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Jeong H, Lee D, Jiang X, Negishi K, Tsubota K, Kurihara T. Topical Application of Bunazosin Hydrochloride Suppresses Myopia Progression With an Increase in Choroidal Blood Perfusion. Invest Ophthalmol Vis Sci 2023; 64:15. [PMID: 37955611 PMCID: PMC10653257 DOI: 10.1167/iovs.64.14.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/23/2023] [Indexed: 11/14/2023] Open
Abstract
Purpose The incidence of myopia has rapidly increased in recent decades, making it a growing public health concern worldwide. Interventions to suppress the progression of myopia are needed; one suggested strategy is the prevention of choroidal thinning, which can improve choroidal blood perfusion (ChBP). Bunazosin hydrochloride (BH) is an alpha1-adrenergic blocker and commercialized glaucoma eye drop that increases in blood circulation in the eye. In this study, we evaluated the efficacy of BH in suppressing the progression of myopia in a lens-induced murine model. Methods Lens-induced myopia was induced in 3-week-old C57BL/6 J mice with -30 diopter (D) lenses for three weeks. Refractive error, axial length, and choroidal thickness were evaluated at three and six weeks of age using an infrared photorefractor and a spectral domain optical coherence tomography (OCT) system. Moreover, ChBP and scleral thickness were evaluated using swept-source OCT and histological analysis. Results Compared with the controls, the administration of BH eye drops suppressed the myopic shift of refractive error (mean difference ± standard error in the eye with -30 D lens, -13.65 ± 5.69 D vs. 2.55 ± 4.30 D; P < 0.001), axial elongation (0.226 ± 0.013 mm vs. 0.183 ± 0.023 mm; P < 0.05), choroidal thinning (-2.01 ± 1.80 µm vs. 1.88 ± 1.27 µm; P < 0.001), and scleral thinning (11.41 ± 3.91 µm vs. 19.72 ± 4.01 µm; P < 0.01) with myopia progression and increased ChBP (52.0% ± 4.1% vs. 59.5% ± 6.3%; P < 0.05). The suppressive effect of BH eye drops was dose-dependent and higher than that of other glaucoma eye drops and alpha1 blockers. Conclusions These results demonstrate the potential of BH eye drops in the treatment of myopia and support further investigation of their efficacy in humans. Further studies are needed to determine the mechanism of action and long-term safety of this treatment.
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Affiliation(s)
- Heonuk Jeong
- Laboratory of Photobiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Deokho Lee
- Laboratory of Photobiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Xiaoyan Jiang
- Laboratory of Photobiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Tsubota Laboratory, Inc., Shinjuku-ku, Tokyo, Japan
| | - Toshihide Kurihara
- Laboratory of Photobiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
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Li H, Han Q, Zhang J, Shao T, Wang H, Long K. Role of corneal epithelial thickness during myopic regression in femtosecond laser-assisted in situ keratomileusis and transepithelial photorefractive keratectomy. BMC Ophthalmol 2022; 22:481. [PMID: 36482343 PMCID: PMC9733129 DOI: 10.1186/s12886-022-02727-x] [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] [Received: 07/11/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The study aimed to investigate the relationship between changes in corneal epithelial thickness and the outcome of myopic regression after femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and transepithelial photorefractive keratectomy (TPRK). METHODS This study included 45 eyes of 25 patients undergoing FS-LASIK and 44 eyes of 24 patients undergoing TPRK. Myopic regression occurred in these patients postoperatively from 8 to 21 months. The corneal epithelial thickness was measured using a spectral-domain optical coherence tomography at the onset of regression, 3 months after treatment, and 3 months after drug withdrawal. RESULTS Compared with that of preoperation, corneal epithelial thickness increased when regression occurred in both groups (all P < 0.05). The thickness of central corneal epithelium in FS-LASIK and TPRK groups reached 65.02 ± 4.12 µm and 61.63 ± 2.91 µm, respectively. The corneal epithelial thickness decreased when myopic regression subsided after 3 months of steroid treatment compared to the onset (P < 0.05). With a decrease in corneal epithelial thickness, the curvature of the anterior corneal surface, central corneal thickness, and refractive power all decreased (all P < 0.05). The corneal epithelial thickness and refractive error remained relatively stable after 3 months of treatment withdrawal (P > 0.05). CONCLUSION The corneal epithelial thickness determined the outcome of myopic regression similarly in FS-LASIK and TPRK. When the corneal epithelium thickened, regression occurred. After steroid treatment, epithelial thickness decreased whereas regression subsided.
