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Sato M, Kamiya K, Hayashi K, Tabuchi H, Kojima T, Goto N, Hatsusaka N, Torii H, Nagata M, Miyata K. Changes in cataract and refractive surgery practice patterns among JSCRS members over the past 20 years. Jpn J Ophthalmol 2024:10.1007/s10384-024-01081-3. [PMID: 39002076 DOI: 10.1007/s10384-024-01081-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 05/29/2024] [Indexed: 07/15/2024]
Abstract
PURPOSE To evaluate changes in cataract and refractive surgery practice patterns among members of the Japanese Society of Cataract and Refractive Surgery (JSCRS) over the past 20 years. STUDY DESIGN Questionnaire survey study. SUBJECTS AND METHODS Clinical surveys were conducted annually between February and April from 2004 to 2023. Survey questions covered various areas, including cataract surgical techniques, anesthesia, endophthalmitis prophylaxis, toric and presbyopia-correcting intraocular lenses (IOLs), complications, and refractive surgery. RESULTS The highest (n=554 [36.8%]) and lowest (n=316 [19.1%]) numbers of responses were collected in 2012 and 2016, respectively. In perioperative management, the intraoperative use of polyvinyl alcohol-iodine solution and topical antibiotic prescription 3 days before surgery has increased. The use of intracameral injection at the end of surgery has also significantly increased, although it has not been established as common practice. In anesthesia, there is a clear polarization between the use of topical drops and tenon injection. The use of toric IOLs and presbyopia-correcting IOLs has significantly increased from 2010 to 2023. In the latter, the use of trifocal IOLs has particularly increased. Regarding IOL power calculations, the Barrett True K and the Barrett Universal II formulas are rapidly gaining popularity for application with and without post-laser vision correction, respectively. In refractive surgery, phakic IOLs and corneal refractive therapy have attracted considerable interest, followed by laser in situ keratomileusis. CONCLUSIONS Evaluation of annual clinical survey data over the past two decades provided valuable insights into the shifting practice patterns and clinical opinions among JSCRS members.
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Affiliation(s)
- Masaki Sato
- Department of Ophthalmology, Sato Eye Clinic, Iias Tsukuba Medical Court, Sato Eye Clinic5-19 Kenkyugakuen, Tsukuba, Ibaraki, 305-0817, Japan.
| | - Kazutaka Kamiya
- Visual Physiology, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Ken Hayashi
- Department of Ophthalmology, Hayashi Eye Hospital, Fukuoka, Japan
| | - Hitoshi Tabuchi
- Department of Ophthalmology, Tsukazaki Hospital, Hyogo, Japan
| | - Takashi Kojima
- Department of Ophthalmology, Nagoya Eye Clinic, Aichi, Japan
| | - Norihito Goto
- Department of Ophthalmology, Toda Goto Eye Clinic, Saitama, Japan
| | - Natsuko Hatsusaka
- Department of Ophthalmology, Kanazawa Medical University, Ishikawa, Japan
| | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Mayumi Nagata
- Department of Ophthalmology, Dokkyo Medical University, Tochigi, Japan
| | - Kazunori Miyata
- Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan
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Chen Y, Fang Y, Zhao J, He W, Ma B, Zhu X. Influence of Lens Thickness on Accuracy of Kane, Hill-RBF 3.0, Barrett Universal II, Emmetropia Verifying Optical, and Pearl-DGS Formulas in Eyes with Nonhigh Myopia and High Myopia. Curr Eye Res 2024; 49:605-614. [PMID: 38363071 DOI: 10.1080/02713683.2024.2316717] [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: 07/28/2023] [Accepted: 02/05/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE To investigate the influence of lens thickness (LT) on accuracy of Kane, Hill-RBF 3.0 Barrett Universal II (BUII), Emmetropia Verifying Optical (EVO), and Pearl-DGS formulas in eyes with different axial lengths (AL). METHODS The prospective cohort study was conducted at Eye and ENT Hospital of Fudan University. Patients who had uneventful cataract surgery between March 2021 and July 2023 were recruited. Manifest refraction was conducted two-month post-surgery. Eyes were divided into 4 groups based on AL: short (<22mm), medium (22-24.5 mm), medium long (24.5-26mm) and very long (≥26mm). In each AL group, eyes were then divided into 3 subgroups based on the LT measured with IOLmaster700: thin (<4.5 mm), medium (4.5-5.0 mm), and thick (≥ 5 mm). The influence of LT on accuracy of Kane, Hill-RBF 3.0, BUII, EVO, and Pearl-DGS formulas were investigated in each AL group. RESULTS A total of 327 eyes from 327 patients were analyzed, with 64, 102, 73 and 88 eyes in each AL group, respectively. In eyes with AL < 24.5 mm, myopic PE was significantly associated with greater LT using all the 5 formulas (all p < 0.05). Backward stepwise multivariate regression analyses revealed that LT was an important influencing factor for PE in all 5 formulas, particularly in eyes with AL <24.5 mm. In eyes with AL <24.5 mm and LT > 5.0 mm, PE of all 5 formulas calculated with the optional parameter LT were more myopic than those calculated without LT. CONCLUSIONS Thicker LT was associated with more myopic PE among eyes with AL <24.5 mm when using all 5 formulas. Further optimization of current formulas is necessary, especially for eyes with short AL and thick LT.
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Affiliation(s)
- Yuxi Chen
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yanwen Fang
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Jing Zhao
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Wenwen He
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Bo Ma
- Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Shaanxi Province, China
| | - Xiangjia Zhu
- Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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Zhao H, Tang T, Lu Y, Li X, Sun L, Chen S, Ma L, Luo Y, Wang K, Zhao M. Development and Validation of Data-Level Innovation Data-Balancing Machine Learning Models for Predicting Optimal Implantable Collamer Lens Size and Postoperative Vault. Ophthalmol Ther 2024; 13:267-286. [PMID: 37943481 PMCID: PMC10776515 DOI: 10.1007/s40123-023-00841-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/20/2023] [Indexed: 11/10/2023] Open
Abstract
INTRODUCTION There are only four sizes of implantable collamer lens (ICL) available for selection, which cannot completely fit all patients as a result of the discontinuity of ICL sizes. Sizing an optimal ICL and predicting postoperative vault are still unresolved problems. This study aimed to develop and validate innovative data-level data-balancing machine learning-based models for predicting ICL size and postoperative vault. METHODS The patients were randomly assigned to training and internal validation sets in a 4:1 ratio. Feature selection was performed using analysis of variance (ANOVA) and Kruskal-Wallis feature importance methods. Traditional linear regression model and machine learning-based models were used. The accuracy of models was assessed using the area under the curve (AUC) and confusion matrix. RESULTS A total of 564 patients (1127 eyes) were eligible for this study, consisting of 808 eyes in the training set, 202 eyes in the internal validation set, and 117 eyes in the external validation set. Compared with the traditional linear regression method, the machine learning model bagging tree showed the best performance for ICL size selection, with an accuracy of 84.5% (95% confidence interval (CI) 83.2-85.8%), and the AUC ranged from 0.88 to 0.99; the prediction accuracy of 12.1 mm and 13.7 mm ICL sizes was improved by 49% and 59%, respectively. The bagging tree model achieved the best accuracy [90.2%, (95% CI 88.9-91.5%)] for predicting the postoperative vault, and the AUC ranged from 0.90 to 0.94. The prediction accuracies of internal and external validation dataset for ICL sizing were 82.2% (95% CI 81.1-83.3%) and 82.1% (95% CI 81.1-83.1%), respectively. CONCLUSIONS The innovative data-level data balancing-based machine learning model can be used to predict ICL size and postoperative vault more accurately, which can assist surgeons in choosing optimal ICL size, thus reducing risks of postoperative complications and secondary surgery.
