Refractive surgical problem

摘要

My recommendation to this patient would be cataract surgery in both eyes. The first step would be to assess the final refractive results she desires. Having already had refractive surgery, I suspect the patient would be interested in some degree of spectacle independence. Thus, my conversation with her would focus on presbyopia-correcting intraocular lenses (IOLs) and the removability of the previously implanted corneal inlays. Additional testing and examinations I would recommend are corneal wavefront assessment, dynamic pupil measurement, confocal biomicroscopy of the cornea (when possible), and posterior segment optical coherence tomography. Once I assessed the suitability of a standard cataract procedure and- the possibility of implanting presbyopia-correcting IOLs, I would suggest removing the inlays and waiting for refractive stability and corneal surface stabilization, which usually take a couple of weeks.