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Affiliation(s)
- Hua Li
- grid.410638.80000 0000 8910 6733Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, 266071 Qingdao, Shandong Province China
| | - Qichao Han
- grid.440330.0Department of Ophthalmology, Zaozhuang Municipal Hospital, 277100 Zaozhuang, Shandong Province China
| | - Jiafan Zhang
- grid.410638.80000 0000 8910 6733Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, 266071 Qingdao, Shandong Province China
| | - Ting Shao
- grid.410638.80000 0000 8910 6733Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, 266071 Qingdao, Shandong Province China
| | - Huifeng Wang
- grid.410638.80000 0000 8910 6733Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, 266071 Qingdao, Shandong Province China
| | - Keli Long
- grid.410638.80000 0000 8910 6733Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, 266071 Qingdao, Shandong Province China
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Wang J, Zhao Y, Yu AY, Wu J, Zhu M, Jiang M, Li X, Zhu D, Zhang P, Zheng X, Bao F, Elsheikh A. Effect of travoprost, latanoprost and bimatoprost PGF2α treatments on the biomechanical properties of in-vivo rabbit cornea. Exp Eye Res 2022; 215:108920. [PMID: 35007519 DOI: 10.1016/j.exer.2022.108920] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 12/07/2021] [Accepted: 12/31/2021] [Indexed: 11/04/2022]
Abstract
Prostaglandin F2α analogues (PGF2α), one of the most commonly prescribed classes of hypotensive agents, could decrease collagen fibril density and remodel the extracellular matrix in cornea. We hypothesized that PGF2α's would induce corneal softening, reduce the accuracy of intraocular pressure (IOP) measurement and lead to uncertainty in the effectiveness of the therapy. We determined the stress-strain behavior of rabbit cornea after PGF2α usage and evaluated the effect of biomechanical changes associated with PGF2α treatment on IOP measurements by Goldmann Applanation Tonometry (GAT). The tangent modulus decreased after PGF2α treatment, while the stromal interfibrillar spacing increased. PGF2α was shown to also affect the lateral eye with lower effect, which did not undergo direct eyedrop treatment. Significant decreases in the numerical predictions of GAT-IOP were predicted in all treated groups relative to control groups. Different PGF2α's (travoprost, latanoprost and bimatoprost) were associated with different extents of reduction in tissue stiffness and changes in corneal microstructure. PGF2α-induced changes in corneal mechanical properties could reduce the accuracy of IOP measurement and may cause an overestimation of the effect of PGF2α in lowering IOP, possibly leading to uncertainties in glaucoma management.
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Affiliation(s)
- JunJie Wang
- Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China; The Institute of Ocular Biomechanics, Wenzhou Medical University, Wenzhou, 325027, China
| | - YiPing Zhao
- Department of Ophthalmology, Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200025, China
| | - AYong Yu
- Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Jie Wu
- Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - ManMan Zhu
- Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - MuChen Jiang
- Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - Xuefei Li
- Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - DaTian Zhu
- Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - PeiPei Zhang
- Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China
| | - XiaoBo Zheng
- Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China; The Institute of Ocular Biomechanics, Wenzhou Medical University, Wenzhou, 325027, China.
| | - FangJun Bao
- Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China; The Institute of Ocular Biomechanics, Wenzhou Medical University, Wenzhou, 325027, China.
