Determinación del poder corneal luego de cirugía refractiva con éxcimer láser en el Centro Oftalmológico Virgilio Galvis

Jaramillo Muñoz, Luis Carlos

dc.contributor.advisor	Galvis Ramírez, Virgilio	spa
dc.contributor.advisor	Tello Hernández, Alejandro	spa
dc.contributor.advisor	Camacho López, Paul Anthony	spa
dc.contributor.author	Jaramillo Muñoz, Luis Carlos	spa
dc.date.accessioned	2020-06-26T20:01:40Z
dc.date.available	2020-06-26T20:01:40Z
dc.date.issued	2015-12
dc.identifier.uri	http://hdl.handle.net/20.500.12749/1777
dc.description.abstract	La cirugía refractiva con excimer láser es un procedimiento quirúrgico muy frecuente desde hace más de 20 años, por lo que actualmente, muchos pacientes con antecedente de cirugía refractiva están llegando a necesitar debido a la aparición de catarata, la implantación de un lente intraocular. Para un adecuado cálculo del mismo, es de suma importancia conocer el poder corneal del paciente, el cual se infiere matemáticamente mediante el uso del índice queratométrico. Desafortunadamente el índice queratométrico es impreciso en aquellos casos en donde haya una alteración de la superficie corneal, como por ejemplo la cirugía refractiva. Varios estudios han demostrado que el cálculo del poder corneal usando el índice queratométrico como guía genera sobre-estimaciones en pacientes con antecedente de corrección miópica y subestimaciones en tratamientos hipermetrópicos. Este estudio tiene como objetivo evaluar la utilidad de la técnica de trazado de rayos (Mean Pupil Power) en el cálculo del poder corneal real ofrecido por el topógrafo Sirius (CSO, Costruzione Strumenti Oftalmici) y si este se correlaciona al calculado por el método de la historia clínica introducido por Holladay en 1989, el cual hasta el momento se considera como la “regla de oro”.	spa
dc.description.tableofcontents	1. INTRODUCCIÓN ............................................................................................................................... 4 2. MARCO TEÓRICO ............................................................................................................................ 6 2.1 Causas de errores biométricos en ojos post-cirugía fotorrefractiva ................................... 8 2.2 Determinación del poder de la córnea en un ojo normal ......................................................... 8 2.3 Error en la determinación del poder corneal después de cirugía fotorrefractiva ...... 12 2.4 Métodos para compensar los errores en la determinación del poder del lente intraocular ............................................................................................................................................................... 14 2.5 Métodos para calcular el poder de la córnea luego de cirugía refractiva ...................... 14 El método de la Historia Clínica................................................................................................................ 14 El método del lente de contacto ................................................................................................................. 15 El método de Hammed-Wang-Koch ........................................................................................................ 16 El método de Wang–Koch-Maloney ........................................................................................................ 17 El método de Shammas ................................................................................................................................. 17 El método de Haigis L .................................................................................................................................... 18 Otros métodos ................................................................................................................................................... 18 3. HIPÓTESIS ........................................................................................................................................ 21 4. OBJETIVOS ....................................................................................................................................... 21 4.1 General ....................................................................................................................................................... 21 4.2 Específicos ................................................................................................................................................. 21 5. METODOLOGÍA ............................................................................................................................. 22 5.1 Tipo de estudio ........................................................................................................................................ 22 5.2 Universo y Muestra ............................................................................................................................... 22 5.3 Población.................................................................................................................................................... 22 5.4 Criterios de Selección ........................................................................................................................... 