OSCE 1 Objective Structured Clinical Examination of FRCOphth exam إمتحان الزمالة البريطانية للعيون скачать в хорошем качестве

OSCE 1 Objective Structured Clinical Examination of FRCOphth exam إمتحان الزمالة البريطانية للعيون

A case of refractive corneal procedure: SMILE: SMall Incision Lenticule Extraction Clinical findings: SMILE incisions for Myopia Posterior Vitreous Detachment and Myopic fundus. Indications: Myopia ranging from -0.5 D to -12 D spherical equivalent, with myopic astigmatism up to -5 D. Age more than18 y Mesopic pupil size less than 7mm Central corneal thickness more than 475 mm Residual stromal bed more than 250 mm Stability of refraction more than 1 year Keratometry : Expected keratometry after procedure more than 35D and less than 47D Contraindications: Absolute: 1-Corneal thinning disorders like keratoconus or pellucid marginal degeneration 2-Corneal scarring or opacity which would prevent laser penetration 3-Uncontrolled glaucoma/uveitis 4-Severe dry eye/blepharitis/severe ocular allergy 5-Active eye inflammation or infection 6- Pregnancy or lactation Relative: 1-Age less than 18 2-Diabetes mellitus 3-Autoimmume disorders 4-Immunodeficient status 5-History of herpex simplex keratitis 6-Mild dry eye/mild ocular allergy 7- Irregular cornea or irregular corneal astigmatism 8- One eyed/single eye functionality 9- Epithelial basement membrane dystrophy Complications : Intraoperative: 1-Suction loss during the procedure. 2-Decentration of the treatment. 3-Incision tear or cap perforation during the procedure. 4-Tearing of the lenticule during the extraction process and subsequent retention of some lenticule tissue within the cornea. 5-Opaque bubble layer leading to difficult extraction of the lenticule. 6-Uncut areas of the lenticule owing to some foreign body or fluid between the contact glass and the cornea. 7-Lenticule adherence to the cap, resulting in a difficult extraction procedure. 8-Bleeding at the incision site. 9-Epithelial defects. Postoperative : 1-Corneal haze. 2-Diffuse lamellar keratitis. 3-Epithelial defects. 4-Ectasia. 5-Dry eyes. 6-Undercorrection or over-correction. 7-Infection.