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Microsoft word - general candidacy considerations.doc

General Candidacy Considerations
Our surgeons are available for questions regarding specific patients. Contraindicated Medications:
• Herpes Simplex – May consider if no outbreak in 3 Patients must be off of these meds for 1 month before the previous years and no corneal scarring, but will need to pre-operative exam, and continue to stay off of them for 1 start course of antiviral meds 1 week prior and continue 1 week after surgery. Patient must have adequate • Ankylosing Spondylitis – May be OK if eye has been • Pregnant/Nursing – No, if pregnant. Patient should be post-partum and done with nursing for 6 weeks prior to LASIK and PRK Limits:
Varies with pachymetry. Close scrutiny over 10 diopters. Pre-Operative Examination Protocol:
• Complete dilated exam at least 48 hours prior to • Cycloplegic exam with tropicamide 1% or cyclogyl 1% New lasers can treat increasingly significant degrees of and refraction 30 minutes after dilation. astigmatism and hyperopia. The diagnostics at our • FDA allows 0.50D change per year in Rx. Document surgical centers are often necessary to make that final age of Rx and patient’s perception of length of Rx stability (old refraction > 2 yrs ideal). Confirm stability • Wavefront patients must have a clear optical media: in younger patients or higher Rx. Old records are Any patient with cataract, corneal scar, lenticular opacity, or vitreous opacity is a poor Wavefront • Clinically significant dry-eye or blepharitis treated prior • Post-operative keratometry values: Between 33-50 (for every 1.00D of myopic correction there is approximately 0.80D of corneal flattening and for every Contacts:
1.00D of hyperopic correction there is 1.00D of corneal Soft or Toric contact lenses may not be worn for one (1) week prior to the pre-operative examination and two (2) • Amblyopia: BCVA must be 20/40 or better in Gas Permeable or PMMA (poly methyl methacrolate, i.e., • Pupil size: Qualifying patients with larger than average hard contacts) lenses may not be worn for four (4) pupil size should be counseled to have Wavefront since consecutive weeks prior to the pre-operative examination this technology has been proven to cause less glare/halo and improve nighttime vision. Wavefront requires a These contact removal guidelines are minimum Previous Eye Surgery:
requirements to achieve the best correction possible. In Radial Keratotomy: -3.00D of myopia, +3.00D some instances, the removal period prior to examination hyperopia, (with) 2.00D of astigmatism – PRK only with MMC. Less then 8 incisions used in initial RK Other Information:
CE with PCIOL: OK if sclera and cornea clear, and • Microstriae: Sometimes seen after high corrections – • Microfolds: Should consult with surgeon for a lift and Glaucoma Surgery: OK if only a glaucoma suspect. If re-float if folds appear to be affecting vision. You may any VF loss, patient needs clearance from the notice that they induce some astigmatism that may physician who is following patient’s glaucoma. Medical Conditions:
• DLK: Should consult surgeon for a possible flap lift Generally, no surgeries for patients with the following and rinsing if inflammation is dense and clumping conditions, but as always, consult with the surgeon. (Grade 3 or 4). May start PF 1% q 2° if Grade 1 or 2, • Active Rheumatoid Arthritis – If requiring medication under the supervision of a rheumatologist. • Retreats: The vision we will consider for an enhancement must be worse than 20/40. Patients must • Controlled diabetes – Any retinal damage must get have a stable prescription, wait at least 3 months after primary myopic LASIK and 6 months for hyperopic • Herpes Zoster Ophthalmicus – No. HIV +, Hepatitis B, LASIK or PRK. All enhancements must be approved

Source: http://www.restorevisioncenters.com/od-reps/pdf/general_candidacy.pdf

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Ototoxicity

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