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Xu J, Liu M, Liu Q. Outcomes of Astigmatic Correction with and without Two Different Cyclotorsion Compensation Methods in Small Incision Lenticule Extraction Surgery. Photodiagnosis Photodyn Ther 2024:104272. [PMID: 39002831 DOI: 10.1016/j.pdpdt.2024.104272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/30/2024] [Accepted: 07/10/2024] [Indexed: 07/15/2024]
Abstract
PURPOSE To compare the astigmatic correction outcomes of small incision lenticule extraction (SMILE) surgery with or without two different cyclotorsion compensation methods. METHODS This is a prospective randomized clinical trial. Patients with myopic astigmatism that underwent SMILE surgery were randomly divided into static cyclotorsion compensated group (SCC group), slit-lamp group and control group. In the SCC and slit-lamp groups, the intraoperative cyclotorsion was manually compensated with different limbal marking methods. In the control group, the cyclotorsion was not compensated. Visual acuity and manifest refraction were measured preoperatively and postoperatively. Astigmatic outcomes were estimated with vector analysis. RESULTS A total of 94 eyes from 94 patients were analyzed postoperatively at the 3-month follow-up. Their mean preoperative cylinder was -1.56±0.86 D (range: -4.25 to -0.25 D). The mean preoperative spherical equivalent was -5.95±1.72 D (range: -10.50 to -2.75 D). All groups showed favorable results in the correction of myopic astigmatism. No statistically differences were found among three groups in postoperative visual acuity, refractive outcomes or vector parameters. CONCLUSION Cyclotorsion compensation with two different manual limbal marking methods was helpful in aligning the surgical position in SMILE, but it was not as effective as expected for the correction of myopic astigmatism under well controlled surgical positioning.
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Affiliation(s)
- Jiping Xu
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, China
| | - Manli Liu
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, China
| | - Quan Liu
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, China.
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Brunson PB, Mann Ii PM, Mann PM, Potvin R. The Impact of Image Registration for Ablation Orientation on Clinical Outcomes After Wavefront-Optimized Refractive Surgery in Eyes with Myopia and Astigmatism. Clin Ophthalmol 2020; 14:3983-3990. [PMID: 33244219 PMCID: PMC7684027 DOI: 10.2147/opth.s280818] [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: 09/07/2020] [Accepted: 10/29/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the clinical outcomes from laser refractive surgery performed with the same laser with and without incorporating iris registration technology to compensate for ocular cyclotorsion. Design Single-site, two-arm, retrospective chart review. Methods Clinical outcomes at a single site after wavefront-optimized LASIK using the Wavelight excimer laser with and without the Vario imaging system for iris registration (IR) were evaluated. Eligible subjects were those that received on-label wavefront-optimized treatment of myopia with astigmatism >1.5 D. Measures of interest were the amount of residual refractive cylinder after surgery, the refractive error, and the best-corrected (BCVA) and uncorrected (UCVA) visual acuities, with a target follow-up of around 90 days. Results A total of 112 eligible eyes that were treated with IR and 126 similar eyes treated without IR (NO IR) were included. The refractive sphere and spherical equivalent refractions were statistically significantly different between groups (p < 0.05), but the mean differences were <0.1 D in both cases. Refractive cylinder averaged around 0.12 D and was not statistically significantly different between groups. The number of eyes with residual cylinder >0.50 D was higher in the NO IR group vs the IR group (6% vs 1%, respectively, p = 0.04). The mean logMAR UCVA and BCVA were statistically significantly better in the IR group, with a difference of 1.5 letters for UCVA and 1.0 letters for BCVA (p < 0.001 for both). Significantly more eyes in the IR group had a UCVA (p = 0.01) and a BCVA of 20/15 or better (p = 0.003). Overall, 96% of eyes in the IR group and 91% of eyes in the NO IR group had uncorrected visual acuity of 20/20 or better. Conclusion Iris registration with the VARIO imaging device demonstrably reduced the overall variability in clinical outcomes.
