Astigmatism surgery by jennyyingdi

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									                                                                                                                           Astigmatism surgery
C O N S E L L E R I A               D E   S A N I T A T




                                                          1. Identification and description of the procedure

                                                          It is defined as astigmatism the loss of ocular parallelism existing in the astigmatism vision of a fixed eye
                                                          (straight) and the other diverted.

                                                          The surgical procedure consists in acting on the extraocular muscles in charge of the ocular motility.
                                                          According to the type of deviation, we will act on one eye or both.

                                                          The surgery is performed weakening the muscles or muscles which are more active together with or not,
                                                          the strengthening of the weaker ones.

                                                          For this we must open the Conjunctive, precede to the muscle dissection and generally we retro-insert
                                                          to weaken and shorten to strengthen. This supposes cutting and suturing the conjunctive and the muscle.

                                                          2. Purpose of the procedure and benefits that are expected to be achieved

                                                          The surgery does not modify the glasses prescription or other indication of the refraction defect if it exists.
                                                          It does not influence the monocular vision hence; the surgery is never programmed for improving the
                                                          visual sharpness.

                                                          The surgical result may not result stable with time, especially in cases of bad functioning prognostic and
                                                          in children while growing.

                                                          Aesthetic purpose:

                                                             In any age to diminish or suppress the deviation. In case of always having had astigmatism, with good
                                                             vision in both eyes, upon recuperating the parallelism there is a risk of double vision. This must always
                                                             be kept n consideration.

                                                          Functional purpose:

                                                             To be able to re-establish the binocular vision if it existed before: Children with late astigmatism adults
                                                             after a muscular paresis or paralysis. In these cases there exists the bothersome symptom of double
                                                             vision (diplopia), which disappears if we are able to perfectly align the eyes, and we restore both eyes
                                                             working in unison.

                                                          In paralysis it is exceptional to restore the normal movements, hence it’s indicated to restore aesthetics
                                                          and binocular normality in a forward position.

                                                          In some cases the surgery is indicated in torticollis of ocular cause, or to be able to block the nystagmus
                                                          (rhythmic and involuntary eye movement).

                                                          3. Reasonable alternatives to this procedure

                                                          The botulinum toxin injection can cause an artificial and reversible paresis of a hyperfunctioning muscle
                                                          it can be indicated in some cases of strabismus.

                                                          4. Foreseeable consequences of its performance

                                                          As indicated before, after the surgery the eye parallelism is restored, at least partially.
      SPECIALITY IN OPHTHALMOLOGY




                                                          5. Foreseeable consequences of its non performance

                                                          If the operation is not performed the eye parallelism is not restored, facilitating the development of an
                                                          amplyopia.

                                                          6. Frequent risks

                                                          Intraoperative:
                                                              Those belonging to general anaesthesia for children or adults.
                                                              Cardiac arrhythmias and bradycardia due to muscular traction
                                                              Muscular or subconjunctival haemorrhage*
                                                              Muscular sliding
                                                              Sclera perforation*
                                                              In re-interventions with more technical difficulty, the anterior may be favourable

                                                          Postoperative:
                                                             Allergic reaction to the sutures
                                                             Sutures becoming undone
                                                             Retractile conjuntival scarring, granulomas and conjuntival cysts
                                                             Marginal keratitis
                                                                                            Astigmatism surgery

After-effects:
   Asymmetry in the palpebral slant*
   Limitation of the ductions*
   Hypo or Hypercorrection of the strabismus deviation*
   Asthenopia
   Diplopia
   Torticollis
The risks of the botulinum toxin injection are indicated with an asterisk (*).
7. Infrequent risks.
Other risks are less frequent, but more serious:
   Orbital cellulites and mortality.
8. Risks depending on the patient's clinical situation
The associated systematic pathologies such as diabetes, hypertension, heart disease, immunodepression
and others, increase the surgical risk and the possibility of intra and post-operative complications.




    9. Declaration of consent
    Mr./Mrs./Miss.                                 aged          , with home address at
                                                    , National Identity No.                          and SIP number

    Mr./Mrs./Miss.                                 aged           , with home address at
                                     acting in the capacity of (the patient's legal representative, relative or close
    friend)                                                       , with National Identity No.
    HEREBY DECLARE:
    That the Doctor                                        has explained to me that it is advisable/necessary in my
    situation to perform


    In                          on                               ,2
                                                                                                                        SPECIALITY IN OPHTHALMOLOGY




    Signed: Mr./Mrs./Miss.                               With National Identity Card No


    Signed: Dr.                                         With National Identity Card No
    Associate number


    10. Revocation of the consent
    I hereby revoke the consent granted on the date of                            ,2               and I do not wish
    to carry on with the treatment that I hereby terminate on this date.
    In                          on                               ,2


    Signed: The Doctor                                  Signed: The patient

    Associate number:

								
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