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Yoon H, Magnago T, Yeom DJ. Three-Month Clinical Outcomes to Correct Myopia or Myopic Astigmatism Using a Femtosecond Laser for Lenticule Creation With Automated Centration and Cyclotorsion Compensation. J Refract Surg 2024; 40:e30-e41. [PMID: 38190561 DOI: 10.3928/1081597x-20231212-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
PURPOSE To individually evaluate the clinical outcomes for right and left eyes in the first 3 months after laser-assisted lenticule extraction for myopia and myopic astigmatism with the use of the new ATOS femtosecond laser system (Smart-Sight; SCHWIND eye-tech-solutions). METHODS A total of 331 eyes from 168 patients (166 right eyes and 165 left eyes) consecutively treated with SmartSight lenticule extraction were retrospective analyzed after a 3-month follow-up period. Patients' mean age was 26 ± 6 years (range: 18 to 47 years) and mean preoperative spherical equivalent (SEQ) was -5.07 ± 1.92 diopters [D] (range: -1.50 to -11.25 D) with a mean astigmatism of -1.04 ± 0.85 D (range: 0.00 to -4.00 D). At 3 months of follow-up, visual acuity, SEQ and cylinder, safety index, efficacy index, corneal higher order aberrations, and intraocular pressure (IOP) were analyzed. Furthermore, refractive and visual outcomes were also analyzed for the right and left eyes individually. All lenticule extraction treatments were performed with the SmartSight treatment method of the SCHWIND ATOS femtosecond laser. RESULTS At 3 months after surgery, mean SEQ was -0.12 ± 0.19 D and 98% of eyes were within ±0.50 D of the SEQ. All eyes were within ±1.00 D of the SEQ. Astigmatism of 0.50 D or less was achieved in 99% of eyes. The change in Snellen lines (difference between preoperative corrected distance visual acuity and postoperative uncorrected distance visual acuity) showed a gain of one or more lines in 13% and in 85% of the eyes the same was achieved. There was a loss of one or more lines at 3 months of follow-up in 1.6%. The safety index was 1.03 and efficacy index was 1.02. No significant difference between the right and left eyes was found. CONCLUSIONS The 3-month follow-up data show that SmartSight treatment for correction of myopia and myopic astigmatism with the SCHWIND ATOS is a safe, efficient, and accurate procedure. It provided excellent results in terms of visual recovery, predictability, and higher order aberrations. [J Refract Surg. 2024;40(1):e30-e41.].
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Kamiya K, Shimizu K, Igarashi A, Kitazawa Y, Kojima T, Nakamura T, Ichikawa K, Fukuoka S, Fujimoto K. A Nationwide Multicenter Study on 1-Year Outcomes of Posterior Chamber Phakic Intraocular Lens Implantation for Low Myopia. Front Med (Lausanne) 2022; 9:762153. [PMID: 35602510 PMCID: PMC9115804 DOI: 10.3389/fmed.2022.762153] [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] [Received: 08/21/2021] [Accepted: 02/14/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To assess the nationwide multicenter outcomes of posterior chamber phakic intraocular lens implantation with a central hole (EVO-ICL, STAAR Surgical) for patients with low myopia. Methods This multicenter study comprised 172 eyes of 111 consecutive patients undergoing hole ICL implantation to correct low myopia and myopic astigmatism [manifest spherical equivalent (MSE);-3 diopters (D) or less] at seven nationwide major surgical facilities. We retrospectively determined safety, efficacy, predictability, stability, and adverse events at 1 week, 1, 3, 6, and 12 months postoperatively, and at the final visit. Results The mean follow-up period was 1.4 ± 1.0 years. Uncorrected and corrected visual acuities at 1 year postoperatively were -0.17 ± 0.12 and -0.24 ± 0.07 logarithm of the minimal angle of resolution (logMAR), respectively. At 1 year postoperatively, 91% and 100% of eyes were within 0.5 and 1.0 D of the target correction, respectively. No significant manifest refraction changes of -0.07 ± 0.26 D occurred from 1 week to 1 year. No vision-threatening complications occurred at any time in this series. Conclusions According to our experience, the EVO-ICL performed well without significant complications throughout the 1-year observation period, even for the correction of low myopia. It is suggested that current ICL implantation is one of the viable surgical options for correcting low myopia.
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Affiliation(s)
- Kazutaka Kamiya
- Visual Physiology, School of Allied Health Sciences, Kitasato University, Tokyo, Japan
| | - Kimiya Shimizu
- Department of Ophthalmology, Sanno Hospital, Tokyo, Japan
| | | | | | - Takashi Kojima
- Department of Ophthalmology, Keio University, Tokyo, Japan
| | | | - Kazuo Ichikawa
- Department of Ophthalmology, Chukyo Eye Clinic, Aichi, Japan
| | - Sachiko Fukuoka
- Department of Ophthalmology, Tane Memorial Eye Hospital, Osaka, Japan
| | - Kahoko Fujimoto
- Department of Ophthalmology, Fujimoto Eye Clinic, Osaka, Japan
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Atchison DA. Recent advances in measurement of monochromatic aberrations of human eyes. Clin Exp Optom 2021; 88:5-27. [PMID: 15658922 DOI: 10.1111/j.1444-0938.2005.tb06659.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2004] [Revised: 11/18/2004] [Accepted: 11/27/2004] [Indexed: 11/29/2022] Open
Abstract
The field of aberrations of the human eye is moving rapidly, being driven by the desire to monitor and optimise vision following refractive surgery. It is important for ophthalmologists and optometrists to have an understanding of the magnitude of various aberrations and how these are likely to be affected by refractive surgery and other corrections. In this paper, I consider methods used to measure aberrations, the magnitude of aberrations in general populations and how these are affected by various factors (for example, age, refractive error, accommodation and refractive surgery) and how aberrations and their correction affect spatial visual performance.
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Affiliation(s)
- David A Atchison
- School of Optometry, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
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Wu F, Yang Y, Dougherty PJ. Contralateral comparison of wavefront‐guided LASIK surgery with iris recognition versus without iris recognition using the MEL80 Excimer laser system. Clin Exp Optom 2021; 92:320-7. [PMID: 19302674 DOI: 10.1111/j.1444-0938.2009.00362.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Fang Wu
- Department of Ophthalmology, the Second Hospital Affiliated to Zhejiang University, Hangzhou, China
| | - Yabo Yang
- Department of Ophthalmology, the Second Hospital Affiliated to Zhejiang University, Hangzhou, China
| | - Paul J Dougherty
- Dougherty Laser Vision Institute, Camarillo, California, USA
- Ophthalmology, Jules Stein Eye Institute at UCLA, Los Angeles, California, USA
E‐mail:
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Jabbour S, Bower KS. Three-Year Outcomes of Implantable Collamer Lens Followed by Excimer Laser Enhancement ("Bioptics") in the Treatment of High Myopic Astigmatism. Clin Ophthalmol 2021; 15:635-643. [PMID: 33623364 PMCID: PMC7896759 DOI: 10.2147/opth.s283888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 01/18/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose Describe three-year outcomes of spherical implantable Collamer lens (ICL) followed by excimer laser enhancement (bioptics) in eyes with high myopic astigmatism. Patients and Methods Retrospective case series of thirty-four cases that underwent bioptics enhancement at the Johns Hopkins Wilmer Eye Institute. All eyes had a preoperative sphere of −6.00 D or more with a cylinder of at least 2.00 D. Uncorrected and corrected distance visual acuity (UDVA and CDVA), manifest spherical equivalent refraction (MSE), ICL vault measurements and central corneal thickness (CCT) were collected. Endothelial cell counts (ECC), root mean square (RMS) of higher order aberrations (HOAs), adverse events and subsequent surgeries were also assessed. Results All patients had a minimum follow-up of 3 years. Preoperative UDVA was 2.29 ± 0.46 logMAR and improved to 0.03 ± 0.23 logMAR at 3 years (p<0.05). MSE was −12.30 ± 4.05 preoperatively and changed to −0.21 ± 0.46 at 3 years (p<0.05). The efficacy and safety indices were 1.28 ± 0.32 and 1.47 ± 0.27 at 3 years post-enhancement. HOA did not significantly change throughout the follow-up (p<0.05). Endothelial cell loss at 12 months was calculated at 5.7%. Two eyes required ICL exchange due to vault-related issues. Conclusion Bioptics offered excellent long-term safe, predictable, and efficient outcomes for high myopic astigmatism and can be considered an option if toric ICL is not available. Results confirm that wavefront-guided photoablation remains an excellent option to manage residual refractive error after phakic IOL.
