Рефракционная хирургия. BCSC, раздел 13 (2021–2022)

Organization of the Course

The Basic and Clinical Science Course comprises 13 volumes, incorporating fundamental ophthalmic knowledge, subspecialty areas, and special topics:

  • 1 Update on General Medicine

  • 2 Fundamentals and Principles of Ophthalmology

  • 3 Clinical Optics

  • 4 Ophthalmic Pathology and Intraocular Tumors

  • 5 Neuro-Ophthalmology

  • 6 Pediatric Ophthalmology and Strabismus

  • 7 Oculofacial Plastic and Orbital Surgery

  • 8 External Disease and Cornea

  • 9 Uveitis and Ocular Inflammation

  • 10 Glaucoma

  • 11 Lens and Cataract

  • 12 Retina and Vitreous

  • 13 Refractive Surgery

References

Readers who wish to explore specific topics in greater detail may consult the references cited within each chapter and listed in the Additional Materials and Resources section at the back of the book. These references are intended to be selective rather than exhaustive, chosen by the BCSC faculty as being important, current, and readily available to residents and practitioners.

xiv • Introduction to the BCSC

Multimedia

This edition of Section 13, Refractive Surgery, includes videos related to topics cov­ ered in the book. Selected by members of the BCSC faculty, the videos are available to readers of the print and electronic versions of Section 13 (www.aao.org/bcscvideo _section13). Mobile-device users can scan the QR code below (a QR-code reader may need to be installed on the device) to access the video content.

Рисунок со страницы 14

Self-Assessment and CME Credit

Each volume of the BCSC is designed as an independent study activity for ophthalmology residents and practitioners. The learning objectives for this volume are given on page 1. The text, illustrations, and references provide the information necessary to achieve the objectives; the study questions allow readers to test their understanding of the material and their mastery of the objectives. Physicians who wish to claim CME credit for this educational activity may do so by following the instructions given at the end of the book.*

Conclusion

The Basic and Clinical Science Course has expanded greatly over the years, with the ad­ dition of much new text, numerous illustrations, and video content. Recent editions have sought to place a greater emphasis on clinical applicability while maintaining a solid foun­ dation in basic science. As with any educational program, it reflects the experience of its authors. As its faculties change and medicine progresses, new viewpoints emerge on controversial subjects and techniques. Not all alternate approaches can be included in this series; as with any educational endeavor, the learner should seek additional sources, including Academy Preferred Practice Pattern Guidelines.

The BCSC faculty and staff continually strive to improve the educational usefulness of the course; you, the reader, can contribute to this ongoing process. If you have any sug­ gestions or questions about the series, please do not hesitate to contact the faculty or the editors.

The authors, editors, and reviewers hope that your study of the BCSC will be of last­ ing value and that each Section will serve as a practical resource for quality patient care.

* This activity meets the Self-Assessment CME requirements defined by the American Board of Oph­ thalmology (ABO). Please be advised that the ABO is not an accrediting body for purposes of any CME program. ABO does not sponsor this or any outside activity, and ABO does not endorse any particular CME activity. Complete information regarding the ABO Self-Assessment CME Maintenance of Certifi­ cation requirements is available at https://abop.org/maintain-certification/cme-self-assessment/.

Objectives

Upon completion of BCSC Section 13, Refractive Surgery, the reader should be able to

  • state the contributions of the cornea’s shape and tissue layers to the optics of the eye and how these components are affected biomechanically by different types of keratorefractive procedures

  • describe the basic concepts of wavefront analysis and its relationship to different types of optical aberrations

  • identify the general types of lasers used in refractive surgeries

  • explain the steps—including medical and social history, ocular examination, and ancillary testing—in evaluating whether a patient is an appropriate candidate for refractive surgery

  • for incisional keratorefractive surgery (radial keratotomy, transverse keratotomy, arcuate keratotomy, and limbal relaxing incisions), describe the history, patient selection, surgical techniques, outcomes, and complications

  • for surface ablation procedures, describe patient selection, epithelial removal, refractive outcomes, and complications

  • for laser in situ keratomileusis (LASIK), describe patient selection, surgical techniques, outcomes, and complications

  • describe the different methods for creating a LASIK flap with a microkeratome or a femtosecond laser, as well as the instrumentation and possible complications associated with each

  • state considerations for, and possible contraindications to, refractive surgery in patients with preexisting ocular or systemic disease

  • list some of the effects of prior refractive procedures on later intraocular lens (IOL) calculations, contact lens wear, and ocular surgery

  • explain recent developments in the application of wavefront technology to surface ablation and LASIK

  • describe how intraocular surgical procedures, including refractive lens exchange or implantation of a phakic IOL, can be used in refractive correction, with or without corneal intervention

  • describe the different types of IOLs used for refractive correction

  • explain the leading theories of accommodation and how they relate to potential treatment of presbyopia

  • describe nonaccommodative and accommodative approaches to the treatment of presbyopia