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Xie M, Deng Y, Sun C, Qiu L, Tang J. Higher-order aberrations and visual quality after incision lenticule extraction surgery with intraoperative angle kappa adjustments between small and large kappa patients: A 2-year follow-up. Indian J Ophthalmol 2023; 71:1849-1854. [PMID: 37203043 PMCID: PMC10391436 DOI: 10.4103/ijo.ijo_3017_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Purpose To evaluate the postoperative visual outcomes, that is, corneal higher-order aberrations (HOAs) and visual quality, of patients with an angle kappa greater than 0.30 mm who underwent angle kappa adjustment during small-incision lenticule extraction (SMILE) 2 years after surgery compared to eyes with an angle kappa less than 0.30 mm. Methods This was a retrospective study and included 12 patients from October 2019 to December 2019 who underwent the SMILE procedure for correction of myopia and myopic astigmatism and had one eye with a large kappa angle and another eye with a small kappa angle. Twenty-four months after surgery, an optical quality analysis system (OQAS II; Visiometrics, Terrassa, Spain) was used to measure the modulation transfer function cutoff frequency (MTFcutoff), Strehl2D ratio, and objective scatter index (OSI). HOAs were measured with a Tracey iTrace Visual Function Analyzer (Tracey version 6.1.0; Tracey Technologies, Houston, TX, USA). Assessment of subjective visual quality was achieved using the quality of vision (QOV) questionnaire. Results At 24 months postoperatively, the mean spherical equivalent (SE) refraction was - 0.32 ± 0.40 and - 0.31 ± 0.35 in the S-kappa group (kappa <0.3 mm) and the L-kappa group (kappa ≥0.3 mm), respectively (P > 0.05). The mean OSI was 0.73 ± 0.32 and 0.81 ± 0.47, respectively (P > 0.05). There was no significant difference in MTFcutoff and Strehl2D ratio between the two groups (P > 0.05). Total HOA, coma, spherical, trefoil, and secondary astigmatism were not significantly different (P > 0.05) between the two groups. Conclusion Adjustment of angle kappa during SMILE helps reduce the decentration, results in less HOAs, and promotes visual quality. It provides a reliable method to optimize the treatment concentration in SMILE.
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Affiliation(s)
- Mengzhen Xie
- Department of Ophthalmology, West China Hospital, Sichuan University; West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chengshu Sun
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lemei Qiu
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jing Tang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Bang SP, Lyu J, Ng CJ, Yoon G. Visual Axis and Stiles-Crawford Effect Peak Show a Positional Correlation in Normal Eyes: A Cohort Study. Invest Ophthalmol Vis Sci 2022; 63:26. [PMID: 36306143 PMCID: PMC9624269 DOI: 10.1167/iovs.63.11.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/03/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to locate the visual axis and evaluate its correlation with the Stiles-Crawford effect (SCE) peak. Methods Ten young, healthy individuals (20 eyes) were enrolled. An optical system was developed to locate the visual axis and measure SCE. To locate the visual axis, 2 small laser spots at 450 nm and 680 nm were co-aligned and delivered to the retina. The participants were asked to move a translatable pinhole until these spots were perceived to overlap each other. The same system assessed SCE at 680 nm using a bipartite, 2-channel (reference and test) Maxwellian-view optical system. The peak positions were estimated using a two-dimensional Gaussian fitting function and correlated with the visual axis positions. Results Both the visual axis (x = 0.24 ± 0.35 mm, y = -0.16 ± 0.34 mm) and the SCE peak (x = 0.27 ± 0.35 mm, y = -0.15 ± 0.31 mm) showed intersubject variability among the cohort. The SCE peak positions were highly correlated in both the horizontal and vertical meridians to the visual axes (R2 = 0.98 and 0.96 for the x and y coordinates, respectively). Nine of the 10 participants demonstrated mirror symmetry for the coordinates of the visual axis and the SCE peak between the eyes (R2 = 0.71 for the visual axis and 0.76 for the SCE peak). Conclusions The visual axis and SCE peak locations varied among the participants; however, they were highly correlated with each other for each individual. These findings suggest a potential mechanism underlying the foveal cone photoreceptor alignment.
