Page 74 - The Book Pi in eye

Rajesh Khanna, MD

Yag Procedure

The lens is implanted in the bag in which the natural human lens
existed. This bag still has living cells, which replicate and drift behind
the lens in the line of sight. These cells and the wrinkles in the bag
prevent clear vision. After at least 12 weeks have passed, a non-
contact painless laser beam (different than the one used in Lasik) can
blast an opening in this capsule. The 12 week wait allows the lens to
form a bond and become attached to the eye. Increasing the duration
between lens implant and YAG increases the safety.

Correcting Astigmatism

This can be achieved at the time of the Prelex procedure by placing
an incision on the sleep axis or performing Limbal Relaxing Incisions
(or LRI). AK incisions are not used as they are unstable. LRI can
also be performed in the office after the procedure.
Even laser vision correction in the form of Lasik (for the younger
with less dry eye) or Lasek / Super Lasik can be deployed to correct
astigmatism.

Correcting Refractory Error

Presbyopic implants require great optics for optimum functioning
as we have seen astigmatism can affect it, so can residual
nearsightedness or far sightedness. These need to be fixed before
Neuroadaptation can begin. The patient and the doctor may have to
wait for the fluctuations in vision to settle down. YAG may change
the final position of the lens, effectively changing the refractory
power.
Hence, Lasik or Lasek to correct refractory error is best performed
a few weeks after Yag. Once both eyes have undergone the above
procedures neuroadaptation can truly begin. Therefore tunings can be
considered as an investment for lifelong improved vision.

Fighting CME

CME stands for cystoid macular edema or fluid in the back of the
macula, which is essential for seeing. This occurs in most patients as

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