Mesothelioma Attorney Magnolia DE
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Review 10.1586/17434440.5.2.209 © 2008 Future Drugs Ltd ISSN 1743-4440 209 www.future-drugs.com Advances in technologies for laser-assisted in situ keratomileusis (LASIK) surgery Expert Rev. Med. Devices 5(2), 209–229 (2008). Miguel J Maldonado † , Juan C Nieto and David P Piñero † Author for correspondence Department of Ophthalmology, Clínica Universitaria, University of Navarra, Avda Pio XII, 36, 31080, Pamplona, Spain Tel.: +34 948 296 331 Fax: +34 948 296 500 [email protected] Laser-assisted in situ keratomileusis (LASIK) has become the most widely used form of refractive surgery today. The objective of this surgical technique is to modify the anterior corneal shape by ablating tissue from the stroma by means of the excimer laser after creating a hinged corneal flap. This way, we are able to change the refractive status of the patient, providing better unaided vision. Continuous improvements in the original technique have made the surgical procedure safer, more accurate and repeatable. These progressions are due to the development of novel technologies that are the responsible for new surgical instrumentation, which makes the surgical procedure easier for the surgeon, and better excimer laser ablation algorithms, which increase the optical quality of the ablation and thus the safety of the vision correction procedure. This article aims to describe the more relevant advances in LASIK that have played an important role in the spread and popularity of this technique. KEYWORDS: aberration • corneal ectasia • excimer laser • LASIK • microkeratome • undersurface ablation of the flap • vision correction • wavefront Several laser and nonlaser refractive surgical pro- cedures have been used to modify the shape of the cornea and correct refractive errors (i.e., myopia, hyperopia, astigmatism and presbyopia). The development of new technologies in refractive surgery has resulted in remarkable improvements in the correction of refractive errors and a sub- stantial rise in the safety, efficacy and predictabil- ity of surgical outcomes. The emergence of the excimer laser (EL) enabled practitioners to reshape the cornea with the highest accuracy (sub- micron precision in steepening or flattening the central and paracentral cornea 360° around and/or in a selected corneal meridian); leading to a better visual outcome for recipients. The elabo- ration of advanced ophthalmic instruments as new models of microkeratomes – devices used for resecting an intended thickness of corneal tissue – for creating more repeatable flaps, the hinged por- tion of anterior cornea that acts as a cap of the exposed stroma, led to the refinement of lamellar refractive surgery. As a result, laser-assisted in situ keratomileusis (LASIK), a surgical procedure aimed for the correction of refractive errors in which a hinged flap is created to allow the laser ablate and reshape the exposed stroma and ends by repositioning the hinged flap, became the refractive surgical procedure of choice in most instances. Despite these advances, complications of LASIK are infrequent but have the potential of degrading vision. In this review, we describe the most important technological advances LASIK surgery has experienced in recent years. Refractive surgery has undergone a signifi- cant evolution during the last 20 years, emerg- ing as a true subspecialty among the ophthal- mology and visual sciences with the aim of decreasing refractive errors in the patients’ eyes. It aims to optimize the quality of the retinal image without any accessory optical correction. In this area, there are different surgical tech- niques: those performed on the cornea with the purpose of improving the refractive state (cor- neal refractive surgery), and refractive intraocu- lar techniques that consist of implanting an additional lens into the eye with adequate power. Since the surface of the cornea and its air–tear interface are responsible for approxi- mately two-thirds of the refractive power of the eye, it is logical that most refractive surgical procedures seek to change its shape. LASIK is a corneal refractive surgery that is the most extended and popular procedure now- adays. In LASIK, the changes produced in the
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Transcript of Mesothelioma Attorney Magnolia DE
Mesothelioma Attorney Magnolia DE
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