Reasons not to select patients for corneal refractive surgery

Reasons not to select patients for corneal refractive surgery

Alternative title Razões para recusar candidatos à cirurgia refrativa corneana
Author Ribeiro, André Luiz Parolin Autor UNIFESP Google Scholar
Schor, Paulo Autor UNIFESP Google Scholar
Allemann, Norma Autor UNIFESP Google Scholar
Chamon, Wallace Autor UNIFESP Google Scholar
Campos, Mauro Silveira de Queiroz Autor UNIFESP Google Scholar
Institution Hospital Oftalmológico setor de Catarata
Universidade Federal de São Paulo (UNIFESP)
Abstract Purpose: To present how the section of Refractive Surgery of the Federal University of São Paulo assesses the candidates and the reasons to indicate for corneal refractive surgery. Methods: We examined 1626 patients. Anamnesis, complete ophthalmologic examination and corneal topography were performed in all patients. The patients spontaneously seeked evaluation at the Refractive Surgery Section by telephone without a previous screening. Reasons to refuse patients for refractive surgery were previously established by the Refractive Surgery Section. Results: Based on current technology and clinical experience, 265 patients (16.29%) were refused for excimer laser corneal refractive surgery. Myopia of patients who had insufficient preoperative corneal pachymetry for the laser treatment was the main cause for refusal (51 patients). Cataract (45 patients), keratoconus (31 patients), amblyopia (21 patients), hyperopia > 5 diopters and mixed astigmatism (19 patients), presbyopia (unaware ness of the need for optical correction after the procedure; 16 patients), pupillary diameter > 5mm (9 patients), single eye (9 patients), progressive myopia (8 patients), postradial keratotomy (7 patients) and low ametropia (7 patients) were among the reasons for the refusal. Conclusion: Candidates for excimer laser corneal refractive surgery may present risk factors that should be known in order to avoid complications.

Objetivo: O objetivo deste estudo é mostrar como o setor de Cirurgia Refrativa da Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP) avalia seus candidatos e quais as razões para não selecioná-los para cirurgia refrativa. Métodos: Foram examinados 1626 pacientes. Anamnese, avaliação oftalmológica completa e topografia corneana foram realizadas em todos os pacientes. Os pacientes procuraram avaliação no setor de Cirurgia Refrativa espontaneamente sem triagem prévia. Resultados: Não foram selecionados 265 pacientes (16,29%) para cirurgia refrativa na córnea. A principal razão para contra-indicar a cirurgia refrativa corneana por excimer laser foi miopia de pacientes que se apresentaram e que não tinham paquimetria corneana suficiente para o tratamento (51 pacientes). Catarata (45 pacientes), ceratocone (31 pacientes), ambliopia (21 pacientes), hipermetropia > 5 dioptrias (19 pacientes), astigmatismo misto (19 pacientes), presbiopia (pacientes que não sabiam que teriam que usar óculos para leitura após a cirurgia; l6 pacientes), diâmetro pupilar > 5 mm em ambiente iluminado (9 pacientes), olho único (9 pacientes), miopia apresentando progressão (8 pacientes), ceratotomia radial prévia (7 pacientes) e, ametropia baixa (7 pacientes) foram as causas de contra-indicação. Conclusão: Candidatos para cirurgia refrativa corneana podem apresentar fatores de risco que devem ser conhecidos de modo a diminuir os riscos pós-operatórios.
Keywords Refractive errors
Cornea
Myopia
Corneal topography
Keratoconus
Erros de refração
Córnea
Miopia
Topografia da córnea
Ceratocone
Language English
Date 2002-08-01
Published in Arquivos Brasileiros de Oftalmologia. Conselho Brasileiro de Oftalmologia, v. 65, n. 4, p. 463-466, 2002.
ISSN 0004-2749 (Sherpa/Romeo)
Publisher Conselho Brasileiro de Oftalmologia
Extent 463-466
Origin http://dx.doi.org/10.1590/S0004-27492002000400013
Access rights Open access Open Access
Type Article
SciELO ID S0004-27492002000400013 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/1498

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