1
|
Alrashidi SH. Effect of Ablation Depth on the Endothelial Status of Eyes of Myopic Patients Undergoing Transepithelial Photorefractive Keratectomy: A Retrospective Study in Saudi Arabia. Cureus 2024; 16:e64527. [PMID: 39139351 PMCID: PMC11321596 DOI: 10.7759/cureus.64527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2024] [Indexed: 08/15/2024] Open
Abstract
PURPOSE The aim of this study was to correlate ablation depth on corneal endothelial cell (EC) indices following transepithelial photorefractive keratectomy (TPRK) in Saudi myopic patients. METHODS This was a retrospective cohort study of myopic eyes treated with TPRK. The changes in EC density and other indices were noted one week (W1) and 12 weeks (W12) after TPRK, which was the primary outcome. The laser ablation depth (AD) was correlated to the EC indices. The preoperative factors were also correlated to the outcomes using regression analysis to review predictors of change in the EC density. RESULTS We had 120 eyes of 60 myopic patients operated on for TPRK. The mean of maximum AD (Adm) and central AD (ADc) were 110.3±23.7 µ and 108.8±24.4 µ, respectively. The median change in EC count at W1 and W12 were -9.5 (interquartile range (IQR) -33.0, 17.0) and -3.0 (IQR -29.3, 13.3), respectively. The ADm was negatively correlated to a change in EC density at W1 (Wilcoxon (Z) =-2.7, P = 0.006) and at W12 (Z = -3.74, P <0.001). ADm (Kruskal-Wallis (K-W) test (P) = 0.167), ADc (K-W P = 0.08), central corneal thickness (K-W P = 0.65), and use of mitomycin-C (K-W P = 0.357) were not significant predictors of the change in EC density at W1. None of the variables significantly influenced the change in EC density at W12. CONCLUSIONS The corneal ablation depth for TPRK is correlated to changes in EC density at W1 and W12 after TPRK.
Collapse
Affiliation(s)
- Sultan H Alrashidi
- Department of Ophthalmology, College of Medicine, Qassim University, Buraidah, SAU
| |
Collapse
|
2
|
Poláčková V, Šindelářová H, Lahodová K, Němcová I, Šín M. Refractive Errors Among Members of the Armed Forces of the Czech Republic. CESKA A SLOVENSKA OFTALMOLOGIE : CASOPIS CESKE OFTALMOLOGICKE SPOLECNOSTI A SLOVENSKE OFTALMOLOGICKE SPOLECNOSTI 2024; 80:34-41. [PMID: 38365580 DOI: 10.31348/2024/7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Objective: To evaluate the prevalence of refractive errors among members of the Armed Forces of the Czech Republic, to recommend a safe way of correcting refractive errors with regard to the specific needs of military personnel (especially members of combat units and flying personnel), and to propose a system for solving these errors in order to increase combat effectivity. Methodology: Questionnaire to determine previous refractive surgery and spectacle correction wear. Measurement of refraction with a hand-held autorefractometer and evaluation of current visual acuity on ETDRS optotypes (Landolt rings). Results: 259 servicemen (518 eyes) were investigated. The return rate of the questionnaires was 100%. The incidence of myopia greater than -0.75D was 22% (113 eyes), myopia greater than -0.5D 32% (166 eyes). The mean value of myopia was -0.78 D (SD ±0.6). Hypermetropia values ranged from +0.25 to +5.0 D. The mean value of hypermetropia was 0.63 D (SD ±0.7). Astigmatism values ranged from -0.25 to -3.75. The mean value of astigmatism was -0.55 Dcyl (SD ±0.49). The average visual acuity was 84.1 letters ETDRS SD (±6.1), visual acuity worse than 80 letters was manifested by 23% of the members of the monitored group. 25 people (10%) had undergone laser refractive surgery. Visual acuity after laser refractive surgery was measured in 19 people (38 eyes). Mean uncorrected post-laser visual acuity was 83.87 (SD ±6.1) ETDRS letters. The mean follow-up period after laser refractive surgery was 6.78 (SD ±4.8) years. Conclusion: Despite the initial selection of military personnel and entry limitations, the prevalence of refractive errors is comparable to the general population. However, in contrast with the general population, refractive errors larger than -3.0 D were not represented in the group. Due to the finding of insufficient correction of refractive errors, increased emphasis should be placed on identifying and regularly observing military personnel with refractive errors
