Download 2011-2012 Basic and Clinical Science Course, Section 13: by Christopher J. Rapuano MD PDF

By Christopher J. Rapuano MD

This up to date quantity covers a couple of subject matters, from the technology of refractive surgical procedure to accommodative and nonaccommodative remedy of presbyopia, from sufferer assessment to overseas views. It examines particular strategies in refractive surgical procedure, in addition to refractive surgical procedure in ocular and systemic ailment. significant revision 2011-2012.

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Additional info for 2011-2012 Basic and Clinical Science Course, Section 13: Refractive Surgery (Basic & Clinical Science Course)

Sample text

The natural shape of the cornea is prolate, or steeper centrally than peripherally. In contrast, an oblate cornea is steeper peripherall y than centrally. The natural prolate corneal shape resul ts in an aspheric optical system, which reduces spherical aberration and therefore minimizes flu ctuat ions in refractive error as the pupil changes size. Oblate corneas in crease spherica l aberrations. Common complaints in patients with Significant spherical aberration include glare, halos, and dec reased night vision.

It is the patient who will ultimately develop KC but shows no obvious clinical signs at the time of examination who poses the greatest difficulty in preoperative evaluation for refractive surgery. Corneal topography may reveal subtle abnormalities that should alert the surgeon to this problem. Although newer screening indices take into account a variety of topographic factors that may indicate a higher likelihood of subclinical KC, none of these indices are definitive. Inferior-superior (I-S) values are useful in screening for KC.

Courtesy of Christopher J. ) intraocular lenses (TOLs) (see Chapter 8) . Careful undilated and dilated evaluation of the crystalline lens for clarity is essential, especially in patients older than 50 years. Surgeons should be wary of progressive myopia due to nuclear sclerosis. Patients with mild lens changes that are visually insignificant should be informed of these findings and advised that the changes may become more significant in the future, independent of refractive surgery. They should also be told that [OL power calculations are not as accurate when performed after keratorefractive surgery.

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