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LASIK Fundamentals, Surgical Techniques, and Complications - part 6

Điều này khả năng cao hơn các biến chứng nhất định xảy ra trong mắt của bệnh nhân thứ hai mà chúng xảy ra trong mắt đầu tiên có thể áp dụng đối với các vấn đề khác (ví dụ như, sự mọc vào trong biểu mô, xuất huyết điểm vàng, tách rời võng mạc). | 246 Hardten et al. in cases of infectious keratitis where again the risks are probably not independent same lid flora degree of blepharitis hygiene etc. but the complication cannot be recognized immediately. This higher likelihood of certain complications occurring in the second eye of patients in whom they occur in the first eye may apply to other problems as well e.g. epithelial ingrowth macular hemorrhage retinal detachment . We have had two cases of presumed infectious keratitis culture negative in more than 25 000 lamellar refractive procedures. These responded quickly to topical antibiotics with no loss of visual acuity. Both of these infections did not become apparent for 3 weeks following the procedure suggesting that unless we waited one month between eyes we still could have been dealing with a complication in both eyes at the same time. We have had intermittent cases of diffuse lamellar keratitis in the first postoperative week with most responding to frequent topical steroids or interface irrigation. With appropriate current management techniques of DLK the risk of loss of best corrected vision from DLK is extremely low. The principal risk of performing bilateral simultaneous LASIK is therefore only related to adverse events occurring in the first 2 to 4 weeks or whatever interval is chosen for sequential surgery after the surgery that cannot be anticipated by the surgeon at the time of surgery. This excludes intraoperative complications which would prevent surgery on the second eye or could only happen to the second eye if surgery was uneventful on the first and later complications which would occur after the intereye waiting period. D. COMPARATIVE STUDIES A prospective randomized study by Waring et al. looked at the results of simultaneous and sequential bilateral LASIK for the correction of myopia 1 . They looked at 357 patients who desired surgical correction of myopia ranging from -2 to -22.50 diopters. The patients were randomized to simultaneous