ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The technique of laser in situ keratomileusis (LASIK) has been used with very encouraging results in the treatment of all degrees of myopia and also shows considerable promise in the treatment of hyperopia. Compared with photorefractive keratectomy, LASIK is advantageous in causing minimal postoperative discomfort, in its rapid recovery of clear vision and stabilization of refractive change, in the infrequent occurrence of haze, and in its greater facility in correcting high degrees of myopia. However, LASIK is the more surgically demanding technique. We discuss our own experience with LASIK as well as published data from other centers. We anticipate that LASIK will continue to increase in importance in the surgical correction of refractive error.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Intracorneal ring technology has shown rapid development in the past 10 years, and clinical results are confirming outstanding results for the correction of low to moderate refractive myopias. Two of these device designs, the Intrastromal Corneal Ring and the Intrastromal Corneal Ring Segments (both manufactured by KeraVision, Inc., Fremont, CA) are currently undergoing rigorous investigation in US Food and Drug Administration- regulated clinical trials. Results to date indicate the surgical procedure is safe and easily performed, the visual results are excellent (preserving best spectacle-corrected visual acuity), and the procedure provides stable and predictable correction through several years postoperatively. Preliminary results show that enhancements can be easily performed by device exchange, and the device can be removed, reversing the refractive effect.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Many factors have led to the improved success rate for clear corneal grafts after penetrating keratoplasty. Unfortunately, postoperative corneal astigmatism commonly occurs and can produce significant visual impairment. Astigmatic correction may include spectacle correction or contact lenses, but if this fails, then surgical options are considered. Refractive surgical techniques such as suture removal or adjustment, relaxing incisions, wedge resections, and photorefractive keratectomy or laser in situ keratomileusis can dramatically reduce postoperative astigmatism after penetrating keratoplasty and lead to improved, functional vision. However, significant variability between results in individual patients can occur. So although general guidelines are useful, it is important to individualize and modify the planned surgery based on qualitative keratoscopy and corneal topography for the initial and subsequent astigmatic corrections.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The informed consent process represents a key component in providing the highest quality of care for our patients and minimizing liability risk. Patients undergoing refractive surgery have high expectations for an excellent outcome and may become easily dissatisfied and upset if this is not achieved. Careful attention by the surgeon and supporting staff to educate the patient in a thorough and supportive fashion is paramount to this process. Breakdown in communication between physicians and patients combined with a poor outcome and feelings of mistrust often leads patients to consider malpractice litigation. The importance of understanding the key components and principles of the informed consent process cannot be over-emphasized and are presented in detail in this review.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Malignant neoplasms of the ocular surface are uncommon but consist of squamous and melanocytic tumors. Surgical excision has been the mainstay of treatment and is perhaps the “gold standard.” However, in those circumstances in which surgical intervention is not feasible, adjunctive treatments have been advocated. Recent attention has been given to the use of mitomycin C and 5-fluorouracil for the treatment of ocular surface squamous neoplasia. This article reviews the major publications relating to the use of antimetabolites in ocular surface neoplasia and highlights the most recent contributions to the ophthalmic literature.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Nonsteroidal anti-inflammatory agents or NSAIDs are potent inhibitors of prostaglandin synthesis. As such, they have found many useful roles in ophthalmology. NSAIDs are approved by the FDA to prevent intraoperative miosis during cataract surgery, reduce postoperative inflammation following cataract surgery, and control symptoms of allergic conjunctivitis and pain following refractive surgery. In addition, they have been shown to be effective in preventing cystoid macular edema following cataract surgery or treating cystoid macular edema once it occurs.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Successful treatment for a corneal ulcer requires proper diagnosis and antibiotic selection. The management should be guided by the severity of the clinical presentation, the ophthalmologist's confidence in making the proper diagnosis of bacterial keratitis, and the level of trust in the antibiotic agents chosen for the causative organisms. Universal standards include pretreatment cultures and dual broad-spectrum fortified antibiotics. Recent changes in practice suggest that empirical monotherapy treatment with a fluoroquinolone antibiotic may be appropriate for certain cases of bacterial keratitis. This article reviews the various diagnostic methods and treatment options currently practiced in the ophthalmic community.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Keratoconjunctivitis sicca is a common ocular surface disease that develops in patients with aqueous tear deficiency. Recent advances have been made in diagnosis, pathogenesis, and therapy of this condition. Advances in diagnosis include improved understanding of the specificity of the tests used for diagnosis, elucidation of the mechanism of the ocular surface rose bengal and fluorescein staining that occurs in this condition, and the expanded use of impression cytology. Advances in pathogenesis include the concept that keratoconjunctivitis sicca is a condition of abnormal growth and differentiation and immune activation of the ocular surface epithelium. These findings indicate that keratoconjunctivitis sicca may represent a chronic wound-healing response to a poorly lubricated and inflamed ocular surface. Advances in therapy include improved nonpreserved artificial tears and therapies targeted at decreasing ocular surface inflammation.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

A wealth of antiallergic drugs is available for ocular allergy, and many new drugs will soon be approved. Pharmaceutical companies frequently seek approval of anti-inflammatory drugs for allergic indications, because it is relatively easy to perform clinical trials for ocular allergy. Extremely safe drugs for mild to moderate degrees of allergic conjunctivitis include antihistamines, mast cell stabilizers, and nonsteroidal anti-inflammatory agents. Topical corticosteroids, preferably those with reduced side effects, are available for more severe forms of ocular allergy. The choice of an antiallergic drug may be guided by the indication for which the drug was approved. The ultimate selection will be made based on the patient's symptoms, the drug's availability, and its cost.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID