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LASIK, or "laser-assisted in situ keratomileusis," is the most commonly performed laser eye surgery to treat myopia, hyperopia and astigmatism. The goal of the treatment is to reshape the cornea to correct the refractive error of the eye.
The cornea is the transparent dome-shaped structure in front of the eye. The cornea refracts light and accounts for about two-thirds of the eye's total optical power. Altering the curvature of the cornea changes the way light rays enter the eye. As a result, the light rays can be focused properly onto the retina for clearer vision.
For nearsighted people, the laser is used to flatten the cornea. For farsighted people, the cornea is made steeper. For patients with astigmatism, the laser is used to smooth the irregularly-shaped cornea into a more regular shape.
The outer layer of the cornea - the epithelium – is capable of replacing itself within a few days after being damaged or removed. The deeper layer of the cornea – the stroma, on the contrary, is a permanent corneal tissue with very limited regenerative capacity. The stroma, if reshaped by a laser, will remain that way permanently.
In this procedure, a thin, circular "FLAP" is created in the surface of the cornea to gain access to the permanent corneal tissue. This can be done with a mechanical cutting tool called a microkeratome, OR, for a blade-free experience, by a femtosecond laser. An excimer laser is then used to remove some corneal tissue to reshape the cornea. Excimer laser uses cool ultraviolet light beams to vaporize microscopic amounts of tissue in a precise manner to accurately reshape the cornea. The excimer laser is computer-controlled and is programmed based on the patient’s refractive error. The flap is then laid back in place and is allowed to heal.
LASIK eye surgery is mostly painless and can be completed within minutes. Improved vision can usually be seen overnight.
PRK, or photorefractive keratectomy, was the first type of laser eye surgery for vision correction and is the predecessor to the popular LASIK procedure. In PRK, NO flap is created. Rather, the epithelial cells on the eye surface are simply removed. An excimer laser is then used to reshape the cornea just like it does in LASIK.
The vision correction outcomes of PRK surgery are comparable to those of LASIK, but the recovery period is longer. This is because the epithelium is completely removed in PRK and it takes a few days to regenerate. PRK patients also have more discomfort and haziness of vision in the first few days after the surgery. Improved vision also takes longer to achieve.
PRK does, however, offer certain advantages. Because PRK does not involve creation of a flap, which contains both epithelial and deeper stromal tissue, the entire thickness of the stroma is available for treatment. The treatment range is therefore higher. This is particularly useful for patients with high levels of myopia or for those whose cornea is too thin for LASIK. PRK is also free of flap-related complication risks.
Curious about LASIK eye surgery? NVISION's Dr. Richard Mauer talks risks, life-changing benefits, and outcomes (plus why he loves what he does!).
Want to start your journey to better vision? Schedule your complimentary consult today! https://bit.ly/3H2i0FU
NVISION: The Eye Doctors' #1 Choice in LASIK and Laser Cataract Surgery
The Dermatology Center, UC Irvine, 949 824 0606. Foam sclerotherapy for leg veins. Unsightly leg veins are best removed with sclerotherapy in 95% of cases. Varicose veins are best removed with stab avulsion or CootTouch endovenous ablation (CTEV). Science and research at UCI.
In this video, we have explained the procedure of total #knee #replacement #surgery in patient in 3D animation.
Learn more: https://ecgkid.com
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Knee replacement, commonly known as complete knee replacement or knee arthroplasty, is a surgical treatment that resurfaces a knee that has been destroyed by arthritis. The extremities of the bones that make up the knee joint, as well as the kneecap, are capped with metal and plastic pieces. Someone with severe arthritis or a major knee injury may benefit from this procedure.
The knee joint can be affected by a variety of arthritis forms. The degradation of joint cartilage and neighboring bone in the knees can be caused by osteoarthritis, a degenerative joint disease that primarily affects middle-aged and older persons. Rheumatoid arthritis produces pain and stiffness by inflaming the synovial membrane and resulting in an excess of synovial fluid. Traumatic arthritis, or arthritis caused by an injury, can harm the joints.
The purpose of knee replacement surgery is to resurface damaged areas of the knee joint and cure knee discomfort that has not responded to prior therapies.