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Affiliation(s)
- Heng Zhao
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Tao Tang
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Yuchang Lu
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Xuewei Li
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Liyuan Sun
- Xuanwu Hospital Capital Medical University, Beijing, China
| | - Sitong Chen
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Lu Ma
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Yan Luo
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
| | - Kai Wang
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China.
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China.
- College of Optometry, Peking University Health Science Center, Beijing, China.
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China.
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China.
| | - Mingwei Zhao
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology and Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
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Cañones-Zafra R, Gros-Otero J, Garcia-Gonzalez M, Casado S, Ketabi S, Villa-Collar C, Teus MA. Atomic force microscopy for the evaluation of corneal surface roughness after femtosecond laser flap creation and excimer ablation. Int Ophthalmol 2023; 43:4131-4136. [PMID: 37505289 DOI: 10.1007/s10792-023-02821-z] [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: 11/15/2021] [Accepted: 07/10/2023] [Indexed: 07/29/2023]
Abstract
INTRODUCTION It is well known that the femtosecond laser lamellar cut induces some degree of surface roughness. Nevertheless, as in femtosecond laser-assisted LASIK (FS-LASIK), an excimer LASIK ablation is performed, and the post-ablation stromal bed should show some degree of smoothening. We decided to compare, using atomic force microscopy (AFM), the roughness of the corneal stromal bed, after a femtosecond lasers device flap was created with or without an excimer myopic ablation. METHODS Using 6 freshly enucleated porcine eyes, we created in every eye a flap using a femtosecond laser. Additionally, in 3 eyes, an excimer laser ablation to correct-3 diopters (D) was made. AFM imaging of the remaining corneal stroma was performed. Ten different square areas of 20 μm x 20 μm at the central area of the stroma of each corneal sample were studied. The roughness parameters used were the root-mean-square deviation from a perfectly flat surface. RESULTS The RMS deviation was 360 ± 120 nm in femtosecond laser only, and 110 ± 20 nm in those cases where excimer is also involved (p < 0.0001). CONCLUSIONS Our results show that the roughness of the surface treated with excimer is clearly lower than in the group with no excimer ablation; thus, the application of laser excimer after a flap created by femtosecond laser seems to soften the nano-irregularities created by this technique.
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Affiliation(s)
- Rafael Cañones-Zafra
- Department of Ophthalmology, Hospital Universitario Príncipe de Asturias, Carretera Alcalá-Meco S/N, 28805, Alcalá de Henares, Madrid, Spain.
- Clínica Novovisión, Madrid, Spain.
| | | | | | | | - Samira Ketabi
- Department of Ophthalmology, Hospital Universitario Príncipe de Asturias, Carretera Alcalá-Meco S/N, 28805, Alcalá de Henares, Madrid, Spain
| | - César Villa-Collar
- Clínica Novovisión, Madrid, Spain
- Department of Pharmacy, Biotechnology, Nutrition, Optics and Optometry, Universidad Europea de, Madrid, Spain
| | - Miguel A Teus
- Department of Ophthalmology, Hospital Universitario Príncipe de Asturias, Carretera Alcalá-Meco S/N, 28805, Alcalá de Henares, Madrid, Spain
- Clínica Novovisión, Madrid, Spain
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Maleki A, Fernandez CC, Philip AM, Manhapra A, Chang PY, Foster CS. Acute macular neuroretinopathy in a patient with birdshot chorioretinopathy after intravitreal triamcinolone suspension injection. Eur J Ophthalmol 2023; 33:NP35-NP40. [PMID: 36062613 DOI: 10.1177/11206721221124653] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To report a case of acute macular neuroretinopathy (AMN) after intravitreal triamcinolone acetonide (TRIESENCE®) injection for cystoid macular edema secondary to birdshot chorioretinopathy. METHOD A case report. PATIENT A 62-year-old female. RESULTS The patient presented with acutely decreased vision and a ring scotoma around her central vision three days after intravitreal triamcinolone acetonide (TRIESENCE®) injection for cystoid macular edema in her right eye (OD) secondary to birdshot chorioretinopathy. She had undergone pars plana vitrectomy, cataract extraction, and secondary intraocular lens implantation OD three months prior to the recent injection. Best-corrected visual acuity (BCVA) was 20/1000 OD and 20/50 OS. Intraocular pressure was 21 mmHg OD and 12 mmHg OS. Fluorescein angiography demonstrated a hypofluorescent area in the perifoveal zone OD. Optical coherence tomography OD depicted hyperreflective areas in the outer nuclear layer, outer plexiform layer, and retinal pigment epithelium. We diagnosed her with AMN OD and started her on brimonidine three times a day OD. She came back a week later with resolved scotoma and her vision improved to 20/60 OD. Five weeks later, BCVA was 20/40 and Intraocular pressures (IOP) was 12 mmHg OD. CONCLUSIONS AND IMPORTANCE Intravitreal triamcinolone injection may be a cause of AMN with cystoid macular edema (CME) and borderline-high intraocular pressure. Brimonidine may be an effective treatment for these patients in the early course of the disease.
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Affiliation(s)
- Arash Maleki
- Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA
- The Ocular Immunology and Uveitis Foundation, Waltham, MA, USA
| | - Carla C Fernandez
- Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA
- The Ocular Immunology and Uveitis Foundation, Waltham, MA, USA
| | - Andrew M Philip
- Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA
- The Ocular Immunology and Uveitis Foundation, Waltham, MA, USA
| | - Ambika Manhapra
- Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA
- The Ocular Immunology and Uveitis Foundation, Waltham, MA, USA
| | - Peter Y Chang
- Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA
- The Ocular Immunology and Uveitis Foundation, Waltham, MA, USA
| | - C Stephen Foster
- Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA
- The Ocular Immunology and Uveitis Foundation, Waltham, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
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Zhang G, Cao H, Qu C. Efficacy, Safety, Predictability, and Stability of LASIK for Presbyopia Correction: A Systematic Review and Meta-analysis. J Refract Surg 2023; 39:627-638. [PMID: 37675909 DOI: 10.3928/1081597x-20230802-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
PURPOSE To determine the efficacy, safety, predictability, and stability of laser in situ keratomileusis (LASIK) in the treatment of presbyopia. METHODS The databases of CNKI, VIP, Wan-Fang, CBM, Chinese Clinical Registry, PubMed, The Cochrane Library, Web of Science, Embase, and ClinicalTrials.gov were searched until March 2023. The authors chose the studies of LASIK in the treatment of presbyopia. Outcomes were efficacy, safety, predictability, and stability. The review was registered in the international platform of registered systematic review and meta-analysis protocols (INPLASY202350005). RESULTS A total of 28 non-randomized controlled trials (15,861 eyes) were included. The results showed that after LASIK, (1) the distance efficacy decreased (mean difference [MD]: 0.02, 95% CI: 0.0 to 0.03, P < .05) and the near efficacy increased (MD: -0.01, 95% CI: -0.19 to-0.02, P < .05); (2) the distance safety decreased (MD: 0.07, 95% CI: 0.04 to 0.10, P < .0001) and near safety increased (MD: -0.19, 95% CI: -0.39 to 0.02, P > .05); (3) the predictability within ±1.00 and ±0.50 D was 94% (relative risk [RR]: 0.94, 95% CI: 0.90 to 0.98, P < .001) and 80% (RR: 0.80, 95% CI: 0.74 to 0.86, P < .001), respectively; and (4) 6 months postoperatively, the percentage of spherical equivalent changing within ±0.50 D was 95% (RR: 0.95, 95% CI: 0.89 to 0.99, P < .001). CONCLUSIONS The near efficacy, predictability, and stability of LASIK for presbyopia correction were satisfactory; however, the distance efficacy and distance safety decreased. [J Refract Surg. 2023;39(9):627-638.].