Collapse
|
3
|
Cione F, De Bernardo M, Gioia M, Oliviero M, Santoro AG, Caputo A, Capasso L, Pagliarulo S, Rosa N. A No-History Multi-Formula Approach to Improve the IOL Power Calculation after Laser Refractive Surgery: Preliminary Results. J Clin Med 2023; 12:jcm12082890. [PMID: 37109228 PMCID: PMC10144756 DOI: 10.3390/jcm12082890] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/06/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
This retrospective comparative study proposes a multi-formula approach by comparing no-history IOL power calculation methods after myopic laser-refractive-surgery (LRS). One-hundred-thirty-two eyes of 132 patients who had myopic-LRS and cataract surgery were examined. ALMA, Barrett True-K (TK), Ferrara, Jin, Kim, Latkany and Shammas methods were evaluated in order to back-calculate refractive prediction error (PE). To eliminate any systematic error, constant optimization through zeroing-out the mean error (ME) was performed for each formula. Median absolute error (MedAE) and percentage of eyes within ±0.50 and ±1.00 diopters (D) of PE were analyzed. PEs were plotted with corresponding mean keratometry (K), axial length (AL), and AL/K ratio; then, different ranges were evaluated. With optimized constants through zeroing-out ME (90 eyes), ALMA was better when K ≤ 38.00 D-AL > 28.00 mm and when 38.00 D < K ≤ 40.00 D-26.50 mm < AL ≤ 29.50 mm; Barrett-TK was better when K ≤ 38.00 D-AL ≤ 26.50 mm and when K > 40.00 D-AL ≤ 28.00 mm or AL > 29.50 mm; and both ALMA and Barrett-TK were better in other ranges. (p < 0.05) Without modified constants (132 eyes), ALMA was better when K > 38.00 D-AL ≤ 29.50 mm and when 36.00 < K ≤ 38.00 D-AL ≤ 26.50 mm; Barrett-TK was better when K ≤ 36.00 D and when K ≤ 38.00 D with AL > 29.50 mm; and both ALMA and Barrett-TK were better in other ranges (p < 0.05). A multi-formula approach, according to different ranges of K and AL, could improve refractive outcomes in post-myopic-LRS eyes.
Collapse
Affiliation(s)
- Ferdinando Cione
- Eye Unit, Department of Medicine Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy
| | - Maddalena De Bernardo
- Eye Unit, Department of Medicine Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy
| | - Marco Gioia
- Eye Unit, Department of Medicine Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy
| | - Marianunzia Oliviero
- Eye Unit, Department of Medicine Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy
| | - Andrea Giuseppe Santoro
- Eye Unit, Department of Medicine Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy
| | - Alessandro Caputo
- Eye Unit, Department of Medicine Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy
| | - Luigi Capasso
- Corneal Transplant Unit, ASL Napoli 1, 80100 Naples, Italy
| | - Sergio Pagliarulo
- Eye Unit, Department of Medicine Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy
| | - Nicola Rosa
- Eye Unit, Department of Medicine Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84081 Baronissi, Italy
| |
Collapse
|
4
|
Janiszewska-Bil D, Czarnota-Nowakowska B, Grabarek BO, Dobrowolski D, Wylęgała E, Lyssek-Boroń A. Comparison of Vision Correction and Corneal Thickness at 180-Day Follow-Up After Femtosecond Laser-Assisted In-Situ Keratomileusis (FS-LASIK), Photorefractive Keratectomy (PRK), and Small Incision Lenticule Extraction (SMILE): A Study from a Single Center in Poland of 120 Patients with Myopia. Med Sci Monit 2023; 29:e939099. [PMID: 36793199 PMCID: PMC9942428 DOI: 10.12659/msm.939099] [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] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND This study from a single center in Poland included 