Role of the corneal epithelium measurements in keratorefractive surgery
| Autor: | Marcella Q. Salomão, Ana Laura Canedo, Rui Carneiro-Freitas, Renato Ambrósio, Bernardo Lopes, Ana Luisa Hofling-Lima, Daniel G. Dawson |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty genetic structures medicine.medical_treatment Patient Care Planning 03 medical and health sciences 0302 clinical medicine Optical coherence tomography Anterior Eye Segment Refractive surgery Ophthalmology Ectasia medicine Humans Corneal epithelium medicine.diagnostic_test business.industry Ultrasound Epithelium Corneal Corneal Topography General Medicine Corneal topography eye diseases 030104 developmental biology medicine.anatomical_structure 030221 ophthalmology & optometry sense organs business Keratorefractive surgery Keratoplasty Penetrating Tomography Optical Coherence |
| Zdroj: | Current Opinion in Ophthalmology. 28:326-336 |
| ISSN: | 1040-8738 |
| DOI: | 10.1097/icu.0000000000000379 |
| Popis: | Purpose of review Refractive surgery has stimulated considerable progress in corneal and anterior segment imaging, and optical characterization of the eye. From front surface corneal topography, we evolved to three-dimensional corneal tomography with limbus to limbus characterization of the front and back corneal surfaces and pachymetric mapping. Corneal anatomical evaluation has further evolved to layered or segmental tomography with the ability to characterize corneal epithelial thickness profile and the elevation of stromal front surface. Further characterization of even more specific structures, such as Bowman's layer and Descement's membrane, has been also demonstrated. The applications of such understanding in keratorefractive surgery are reviewed. Recent findings Understanding the corneal epithelial profile is of interest in many areas of ophthalmology, especially in refractive surgery. The most relevant applications include screening candidates at higher risk for complications (i.e. progressive ectasia and tear dysfunction syndrome), planning primary procedures, enhancements, and therapeutic surgery, and also postoperatively understanding the wound healing and clinical outcomes. Summary Corneal epithelial thickness was first available using digital very-high-frequency ultrasound. Advances in anterior segment optical coherence tomography enabled such fundamental evaluation, which accelerated progress. Such knowledge significantly impacts safety and efficacy of refractive surgery, and also allows for significant improvement for therapeutic procedures. VIDEO ABSTRACT. |
| Databáze: | OpenAIRE |
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