| | - Ahmed Elsheikh
- School of Engineering, University of Liverpool, Liverpool, L69 3GH, UK; National Institute for Health Research (NIHR) Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK; Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China
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Singh A, Gour A, Dave A, Chouhan L, Buckshey A, Mathur U. Effect of timolol maleate (0.5%) in the management of myopic regression post laser-assisted in-situ keratomileusis: Clinical and topographical outcomes. Indian J Ophthalmol 2020; 68:2990-2994. [PMID: 33229683 PMCID: PMC7856950 DOI: 10.4103/ijo.ijo_1503_20] [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: 11/04/2022] Open
Abstract
Purpose The aim of this study was to analyze the effect of timolol maleate (0.5%) eye drops in the treatment of myopic regression after laser-assisted in-situ keratomileusis (LASIK). Methods The study was conducted at a tertiary care eye hospital in north India between April 2017 & March 2018 as a prospective interventional study. Patients who underwent uneventful myopic LASIK with hansatome mechanical keratome and presented with regression were included in the study. Baseline demographic characteristics, time to presentation with regression best-corrected visual acuity (BCVA), refraction, intraocular pressure, central corneal thickness and keratometry were recorded at baseline and at each follow-up visit. The enrolled patients were prescribed timolol maleate (0.5%) eyedrops twice daily. They were followed up every month till 3 months on timolol maleate (0.5%) eyedrops and at 6 months post stopping the treatment. Results Twenty-nine eyes of 15 patients were enrolled in the study. Mean pre LASIK spherical equivalent (SE) was - 7.48 ± 2.9 Diopters (Range-3.125 to -11.75 Diopters) and mean regression spherical equivalent was -1.02 ± 1.1 Diopters. There was a decrease in mean SE from presentation (intervention start point) up to 6 months follow-up (-1.34 ± 0.89 to -0.30 ± 0.29 Diopters). While posterior corneal curvature (K1 and K2 Back) changed significantly over treatment period (P = 0.0029, P = 0.0024 respectively), changes in anterior corneal curvature (K1 and K2 Front) were not significant (P = 0.05, P = 0.06 respectively). Central corneal thickness (CCT) and intraocular pressure (IOP) did not change significantly over treatment course. Conclusion Timolol maleate (0.5%) eyedrop is an effective modality for the treatment of refractive regression post LASIK circumventing the need for laser re-treatment in such patients. The most probable mechanism is reversal of the anterior bowing of the cornea in response to intraocular pressure changes.
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Affiliation(s)
- Aastha Singh
- Department of Cornea and Refractive Surgery, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Abha Gour
- Department of Cornea and Refractive Surgery, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Abhishek Dave
- Department of Cornea and Refractive Surgery, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Lokesh Chouhan
- Department of Biostatistics, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | | | - Umang Mathur
- Department of Cornea and Refractive Surgery, Dr. Shroff's Charity Eye Hospital, New Delhi, India
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Ryu IH, Kim WK, Nam MS, Kim JK, Kim SW. Reduction of corneal epithelial thickness during medical treatment for myopic regression following FS-LASIK. BMC Ophthalmol 2020; 20:296. [PMID: 32682402 PMCID: PMC7368729 DOI: 10.1186/s12886-020-01570-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/14/2020] [Indexed: 11/10/2022] Open
Abstract
Background To evaluate corneal epithelial thickness change during medical treatment for eyes with myopic regression after femtosecond laser-assisted in situ keratomileusis (FS-LASIK). Methods This study included 84 eyes of 54 subjects diagnosed with myopic regression after FS-LASIK and treated using topical steroid and anti-glaucoma drugs. Corneal epithelial thickness was measured using Fourier-domain optical coherence tomography before and after treatment. Subjects were divided into three groups based on their corneal epithelial thickness at the time of myopic regression and regression analyses were used to investigate the association between corneal epithelial thickness, visual acuity, and refraction. Logistic regression and receiver operating characteristic (ROC) curve analysis was performed to determine whether corneal epithelial thickness could predict the success of treatment, improvements of ≥ two lines in uncorrected distance visual acuity and ≥ 0.5 diopter in refraction or K. Results Corneal epithelial thickness decreased with greater change in the center as myopic regression subsided during medical treatment. Subgroup with the thickest epithelium (≥ 62 μm) showed a higher success rate and greater changes in refraction and vision. Reduced magnitude of corneal epithelial thickness showed significant correlations with changes of K and refractive error (all P < 0.001). Corneal epithelial thickness was a significant factor for the success of treatment and ROC curve showed that corneal epithelial thickness > 60.50 μm had 81.5% sensitivity and 84.2% specificity for the success of medical treatment. Conclusion Corneal epithelial thickness decreases proportionally with the magnitude of improvement of myopic regression during treatment with steroid and anti-glaucoma drugs in post-LASIK eyes with myopic regression.