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Mortazavi SAA, Fazel F, Radmanesh P, Peyman A, Pourazizi M. Wavefront-guided photorefractive keratectomy with and without iris registration: comparison of astigmatic correction. Lasers Med Sci 2020; 36:75-81. [PMID: 32297251 DOI: 10.1007/s10103-020-03010-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 03/25/2020] [Indexed: 11/26/2022]
Abstract
This study aimed to compare the visual outcomes after photorefractive keratectomy (PRK), with and without the iris registration (IR) technology. The retrospective cohort study was performed for wavefront-guided PRK using the Technolas 217z100 excimer laser system in patients with myopic astigmatism (cylinder error - 2 to - 4 diopter [D]). Eyes were divided into IR group (IRPRK) and non-IR group (non-IRPRK). Visual acuity (VA), cylindrical refraction, and the astigmatic vector components using the Alpins method were compared between the two groups preoperatively and 6 months postoperatively. Fifty IRPRK patients (66% female, mean age 30.56 ± 6.31 years) and 50 non-IRPRK (60% female, mean age 29.60 ± 5.63 years) were enrolled. The mean logMAR uncorrected VA improved from 0.89 ± 0.44 to 0.032 ± 0.05 in the IRPRK group (P < 0.001) and from 0.89 ± 0.46 to 0.042 ± 0.06 postoperatively while follow-up in the non-IRPRK group (P < 0.001). No statistically significant differences were observed between the two groups regarding mean uncorrected distance VA (P = 0.4), corrected distance VA (P = 0.5), spherical equivalent (P = 0.16), defocus equivalent (P = 0.18), and absolute cylinder (P = 0.94). More than 90% eyes were within ± 1.00 D of emmetropia in both groups. Moreover, Alpins vector analysis revealed that no significant differences were found in any astigmatic parameters between the two groups (P > 0.05). Wavefront-guided PRK independent of the IR status is effective, safe, and predictable in patients with myopic astigmatism. No statistical significance was observed supporting data for the better outcome of visual acuity and astigmatism correction using IR in comparison with a non-IR system.
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Affiliation(s)
- Seyed Ali-Akbar Mortazavi
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farhad Fazel
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Pouria Radmanesh
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Peyman
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohsen Pourazizi
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran.
- Department of Ophthalmology, Feiz Hospital, Modares St, Isfahan, Isfahan, Iran.
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Lloyd-McKernan A, Simo Mannion L, O’Dwyer V. The effect of previous soft contact lens wear on corneal refractive surgery outcomes. Cont Lens Anterior Eye 2017; 40:301-310. [DOI: 10.1016/j.clae.2017.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 05/29/2017] [Accepted: 05/30/2017] [Indexed: 10/19/2022]
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Lee JJ, Kim MK, Wee WR. Effect of Iris registration on visual outcome in wavefront-guided LASEK for myopic astigmatism. Int Ophthalmol 2017; 38:513-525. [PMID: 28285388 DOI: 10.1007/s10792-017-0486-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 03/04/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE This study aimed to investigate the effect of iris registration (IR) on visual outcomes in wavefront-guided LASEK for myopic astigmatism. METHODS The retrospective chart review was performed for wavefront-guided LASEK using VISX Star S4 in patients with myopic astigmatism (cylinder ≥ 1.00 diopter[D]). Eyes were divided into IR group (LASEK with IR at the time of surgery) and Non-IR group (LASEK without IR system + failed-IR engagement during LASEK). Visual acuity (VA), astigmatism, higher-order aberration (HOA), and contrast sensitivity were assessed preoperatively and 3 months postoperatively. The IR and Non-IR groups were subcategorized depending on the spherical equivalent (lower myopia ≤-5.00 D vs. higher myopia >-5.00 D) for the comparison of HOA changes. RESULTS Postoperative uncorrected VAs showed no differences between IR (n = 30) and Non-IR (n = 46). In astigmatic vector analyses, no differences were noted in the mean magnitude of error and the mean angle of error between two groups. There were no differences in postoperative total HOA, spherical aberration (SA), coma, and trefoil between the groups, either. The total HOA and SA increased in both groups, while coma increased only in Non-IR. In higher myopia, ΔRMS of coma was smaller in IR. Preoperative and postoperative total HOA were linearly correlated in Non-IR, but not for IR. Contrast sensitivity of 12 cycles per degree improved in both groups. CONCLUSION IR had similar outcomes to conventional trackers in wavefront-guided LASEK, with less tendency of inducing coma, especially in higher myopia.
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Affiliation(s)
- Jong Joo Lee
- Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. .,Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea.