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Russo A, Filini O, Savini G, Festa G, Morescalchi F, Boldini A, Semeraro F. Predictability of the vault after implantable collamer lens implantation using OCT and artificial intelligence in White patient eyes. J Cataract Refract Surg 2023; 49:724-731. [PMID: 36913536 PMCID: PMC10284125 DOI: 10.1097/j.jcrs.0000000000001182] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/28/2023] [Accepted: 03/05/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE To compare the predicted vault using machine learning with the achieved vault using the online manufacturer's nomogram in patients undergoing posterior chamber implantation with an implantable collamer lens (ICL). SETTING Centro Oculistico Bresciano, Brescia, Italy, and I.R.C.C.S.-Bietti Foundation, Rome, Italy. DESIGN Retrospective multicenter comparison study. METHODS 561 eyes from 300 consecutive patients who underwent ICL placement surgery were included in this study. All preoperative and postoperative measurements were obtained by anterior segment optical coherence tomography (AS-OCT; MS-39). The actual vault was quantitatively measured and compared with the predicted vault using machine learning of AS-OCT metrics. RESULTS A strong correlation between model predictions and achieved vaulting was detected by random forest regression (RF; R2 = 0.36), extra tree regression (ET; R2 = 0.50), and extreme gradient boosting regression ( R2 = 0.39). Conversely, a high residual difference was observed between achieved vaulting values and those predicted by the multilinear regression ( R2 = 0.33) and ridge regression ( R2 = 0.33). ET and RF regressions showed significantly lower mean absolute errors and higher percentages of eyes within ±250 μm of the intended ICL vault compared with the conventional nomogram (94%, 90%, and 72%, respectively; P < .001). ET classifiers achieved an accuracy (percentage of vault in the range of 250 to 750 μm) of up to 98%. CONCLUSIONS Machine learning of preoperative AS-OCT metrics achieved excellent predictability of ICL vault and size, which was significantly higher than the accuracy of the online manufacturer's nomogram, providing the surgeon with a valuable aid for predicting the ICL vault.
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Affiliation(s)
- Andrea Russo
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
| | - Ottavia Filini
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
| | - Giacomo Savini
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
| | - Giulia Festa
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
| | - Francesco Morescalchi
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
| | - Alessandro Boldini
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
| | - Francesco Semeraro
- From the Centro Oculistico Bresciano, Brescia, Italy (Russo, Filini, Festa); Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Italy (Russo, Morescalchi, Boldini, Semeraro); I.R.C.C.S.—G.B. Bietti Foundation, Rome, Italy (Savini)
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Cakir I, Sonmez O, Pehlivanoglu S, Cakir GY, Yildiz BK, Yildirim Y, Agca A. Long-term results of a new posterior chamber phakic intraocular lens in patients with high myopia: 5-year results. J Cataract Refract Surg 2023; 49:409-415. [PMID: 36888565 DOI: 10.1097/j.jcrs.0000000000001110] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/27/2022] [Indexed: 03/09/2023]
Abstract
PURPOSE To evaluate the long-term refractive outcomes of Eyecryl posterior chamber spherical phakic intraocular lens (pIOL) implantation in high myopia and endothelial cell density (ECD) change. SETTING Beyoglu Eye Training and Research Hospital, Istanbul, Turkey. DESIGN Retrospective. METHODS Eyes that were not suitable for corneal refractive surgery, had high myopia between -6.00 diopters (D) and -20.00 D, had Eyecryl posterior chamber spherical pIOL implantation, and had at least 5 years of follow-up were included. Preoperative ECD was ≥2300 cells/mm 2 and cylindrical value was ≤2.0 D in all cases. Preoperative and postoperative first, third, and fifth years of refraction, uncorrected and corrected distance visual acuity (UDVA/CDVA), and ECD were recorded. RESULTS 36 eyes of 18 patients were examined. The mean UDVA and CDVA in postoperative fifth years were 0.24 ± 0.19 logMAR and 0.12 ± 0.18 logMAR, respectively. The safety and efficacy indices were 1.52 ± 0.54 and 1.14 ± 0.38, respectively. At 5 years, the spherical equivalent was ±0.50 D in 75% of eyes and ±1.00 D in 92% of eyes. After 5 years, the mean cumulative ECD loss was 6.91% ( P = .07). The annual ECD loss was 1.57% in the first year, 0.26% between 1 year and 3 years, and 2.38% between 3 years and 5 years. Asymptomatic anterior capsule opacity developed in 1 eye 4 years after surgery. Rhegmatogenous retinal detachment developed in 1, and myopic choroidal neovascular membrane occurred in 1 eye. CONCLUSIONS Eyecryl posterior chamber spherical pIOL implantation is one of the effective and safe refractive surgical methods in correcting high myopia with predictable and stable refractive results over a 5-year period. Longer-term studies are needed for complications such as decreased ECD, retinal complications, and lens opacity.
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Affiliation(s)
- Ihsan Cakir
- From the Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey (I. Cakir, Sonmez, Pehlivanoglu, G.Y. Cakir, Yildiz, Yildirim); Atakoy World Eye Hospital, Istanbul, Turkey (Agca)
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Outcomes and Complications in Patients With Hypermobile Ehlers-Danlos Syndrome Who Have Undergone Laser In Situ Keratomileusis Surgery. Cornea 2023; 42:284-291. [PMID: 35389912 DOI: 10.1097/ico.0000000000003028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/10/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to determine the safety and outcomes of myopic laser in situ keratomileusis (LASIK) in patients who were secondarily diagnosed with hypermobile Ehlers-Danlos syndrome (EDS). METHODS We conducted a case series study on patients with hypermobile EDS who underwent myopic LASIK surgery. Visual acuity, manifest refraction, a full dilated eye examination, biometry measurements, and Scheimpflug imaging were performed in the Wilmer outpatient clinic. RESULTS There were 24 eyes of 12 patients included in this study. All participants were White women with a mean age of 46.58 years (SD 8.91 years). Participants were seen at an average of 13.83 years (SD 4.3 years, range 6-21 years) after undergoing LASIK. None of the patients in the series had a diagnosis of hypermobile EDS before LASIK surgery. Overall, 92% of patients were happy they got LASIK. The uncorrected distance visual acuity was 20/20 or better in 68% of eyes, and the best-corrected visual acuity was 20/20 or better in 92% of eyes. Manifest refraction was within 1 diopter of plano in 79% of patients. Dry eye symptoms were present in 83% of patients, and 46% of eyes had either punctate epithelial erosions or decreased tear break-up time. One of the 12 patients developed corneal ectasia in both eyes. CONCLUSIONS Patients with hypermobile EDS are generally satisfied with myopic LASIK correction, with good visual acuity outcomes and low rates of myopic regression. However, the risk of corneal ectasia may prevent laser vision correction from being a viable treatment option in these patients. Further studies are needed to make a definitive recommendation.