120 patients with myopia, and the aim was to compare vision correction and corneal thickness at the 180-day follow-up after femtosecond laser-assisted in-situ keratomileusis (FS-LASIK), photorefractive keratectomy (PRK), or small incision lenticule extraction (SMILE). MATERIAL AND METHODS The effectiveness and safety of laser vision correction (LVC) procedures were evaluated by determining pre- and post-procedure uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) values on the Snell chart. Twenty patients with diagnosed mild myopia (sphere maximum -3.0 diopters D; cylinder maximum 0.5 D) were qualified for PRK surgery. Fifty patients with diagnosed intolerance (sphere maximum -6.0 D; cylinder maximum 5.0 D) were eligible for the FS-LASIK procedure. Fifty patients with diagnosed myopia (sphere maximum -6.0 D cylinder 3.5 D) were qualified for the SMILE procedure. RESULTS Regardless of which procedure was performed, both UDVA and CDVA improved significantly postoperatively (P<0.05). In addition, the UDVA and CDVA values were similar in the postoperative period (P>0.05). For each procedure, the EI was no less than 0.94. Regardless of which type of LVC procedure was performed, CET at the center and 1.5 mm from the center in 4 meridians thickened, and this change was not statistically significant over the observation period (P>0.05). CONCLUSIONS Our analysis demonstrated similar effectiveness of the 3 methods - PRK, FS-LASIK, and SMILE - in patients with mild and moderate myopia.
Collapse
Affiliation(s)
- Dominika Janiszewska-Bil
- Department of Ophthalmology, Trauma Centre, St. Barbara Hospital, Sosnowiec, Poland,Department of Ophthalmology, Faculty of Medicine in Zabrze, Academy of Silesia, Zabrze, Poland,Optegra Clinic in Katowice, Katowice, Poland
| | | | - Beniamin Oskar Grabarek
- Department of Histology, Cytophysiology and Embryology, Faculty of Medicine, Academy of Silesia, Zabrze, Poland
| | - Dariusz Dobrowolski
- Department of Ophthalmology, Trauma Centre, St. Barbara Hospital, Sosnowiec, Poland,Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, The Medical University of Silesia in Katowice, Katowice, Poland,Department of Ophthalmology, District Railway Hospital, Katowice, Poland
| | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Anita Lyssek-Boroń
- Department of Ophthalmology, Trauma Centre, St. Barbara Hospital, Sosnowiec, Poland,Department of Ophthalmology, Faculty of Medicine in Zabrze, Academy of Silesia, Zabrze, Poland,Optegra Clinic in Cracow, Cracow, Poland
| |
Collapse
|
5
|
De Bernardo M, Pagliarulo S, Rosa N. Unexpected ocular morphological changes after corneal refractive surgery: A review. Front Med (Lausanne) 2022; 9:1014277. [PMID: 36523778 PMCID: PMC9745030 DOI: 10.3389/fmed.2022.1014277] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/24/2022] [Indexed: 08/15/2023] Open
Abstract
Corneal refractive surgery (CRS) currently is widely used to correct refractive errors because of its efficacy and reliability. Several studies dealt with the corneal modification induced by this type of surgery, but it is still debated if CRS can induce unexpected changes namely anterior chamber depth (ACD) and axial length (AL). A literature review was performed, including all articles regarding CRS and eye-variations from 1999 to December 2021. Excluding articles about specific systemic conditions (e.g., pregnancy), pathological conditions, post-surgical complications or about only corneal flattening and thinning post CRS, we found nine studies that met the search criteria. We divided the found articles according to the type of surgery performed (radial keratotomy, PRK/LASEK, lasik) and analyzed the results about ACD and AL. Finally, according to the literature, we can conclude that CRS not only gives a corneal flattening, thinning and biomechanical changes, but also induces AL and ACD decrease. This makes the AL and ACD measurements obtained before CRS uselessness in case of IOL power calculation.
