Evaluation of laser in situ keratomileusis for myopic correction performed under thin flaps

AIM: To evaluate the efficacy and safety of laser-assisted subepithelial keratectomy (LASIK) for myopic correction done under thin flaps (120 μm) and compare with results obtained under thick flaps (150 μm).

METHODS: The study included 150 myopic eyes of 75 patients without previous refractive surgery who underwent LASIK prospectively. Two microkeratome heads (90 and 130) were used to create a flap with thickness of 120 μm and 150 μm, respectively. Thin flap group (120 μm) included 75 eyes while thick flap group included 75 eyes. Follow-up period was 12 mo. Efficacy, safety, and stability were evaluated and compared between the two groups.

RESULTS: In 150 eyes, the mean preoperative spherical equivalent refraction was -8.65 ± 2.6 D, mean sphere was -4.4 ± 3.5 D, and mean cylinder was -1.0 ± 1.3 D. The amount of ablation was significantly larger in the thin flap (88.5 ± 32.21 μm) group than in the thick flap group (64 ± 28.13 μm). Percentage of safety was higher in the thin flap group (94.8%) than in the thick flap group (91.7%). There were no intraoperative complications, especially flap-related problems. Subjective symptoms of dry eye occurred in 20.7% and 33.3% of eyes in the thin and thick flap groups, respectively.

CONCLUSION: Thin-flap LASIK is effective and safe in correcting myopic defects. It achieves better visual results, rapid visual recovery, and stable postoperative refraction than LASIK with thick flaps.

What is the purpose of launching the World Journal of Ophthalmology?

Welcome to the World Journal of Ophthalmology (WJO), a new general ophthalmology journal from Baishideng Publishing Group. The aim of the journal is to promote high quality research for and from eye-care practitioners all over the world. The WJO is a new member of the World Journal series of peer-reviewed, international English-language, open-access journals that are designed to provide a fast peer review process for all submitted manuscripts. We intended to provide the most up-to-date electronic means of articles in all fields of ophthalmology. New journal that is available on internet for everyone will provide a forum for publication and free access of high quality scientific papers documenting clinical and experimental advances in the areas of ophthalmology. All subspecialties within ophthalmology, visual sciences, pharmacology and drug therapy in eye diseases, primary and secondary eye care, patient safety reports, surgical techniques, and improvements in quality of care will be accepted for publication. We look forward in the future to your fascinating contributions to the WJO.

Changes in peripapillary retinal nerve fiber layer thickness in patients with primary open-angle glaucoma after deep sclerectomy

AIM: To assess changes in peripapillary retinal nerve fiber layer (RNFL) thickness and visual field (VF) in patients with glaucoma after reduction of intraocular pressure (IOP).

METHODS: Thirty-five consecutive patients with bilateral high tension glaucoma were included in the study. Thirty-five eyes underwent monocular deep sclerectomy (surgery group) and the medically treated fellow eyes served as controls (control group). Quantitative analyses of the peripapillary RNFL thickness by optical coherence tomography (OCT) and global VF indices by automated perimetry were performed before surgery and six months after surgery in both eyes. The changes in RNFL thickness overall and by quadrant were evaluated and studied with respect to age, best-corrected visual acuity (BCVA), preoperative global VF indices, postoperative IOP changes, and postoperative changes in global VF indices. Changes observed in RNFL thickness and VF indices were compared between eyes after surgery and fellow eyes.

RESULTS: Six months after surgery, the overall IOP decreased from a baseline mean of 24.5 ± 3.2 mmHg to 11.5 ± 2.7 mmHg (P < 0.001) at the time of OCT testing. A significant increase in the overall mean RNFL thickness was observed after surgery (P < 0.001). The preoperative VF mean deviation was significantly correlated with a postoperative increase in the RNFL thickness (P < 0.075). No correlation was found between RNFL thickness changes and age, BCVA, or changes in the global VF indices. There was no significant difference between eyes with an IOP reduction of more than 50% and those with a reduction in IOP less than 30% (P = 0.312).

CONCLUSION: A significant increase in the peripapillary RNFL thickness was associated with IOP reduction by glaucoma filtration surgery as measured by OCT.