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Affiliation(s)
| | | | - Myoung Sik Nam
- Department of Ophthalmology, Yonsei University Wonju College of Medicine, 20, Ilsan-ro, Wonju, Gangwon-do, 26426, South Korea
| | | | - Sun Woong Kim
- Department of Ophthalmology, Yonsei University Wonju College of Medicine, 20, Ilsan-ro, Wonju, Gangwon-do, 26426, South Korea.
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Yan MK, Chang JS, Chan TC. Refractive regression after laser in situ keratomileusis. Clin Exp Ophthalmol 2018; 46:934-944. [PMID: 29700964 DOI: 10.1111/ceo.13315] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 04/13/2018] [Accepted: 04/19/2018] [Indexed: 12/23/2022]
Abstract
Uncorrected refractive errors are a leading cause of visual impairment across the world. In today's society, laser in situ keratomileusis (LASIK) has become the most commonly performed surgical procedure to correct refractive errors. However, regression of the initially achieved refractive correction has been a widely observed phenomenon following LASIK since its inception more than two decades ago. Despite technological advances in laser refractive surgery and various proposed management strategies, post-LASIK regression is still frequently observed and has significant implications for the long-term visual performance and quality of life of patients. This review explores the mechanism of refractive regression after both myopic and hyperopic LASIK, predisposing risk factors and its clinical course. In addition, current preventative strategies and therapies are also reviewed.
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Affiliation(s)
- Mabel K Yan
- The Alfred Hospital, Melbourne, Victoria, Australia
| | - John Sm Chang
- Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong.,Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Tommy Cy Chan
- Department of Ophthalmology, Hong Kong Sanatorium and Hospital, Hong Kong.,Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
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Twelve-Year Follow-Up of Laser In Situ Keratomileusis for Moderate to High Myopia. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9391436. [PMID: 28596969 PMCID: PMC5449750 DOI: 10.1155/2017/9391436] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 04/09/2017] [Indexed: 11/18/2022]
Abstract
Purpose To assess the long-term clinical outcomes of conventional laser in situ keratomileusis (LASIK) for moderate to high myopia. Methods We retrospectively examined sixty-eight eyes of 37 consecutive patients who underwent conventional LASIK for the correction of myopia (−3.00 to −12.75 diopters (D)). At 3 months and 1, 4, 8, and 12 years postoperatively, we assessed the safety, efficacy, predictability, stability, mean keratometry, central corneal thickness, and adverse events. Results The safety and efficacy indices were 0.82 ± 0.29 and 0.67 ± 0.37, respectively, 12 years postoperatively. At 12 years, 53% and 75% of the eyes were within 0.5 and 1.0 D, respectively, of the targeted correction. Manifest refraction changes of −0.74 ± 0.99 D occurred from 3 months to 12 years after LASIK (p < 0.001). We found a significant correlation of refractive regression with the changes in keratometric readings from 3 months to 12 years postoperatively (Pearson correlation coefficient, r = −0.28, p = 0.02), but not with the changes in central corneal thickness (r = −0.08, p = 0.63). No vision-threatening complications occurred in any case. Conclusions Conventional LASIK offered good safety outcomes during the 12-year observation period. However, the efficacy and the predictability gradually decreased with time owing to myopic regression in relation to corneal steepening.
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Qi H, Gao C, Li Y, Feng X, Wang M, Zhang Y, Chen Y. The effect of Timolol 0.5% on the correction of myopic regression after LASIK. Medicine (Baltimore) 2017; 96:e6782. [PMID: 28445315 PMCID: PMC5413280 DOI: 10.1097/md.0000000000006782] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUD Postlaser in situ keratomileusis (post-LASIK) refractive regression is defined as the gradual, partial, or total loss of initial correction that limits the predictability, efficiency, and long-term stability of LASIK. Our study assesses the effect of Timolol 0.5% on the correction of myopic regression after LASIK. METHODS This prospective, randomized, controlled study included 62 eyes of 62 patients with myopic regression of -1.18 ± 0.86 diopters (D) after myopic LASIK. They were randomly assigned into either Group 1 who received Timolol 0.5% eye drops for 3 months or Group 2 who received artificial tears as control (during treatment). Patients were followed an additional 2 months after cessation of eye drops treatment (posttreatment). RESULTS During treatment in Group 1, as the mean true intraocular pressure (IOPT) lowered significantly, regression stopped. As the mean IOPT increased significantly posttreatment and returned to its pretreatment level, regression recurred. The effective rate of Timolol therapy dropped from 62.5% during treatment to 40.6% posttreatment. On the contrary in Group 2, although the mean IOPT did not change significantly, regression continually happened as time passed. During treatment, the mean IOPT, uncorrected visual acuity, spherical equivalent (SE), and corneal refractive power showed significant difference between the 2 groups. In Group 1, the differences of effective rate of Timolol therapy between each of the 2 subgroups of age, gender, preoperative SE (PSE), or pretreatment time (how long we start treatment with Timolol post-LASIK) were not statistically significant. CONCLUSION IOP-lowering eye drop Timolol was effective for the correction of myopic regression when a 0.5-D or greater myopic shift is detected after LASIK in patients regardless of age, gender, PSE, or anytime we started the treatment only if regression happened. However, the myopic regression recurred after cessation of Timolol treatment.