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Affiliation(s)
- Samir Jabbour
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kraig S Bower
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Moore J, Shu X, Lopes BT, Wu R, Abass A. Limbus misrepresentation in parametric eye models. PLoS One 2020; 15:e0236096. [PMID: 32970690 PMCID: PMC7514007 DOI: 10.1371/journal.pone.0236096] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 06/29/2020] [Indexed: 11/20/2022] Open
Abstract
Purpose To assess the axial, radial and tangential limbus position misrepresentation when parametric models are used to represent the cornea and the sclera. Methods This retrospective study included 135 subjects aged 22 to 65 years (36.5 mean ±9.8 STD), 71 females and 64 males. Topography measurements were taken using an Eye Surface Profiler topographer and processed by a custom-built MATLAB code. Eye surfaces were freed from edge-effect artefacts and fitted to spherical, conic and biconic models. Results When comparing the radial position of the limbus, average errors of -0.83±0.19mm, -0.76±0.20mm and -0.69±0.20mm were observed within the right eye population for the spherical, conic and biconic models fitted up to 5mm. For the same fitting radius, the average fitting errors were -0.86±0.23mm, -0.78±0.23mm and -0.73±0.23mm for the spherical, conic and biconic models respectively within the left eye population. For the whole cornea fit, the average errors were -0.27±0.12mm and -0.28±0.13mm for the spherical models, -0.02±0.29mm and -0.05±0.27mm for the conic models, and -0.22±0.16mm and 0.24±0.17mm for the biconic models in the right and left eye populations respectively. Conclusions Through the use of spherical, conic and biconic parametric modelling methods, the eye’s limbus is being mislocated. Additionally, it is evident that the magnitude of fitting error associated with the sclera may be propagating through the other components of the eye. This suggests that a corneal nonparametric model may be necessary to improve the representation of the limbus.
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Affiliation(s)
- Joshua Moore
- Department of Mathematical Sciences, University of Liverpool, Liverpool, United Kingdom
- School of Engineering, University of Liverpool, Liverpool, United Kingdom
| | - Xuhan Shu
- College of Physical Sciences, University of Guelph, Guelph, Canada
| | - Bernardo T. Lopes
- School of Engineering, University of Liverpool, Liverpool, United Kingdom
- Department of Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Richard Wu
- Department of Optometry, Central Taiwan University of Science and Technology, Taichung, Taiwan
- College of Optometry, Pacific University, Forest Grove, Oregon, United States of America
| | - Ahmed Abass
- School of Engineering, University of Liverpool, Liverpool, United Kingdom
- * E-mail:
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Schrecker J, Schröder S, Langenbucher A, Seitz B, Eppig T. Individually Customized IOL Versus Standard Spherical Aberration-Correcting IOL. J Refract Surg 2019; 35:565-574. [PMID: 31498414 DOI: 10.3928/1081597x-20190814-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 08/14/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the visual performance of an individually customized intraocular lens (IOL) versus a standard spherical aberration-correcting IOL. METHODS In this prospective comparative study, 74 eyes of 60 patients scheduled for cataract surgery were randomized in a 2:1 ratio to receive either an individually customized IOL (; HumanOptics AG, Erlangen, Germany; customized group) or an aspheric IOL with a standard correction of spherical aberration (SA) (Tecnis ZCB00; Johnson & Johnson Vision Surgical, Inc., Santa Ana, CA; standardized group). In the customized group, IOL calculation was based on a minimum of a merit function that contained terms representing residual refraction, residual SA, and modulation transfer function. In the standardized group, the IOL was calculated with a routine procedure using the Holladay formula and had a standard SA correction of -0.27 µm. Refraction, visual acuity (far, intermediate, near), photopic and mesopic contrast sensitivity, defocus curve, corneal and ocular spherical aberration, and pupil size were measured 4 weeks and 3 months postoperatively. RESULTS The customized group comprised 48 eyes of 37 patients and the standardized group 26 eyes of 23 patients. At 3 months, mean total ocular SA (5 mm) was 0.04 ± 0.06 µm in the customized group and -0.01 ± 0.05 µm in the standardized group. Uncorrected distance visual acuity and distance-corrected near visual acuity were statistically significantly better in the customized group. Contrast sensitivity testing yielded significantly better results in the customized group under photopic and mesopic conditions for almost all spatial frequencies. Compared to the standardized group, the defocus curve of the customized group showed a wider plateau surrounding the distance focal point. CONCLUSIONS With the implantation of an individually optimized aspheric IOL visual performance, especially contrast sensitivity, can be significantly improved compared to a standard aberration-correcting IOL. [J Refract Surg. 2019;35(9):565-574.].
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Zhou W, Reinstein DZ, Chen X, Chen S, Xu Y, Utheim TP, Stojanovic A. Transepithelial Topography-Guided Ablation Assisted by Epithelial Thickness Mapping for Treatment of Regression After Myopic Refractive Surgery. J Refract Surg 2019; 35:525-533. [DOI: 10.3928/1081597x-20190730-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 07/30/2019] [Indexed: 11/20/2022]
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Vector Analysis of 1-Year Astigmatic Outcomes From a Randomized Fellow Eye Comparison of Photorefractive Keratectomy Using 2 Excimer Laser Platforms. Eye Contact Lens 2018; 44 Suppl 1:S71-S76. [PMID: 28002091 DOI: 10.1097/icl.0000000000000332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare the astigmatic outcomes of photorefractive keratectomy (PRK) with a wavefront-guided (WFG) and a wavefront-optimized (WFO) excimer laser performed on two different platforms. METHODS Setting: institutional. DESIGN Prospective, randomized, fellow eye comparison clinical trial. PARTICIPANTS A total of 142 eyes of 71 patients with myopia of 12 diopters (D) or less and astigmatism of 3D or less were enrolled at the Byers Eye Institute at Stanford between April 2009 and March 2011. INTERVENTION One eye of each patient underwent WFG-PRK with the VISX CustomVue Star S4 IR (Abbott Medical Optics, Abbott Park, IL) and the contralateral eye underwent WFO-PRK with the Wavelight Allegretto Eye-Q 400-Hz laser platform (Alcon, Inc., Hüenberg, Switzerland). Alpins vector analysis of astigmatism was performed using manifest refraction measured preoperatively and 12 months postoperatively and vertexed to the corneal plane. Eyes were stratified for subgroup analysis based on preoperative manifest astigmatism. RESULTS WFG-PRK and WFO-PRK were similar regarding surgically induced astigmatism, difference vector, magnitude of error, correction index, flattening index, and index of success. The angle of error was 60% less in the WFG group compared with the WFO group (4.9±1.1° vs. 11.8±2.4°, P=0.01). CONCLUSIONS WFG-PRK with the VISX CustomVue Star S4 IR and WFO-PRK with the Alcon WaveLight Allegretto Eye-Q 400-Hz excimer laser platform produce similar astigmatic results in myopic patients; however, the WFG mode may produce slightly more predictable astigmatic corrections.
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Kataoka T, Nishida T, Murata A, Ito M, Isogai N, Horai R, Kojima T, Yoshida Y, Nakamura T. Control-matched comparison of refractive and visual outcomes between small incision lenticule extraction and femtosecond laser-assisted LASIK. Clin Ophthalmol 2018; 12:865-873. [PMID: 29785082 PMCID: PMC5953304 DOI: 10.2147/opth.s161883] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Purpose This retrospective case-matched study aimed to compare visual and refractive outcomes between small incision lenticule extraction (SMILE) and LASIK. Patients and methods Patients who underwent SMILE (34 eyes of 23 patients) or LASIK (34 eyes of 24 patients) were enrolled and matched according to preoperative manifest refractive spherical equivalents. The mean preoperative manifest refractive spherical equivalent was −4.69±0.6 and −4.67±0.64 D in the SMILE and LASIK groups, respectively. The safety, efficacy, and predictability were compared 3 months after surgery. Changes in corneal refractive power from the center to peripheral points and their maintenance ratios were analyzed and compared between the two groups. Results In the SMILE and LASIK groups, 82.4% and 85.3% of patients, respectively, achieved 20/13 or better uncorrected distance visual acuity (p=1.00). There were no eyes that lost two or more lines of corrected distance visual acuity in either group. The maintenance ratios of corneal refractive power changes at the peripheral points in the SMILE group were significantly higher than those in the LASIK group (p<0.05). Conclusion Both groups achieved similar high efficacy and safety. SMILE surgery resulted in higher refractive power correction in the peripheral cornea than LASIK surgery.
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Affiliation(s)
| | | | | | | | | | | | - Takashi Kojima
- Nagoya Eye Clinic, Nagoya, Japan.,Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
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Arba Mosquera S, de Ortueta D, Verma S. The art of nomograms. EYE AND VISION 2018; 5:2. [PMID: 29417088 PMCID: PMC5784507 DOI: 10.1186/s40662-018-0096-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 01/08/2018] [Indexed: 11/10/2022]
Abstract
Background To retrospectively analyse strategies for adjusting refractive surgery plans with reference to the preoperative manifest refraction. Methods We constructed seven nomograms based on the refractive outcomes (sphere, cylinder, axis [SCA]) of 150 consecutive eyes treated with laser in situ keratomileusis for myopic astigmatism. We limited the initial data to the SCA of the manifest refraction. All nomograms were based on the strategy: if for x diopters (D) of attempted metric, y D is achieved; we can reverse this sentence and state for achieving y D of change in the metric, x D will be planned. The effects of the use of plus or minus astigmatism notation, spherical equivalent, sphere, principal meridians notation, cardinal and oblique astigmatism, and astigmatic axis were incorporated. Results All nomograms detected subtle differences in the spherical component (p < 0.0001). Nomograms 5 and 7 (using power vectors) and 6 (considering axis shifts) detected significant astigmatic differences (nomogram 5, p < 0.001; nomogram 6, p < 0.05; nomogram 7, p < 0.005 for cardinal astigmatism, p = 0.1 for oblique astigmatism). We observed mild clinically relevant differences (~ 0.5 D) in sphere or astigmatism among the nomograms; differences of ~ 0.25 D in the proposals for sphere or cylinder were not uncommon. All nomograms suggested minor improvements versus actual observed outcomes, with no clinically relevant differences among them. Conclusions All nomograms anticipated minor improvements versus actual observed outcomes without clinically relevant differences among them. The minimal uncertainties in determining the manifest refraction (~ 0.6 D) are the major limitation to improving the accuracy of refractive surgery nomograms.
