Tapping on specific areas of the body to check for the presence of air, liquid, or solid structures.Listening to internal body sounds to check the heart, lungs, or abdominal organs.Touching areas of a person's body to check for pain, tenderness, swelling, lumps, masses, or other changes.Looking at a person's body to check for normal findings and any changes that may indicate a diagnosis.Checking a person's vital signs, including temperature, heart rate, breathing rate, blood pressure, weight, and height.The methods used during the exam may differ depending on the symptoms but commonly involve: If available, the doctor may also review a patient's medical records including the results of previous tests and procedures.ĭuring the physical exam, the doctor will study the patient's body to look for physical signs of a medical problem. They also commonly ask about the past medical history, medications, allergies, the patient's social history, and the family's medical history. Combined treatments and improved screening could eliminate the need for surgical management in most cases of PMD.To begin the diagnostic process, a doctor or other health care provider will take a medical history by asking questions about the patient's current symptoms and diagnoses. Corneal collagen cross-linking is especially exciting because it halts disease progression. Combining treatments such as ICRS, CXL, toric PIOL implantation, and refractive surgery is promising, but additional studies are needed to investigate their efficacy and safety.Īlthough little is understood about the etiology, pathophysiology, epidemiology, and genetics of PMD, new treatments are improving visual outcomes and reducing complications. CXL demonstrates effectiveness without complications, although data are limited and long-term results are needed. ICRS implantation can delay penetrating keratoplasty and improve contact lens tolerance, but does not treat the underlying process. Toric PIOL implantation is effective, but ectasia progression is a concern. Crescentic lamellar keratoplasty and TILK are effective, but technically difficult and without long-term results. CLWR is effective, but lacks long-term results. FTCWR has good visual outcomes, but with significant astigmatic drift. DALK provides visual outcomes similar to penetrating keratoplasty without the risk of immune-mediated graft rejection, but its complexity and relative novelty limit its acceptance. Penetrating keratoplasty is the treatment of last resort in PMD and is effective, but with considerable complications. Reported data for each treatment is presented. This is the first review article looking at the literature specific to PMD. To review and evaluate current and future directions in the diagnosis and surgical management of pellucid marginal degeneration (PMD), including penetrating keratoplasty, full-thickness crescentic wedge resection (FTCWR), deep anterior lamellar keratoplasty (DALK), crescentic lamellar wedge resection (CLWR), crescentic lamellar keratoplasty, tuck-in lamellar keratoplasty (TILK), toric phakic intraocular lens (PIOL) implantation, intrastromal corneal ring segment implantation (ICRS), corneal collagen cross-linking (CXL), and combined therapies.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |