SMILE A Solution to Those who go in Harm s Way

Transcription

1 SMILE A Solution to Those who go in Harm s Way Steven Schallhorn, M.D. Chief Medical Officer November 12, 2016

2 Operational Basis for Involvement Commander of Naval Special Warfare identified deficiencies of glasses and contact lenses to correct the vision of special forces Tasking for analysis of PRK

3 US Military Refractive Surgery Centers Joint Army Navy Air Force

4 Cummulative Military Refractive Surgery Procedures 600, , ,000 Total: 553,537procedures 553, , , , , , , , , , , , , ,799 60,151 31,386 14,306 4,

5 Contribution to the Community: Peer Review Publications 1. Franklin QJ, Tanzer DJ. Late traumatic flap displacement after laser in situ keratomileuisis. Mil Med Apr;169(4): Schallhorn SC, Kaupp SE, Tanzer DJ, Tidwell J, Laurent J, Bourque LB. Pupil size and quality of vision after LASIK. Ophthalmology Aug;110(8): Amesbury EC, Schallhorn SC. Contrast sensitivity and limits of vision. Int Ophthalmol Clin Spring;43(2): Grimson JM, Schallhorn SC, Kaupp SE. Contrast sensitivity: establishing normative data for use in screening prospective naval pilots. Aviat Space Environ Med Jan;73(1): Kasetsuwan N, Pangilinan RT, Moreira LL, DiMartino DS, Shah SS, Schallhorn SC, McDonnell PJ. Real time intraocular pressure and lamellar corneal flap thickness in keratomileusis. Cornea Jan;20(1): Tanzer DJ, Schallhorn SC, Brown MC. Ejection from an aircraft following photorefractive keratectomy: a case report. Aviat Space Environ Med Oct;71(10): Rao SN, Fong Y, Kampmeier J, LaBree LD, Tanzer DJ, McDonnell PJ. The effectiveness of a topical antibiotic irrigating solution in a model of staphylococcal keratitis after lamellar keratectomy. Am J Ophthalmol Jul;130(1): Lattimore MR Jr, Schallhorn SS, Lewis RB 4th, Kaupp S. Bandage soft contact lens barrier function: a clinical research note. Cont Lens Anterior Eye. 2000;23(4): Lattimore MR Jr, Kaupp S, Schallhorn S, Lewis R 4th. Orbscan pachymetry: implications of a repeated measures and diurnal variation analysis. Ophthalmology May;106(5): Choplin NT, Schallhorn SC. The effect of excimer laser photorefractive keratectomy for myopia on nerve fiber layer thickness measurements as determined by scanning laser polarimetry. Ophthalmology May;106(5): Kampmeier J, Tanzer DJ, Er H, Schallhorn SC, LaBree L, McDonnell PJ. Significance of corneal topography in predicting patient complaints after photorefractive keratectomy. J Cataract Refract Surg Apr;25(4): Tanzer DJ, Smith RE. Superficial punctate keratitis of thygeson: the longest course on record? Cornea Nov;18(6): Tanzer DJ, Smith RE. Black iris-diaphragm intraocular lens for aniridia and aphakia. J Cataract Refract Surg Nov;25(11): Fuerst DJ, Tanzer DJ, Smith RE. Rheumatoid diseases. Int Ophthalmol Clin Fall;38(4): Tanzer DJ, Isfahani A, Schallhorn SC, LaBree LD, McDonnell PJ. Photorefractive keratectomy in African Americans including those with known dermatologic keloid formation. Am J Ophthalmol Nov;126(5): Blanton CL, Schallhorn SC, Tidwell JL. Radial keratotomy learning curve using the American technique. J Cataract Refract Surg Apr;24(4): Schallhorn SC, Reid JL, Kaupp SE, Blanton CL, Zoback L, Goforth H Jr, Flowers CW, McDonnell PJ. Topographic detection of photorefractive keratectomy. Ophthalmology Mar;105(3): Tanzer DJ, McClatchey SK. Spontaneous hyphema secondary to a prominent pupillary membrane in a neonate. J Pediatr Ophthalmol Strabismus Sep- Oct;34(5): Mader TH, Blanton CL, Gilbert BN, Kubis KC, Schallhorn SC, White LJ, Parmley VC, Ng JD. Refractive changes during 72-hour exposure to high altitude after refractive surgery. Ophthalmology Aug;103(8): Schallhorn SC, Blanton CL, Kaupp SE, Sutphin J, Gordon M, Goforth H Jr, Butler FK Jr. Preliminary results of photorefractive keratectomy in active-duty United States Navy personnel. Ophthalmology Jan;103(1): Schallhorn S. Photorefractive surgery in the Navy. Navy Med Jan-Feb;85(1): Varley GA, Huang D, Rapuano CJ, Schallhorn S, Boxer Wachler BS, Sugar A; Ophthalmic Technology Assessment Committee Refractive Surgery Panel, Ameican Academy of Ophthalmology. LASIK for hyperopia, hyperopic astigmatism, and mixed astigmatism: a report by the American Academy of Ophthalmology. Ophthalmology Aug;111(8): Hessert D, Tanzer D, Brunstetter T, Kaupp S, Murdoch D, Mirzaoff M. Topical Cyclosporine A for Postoperative Photorefractive Keratectomy and Laser in situ Keratomileusis. J Cataract Refractive Surg. 2013; 39:

6 US Military studies have profoundly changed vision standards throught the world

7 US Navy Procedure Type 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% % LASIK % PRK

8 Traumatic Flap Dislocation

9 Which Corneal Laser Refractive Procedure? PRK LASIK SMILE

10 Strength of the Cornea The anterior corneal stroma has the highest cohesive tensile strength. (direct measurement) Randleman JB et al. JRS 2008;24:S85-S89 The anterior corneal stroma has the highest elastic modulus. (Brilloiun microscopy) Scarcelli G et al. IOVS 2012;53:

11 Location of Lenticule Removal Reinstein D. JRS 2013;29(7):

12 Conclusions Refractive Surgery can greatly benefit people that go into harm s way SMILE addresses some of the key concerns of LVC

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