By Christopher J. Rapuano MD
This up to date quantity covers a few issues, from the technological know-how of refractive surgical procedure to accommodative and nonaccommodative therapy of presbyopia, from sufferer overview to overseas views. It examines particular methods in refractive surgical procedure, in addition to refractive surgical procedure in ocular and systemic ailment. significant revision 2011-2012.
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Extra info for 2011-2012 Basic and Clinical Science Course, Section 13: Refractive Surgery (Basic & Clinical Science Course)
Other risk factors for postoperative glare include higher degrees of myopia or astigmatism. As a rule, pupil size greater than the effective optical zone (usually 6-8 mm) increases the risk of glare, but large pupil size is not the only determinant of glare. When asked, patients often note that they had glare under dim-light conditions even before refractive surgery. It is important that patients become aware of their glare and halo symptoms preoperatively, as th is may minimize postoperative complaints.
Although laser manufacturers do not recommend excimer laser surgery in patients with cardiac pacemakers and implanted defibrillators, many such patients have undergone the surgery without problems. It may be best to check with the pacemaker and defibrillator manufacturer before laser surgery. Refractive surgery is also generally contraindicated in pregnant and nursing women, because of possible changes in refraction and corneal hydration status. Many surgeons recommend waiting at least 3 months after delivery and cessation of nursing before performing the refractive surgery evaluation and procedure.
5 0 Color Step8 Figure '·16 Pellucid marginal cornea l degeneration. Examples of topographi es. (Courtesy of J. ) In addition to these topographic metrics, significant displacement of the thinnest area of the cornea from the center as seen with corneal tomography is also suggestive of KC. Normal corneas are significantly thicker peripherally than centrally (by approximately 50-60 [lm), and corneas that are not thicker peripherally suggest an ectatic disorder. Some clinicians utilize posterior elevation measurements to quantitate the extent of anterior bulging of the posterior corneal surface as indicative of KC.
2011-2012 Basic and Clinical Science Course, Section 13: Refractive Surgery (Basic & Clinical Science Course) by Christopher J. Rapuano MD