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Affiliation(s)
- Hong Qi
- Department of Ophthalmology, Peking University Third Hospital
- Key Laboratory of Vision Loss and Restoration, Ministry of Education
| | - Caifeng Gao
- Department of Ophthalmology, Peking University Third Hospital
- Key Laboratory of Vision Loss and Restoration, Ministry of Education
| | - Yaxin Li
- Department of Ophthalmology, Peking University Third Hospital
- Key Laboratory of Vision Loss and Restoration, Ministry of Education
| | - Xue Feng
- Department of Ophthalmology, Peking University Third Hospital
- Key Laboratory of Vision Loss and Restoration, Ministry of Education
- Moslem Hospital, Beijing, China
| | - Miao Wang
- Department of Ophthalmology, Peking University Third Hospital
- Key Laboratory of Vision Loss and Restoration, Ministry of Education
| | - Yu Zhang
- Department of Ophthalmology, Peking University Third Hospital
- Key Laboratory of Vision Loss and Restoration, Ministry of Education
| | - Yueguo Chen
- Department of Ophthalmology, Peking University Third Hospital
- Key Laboratory of Vision Loss and Restoration, Ministry of Education
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Pillunat KR, Spoerl E, Terai N, Pillunat LE. Effect of selective laser trabeculoplasty on corneal biomechanics. Acta Ophthalmol 2016; 94:e501-4. [PMID: 26749244 DOI: 10.1111/aos.12947] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 11/05/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the effect of selective laser trabeculoplasty (SLT) on ocular biomechanics as measured with the ocular response analyzer (ORA, AMETEK Inc. and Reichert Inc.). METHODS In a prospective case series, 52 eyes of 52 patients (aged 66.6 ± 9.6 years) with insufficient intraocular pressure (IOP) control despite maximum tolerated medical therapy underwent SLT (Solo(™) SLT, Ellex Inc.) for further IOP reduction. Goldmann-correlated IOP (IOPg), corneal-compensated IOP (IOPcc), corneal hysteresis (CH) and the corneal resistance factor (CRF) were measured with the ORA prior to and at least 4 weeks following SLT. RESULTS IOPg decreased statistically significantly from 18.0 ± 6.4 to 14.8 ± 3.8 mmHg and IOPcc from 20.2 ± 6.5 to 16.7 ± 3.4 mmHg (p < 0.001). CH increased from 8.53 ± 2.03 to 9.12 ± 1.83 mmHg (p = 0.028) and CRF decreased from 9.58 ± 2.18 to 9.1 ± 2.1 mmHg (p = 0.037), which was statistically significant. Correcting the CH and CRF data for the influence of IOP reduction with a covariance analysis, however, resulted in an unchanged CH (IOPg adjusted: p = 0.318; IOPcc adjusted: p = 0.468) and CRF (IOPg adjusted: p = 0.320; IOPcc adjusted: p = 0.464) after SLT. CONCLUSION Selective laser trabeculoplasty does not change corneal biomechanical properties as measured with the ORA in already pretreated patients with glaucoma. The measured increase in CH and decrease in CRF can be solely explained by IOP reduction.