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Affiliation(s)
- Samuel Arba Mosquera
- 1Recognized Research Group in Optical Diagnostic Techniques, University of Valladolid, Valladolid, Spain.,SCHWIND eye-tech-solutions, Mainparkstr. 6-10, D-63801 Kleinostheim, Germany.,3Department of Ophthalmology and Sciences of Vision, University of Oviedo, Oviedo, Spain
| | | | - Shwetabh Verma
- SCHWIND eye-tech-solutions, Mainparkstr. 6-10, D-63801 Kleinostheim, Germany.,5Experimental Radiation Oncology, University Medical Center Mannheim, Heidelberg University, Heidelberg, Germany.,6Interdisciplinary Center for Scientific Computing (IWR), Heidelberg University, Heidelberg, Germany.,7Central Institute for Computer Engineering (ZITI), Heidelberg University, Heidelberg, Germany
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Hashemian SJ, Farrokhi H, Foroutan A, Jafari ME, Hashemian SM, Alemzadeh SA, Hashemian MS. Ocular higher-order aberrations changes after implantable collamer lens implantation for high myopic astigmatism. J Curr Ophthalmol 2017; 30:136-141. [PMID: 29988885 PMCID: PMC6033773 DOI: 10.1016/j.joco.2017.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 09/23/2017] [Accepted: 10/18/2017] [Indexed: 10/29/2022] Open
Abstract
Purpose To investigate the changes in higher-order aberrations (HOAs) induced by the implantation of implantable collamer lenses (ICLs) and Toric ICL (TICL) in eyes with high myopia and high myopic astigmatism. Methods We investigated 33 eyes of 18 consecutive patients (in a prospective, interventional case series study), with spherical equivalent errors of -6.00 to -21.09 diopters (D) and cylindrical errors of -0.5 to -4.75 D, who underwent ICL and TICL implantation. Before and after 5 days, 2 and 6 months of surgery, the uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), defocus and adverse events of the surgery were assessed. Ocular HOAs were also evaluated by Hartmann-Shack aberrometry (Technolas PV, Rochester, New York, USA) before and after 6 months of surgery. Results At 6.0 months after surgery, the UCVA and BCVA in 40% and 66.7% of eyes were 20/20, respectively. Mean defocus refraction and astigmatism was reduced to -0.66 and 0.65 D from -12.79 and 2.18 at baseline, respectively. For a 6 mm pupil, HOAs were not significantly changed, merely from 0.417 ± 0.162 μ before surgery to 0.393 ± 0.119 μ after surgery (P = 0.45). Spherical aberration (Z400) increased significantly (P = 00.0). Surgical induced astigmatism was lower than 0.25 D, and there were no changes in trefoils and coma aberration. No vision-threatening complications occurred during the observation period. Conclusion This study shows that the ICL and TICL performed well in correcting high myopic astigmatism without significant changes in HOAs during a 6-month observation period, although the spherical aberration (Z400) increased significantly.
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Affiliation(s)
- Seyed Javad Hashemian
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Hosein Farrokhi
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Foroutan
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ebrahim Jafari
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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Predictive Factors of the Standard Cross-linking Outcomes in Adult Keratoconus: One-Year Follow-Up. J Ophthalmol 2017; 2017:4109208. [PMID: 28951783 PMCID: PMC5603124 DOI: 10.1155/2017/4109208] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 07/09/2017] [Accepted: 07/24/2017] [Indexed: 11/25/2022] Open
Abstract
Purpose To evaluate the effects of preoperative presumed predictor factors on clinical and topographic outcomes in adult keratoconus (KC) 1 year after the standard corneal cross-linking (CXL). Design Retrospective cohort study. Methods The study included 84 KC patients (136 eyes) who were treated with conventional CXL. Postoperative best-corrected visual acuity (BCVA) and K max were considered the main predicted variables. The entire participants were divided into subgroups with cutoff values in accordance with the predictive variables. The predicted postoperative outcomes at one year were compared between the subgroups. Next, the predictive variables were analyzed by univariate and multivariate linear regression. Results In respect to the BCVA, univariate analysis showed that the worse BCVA, the higher K max, and the relative thinner corneas were relatively good predictors of improvement, while multivariate evaluation revealed a strong interrelation with preoperative BCVA only. Regarding the postoperative flattening, univariate analysis found that the cone location and worse preoperative BCVA were the pronounced predictors, whereas the multivariate evaluation focused on the impact of the cone location only. Conclusions The multivariate analysis disclosed a significant negative association between the baseline BCVA and postoperative BCVA and a positive relationship between the cone eccentricity and postoperative K max.
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Kamiya K, Shimizu K, Igarashi A, Kitazawa Y, Kojima T, Nakamura T, Oka Y, Matsumoto R. Posterior chamber phakic intraocular lens implantation: comparative, multicentre study in 351 eyes with low-to-moderate or high myopia. Br J Ophthalmol 2017; 102:177-181. [PMID: 28611132 DOI: 10.1136/bjophthalmol-2017-310164] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 04/18/2017] [Accepted: 05/21/2017] [Indexed: 11/03/2022]
Abstract
AIM To compare the clinical outcomes of posterior chamber phakic intraocular lens implantation with a central hole (Hole Implantable Collamer Lens (ICL), STAAR Surgical) for low-to-moderate myopia and for high myopia. METHODS This multicentre retrospective case series comprised 351 eyes of 351 consecutive patients undergoing ICL implantation. Eyes were divided into groups based on preoperative degree of myopia: group 1; 57 eyes, manifest spherical equivalent less than -6 dioptres (D), and group 2; 294 eyes, -6 D or more. Safety, efficacy, predictability, stability and adverse events were compared preoperatively; and at 1 day, 1 week and 1, 3, 6 and 12 months postoperatively, RESULTS: Uncorrected and corrected visual acuities were -0.17±0.14 and -0.21±0.10 logMAR in group 1, and -0.16±0.09 and -0.21±0.08 logMAR in group 2, 1 year postoperatively. In groups 1 and 2, 98% and 99% of eyes were within 1.0 D of the targeted correction. Manifest refraction changes of -0.12±0.34 D (group 1) and -0.18±0.43 D (group 2) occurred from 1 day to 1 year. ICL exchanges were necessary in two eyes (0.7%) in group 2. No vision-threatening complications occurred at any time. CONCLUSIONS The ICL performed well for the correction of both low-to-moderate myopia and high myopia throughout the 1-year observation period. The clinical outcomes of ICL implantation for low-to-moderate myopia are essentially equivalent to those for high myopia.
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Affiliation(s)
- Kazutaka Kamiya
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
| | - Kimiya Shimizu
- Department of Ophthalmology, Sanno Hospital, Tokyo, Japan
| | | | | | - Takashi Kojima
- Department of Ophthalmology, Japanese Red Cross Gifu Hospital, Gifu, Japan
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Comprehensive Evaluation of Anterior Corneal Change in Asphericity Calculated by the Tangential Radius of Curvature after LASIK. J Ophthalmol 2017; 2017:3874371. [PMID: 28265465 PMCID: PMC5317105 DOI: 10.1155/2017/3874371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 11/25/2016] [Accepted: 12/19/2016] [Indexed: 11/17/2022] Open
Abstract
To evaluate the change in the anterior corneal asphericity (ΔQ) comprehensively calculated using the tangential radius (rt) after LASIK. Forty-two right eyes were evaluated using the Orbscan II corneal topographer. The pre- and postoperative Q-values of the flat principal semimeridians calculated by the sagittal radius were compared to those by the tangential radius. The Q-value of each semimeridian in the horizontal region was calculated by rt. Fourier fitting was used to model the 360-semimeridional variation of Q-values and to fit the Q-values in the vertical region before and after surgery. There were significant differences in Q-values between the two methods before (P < 0.001) and after surgery (P = 0.003). A significant increase in postoperative Q-value was detected compared to preoperative Q-value (P < 0.001) calculated by rt. The 360-semimeridional variation of the Q-values was well fitted with a third- and fourth-degree Fourier function before and after surgery. The ΔQ-value distribution presented double valley variation, with the amount of ΔQ being lowest in the near-vertical regions and highest in the near-horizontal regions. Calculating the Q-value with rt combined with Fourier fitting, we evaluated 360 ΔQ-values' variation of semimeridians of the entire anterior corneal surface and then displayed true and complete anterior corneal shape after LASIK.
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Errors in Treatment of Lower-order Aberrations and Induction of Higher-order Aberrations in Laser Refractive Surgery. Int Ophthalmol Clin 2016; 56:19-45. [PMID: 26938336 DOI: 10.1097/iio.0000000000000113] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Yaguchi Y, Negishi K, Saiki M, Torii H, Tsubota K. Comparison of the accuracy of intraocular lens power calculations for cataract surgery in eyes after phototherapeutic keratectomy. Jpn J Ophthalmol 2016; 60:365-72. [PMID: 27277426 DOI: 10.1007/s10384-016-0452-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 03/23/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE To compare the accuracy of several methods of intraocular lens (IOL) power calculations used for cataract surgery in eyes treated with phototherapeutic keratectomy (PTK) that results in changes in the anterior corneal surface and axial length; these results make power calculations less predictable. METHODS We evaluated the medical records of 23 eyes of 13 patients (mean age, 68.8 years; range 62-80 years) who underwent cataract surgery after PTK at Keio University Hospital, Tokyo, Japan. The prediction error, defined as the difference between the estimated postoperative spherical equivalent and the postoperative manifest refraction at the spectacle plane, was calculated using five formulas: SRK/T, Haigis-L, Shammas-PL, Camellin-Calossi, and OKULIX ray tracing software. We compared the median values of the arithmetic and absolute prediction errors among the five formulas. RESULTS The median arithmetic errors after cataract surgery for the five formulas were 0.70 D (diopter) (range -0.41 to 2.78), -0.96 D (range -2.14 to 0.81), -0.81 D (range -1.89 to 1.15), -0.04 D (range -1.35 to 1.47), and 0.68 D (range -0.61 to 2.50), respectively. CONCLUSION The Camellin-Calossi formula is a good option for calculating IOL powers in eyes that underwent PTK.
