By Christopher J. Rapuano, MD
This part underwent significant revision for the 2008-2009 edition.Reviews the underlying recommendations in refractive surgical procedure, together with its medical foundation, the function of the FDA, and sufferer assessment. particular tactics are mentioned intimately, and using refractive surgical procedure to regard presbyopia is tested. a brand new bankruptcy discusses overseas views.
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Extra resources for 2008-2009 Basic and Clinical Science Course: Section 13: Refractive Surgery
This does not mean that the device is contraindicated in dry-eye patients but that the safety and effectiveness of the device cannot be evaluated in this population because there are no data. Some exclusion criteria may be contraindications to treatment. For example, keratoconus could be an exclusion criterion as well as a contraindication to laser in situ keratomileusis (LASIK). The clinical trial is performed for a limited range of refractive errors. Safety and effectiveness data guide the range of refractive error that is approved for use in the PMA labeling.
Is induced Flattening 90° away Surgery. 23 Limbal relaxing incisions is induced in the axis of the incisions (at 90° in from the incisions (at 180° in this case). (Illustra- approximately an II-mm diameter is achieved, and then the effect reverses. The larger the angle severed by the tangential incision, the greater the effect. For optimum effect, an incision should be 85%-90% deep to retain an intact posterior lamella and maximum anterior bowing of the other lamellae. Nomograms for numbers of incisions and optical zone size can be calculated based on finite element analysis, but they are typically generated empirically.
Mitomycin C has been applied to the stromal bed after excimer ablation to attempt to decrease haze formation (see Chapter 6). It has been proposed that vitamin C may playa role in protecting the cornea from ultraviolet light damage by the excimer laser, but a randomized, prospective clinical trial has not yet been performed. A number of growth factors that have been found to promote wound healing after PRK, including transforming growth factor ~, may be useful in the future. With the LASEK technique, the corneal epithelial basement membrane is cleaved between the lamina lucida and the lamina densa.