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Corneal Disorders
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
Darren S. J. Ting, Rashmi Deshmukh, Daniel S. W. Ting, Marcus Ang
Refractive surgery is one of the most common ophthalmic surgeries performed in the world. It has been shown to improve spectacle independence, cosmesis, and, more importantly, the quality of life of many people.146 However, meticulous preoperative assessment is critical to optimize the visual and refractive outcomes, patient satisfaction, and safety, as well as to minimize postoperative complications such as corneal ectasia following corneal refractive surgery.146 AI has demonstrated its clinical potential in detecting patients who are at higher risk of developing post-laser in situ keratomileusis (LASIK) ectasia.147,148 For instance, Xie et al.148 developed a DL-based AI classification, using Pentacam InceptionResNetV2 Screening System (PIRSS), to screen candidates for corneal refractive surgery. Based on 1,385 patients and 6,465 corneal tomographic images, the AI algorithm was able to achieve an overall detection accuracy of 95%, which was comparable to senior refractive surgeons. Another study similarly demonstrated a detection accuracy of 93% in predicting suitability for corneal refractive surgery.149
Ophthalmic Injuries
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Refractive surgery procedures such as laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) have been shown to be safe and effective and post-operative complications are rare. An early ophthalmology consultation should be sought if there is concern about eye injury in a patient with a history of refractive surgery, as traumatic corneal abrasions occurring after PRK can lead to corneal haze and permanent loss of uncorrected and corrected visual acuity. In addition to topical antibiotics, an ophthalmologist may recommend topical steroid drops, oral vitamin C and ultraviolet (UV) light protection using sunglasses to prevent haze.
Management of Ophthalmic Injuries by the Forward Surgical Team
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
Richard J. Blanch, Johno Breeze, William G. Gensheimer
Refractive surgery procedures such as LASIK and photorefractive keratectomy (PRK) have been shown to be safe and effective. Post-operative complications including traumatic LASIK flap dislocations are rare. Never attempt to repair an eye after trauma or remove a LASIK flap. Traumatic corneal abrasions occurring after PRK can lead to corneal haze and loss of uncorrected and corrected visual acuity. In addition to topical antibiotics, an ophthalmologist may recommend topical steroid drops, oral vitamin C, and ultraviolet (UV) light protection, using sunglasses to prevent the development of corneal stromal haze.
A Stargardt disease-like phenotype in GAS8-related primary ciliary dyskinesia
Published in Ophthalmic Genetics, 2022
A 43-year-old Emirati female was referred for further evaluation of Stargardt disease, which had been diagnosed at 40 years old when she sought ophthalmic evaluation for dry eye complaints. Past ocular history was significant for refractive surgery at 31 years old. Past medical history was significant for clinically-diagnosed primary ciliary dyskinesia, confirmed by endotracheal brush sampling at 38 years old. Since childhood, she had had recurrent sino-pulmonary infections and bronchiectasis. She was also unable to conceive and suffered from decreased hearing with tinnitus. In addition, she had gastroesophageal reflux disease. Her chest X-ray did not show situs inversus. Medications for her primary ciliary dyskinesia included acetylcysteine, fluticasone furoate-vilanterol inhaler, and mometasone nasal spray.
Utilization of Crowdfunding for Cataract and LASIK Procedures
Published in Seminars in Ophthalmology, 2022
Sachi A. Patil, Amanda Luu, Daniel G. Vail, Arjun Watane, Russell Levine, Brian Hafler, Ravi Parikh
Globally, 2.2 billion people face vision impairment or blindness of which refractive error and cataract are the two leading causes.1 Fortunately, these are addressable forms of vision loss, however, globally the “coverage gap” or out of pocket costs to address these conditions are estimated to be United States $24.8 billion (WHO 2019). Refractive error and cataract account for the highest share of direct medical costs among those 40–64 and those 65 and older, respectively, in the United States.2Medicare will cover the majority of the price of a standard cataract procedure, with the patient paying $357-$565 in facility fees.3 Refractive surgery, while cost-effective in the long-term by offsetting the costs of contact lenses and glasses, places burdens on patients in the short-term due to substantial out of pocket expenditures not covered by insurance.4 Direct costs to patients of cataract surgery have been exacerbated by advances in refractive cataract surgery, such as multifocal lenses, toric lenses, and laser assisted cataract surgery, which are not covered by Medicare or most commercial insurers.5 As patients in the United States have increasingly turned to fundraising to address gaps in insurance coverage6 we assessed the prevalence of online campaigns to raise funds for refractive and cataract surgery, two of the most common reasons for elective ophthalmic surgery in the United States7.
Can toric IOL rotation be minimized? Toric IOL-Capsular Tension Ring suturing technique and its clinical outcomes
Published in Seminars in Ophthalmology, 2022
Today, cataract surgery is also considered as a refractive surgery. Patients want to achieve good visual acuity without the need for spectacles or contact lenses. However, a majority of the patients undergoing cataract surgery have a visually significant amount of anterior corneal astigmatism. In a study where biometry data sets of 23,239 eyes were examined, 63.96% of the eyes had <1 D of anterior corneal astigmatism and 36.05% had ≥1 D of anterior corneal astigmatism.1 Various methods, including limbal relaxing incisions, opposite clear corneal incisions, laser arcuate incisions, Excimer laser, and toric IOL implantation, have been performed as treatments for astigmatism in these patients.2–4 Out of these, toric intraocular lens (IOL) implantation has shown highly satisfactory results in the treatment of astigmatism in cataract patients.5