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 review to foreign views. It examines particular techniques in refractive surgical procedure, in addition to refractive surgical procedure in ocular and systemic disorder. 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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Additional info for 2011-2012 Basic and Clinical Science Course, Section 13: Refractive Surgery (Basic & Clinical Science Course)
2008;24(4),5424- 5430. Corneal Wound Healing All forms of keratorefractive surgery are exquisitely dependent on corneal wound healing to achieve the desired results. Satisfactory results require either modifying or reducing wound healing or exploiting normal wound healing for the benefit of the patient. For example, astigmatic keratotomy requ ires in itial weakening of the cornea followed by permanent corneal healing, with replacement of the epithelial plugs with collagen and remodeling of the collagen to ensure stability and avoid long-term hyperopic drift.
Typically, clinicians in the United States use corticosteroids in a taper- ing manner follOWing surgery to reduce inflam mation. Mitomycin C has been applied to the stromal bed after excimer surface ablation to attempt to decrease haze formation (see Chapter 6). It has been proposed that vita min C may playa role in protecting the cornea from ultraviolet light damage by the excimer laser, but no randomized, prospective clinical trial has yet been performed. A number of growth factors that have been fo und to promote wound healing after PRK, includi ng transforming growth facto r ~ , may be useful in the future.
Social History The social history and medical history can identify the visual requirements of the patient's profession. Certain jobs require that best vision be at a speCific distance. For example, a preacher may desire that best uncorrected vision be at arm's length, so that reading can be done at the pulpit witho ut glasses. Milita ry personnel, firefighters, or police may have restrictions on mini mal UCVA and BCYA and also on the type of refractive surgery they can have. The type of sports and recreational activities a patient prefers may help select the best refractive procedure or determi ne whether that patient is even a good candidate for refractive surgery.
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