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 assessment to foreign views. It examines particular techniques in refractive surgical procedure, in addition to refractive surgical procedure in ocular and systemic ailment. significant revision 2011-2012.
Read Online 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)
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. Broad -beam lasers and some scanning-slit lasers require a mechanical iris diaphragm or ablatable mask to create the desired shape in the cornea, while the rest of the scanning-slit lasers and the flying spot lase rs use a pattern projected onto the surface to guide the ablation profile without masking.
For patients who wear RG P lenses and find glasses a significant hardship, some surgeons suggest changing to soft lenses for a period to aid stabilization and regularization of the corneal curvature. Patient Age, Presbyopia, and Monovision The age of a patient is ve ry important in predicting postoperative patient satisfaction. The loss of near vision with aging should be discussed with all patients. Before age 40, emmetropic individuals generally do not require reading adds to see a near target.
In a study of 896 eyes undergoing LASIK, the mean central corneal thickness was 550 ~m ± 33 ~m , with a range of 472 ~m to 65 1 ~m. It is possible that an unusually thin cornea (beyond perh aps 2 standard deviations) suggests inherent instability that would not be ideal for any refractive surgery. Consequently, even if there is adequate stromal tissue for an excimer ablation, most refract ive surgeons will not consider LAS IK belm\! a 40 • Refractive Surgery certain lower limit of corneal thickness.