Laser Eye Surgery and Boxing

Dave Allamby — Sun, 26 Sep 2010 21:52:14 +0000

Winston asked:

I am 19 , with -6.25 in the left eye and -7.25 in right. I have been wearing glasses for about 9 to 10 ten years.
What would you recommend? I do boxing as well as other physical activity.

Is your prescription for your glasses now stable? Has it changed since last year? If not, you may well be suitable. In view of your boxing, you should consider having PRK (LASEK) instead of LASIK, to avoid risks from direct trauma to the LASIK flap, during sparring or matches. Although modern thin flaps created with femtosecond lasers do heal down well, this can take a year or so. Normal rubbing of course cannot move a flap, but a hard physical blow in the first months potentially could.

In view of your high prescription, we would use a drug called mitomycin at the time of PRK surgery to ensure a stable vision result for you. Mitomycin (MMC) will prevent haze scarring and weakening of your vision following treatment.

Keratomes & Femotsecond Lasers; Mitomycin

Dave Allamby — Thu, 01 Jul 2010 12:37:37 +0000

Amar asked:

You mentioned using mytomycin C for LASEK procedures. Is this generally a safe drug to use on ones corneas? In your opinion, what does a femtosecond laser offer over a microkeratome procedure. Can it be said if one is better than the other? Also, in higher prescriptions, given all other parameters are met including corneal thickness, which flap creation technique would be more advisable. Can both options create buttonholes?
Thank you so much for your help, Amar

Thanks Amar. MMC (mitomycin) appears to be safe. In 2000, Majdamur and colleagues were the first to describe MMC effects on post-PRK and postradial keratotomy subepithelial fibrosis (haze formation). We have not seen significant complications with its use over the past decade and I do use it on eyes where there is greater risk of haze.
I have written plenty on femtosecond lasers and blade keratomes, and you can see those posts under the lasik and safety categories. Both can create buttonholes, but the great advantage of the femotsecond laser is that you can identify the hole without lifting the flap and so get a complication-free healing, which isn’t always the same with a blade cut. In that case, the flap is already lifted by the keratome and there are risks of scarring at the edge of the hole and possible epithelial ingrowth.
Go for the femtosecond flap if you have the option.

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Laser Eye Surgery and Boxing

Keratomes & Femotsecond Lasers; Mitomycin