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Affiliation(s)
- Seung Pil Bang
- Department of Biomedical Engineering, University of Rochester, Rochester, New York, USA
| | - Jiakai Lyu
- Institute of Optics, University of Rochester, Rochester, New York, USA
| | - Cherlyn J. Ng
- College of Optometry, University of Houston, Houston, Texas, USA
| | - Geunyoung Yoon
- College of Optometry, University of Houston, Houston, Texas, USA
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Niu L, Zhang Z, Miao H, Zhao J, Li M, He JC, Yao P, Zhou X. Effects of tilt and decentration of Visian Implantable Collamer Lens (ICL V4c) on visual quality: an observational study. BMC Ophthalmol 2022; 22:294. [PMID: 35790941 PMCID: PMC9254425 DOI: 10.1186/s12886-022-02499-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 06/17/2022] [Indexed: 01/19/2023] Open
Abstract
Background The central hole of the Visian Implantable Collamer Lens (ICL V4c) provides a reference to observe its tilt or decentration. This study aimed to investigate the tilt and decentration effects of ICL V4c on visual quality after implantation. Methods A total of 135 eyes from 69 patients who underwent ICL V4c implantation were included in this study. Evaluation of uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and aberrations were performed 6-months postoperatively. The anterior segment parameters were collected using CASIA2 anterior segment-optical coherence tomography, tilt and decentration of ICL V4c were analyzed using MATLAB software. All patients received questionnaires to investigate the visual quality postoperatively. Results The safety and effectiveness were 1.18 ± 0.17 and 1.11 ± 0.18, respectively. No significant changes were observed regarding higher-order and spherical aberrations after the operation; however, coma and trefoil significantly increased compared to preoperative values. The average total decentration and tilt was 0.21 ± 0.12 mm and 2.54 ± 1.00°, respectively. Horizontal, vertical, and total values of tilt and decentration were not significantly associated with postoperative CDVA, UDVA, and aberrations. The most common visual symptom was halo, and 97.04% of patients had a satisfaction score ≥ 8. The total or horizontal tilt was significantly positively correlated with the frequency, severity, and bothersome scores from the questionnaires. Conclusions ICL V4c implantation can obtain high visual quality and patient satisfaction. Although the degree of tilt and decentration after ICL V4c implantation was small, a positive effect on subjective visual quality was observed. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-022-02499-4.
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Tokuhisa T, Watanabe T, Watanabe A, Nakano T. Refractive error induced by intraocular lens tilt after intrascleral intraocular lens fixation. Int Ophthalmol 2022; 42:1213-1220. [PMID: 35064856 DOI: 10.1007/s10792-021-02106-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 10/21/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To investigate the spherical shift of intraocular lens (IOL) tilt after intrascleral fixation. METHODS We retrospectively reviewed the medical records of patients who underwent flanged intrascleral IOL fixation with transconjunctival 25- or 27-gauge pars plana vitrectomy at the Department of Ophthalmology of the Jikei University Hospital. The minimum follow-up duration was 3 months. Second-generation anterior segment optical coherence tomography (CASIA2; TOMEY) was used to obtain the values of tilt and decentration of the intrasclerally fixated IOL and postoperative anterior chamber depth. We investigated the relationship between refractive error and various parameters, such as IOL tilt and decentration, axial length, and keratometry. In addition to our clinical investigation, we conducted optical simulations using Zemax to evaluate the spherical shift of the IOL tilt by means of the through-focus response and change in spherical equivalent power. RESULTS The study involved 72 eyes of 67 patients. The degree of IOL tilt was correlated with the amount of refractive error (Spearman's rank correlation coefficient [CC] = - 0.32; P = 0.006). In particular, a tilt angle greater than 10° strongly affected the refractive error. The postoperative anterior chamber depth also correlated with the refractive error (CC = 0.50; P < 0.001), as opposed to decentration (CC = - 0.17; P = 0.15), axial length (CC = - 0.08; P = 0.49), and keratometry (CC = - 0.06; P = 0.64). Optical simulations also revealed a myopic shift that exponentially increased as the tilt became greater. CONCLUSION IOL tilts that are greater than 10° induce refractive error.