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Affiliation(s)
- Yukari Yaguchi
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Megumi Saiki
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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Chen X, Stojanovic A, Simonsen D, Wang X, Liu Y, Utheim TP. Topography-Guided Transepithelial Surface Ablation in the Treatment of Moderate to High Astigmatism. J Refract Surg 2016; 32:418-25. [PMID: 27304606 DOI: 10.3928/1081597x-20160428-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 03/17/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To analyze the outcomes of treatment of astigmatism of 2.00 diopters (D) or greater with topography-guided transepithelial surface ablation. METHODS Retrospective analysis of a series of 206 eyes divided into two groups: myopic astigmatism (153 eyes) and mixed astigmatism (53 eyes). All cases were treated with topography-guided transepithelial surface ablation. Efficacy, safety, and predictability were evaluated, and vector analysis of cylindrical correction was performed. RESULTS The median preoperative spherical equivalent was -2.63 and -0.63 D for the myopic and mixed astigmatism groups, respectively, with median cylinder of -2.50 D. Postoperative uncorrected distance visual acuity was 20/20 or better in 92% and 83% of eyes in the myopic and mixed astigmatism groups, respectively; the corresponding efficacy indices were 1.00 and 0.96 and residual astigmatism of 0.50 D or less was present in 82.4% and 56.7% of eyes in the myopic and mixed astigmatism groups, respectively. The arithmetic mean magnitude of the difference vector was 0.38 (myopic) and 0.65 (mixed) D. Difference vector magnitude was positively correlated with the magnitude of target induced astigmatism in both groups. The geometric mean coefficient of adjustment index was 1.04 and 1.19, representing undercorrection of 4% and 19% in the myopic and mixed astigmatism groups, respectively. CONCLUSIONS Topography-guided transepithelial ablation is a safe, effective, and predictable treatment for moderate to high astigmatism. [J Refract Surg. 2016;32(6):418-425.].
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Wang L, Shoukfeh O, Koch DD. Custom selection of aspheric intraocular lens in eyes with previous hyperopic corneal surgery. J Cataract Refract Surg 2016; 41:2652-63. [PMID: 26796446 DOI: 10.1016/j.jcrs.2015.06.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 06/04/2015] [Accepted: 06/07/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE To determine the optimum amount of spherical aberration in intra-ocular lenses (IOLs) to maximize optical quality in eyes with previous hyperopic corneal surgery. SETTING Cullen Eye Institute, Baylor College of Medicine, Houston, Texas. DESIGN Theoretical simulation study. METHODS The amount of spherical aberration in the IOL was varied to produce residual ocular spherical aberration ranging from -0.50 to +0.50 μm. With the use of the Zernike Tool Program, the polychromatic point-spread function with Stiles-Crawford effect was calculated for 6.0 mm and 4.0 mm pupils and defocus of 0.00 diopter (D), -0.50 D, and +0.50 D. The IOL spherical aberration at which maximum image quality was achieved was determined. Stepwise multiple regression analysis was performed to assess the predictors of optimum IOL spherical aberration. RESULTS Aspheric IOL implantation was simulated in 106 eyes of 80 patients; ages ranged from 40 to 59 years. With 0.00 D, -0.50 D, and +0.50 D defocus, respectively, the ranges of 25th to 75th percentiles of the optimum IOL spherical aberration were -0.12 to +0.20 μm, +0.10 to +0.42 μm, and -0.35 to -0.03 μm for the 6.0 mm pupil and -0.14 to +0.26 μm, +0.41 to +0.86 μm, and -0.74 to -0.24 μm for the 4.0 mm pupil. The amount of optimum IOL spherical aberration could be predicted on the basis of other higher-order aberrations (HOAs) of the cornea with multiple correlation coefficients up to 0.98. CONCLUSIONS The amount of IOL spherical aberration producing the best image quality in eyes with previous hyperopic corneal surgery varied widely and could be predicted on the basis of the full spectrum of corneal HOAs. FINANCIAL DISCLOSURE Supported in part by an unrestricted grant from Research to Prevent Blindness, New York, New York. No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Li Wang
- From Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | - Omar Shoukfeh
- From Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
| | - Douglas D Koch
- From Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
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Molchan RP, Taylor KR, Panday VA, Caldwell MC, Reilly CD. Retrospective Analysis Comparing the Preoperative and Postoperative "Q" Values for 2 Different Lasers in Refractive Surgery. Cornea 2015; 34:1437-40. [PMID: 26356749 DOI: 10.1097/ico.0000000000000611] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the presurgical and postsurgical corneal asphericity, or "Q value," between VISX Wavefront-guided treatment and Allegretto Wave Wavefront-optimized treatment in photorefractive keratectomy for the correction of myopia. METHODS This is a retrospective database analysis performed at the Joint Warfighter Refractive Surgery Center, Lackland Air Force Base, TX. All data were accessed through the Institutional Review Board-approved Joint Warfighter Refractive Surgery Center database. Fifty-one patient records (102 eyes) were reviewed to determine the change in the Q value after photorefractive keratectomy for the correction of myopia. RESULTS The average change in the Q value per diopter of treatment sphere over the entire study population was 0.12 (±0.04) for Allegretto and 0.14 (±0.04) for VISX (P = 0.004). There was no statistical difference among the preoperative and postoperative best-corrected visual acuities (BCVAs), low-contrast BCVA (BCVA 5%), or quality of vision complaints between both platforms. CONCLUSIONS Low to moderate myopic correction with the Allegretto laser was associated with a smaller change in the Q value per diopter of treatment and therefore more closely maintained the original prolate shape of the cornea when compared with VISX. No difference in the postoperative visual outcome between both groups was detected.
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Affiliation(s)
- Ryan P Molchan
- *Joint Warfighter Refractive Surgery Center, Lackland AFB, TX; and †14th Medical Operations Squadron, Columbus AFB, MS
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Toy BC, Yu C, Manche EE. Vector analysis of 1-year astigmatic outcomes from a prospective, randomized, fellow eye comparison of wavefront-guided and wavefront-optimized LASIK in myopes. J Refract Surg 2015; 31:322-7. [PMID: 25974971 DOI: 10.3928/1081597x-20150424-08] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 04/02/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the astigmatic outcomes of LASIK with a single excimer laser platform using either wavefront-guided (WFG) or wavefront-optimized (WFO) modes. METHODS Sixty-eight eyes of 34 patients underwent LASIK for myopia with the Wavelight Allegretto Eye-Q 400-Hz laser platform (Alcon Laboratories, Inc., Hüenberg, Switzerland). One eye underwent WFG-LASIK and the contralateral eye underwent WFO-LASIK. Alpins vector analysis of astigmatism was performed using manifest refraction measured preoperatively and 12 months postoperatively and vertexed to the corneal plane. Eyes were stratified for subgroup analysis based on preoperative manifest astigmatism. RESULTS WFG-LASIK and WFO-LASIK were similar with regard to surgically induced astigmatism, difference vector, magnitude of error, correction index, flattening index, and index of success. The angle of error was 80% less in the WFG group compared to the WFO group (1.92° ± 0.67º vs 9.66° ± 3.7º, P = .04). CONCLUSIONS WFG-LASIK and WFO-LASIK using the Alcon WaveLight Allegretto Eye-Q 400-Hz excimer laser platform produce similar astigmatic results in myopic patients; however, the WFG mode may produce slightly more predictable astigmatic corrections.
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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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Khalifa MA, Mossallam EF, Massoud TH, Shaheen MS. Comparison of visual outcomes after variable spot scanning ablation versus wavefront-optimized myopic LASIK. J Refract Surg 2015; 31:22-8. [PMID: 25599540 DOI: 10.3928/1081597x-20141218-03] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 10/29/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the refractive and visual outcomes of variable spot scanning ablation versus the wavefront-optimized ablation for myopia and myopic astigmatism. METHODS Fifty patients with myopia who underwent LASIK (100 eyes) were divided into two equal groups. Myopic correction performed using the variable spot scanning (VSS) ablation with the VISX STAR S4/IR platform (Abbott Medical Optics, Inc., Santa Ana, CA) (VSS group) and wavefront-optimized (WFO) ablation profile with the WaveLight Allegretto Wave Eye-Q platform (Alcon Laboratories, Inc., Fort Worth, TX) (WFO group). Manifest refraction, uncorrected distance visual acuity, and corrected distance visual acuity were obtained preoperatively and 1 day and 1 and 3 months postoperatively. Wavefront measurement and contrast sensitivity testing were done preoperatively and 3 months postoperatively. RESULTS Postoperative mean refractive spherical equivalent was -0.14 ± 0.2 diopters for the VSS group and -0.15 ± 0.28 diopters for the WFO group. Forty-eight eyes of the VSS group and 47 eyes of the WFO group were within ±0.5 diopters. Postoperative mean corrected distance visual acuity was 1.05 ± 0.13 for the VSS group and 1.06 ± 0.12 for the WFO group. The postoperative uncorrected distance visual acuity was 1.01 ± 0.16 for the VSS group and 1.01 ± 0.11 for the WFO group. The safety index was 1.12 for the VSS group and 1.06 for the WFO group, whereas the efficacy index was 1.07 for the VSS group and 1.01 for the WFO group. The mean induced positive spherical aberration was 0.041 ± 0.046 µm for the VSS group and 0.195 ± 0.171 µm for the WFO group (P < .001). Mesopic contrast sensitivity testing showed no statistically significant differences between groups at all tested spatial frequencies. CONCLUSIONS Both VSS and WFO treatments showed similar refractive and visual outcomes. Both induced significant positive spherical aberration, significantly more with WFO.