Collapse
|
6
|
De Bernardo M, Cione F, Capasso L, Coppola A, Rosa N. A formula to improve the reliability of optical axial length measurement in IOL power calculation. Sci Rep 2022; 12:18845. [PMID: 36344612 PMCID: PMC9640640 DOI: 10.1038/s41598-022-23665-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
To verify the influence of axial length (AL) variations after cataract surgery in IOL power calculation. Patients underwent ophthalmic evaluation before surgery, including optical biometry with IOLMaster 500. Same exams were repeated 2 months after surgery: AL of operated eye was evaluated using two modes (pseudophakic/aphakic options). Mean Keratometry and AL changes were analyzed. Furthermore, refractive prediction error (PE) was back-calculated with Barrett Universal-II, Hoffer-Q, Holladay-1 and SRK/T formulas. To eliminate any systematic error, the mean error (ME) was zeroed-out for each formula. MEs and median absolute errors (MedAEs) of PEs were analyzed. Two-hundred-one operated eyes of 201 patients and 201 opposite eyes were evaluated. In operated eyes, mean AL difference was - 0.11 ± 0.07 mm (p < 0.001) with pseudophakic option and 0.00 ± 0.07 mm (p = 0.922) with aphakic option. There were not-statistically significant differences between MedAE of PEs calculated after zeroing-out the ME with different ALs (p > 0.05). Instead, only MEs of PEs obtained with postoperative ALs-pseudophakic option were not-statistically different from zero (p > 0.05). AL measurement change after cataract surgery is probably due to a systematic error in optical biometer in case of phakic eyes. A correction factor applied to preoperative AL could eliminate any systematic error in IOL power calculation without modifying the lens constant.
Collapse
Affiliation(s)
- Maddalena De Bernardo
- grid.11780.3f0000 0004 1937 0335Eye Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Via Salvador Allende 1, Baronissi, Salerno, Italy
| | - Ferdinando Cione
- grid.11780.3f0000 0004 1937 0335Eye Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Via Salvador Allende 1, Baronissi, Salerno, Italy
| | - Luigi Capasso
- Corneal Transplant Unit, ASL Napoli 1, Naples, Italy
| | - Alessia Coppola
- grid.11780.3f0000 0004 1937 0335Eye Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Via Salvador Allende 1, Baronissi, Salerno, Italy
| | - Nicola Rosa
- grid.11780.3f0000 0004 1937 0335Eye Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Via Salvador Allende 1, Baronissi, Salerno, Italy
| |
Collapse
|
7
|
Branger GA, Le MT, Inauen LO, Reichmuth V, Kaufmann C, Baenninger P. Ten-Year Outcome of Topography-Guided Transepithelial Surface Ablation for Refractive Myopia Treatment. Klin Monbl Augenheilkd 2022; 239:382-385. [PMID: 35320865 DOI: 10.1055/a-1739-0212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND To evaluate 10-year long-term refractive visual stability and participants' satisfaction in the refractive treatment of myopic eyes undergoing topography-guided transepithelial surface ablation using a 1KHz excimer laser. PATIENTS AND METHODS This single-center prospective survey assessed participants' satisfaction 10 years after the treatment using a non-validated questionnaire with regards to visual outcome, dry eye, and visual disturbance symptoms. Pre- and postoperative visual and refractive data were evaluated. RESULTS Of 106 participants (54% females) with a mean patient age of 36 (± 8.6) years, 166 eyes were included. Mean preoperative spherical equivalent (SE) was - 4.23 (± 2.48) diopters (D). Uncorrected distant visual acuity (UCVA) after 10 years was ≥ 1.0 (Snellen) in 92% of the eyes. Manifest SE was within ± 1.0 D of the desired refraction in 86% of the eyes after 10 years. Mean quality of life (QOL) improvement was high (9.15 out of 10 points). Dry eye symptoms were reported by 35 out of 104 (34%) patients. Visual symptoms like halos or starbursts were reported by 24 out of 101 (24%) and 12 out of 100 (12%) patients, respectively. CONCLUSIONS Topography-guided transepithelial surface ablation for myopia provided stable long-term results in terms of UCVA and SE. Participant satisfaction was high, with only low rates of dry eye or visual symptoms.