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Affiliation(s)
- Teruaki Tokuhisa
- Department of Ophthalmology, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minatoku, Tokyo, 105-0003, Japan.
| | - Tomoyuki Watanabe
- Department of Ophthalmology, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minatoku, Tokyo, 105-0003, Japan
| | - Akira Watanabe
- Department of Ophthalmology, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minatoku, Tokyo, 105-0003, Japan
| | - Tadashi Nakano
- Department of Ophthalmology, The Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minatoku, Tokyo, 105-0003, Japan
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Rabina G, Mimouni M, Slomovic J, Sorkin N, Nemet A, Kaiserman I. Centration of myopic refractive ablation: should we center treatment on the pupil or the visual axis? Lasers Med Sci 2021; 36:1733-1739. [PMID: 34185167 DOI: 10.1007/s10103-021-03358-2] [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: 01/12/2021] [Accepted: 06/07/2021] [Indexed: 11/30/2022]
Abstract
The purpose of this study is to compare pupil versus corneal vertex-centered ablation for myopic laser refractive surgery. This study is a retrospective case series of right eyes of consecutive myopic patients undergoing either photorefractive keratectomy (PRK) or laser-assisted in situ keratomileusis (LASIK) with pupil or corneal vertex-centered ablation from January 2018 to April 2018. Overall 258 eyes of 258 patients were included. Of the 104 that underwent LASIK, 52 were treated centered on the corneal vertex (50%), and of the 154 that underwent PRK, 77 were treated centered on the corneal vertex (50%). There were no significant differences in baseline age, gender, spherical equivalence, sphere, cylinder, or angle kappa between both groups in either LASIK or PRK. There were no significant differences between the corneal vertex-centered and pupil-centered groups in terms of efficacy index (LASIK: 1.02 ± 0.14 vs 1.01 ± 0.13, p = 0.86; PRK: 1.00 ± 0.13 vs 0.99 ± 0.15, p = 0.61), safety index (LASIK: 1.02 ± 0.12 vs 1.01 ± 0.13, p = 0.70; PRK:1.02 ± 0.12 vs 1.02 ± 0.09, p = 0.97), and residual astigmatism (LASIK: 0.26 ± 0.25 vs 0.23 ± 0.28, p = 0.65; PRK:0.37 ± 0.41 vs 0.39 ± 0.31, p = 0.78). In mixed effect models, there were no significant differences between the corneal vertex-centered and pupil-centered groups when accounting for angle kappa (p > 0.05). Patients with large angle kappa (> 300 μm) eyes yielded similar results (p > 0.05). For conclusion, in myopic refractive surgery, performing ablation centered on the corneal vertex or on the pupil leads to similar outcomes regardless of the amount of angle kappa.