| | - Won Ryang Wee
- Department of Ophthalmology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.,Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
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Kruh JN, Garrett KA, Huntington B, Robinson S, Melki SA. Risk Factors for Retreatment Following Myopic LASIK with Femtosecond Laser and Custom Ablation for the Treatment of Myopia. Semin Ophthalmol 2016; 32:316-320. [DOI: 10.3109/08820538.2015.1088552] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jonathan N. Kruh
- Boston Eye Group, Boston, MA, USA
- Jamaica Hospital Medical Center, Jamaica, NY, USA
| | - Kenneth A. Garrett
- Boston Eye Group, Boston, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
| | - Brian Huntington
- Boston Eye Group, Boston, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
| | - Steve Robinson
- Boston Eye Group, Boston, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
| | - Samir A. Melki
- Boston Eye Group, Boston, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
- Massachusetts Eye & Ear Infirmary, Boston, MA, USA
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Mosquera SA, Verma S. Effects of torsional movements in refractive procedures. J Cataract Refract Surg 2015; 41:1752-66. [DOI: 10.1016/j.jcrs.2015.07.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 01/13/2015] [Accepted: 01/14/2015] [Indexed: 11/26/2022]
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Schallhorn S, Brown M, Venter J, Teenan D, Hettinger K, Yamamoto H. Early clinical outcomes of wavefront-guided myopic LASIK treatments using a new-generation hartmann-shack aberrometer. J Refract Surg 2013; 30:14-21. [PMID: 24202703 DOI: 10.3928/1081597x-20131029-02] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 08/05/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE To provide an initial retrospective evaluation of early postoperative outcomes after wavefront-guided myopic LASIK using a new-generation Hartmann-Shack wavefront sensor. METHODS A noncomparative, retrospective study of 243 eyes of 126 patients that underwent primary wavefront-guided LASIK, using wavefront data obtained with a new Hartmann-Shack aberrometer (iDesign Advanced WaveScan aberrometer; Abbott Medical Optics, Inc., Santa Ana, CA). Visual acuity, refraction, and patient satisfaction were evaluated 1 month after surgery. RESULTS The manifest spherical equivalent was reduced from -3.28 ± 1.79 diopters (D) (range: -9.88 to -0.38 D) before surgery to -0.03 ± 0.29 D (range: -1.00 to +1.25 D) 1 month after surgery. The manifest spherical equivalent was within 0.50 and 1.00 D of target in 93.0% and 99.6% of eyes, respectively. Manifest astigmatism preoperatively (-0.72 ± 0.67 [range: 0.0 to -5.00 D]) was reduced to -0.14 ± 0.20 (range: 0.0 to -1.00 D) at 1 month and the vector-derived correction ratio (surgically induced refractive change/intended refractive correction) was 1.02 ± 0.30. Uncorrected distance visual acuity of 20/16, 20/20, and 20/25 or better was achieved in 79.0%, 93.4%, and 96.7% of eyes, respectively. No eyes lost two or more lines of corrected distance visual acuity, whereas a gain of one or more lines was observed in 14.0%. Most patients (98.5%) reported that they were satisfied with the outcome of their procedure. CONCLUSIONS Wavefront-guided LASIK using the new aberrometer in this retrospective evaluation was effective, safe, and predictable in the early postoperative time period for the correction of myopia with high patient satisfaction.
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Eye-tracker-guided non-mechanical excimer laser assisted penetrating keratoplasty. SENSORS 2013; 13:3753-64. [PMID: 23507821 PMCID: PMC3658773 DOI: 10.3390/s130303753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 03/04/2013] [Accepted: 03/07/2013] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of the study was to implement a new eye tracking mask which could be used to guide the laser beam in automated non-mechanical excimer laser assisted penetrating keratoplasty. MATERIALS AND METHODS A new trephination mask design with an elevated surface geometry has been proposed with a step formation between conical and flat interfaces. Two recipient masks of 7.5/8.0 mm have been manufactured and tested. The masks have outer diameter of 12.5 mm, step formation at 10.5 mm, and slope of conical surfaces 15°. Its functionality has been tested in different lateral positions and tilts on a planar surface, and pig eye experiments. After successful validation on porcine eyes, new masks have been produced and tested on two patients. RESULTS The build-in eye tracking software of the MEL 70 was always able to capture the masks. It has been shown that the unwanted pigmentation/pattern induced by the laser pulses on the mask surface does not influence the eye-tracking efficiency. The masks could be tracked within the 18 × 14 mm lateral displacement and up to 12° tilt. Two patient cases are demonstrated. No complications were observed during the surgery, although it needs some attention for aligning the mask horizontally before trephination. Stability of eye tracking masks is emphasized by inducing on purpose movements of the patient head. CONCLUSION Eye-tracking-guided penetrating keratoplasty was successfully applied in clinical practice, which enables robust tracking criteria within an extended range. It facilitates the automated trephination procedure of excimer laser-assisted penetrating keratoplasty.
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Prakash G, Agarwal A, Kumar DA, Jacob S, Agarwal A. Comparison of laser in situ keratomileusis for myopic astigmatism without iris registration, with iris registration, and with iris registration–assisted dynamic rotational eye tracking. J Cataract Refract Surg 2011; 37:574-81. [DOI: 10.1016/j.jcrs.2010.11.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Revised: 10/06/2010] [Accepted: 10/11/2010] [Indexed: 11/25/2022]
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Cha D, Kim SK, Roh GH, Kim HM, Song JS. Effects of Eye Registration on the Astigmatism Correction in the Surface Laser Ablation. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2010. [DOI: 10.3341/jkos.2010.51.6.809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Deoksun Cha
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Sang Kyoon Kim
- Department of Ophthalmology, Hongseong Medical Center, Hongseong, Korea
| | | | - Hyo Myung Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Jong Suk Song
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
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Current world literature. Curr Opin Ophthalmol 2009; 20:333-41. [PMID: 19535964 DOI: 10.1097/icu.0b013e32832e478f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Factors affecting iris registration during LASIK. J Cataract Refract Surg 2009; 35:405; author reply 405-6. [DOI: 10.1016/j.jcrs.2008.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2008] [Accepted: 11/15/2008] [Indexed: 11/21/2022]
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