Collapse
Affiliation(s)
| | - Minh Tu Le
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland
| | | | | | - Claude Kaufmann
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland.,Faculty of Medicine, University of Zurich Faculty of Medicine, Zurich, Switzerland
| | - Philipp Baenninger
- Augenklinik, Luzerner Kantonsspital, Luzern, Switzerland.,Faculty of Medicine, University of Zurich Faculty of Medicine, Zurich, Switzerland
| |
Collapse
|
8
|
[Long-term outcomes of PRK, LASIK and SMILE]. Ophthalmologe 2021; 119:163-169. [PMID: 34241701 DOI: 10.1007/s00347-021-01449-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/10/2021] [Accepted: 06/14/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Patients and refractive surgeons have a legitimate interest in the long-term results of the most commonly used laser procedures for correction of ametropia. OBJECTIVE To assess the safety, predictability, stability and late complications according to the current recommendations of the committee for refractive surgery (KRC). METHODS Literature search in PubMed with the search term "long-term outcome" combined with either "PRK", "LASIK" or "SMILE". Articles about PRK and LASIK with a minimum follow-up of 10 years and SMILE with a minimum follow-up of 5 years were evaluated and duplications were eliminated. RESULTS From a total of 440 articles that matched these search terms 15 articles were selected and analyzed. The results of PRK were described in 4 studies with a total of 666 eyes, 7 studies (566 eyes) described the results of LASIK and 5 studies (188 eyes) the results after SMILE. CONCLUSION Long-term studies with follow-up periods of at least 10 years have shown that PRK and LASIK treatment carried out in the early days of medical excimer lasers have a very high level of safety and late complications occurred only rarely. The effectiveness of particularly high corrections declined over time. In contrast, there was no clinically significant regression within the indications recommended by the KRC. The results of SMILE were not inferior to those of PRK and LASIK. In direct long-term comparisons no procedure showed a clear superiority. Due to technological improvements in hardware and software for both preoperative diagnostics and lasers, treatment performed nowadays is presumably even safer, more efficient and also more stable over a long period of time.
Collapse
|
9
|
Comparison between two devices in the detection of corneal thickness changes after cataract surgery. Sci Rep 2021; 11:6709. [PMID: 33758298 PMCID: PMC7988103 DOI: 10.1038/s41598-021-86158-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 03/10/2021] [Indexed: 12/14/2022] Open
Abstract
This study compared corneal thickness (CT) changes obtained with specular microscopy (SM) and a rotating Scheimpflug camera (RSC) after conventional phacoemulsification surgery (PS). One hundred sixty six eyes of 83 patients were analyzed before and one month after PS. One eye underwent PS, while the fellow phakic one was used as control. CT was measured with SM at the center of the cornea and with RSC at the pupil center, at the corneal apex and at the thinnest point. In the operated eye, SM showed a larger CT mean increase than those one detected at the three different measurements’ points evaluated by RSC. Inversely, in the fellow phakic eye, SM showed a greater CT mean decrease than those one registered by RSC at its three measurement’s points. Thus, one month after surgery, even if cornea appears clear at the slit-lamp, a significant thickness increase is still present. This is even more evident if the slight decrease of the fellow phakic eye is considered. The differences between the two devices are probably related to the different measured areas.
Collapse
|
10
|
Abdolalizadeh P, Hashemian S, Es'haghi A, Ghiasian L, Aghaei H, Jafari M, Hashemian M, Hashemian S. Long-term visual and refractive stability and ocular biometric changes after laser-assisted subepithelial keratomileusis for correction of myopia: An 8-year follow-up. J Curr Ophthalmol 2021; 33:417-421. [PMID: 35128188 PMCID: PMC8772487 DOI: 10.4103/joco.joco_29_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 05/22/2021] [Accepted: 05/30/2021] [Indexed: 11/04/2022] Open
|