Decision Making alarming for Treatment Plan for Lasik

Decision Making alarming for Treatment Plan for Lasik

1- Degree of correction (range )

Myopia:

≤ –12.00 D sphere
≤ – 5.00 D of cylinder

• Hyperopia:
≤ +5.00 D sphere
<+4.00 D of cylinder

• Mixed astigmatism:
≤6.00 D cylinder

• Custom myopia:
≤ – 6.00 D sphere with ≤ -3.00 D cylinder

• Custom hyperopia:
≤ +3.00 D sphere with ≤ +2.00 D cylinder

• Custom mixed astigmatism:
≤5.00 D cylinder.

2- Steep cornea

• average K > 48.50 D increased risk of buttonhole

• average K > 45.00 D, use 8.5-mm Hansatome ring

• Consider femtosecond laser flap

• Caution: flaps cut on steep corneas with blade microkeratomes tend to be large

• If buttonhole: replace flap, no laser, consider PRK with or without mitomycin-C application

3- Flat cornea

• average K < 40.00 D increased risk of free cap

• average K < 45.00 D, use 9.5-mm Hansatome ring

• Consider femtosecond laser flap

• If free flap or small flap, replace flap, no laser, BCL, return in 6 mo to cut new flap using thicker plate.

Decision Making alarming for Treatment Plan for Lasik power point presentations:

Preoperative evaluation for LASIK & PRK By Dr. Mohammad Mousa

1. Lasik Introduction• The purpose of the pre-operative assessment is:1. • To determine by physical measurement whether it is possible to correct a patient’s individual refractive error.2. • To determine by examination whether the ocular health is adequate for this procedure.3. • To identify if there is any increased risk of complications specific to that patient.
2. Lasik Evaluation• History – Age – Sex – Occupation – Stability – expectation – General health – Ocular health
3. • lasik Absolute general health contra- indications• Relative general health contra- indications• Absolute ocular health contra- indications• Relative ocular health contra- indications
4. Lasik Absolute general health contra-indications• Auto-immune disease e.g. RA,SLE, Thyroid disease.• Immune suppression – HIV or immune suppression drugs.• Pregnancy-wait 6 months after giving birth or cessation of breast feeding.• Systemic steroids• Amiadarone• 5-Hydroxy-tryptamine e.g. sumatriptan – there is an increased risk of vascular occlusion when the intraocular pressure is raised during treatment.
5. Lasik Relative general health contra- indications• Tricyclics or lithium-based medication-the need for such medication indicates that the patient may have obsessive or compulsive personality or is suffering from a significant level of depression. These patients can have expectations of surgery that are too high and are unlikely to be satisfied following surgery.
6. Lasik Relative general health contra- indications• Diabetes – diabetics can have an increased risk of epithelial complications after Treatment. Eyes which have signs of diabetic retinopathy are contra-indicated.• Active atopy – any active or uncontrolled atopic disease would be contraindicated until it is well controlled.
7. Lasik Relative general health contra- indications• Epilepsy – the patient must be able to remain relatively still during the procedure. Therefore, only patients that have not had an epileptic episode for 12 months or more may be considered for treatment.• • History of frequent fainting – these patients may have a low threshold for vasovagal attack. Patients that have a low oculocardiac reflex would also be unsuitable.• • Hepatitis B and C – patients with these conditions will not be considered for surgery in many clinics due to the potential risk to surgical staff.
8. Lasik Absolute ocular health contra- indications• Diabetic retinopathy – this is an absolute contra-indication as it can accelerate the progression of diabetic retinopathy.• Glaucoma – During LASIK treatment, the intraocular pressure (IOP) is raised to above 65 mmHg which may cause further damage to the optic disc. The topical steroids used postoperatively may also affect IOP• Corneal thinning dystrophies e.g. keratoconus – in dystrophies where the cornea is abnormally thin, LASIK would reduce the corneal thickness.

Decision Making alarming for Treatment Plan for Lasik videos :

How LASIK Eye Surgery Is Performed – YouTube

Lasik Laser Eye Surgery Procedure – Live Surgery – YouTube

https://www.youtube.com/watch?v=LEewS9XhrWM

Decision Making alarming for Treatment Plan for lasik