Objectives: L'objectif de ce travail récapitulatif est de s'opposer vigoureusement à la disparition du microkératome pour la pratique des lasiks et de défendre la formation au cours de l'internat de l'utilisation de celui-ci.

Introduction: En france à ce jour, seules quelques centres hospitalo-universitaires peuvent se vanter de former de jeunes ophtalmologistes à la pratique de la chirurgie réfractive. Sans prendre trop de risque, je pense pouvoir affirmer qu'aucun de ces jeunes ophtalmologistes n'a été formé à la pratique du microkératome ce qui a terme, générera la disparition de sa pratique, qui peut pourtant dans certains cas particuliers se révéler supérieure à celle d'un laser femtoseconde...

Materials / method: Nous avons recensé la quasi totalité des travaux publiés depuis de nombreuses années comparant l'utilisation du microkératome et celle du laser femtoseconde. L'ensemble de ces résultats a ensuite été comparé à une pratique personnelle mixte microkératome/ laser femtoseconde.

Results: En terme de résultats fonctionnels et de complications, aucune différence significative n'a pu être dégagée entre les deux techniques. On note néanmoins plus de kératite lamellaire diffuse avec les femtosecondes de première génération et d'invasion épithéliale avec les microkératomes. La reproductibilité de la profondeur des découpes n'est plus significative entre la femtoseconde et les microkératomes de dernière génération. Dans notre expérience, le microkératome présente des avantages non négligeables en cas d'enophtalmie, de taie cornéenne, de forte hypermétropie, et de patients stressés...

Conclusion: Si le laser femtoseconde est une machine extraordinaire permettant d'assister le chirurgien dans de nombreuses chirurgies cornéennes, nous regrettons qu'il ait totalement supplanté le microkératome dans la pratique des lasiks sans aucun argument scientifique solide ou valable.....

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Objectives: FOR PRK WITHOUT PAIN , RAPID RECOVERY AND EXCELLENT CORNEAL CICATRISATION
Modern PRK with use of mitomycin 0.02 % , bandage lens soaked with diclofenac 0.3 mg/0.3 ml , immediate topical use of dexamethasone 1mg/ ml during 5 days and non steroids anti-inflammatory per 3 days , punctal plugs, abundant use of hyaluronic acid and night ointment , very smooth photo ablation excimer laser profiles with very proprietary new algorithms from Nidek Quest M2, epithelium off without alcohol use, is the key success for very good results , without pain, rapid recovery of visual acuity and good quality of vision with very low HOA and very safely without flap linked complications and ectasic disorders.
Moreover PRK can be a very good option for patient with thin corneas up to 470 microns and irregular astigmatism and those who practice dangerous sports.

Introduction: Modern PRK should be considered the best and safest option for modern refractive surgery for myopic , astigmatism , hyperopic and presbyopic patients when they are eligible

Materials / method: Very large population of myopic, astigmatism , hyperopic and presbyopic patient
Age from 23 Y old up to 58 Y old
Nidek excimer laser Quest M2
2 years follow up with clinical results , Oct and Opscan 3 évaluations

Results: Modern PRK is considered now in 2019 by patients as a painless procedure, very safe, stressless with quick vision recovery

Conclusion: Modern PRK is under employed and should be reconsidered as a procedure of choice for refractive surgeons

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability