Refractive surgery in children
-
Upload
hany-el-defrawy -
Category
Documents
-
view
670 -
download
3
Transcript of Refractive surgery in children
![Page 1: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/1.jpg)
Refractive surgery in children: Treatment options, Outcomes and Controversies
By Hany EL-DefrawyPediatric fellow, Bristol Eye hospital
![Page 2: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/2.jpg)
Medline Literature review (1950-2007) Cochrane library Cumulative index for nursing and allied health
literature English language articles using MeSH terms and key
words
Pediatric refractive errors & amblyopia, ansiometropia, hyperopia, myopia, LASIK, PRK,excimer laser, refractive intraocular lens
![Page 3: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/3.jpg)
Alhazen (Ibn al-Haytham)(965 – 1040)
![Page 4: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/4.jpg)
Spectacles
![Page 5: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/5.jpg)
Problems with high powered spectacles
![Page 6: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/6.jpg)
Contact lenses
Myopia Hyperopia Anisometropia Monocular aphakia Astigmatism (Toric)
![Page 7: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/7.jpg)
Contact lens problems
![Page 8: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/8.jpg)
LASIK
![Page 9: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/9.jpg)
PRK
![Page 10: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/10.jpg)
LASEK
![Page 11: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/11.jpg)
COMPLICATIONS OF REFRACTIVE SURGERY
Regression Flap related complications Interface deposits Infection Post LASIK Kerato-ectasia
![Page 12: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/12.jpg)
Cornea refractive surgery for myopic anisometropia
![Page 13: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/13.jpg)
Refractive surgery in children
IOL insertion in congenital cataract. Epikeratophakia
![Page 14: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/14.jpg)
Refractive surgery in High myopia, preliminary studies
![Page 15: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/15.jpg)
Cornea refractive surgery for hyperopic anisometropia
![Page 16: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/16.jpg)
Artisan Iris Claw lens
![Page 17: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/17.jpg)
Intraocular surgery studies for myopic Anisometropia
![Page 18: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/18.jpg)
Risks and benefits of phakic IOLs
![Page 19: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/19.jpg)
ARE WE READY?
![Page 20: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/20.jpg)
Controversies
At what age should refractive surgery be performed? Should the same limit of residual corneal thickness used in
adults applied to children? Should conventional antiamblyopia therapy be carried out in
conjunction to refractive surgery? How much myopic regression can be expected in pediatric
patients with high myopia? What is the true rate of corneal haze? Can mitomycin be used safely to lessen the haze? What are the risks of general anesthesia ? Which technique?
![Page 21: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/21.jpg)
Discussion
Small number Selection bias Healing in children Flap related complications Visual acuity affected by amblyopia Regression Haze
![Page 22: Refractive surgery in children](https://reader034.fdocuments.net/reader034/viewer/2022051213/55a74a8b1a28ab5c248b4682/html5/thumbnails/22.jpg)
Conclusion
No multicenter long term controlled trial has been published on the use of refractive surgery in children
Small retrospective short term studies show that refractive surgery is promising