22 Inclusión............................................................................................................................................................... 22 Exclusión ............................................................................................................................................................. 22 5.5 Instrumentos de Recolección ............................................................................................................. 23 5.6 Procedimiento Quirúrgico .................................................................................................................. 23 5.7 Recolección y Análisis de Datos ....................................................................................................... 23 6. CONSIDERACIONES ÉTICAS .................................................................................................. 25 7. RESULTADOS ................................................................................................................................. 26 8. DISCUSIÓN ....................................................................................................................................... 38 9. CONCLUSIONES ............................................................................................................................ 42 10. REFERENCIAS BIBLIOGRÁFICAS ................................................................................... 43 Anexo 1 ........................................................................................................................................................ 48 Carta de Aval del Comité de Ética en Investigaciones Foscal (CEI - FOSCAL) ...................... 48	spa
dc.format.mimetype	application/pdf	spa
dc.language.iso	spa	spa
dc.rights.uri	http://creativecommons.org/licenses/by-nc-nd/2.5/co/	*
dc.title	Determinación del poder corneal luego de cirugía refractiva con éxcimer láser en el Centro Oftalmológico Virgilio Galvis	spa
dc.title.translated	Determination of corneal power after refractive surgery with laser excimer at the Virgilio Galvis Ophthalmological Center	eng
dc.degree.name	Especialista en Oftalmología	spa
dc.coverage	Bucaramanga (Santander, Colombia)	spa
dc.publisher.grantor	Universidad Autónoma de Bucaramanga UNAB	spa
dc.rights.local	Abierto (Texto Completo)	spa
dc.publisher.faculty	Facultad Ciencias de la Salud	spa
dc.publisher.program	Especialización en Oftalmología	spa
dc.description.degreelevel	Especialización	spa
dc.type.driver	info:eu-repo/semantics/masterThesis
dc.type.local	Tesis	spa
dc.type.coar	http://purl.org/coar/resource_type/c_bdcc
dc.subject.keywords	Refractive surgery	eng
dc.subject.keywords	Cornea	eng
dc.subject.keywords	Laser surgery	eng
dc.subject.keywords	Medicine	eng
dc.subject.keywords	Ophthalmology	eng
dc.subject.keywords	Research	eng
dc.identifier.instname	instname:Universidad Autónoma de Bucaramanga - UNAB	spa
dc.identifier.reponame	reponame:Repositorio Institucional UNAB	spa
dc.type.hasversion	info:eu-repo/semantics/acceptedVersion
dc.rights.accessrights	info:eu-repo/semantics/openAccess	spa
dc.rights.accessrights	http://purl.org/coar/access_right/c_abf2	spa
dc.relation.references	Jaramillo Muñoz, Luis Carlos (2015). Determinación del poder corneal luego de cirugía refractiva con éxcimer láser en el centro oftalmológico Virgilio Galvis. Bucaramanga (Santander, Colombia) : Universidad Autónoma de Bucaramanga UNAB	spa
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dc.contributor.cvlac	https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0001009125;https://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000552453	*
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dc.contributor.researchgate	https://www.researchgate.net/profile/Virgilio_Galvis	*
dc.subject.lemb	Cirugía refractiva	spa
dc.subject.lemb	Córnea	spa
dc.subject.lemb	Cirugía laser	spa
dc.subject.lemb	Medicina	spa
dc.subject.lemb	Oftalmología	spa
dc.subject.lemb	Investigaciones	spa
dc.description.abstractenglish	Refractive surgery with excimer laser is a very common surgical procedure since more than 20 years ago, so today, many patients with a history of surgery refractive are coming to need due to the appearance of cataract, the implantation of a intraocular lens. For an adequate calculation of the same, it is very important to know the corneal power of the patient, which is mathematically inferred by using the keratometric index. Unfortunately the keratometric index is imprecise in those cases where there is an alteration of the corneal surface, such as refractive surgery. Various studies have shown that the calculation of corneal power using the keratometric index as a guide, it generates overestimations in patients with a history of myopic correction and underestimations in hyperopic treatments. This study aims to evaluate the usefulness of the ray tracing technique (Media Pupil Power) in the calculation of the real corneal power offered by the Sirius surveyor (CSO, Costruzione Strumenti Oftalmici) and if this correlates to that calculated by the clinical history introduced by Holladay in 1989, which until now is considered as the "golden rule".	eng
dc.rights.creativecommons	Atribución-NoComercial-SinDerivadas 2.5 Colombia	*