Atlas of Refractive Surgery by Benjamin F. Boyd

By Benjamin F. Boyd

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A similar consideration applies to very high myopes Index 1 2 3 4 5 treated with phakic IOL’s. Be cautious in implanting soft, foldable posterior chamber phakic IOL’s in them because the IOL’s optical zone may be smaller than these patients need and they may have visual problems at night. In other, less highly myopic patients, these IOL’s are quite successful (Fig. 24). Elements Not Related to Refractive Errors 1. Orbit Configuration: Patients with small or deep-set orbits and narrow palpebral fissures should be discouraged from having LASIK because the microkeratome suction ring cannot be well-positioned and may interfere with passage of the microkeratome itself.

Mires larger in diameter, broader in width or more widely separated than normal are an indication of low power of the underlying cornea. The steeper portion of the cornea reflects the rings in a pattern in which they appear closer together (R - Fig. 32). Figure 34 shows the irregularities in the Placido disk image following radial keratotomy. A similar visual inspection approach is used with intraoperative keratoscopes to reduce the amount of Subjects Index 1 2 3 4 5 6 7 8 9 10 postoperative astigmatism following corneal transplantation.

24). Elements Not Related to Refractive Errors 1. Orbit Configuration: Patients with small or deep-set orbits and narrow palpebral fissures should be discouraged from having LASIK because the microkeratome suction ring cannot be well-positioned and may interfere with passage of the microkeratome itself. PRK as advised by Lindstrom or RK are the procedures of choice in these cases. 2. Autoimmune Diseases and Collagen Vascular Diseases: PRK is absolutely contraindicated because of the risk of stromal melt with an exposed stromal surface.

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