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2014-2015 Basic and Clinical Science Course (BCSC): Section by American Academy of Ophthalmology, M. Bowes Hamill MD

By American Academy of Ophthalmology, M. Bowes Hamill MD

Significant revision for 2014-2015!

Covers the technology of refractive surgical procedure, accommodative and nonaccommodative remedy of presbyopia, and sufferer evaluate. Examines particular tactics in refractive surgical procedure and their capability issues, in addition to refractive surgical procedure in ocular and systemic sickness. This year's significant revision gains new portraits and up to date details on lens implants utilized in the U.S. and different countries.

Upon finishing touch of part thirteen, readers may be capable to:

Identify the final sorts of lasers utilized in refractive surgeries
Explain the stairs together with clinical and social background, ocular exam and ancillary checking out in comparing even if a sufferer is a suitable candidate for refractive surgery
For incisional keratorefractive surgical procedure, describe the background, sufferer choice, surgical recommendations, results, and complications
Explain fresh advancements within the software of wavefront know-how to floor ablation and LASIK
Describe the different sorts of IOLs used for refractive correction

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Extra info for 2014-2015 Basic and Clinical Science Course (BCSC): Section 13: Refractive Surgery

Sample text

Figure 1-13 r CHAPTER 1: The Science of Refractive Surgery • 23 because the abnormal cornea has an unpredictable response and/or progressive ectasia. Forme fruste, or subclinical, keratoconus typically is considered a contraindication to ablative refractive surgery. Studies are under way to determine the suitability of some keratorefractive procedures in combination with corneal collagen crosslinking as alternative therapeutic modalities for these patients (see also Chapter 7). Corneal topography and tomography can also be used to demonstrate the effects of keratorefractive procedures.

The wavefront-guided laser attempts to treat both lower-order (ie, myopia or hyperopia and/or astigmatism) and higher-order aberrations by applying complex ablation patterns to the cornea to correct the wavefront deviations. The correction of higher-order aberrations requires non-radially symmetric patterns of ablation (which are often much smaller in magnitude than ablations needed to correct defocus and astigmatism). The difference between the desired and the actual wavefront is used to generate a 3-dimensional map of the planned ablation.

Theoretical limits for residual posterior cornea apply the same as they do for PRK. Flaps range in thickness from ultrathin (80-100 µm) to standard (130-180 µm). The thickness and diameter of the LASIK flap depend on instrumentation, corneal diameter, corneal curvature, and corneal thickness. Treatments for myopia flatten the cornea by removing central corneal tissue, whereas those for hyperopia steepen the cornea by removing a doughnut-shaped portion of midperipheral tissue. Some lasers use a multizone treatment algorithm to conserve tissue by employing several concentric optical zones to achieve the total correction required.

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