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The Effect of Silicone Hydrogel Bandage Soft Contact Lens Base Curvature on Comfort and Outcomes After Photorefractive Keratectomy. Eye Contact Lens 2015; 41:77-83. [DOI: 10.1097/icl.0000000000000067] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dausch D, Dausch B, Wottke M, Sluyterman van Langeweyde G. Comparison of clinical outcomes in PRK with a standard and aspherical optimized profile: a full case analysis of 100 eyes with 1-year follow-up. Clin Ophthalmol 2014; 8:2251-60. [PMID: 25473256 PMCID: PMC4251749 DOI: 10.2147/opth.s66608] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE One hundred eyes from 55 adult patients with myopia were retrospectively studied to determine the comparative safety, efficacy, and predictability of aberration smart ablation (ASA) and a new advanced ablation algorithm (Triple-A) using the MEL(®) 80 excimer laser. METHODS Fifty myopic eyes with a manifest refraction spherical equivalent (MRSE) between -1.0 diopters (D) and -9.75 D were consecutively treated with photorefractive keratec-tomy ASA, and 50 myopic eyes with an MRSE between -1.38 D and -11.0 D with photorefractive keratectomy Triple-A. Uncorrected distance visual acuity, MRSE, the absolute value of the cylinder, corrected distance visual acuity, and postoperative complications at 1 month, 3 months, 6 months, and 12 months (1 year) were descriptively analyzed and compared at 1 year. RESULTS After 12 months, the MRSE variance was statistically significantly better in patients triaged to receive Triple-A compared with patients receiving ASA (ASA, ±0.7 D; Triple-A, ±0.15 D; P<0.001). Furthermore, no patient in the Triple-A group had any cylinder postoperatively. Patients in the Triple-A treatment arm achieved a superior result. No statistically significant difference in the two treatment arms was noted for the analysis of the mean MRSE at 12 months (P=0.78). CONCLUSION Triple-A was more effective than standard aspherical surgical intervention in a number of treatment outcome parameters (eg, MRSE, astigmatism, efficacy index). The two surgical procedures were equivalent in terms of safety.
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Affiliation(s)
- Dieter Dausch
- Chung-Ang University, Seoul, South Korea ; Augen-Laser-Klinik Nürnberg, Nuremberg, Germany
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Sáles CS, Manche EE. One-year eye-to-eye comparison of wavefront-guided versus wavefront-optimized laser in situ keratomileusis in hyperopes. Clin Ophthalmol 2014; 8:2229-38. [PMID: 25419115 PMCID: PMC4235493 DOI: 10.2147/opth.s70145] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background To compare wavefront (WF)-guided and WF-optimized laser in situ keratomileusis (LASIK) in hyperopes with respect to the parameters of safety, efficacy, predictability, refractive error, uncorrected distance visual acuity, corrected distance visual acuity, contrast sensitivity, and higher order aberrations. Methods Twenty-two eyes of eleven participants with hyperopia with or without astigmatism were prospectively randomized to receive WF-guided LASIK with the VISX CustomVue S4 IR or WF-optimized LASIK with the WaveLight Allegretto Eye-Q 400 Hz. LASIK flaps were created using the 150-kHz IntraLase iFS. Evaluations included measurement of uncorrected distance visual acuity, corrected distance visual acuity, <5% and <25% contrast sensitivity, and WF aberrometry. Patients also completed a questionnaire detailing symptoms on a quantitative grading scale. Results There were no statistically significant differences between the groups for any of the variables studied after 12 months of follow-up (all P>0.05). Conclusion This comparative case series of 11 subjects with hyperopia showed that WF-guided and WF-optimized LASIK had similar clinical outcomes at 12 months.
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Affiliation(s)
- Christopher S Sáles
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Edward E Manche
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
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Liu TX, Luo X. Stability of axis and patient satisfaction after toric implantable collamer lens implantation for myopic astigmatism. Pak J Med Sci 2014; 29:1371-4. [PMID: 24550956 PMCID: PMC3905361 DOI: 10.12669/pjms.296.3986] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 08/05/2013] [Accepted: 08/10/2013] [Indexed: 11/21/2022] Open
Abstract
Objectives: To assess the stability of axis and patient satisfaction after toric visian implantable collamer lens (TICL) implantation for moderate to high myopic astigmatism. Methods: Total 33 eyes of 21 consecutive patients who underwent implantation of TICL for the correction of moderate to high myopic astigmatism were recorded and a minimum follow-up of six months was performed. The deviation of axis of TICL was detected from one week to six months postoperatively. The evaluation of the visual functions was done by the same clinician at six months after surgery. Results: The mean refractive cylinder decreased from -2.48±0.91 diopters (D) preoperatively to -0.54±0.25D and -0.50±0.19D at one week and six months after surgery respectively. Mean changes in astigmatism from one week to six months after surgery was 0.03±0.17D. The mean deviation of axis of TICL from one week to six months postoperatively was 2.48±1.25°(range,1°~ 6°) and no TICL required secondary repositioning. 14.3% patients felt difficult about the middle distant visual function (Reading Computer Screen). Evaluations of other visual functions were positive or very positive. Conclusions: Six months after implantation of the TICL, it showed slightly axis rotation and high satisfaction about the visual functions.
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Affiliation(s)
- Tai-Xiang Liu
- Tai-xiang Liu, Zhongshan Ophthalmic centre of Sun Yat-Sen University, Guangzhou 510060, China. Department of Ophthalmology, Affiliated Hospital of Zunyi Medical College, Zunyi 563003, China
| | - Xin Luo
- Xin Luo, Department of Ophthalmology, Affiliated Hospital of Zunyi Medical College, Zunyi 563003, China
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Kamiya K. Visual performance after posterior chamber phakic intraocular lens implantation for myopia. EXPERT REVIEW OF OPHTHALMOLOGY 2014. [DOI: 10.1586/eop.12.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Arba-Mosquera S, Verma S. Analytical optimization of the ablation efficiency at normal and non-normal incidence for generic super Gaussian beam profiles. BIOMEDICAL OPTICS EXPRESS 2013; 4:1422-1433. [PMID: 24010004 PMCID: PMC3756584 DOI: 10.1364/boe.4.001422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 07/11/2013] [Accepted: 07/11/2013] [Indexed: 06/02/2023]
Abstract
We suggest a general method to determine the optimum laser parameters for maximizing the ablation efficiency for different materials (in particular human cornea) at different incidence angles. The model is comprehensive and incorporates laser beam characteristics and ablative spot properties. The model further provides a method to convert energy fluctuations during ablation to equivalent ablation deviations in the cornea. The proposed model can be used for calibration, verification and validation purposes of laser systems used for ablation processes at relatively low cost and would directly improve the quality of results.
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Photorefractive keratectomy for myopia and myopic astigmatism correction using the WaveLight Allegretto Wave Eye-Q excimer laser system. Int Ophthalmol 2013; 34:477-84. [DOI: 10.1007/s10792-013-9833-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Accepted: 07/11/2013] [Indexed: 10/26/2022]
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Ahn HS, Chung JL, Kim EK, Seo KY, Kim TI. Changes in spherical aberration after various corneal surface ablation techniques. KOREAN JOURNAL OF OPHTHALMOLOGY 2013; 27:81-6. [PMID: 23543818 PMCID: PMC3596623 DOI: 10.3341/kjo.2013.27.2.81] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 07/19/2012] [Indexed: 11/23/2022] Open
Abstract
Purpose The corneal change induced by refractive procedures influence both the postoperative refractive status and the ocular spherical aberration (SA). We evaluated changes in corneal SA after three types of surface ablation: phototherapeutic keratectomy (PTK), myopic photorefractive keratectomy (PRK), and myopic wavefront-guided laser epithelial keratomileusis (LASEK). Methods Twenty-six eyes (25 patients) were subjected to PTK 26 eyes (14 patients) to PRK, and 34 eyes (17 patients) to wavefront-guided LASEK. Corneal SA was measured with the iTrace in all patients both preoperatively and 6 months postoperatively. Results Six months after surgery, mean corneal SA was -0.173 ± 0.171 µm in the PTK group, 0.672 ± 0.200 µm in the PRK group, and 0.143 ± 0.136 µm in the wavefront-guided LASEK group. The mean difference between the preoperative and postoperative corneal SA (ΔSA) was -0.475 µm in the PTK group, 0.402 µm in the PRK group, and -0.143 µm in the wavefront-guided LASEK group. Conclusions Surgically induced changes in corneal SA vary with procedure. The prediction of the pattern of SA change induced by various surface ablation procedures may be helpful for developing future surgical procedures.
