Refractive Surgery and Oculoplasty
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Corneal Refractive Surgery is so intimately related to Oculoplasty as the cornea is an integral part of the ocular surface and is affected by the anatomical and functional status of the ocular adnexa and tear production and function. Preoperative evaluation of patients seeking refractive correction can guide the surgeon to the proper timing of surgery, select the best technique for each patient and allow him to treat any preexisting conditions that may lead to certain operative challenges or possible postoperative complications. Abnormalities in lid margin, palpebral fissure, blinking pattern or lid inflammations are such examples. Tear film evaluation both quantitatively and qualitatively is essential. Intraoperative challenges related to ocular adnexa should be anticipated, prevented and/or properly managed. Postoperative changes in corneal sensation and their effect on tear production, corneal healing and patient subjective symptoms of dry eye and finally on his quality of vision and satisfaction should be properly understood and managed. Failure to identify and manage these challenges before, during and after refractive surgery may lead to serious complications and can affect the final visual outcome and patient satisfaction.
KeywordsRefractive surgery Corneal topography Myopia Astigmatism Smile Lasik Surface ablation Corneal healing Quality of vision Tear film stability Corneal sensation Dry eye Blinking pattern Floppy lid syndrome Punctal occlusion Artificial tears
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