Tuesday, July 31, 2007
Closing safe deposit
Public Bank send me a letter last few weeks to ask me to come and take back all my precious. They said the business model change and they no longer want to have safe deposit services in that branch. This is ridiculous. I just open the safe deposit 1 year ago and now I have to close it. I will have to find some place to put my precious. Please don't come and rob my house now :P
New 22" Monitor
I finally got myself an LCD monitor after thinking for so long. As from my previous post, I've get rid of my beautiful CRT monitor. Hopefully the substitute is beautiful as well. When I go back home today, I'll hook it up and make sure there's no dead pixel etc. Anyway, for the price, RM849 + RM65 (add 2 years warranty to become 5 years warranty), I can't be choosy. It'll be full 5 years before I think about changing my monitor again.
A brief history of the 22" monitor that I've bought:
Dell E228WFP 22" Entry Wide Screen Flat Panel
This monitor is considered as low end monitor. It uses TN panel as opposed to S-PVA/S-IPS panel used in more expensive 24" counterparts. The viewing angle will be bad. I need to look straight into monitor so that everything will be bright and clear. I was thinking of buy the 24" one but the price is RM1899. I'm not going to spend that much since I'm going to do LASEK operation to my eyes which will cost me RM5000.
The excuse I gave myself to buy LCD is less radiation and save space. :P
A brief history of the 22" monitor that I've bought:
Dell E228WFP 22" Entry Wide Screen Flat Panel
This monitor is considered as low end monitor. It uses TN panel as opposed to S-PVA/S-IPS panel used in more expensive 24" counterparts. The viewing angle will be bad. I need to look straight into monitor so that everything will be bright and clear. I was thinking of buy the 24" one but the price is RM1899. I'm not going to spend that much since I'm going to do LASEK operation to my eyes which will cost me RM5000.
The excuse I gave myself to buy LCD is less radiation and save space. :P
Tuesday, July 17, 2007
LASIK, LASEK and EPI-LASIK
I'm suddenly thinking of doing laser eye surgery. Actually I have this thought few years ago. But due to money and also a bit scared to do it, I've waited until now.
From various online document I've read, I found that EPI-LASIK is better than LASEK because EPI-LASIK does not use alcohol, while LASEK is better than LASIK or IntraLASIK because it only cut the epithalium which can grow back compared to cutting of cornea for LASIK. Of course IntraLASIK is better than LASIK because using laser to cut is more precise. But the act of cutting cornea is point of no return. Means your eyes cornea is no longer same as before. But with EPI-LASIK and LASEK, the epithalium can grow back.
Here is the research done:
New device creates alcohol-free epithelial flaps to improve healing and reduce haze
Roibeard O'hÉineacháin
in Munich
A NEW technique combining LASIK and LASEK characteristics may create a healthier epithelial flap, improve postoperative healing and reduce the risk of haze, according to its developer Ioannis Pallikaris MD.
The technique involves the mechanical separation of the epithelium from the Bowman's membrane with a specially designed epithelial separator device. Since it does not involve the use of alcohol it has no toxic effects on the epithelium, said Dr Pallikaris, who will be presenting his findings here at the XXI Congress of the ESCRS.
Dr Pallikaris and his associates carried out a study involving 10 eyes of 10 patients who underwent de-epithelialisation either through alcohol-assisted LASEK or with the new customised epithelial microkeratome.
Microscopic examination of the removed epithelial sheets showed a smooth and undisrupted basementl membrane in those created mechanically, while in those created with alcohol the basement membrane had significant disruptions, he noted.
"We found that mechanical separation of the epithelium preserved epithelium stratification and integrity with minimal trauma and oedema," Dr Pallikaris said.
In the six eyes which underwent mechanical epithelial sheet creation, the sub-epithelial separator cleaved the epithelium at the level where lamina densa of the basement membrane makes contact with the Bowman's membrane. Moreover, the lamina densa and lamina lucida of the mechanically separated epithelial sheets all had normal morphology along nearly the whole length of the basement membrane.
In contrast, in the four eyes which underwent alcohol-assisted flap creation, the cleavage plane was within the basement membrane. Furthermore, the lamina lucida layer of cells demonstrated significant interruptions, while lamina densa cells were almost entirely absent.
The concentration of alcohol used in the conventional LASEK group was 15% or 20%. The solution was left on the eye for 20 seconds, he noted. In eyes which underwent mechanical flap creation, Dr Pallikaris used a suction ring and then applied his specially customised epithelial separator to the epithelium.
"It looks like a LASIK microkeratome but it isn't. It has a dull plastic blade which doesn't cut through the cornea but only separates the epithelium from the Bowman's membrane. It is then easy to fold the flap back using a merocel sponge," he said.