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Shortt AJ, Allan BDS, Evans JR. Laser-assisted in-situ keratomileusis (LASIK) versus photorefractive keratectomy (PRK) for myopia. Cochrane Database Syst Rev 2013:CD005135. [PMID: 23440799 DOI: 10.1002/14651858.cd005135.pub3] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Myopia (also known as short-sightedness or near-sightedness) is an ocular condition in which the refractive power of the eye is greater than is required, resulting in light from distant objects being focused in front of the retina instead of directly on it. The two most commonly used surgical techniques to permanently correct myopia are photorefractive keratectomy (PRK) and laser-assisted in-situ keratomileusis (LASIK). OBJECTIVES To compare the effectiveness and safety of LASIK and PRK for correction of myopia by examining post-treatment uncorrected visual acuity, refractive outcome, loss of best spectacle-corrected visual acuity, pain scores, flap complications in LASIK, subepithelial haze, adverse events, quality of life indices and higher order aberrations. SEARCH METHODS We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 11), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to November 2012), EMBASE (January 1980 to November 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to November 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 15 November 2012. We also searched the reference lists of the studies and the Science Citation Index. SELECTION CRITERIA We included randomised controlled trials comparing LASIK and PRK for the correction of any degree of myopia. DATA COLLECTION AND ANALYSIS Two authors independently assessed trial quality and extracted data. We summarised data using the odds ratio and mean difference. We combined odds ratios using a random-effects model after testing for heterogeneity. MAIN RESULTS We included 13 trials (1135 participants, 1923 eyes) in this review. Nine of these trials randomised eyes to treatment, two trials randomised people to treatment and treated both eyes, and two trials randomised people to treatment and treated one eye. None of the paired trials reported an appropriate paired analysis. We considered the overall quality of evidence to be low for most outcomes because of the risk of bias in the included trials. There was evidence that LASIK gives a faster visual recovery than PRK and is a less painful technique. Results at one year after surgery were comparable: most analyses favoured LASIK but they were not statistically significant. AUTHORS' CONCLUSIONS LASIK gives a faster visual recovery and is a less painful technique than PRK. The two techniques appear to give similar outcomes one year after surgery. Further trials using contemporary techniques are required to determine whether LASIK and PRK as currently practised are equally safe. Randomising eyes to treatment is an efficient design, but only if analysed properly. In future trials, more efforts could be made to mask the assessment of outcome.
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Affiliation(s)
- Alex J Shortt
- The Moorfields Eye Hospital/UCL Institute of Ophthalmology National Institute for Health Research Biomedical Research Centre,London, UK.
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Yam JCS, Cheng ACK. Reduced cross-linking demarcation line depth at the peripheral cornea after corneal collagen cross-linking. J Refract Surg 2013; 29:49-53. [PMID: 23311741 DOI: 10.3928/1081597x-20121228-03] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Accepted: 10/31/2012] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the corneal collagen cross-linking (CXL) demarcation line depth between the central and peripheral cornea after cross-linking using anterior segment optical coherence tomography. METHODS Retrospective interventional case series of 38 eyes with keratoconus or postoperative LASIK ectasia treated with riboflavin ultraviolet A CXL (UV-X, IROC). CXL demarcation line depth, corneal thickness, and the ratio of the CXL demarcation line depth to the corneal thickness were measured using anterior segment optical coherence tomography at the central cornea and at 2 and 4 mm from the corneal center in four regions: temporal, nasal, superior, and inferior. The CXL demarcation line depths at the center and periphery were compared using the Friedman test. RESULTS The CXL demarcation line was deepest in the central cornea (302 μm; range: 180 to 397 μm) and was reduced progressively toward the peripheral cornea, at nasal 2 mm (289.5 μm; range: 125 to 370 μm), at nasal 4 mm (206.5 μm; range: 100 to 307 μm), at temporal 2 mm (278.5 μm; range: 128 to 375 μm), and at temporal 4 mm (194 μm; range: 80 to 325 μm) (P<.001). The penetration proportion was greatest at the central cornea (64.8%; range: 44% to 80%) and was decreased toward the periphery, at nasal 2 mm (53.8%; range: 30% to 74%), at nasal 4 mm (33.8%; range: 19% to 53%), at temporal 2 mm (54.1%; range: 29% to 77%), and at temporal 4 mm (34.1%; range: 15% to 54%) (P⩽.001). CONCLUSIONS Both the CXL demarcation line depth and its proportion over the corneal thickness were greater at the central cornea than the peripheral cornea.
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Affiliation(s)
- Jason C S Yam
- Department of Opthalmology, Hong Kong Sanatorium and Hopsital, Hong Kong PR China
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Agrawal V. Outcomes of Corneal Collagen Cross-linking for Keratoconus the Effect of Cone Location. ACTA ACUST UNITED AC 2013. [DOI: 10.5005/jp-journals-10025-1042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
ABSTRACT
Aim
One-year outcome of corneal collagen cross-linking (CXL) for keratoconus with reference to topographic cone location.
Materials and methods
Clinical audit of the results of CXL were used. Three hundred and seventy-eight eyes of 225 patients with preoperative and 12-month completed follow-up were included. Cone location was defined by cone location magnitude index (CLMI) using the Keratron scout topography system. The eyes were divided into two groups–central with cone location within 3 mm zone of the topography map and paracentral with cone location between the 3 and 5 mm zones.
Results
The overall group showed a mean flattening of the CLMI of 1.67 D [preoperative 53.35 ± 5.63 D, 12 months 51.69 ± 4.67 (p = 0.095)]. The flattening in central cone group was 2.67 D [preoperative 54.01 ± 5.3819, at 12 months to 51.341 ± 4.588 (p = 0.016)]. In paracentral cone group the flattening was lesser at 1.73 D [preoperative apex K 52.805 ± 6.382, at 12 months 51.03 ± 4.82 (p = 0.006)]. The difference between groups was statistically significant (p < 0.001). The central cone group showed no significant shift in cone position [preoperative 1.0059 ± 0.24, at 12 months 0.986 ± 0.206 (p = 0.45)]. The paracentral cone group showed a significant mean shift of 1.05 mm in cone location [preoperative 2.224 ± 0.440, at 12 months 1.196 ± 0.529 (p = 0.001)].
Conclusion
Cone location has an impact on the results of corneal cross-linking. The paracentral cones show a significant shift toward the center of the cornea and the central cones show a larger flattening.
How to cite this article
Agrawal V. Outcomes of Corneal Collagen Cross-linking for Keratoconus the Effect of Cone Location. Int J Kerat Ect Cor Dis 2013;2(1):16-19.
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Kamiya K, Shimizu K, Igarashi A, Kobashi H, Komatsu M. Comparison of visual acuity, higher-order aberrations and corneal asphericity after refractive lenticule extraction and wavefront-guided laser-assisted in situ keratomileusis for myopia. Br J Ophthalmol 2012; 97:968-75. [DOI: 10.1136/bjophthalmol-2012-302047] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Khalifa MA, Allam WA, Shaheen MS. Visual outcome after correcting the refractive error of large pupil patients with wavefront-guided ablation. Clin Ophthalmol 2012; 6:2001-11. [PMID: 23271878 PMCID: PMC3526903 DOI: 10.2147/opth.s38182] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the efficacy and predictability of wavefront-guided laser in situ keratomileusis (LASIK) treatments using the iris registration (IR) technology for the correction of refractive errors in patients with large pupils. Setting Horus Vision Correction Center, Alexandria, Egypt. Methods Prospective noncomparative study including a total of 52 eyes of 30 consecutive laser refractive correction candidates with large mesopic pupil diameters and myopia or myopic astigmatism. Wavefront-guided LASIK was performed in all cases using the VISX STAR S4 IR excimer laser platform. Visual, refractive, aberrometric and mesopic contrast sensitivity (CS) outcomes were evaluated during a 6-month follow-up. Results Mean mesopic pupil diameter ranged from 8.0 mm to 9.4 mm. A significant improvement in uncorrected distance visual acuity (UCDVA) (P < 0.01) was found postoperatively, which was consistent with a significant refractive correction (P < 0.01). No significant change was detected in corrected distance visual acuity (CDVA) (P = 0.11). Efficacy index (the ratio of postoperative UCDVA to preoperative CDVA) and safety index (the ratio of postoperative CDVA to preoperative CDVA) were calculated. Mean efficacy and safety indices were 1.06 ± 0.33 and 1.05 ± 0.18, respectively, and 92.31% of eyes had a postoperative spherical equivalent within ±0.50 diopters (D). Manifest refractive spherical equivalent improved significantly (P < 0.05) from a preoperative level of −3.1 ± 1.6 D (range −6.6 to 0 D) to −0.1 ± 0.2 D (range −1.3 to 0.1 D) at 6 months postoperative. No significant changes were found in mesopic CS (P ≥ 0.08), except CS for three cycles/degree, which improved significantly (P = 0.02). Magnitudes of primary coma and trefoil did not change significantly (P ≥ 0.34), with a small but statistically significant increase in primary spherical aberration. Conclusion Wavefront-guided LASIK provides an effective correction of low to moderate myopia or myopic astigmatism in large pupil patients without deterioration of visual quality.
