AMBIO disc use in PRK and PRK+CXL combination for keratoconus and ectasia A. John Kanellopoulos, MD Director, Laservision.gr Institute, Athens, Greece Clinical Professor NYU Medical School, NY Disclosures: Alcon, Avedro Kanellopoulos MD 1 The Athens Protocol: Bilateral LASIK ectasia treated with topoPRK+CXL: OD OS The Athens Protocol 7-years Topo-guided partial PRK 1-Topolyzer:Placido disc topography 2-Pentacam (Oculyzer) 3-Pentacam HD (oculyzer II)-Refractive suite 4-Vario (placido disc +pupil sensor+iris recognition+limbal landmarks recognition) WaveLight® FS200 Femtosecond Laser WaveLight® EX500 Excimer Laser WaveLight® Refractive Suite The Athens Protocol 4 steps: same day PTK > topoPRK > MMC > CXL (10mW/cm2 x 10 min) 4-: CXL 1- PTK 6 2- topo -guided PRK 3- 30” MMC The Athens Protocol, in short video: Short and long term complications of combined topography guided PRK and CXL (the Athens Protocol) in 412 keratoconus eyes (2-7 years follow-up) Anastasios John Kanellopoulos, MD Director, Laservision.gr Institute, Athens, Greece Clinical Professor NYU Medical School, NY Financial Interests: Alcon. Wavelight Delayed epi-closure: day 5 Active epithelial surface after reepitheliazation Hyaline (Salzman’s-like), supre-epi scar 12 similar 13 2 months after AP Late stromal scar Ambiodisc use 16 Late stromal scar-resolving AP15mos 3 months later (lotemax, Autologous) 2 weeks out-delayed epitheliazation 2 weeks later (1 month postop) Early haze (2 months-gone after 6 months) Delayed epithelial healing Delayed epithelial healing with haze OD simple AP, OS after K scar from CL 2 weeks-delayed healing with heaped-up white margins 2 months-PRK scar 2 months-PRK anterior stromal scar 2 weeks-elevated epi scar Severe scar of the cornea BCVA 20/200, Lamellar or PK? Kanellopoulos,MD 29 Kanellopoulos,MD 30 From 20/200 to 20/40! Kanellopoulos,MD 31 Conclusions-AMT+Athens Protocol • • • • • • Effective means for recovery of ocular surface Reduced re-epi time Reduced haze/scarring Reduced PAIN! Increased cost Must be implanted upside down Thank you Join us at the CXL AAO spotlight session Sunday Nov 11th at 14:00-15:30 Grand Ballroom S100A/BB