Dr Pallikaris noted that LASEK was introduced a few years ago as a means of correcting refractive errors with the comfort and rapid rehabilitation of LASIK and the safety of PRK.
Early reports indicated that patients undergoing LASEK did appear to experience less pain than they would with PRK, although still slightly more than LASIK. They also had a more rapid normalisation of their epithelial tissues with less postoperative haze.
The advent of customised ablation has brought about a resurgence of interest in PRK, as refractive surgeons became aware that the creation of LASIK flaps induces aberrations in an unpredictable way.
Several reports, notably those of Marguerite MacDonald MD and from Dr Pallikaris' own centre supported the theory that customised surface ablations produced more predictable results than customised LASIK.
Subsequent studies have indicated that LASEK has several of the same advantages as PRK, and that just as with conventional non-customised ablations it achieves the advantages with less pain and less haze.
However, some centres have reported more equivocal results with some cases of delayed healing and haze. These effects are more pronounced when higher concentrations of alcohol are used, Dr Pallikaris said.
"The major problem with LASEK is related to alcohol. It has been histologically proven that alcohol has an effect on the basal epithelial membrane and generally 80% of cells in a LASEK epithelial flap will die within the first postoperative day. Furthermore, when we use alcohol we separate the membrane between the two layers of the basal membrane, the lamina densa and the lamina lucida, undermining the integrity of the separated epithelial sheet.
"With Epi-LASIK however, the basal membrane remains intact and the epithelial cells are able to generate hemidesmosomes which can serve to anchor the flap to the stroma. Furthermore, the intact double lamina can act as a shielding mechanism and prevent the activation of keratocytes. With LASEK and PRK the activation of the exposed keratocytes induces the production of disoriented collagen fibres, which is the origin of haze."
Dr Pallikaris said he and his associates have so far used the epi-LASIK technique in 30 eyes in 30 patients. All of the patients underwent PRK in their fellow eye and nearly all cases have had a follow-up of three months and some have had six months follow-up. He noted that while it is still too early in the study and the groups were too small to quantitatively compare haze outcomes, all of the epi-LASIK eyes so far appear to have almost no haze while the PRK do appear to have noticeable amounts in some cases.
As a further enhancement to the technique, Dr Pallikaris has begun using dehydrated contact lenses to lift the epithelium. After performing the laser ablation he uses the contact lens to flip the epithelial flap back in place. After a few days, when epithelial healing allows the flap to adhere to the stroma, he removes the lens. It is alternatively possible to remove the lens by rehydrating it, which automatically separates it from the flap without lifting the flap from the stroma, he said.
Ciba Vision is planning to market the new microkeratome under the name Centurion SES™. Versions will be available for both LASIK and LASEK. Dr Pallikaris said he expects CE mark and FDA approval for the device within the next month.
Ioannis Pallikaris MD
Heraklion University Hospital, Crete, Greece
From various online document I've read, I found that EPI-LASIK is better than LASEK because EPI-LASIK does not use alcohol, while LASEK is better than LASIK or IntraLASIK because it only cut the epithalium which can grow back compared to cutting of cornea for LASIK. Of course IntraLASIK is better than LASIK because using laser to cut is more precise. But the act of cutting cornea is point of no return. Means your eyes cornea is no longer same as before. But with EPI-LASIK and LASEK, the epithalium can grow back.
Here is the research done:
New device creates alcohol-free epithelial flaps to improve healing and reduce haze
Roibeard O'hÉineacháin
in Munich
A NEW technique combining LASIK and LASEK characteristics may create a healthier epithelial flap, improve postoperative healing and reduce the risk of haze, according to its developer Ioannis Pallikaris MD.
The technique involves the mechanical separation of the epithelium from the Bowman's membrane with a specially designed epithelial separator device. Since it does not involve the use of alcohol it has no toxic effects on the epithelium, said Dr Pallikaris, who will be presenting his findings here at the XXI Congress of the ESCRS.
Dr Pallikaris and his associates carried out a study involving 10 eyes of 10 patients who underwent de-epithelialisation either through alcohol-assisted LASEK or with the new customised epithelial microkeratome.
Microscopic examination of the removed epithelial sheets showed a smooth and undisrupted basementl membrane in those created mechanically, while in those created with alcohol the basement membrane had significant disruptions, he noted.
"We found that mechanical separation of the epithelium preserved epithelium stratification and integrity with minimal trauma and oedema," Dr Pallikaris said.
In the six eyes which underwent mechanical epithelial sheet creation, the sub-epithelial separator cleaved the epithelium at the level where lamina densa of the basement membrane makes contact with the Bowman's membrane. Moreover, the lamina densa and lamina lucida of the mechanically separated epithelial sheets all had normal morphology along nearly the whole length of the basement membrane.