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Affiliation(s)
- Gilad Rabina
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239, Tel-Aviv, Israel. .,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Michael Mimouni
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel.,Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Care-Vision Laser Centers, Tel-Aviv, Israel
| | - Jacqueline Slomovic
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Nir Sorkin
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, 64239, Tel-Aviv, Israel.,Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Achia Nemet
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Igor Kaiserman
- Care-Vision Laser Centers, Tel-Aviv, Israel.,Department of Ophthalmology, Barzilai Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel
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Age-related Changes in Crystalline Lens Tilt and Decentration: A Swept-source Optical Coherence Tomography Study. J Cataract Refract Surg 2021; 47:1290-1295. [PMID: 33769810 DOI: 10.1097/j.jcrs.0000000000000632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 02/23/2021] [Indexed: 11/25/2022]
Abstract
Purpose To investigate the age-related tilt and decentration of crystalline lenses using a swept-source optical coherence tomography biometer (Casia 2, TOMEY, Japan). Setting Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China. Design Cross-sectional study. Methods The direction and magnitude of the crystalline lens were evaluated in 230 participants with ages ranging from 7 to 90 years using swept-source optical coherence tomography. The participants were divided into four age groups, and the differences among the groups were analyzed. Multiple linear regression was used to investigate the main factors influencing crystalline lens tilt and decentration. Results The natural crystalline lens tilted towards the inferotemporal direction with a mean magnitude of 4.3+/-1.5[degrees] (range 0.7-8.95[degrees]). The average decentration toward the superotemporal direction was 0.17+/-0.12 mm (range 0.03-1.15 mm). There was mirror symmetry between the right and left eyes. There were significant differences in the crystalline lens tilt and decentration among the age groups. Multiple linear regression showed that changes in crystalline lens tilt depended on angle [alpha] (p<.01) and anterior chamber depth (ACD; P=.008), while crystalline lens decentration depended on angle [kappa] (P=.003), age (P<.01), and angle [alpha] (P=.002). Conclusions Although there was a significant difference in crystalline lens tilt and decentration among age groups, the variation in the crystalline lens position was partially affected by age. The crystalline lens tilt was greater in eyes with wider angle [alpha] and shallower ACD, while crystalline lens decentration was greater in younger eyes with wider angles [kappa] and [alpha].
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Clinical outcomes of corneal refractive surgery comparing centration on the corneal vertex with the pupil center: a meta-analysis. Int Ophthalmol 2020; 40:3555-3563. [PMID: 32671600 DOI: 10.1007/s10792-020-01506-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 07/06/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To compare the visual and refractive outcomes between centration on the corneal vertex and the pupil center in corneal refractive surgery. METHODS A comprehensive literature search was conducted using PubMed, MEDLINE, EMBASE, and the Cochrane Library to identify relevant studies. The primary outcomes were the postoperative spherical equivalent (SE), effectiveness [uncorrected distance visual acuity (UDVA) ≥ 20/20, eyes within ± 0.50 diopter (D) of target refraction], and safety [loss ≥ 2 lines of corrected distance visual acuity (CDVA)]. Higher-order aberrations were considered secondary outcomes. RESULTS Seven studies describing a total of 1964 eyes were included in this meta-analysis. A statistical significance in postoperative SE was found between the two centration methods for the correction of myopia that favor the CV-centered method (p < 0.001). No significant differences were observed in the proportion of eyes with UDVA ≥ 20/20 or loss ≥ 2 lines of CDVA postoperatively. However, the proportion of eyes within ± 0.50 D was slightly higher (p = 0.02) and the coma aberration was much lower in the corneal vertex-centered method (p < 0.001). CONCLUSION Preferable visual and refractive outcomes could be achieved with either centering on the corneal vertex or pupil center in corneal refractive surgery; however, the corneal vertex-centered method has shown partial benefits in some clinical indices. In order to obtain higher quality of clinical evidences, more randomized controlled trials (RCTs) are required in further investigations.
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Lower- and higher-order aberrations after photorefractive keratectomy with and without compensation of pupil centroid shift: fellow eye comparison. J Cataract Refract Surg 2020; 46:267-275. [PMID: 32126041 DOI: 10.1097/j.jcrs.0000000000000010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To study the effect of pupil centroid shift (PCS) compensation on lower- and higher-order aberrations (HOAs) after photorefractive keratectomy (PRK). SETTING Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. DESIGN Prospective intrasubject fellow eye study. METHODS One hundred twelve eyes of 56 patients with simple myopia or myopic astigmatism scheduled for PRK were enrolled. Preoperatively, the amount of PCS was measured in the horizontal and vertical directions. All eyes received wavefront-optimized treatment with static cyclotorsion compensation. PCS compensation was turned on for the right eye of each subject (PCS-on group), and turned off for the left eye (PCS-off group). Postoperatively, refraction and corneal HOAs were compared between the study groups at 6 months. RESULTS Mean preoperative myopia was -3.84 diopters (D) ± 2.41 (SD) vs -3.75 ± 2.27 D (P = .408), whereas mean preoperative cylinder was -1.18 D ± 1.15 (SD) vs -1.14 ± 1.16 D (P = .769) in the PCS-on and PCS-off groups, respectively. Mean absolute PCS values were 62.25 μm ± 41.82 (SD) vs 55.92 ± 37.47 μm (P = .45) in the horizontal direction and 65.04 ± 47.16 μm vs 58.40 ± 45.44 μm in the vertical direction (P = .29) in the PCS-on and PCS-off groups, respectively. The study groups were comparable in terms of postoperative refraction and root mean square of total corneal HOAs. CONCLUSIONS Compensation of PCS did not affect lower- and higher-order aberrations after wavefront-optimized PRK with static cyclotorsion compensation in myopic or myopic astigmatic eyes.