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Chang P, Zhang F, Li H, Liu Z, Li S, Qian S, Zhao Y. Femtosecond Laser-Assisted Cataract Surgery versus Conventional Phacoemulsification Surgery: Clinical Outcomes with EDOF IOLs. J Pers Med 2023; 13:jpm13030400. [PMID: 36983582 PMCID: PMC10056641 DOI: 10.3390/jpm13030400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
In this study, we evaluate and compare the outcomes of conventional phacoemulsification cataract surgery (CPS) and femtosecond laser-assisted cataract surgery (FLACS) with the implantation of an extended depth of field (EDOF) intraocular lens (IOL). A prospective, consecutive cohort study was conducted. Patients were given the option to choose FLACS or CPS and were implanted with an EDOF IOL. Refractive data, visual acuity data, ocular aberration measured with a wavefront aberrometer, and optical quality measured with an optical quality analysis system II were collected at one month postoperatively. A total of 92 eyes of 64 patients were enrolled in this study; 35 eyes of 26 patients were treated with FLACS, whereas 57 eyes of 38 patients were treated with CPS. Uncorrected visual acuity at far, intermediate, and near distance and best-spectacle-corrected visual acuity were not statistically significantly different between the groups (all p > 0.05), nor were the mean cylinder and mean spherical equivalent refraction (both p > 0.05). The FLACS group had a lower ocular trefoil than the CPS group (p = 0.033), and there was no significant difference between the two groups considering other aberration parameters, whether ocular or internal (all p > 0.05). Optical-quality-related parameters showed also no significant difference between the two groups (all p > 0.05). In conclusion, there was no significant difference between FLACS and CPS with implantation of EDOF IOLs in postoperative ocular parameters, refractive outcomes, ocular aberration, optical quality, and aberration parameters, except a lower ocular trefoil in the FLACS group. In terms of these indicators, FLACS does not provide an additional clinical benefit for patients over CPS.
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Affiliation(s)
- Pingjun Chang
- Department of Ophthalmology, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, China
- Key Laboratory of Vision Science, Ministry of Health, Wenzhou 325027, China
| | - Fan Zhang
- Department of Ophthalmology, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, China
- Key Laboratory of Vision Science, Ministry of Health, Wenzhou 325027, China
| | - Hongzhe Li
- Department of Ophthalmology, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, China
- Key Laboratory of Vision Science, Ministry of Health, Wenzhou 325027, China
| | - Zhuohan Liu
- Department of Ophthalmology, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, China
- Key Laboratory of Vision Science, Ministry of Health, Wenzhou 325027, China
| | - Siyan Li
- Department of Ophthalmology, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, China
- Key Laboratory of Vision Science, Ministry of Health, Wenzhou 325027, China
| | - Shuyi Qian
- Department of Ophthalmology, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, China
- Key Laboratory of Vision Science, Ministry of Health, Wenzhou 325027, China
| | - Yune Zhao
- Department of Ophthalmology, Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325027, China
- Key Laboratory of Vision Science, Ministry of Health, Wenzhou 325027, China
- Correspondence:
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Savini G, Lupardi E, Hoffer KJ, Aramberri J, Schiano-Lomoriello D. Corneal diameter measurements by 3 optical biometers and their effect on phakic intraocular lens sizing. J Cataract Refract Surg 2022; 48:1292-1296. [PMID: 35616506 DOI: 10.1097/j.jcrs.0000000000000976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/22/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare phakic intraocular lens size calculations based on corneal diameter (CD) measurements by 3 instruments. SETTING G.B. Bietti Foundation I.R.C.C.S., Rome, Italy. DESIGN Retrospective interventional case series. METHODS Preoperatively, CD was measured with the Aladdin, IOLMaster 700, and Pentacam AXL Wave. The simulated ICL size was computed by entering CD measurements into the manufacturer's calculator. Postoperatively, vaulting was measured by anterior segment optical coherence tomography. The optimal ICL size (OIS) was calculated and compared with the commercially available OIS (CAOIS). RESULTS 54 eyes (29 patients) with the implantable collamer lens (ICL) were enrolled. The mean CD was 12.02 ± 0.36 mm with the Aladdin, 12.35 ± 0.39 mm with the IOLMaster 700, and 12.22 ± 0.41 mm with the Pentacam AXL Wave ( P &lt; .0001), with the closest agreement between the Pentacam AXL Wave and IOLMaster 700 (95% limits of agreement: -0.43 to +0.17 mm). Vaulting (mean: 558 ± 261 μm) was within 251 and 1000 μm in 49 eyes (83.3%). The mean difference between the simulated ICL size and OIS ranged between -0.11 ± 0.35 mm and 0.10 ± 0.30 mm ( P &lt; .0001), with no statistically significant difference between the IOLMaster 700 and Pentacam AXL Wave. The simulated ICL size was equal to CAOIS in 38 eyes (70.37%) with the Aladdin, 37 eyes (68.52%) with the IOLMaster 700, and 39 eyes (72.22%) with the Pentacam AXL Wave, without any statistically significant difference. CONCLUSIONS CD measurements by the 3 devices lead to similar percentages of eyes with an ICL size equal to the OIS. Agreement is closer between the IOLMaster 700 and Pentacam AXL Wave.
