Úlcera de córnea bilateral por Pseudomonas em usuário de lente de contato descartável

Lipener, César; Ribeiro, André Luiz Parolin

doi:10.1590/s0004-27491999000600017

Cited by 3 publications

(1 citation statement)

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“…Refractive surgery is and should be treated as an elective option instead of spectacles or contact lens wearing, which are clinical methods with less, although present, risks (2) .…”

Section: Razões Para Recusar Candidatos à Cirurgia Refrativa Corneanamentioning

confidence: 99%

Reasons not to select patients for corneal refractive surgery

Ribeiro¹,

Schor²,

Allemann³

et al. 2002

Arq. Bras. Oftalmol.

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Purpose: To present how the section of Refractive Surgery of the Federal University of São Paulo assesses the candidates and the reasons to indicate for corneal refractive surgery. Methods: We examined 1626 patients. Anamnesis, complete ophthalmologic examination and corneal topography were performed in all patients. The patients spontaneously seeked evaluation at the Refractive Surgery Section by telephone without a previous screening. Reasons to refuse patients for refractive surgery were previously established by the Refractive Surgery Section. Results: Based on current technology and clinical experience, 265 patients (16.29%) were refused for excimer laser corneal refractive surgery. Myopia of patients who had insufficient preoperative corneal pachymetry for the laser treatment was the main cause for refusal (51 patients). Cataract (45 patients), keratoconus (31 patients), amblyopia (21 patients), hyperopia > 5 diopters and mixed astigmatism (19 patients), presbyopia (unaware ness of the need for optical correction after the procedure; 16 patients), pupillary diameter > 5mm (9 patients), single eye (9 patients), progressive myopia (8 patients), postradial keratotomy (7 patients) and low ametropia (7 patients) were among the reasons for the refusal. Conclusion: Candidates for excimer laser corneal refractive surgery may present risk factors that should be known in order to avoid complications. Since the 80's, laser light has been studied as a tool for the correction of ametropias. At present, the argon fluoride excimer laser (193 nm) is used for the corneal curvature in an effective, safe and stable way (1) . There are two major procedures for laser application to the cornea: photorrefractive keratectomy (PRK) and lamellar photorrefractive keratectomy (LASIK). In PRK, the corneal epithelium is removed and laser is applied to the superficial corneal stroma. In the LASIK technique, a corneal flap is made with a microkeratome and the laser is applied to the underlying stroma. The choice between the techniques depends on the surgeon's experience and the ametropia to be treated. Razões para recusar candidatos à cirurgia refrativa corneanaWith the widespread use of excimer laser for correction of ametropias, it is important to select candidates who may benefit from the surgery and, mainly, not to operate in cases where expectancy of results has shown a poor correlation with the clinically obtained results.Refractive surgery is and should be treated as an elective option instead of spectacles or contact lens wearing, which are clinical methods with less, although present, risks (2) .Regarding safety, complications of the surgical method which lead to Keywords: Refractive errors/surgery; Cornea/surgery; Myopia; Corneal topography; KeratoconusReasons not to select patients for corneal refractive surgery

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“…Refractive surgery is and should be treated as an elective option instead of spectacles or contact lens wearing, which are clinical methods with less, although present, risks (2) .…”

Section: Razões Para Recusar Candidatos à Cirurgia Refrativa Corneanamentioning

confidence: 99%