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Corneal Topographic Astigmatism Based on Total Corneal Power Data (CorT Total): A Benchmark for Total Corneal Astigmatism. Cornea 2019; 39:431-436. [DOI: 10.1097/ico.0000000000002162] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Liu Y, Wang Y. Optical quality comparison between laser ablated myopic eyes with centration on coaxially sighted corneal light reflex and on entrance pupil center. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2019; 36:B103-B109. [PMID: 31044979 DOI: 10.1364/josaa.36.00b103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 02/24/2019] [Indexed: 06/09/2023]
Abstract
This paper aims to compare the image quality between centration on the coaxially sighted corneal light reflex (CSCLR) and on the entrance pupil center (EPC). Myopic laser ablation was simulated on eye models, and the optical performances were compared. Centration on the EPC leads to higher wavefront aberrations and lower modulation transfer function. The two centration methods give nearly identical retinal images for angle kappa less than 5°. Because of less tissue removal, centration on the EPC is probably preferable for angle kappa less than 5°, but CSCLR centration may be preferable for angle kappa larger than 5°. The degree of tilt of the post-surgery anterior corneal surface explains the differences between the two methods.
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Assessment of tilt and decentration of crystalline lens and intraocular lens relative to the corneal topographic axis using anterior segment optical coherence tomography. PLoS One 2017; 12:e0184066. [PMID: 28863141 PMCID: PMC5581187 DOI: 10.1371/journal.pone.0184066] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 08/17/2017] [Indexed: 12/18/2022] Open
Abstract
Purpose To investigate the tilt and decentration of the crystalline lens and the intraocular lens (IOL) relative to the corneal topographic axis using anterior segment ocular coherence tomography (AS-OCT). Methods A sample set of 100 eyes from 49 subjects (41 eyes with crystalline lenses and 59 eyes with IOLs) were imaged using second generation AS-OCT (CASIA2, TOMEY) in June and July 2016 at Okayama University. Both mydriatic and non-mydriatic images were obtained, and the tilt and decentration of the crystalline lens and the IOL were quantified. The effects of pupil dilation on measurements were also assessed. Results The crystalline lens showed an average tilt of 5.15° towards the inferotemporal direction relative to the corneal topographic axis under non-mydriatic conditions and 5.25° under mydriatic conditions. Additionally, an average decentration of 0.11 mm towards the temporal direction was observed under non-mydriatic conditions and 0.08 mm under mydriatic conditions. The average tilt for the IOL was 4.31° towards the inferotemporal direction relative to the corneal topographic axis under non-mydriatic conditions and 4.65° in the same direction under mydriatic conditions. The average decentration was 0.05 mm towards the temporal direction under non-mydriatic conditions and 0.08 mm in the same direction under mydriatic conditions. A strong correlation was found between the average tilt and decentration values of the crystalline lens and the IOL under both non-mydriatic and mydriatic conditions (all Spearman correlation coefficients, r ≥ 0.800; all P < 0.001). Conclusion When measured using second generation AS-OCT, both the crystalline lens and the IOL showed an average tilt of 4–6° toward the inferotemporal direction relative to the corneal topographic axis and an average decentration of less than 0.12 mm towards the temporal direction. These results were not influenced by pupil dilation and they showed good repeatability.