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Affiliation(s)
- Karin R. Pillunat
- Department of Ophthalmology; University Hospital Carl Gustav Carus; TU Dresden Germany
| | - Eberhard Spoerl
- Department of Ophthalmology; University Hospital Carl Gustav Carus; TU Dresden Germany
| | - Naim Terai
- Department of Ophthalmology; University Hospital Carl Gustav Carus; TU Dresden Germany
| | - Lutz E. Pillunat
- Department of Ophthalmology; University Hospital Carl Gustav Carus; TU Dresden Germany
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Park YM, Hwang SH, Lee JW, Lee JS. Effects of Topical Brinzolamide/Timolol on Refractive Outcomes
in Eyes with Myopic Regression after Corneal Refractive Surgeries. INT J PHARMACOL 2016. [DOI: 10.3923/ijp.2016.556.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Efficacy and Safety of Topical Timolol Eye Drops in the Treatment of Myopic Regression after Laser In Situ Keratomileusis: A Systematic Review and Meta-Analysis. J Ophthalmol 2015; 2015:985071. [PMID: 26798507 PMCID: PMC4698735 DOI: 10.1155/2015/985071] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 12/02/2015] [Indexed: 11/17/2022] Open
Abstract
Aims. The aim of this study was to assess the efficacy and safety of timolol in the treatment of myopic regression after laser in situ keratomileusis (LASIK). Methods. We searched MEDLINE, CENTRAL, EMBASE, China National Knowledge Infrastructure (CNKI), and Chinese Biological Medicine (CBM) from the inception to July 2015 for relevant randomized controlled trials that examined timolol therapy for myopic regression. The methodological quality of the studies included was assessed using the Revman 5.3 software. Results. We included six clinical trials involving 483 eyes in this review, including 246 eyes in treated group and 237 eyes in controlled group. We observed statistically significant improvements on the postoperative SE in the 3 months. However, the change of CCT was not statistically different between the control group and the experimental group. There were fewer cases of IOP, UDVA, and CDVA in treated group having significant difference from the controlled group. Conclusions. Topical timolol could be an effective treatment for reduction of myopic regression especially the spherical errors after myopic LASIK. Further RCTs with larger sample sizes for these trials are warranted to determine the efficacy and limitation for myopic regression after LASIK.
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Effect of Myopic Defocus on Visual Acuity after Phakic Intraocular Lens Implantation and Wavefront-guided Laser in Situ Keratomileusis. Sci Rep 2015; 5:10456. [PMID: 25994984 PMCID: PMC4440037 DOI: 10.1038/srep10456] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 04/15/2015] [Indexed: 11/09/2022] Open
Abstract
This study aimed to investigate the effect of myopic defocus on visual acuity after phakic intraocular lens (IOL) implantation and wavefront-guided laser in situ keratomileusis (wfg-LASIK). Our prospective study comprised thirty eyes undergoing posterior chamber phakic IOL implantation and 30 eyes undergoing wfg-LASIK. We randomly measured visual acuity under myopic defocus after cycloplegic and non-cycloplegic correction. We also calculated the modulation transfer function by optical simulation and estimated visual acuity from Campbell &Green's retinal threshold curve. Visual acuity in the phakic IOL group was significantly better than that in the wfg-LASIK group at myopic defocus levels of 0, -1, and -2 D (p < 0.001, p < 0.001, and p = 0.02, Mann-Whitney U-test), but not at a defocus of -3 D (p = 0.30). Similar results were also obtained in a cycloplegic condition. Decimal visual acuity values at a myopic defocus of 0, -1, -2, and -3 D by optical simulation were estimated to be 1.95, 1.21, 0.97, and 0.75 in the phakic IOL group, and 1.39, 1.11, 0.94, and 0.71 in the wfg-LASIK group, respectively. From clinical and optical viewpoints, phakic IOL implantation was superior to wfg-LASIK in terms of the postoperative visual performance, even in the presence of low to moderate myopic regression.
