Contraindications of Corneal Laser Refractive Surgery
Valonen, Emilia (2024)
2024
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https://urn.fi/URN:NBN:fi:amk-2024112730521
https://urn.fi/URN:NBN:fi:amk-2024112730521
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Background: More than 25 years of experience have shown that refractive surgery techniques and corneal laser refractive surgery are safe and effective methods by correcting refractive errors. Contraindications of laser refractive surgery can be easily related to complications, and they need to be given particular attention.
Purpose: The purpose of this thesis was to describe contraindications in laser refractive surgery based on literature review and to create a guideline about the contraindications of laser refractive surgery for optometrists at Eira´s Hospital. The main task was to create a clinical assessment guideline for optometrists in their everyday work for identifying potential and non-potential pre-surgery patients.
Methods: A literature review was conducted through PubMed, Ebscohost and ScienceDirect to identify studies about contraindications of corneal laser refractive surgery. The final literature search was done in cooperation with information specialist from Oulu University Library in March 2024. The search was limited to articles written in English language and the aim was to select literature no older than 10 years. The number of studies were altogether 227. After screening the studies by reading the titles or the abstract of the studies, 18 studies were included in for further evaluation and analysis.
Results: From the chosen literature, the key elements of contraindications were defined and those were age below 18 years, corneal abnormalities, diabetes mellitus, certain drugs, external eye disease, glaucoma, the shape and thickness of cornea, pregnancy and lactation, refractive stability, uncontrolled systemic autoimmune disease, unrealistic expectations and uveitis. According to the results of the workshop, a table about contraindications was created. The guidance will increase the knowledge about contraindications and decrease unnecessary complications after corneal laser refractive surgery. In this way a better service will be given to patients, and it will lower patient unsatisfaction.
Conclusions: More optometrists work in the field of optometry and in the eye clinics nowadays and that is why the knowledge about contraindication is important. Doing the pre-examinations in a standardized way and having a specific protocol for that is crucial. When optometrists know the contraindications of corneal laser refractive surgery, the easier it is to determine whether the pre-surgery patient is a good candidate for the surgery or not.
Purpose: The purpose of this thesis was to describe contraindications in laser refractive surgery based on literature review and to create a guideline about the contraindications of laser refractive surgery for optometrists at Eira´s Hospital. The main task was to create a clinical assessment guideline for optometrists in their everyday work for identifying potential and non-potential pre-surgery patients.
Methods: A literature review was conducted through PubMed, Ebscohost and ScienceDirect to identify studies about contraindications of corneal laser refractive surgery. The final literature search was done in cooperation with information specialist from Oulu University Library in March 2024. The search was limited to articles written in English language and the aim was to select literature no older than 10 years. The number of studies were altogether 227. After screening the studies by reading the titles or the abstract of the studies, 18 studies were included in for further evaluation and analysis.
Results: From the chosen literature, the key elements of contraindications were defined and those were age below 18 years, corneal abnormalities, diabetes mellitus, certain drugs, external eye disease, glaucoma, the shape and thickness of cornea, pregnancy and lactation, refractive stability, uncontrolled systemic autoimmune disease, unrealistic expectations and uveitis. According to the results of the workshop, a table about contraindications was created. The guidance will increase the knowledge about contraindications and decrease unnecessary complications after corneal laser refractive surgery. In this way a better service will be given to patients, and it will lower patient unsatisfaction.
Conclusions: More optometrists work in the field of optometry and in the eye clinics nowadays and that is why the knowledge about contraindication is important. Doing the pre-examinations in a standardized way and having a specific protocol for that is crucial. When optometrists know the contraindications of corneal laser refractive surgery, the easier it is to determine whether the pre-surgery patient is a good candidate for the surgery or not.