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Affiliation(s)
- Giacomo Savini
- From the I.R.C.C.S., G.B. Bietti Foundation, Rome, Italy (Savini, Schiano-Lomoriello); University Eye Clinic, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy (Lupardi); Stein Eye Institute, University of California, Los Angeles, California (Hoffer); St. Mary's Eye Center, Santa Monica, California (Hoffer); Clínica Miranza Begitek, San Sebastian and Clinica Miranza Ókular, Vitoria, Spain (Aramberri)
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Chen Y, Meng J, Cheng K, Lu Q, Wei L, Lu Y, Zhu X. Influence of IOL Weight on Long-Term IOL Stability in Highly Myopic Eyes. Front Med (Lausanne) 2022; 9:835475. [PMID: 35479960 PMCID: PMC9035698 DOI: 10.3389/fmed.2022.835475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/07/2022] [Indexed: 01/17/2023] Open
Abstract
Purpose This study aimed to investigate the influence of intraocular lens (IOL) weight on long-term IOL stability in highly myopic eyes. Materials and Methods A total of 205 highly myopic cataract eyes of 205 patients implanted with the MC X11 ASP (Group A, 86 eyes) or 920H IOL (Group B, 119 eyes) were included in this retrospective study. Eyes were divided into 3 subgroups according to the IOL power: low (≥-5 to <5 D), medium (≥5 to <14 D), and high (≥14 D) IOL power. At 3 years after surgery, IOL decentration and tilt, high-order aberrations, and anterior capsular opening (ACO) area were measured. The influence of IOL weight on long-term IOL stability was evaluated. Results Group B had a significantly greater IOL weight than Group A (Group B vs. Group A: 28.31 ± 2.01 mg vs. 25.71 ± 4.62 mg, P < 0.001). Correspondingly, Group B presented significantly greater overall and inferior decentration than Group A, especially for low and medium IOL power (all P < 0.05). In both groups, overall and vertical decentration was significantly correlated with IOL weight (all P < 0.05). Group B showed a significantly greater ACO area than Group A (P < 0.05). Multivariate analysis showed that decentration in Group A was affected by IOL weight, while decentration in Group B was affected by IOL weight and AL. Conclusions Higher IOL weight may lead to greater long-term IOL decentration in highly myopic eyes, while the haptic design may play a role in anterior capsular contraction.
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Affiliation(s)
- Yuxi Chen
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Jiaqi Meng
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Kaiwen Cheng
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Qiang Lu
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Ling Wei
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Yi Lu
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
- Yi Lu
| | - Xiangjia Zhu
- Department of Ophthalmology and Eye Institute, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
- Key Laboratory of Myopia (Fudan University), National Health Commission, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
- *Correspondence: Xiangjia Zhu
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Abtahi SH, Nouri H, Moradian S, Yazdani S, Ahmadieh H. Eye Disorders in the Post-COVID Era. J Ophthalmic Vis Res 2021; 16:527-530. [PMID: 34840673 PMCID: PMC8593548 DOI: 10.18502/jovr.v16i4.9740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This is an Editorial and does not have an abstract. Please download the PDF or view the article HTML.
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Affiliation(s)
- Seyed-Hossein Abtahi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hosein Nouri
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Siamak Moradian
- Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahin Yazdani
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Ahmadieh
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Kamiya K, Ryu IH, Yoo TK, Kim JS, Lee IS, Kim JK, Ando W, Shoji N, Yamauchi T, Tabuchi H. Prediction of Phakic Intraocular Lens Vault Using Machine Learning of Anterior Segment Optical Coherence Tomography Metrics. Am J Ophthalmol 2021; 226:90-99. [PMID: 33577789 DOI: 10.1016/j.ajo.2021.02.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 02/05/2021] [Accepted: 02/06/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To compare the achieved vault using the conventional manufacturer's nomogram and the predicted vault using machine learning, in a large cohort of eyes undergoing posterior chamber phakic intraocular lens (EVO implantable collamer lens [ICL]; STAAR Surgical) implantation. DESIGN Reliability and validity assessment and comparison. METHODS Our study comprised a total of 1,745 eyes of 1,745 consecutive patients (mean age ± standard deviation, 26.2 ± 6.8 years) undergoing ICL implantation. At 1 month postoperatively, we quantitatively measured the actual vault, and compared it with the predicted vault using machine leaning of anterior segment optical coherence tomography metrics. RESULTS All machine learning methods, such as support vector regressor (SVR), gradient boost regressor (GBR), random forest regressor (RFR), and linear regressor (LR), showed significantly less mean absolute error and higher percentages of eyes within 50-200 µm of the targeted ICL vault than the conventional nomogram (P < .001). The RFR provided the lowest mean absolute errors and the highest percentages of eyes within 50 to 200 µm, followed by the GBR, the LR, and the SVR (P < .01). CONCLUSIONS Machine learning of the preoperative anterior segment optical coherence tomography metrics, especially the RFR, provided significantly higher predictability of the ICL vault than the conventional manufacturer's nomogram, suggesting that it will become an aid for predicting the ICL vault and subsequently selecting the proper ICL size in daily practice.
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Affiliation(s)
| | - Ik Hee Ryu
- Kitasato University, Kanagawa, Japan; B&VIIT Eye Center, Seoul, South Korea
| | - Tae Keun Yoo
- Kitasato University, Kanagawa, Japan; B&VIIT Eye Center, Seoul, South Korea; Department of Ophthalmology, Aerospace Medical Center, Republic of Korea Air Force, Cheongju, South Korea
| | - Jung Sub Kim
- Kitasato University, Kanagawa, Japan; B&VIIT Eye Center, Seoul, South Korea
| | - In Sik Lee
- Kitasato University, Kanagawa, Japan; B&VIIT Eye Center, Seoul, South Korea
| | - Jin Kook Kim
- Kitasato University, Kanagawa, Japan; B&VIIT Eye Center, Seoul, South Korea
| | - Wakako Ando
- the Department of Ophthalmology, School of Medicine
| | | | | | - Hitoshi Tabuchi
- Department of Ophthalmology, Tsukazaki Hospital, Hyogo, Japan
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Pinto C, Monteiro T, Franqueira N, Faria-Correia F, Mendes J, Vaz F. Posterior chamber collamer phakic intraocular lens implantation: Comparison of efficacy and safety for low and moderate-to-high myopia. Eur J Ophthalmol 2021; 32:11206721211012861. [PMID: 33887990 DOI: 10.1177/11206721211012861] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To compare visual, refractive and safety outcomes of central-hole posterior chamber collamer phakic intraocular lens implantation for low and moderate-to-high myopia. SUBJECTS/METHODS This retrospective cohort study included 338 eyes submitted to posterior chamber collamer phakic intraocular lens implantation that completed a 12-month postoperative follow-up. Two groups were defined depending on preoperative spherical equivalent: group 1 comprised 106 eyes with manifest spherical equivalent of -6.00 D or less; group 2 comprised 232 eyes with manifest spherical equivalent higher than -6.00 D. Effectiveness, predictability, stability and safety outcomes were compared preoperatively and at 1, 6 and 12 months postoperatively. RESULTS At 1-year postoperative, uncorrected and corrected visual acuities were 0.02 ± 0.17 and -0.01 ± 0.12 logMAR (group 1) and 0.04 ± 0.20 and 0.01 ± 0.16 logMAR (group 2), with an efficacy index of 1.05 ± 0.17 and 1.17 ± 0.28. Respectively, 92 (86.8%) and 199 (85.8%) eyes were within ±0.50 D of targeted refraction, and postoperative manifest refraction changes were -0.07 ± 0.25 D and -0.07 ± 0.35 D. Intraocular pressure did not change significantly. The mean rate of endothelial cell loss was 1.12% and 1.10%, respectively. One case of anterior subcapsular cataract (group 2) was observed. ICL exchange occurred in one case (group 1) and three cases (group 2). No vision-threatening complications were reported. CONCLUSION The posterior chamber collamer phakic intraocular lens implantation demonstrated high visual and refractive efficacy with an excellent safety profile for the correction of both low and moderate-to-high myopia, revealing equivalent 1-year outcomes regardless of the degree of preoperative myopia.
