By Christopher J. Rapuano, MD
This part underwent significant revision for the 2008-2009 edition.Reviews the underlying techniques in refractive surgical procedure, together with its clinical foundation, the function of the FDA, and sufferer assessment. particular strategies are mentioned intimately, and using refractive surgical procedure to regard presbyopia is tested. a brand new bankruptcy discusses foreign views.
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Extra resources for 2008-2009 Basic and Clinical Science Course: Section 13: Refractive Surgery
75 D. For most patients, such a refraction allows good uncorrected distance and near vision without intolerable anisometropia.
When the cornea is in a dehydrated state, stress is distributed principally to the posterior layers or uniformly over the entire structure. When the cornea is healthy or edematous, the anterior lamellae take up the strain. There are differences in glycosaminoglycans 20 . Refractive Surgery I ... Figure 1-14 Zernike representation of quadrafoil. (Used with permission, Alcon Laboratories.! between the anterior and posterior stroma, as well as more lamellar interweaving in the anterior corneal stroma, and thus the anterior cornea swells far less than the posterior cornea, Stress within the tissue is partly related to lOP but not in a linear manner under physiologic conditions (normal lOP range).
0 mm) that are scanned at a higher repetition rate, but to create the desired pattern of ablation, a tracking mechanism is required for precise placement. Broad-beam lasers and some scanning-slit lasers require a mechanical iris diaphragm or ablatable mask to create the desired shape in the cornea. The flying-spot lasers and some of the 30 . Refractive Surgery scanning-slit lasers use the pattern projected onto the surface to create the desired laser ablation profile without masking. Wavefront-Optimized and Wavefront-Guided Laser Ablations In the past, conventional treatments used laser profiles with smaller blend zones and created a more oblate corneal shape postoperatively, with induced higher-order aberrations, especially spherical aberration and coma.
2008-2009 Basic and Clinical Science Course: Section 13: Refractive Surgery by Christopher J. Rapuano, MD