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Zhou C, Li Y, Wang Y, Fan Q, Dai L. Comparison of visual quality after SMILE correction of low-to-moderate myopia in different optical zones. Int Ophthalmol 2023; 43:3623-3632. [PMID: 37453939 PMCID: PMC10504213 DOI: 10.1007/s10792-023-02771-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 06/22/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE To compare the effects of different optical zones for small-incision lenticule extraction (SMILE) on postoperative visual quality in low-to-moderate myopia. METHODS This retrospective case-control study involved patients who underwent SMILE using two optical-zone diameters: 6.5 mm (50 patients, 100 eyes) and 6.8 mm (50 patients, 100 eyes). Uncorrected visual acuity (UCVA), best corrected visual acuity, spherical equivalent (SE), corneal higher-order aberrations (HOAs), and subjective visual-quality questionnaire scores were assessed. RESULTS Postoperatively, UCVA and SE did not differ between the two groups (P > 0.05). In both groups, corneal HOAs, spherical aberration, and coma significantly increased at 1 and 3 months postoperatively (P < 0.05), while trefoil was unchanged after surgery (P > 0.05). Corneal HOAs, spherical aberration, and coma significantly differed between the groups at 1 and 3 months (P < 0.05), while trefoil did not (P > 0.05). Visual-quality scores were higher in the 6.8 mm group than in the 6.5 mm group at 1 month (P = 0.058), but not at 3 months (P > 0.05). In both groups, subjective scores significantly decreased at 1 month (P < 0.05) and gradually returned to the preoperative level at 3 months (P > 0.05). The subjective visual-quality scores were negatively and positively correlated with pupillary and optical-zone diameter, respectively (P < 0.05 for both). Objective visual-quality indicators (HOAs, spherical aberration, and coma) were negatively correlated with optical-zone diameter (P < 0.05) but not pupillary diameter (P > 0.05). CONCLUSION SMILE in different optical zones effectively corrected low-to-moderate myopia. The larger the optical-zone diameter, the better the early postoperative visual quality.
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Affiliation(s)
- Cong Zhou
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, No. 246, Xuefu Road, Nangang District, Harbin, 150086, China
| | - Ying Li
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, No. 246, Xuefu Road, Nangang District, Harbin, 150086, China
| | - Yinghan Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, No. 246, Xuefu Road, Nangang District, Harbin, 150086, China
| | - Qiuyang Fan
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, No. 246, Xuefu Road, Nangang District, Harbin, 150086, China
| | - Lili Dai
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, No. 246, Xuefu Road, Nangang District, Harbin, 150086, China.
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Zhang H, Li M, Cen Z. Excimer Laser Corneal Refractive Surgery in the Clinic: A Systematic Review and Meta-analysis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:7130422. [PMID: 35756422 PMCID: PMC9217613 DOI: 10.1155/2022/7130422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/12/2022] [Accepted: 05/18/2022] [Indexed: 12/04/2022]
Abstract
Objective To systematically evaluate the efficacy, safety, recovery speed, and long-term visual quality of excimer laser corneal refractive surgery and to provide evidence-based medicine for the promotion and use of excimer laser corneal refractive surgery. Methods Randomized controls on excimer laser refractive surgery in Web of science, PubMed, EMBASE, ScienceDirect, Cochrane Library, China Knowledge Network (CNKI), China VIP Database, Wan Fang Database, and China Biomedical Literature Database (CBM) were searched by the computer. Randomized controlled trial (RCT) data were extracted independently by two researchers, and the risk of bias of each included RCT was assessed according to the Cochrane Handbook 5.1.0 criteria. Meta-analysis of the collected data was performed using RevMan5.4 statistical software. Results In the end, 9 high-quality literatures were included, with a total of 4366 samples, and meta-analysis was used. There was no significant difference in uncorrected visual acuity WMD after excimer laser keratorefractive surgery, but there was a statistically significant difference in WMD in the safety of excimer laser keratorefractive surgery. The results of uncorrected visual acuity (close) indicated the following: Chi2 = 13.56, DF = 5, P = 0.02, and I2 = 100%; the results of uncorrected visual acuity (distance) indicated the following: Chi2 = 34.44, DF =5 (P < 00000), and I2 = 85%; the results of best corrected visual acuity (myopia) indicated the following: Chi2 = 0.65, DF = 3, P = 088 > 0.05, and I2 = 0%; the results of best corrected visual acuity (hyperopia) indicated the following: Chi2 = 1.80, DF = 3, P = 0.61 > 0.05, and I2 = 0%. Conclusion Excimer laser corneal refractive surgery is safe and effective, with faster recovery and better long-term visual acuity treatment effect. However, more studies and follow-up with higher methodological quality and longer intervention time are needed for further validation.