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Salah-Mabed I, Saad A, Gatinel D. Assessing Repeatability of Pupillometric Measurements in the Eyes of Refractive Surgery Candidates Using Infrared Pupillometer. J Refract Surg 2017; 33:552-557. [DOI: 10.3928/01913913-20170619-03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 05/16/2017] [Indexed: 11/20/2022]
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Zhang J, Zhang SS, Yu Q, Lian JC. Comparison of visual effects of FS-LASIK for myopia centered on the coaxially sighted corneal light reflex or the line of sight. Int J Ophthalmol 2017; 10:624-631. [PMID: 28503438 DOI: 10.18240/ijo.2017.04.20] [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: 11/04/2015] [Accepted: 12/01/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To compare visual quality after femtosecond laser in situ keratomileusis (FS-LASIK), between the coaxially sighted corneal light reflex (CSCLR) group and conventional ablation line of sight (LOS) group. METHODS In total, 243 eyes (122 patients) were treated with centration on the CSCLR (visual axis) and 238 eyes (119 patients) treated with centration on the pupil center (LOS). Postoperative outcomes [uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA)], safety index, efficacy index, refractive outcome, ablation center distance from the visual axis, corneal high-order aberrations, subjective discomfort glare and shadowing incidence rate, and contrast sensitivity at 1, 3, and 6mo were measured and compared. RESULTS The mean age was 27.77±7.1y in the CSCLR group and 26.03±7.70y in the LOS group. Preoperatively, the manifest refraction spherical equivalent (MRSE) was -6.68±2.60 D in the CSCLR group and -6.65±2.68 D in the LOS group. The postoperative UCVA, BSCVA, MRSE (-0.03±0.263 D in the CSCLR group, -0.05±0.265 D in the LOS group), efficacy index (1.04, 1.03), and safety index (1.09, 1.08) were not significantly different between the groups (all P>0.05). In total, 3% lost one line and more of BSCVA in the CSCLR group, as 9% in the LOS group postoperatively (P<0.05). The ablation center deviation was 0.20±0.15 mm from the visual axis (Pentacam system default setting; range, 0-0.75 mm) in the CSCLR group, and 0.43±0.22 mm (range, 0-1.32 mm) in the LOS group (P<0.0001). Statistically significant greater augmentation of total corneal higher-order aberrations (0.15±0.10 µm and 0.20±0.12 µm respectively, P=0.03) and vertical and horizontal coma (P<0.0001) were noted in the LOS group. Subjective discomfort glare and shadowing incidence rates were 8.59% and 17.5% in the CSCLR and LOS groups, respectively (P<0.05). The 1-month postoperative contrast sensitivity visual acuity in the CSCLR group was significantly higher than that in the LOS group on contrast (100%, 25%, 10%) with a dark background, but there was no significant difference between the groups at 3 or 6m. CONCLUSION Myopic LASIK centered on the CSCLR achieves significantly lower induction of loss of BSCVA, corneal high-order aberrations, and lower risk of subjective discomfort glare and shadowing, and lower decline in early contrast sensitivity by comparison with centration on the LOS, giving advantages in visual quality postoperatively.
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Affiliation(s)
- Jing Zhang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
| | | | - Qin Yu
- New Vision Eye Clinic, Shanghai 200011, China
| | - Jing-Cai Lian
- Shanghai Xinshijie Zhongxing Eye Hospital, School of Medicine, Shanghai Tongji University, Shanghai 200070, China
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Arba-Mosquera S, de Ortueta D. LASIK for Hyperopia Using an Aberration-Neutral Profile With an Asymmetric Offset Centration. J Refract Surg 2016; 32:78-83. [DOI: 10.3928/1081597x-20151119-04] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 11/03/2015] [Indexed: 11/20/2022]
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Arba Mosquera S, Verma S, McAlinden C. Centration axis in refractive surgery. EYE AND VISION 2015; 2:4. [PMID: 26605360 PMCID: PMC4655455 DOI: 10.1186/s40662-015-0014-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 02/10/2015] [Indexed: 11/10/2022]
Abstract
The human eye is an asymmetric optical system and the real cornea is not a rotationally symmetrical volume. Each optical element in the eye has its own optical and neural axes. Defining the optimum center for laser ablation is difficult with many available approaches. We explain the various centration approaches (based on these reference axes) in refractive surgery and review their clinical outcomes. The line-of-sight (LOS) (the line joining the entrance pupil center with the fixation point) is often the recommended reference axis for representing wavefront aberrations of the whole eye (derived from the definition of chief ray in geometrical optics); however pupil centration can be unstable and change with the pupil size. The corneal vertex (CV) represents a stable preferable morphologic reference which is the best approximate for alignment to the visual axis. However, the corneal light reflex can be considered as non-constant, but dependent on the direction of gaze of the eye with respect to the light source. A compromise between the pupil and CV centered ablations is seen in the form of an asymmetric offset where the manifest refraction is referenced to the CV while the higher order aberrations are referenced to the pupil center. There is a need for a flexible choice of centration in excimer laser systems to design customized and non-customized treatments optimally.
