By Christopher J. Rapuano MD
This up to date quantity covers a couple of subject matters, from the technological know-how of refractive surgical procedure to accommodative and nonaccommodative remedy of presbyopia, from sufferer overview to overseas views. It examines particular strategies in refractive surgical procedure, in addition to refractive surgical procedure in ocular and systemic disorder. 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)
Another is to have a patient make an "okay sign" with one hand and look at the exam iner through the opening. Examination Uncorrected Visual Acuity and Manifest and Cycloplegic Refraction Acuity The refractive elements of the preoperative examination are critically important because they directly determine the amount of surgery that is performed. UCVA at distance and near should be measured. The current glasses prescription and vision wi th those glasses should also be measured, and a manifest refraction should be performed.
Flaps range in thickness from ultra-thin (80-100 ~m) to standard (130- 180 ~m) flaps. The thickness and diameter of the LASIK flap depend on instrumentation, corneal diameter, corneal curvature, and corneal thickness. Myopic treatments remove central corneal tissue, whereas hyperopic treatments steepen the cornea by removing a doughnut-shaped portion of midperipheral tissue. Multizone keratectomies use several concentr ic optical zones to generate the total refraction required. Th is method can provide the full correction centrally, while the tapering peripheral zones redu ce symptoms and allow higher degrees of myopia to be treated.
Confrontation fields should be considered, if clinically indicated. The general anatomy of the orbits should also be assessed. Patients with small palpebral fissures and/or large brows may not be ideal candidates for LASIK or epipolis LASIK (epi-LASIK) because there may be inadequate exposure and difficulty in achieving suction with the microkeratome or laser suction ring. Intraocular Pressure The intraocular pressure (lOP) should be checked after the man ifest refraction is done and corneal topography measurements are taken.
2011-2012 Basic and Clinical Science Course, Section 13: Refractive Surgery (Basic & Clinical Science Course) by Christopher J. Rapuano MD