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Affiliation(s)
- Mounir A Khalifa
- Ophthalmology Department, Tanta University Eye Hospital, Tanta, Egypt ; Horus Vision Correction Center, Alexandria, Egypt
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Ryan A, O'Keefe M. Wavefront-guided and aspheric ablation for myopia -- one-year results of the zyoptix personalized treatment advanced algorithm. Am J Ophthalmol 2012; 153:1169-77.e2. [PMID: 22330308 DOI: 10.1016/j.ajo.2011.11.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 11/11/2011] [Accepted: 11/09/2011] [Indexed: 10/14/2022]
Abstract
PURPOSE To evaluate the visual outcome and change in higher-order aberrations (HOAs) 1 year post simultaneous wavefront-guided and aspheric photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK). DESIGN Prospective interventional case series. METHODS Consecutive myopic patients undergoing PRK (38 eyes of 23 patients) and LASIK (42 eyes of 25 patients) using the Technolas 217z100 excimer laser (Technolas Perfect Vision) in a private laser clinic were included. Main outcome measures were uncorrected distance visual acuity (UDVA), manifest refraction (MRSE), HOAs, and spherical aberration (Z(4)(0)). RESULTS At 1 year, 87% (32/37) of PRK eyes and 81% (30/37) of LASIK eyes had UDVA of 20/20 or better (P = .75). Mean ± SD MRSE was -0.26 ± 0.31 diopters (D) in the PRK and -0.16 ± 0.34 D in the LASIK group (P = .222). There was no significant increase in total HOA root mean square (RMS) in the PRK group. Mean ± SD total HOA RMS increased from 0.402 ± 0.14 μm to 0.496 ± 0.17 μm (P = .013) in the LASIK group at 1 year. Z(4)(0) increased from mean ± SD -0.045 ± 0.12 μm to -0.109 ± 0.15 μm (P = .006, factor 2.42) in the PRK group and did not significantly increase in the LASIK group (mean ± SD -0.16 ± 0.17 μm to -0.17 ± 0.15 μm (P = .469, factor 1.08) at 6 mm pupil. CONCLUSIONS Visual outcome was excellent in both treatment groups. HOAs were still increased following LASIK by a factor of 1.23 but not PRK. Z(4)(0) was not induced by LASIK with the treatment algorithm but was negatively induced in PRK eyes.
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Résultats à long terme de l’implantation phaque de chambre postérieure pour la correction des amétropies fortes. J Fr Ophtalmol 2012; 35:402-11. [DOI: 10.1016/j.jfo.2011.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Revised: 06/05/2011] [Accepted: 06/23/2011] [Indexed: 11/21/2022]
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Visual performance after posterior chamber phakic intraocular lens implantation and wavefront-guided laser in situ keratomileusis for low to moderate myopia. Am J Ophthalmol 2012; 153:1178-86.e1. [PMID: 22365084 DOI: 10.1016/j.ajo.2011.12.005] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Revised: 12/09/2011] [Accepted: 12/09/2011] [Indexed: 11/22/2022]
Abstract
PURPOSE To compare postoperative visual function after implantable collamer lens (ICL) implantation and after wavefront-guided laser in situ keratomileusis (LASIK) in eyes with low to moderate myopia. DESIGN Retrospective observational case study. PATIENTS AND METHODS We investigated 30 eyes of 20 patients undergoing ICL implantation and 64 eyes of 38 patients undergoing wavefront-guided LASIK for the correction of low to moderate myopia (manifest spherical equivalent: -3.00 to -5.88 diopters [D]). Ocular higher-order aberrations (HOAs) and contrast sensitivity (CS) function were measured by Hartmann-Shack aberrometry and a contrast sensitivity unit before and 3 months after surgery, respectively. From the contrast sensitivity, the area under the log contrast sensitivity function was calculated. RESULTS For 4-mm and 6-mm pupils, the changes in ocular third-order aberrations, fourth-order aberrations, and total HOAs after ICL implantation were significantly less than those after wavefront-guided LASIK (P < .05, Mann-Whitney U test). The postoperative area under the log contrast sensitivity function was significantly increased after ICL implantation (P < .001), whereas, after wavefront-guided LASIK, it was not significantly changed (P = .11). CONCLUSIONS ICL implantation induces significantly fewer ocular HOAs than wavefront-guided LASIK. Moreover, CS was significantly improved after ICL implantation but unchanged after wavefront-guided LASIK in eyes with low to moderate myopia. Thus, even in the correction of low to moderate myopia, ICL implantation appears to be superior in visual performance to wavefront-guided LASIK, suggesting that it may be a viable surgical option for the treatment of such eyes.
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Greenstein SA, Fry KL, Hersh PS. Effect of Topographic Cone Location on Outcomes of Corneal Collagen Cross-linking for Keratoconus and Corneal Ectasia. J Refract Surg 2012; 28:397-405. [DOI: 10.3928/1081597x-20120518-02] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 03/27/2012] [Indexed: 11/20/2022]
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Hsieh YT, Wang IJ, Hu FR. Anterior corneal optical irregularity measured by higher-order aberrations induced by a broad beam excimer laser. Clin Exp Optom 2012; 95:522-30. [PMID: 22591225 DOI: 10.1111/j.1444-0938.2012.00718.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The aim was to analyse anterior corneal optical irregularity in patients receiving photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) with a conventional broad beam laser. METHODS Pre- and post-operative anterior corneal aberrations including Zernike coefficients and root mean squares of higher-order aberrations were measured and derived with a Placido-ring-based corneal topographer and wavefront software, respectively, from 768 right eyes of patients receiving either PRK or LASIK for myopia with a conventional broad beam excimer laser in National Taiwan University Hospital, Taipei, Taiwan. Multiple linear regression models selected by Mallows' Cp criteria were used to evaluate predictability of surgically induced aberrations and relevant factors. RESULTS Mean attempted spherical equivalent correction was -7.37 ± 2.33 D (range: -16.5 to -1.95). Root mean squares of higher-order aberrations and variances of Zernike coefficients all increased significantly after surgery (p < 0.01). All post-operative higher-order aberrations increased with the amount of attempted myopic correction and secondary astigmatism increased with attempted cylindrical correction. LASIK surgery induced less coma and third-order aberrations but more fifth- and sixth-order aberrations than PRK, although squared partial correlation coefficients were low. Larger optic and transitional zones meant fewer higher-order aberrations after surgery. Younger patients tended to have more surgically induced aberrations in the 3.0 mm pupil zone. CONCLUSIONS Anterior corneal optical irregularity increased tremendously after refractive surgery by conventional broad beam lasers and correlated with greater attempted myopic correction, younger age and a smaller treatment zone. The effect of corneal flaps on post-operative corneal irregularity differed trivially.
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Affiliation(s)
- Yi-Ting Hsieh
- Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Taipei, Taiwan
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Christiansen SM, Neuffer MC, Sikder S, Semnani RT, Moshirfar M. The effect of preoperative keratometry on visual outcomes after moderate myopic LASIK. Clin Ophthalmol 2012; 6:459-64. [PMID: 22536037 PMCID: PMC3334209 DOI: 10.2147/opth.s28808] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate visual outcomes in moderately myopic eyes with flat and steep corneas (preoperatively) that have been treated with laser-assisted in situ keratomileusis (LASIK). Patients and methods Records of ninety-six eyes with average preoperative keratometry (K) values between 39.9 and 42.0 diopters (D) (flat) were matched with 103 eyes with preoperative K values between 46.0 and 47.2 D (steep) that underwent LASIK between March 2007 and March 2010 for moderate myopia, and were retrospectively reviewed. The primary outcome measures used to determine the effect of preoperative keratometry on visual prognosis were refraction, visual acuity, change in keratometry (ΔK), and change in spherical equivalent (ΔSE), measured at 1, 3, 6, and 12 months postoperatively. Results Significant differences were found at 6 months postoperatively between the flat group and steep group in SE (P = 0.029), sphere (P = 0.018), ΔK (P = 0.002), percentage of eyes achieving SE of −0.25 to + 0.25 D (P = 0.0125), −0.26 to −0.50 D (P = 0.003), −0.51 to −1.00 D (P = 0.044), and the percentage of eyes achieving uncorrected distance visual acuity of 20/15 or better (P = 0.0006). Conclusion Moderately myopic eyes with flatter corneas preoperatively have better visual prognosis following LASIK compared with moderately myopic eyes with steeper corneas.
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Kamiya K, Umeda K, Igarashi A, Ando W, Shimizu K. Factors influencing the changes in coma-like aberrations after myopic laser in situ keratomileusis. Curr Eye Res 2011; 36:905-9. [PMID: 21950695 DOI: 10.3109/02713683.2011.593729] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To assess factors affecting changes in coma-like aberrations after myopic laser in situ keratomileusis (LASIK). METHODS We retrospectively examined 91 eyes of 48 patients undergoing LASIK (mean patient age ± standard deviation, 29.6 ± 8.1 years; gender, 29 male and 19 female; manifest refraction, -4.76 ± 1.42 diopters). We quantitatively assessed the values of coma-like aberrations for 4-mm and 6-mm pupils using a Hartmann-Shack aberrometer before and 3 months after surgery. Multiple regression analysis was used to assess the relevant factors of the changes in coma-like aberrations. RESULTS The mean changes in coma-like aberrations for 4-mm and 6-mm pupils were 0.08 ± 0.09 μm and 0.31 ± 0.30 μm, respectively. Explanatory variables relevant to the changes in coma-like aberrations were, in order of influence, amount of spherical equivalent correction (partial regression coefficient B = 0.022, p <0.001 for a 4-mm pupil, B = 0.090, p <0.001 for a 6-mm pupil), and surgical technique (B = -0.062, p = 0.01 for a 4-mm pupil, B = -0.169, p = 0.03 for a 6-mm pupil). No significant correlation was seen with other clinical factors such as age, gender, astigmatism correction, mean keratometric readings, central corneal thickness, or eye tracking (with or without). CONCLUSIONS High myopic eyes requiring larger amounts of laser correction and eyes undergoing conventional LASIK tend to induce more coma-like aberration after surgery. Wavefront-guided LASIK may be a better surgical approach for preventing the induction of coma-like aberrations, especially in eyes with high myopia.
