By Michael O'Keefe
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Additional info for Current Understanding and New Techniques in Refractive Surgery
Must be checked and cleaned after each passage to prevent adding epithelial cells. The flap is then repositioned and a contact lens applied. If the first surgery is not sufficient the flap needs to be lifted again and the cleaning procedure repeated with moderate scraping of the involved surfaces; some Authors suggest eliminating the epithelial cells by applying 20% to 50% ethanol or by PTK treatment of both stromal surfaces; this should be done after accurately cleaning the involved areas. For cases of significant epithelial growth, it is advisable to act early since the stroma between the interface epithelium and surface epithelium may undergo necrosis with flap melting.
These factors may include: low blink rate, wide lid aperture, aging, low androgen pool, low relative humidity, high wind velocity, dusty environment and some systemic drugs (antihistamines, betablockers, antispasmodics, diuretics and some psychomotor drugs) . 7% in Asian Studies . Some of the variation may be due to different study criteria. Effects on QOL Dry eye can have a very detrimental effect to a patient‘s quality of life. This deleterious effect may be mediated via: pain and irritative symptoms; effects upon ocular as well as general health and well being; effects upon the perception of visual function; impact upon actual visual performance .
The treatment protocol will need to be adjusted once the antibiogram response is obtained. Prevention for avoiding this devastating complication includes the use of sterile material and isolating the eyelashes during surgery using adhesive surgical drape Even if treated correctly, the outcome of these complications can often be very serious with significant loss in visual acuity. In the most serious cases, the last treatment is complete anterior lamellar or perforating cornea transplant, based on the depth of the residual corneal scarring.
Current Understanding and New Techniques in Refractive Surgery by Michael O'Keefe