Weighing The Benefits And Drawbacks Of RLE In Presbyopes

Cosmetic surgeons have actually seen differing degrees of interest in RLE in presbyopic patients in current years. At a practice like that of Daniel S. Durrie, M.D., clinical professor of ophthalmology, University of Kansas, Overland Park, most of presbyopic clients will have RLE carried out. His practice does not accept Medicare and is personal pay only. By contrast, Y. Ralph Chu, M.D., adjunct partner teacher of ophthalmology, University of Minnesota, Minneapolis, and medical professor of ophthalmology, University of Utah, Salt Lake City, said just a little portion of his clients are RLE.

Dr. Chu said. Dr. Packer, an avid fan of RLE, said the number of RLEs he has actually carried out has actually reduced since 2007 and 2008, a pattern he believes relates to the financial decline. Dr. Hovanesian said.

Because enhancement is needed in 10-20% of patients at Dr. Hovanesian's practice, the expense of laser enhancement is consisted of with the cost of RLE. Selecting the right patient for RLE involves a comprehensive diagnostic work up that consists of retinal optical coherence tomography, endothelial cell counts, and examination (and possible treatment) of the patient's lashes, covers, and tear movie, Dr. Durrie stated.

If pre-op screening finds the client has any concomitant pathology such as epiretinal membranes or glaucoma, Dr. Packer takes a more careful approach with RLE. RLE can be an ideal fit for lots of hyperopic clients, however it also can be an choice for some myopes. A lot of cosmetic surgeons stated they don't discover RLE a great fit for high myopes. Dr. Hovanesian stated. There is likewise the threat for higher cystoid macular edema, Dr. Chu stated. Dr. Waltz said. For this factor, he rarely will perform RLE in high myopes.

Although there is higher care with high myopes and RLE, this risk is not a factor if the patient has previously had a posterior vitreous detachment, Dr. Packer said. A pre-op peripheral fundus examination can help examine for lattice degeneration, he said. Some studies have actually even revealed that the association between retinal detachment and RLE may be debatable, Dr. Packer said. Ultimately, he thinks the advantages of RLE may outweigh the risk for retinal detachment. However, he will preserve a closer observation of patients who are 6 or 8 D and have not previously had a posterior vitreous detachment. Much of the decision of carrying out RLE in myopesor any patientgoes back to cautious client choice and education, Dr. Waltz stated.

The role of client education Although education is necessary with any treatment, it plays an even more essential role in RLE to assist patients comprehend advantages and risks . Dr. Hovanesian chooses to provide much of the patient education himself. At Dr. Durrie's practice, he and Dr. Stahl discuss with patients their long-term and short-term vision objectives to pick the finest surgical alternatives for them. Other staff members and composed or audiovisual products have their role in the education procedure. Dr. Packer stated. The client education process is likewise the time to bring up the possibility of post-op LVC, Dr. Waltz stated. Editors' note: Dr. Chu has financial interests with Abbott Medical Optics (AMO, Santa Ana, Calif.) and Bausch & Lomb (Rochester, N.Y.). Dr. Durrie has monetary interests with AMO and Alcon (Fort Worth, Texas). Dr. Hovanesian has monetary interests with AMO and Bausch & Lomb. Dr. Packer has monetary interests with AMO and Bausch & Lomb. Dr. 20 20 lasik denver Waltz has a financial interest with AMO. Waltz: 317-845-9488, [email protected] All rights reserved.

Dr. Solomon examines this highly in-depth profile and transfers it to the laser. Step 2: Dr. Solomon utilizes the security and accuracy of the computer-controlled laser to create a corneal flap.

He carefully folds this flap back to prepare the eye for the treatment laser. Step 3: Dr. Solomon utilizes a cool laser beam to improve the cornea and lower sources of irregularities. During this procedure, he uses multiple tracking and positioning systems to guarantee both safety and precision throughout the whole procedure. Step 4: Finally, Dr. Solomon moves the protective flap that was produced in action 2 back to its initial position. The cornea begins healing right away, and the client may return home. We make vision correction more affordable with our unique deals.

Dr. Packer, an devoted advocate of RLE, stated the number of RLEs he has performed has decreased because 2007 and 2008, a trend he thinks relates to the economic decline. Selecting the best client for RLE includes a comprehensive diagnostic work up that includes retinal optical coherence tomography, endothelial cell counts, and examination (and possible treatment) of the patient's lashes, lids, and tear movie, Dr. Durrie stated. There is higher caution with high myopes and RLE, this risk is not a aspect if the patient has previously had a posterior vitreous detachment, Dr. Packer stated. Much of the choice of performing RLE in myopesor any patientgoes back to cautious client choice and education, Dr. Waltz stated.


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At Dr. Durrie's practice, he and Dr. Stahl go over with patients their short-term and long-lasting vision goals to choose the best surgical alternatives for them.