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M.M. Pagliara, S. Trimboli, F. Molle, D. Lepore; Changes on Indication for Refractive Surgery by Means of Aberrometric Parameters . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2584.
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Purpose:the aim of this study is to evaluate the changes in the percentage of patients discarded for refractive surgery based on pre operative aberrometric examination. Methods: Starting from Nov.1999 to Jun.2001 we examined 260 candidates for refractive surgery. The mean age was 33.4 year (range: 21/58years). The mean spherical equivalent was –4.45 (range: +3.50/-13.0). Preoperatively we recorded UCVA, BVCA, manifest, automated and cycloplegic refraction, keratometric K1 and K2, topographic simK1 and K2 and I/S index, pupillometry, IOP and patient history. Uncontrolled glaucoma, autoimmune disorders, diabetes were cause of exclusion. From Jun to Sept '02 80 new candidates for refractive surgery were studied: a detailed examination of the optic quality of the corneal surface and wavefront generated by the anterior surface of the cornea study using an Eye Top CSO Topograph was added to the preoperative protocol. Results:from Nov '99 to Jun '01 49 (18,85%) patients were discarded due to insufficient residual corneal thickness, ocular hypertension and topographic diagnosed keratoconus. After the introduction of aberrometric preoperative evaluation the percentage patient judged not suitable for refractive surgery raised up to 40% (32 on 80), due to the presence of coma, and other high order aberrations. Conclusions: the use of aberrometric studies in the pre operative evaluation deeply modify the percentage of patients discarded for refractive surgery. The authors also discuss the impact of this new diagnostic technique on out coming quality of vision.
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