By Christopher J. Rapuano MD
This up to date quantity covers a few themes, from the technological know-how of refractive surgical procedure to accommodative and nonaccommodative therapy of presbyopia, from sufferer overview to foreign views. It examines particular methods in refractive surgical procedure, in addition to refractive surgical procedure in ocular and systemic affliction. 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)
50 to - 1. 75 D. For most patients. such a refra ction allows good uncorrected distance and near vision without intolerable anisometropia. 75 D, which allows some near vision with better distance vis ion and less anisometropia. The exact amount of monovision depends on the desires of the patient. 50 D) can be used successfully in selected patients who want excellent postoperative near vision. However, in some patients with a higher degree of postoperative myopia. im proving near vision may lead to the unwanted side effects of loss of depth perception and CHAPTER 2: Patient Evaluation • 33 anisometropia.
50 .. 50 Keratometric A~lThL _ _ _~ Figure '·'5 Keratoconus. Suspected case (A) and topography of confirmed case (8). 5 0 Color Steps (Courtesy of J. 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.
Keratoconus-like topographic changes in keratoconjunctivitis sicca. Cornea. 2003;22(1):22- 24. 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.
2011-2012 Basic and Clinical Science Course, Section 13: Refractive Surgery (Basic & Clinical Science Course) by Christopher J. Rapuano MD