Ophthalmology6 (2021): 745-750.
  11. Bhalla JS., et al. “Immediate sequential bilateral cataract surgery and its relevance in COVID-19 era”. Indian Journal of Ophthalmology 6 (2021): 1587-1591.
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Citation

Citation: Karl Stonecipher., et al. “Management of Post-operative LASIK Patients Before and After COVID-19: New Treatment Protocols".Acta Scientific Ophthalmology 4.11 (2021): 47-52.




Metrics

Acceptance rate35%
Acceptance to publication20-30 days
ISI- IF1.042
JCR- IF0.24

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