In contrast, in the four eyes which underwent alcohol-assisted flap creation, the cleavage plane was within the basement membrane. Furthermore, the lamina lucida layer of cells demonstrated significant interruptions, while lamina densa cells were almost entirely absent.
The concentration of alcohol used in the conventional LASEK group was 15% or 20%. The solution was left on the eye for 20 seconds, he noted. In eyes which underwent mechanical flap creation, Dr Pallikaris used a suction ring and then applied his specially customised epithelial separator to the epithelium.
"It looks like a LASIK microkeratome but it isn't. It has a dull plastic blade which doesn't cut through the cornea but only separates the epithelium from the Bowman's membrane. It is then easy to fold the flap back using a merocel sponge," he said.
Dr Pallikaris noted that LASEK was introduced a few years ago as a means of correcting refractive errors with the comfort and rapid rehabilitation of LASIK and the safety of PRK.
Early reports indicated that patients undergoing LASEK did appear to experience less pain than they would with PRK, although still slightly more than LASIK. They also had a more rapid normalisation of their epithelial tissues with less postoperative haze.
The advent of customised ablation has brought about a resurgence of interest in PRK, as refractive surgeons became aware that the creation of LASIK flaps induces aberrations in an unpredictable way.
Several reports, notably those of Marguerite MacDonald MD and from Dr Pallikaris' own centre supported the theory that customised surface ablations produced more predictable results than customised LASIK.
Subsequent studies have indicated that LASEK has several of the same advantages as PRK, and that just as with conventional non-customised ablations it achieves the advantages with less pain and less haze.
However, some centres have reported more equivocal results with some cases of delayed healing and haze. These effects are more pronounced when higher concentrations of alcohol are used, Dr Pallikaris said.
"The major problem with LASEK is related to alcohol. It has been histologically proven that alcohol has an effect on the basal epithelial membrane and generally 80% of cells in a LASEK epithelial flap will die within the first postoperative day. Furthermore, when we use alcohol we separate the membrane between the two layers of the basal membrane, the lamina densa and the lamina lucida, undermining the integrity of the separated epithelial sheet.
"With Epi-LASIK however, the basal membrane remains intact and the epithelial cells are able to generate hemidesmosomes which can serve to anchor the flap to the stroma. Furthermore, the intact double lamina can act as a shielding mechanism and prevent the activation of keratocytes. With LASEK and PRK the activation of the exposed keratocytes induces the production of disoriented collagen fibres, which is the origin of haze."
Dr Pallikaris said he and his associates have so far used the epi-LASIK technique in 30 eyes in 30 patients. All of the patients underwent PRK in their fellow eye and nearly all cases have had a follow-up of three months and some have had six months follow-up. He noted that while it is still too early in the study and the groups were too small to quantitatively compare haze outcomes, all of the epi-LASIK eyes so far appear to have almost no haze while the PRK do appear to have noticeable amounts in some cases.
As a further enhancement to the technique, Dr Pallikaris has begun using dehydrated contact lenses to lift the epithelium. After performing the laser ablation he uses the contact lens to flip the epithelial flap back in place. After a few days, when epithelial healing allows the flap to adhere to the stroma, he removes the lens. It is alternatively possible to remove the lens by rehydrating it, which automatically separates it from the flap without lifting the flap from the stroma, he said.
Ciba Vision is planning to market the new microkeratome under the name Centurion SES™. Versions will be available for both LASIK and LASEK. Dr Pallikaris said he expects CE mark and FDA approval for the device within the next month.
Ioannis Pallikaris MD
Heraklion University Hospital, Crete, Greece
Monday, July 9, 2007
Monitor and ex-gf
There's a sad thing happened last Friday. I was surfing forum.lowyat.net and stumbled upon a forumer who wants to buy a 17" monitor in Penang. I thought, I might want to get a LCD. So might as well sell my monitor now. I was hesitating all the time up until now. The price I quote is RM120. That's very low compare to the price I pay (rm4xx or rm6xx). So on Friday, I rush home and take off the screen filter. I don't sell it together with the filter. And the shiny and reflective screen caught my eyes. My heart skipped a bit. Why do I want to sell my lovely monitor? This monitor has accompany me for few years. That time I was still with my ex-gf. This might still store some memory for her. It stay in her house for sometimes when I went to US for business trip. My heart just sank. But I can't turn back on my decision. Reluctantly, I force myself to hold and lug it to the guard house and pass it to the buyer. It was a long and heavy journey. I say to myself. This monitor is so heavy. To think of it now. Maybe its heavy because it doesn't want to be sold off. :( I feel like crying now. But in Chinese saying, rice already become porridge. As with my relationship with my ex-gf. I can't turn back time. I just wish her and the monitor to have a better life. I will be without monitor for a while to punish myself for what I've done.
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