By Christopher J. Rapuano MD
This up-to-date quantity covers a couple of issues, from the technological know-how of refractive surgical procedure to accommodative and nonaccommodative therapy of presbyopia, from sufferer overview to foreign views. It examines particular tactics in refractive surgical procedure, in addition to refractive surgical procedure in ocular and systemic affliction. 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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Extra resources for 2011-2012 Basic and Clinical Science Course, Section 13: Refractive Surgery (Basic & Clinical Science Course)
17 on the part of the ophthalmologist and is considered a contraindication to LASIK; the safety and efficacy of surface ablation in these cases remains to be determined. Studies are under way to determine the suitability of some keratorefractive procedures in combination with corneal collagen crosslinking as alternative therapeutic modalities for these patients. Corneal topography and tomography can also be used to demonstrate the effects of keratorefractive procedures. Preoperative and postoperative maps may be compared to determine the refractive effect achieved (difference map; Fig 1-13).
The cornea should be evaluated for surface abnormalities such as decreased tear breakup time (Fig 2-1) and punctate epithelial erosions (Fig 2-2). Significant blepharitis (Fig 2-3), meibomitis, and dry-eye syndro me should be addressed before refractive surgery, as they are associated with increased postoperative discomfort and decreased vision. A careful examination for epithelial basement membrane dystrophy (Fig 2-4) is required, because its presence increases the risk of flap complications during LASIK.
Moderate crusting at the base of the lashes is found in this patient with seborrheic blepharitis. (Courtesy of Christopher J. ) B A Figure 2-4 Epithelial basement membrane dystrophy. Epithe lial map changes can be obvious (Al ar more subtle (B). Arrows show geographic map lines. (Pan A counesyof Vincent P deLuise, MD; part B courtesy of Chris(Opher J. ) a record of their preoperative refractions and keratometry measurements along with the amount of laser ablation performed and the postoperative refraction.