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Affiliation(s)
- Samuel Arba Mosquera
- SCHWIND eye-tech-solutions, Kleinostheim, Germany ; Recognized Research Group in Optical Diagnostic Techniques, University of Valladolid, Valladolid, Spain ; Department of Ophthalmology and Sciences of Vision, University of Oviedo, Oviedo, Spain
| | | | - Colm McAlinden
- Flinders University, Adelaide, South Australia Australia ; Wenzhou Medical University, Wenzhou, Zhejiang China
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Two target locations for corneal inlay implantation combined with laser in situ keratomileusis. J Cataract Refract Surg 2014; 41:162-70. [PMID: 25465218 DOI: 10.1016/j.jcrs.2014.03.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 03/18/2014] [Accepted: 03/24/2014] [Indexed: 11/21/2022]
Abstract
PURPOSE To compare the visual acuity outcomes between 2 target locations for corneal inlay implantation with concurrent laser in situ keratomileusis (LASIK) to compensate for presbyopia. SETTING Shinagawa LASIK Center, Tokyo, Japan. DESIGN Retrospective cohort study. METHODS Bilateral LASIK was performed simultaneously with inlay implantation in the nondominant eye. The preoperative and 6-month postoperative uncorrected distance (UDVA) and uncorrected near (UNVA) visual acuities were evaluated. Patients were divided into the following 2 groups based on the pupil center to Purkinje reflex distance (Pp-Pk): small (≤300 μm) and large (>300 μm). Each group was divided into subgroups according to the distance of the inlay center to the Purkinje reflex (I-Pk) or to the midpoint between the pupil center and Purkinje reflex (I-M). The inlay position was classified as 0 to 100 μm, 101 to 200 μm, 201 to 300 μm, and 301 to 400 μm from the Purkinje reflex and from the midpoint. RESULTS Of 1008 patients, 992 were available for postoperative follow-up. The UDVA and UNVA improved in both subgroups with all inlay positions (P < .0001). There were no statistically significant differences in UDVA or UNVA within or between the small Pp-Pk group and the large Pp-Pk group (P > .05). The Spearman rank-order correlation showed weak associations between the inlay distance and visual acuity. CONCLUSION The amount of inlay decentration had no influence on postoperative visual acuity. FINANCIAL DISCLOSURE Dr. Tomita is a consultant to Acufocus, Inc. No other author has a financial or proprietary interest in any material or method mentioned.