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Affiliation(s)
| | - Tiago Monteiro
- Department of Ophthalmology, Hospital de Braga, Braga, Portugal
- Life and Health Sciences Research Institute (ICVS), Escola de Medicina, Universidade do Minho, Braga, Portugal
| | - Nuno Franqueira
- Department of Ophthalmology, Hospital de Braga, Braga, Portugal
| | - Fernando Faria-Correia
- Department of Ophthalmology, Hospital de Braga, Braga, Portugal
- Life and Health Sciences Research Institute (ICVS), Escola de Medicina, Universidade do Minho, Braga, Portugal
| | - José Mendes
- Department of Ophthalmology, Hospital de Braga, Braga, Portugal
- Life and Health Sciences Research Institute (ICVS), Escola de Medicina, Universidade do Minho, Braga, Portugal
| | - Fernando Vaz
- Department of Ophthalmology, Hospital de Braga, Braga, Portugal
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Mikalauskiene L, Grzybowski A, Zemaitiene R. Ocular Surface Changes Associated with Ophthalmic Surgery. J Clin Med 2021; 10:jcm10081642. [PMID: 33921534 PMCID: PMC8069708 DOI: 10.3390/jcm10081642] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 01/13/2023] Open
Abstract
Dry eye disease causes ocular discomfort and visual disturbances. Older adults are at a higher risk of developing dry eye disease as well as needing for ophthalmic surgery. Anterior segment surgery may induce or worsen existing dry eye symptoms usually for a short-term period. Despite good visual outcomes, ocular surface dysfunction can significantly affect quality of life and, therefore, lower a patient’s satisfaction with ophthalmic surgery. Preoperative dry eye disease, factors during surgery and postoperative treatment may all contribute to ocular surface dysfunction and its severity. We reviewed relevant articles from 2010 through to 2021 using keywords “cataract surgery”, ”phacoemulsification”, ”refractive surgery”, ”trabeculectomy”, ”vitrectomy” in combination with ”ocular surface dysfunction”, “dry eye disease”, and analyzed studies on dry eye disease pathophysiology and the impact of anterior segment surgery on the ocular surface.
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Affiliation(s)
- Lina Mikalauskiene
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, 44037 Kaunas, Lithuania;
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, 10719 Olsztyn, Poland;
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, 61553 Poznan, Poland
| | - Reda Zemaitiene
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, 44037 Kaunas, Lithuania;
- Correspondence:
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Meng J, He W, Rong X, Miao A, Lu Y, Zhu X. Decentration and tilt of plate-haptic multifocal intraocular lenses in myopic eyes. EYE AND VISION 2020; 7:17. [PMID: 32280721 PMCID: PMC7137526 DOI: 10.1186/s40662-020-00186-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 03/17/2020] [Indexed: 12/18/2022]
Abstract
Background To investigate the decentration and tilt of plate-haptic multifocal intraocular lenses (MfIOLs) in myopic eyes. Methods Myopic (axial length [AXL] > 24.5 mm) and non-myopic (21.0 mm < AXL ≤ 24.5 mm) cataract eyes were enrolled in this prospective study and randomly assigned to receive implantation of Zeiss AT LISA tri 839MP lenses (Group A) or Tecnis ZMB00 lenses (Group B). In total, 122 eyes of 122 patients were available for analysis. Decentration and tilt of MfIOLs, high-order aberrations (HOAs), and modulation transfer functions (MTFs) were evaluated using the OPD-Scan III aberrometer 3 months postoperatively. Subjective symptoms were assessed with a Quality of Vision questionnaire. Results Near and distance visual acuities, tilt and horizontal decentration did not differ between the two groups, postoperatively. However, myopic eyes of Group B showed greater vertical decentration than those of Group A (− 0.17 ± 0.14 mm vs. -0.03 ± 0.09 mm, respectively), particularly when the MfIOLs were placed horizontally or obliquely. Overall decentration of myopic eyes was greater in Group B than in Group A (0.41 ± 0.15 mm vs. 0.16 ± 0.10 mm, respectively). In Group B, AXL was negatively correlated with vertical decentration and positively correlated with overall decentration. No such correlations were found in Group A. Intraocular total HOAs, coma, trefoil and spherical aberrations were lower in Group A than in Group B for a 6.0 mm pupil among myopic eyes. Generally, Group A had better MTFs and fewer subjective symptoms than Group B among myopic eyes. Conclusions Plate-haptic design of MfIOLs may be a suggested option for myopic cataract eyes due to the less inferior decentration and better visual quality postoperatively.
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Affiliation(s)
- Jiaqi Meng
- 1Eye Institute, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031 China
| | - Wenwen He
- 1Eye Institute, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031 China.,2Key Laboratory of Myopia, Ministry of Health, Shanghai, China.,Key Laboratory of Visual Impairment and Restoration, Shanghai, China.,4Key NHC key Laboratory of Myopia (Fudan University), Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xianfang Rong
- 1Eye Institute, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031 China
| | - Ao Miao
- 1Eye Institute, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031 China
| | - Yi Lu
- 1Eye Institute, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031 China.,2Key Laboratory of Myopia, Ministry of Health, Shanghai, China.,Key Laboratory of Visual Impairment and Restoration, Shanghai, China.,4Key NHC key Laboratory of Myopia (Fudan University), Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xiangjia Zhu
- 1Eye Institute, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031 China.,2Key Laboratory of Myopia, Ministry of Health, Shanghai, China.,Key Laboratory of Visual Impairment and Restoration, Shanghai, China.,4Key NHC key Laboratory of Myopia (Fudan University), Shanghai, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
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Schallhorn JM, Schallhorn SC, Teenan D, Hannan SJ, Pelouskova M, Venter JA. Incidence of Intraoperative and Early Postoperative Adverse Events in a Large Cohort of Consecutive Laser Vision Correction Treatments. Am J Ophthalmol 2020; 210:97-106. [PMID: 31634446 DOI: 10.1016/j.ajo.2019.10.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the incidence of adverse events (AE) following laser vision correction. DESIGN Retrospective case series. METHODS Optical Express, UK. Patients/study population: patients who underwent laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) between July 1, 2014, and June 30, 2016. Intervention/observation procedures: all AEs recorded in the electronic medical record were extracted and retrospectively reviewed. The total incidence of AE and serious adverse events (SAE) was calculated. Loss of 2 or more lines of corrected distance visual acuity (CDVA) was calculated for the entire cohort of patients that attended a minimum of 3 months follow-up. MAIN OUTCOME MEASURES AEs; Preoperative and last available postoperative clinical data. RESULTS A total of 31,921 (61,833 eyes) were included in the study for LASIK and 5,016 (9,467 eyes) for PRK. The total number of AE was 850 for LASIK (occurring in 783 eyes of 657 patients; incidence of 1.3% or 1:79 eyes) and 227 for PRK (occurring in 218 eyes of 170 patients; incidence of 2.3% or 1:43 eyes). In the LASIK group, there were 287 SAEs (271 eyes of 226 patients; incidence of 0.4% or 1:228 eyes), and the number of SAEs in PRK group was 65 (65 eyes of 39 patients; incidence 0.7% or 1:146 eyes). Combining LASIK and PRK data, the loss of 2 or more lines of CDVA was recorded in 0.37% of eyes. CONCLUSIONS Contemporary LASIK and PRK are safe procedures with a low incidence of serious adverse events.