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Affiliation(s)
- Huang Zhang
- Department of Ophtalmology, Zhongshan Torch Development Zone People's Hospital, Zhongshan 528437, Guangdong Province, China
| | - Mingming Li
- Department of Ophtalmology, Zhongshan Torch Development Zone People's Hospital, Zhongshan 528437, Guangdong Province, China
| | - Zhimin Cen
- Department of Ophtalmology, Zhongshan Torch Development Zone People's Hospital, Zhongshan 528437, Guangdong Province, China
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Al-Mohaimeed MM. Effect of the Optical Zone Ablation Diameter on Higher Order Aberrations After Transepithelial Photorefractive Keratectomy: A Cohort Study. Cureus 2021; 13:e17630. [PMID: 34646679 PMCID: PMC8485363 DOI: 10.7759/cureus.17630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To study the effect of the optical zone diameter of ablation on higher order aberrations after transepithelial photorefractive keratectomy for myopia and myopic astigmatism. METHODS In this historical cohort study in 2019, patients were grouped into 7-mm (Gr-1) and 6.5-mm optical zones of ablation (Gr-2). Topographic and higher order aberrations at analysis diameters of 2, 4, and 6 mm were measured before and six months after transepithelial photorefractive keratectomy. The changes in the five types of higher order aberrations in the 6.5 mm and 7 mm groups were compared. The pupillary diameter was correlated with the change in the higher order aberrations. RESULTS We had 24 eyes of 12 patients in Gr-1 and 80 eyes of 40 patients in Gr-2. The trefoil type of higher order aberrations at 6 mm was significantly more prevalent in Gr-2 than in Gr-1 before surgery (p = 0.038). The change in spherical aberration six months after surgery compared with before was significantly more at 6 mm in the eyes of Gr-2 patients (p = 0.02). For the eyes managed by the 7-mm optical zone of ablation for transepithelial photorefractive keratectomy, the decline in the different types of higher order aberrations was significant. The pupillary diameter was positively correlated with the change in the third-order coma in Gr-2 (Spearman coefficient, p = 0.005). All the eyes had an uncorrected visual acuity of 0.0 LogMAR in Gr-1 and 95% in Gr-2 after surgery. CONCLUSIONS The higher order aberrations six months after transepithelial photorefractive keratectomy were similar in eyes managed with 7-mm and 6.5-mm optical zone for ablation. But a lower aberration coefficient in eyes was managed by the 7-mm zone than the 6.5-mm zone of optical ablation at 6-mm analysis diameter.
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Moshirfar M, Huynh R, Bundogji N, Tukan AN, Sant TM, McCabe SE, West WB, Drennan K, Ronquillo YC, Hoopes PC. Comparison of 6.0 mm versus 6.5 mm Optical Zone on Visual Outcomes after LASIK. J Clin Med 2021; 10:jcm10173776. [PMID: 34501222 PMCID: PMC8432203 DOI: 10.3390/jcm10173776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/13/2021] [Accepted: 08/20/2021] [Indexed: 11/24/2022] Open
Abstract
Previous studies have demonstrated safety and efficacy using 6.0 and 6.5 mm optical zones in the WaveLight EX500 Excimer Laser System but have not evaluated if differing optical zone sizes influence refractive outcomes. This study examines visual outcomes between two study populations undergoing LASIK with either a 6.0 mm (1332 patients) or 6.5 mm (1332 patients) optical zone. Outcomes were further stratified by severity of myopia (low, moderate, and high) and astigmatism (low and high). Patients were matched by age and preoperative manifest sphere and cylinder. Postoperative measurements were then compared. The 6.5 mm group demonstrated better postoperative manifest refractive spherical equivalent (MRSE), manifest sphere, and absolute value of the difference in actual and target spherical equivalent refraction (|∆ SEQ|), within the total population, moderate myopia, and low astigmatism groups, but this did not lead to improved postoperative uncorrected distance visual acuity (UDVA) or best corrected distance visual acuity (CDVA). Though astigmatic correction and postoperative angle of error were similar between optical zone sizes, they were significantly worse with high myopia. Overall, this study demonstrates differences in visual outcomes between the 6.0 and 6.5 mm optical zone sizes that may warrant consideration; however, essentially, the results are comparable between them.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA; (S.E.M.); (K.D.); (Y.C.R.); (P.C.H.)
