الفهرس 
Microscopic Anatomy:Only 14 pages are availabe for public view
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Abstract
Post-LASIK regression is not extremely common and can be a significant problem for affected patients and their eye-care providers. Patients should be examined carefully prior to LASIK for any signs of ocular surface disease, and treated to optimize the ocular surface in order to increase both the accuracy of surgery and the patients’ postoperative comfort. Careful attention should be taken during surgery to minimize ocular surface damage.
Identifying preoperative dry eyes, and conscientious attention and treatment in the perioperative time period, can lead to enhanced patient satisfaction and more accurate visual outcomes. Improved understanding of the development of dry eyes after LASIK will advance our understanding of the complex pathophysiology of dry eye disease. In patients with symptomatic post-LASIK dry eyes, symptoms and signs should be treated aggressively to optimize visual outcomes, speed visual recovery and improve comfort
One of the major disadvantages of LASIK is the reductions of the biomechanical stability of the cornea. Prophylactic collagen cross-linking for high-risk LASIK cases appears to be a safe and effective adjunctive treatment for refractive regression and potential ectasia. This application may be viewed as prophylactic customization of the biomechanical behavior of corneal collagen. Several presentations and pertinent publications are reviewed, along with the key steps of the enhanced LASIK procedure. . Long term outcome data support the safety and efficacy of LASIK Xtra in stabilizing myopic and hyperopic LASIK results. In conclusion, they have compelling evidence that LASIK Xtra is a safe and effective adjunct.
The pattern of peripheral refraction changes significantly after LASIK surgery. This change in peripheral focusing of the postsurgical eye is statistically significant beyond the central 35° of the central visual field. they feel that the opportunity to actively participate in controlling myopia in post-refractive surgery patients is a responsibility of the eyecare profession whether we use conventional or orthokeratology lenses. Overnight ortho-k lenses offer patients an alternative to the current options of additional surgery, daytime spectacles or contact lenses. Corneal refractive therapy/ortho-k is another tool to help us provide our patients with optimal visual quality and convenience.
Regression after LASIK is associated with epithelial hyperplasia. It’s hypothesized that epithelial hyperplasia may be due to both hyperactive basal epithelium and decreased exfoliation of the superficial epithelium in ablated cornea depressed by the eyelids during blinking. Regression rarely recurs after an enhancement, even though the ablated area becomes depressed again. Possibly the basal epithelium becomes less active as time passes after original keratectomy, or perhaps the second correction is simply too minimal to induce significant activity of the basal epithelium. If the activity of the basal epithelium indeed normalizes at 3 months after the original LASIK, partial ablation of superficial epithelium following LASIK regression may produce a stable result.