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Jonker SM, Van Averbeke AA, Berendschot TT, Saelens IE, Nuijts RM. Risk factors for explantation of iris-fixated phakic intraocular lenses. J Cataract Refract Surg 2019; 45:1092-1098. [DOI: 10.1016/j.jcrs.2019.03.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/08/2019] [Accepted: 03/11/2019] [Indexed: 10/26/2022]
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A Multicenter Study on Early Outcomes of Small-Incision Lenticule Extraction for Myopia. Sci Rep 2019; 9:4067. [PMID: 30858493 PMCID: PMC6411974 DOI: 10.1038/s41598-019-40805-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 02/20/2019] [Indexed: 11/08/2022] Open
Abstract
This study was aimed to investigate the early clinical outcomes of small-incision lenticule extraction (SMILE) to correct both myopia and myopic astigmatism at major clinical centers in Japan. This case series consisted of two hundred fifty-two eyes of 130 consecutive patients who underwent SMILE surgery (29.5 ± 6.3 years, mean age ± standard deviation), with spherical equivalents of -4.33 ± 1.61 D. We determined the safety, efficacy, predictability, stability, and adverse events of this procedure. Corrected distance visual acuity significantly improved, from -0.18 ± 0.04 preoperatively to -0.19 ± 0.07 logMAR postoperatively (paired t-test, p < 0.001). Uncorrected distance visual acuity also significantly improved, from 1.05 ± 0.26 preoperatively to -0.15 ± 0.11 logMAR postoperatively (p < 0.001). 88% and 98% of eyes were within ± 0.5 and 1.0 D of the targeted correction, respectively. Changes in manifest spherical equivalent from 1 week postoperatively were 0.02 ± 0.35 D (p = 0.127). No vision-threatening complications were observed in any of the cases. SMILE performed well in the correction of myopic refractive errors, and we experienced no severe complications in this series, indicating its feasibility as a surgical option for the treatment of these eyes.
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Bohac M, Koncarevic M, Pasalic A, Biscevic A, Merlak M, Gabric N, Patel S. Incidence and Clinical Characteristics of Post LASIK Ectasia: A Review of over 30,000 LASIK Cases. Semin Ophthalmol 2018; 33:869-877. [PMID: 30359155 DOI: 10.1080/08820538.2018.1539183] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE To report the incidence of postoperative ectasia after laser in situ keratomileusis (LASIK). METHODS A retrospective case review of 30,167 eyes (16,732 patients) was conducted following LASIK between August 2007 and August 2015. The follow-up was between 2 and 8 years. Tomography was performed after 2 years postop. After identifying cases of ectasia, the charts of these patients were examined to identify any common factors that may have predisposed them to develop ectasia. RESULTS Ten eyes of seven patients developed post-LASIK ectasia. Eight eyes had been treated for myopia and myopic astigmatism, two eyes for mixed astigmatism. There were no cases of ectasia after LASIK for hyperopia. All 10 cases of ectasia had a flap that was created using the Moria M2 mechanical microkeratome (average flap thickness 118.15 ± 12.88 µm) and refractive error corrected using the Wavelight Allegretto excimer laser. Retrospectively, most prevalent risk factors were thin cornea (≤ 500 µm, 50% of cases), anterior topographic map irregularities (e.g., asymmetric bow tie, 40% of cases), Ectasia Risk Score > 3 (40% of cases), percent tissue thickness alteration ≥ 40% (20% of cases) and low residual stromal bed (≤ 300 µm, 30% of cases). One eye had no identifiable risk factors. In the retrospective chart review 14.97% (4,506) of all the eyes had similar risk factors to the cases that went on to develop ectasia. CONCLUSION The incidence of ectasia was 0.033% over 8 years. The incidence could be higher as some cases may destabilize beyond this period and some patients were lost to follow-up asymptomatic of any clinical signs. Other intrinsic factors may trigger the development of post LASIK ectasia. The current widely accepted risk factors are not sufficiently rigorous for screening out potential ectasia from developing after LASIK. There is a need to augment accuracy with higher sensitivity and specificity.
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Affiliation(s)
- Maja Bohac
- a School of Medicine, University of Rijeka , Specialty Eye Hospital "Svjetlost" , Zagreb , Croatia
| | - Mateja Koncarevic
- a School of Medicine, University of Rijeka , Specialty Eye Hospital "Svjetlost" , Zagreb , Croatia
| | - Adi Pasalic
- a School of Medicine, University of Rijeka , Specialty Eye Hospital "Svjetlost" , Zagreb , Croatia
| | - Alma Biscevic
- a School of Medicine, University of Rijeka , Specialty Eye Hospital "Svjetlost" , Zagreb , Croatia
| | - Maja Merlak
- b Department of Ophthalmology , School of Medicine, University of Rijeka , Rijeka , Croatia
| | - Nikica Gabric
- a School of Medicine, University of Rijeka , Specialty Eye Hospital "Svjetlost" , Zagreb , Croatia
| | - Sudi Patel
- a School of Medicine, University of Rijeka , Specialty Eye Hospital "Svjetlost" , Zagreb , Croatia.,c NHS National Services Scotland , Edinburgh , UK
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Chua D, Htoon HM, Lim L, Chan CM, Mehta JS, Tan DTH, Rosman M. Eighteen-year prospective audit of LASIK outcomes for myopia in 53 731 eyes. Br J Ophthalmol 2018; 103:1228-1234. [PMID: 30355717 DOI: 10.1136/bjophthalmol-2018-312587] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 09/28/2018] [Accepted: 10/06/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND To assess the outcomes of laser-assisted in situ keratomileusis (LASIK) performed for the treatment of myopia in terms of safety, efficacy and predictability in an 18-year clinical audit. METHOD In this single-centre, prospective, non-randomised study, preoperative and postoperative refractions, uncorrected (UCVA), best-corrected Snellen visual acuity (BCVA) and complications of all eyes undergoing myopic LASIK were recorded. Safety, efficacy, refractive predictability, treatment trends, retreatment rates and complication rates were evaluated. RESULTS Between 1998 and 2015, 53 731 eyes of 27312 patients underwent myopic LASIK. Patients' median age was 31.6 years (mean, 32.6±7.3 years); there were 9703 males (35.5%). Patients were predominantly ethnic Chinese (87.4%). Mean follow-up time was 78±75.6 days (median, 86 days). Overall efficacy index was 0.91 with >99% of eyes achieving UCVA of ≥20/40 and >70% achieving 20/20 since 2010. 95.43% of eyes had no loss of vision postoperatively and 4.2% and 0.37% lost 1 and ≥2 lines BCVA, respectively. From 2010 the safety index has been >1.05. More than 94.0% of eyes achieved within ±1.0 D of target refraction and at least 70% achieved within ±0.50 D of target from 2010 onwards. Retreatment rate was 2.55% and after retreatment 98.4% of eyes achieved ≥20/40 UCVA and 63.5% achieved ≥20/20 UCVA. The overall complication rate is 0.98%, and since 2010, the annual complication rate has been <0.8%. CONCLUSIONS Myopic LASIK performed in Asian eyes is safe and effective with high refractive predictability in a comprehensive LASIK programme with appropriate clinical audit.