Uterine fibroids are the most common benign tumors and can affect one in three in Canada. While most fibroids are asymptomatic, they can cause heavy and painful periods, urinary frequency and urgency and pelvic discomfort and pain. A new treatment is available that doesn’t involve invasive surgery. With Fibristal, you can treat fibroids, relieve symptoms and finally live your life the way you want to!
The infection is generally transmitted by direct contact with the mucus or sores of someone else with strep. Common symptoms include sore throat, fever, and swollen lymph nodes in the neck. Rarely, complications can involve the heart or kidneys. Treatment is important to reduce complications. Oral antibiotics like penicillin, amoxicillin, cephalexin, or azithromycin are commonly used. Other medicines such as acetaminophen or ibuprofen can help with pain and fever.
Porcelain gallbladder is a condition characterized by calcium salt deposits in the wall of a chronically inflamed gallbladder. The calcifications can be thin or faintly visible, or may be amorphous, patchy, and thick. The gallbladder is generally large, but its size can vary considerably. Most porcelain gallbladders are associated with gallstones. A plain radiograph generally detects these, but computed tomography (CT) has a higher specificity; therefore, a CT scan is performed to confirm the diagnosis. Due to their high risk of gallbladder carcinoma, all patients with porcelain gallbladder should have an elective cholecystectomy.
Atrial fibrillation (also called AFib or AF) is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications. Some people refer to AF as a quivering heart. An estimated 2.7 million Americans are living with AF.
INDICATIONS The Absorb GT1 Bioresorbable Vascular Scaffold (BVS) is a temporary scaffold that will fully resorb over time and is indicated for improving coronary luminal diameter in patients with ischemic heart disease due to de novo native coronary artery lesions (length ≤ 24 mm) with a reference vessel diameter of ≥ 2.5 mm and ≤ 3.75 mm WHAT ARE THE POTENTIAL RISKS AND COMPLICATIONS? Treatment options for CAD have become increasingly common but, as with any invasive procedure, there are potential risk factors and complications. Serious complications do not occur often, and research is ongoing to make these procedures even safer and more effective. The risk of complications from percutaneous treatment methods may be higher for individuals: 75 years of age and older Who are women Who have kidney disease or diabetes Who have serious heart disease Who have had prior cardiac interventions
Phacolytic glaucoma usually is associated with a mature or hypermature cataract and typically occurs in elderly patients. Today, phacolytic glaucoma is rare in the United States, found primarily in areas where access to care is poor. Will the increase in the number of under- and uninsured patients lead to an increase in this condition? Evaluation and Diagnosis Signs and symptoms. Patients typically report acute-onset pain, decreased vision, tearing and photophobia. Examination will reveal injection, corneal edema, elevated IOP, anterior chamber reaction with or without pseudohypopyon, particles on the lens capsule and anterior capsule wrinkling. Patient history. The duration of symptoms should be elicited; a delayed presentation of more than five days since onset can result in glaucomatous disc damage and poorer prognosis.¹ The ocular history may reveal that the patient decided against removal of an advanced cataract. Prior intraocular surgery or trauma may have left residual lens material that could cause phacoanaphylactic glaucoma or exacerbate infectious endophthalmitis. Visual acuity and visual potential should be assessed. Exam essentials. A complete ophthalmologic examination should be done. The eye should be inflamed, and the cornea may be edematous due to the high IOP. The anterior chamber will demonstrate massive inflammation and/ or pseudohypopyon. Gonioscopy is essential; it will help rule out angle closure due to phacomorphic glaucoma or neovascularization of the angle. Assess ment of the posterior pole should be performed to rule out vitreous hemorrhage (which can result in ghost-cell glaucoma) or vitritis (which may be associated with infectious endophthalmitis or panuveitis). If the view to the fundus is obstructed, B-scan ultrasonography also should be performed. Differential diagnosis. The differential diagnosis includes infectious endophthalmitis, phacoanaphylactic glaucoma, inflammatory glaucoma, glaucoma secondary to intraocular tumor, phacomorphic glaucoma, acute-angle closure glaucoma and neovascular glaucoma. Management Medication. Medical management is used to temporarily control the glaucoma and inflammation. Initial treatment consists of hyperosmotic agents, aqueous suppressants, anti-inflammatory drugs and cycloplegics. Surgery. Definitive treatment is removal of the lens via extracapsular cataract extraction with or without an IOL. Some ophthalmologists defer placement of an IOL until after the inflammation subsides; however, there is no significant difference in final visual acuity between those patients who did receive an IOL and those who did not.