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Mabed IS, Saad A, Guilbert E, Gatinel D. Measurement of Pupil Center Shift in Refractive Surgery Candidates With Caucasian Eyes Using Infrared Pupillometry. J Refract Surg 2014; 30:694-700. [DOI: 10.3928/1081597x-20140903-07] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 06/02/2014] [Indexed: 11/20/2022]
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Ahn JM, Choi BJ, Kim EK, Sgrignoli B, Kim TI. Three different aspheric treatment algorithms of laser-assisted sub-epithelial keratectomy in patients with high myopia. Jpn J Ophthalmol 2012; 57:191-8. [PMID: 23224677 DOI: 10.1007/s10384-012-0218-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 08/28/2012] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare visual outcomes and quality in high myopia patients treated using one of three aspheric treatment algorithms based on the NIDEK Advanced Vision Excimer Laser System. METHODS Sixty eyes of 60 high myopia patients (>-6 diopter) underwent topography-guided (CATz) (20 eyes), wavefront-guided (OPDCAT) (20 eyes), or topography and wavefront-guided (OPA) (20 eyes) laser-assisted sub-epithelial keratectomy. Visual acuity, manifest refraction spherical equivalent (MRSE), ocular and corneal higher order aberrations, corneal asphericity, point spread function (Strehl ratio) and modulation transfer function (MTF) were compared preoperatively and 1, 3 and 6 months postoperatively. RESULTS Six months after surgery, logMAR uncorrected visual acuity was 0.02 ± 0.09 in the CATz group, 0.02 ± 0.07 in the OPDCAT group and 0.02 ± 0.08 in the OPA group, and there were no statistically significant differences (P = 0.5355). No statistical differences were found among the three groups in MRSE (P = 0.3541). Induced spherical aberrations and the change of corneal asphericity were less in the OPA group than in the others (P < 0.0001). The MTF was slightly better in the OPA group than in the others. The Strehl ratio showed no statistically significant differences among the three groups. CONCLUSIONS All three aspheric treatment algorithms were safe and effective in correcting high myopia. Among them, the OPA algorithm maintained optical quality and physiologic cornea longer than the others.
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Serrao S, Buratto L, Lombardo G, De Santo MP, Ducoli P, Lombardo M. Optimal parameters to improve the interface quality of the flap bed in femtosecond laser-assisted laser in situ keratomileusis. J Cataract Refract Surg 2012; 38:1453-9. [PMID: 22814052 DOI: 10.1016/j.jcrs.2012.05.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 03/07/2012] [Accepted: 03/07/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE To analyze the interface quality of the anterior stroma after femtosecond laser flap creation using atomic force microscopy. SETTING IRCCS Fondazione G.B. Bietti, Rome, Italy. DESIGN Experimental study. METHODS A 110 μm depth flap was created in 20 human corneal tissues using a femtosecond laser platform (Intralase iFS). Tissues were divided into 4 groups of various cutting parameters: pulse energy and spot separation of 0.75 μJ and 6 μm (Group 1), 0.65 μJ and 5 μm (Group 2), 0.55 μJ and 4 μm (Group 3), and 0.45 μJ and 4 μm (Group 4). Four additional tissue sections were cut using a motorized microkeratome (Hansatome). Atomic force microscopy (Autoprobe CP) analysis was performed on the stromal bed of each sample. RESULTS The corneal tissues treated with higher pulse energies and wider spot separations (Groups 1 and 2) showed a rougher stromal bed interface (root mean square [RMS] rough = 0.23 μm ± 0.008 (SD) and 0.24 ± 0.009 μm, respectively) than tissues in Groups 3 and 4 (RMS rough = 0.18 ± 0.006 μm and 0.18 ± 0.008 μm, respectively; P<.001, 1-way analysis of variance). The stromal surface quality of tissues treated with pulse energies of 0.55 μJ or lower and 4 μm spot separation compared favorably with that of tissues cut by the microkeratome (RMS rough = 0.17 ± 0.006 μm; P>.05, Tukey). CONCLUSIONS The femtosecond stromal interface quality was improved with pulse energy lower and spot separations narrower than those currently used in the clinical setting. The flap interface smoothness created by the femtosecond laser was comparable to that created by the microkeratome. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Arba Mosquera S, Ewering T. New Asymmetric Centration Strategy Combining Pupil and Corneal Vertex Information for Ablation Procedures in Refractive Surgery: Theoretical Background. J Refract Surg 2012; 28:567-73. [DOI: 10.3928/1081597x-20120703-01] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Accepted: 03/27/2012] [Indexed: 11/20/2022]
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Current world literature. Curr Opin Ophthalmol 2012; 23:330-5. [PMID: 22673820 DOI: 10.1097/icu.0b013e32835584e4] [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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