By Christopher J. Rapuano MD
This up to date quantity covers a couple of themes, from the technological know-how of refractive surgical procedure to accommodative and nonaccommodative therapy of presbyopia, from sufferer evaluate to foreign views. It examines particular tactics in refractive surgical procedure, in addition to refractive surgical procedure in ocular and systemic illness. significant revision 2011-2012.
Read or Download 2011-2012 Basic and Clinical Science Course, Section 13: Refractive Surgery (Basic & Clinical Science Course) PDF
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Additional info for 2011-2012 Basic and Clinical Science Course, Section 13: Refractive Surgery (Basic & Clinical Science Course)
The accu racy of the pachymetry measurements of scannin g-s lit systems decreases markedly after keratorefractive surgery is performed. Because the thi nnest part of the cornea is typically located centrally, a central measurement should always be performed. Unusually thin corneas may reveal early keratoconus. Some surgeons also check the mid peripheral corneal th ickness for inferi or thinning, which may also suggest early keratoconus. Unusually thick corneas may suggest mild Fuchs dystrophy. The thickness of the corn ea is an important facto r in determining whether the patient is a cand idate for refrac ti ve surgery and which procedure may be best.
An immunocompromised state-for example from cancer or HIV/ AIDS-may increase the risk of infection after refractive surgery (see Chapter 10). Medications that affect healing or the ability to fight infection, such as systemic corticosteroids or chemotherapeutic agents, should be speCifically noted. The use of corticosteroids and some diseases, such as diabetes, increase the risk of cataract development, which could compromise the long-term postoperative visual outcome. Certain medications- for example, isotretinoin (eg, Sotret, Claravis) and amiodarone (eg, Cordarone, Pacerone)-have been traditionally thought to increase the risk of poor results with photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) due to a potentially increased risk of poor corneal healing; however, there is no evidence for this in the peer-reviewed literature.
Illus tration by Cyndie C. H. ) Figure 1-20 CHAPTER 1: The Science of Refractive Surgery. 25 and requi re a small number of pulses to ablate the cornea. Scanning-slit lasers use excimer technology to generate a narrower slit beam that is scanned over the surface of the tissue to alter the photoablation profile, thus improving the smoothness of the ablated cornea and allowing for larger-diameter ablation zones. 0 mm) that are scanned at a higher repetition rate; they require a tracking mechanism for precise placement of the des ired pattern of ablation.
2011-2012 Basic and Clinical Science Course, Section 13: Refractive Surgery (Basic & Clinical Science Course) by Christopher J. Rapuano MD