¹ If the phacolytic glaucoma is of long duration (more than seven days), a combined trabeculectomy may be needed to prevent postoperative IOP spikes.² In eyes with hypermature Morgagnian cataracts, one must be especially careful, as the capsule is fragile, the zonules are weak and the view is difficult due to the white, milky cortex. Vision limited to light perception on presentation is not a contraindication to performing cataract extraction. Surgical Tips For a planned extracapsular cataract extraction with a posterior chamber IOL, fashion a superior fornix-based conjunctival flap.³ Make a partial-thickness incision along the sclerolimbal junction superiorly for 120 degrees with a No. 69 blade. Forty-five degrees away, a paracentesis should be done to decompress the eye. The anterior chamber fluid can be withdrawn for analysis, to look for macrophages and high molecular-weight proteins. Inject balanced salt solution in a cannula to wash out any residual particulate matter, then inject Healon or viscoelastic into the anterior chamber. Make an incision entering the anterior chamber at the 12 o’clock position with a keratome. A 26-gauge cystotome mounted on a syringe is then introduced through the 12 o’clock incision and used to puncture the capsular bag. The milky cortex should be aspirated as much as possible, until the nucleus is visible. Withdraw the needle through the keratome incision, then inject Healon through the 12 o’clock incision into the capsular bag. Next, enlarge the corneoscleral keratome incision with curved Westcott scissors to 120 degrees. Perform a partial V-shaped capsulotomy; this can be done either with the cystotome or with an angled Vannas scissors. Place viscoelastic under the nucleus to float the nucleus and sever any adhesions between the nucleus and the capsule. The nuclear portion of the lens can then be removed with an irrigating vectis (lens loop) with or without gentle pressure at the inferior limbus (6 o’clock). Irrigate and aspirate the residual cortex with the Simcoe cannula. Inspect the capsular bag; if it is intact, place a posterior chamber IOL into the bag. Close the incision with several interrupted 10-0 monofilament nylon sutures and reattach the conjunctival flap. Potential Sequelae and Prognosis Postoperatively, the patient should be managed with topical steroids and/or aqueous suppressants and hyperosmotics if necessary. Vitreous opacification behind the posterior capsule occurs in a small percentage of eyes. These vitreous opacities are typically absorbed by one to two weeks postoperatively. IOP usually is controlled without antiglaucoma medications after the cataract removal. A detailed glaucoma evaluation (including repeat gonioscopy to assess for peripheral anterior synechiae, visual field and optic nerve status) should be done to assess the extent of glaucomatous damage. The prognosis is dependent on the duration of elevated IOP, PAS and optic nerve damage. In one study, patients who were older than 60 and whose glaucoma was present for more than five days did significantly worse than a comparison group of younger individuals with shorter disease duration.
Urinary tract infections (UTIs) are infections of the urethra, bladder, ureters, or the kidneys, which comprise the urinary tract. E. coli bacteria cause the majority of UTIs, but many other bacteria, fungi, and parasites may also cause UTIs. Females have a higher risk for UTIs than most males, probably because of their anatomy; other risk factors for UTIs include any condition that may impede urine flow (e.g., enlarged prostate, kidney stones, congenital urinary tract abnormalities, and inflammation). Patients with catheters or those who undergo urinary surgery and men with enlarged prostates are at higher risk for UTIs.
Epidural hematoma (EDH) is a traumatic accumulation of blood between the inner table of the skull and the stripped-off dural membrane. EDH results from traumatic head injury, usually with an associated skull fracture and arterial laceration.The inciting event often is a focused blow to the head, such as that produced by a hammer or baseball bat. In 85-95% of patients, this type of trauma results in an overlying fracture of the skull. Blood vessels in close proximity to the fracture are the sources of the hemorrhage in the formation of an epidural hematoma. Because the underlying brain has usually been minimally injured, prognosis is excellent if treated aggressively. Outcome from surgical decompression and repair is related directly to patient's preoperative neurologic condition. [1]