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Affiliation(s)
- Daniel Chua
- Singapore National Eye Centre, Singapore, Singapore.,Singapore Eye Research Institute, Singapore, Singapore
| | - Hla Myint Htoon
- Singapore National Eye Centre, Singapore, Singapore.,Singapore Eye Research Institute, Singapore, Singapore
| | - Li Lim
- Singapore National Eye Centre, Singapore, Singapore.,Singapore Eye Research Institute, Singapore, Singapore
| | - Cordelia Ml Chan
- Singapore National Eye Centre, Singapore, Singapore.,Singapore Eye Research Institute, Singapore, Singapore
| | - Jodhbir S Mehta
- Singapore National Eye Centre, Singapore, Singapore.,Singapore Eye Research Institute, Singapore, Singapore
| | - Donald T H Tan
- Singapore National Eye Centre, Singapore, Singapore.,Singapore Eye Research Institute, Singapore, Singapore
| | - Mohamad Rosman
- Singapore National Eye Centre, Singapore, Singapore .,Singapore Eye Research Institute, Singapore, Singapore
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Early Results with a New Posterior Chamber Phakic Intraocular Lens in Patients with High Myopia. J Ophthalmol 2018; 2018:1329874. [PMID: 30018818 PMCID: PMC6029447 DOI: 10.1155/2018/1329874] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 05/03/2018] [Indexed: 01/22/2023] Open
Abstract
Purpose To report clinical results of a foldable, hydrophilic acrylic, single-piece, injectable, posterior chamber phakic intraocular lens (pIOL). Material and Methods Medical records of patients who underwent posterior chamber phakic IOL (Eyecryl Phakic IOL, Biotech Vision Care, Ahmedabad, India) implantation for surgical correction of myopia were retrospectively reviewed. Only patients with at least a one-year follow-up were included. Manifest refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), endothelial cell density (ECD), and pIOL vault were analyzed at 1, 3, 6, and 12 months after surgery. Complications observed during and after surgery were also recorded. Results The study included 58 eyes of 29 patients. Mean patient age was 32 ± 7 years. Spherical equivalent of manifest refraction was −13.41 ± 3.23 D preoperatively and −0.44 ± 0.55 D postoperatively. Preoperative CDVA was 0.29 ± 0.71 logMAR. Postoperative UDVA and CDVA were 0.21 ± 0.66 and 0.15 ± 0.69 logMAR, respectively, at the 12-month visit. At the 12-month visit, the efficacy index was 1.20 and the safety index was 1.39. Mean ECD was 2713 ± 339 cells/mm2 at the preoperative visit and 2608 ± 362 cells/mm2 at the 12-month visit (3.9% loss, p < 0.001). ECD loss from 3 months to 12 months was not statistically significant. No significant cataract formation, significant endothelial cell loss, glaucoma, uveitis, or any other vision-threatening complication was observed. Conclusion Based on postoperative experience, we have found that Eyecryl Phakic IOL is safe and effective for treating high myopia.
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Zhu X, He W, Zhang Y, Chen M, Du Y, Lu Y. Inferior Decentration of Multifocal Intraocular Lenses in Myopic Eyes. Am J Ophthalmol 2018; 188:1-8. [PMID: 29355482 DOI: 10.1016/j.ajo.2018.01.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 12/23/2017] [Accepted: 01/08/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate the tilt and decentration of multifocal intraocular lenses (MfIOLs) implanted in myopic eyes. DESIGN A prospective cohort study. METHODS Twenty-eight myopic eyes and 56 emmetropic eyes were evaluated. Phacoemulsification with Tecnis ZMB00 MfIOL (Abbott Medical Optics, Santa Ana, California, USA) implantation was performed. At 1 year post-surgery, routine postoperative examinations were performed, and tilt and decentration of the MfIOLs, high-order aberrations, and modulation transfer function (MTF) were evaluated using the OPD-Scan III aberrometer (Nidek Co, Ltd, Gamagori, Japan). Subjective symptoms were assessed with a Quality of Vision questionnaire. RESULTS Postoperative uncorrected distance visual acuity (VA), best-corrected distance VA, and uncorrected near VA did not differ between the 2 groups. The mean IOL tilt and horizontal decentration were not different between the control and myopic groups. However, the myopic group presented significantly inferior decentration in the capsular bag compared with the control group (-0.03 ± 0.22 mm vs -0.21 ± 0.29 mm, P = .002). The overall decentration values were 0.32 ± 0.14 mm in the controls and 0.40 ± 0.18 mm in the myopic group (P = .023). Axial length was negatively correlated with vertical decentration (r = -0.268, P = 0.014) and positively correlated with overall decentration (r = 0.334, P = .002). Worse aberration data, poorer MTF, and more subjective symptoms were also found in the myopic group than in the controls. CONCLUSION Greater inferior decentration of MfIOLs and a consequent decrease in visual quality were found in myopic eyes, indicating that the increasing incompatibility between IOL and capsular bag size with axial length elongation should not be underestimated.
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Kamiya K, Igarashi A, Hayashi K, Negishi K, Sato M, Bissen-Miyajima H. A Multicenter Retrospective Survey of Refractive Surgery in 78,248 Eyes. J Refract Surg 2017; 33:598-602. [PMID: 28880334 DOI: 10.3928/1081597x-20170621-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 05/24/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To retrospectively evaluate the current practice, trends, and outcomes of refractive surgery in Japan. METHODS This multicenter survey comprised 78,248 eyes of 39,727 consecutive patients who underwent refractive surgery at 45 major institutions in Japan. The corresponding ophthalmologists responded to a selfadministered questionnaire. The authors especially evaluated the safety, efficacy, predictability, stability, and adverse events of LASIK and phakic intraocular lens (IOL) implantation 3 months postoperatively. RESULTS The most common refractive surgery was LASIK (90.9%), followed by corneal inlay (5.0%), posterior chamber phakic IOL implantation (1.3%), laser-assisted subepithelial keratomileusis (1.0%), refractive lens exchange (0.9%), photorefractive keratectomy (0.3%), and refractive lenticule extraction (0.2%). For subgroup analysis, 69,987 eyes (99.5%) and 67,512 eyes (95.9%) achieved corrected and uncorrected distance visual acuity of 20/20 or better, respectively, after LASIK, and 935 eyes (98.8%) and 890 eyes (94.1%), respectively, after phakic IOL implantation. There were 69,176 eyes (98.3%) and 908 eyes (96.0%) within ±1.00 diopter (D) of the attempted correction after LASIK and phakic IOL implantation, respectively. There were 1,926 eyes (2.7%) and 1 eye (0.1%) with changes in refraction of 1.00 D or less from 1 week to 3 months after LASIK and phakic IOL implantation, respectively. No vision-threatening complications occurred in any case. CONCLUSIONS According to this survey, LASIK remains the most prevalent surgical technique in Japan. Both LASIK and phakic IOL implantation offered good safety and efficacy outcomes, yielding predictable and stable results. [J Refract Surg. 2017;33(9):598-602.].
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