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Affiliation(s)
- Kazutaka Kamiya
- Department of Ophthalmology, University of Kitasato School of Medicine, Sagamihara, Kanagawa, Japan.
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AlMahmoud T, Munger R, Jackson WB. Advanced corneal surface ablation efficacy in myopia: changes in higher order aberrations. Can J Ophthalmol 2011; 46:175-81. [PMID: 21708087 DOI: 10.3129/i10-104] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To evaluate the change of ocular and corneal higher order aberrations (HOAs) after wavefront-guided advanced surface ablation (WF-ASA) for myopia using 4 different epithelial management techniques (AA-PRK, LASEK, Epi-PRK, and Epi-LASIK). DESIGN Retrospective single centre excimer database analysis. PARTICIPANTS Two hundred and forty eyes equally divided between the 4 WF-ASA techniques, matched for mean and range of required spherical correction. METHODS Ocular wavefront aberrations were measured using the wavescan aberrometer and corneal aberrations were obtained from corneal topography elevation maps and calculated by ray-tracing. All data were collected preoperatively and 3 months following treatment. The aberrations were described as Zernike polynomials, and analysis focused on total HOAs and spherical aberration (SA). RESULTS Three months postoperatively, there was a statistically significant surgically induced increase in total HOAs and SA both for ocular and corneal analysis (p < 0.001). There was no statistically significant difference in the induced ocular SA and HOAs between the groups, but the differences in induced corneal SA and HOAs were significant (p < 0.010). Ocular changes in SA were weakly correlated to preoperative SA (20.30, p < 0.001) but strongly correlated to applied spherical correction (20.68, p < 0.001). Surgically induced corneal SA was weakly correlated to preoperative corneal SA (20.34, p < 0.001) and applied spherical correction (20.46, p < 0.001). CONCLUSIONS Three months postoperatively, all procedures resulted in an increase in ocular and cornealHOAs and SA. Induced aberrations were most strongly correlated to the applied spherical power correction. Modifying the existing ablation pattern to compensate for induced HOAs might improve the outcome.
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Affiliation(s)
- Tahra AlMahmoud
- Department of Surgery, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE.
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Bottos KM, Leite MT, Aventura-Isidro M, Bernabe-Ko J, Wongpitoonpiya N, Ong-Camara NH, Purcell TL, Schanzlin DJ. Corneal asphericity and spherical aberration after refractive surgery. J Cataract Refract Surg 2011; 37:1109-15. [PMID: 21596254 DOI: 10.1016/j.jcrs.2010.12.058] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Revised: 11/17/2010] [Accepted: 12/07/2010] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate changes in corneal asphericity (Q) and spherical aberrations after refractive surgery using Scheimpflug imaging. SETTING University of California, San Diego, Shiley Eye Center, La Jolla, California, USA. DESIGN Cohort study. METHODS After wavefront-guided laser in situ keratomileusis, patients within ± 0.50 diopter of plano and with an uncorrected distance visual acuity of at least 20/20 were evaluated. The Q values and corneal spherical aberration Zernike values were obtained using Scheimpflug imaging preoperatively and 1 to 3 months postoperatively. RESULTS The study enrolled 177 myopic eyes and 32 hyperopic eyes. The mean Q value was -0.28 ± 0.11 (SD) and -0.22 ± 0.15, respectively, preoperatively and +0.35 ± 0.44 and -0.64 ± 0.31, respectively, postoperatively. The asphericity change was highly correlated with preoperative spherical equivalent (r(2) = 0.81; P ≤ .001). The mean corneal spherical aberration was +0.21 ± 0.08 μm in myopic eyes and +0.36 ± 0.11 μm in hyperopic eyes preoperatively and +0.36 ± 0.17 μm and 0.00 ± 0.29 μm, respectively, postoperatively. The corneal spherical aberration changes were correlated with the amount of preoperative refractive error (r(2) = 0.34; P < .001). There was a tendency for Q values and spherical aberrations to become more positive after myopic ablation and more negative after hyperopic ablation. CONCLUSIONS Myopic and hyperopic corrections induced changes in the Q value and spherical aberrations in opposite directions (ie, positive and negative, respectively). The changes depended on the magnitude of the refractive correction. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Katia M Bottos
- Shiley Eye Center, University of California San Diego, La Jolla, California, USA
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Serrao S, Lombardo G, Ducoli P, Lombardo M. Long-term corneal wavefront aberration variations after photorefractive keratectomy for myopia and myopic astigmatism. J Cataract Refract Surg 2011; 37:1655-66. [PMID: 21782383 DOI: 10.1016/j.jcrs.2011.03.046] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Revised: 03/08/2011] [Accepted: 03/10/2011] [Indexed: 11/30/2022]
Abstract
PURPOSE To analyze the higher-order corneal wavefront aberration during an 8-year follow-up after photorefractive keratectomy (PRK). SETTING IRCCS Fondazione G.B. Bietti, Rome, Italy. DESIGN Case series. METHODS Patients having PRK using the Technolas 217C excimer laser platform were divided into 3 groups according to the preoperative refraction as follows: low myopia, high myopia, and astigmatism. The preoperative and 1-, 4-, 6-, and 8-year postoperative root mean square (RMS) values of coma, spherical aberration, and total higher-order aberrations (HOAs) were calculated with 3.5 mm and 6.0 mm simulated pupils. The mean preoperative and postoperative higher-order corneal wavefront aberration maps, point-spread functions, and radial modulation transfer functions (MTFs) were represented to describe the impact of PRK on the optical quality of the anterior cornea. RESULTS The study enrolled 33 patients (66 eyes). Corneal spherical aberration was statistically significantly higher after PRK for simple myopia with 3.5 mm and 6.0 mm pupils (P<.05). The postoperative increase in coma was statistically significant in the high-myopia group with both pupil sizes (P<.05). Total RMS HOAs increased postoperatively with a 6.0 mm pupil in all groups (P<.05). The mean radial MTF was almost stable in all groups between preoperatively and postoperatively. CONCLUSIONS Higher-order corneal wavefront aberrations stabilized 1 year after PRK to treat myopia or myopic astigmatism. The effect of induced corneal HOAs tended to increase after correction of high myopia with large pupils, although without degrading the image optical quality of the cornea over the long term.
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Keir NJ, Simpson T, Hutchings N, Jones L, Fonn D. Outcomes of wavefront-guided laser in situ keratomileusis for hyperopia. J Cataract Refract Surg 2011; 37:886-93. [DOI: 10.1016/j.jcrs.2010.12.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Revised: 11/25/2010] [Accepted: 12/01/2010] [Indexed: 10/18/2022]
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Biebesheimer JB, Kang TS, Huang CY, Yu F, Hamilton DR. Development of an advanced nomogram for myopic astigmatic wavefront-guided laser in situ keratomileusis (LASIK). Ophthalmic Surg Lasers Imaging Retina 2011; 42:241-7. [PMID: 21410091 DOI: 10.3928/15428877-20110303-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Accepted: 02/07/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To identify the relationship between preoperative parameters and postoperative overcorrection or undercorrection in eyes with myopic astigmatism treated with wavefront-guided laser in situ keratomileusis (LASIK), and to develop an advanced surgical nomogram. PATIENTS AND METHODS A retrospective chart review of 468 eyes that underwent wavefront-guided LASIK for myopia with astigmatism with the Alcon LADARVision 4000 (Alcon Laboratories, Fort Worth, TX), of which 235 had flaps created by microkeratome (OneUse; Moria Surgical, Doylestown, PA) and 233 by femtosecond laser (Intralase; AMO, Santa Ana, CA). Manifest sphere, cylinder, and spherical equivalent were recorded preoperatively and 3 months postoperatively. Various parameters from patient records were analyzed to identify which had greatest influence on outcomes. RESULTS Manifest spherical equivalent was the most important predictor of surgical overcorrection, with the second being spherical aberration. In both groups, there was a statistically significant (P < .0001) correlation of spherical aberration with the amount of overcorrection. Using these two parameters, compensatory nomograms were derived. CONCLUSION Surgical overcorrection in wavefront-guided LASIK for myopic astigmatism correlates positively with the amount of spherical equivalent treated and preoperative spherical aberration. Nomograms incorporating spherical aberration may improve accuracy of outcomes.
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Affiliation(s)
- Jesse B Biebesheimer
- Jules Stein Eye Institute, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA 90095, USA
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Arba Mosquera S, de Ortueta D. Optimized Zernike Term Selection in Customized Treatments for Laser Corneal Refractive Surgery: Case Report. J Refract Surg 2011; 27:148-152. [DOI: 10.3928/1081597x-20100224-01] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2008] [Accepted: 02/10/2009] [Indexed: 11/20/2022]
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