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Sam Melki's Articles in Health & Fitness

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  • Flattening the Recalcitrant LASIK Flap Fold & Epithelial Ingrowth after Lasik
    Lasik flap folds can induce irregular astigmatism with optical aberrations and loss of BCVA especially if they involve the visual axis. 'Macrofolds' are easily seen by slitlamp exam and represent full thickness flap tenting in a linear fashion. On the other hand, 'microfolds' within the flap itself may represent wrinkles in Bowman's layer or in the epithelial basement membrane.
  • Lasik Flap Dilemmas
    Obtaining adequate suction to certain globes is occasionally an elusive target. This includes small hyperopic eyes, flat or small diameter corneas, narrow palpebral fissures… If the level of myopia permits, one has to remember that PRK is always an available option and patients must be made aware of this alternative and be consented for it prior to the procedure.
  • Managing Lasik Flap Buttonholes
    Thin, irregular and perforated flaps seem to result from a common etiology; an inadequate coupling of the blade to the cornea. Steep corneas have been compared to tennis balls that would buckle centrally upon applanating pressure.
  • Managing Lasik Keratome Complications
    Application of adequate suction is essential for intraocular pressure upsurge and dissection of good quality corneal flaps. On occasion, the suction ring slides prior to the buildup of adequate vacuum and the flap is decentered from the pupillary axis.

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