2011-2012 Basic and Clinical Science Course, Section 13: by Christopher J. Rapuano MD

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 evaluate to foreign views. It examines particular techniques in refractive surgical procedure, in addition to refractive surgical procedure in ocular and systemic illness. significant revision 2011-2012.

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Extra resources for 2011-2012 Basic and Clinical Science Course, Section 13: Refractive Surgery (Basic & Clinical Science Course)

Example text

Corneal haze is localized in the subepithelial anterior stroma and may last for several years after surface ablation. Clin ically Significant haze, however, is present only in a small percentage of eyes. The tendency toward haze format ion is greater with deeper ablations, surface irregularity, and prolonged absence of the epitheli um. Despite loss of the Bowman layer, normal or even enhanced numbers of hem idesmosomes and anchoring fibrils form to secure the epitheliu m to the stroma. Controversy persists over the value of different agents for modulati ng wound healing in surface ablation.

Ocular Motility. Confrontation Fields. and Ocular Anatomy Ocular motility should also be evaluated. Patients with an asymptomatic tropia or phoria may develop symptoms after refractive surgery if the change in refraction causes the motility status to break down. If there is a history of strabismus (see Chapte r 10) or a concern regard ing ocular alignment postoperatively, a trial with contact lenses before surgery CHAPTER 2: Patient Evaluation. 35 should be considered. A sensory motor evaluation can be obtained preoperatively if strabismus is an issue.

Rabinowitz YS, Yang H, Brickman Y, et al. Videokeratography database of normal human corneas. 1996;80(n61O-616. Difference -"- OJ! ;' " '. '""";; . -::,,/,.. 00 Cylp"". R . 3mm M_ 2l3' 00 Figure 1-13 Diffe rence maps demonstrating corneal power change before and after (A) myopic and (B) hype ropic LAS IK. 00 A~~ Figure 1-14 ________________ ~ A, Small optical zone after excimer laser ablation; 8, decentered ablation. (Courtes y of J. ) Clinical Situations Illustrating the Role of Corneal Topography in Refractive Surgery Corneal ectatic disorders (keratoconus and pellucid marginal degeneration) Keratoconus (KC) and pellucid marginal degeneration (PMD) are generally progressive conditions in which thinning occurs in the central, paracentral, or peripheral cornea, resulting in asymmetric corneal steepening and reduced spectacle-corrected visual acuity.

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2011-2012 Basic and Clinical Science Course, Section 13: by Christopher J. Rapuano MD
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