- John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT 84132, USA
- Utah Lions Eye Bank, Murray, UT 84107, USA
- Correspondence: ; Tel.: +1-(801)-568-0200; Fax: +1-(801)-563-0200
| | - Rachel Huynh
- University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (R.H.); (T.M.S.); (W.B.W.J.)
| | - Nour Bundogji
- University of Arizona College of Medicine Phoenix, Phoenix, AZ 85004, USA; (N.B.); (A.N.T.)
| | - Alyson N. Tukan
- University of Arizona College of Medicine Phoenix, Phoenix, AZ 85004, USA; (N.B.); (A.N.T.)
| | - Thomas M. Sant
- University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (R.H.); (T.M.S.); (W.B.W.J.)
| | - Shannon E. McCabe
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA; (S.E.M.); (K.D.); (Y.C.R.); (P.C.H.)
- Mission Hills Eye Center, Pleasant Hill, CA 94523, USA
| | - William B. West
- University of Utah School of Medicine, Salt Lake City, UT 84132, USA; (R.H.); (T.M.S.); (W.B.W.J.)
| | - Kirk Drennan
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA; (S.E.M.); (K.D.); (Y.C.R.); (P.C.H.)
| | - Yasmyne C. Ronquillo
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA; (S.E.M.); (K.D.); (Y.C.R.); (P.C.H.)
| | - Phillip C. Hoopes
- Hoopes Vision Research Center, Hoopes Vision, Draper, UT 84020, USA; (S.E.M.); (K.D.); (Y.C.R.); (P.C.H.)
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Yuan B, Li J, Song H. Effect of misalignment at different orientations associated with angle κ on optical performance of aspheric intraocular lenses with different surface designs. APPLIED OPTICS 2021; 60:5917-5924. [PMID: 34263818 DOI: 10.1364/ao.423000] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/22/2021] [Indexed: 06/13/2023]
Abstract
Intraocular lens (IOL) misalignment and angle κ have had significant negative impact on post-operative quality of vision. ZEMAX software has been used to imitate the optical performance of pseudophakic eyes with different IOL surface designs at different orientations of IOL misalignment (decentration of 0.4 mm and tilt of 7°, and with the existence of 0.5 mm angle κ). We found that an aspheric balanced curve optic surface maintained better optical performance via inducing less coma aberration. Coma aberration played an unexpectedly important role in the optical performance. With angle κ, the impact of IOL misalignment on visual quality was associated with the orientation of decentration and tilt, indicating that the coma compensation also took effect in pseudophakic eyes. Due to the high incidence of post-operative IOL misalignment, our results provide evidence of the importance of considering personalized angle κ before cataract surgery for patients.
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Mortazavi SAA, Fazel F, Radmanesh P, Peyman A, Pourazizi M. Wavefront-guided photorefractive keratectomy with and without iris registration: comparison of astigmatic correction. Lasers Med Sci 2020; 36:75-81. [PMID: 32297251 DOI: 10.1007/s10103-020-03010-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 03/25/2020] [Indexed: 11/26/2022]
Abstract
This study aimed to compare the visual outcomes after photorefractive keratectomy (PRK), with and without the iris registration (IR) technology. The retrospective cohort study was performed for wavefront-guided PRK using the Technolas 217z100 excimer laser system in patients with myopic astigmatism (cylinder error - 2 to - 4 diopter [D]). Eyes were divided into IR group (IRPRK) and non-IR group (non-IRPRK). Visual acuity (VA), cylindrical refraction, and the astigmatic vector components using the Alpins method were compared between the two groups preoperatively and 6 months postoperatively. Fifty IRPRK patients (66% female, mean age 30.56 ± 6.31 years) and 50 non-IRPRK (60% female, mean age 29.60 ± 5.63 years) were enrolled. The mean logMAR uncorrected VA improved from 0.89 ± 0.44 to 0.032 ± 0.05 in the IRPRK group (P < 0.001) and from 0.89 ± 0.46 to 0.042 ± 0.06 postoperatively while follow-up in the non-IRPRK group (P < 0.001). No statistically significant differences were observed between the two groups regarding mean uncorrected distance VA (P = 0.4), corrected distance VA (P = 0.5), spherical equivalent (P = 0.16), defocus equivalent (P = 0.18), and absolute cylinder (P = 0.94). More than 90% eyes were within ± 1.00 D of emmetropia in both groups. Moreover, Alpins vector analysis revealed that no significant differences were found in any astigmatic parameters between the two groups (P > 0.05). Wavefront-guided PRK independent of the IR status is effective, safe, and predictable in patients with myopic astigmatism. No statistical significance was observed supporting data for the better outcome of visual acuity and astigmatism correction using IR in comparison with a non-IR system.
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Affiliation(s)
- Seyed Ali-Akbar Mortazavi
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farhad Fazel
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Pouria Radmanesh
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Peyman
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohsen Pourazizi
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran.
- Department of Ophthalmology, Feiz Hospital, Modares St, Isfahan, Isfahan, Iran.
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