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Salem T, Nehad T. Lowering Postoperative Intraocular Pressure Ameliorates Myopic Regression
after Laser in situ Keratomileusis: A Placebo-Controlled Comparative
Study. JOURNAL OF MEDICAL SCIENCES 2014. [DOI: 10.3923/jms.2014.283.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Kim G, Christiansen SM, Moshirfar M. Change in keratometry after myopic laser in situ keratomileusis and photorefractive keratectomy. J Cataract Refract Surg 2014; 40:564-74. [PMID: 24568721 DOI: 10.1016/j.jcrs.2013.09.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 09/24/2013] [Accepted: 09/29/2013] [Indexed: 10/25/2022]
Abstract
PURPOSE To compare the change in keratometry (K), spherical equivalent (SE), and visual acuity after myopic laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). SETTING Academic tertiary care center. DESIGN Retrospective review. METHODS The postoperative K, SE, and uncorrected and corrected distance visual acuities were measured 6 months, 9 months, 1 year, 2 years, 3 years, 4 to 5 years, 6 to 7 years, and 8+ years postoperatively. A difference (Δ) for each variable was calculated from its 6-month postoperative baseline. The rates of change were grouped based on the magnitude of myopic correction (0.00 to 2.99 diopters [D]; 3.00 to 5.99 D; 6.00 to 8.99 D), type of surgery (LASIK versus PRK), and age (<34 years; 34 to 45 years; >45 years). RESULTS Statistically significant differences were found in the rates of change between low and moderate corrections to high corrections for ΔKavg (P=.0472 and P=.0091, respectively) and ΔSE (both P<.0001). Statistically significant differences were found in the rate of change in ΔKavg between all 3 ages groups (P=.0330, P=.0051, and P<.0001) and in ΔSE between ages less than 34 years and 34 to 45 years to ages over 45 years (P=.0158 and P=.0015, respectively). There was no significant difference in the rate of change in ΔKavg and ΔSE between LASIK and PRK (P=.3599 and P=.9403, respectively). CONCLUSION There was keratometric and refractive regression for myopic LASIK, with the rate of regression depending on treatment magnitude and age. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Gene Kim
- From the John A. Moran Eye Center (Kim, Christiansen, Moshifar), University of Utah, Salt Lake City, Utah, and the Ruiz Department of Ophthalmology and Visual Science (Kim), University of Texas Medical School at Houston, and the Robert Cizik Eye Clinic (Kim), Houston, Texas, USA
| | - Steven M Christiansen
- From the John A. Moran Eye Center (Kim, Christiansen, Moshifar), University of Utah, Salt Lake City, Utah, and the Ruiz Department of Ophthalmology and Visual Science (Kim), University of Texas Medical School at Houston, and the Robert Cizik Eye Clinic (Kim), Houston, Texas, USA
| | - Majid Moshirfar
- From the John A. Moran Eye Center (Kim, Christiansen, Moshifar), University of Utah, Salt Lake City, Utah, and the Ruiz Department of Ophthalmology and Visual Science (Kim), University of Texas Medical School at Houston, and the Robert Cizik Eye Clinic (Kim), Houston, Texas, USA.
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Kim GA, Ahn JM, Chung WS. Transient Myopic Shift Due to Increased Latent Accommodation after LASEK. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2014. [DOI: 10.3341/jkos.2014.55.1.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Gyu Ah Kim
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea
- Siloam Eye Hospital, Seoul, Korea
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Sung KR, Lee JY, Kim MJ, Na JH, Kim JY, Tchah HW. Clinical characteristics of glaucomatous subjects treated with refractive corneal ablation surgery. KOREAN JOURNAL OF OPHTHALMOLOGY 2013; 27:103-8. [PMID: 23542822 PMCID: PMC3596612 DOI: 10.3341/kjo.2013.27.2.103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Accepted: 06/27/2012] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the clinical characteristics of newly diagnosed glaucomatous subjects who had a history of refractive corneal ablation surgery (RCAS). Methods Sixty-eight glaucomatous subjects who had a history of RCAS and 68 age- and visual field (VF) mean deviation-matched glaucomatous subjects with no history of RCAS were included. Intraocular pressure (IOP), central corneal thickness (CCT), VF, and retinal nerve fiber layer thickness determined by optical coherence tomography were assessed. Parameters were compared between patients with and without a history of RCAS. Between-eye comparisons in the same participant (more advanced vs. less-advanced eye, in terms of glaucoma severity) were performed in the RCAS group. Results With similar levels of glaucoma severity, those with a history of RCAS showed significantly lower baseline IOP and a thinner CCT than the eyes of individuals without a RCAS history (13.6 vs. 18.7 mmHg, 490.5 vs. 551.7 µm, all p < 0.001). However, the extent of IOP reduction after anti-glaucoma medication did not significantly differ between the two groups (17% vs. 24.3%, p = 0.144). In the between-eye comparisons of individual participants in the RCAS group, the more advanced eyes were more myopic than the less-advanced eyes (-1.84 vs. -0.58 diopter, p = 0.003). Conclusions Eyes with a history of RCAS showed a similar level of IOP reduction as eyes without such a history after anti-glaucoma medication. Our finding that the more advanced eyes were more myopic than the less-advanced eyes in the same participant may suggest an association between glaucoma severity and myopic regression.
