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Cataract and Refractive Surgery - part 8

Bệnh nhân phẫu thuật khúc xạ có những kỳ vọng cao hơn, nhưng cần phải thấu hiểu toàn bộ rủi ro của phẫu thuật nội nhãn. Các tần số biến chứng có thể không lớn nhưng mức độ rủi ro có thể là một vấn đề. | 9.15 Conclusion 123 Table 9.10 Percentage of Ophthalmic Mutual Insurance Company of USA OMICS ophthalmologists insured for different types of refractive surgery Laser assisted in situ keratomileusis 29.2 Photorefractive keratectomy 28.9 Radial keratotomy 12.7 Refractive lens exchange 8.0 Conductive keratoplasty 2.3 Laser thermokeratoplasty 1.8 Intacs 1.6 Phakic intraocular lens implantation 0.6 Refractive surgery patients have higher expectations but need to fully comprehend the risks of intraocular surgery. The frequency of complications may not be great but the seriousness of the possible risks is an issue. Ophthalmologists could have a difficult time in front of a judge or jury to defend this procedure in the event of an adverse outcome especially if the patient is relatively young with minimal refractive error and no evidence of cataract. Sometimes patients may have unrealistic expectations and be very disappointed with the ultimate results. Near intermediate and distance vision are considerations that may lead to patient dissatisfaction with outcome. Insurance by OMICS generally provides cover only for cases performed on patients with more than -10 D of myopia or between 3 and 15 D of hyperopia ranges for which other refractive procedures are not as effective as they are for lower refractive errors. OMIC is also willing to consider exceptions to these patient selection criteria on a case-by-case basis due to special situations Table 9.10 . In the UK professional indemnity to cover the practice of refractive surgery has escalated proportionately to the rise in litigation although the majority of refractive litigation is laser corneal surgery-based. 9.15 Conclusion Emmetropization of myopic eyes by lens exchange embraces risk the scale of which can be deduced by a comparison of RRD rates in a general population and by grading the severity of the myopia axial length and patient age in particular. Table 9.3 indicates the wide disparity in the annual incidence of .