By Christopher J. Rapuano MD

ISBN-10: 1615251200

ISBN-13: 9781615251209

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

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

Sample text

Schmack I, Dawson DG, McCarey BE, Waring GO III, Grossniklaus HE, Edelhauser HE Cohesive tensile strength of human LASIK wounds with histologic, ultrastructural, and clinical correlations. J Refract Surg. 2005;21 {5}:433 - 445. CHAPTER 2 Patient Evaluation A thorough preoperative patient evaluation is critically imp ortant in achieving a successful outcome follow ing refractive surgery. It is during this encounter that the physician begins to develop an impression as to whether the patient is a good candidate for refractive surgery.

Photoablation, the most important lasertissue interact ion in refractive surgery, breaks chemical bonds using excimer (for "excited dimer") lasers or other lasers of the appropriate wavelength. Laser energy of more than 4 eV per photon is sufficient to break carbon - nitrogen or carbon-carbo n tissue bonds. Argon-fluoride (ArF) lasers are excimer lasers that use electrical energy to stimulate argon to form dimers with the caustic fluorine gas. 4 eV per photon. The 193-nm light is in the ultraviolet C (high ultraviolet) range, approaching the wavelength of x-rays.

Radial incisions lead to flattening in both the meridian of the incision and 90° away. Tangential (arcuate or linear) incisions (Fig 1-1 7) lead to flattening in the meridian of the incision and steepening in the meridian 90° away that may be equal to or less than the magnitude of the decrease in the primary meridian; this phenomenon is known as coupling (see Chapter 3, Fig 3-5). The closer that radial incisions approach the visual axis (ie, the smaller the optical zone), the greater their effect; similarly, the closer th at tangential incisions are placed to the visual axis, the greater the effect.

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2011-2012 Basic and Clinical Science Course, Section 13: Refractive Surgery (Basic & Clinical Science Course) by Christopher J. Rapuano MD


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