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Affiliation(s)
- Kyung Rim Sung
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Shojaei A, Eslani M, Vali Y, Mansouri M, Dadman N, Yaseri M. Effect of timolol on refractive outcomes in eyes with myopic regression after laser in situ keratomileusis: a prospective randomized clinical trial. Am J Ophthalmol 2012; 154:790-798.e1. [PMID: 22935601 DOI: 10.1016/j.ajo.2012.05.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 05/15/2012] [Accepted: 05/15/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the effects of timolol on refractive outcomes in eyes with myopic regression after laser in situ keratomileusis (LASIK) with a control-matched group. DESIGN Prospective, randomized, parallel-controlled, double-masked clinical trial. A computer-generated randomization list based on random block permutation (length 4 to 8) was used for treatment allocation. METHODS setting: Basir Eye Center, Tehran, Iran. PATIENT POPULATION Of 124 eyes with myopic regression after LASIK using Technolas 217-Z, 45 eyes in each group were analyzed. INTERVENTION Patients were randomly assigned into either Group 1, who received timolol 0.5% eye drops, or Group 2, who received artificial tears for 6 months. MAIN OUTCOME MEASURE Spherical equivalent (SE) at 6 months posttreatment. RESULTS In Group 1, SE improved from -1.48 ± 0.99 diopter (D) before treatment to -0.88 ± 0.91 D and -0.86 ± 0.93 D 6 months after treatment and 6 months after timolol discontinuation, respectively (P < .001). In Group 2, it was -1.57 ± 0.67 D, -1.83 ± 0.76 D, and -1.91 ± 0.70 D, respectively (P < .001). SE was significantly better in Group 1 6 months after treatment and 6 months after discontinuation of treatment (P < .001 for both comparisons). There was a 0.26 D decrease in SE improvement every 4 months after the surgery in the Group 1 (P < .001). CONCLUSIONS Timolol application is effective for the treatment of myopic regression after LASIK compared with control group. Its effects last for at least 6 months after its discontinuation.
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Effect of prostaglandin analogues on tear proteomics and expression of cytokines and matrix metalloproteinases in the conjunctiva and cornea. Exp Eye Res 2012; 94:13-21. [DOI: 10.1016/j.exer.2011.10.017] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 10/26/2011] [Accepted: 10/27/2011] [Indexed: 11/17/2022]
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Gefen A, Shalom R, Elad D, Mandel Y. Biomechanical analysis of the keratoconic cornea. J Mech Behav Biomed Mater 2009; 2:224-36. [PMID: 19627827 DOI: 10.1016/j.jmbbm.2008.07.002] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2008] [Revised: 06/25/2008] [Accepted: 07/04/2008] [Indexed: 10/21/2022]
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Current world literature. Curr Opin Ophthalmol 2009; 20:333-41. [PMID: 19535964 DOI: 10.1097/icu.0b013e32832e478f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kamiya K, Shimizu K. Reply. Am J Ophthalmol 2009. [DOI: 10.1016/j.ajo.2008.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Nowroozzadeh MH. Prostaglandin analogs may aggravate myopic regression after laser in situ keratomileusis. Am J Ophthalmol 2009; 147:754; author reply 754-5. [PMID: 19327446 DOI: 10.1016/j.ajo.2008.12.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2008] [Accepted: 12/10/2008] [Indexed: 10/21/2022]
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Weiss JS, Mokhtarzadeh M. Myopic regression after laser in situ keratomileusis: a medical alternative to surgical enhancement. Am J Ophthalmol 2008; 145:189-90. [PMID: 18222186 DOI: 10.1016/j.ajo.2007.11.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2007] [Revised: 11/15/2007] [Accepted: 11/16/2007] [Indexed: 12/01/2022]
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