1
|
Salouti R, Razeghinejad R, Eslami G, Zare M, Salouti K, Ghoreyshi M, Nowroozzadeh MH. Agreement of ocular response analyzer cornea compensated IOP with corvis ST biomechanical IOP following Femtosecond Laser-assisted LASIK. Eye (Lond) 2023; 37:263-266. [PMID: 35013609 PMCID: PMC9873612 DOI: 10.1038/s41433-021-01928-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 12/08/2021] [Accepted: 12/22/2021] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES To compare intraocular pressure (IOP) measurement by ORA-IOPcc and Corvis-bIOP after femtosecond laser-assisted LASIK (FS-LASIK). METHODS In this prospective cohort study, 56 eyes from 56 consecutive patients scheduled for FS-LASIK were enrolled. All patients had IOP measurement with ORA and Corvis ST by two blinded independent expert examiners. IOP examinations were conducted between 8 and 11 A.M. Data were collected at baseline and 3 months after FS-LASIK. RESULTS The mean age of the participants was 29.1 ± 6.3 years, and 42 (75%) were female. The average of central corneal thickness (CCT) decreased from 537 ± 23 µm at baseline to 458 ± 31 µm after FS-LASIK. The mean postoperative change of IOP was 0.0 ± 2.1 for bIOP and -2.5 ± 3.2 mmHg for IOPcc. The corresponding 95% limits of agreement (LoA) was -4.1 to 4.1 mmHg and -3.8 to 8.8 mmHg, respectively. Both methods showed no significant correlation between ∆IOP and ∆CCT. The 95% LoA between bIOP and IOPcc after FS-LASIK was -4.8 to 9.1 mmHg. CONCLUSIONS Compared to the ORA-IOPcc, the Corvis-bIOP showed less variation after FS-LASIK and might be a more appropriate choice for measuring IOP in this condition. The agreement of bIOP vs. IOPcc after FS-LASIK is below the clinically acceptable level, and the two methods could not be regarded as interchangeable.
Collapse
Affiliation(s)
- Ramin Salouti
- Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Salouti Cornea Research Center, Salouti Eye Clinic, Shiraz, Iran
| | | | - Gholamreza Eslami
- Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mousa Zare
- Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kia Salouti
- Science Department, The University of British Columbia, Vancouver, Canada
| | - Maryam Ghoreyshi
- Salouti Cornea Research Center, Salouti Eye Clinic, Shiraz, Iran
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M Hossein Nowroozzadeh
- Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
2
|
Yusef YN, Ermakova SV, Sheludchenko VM, Alkharki L. [Complications of femto-LASIK and features of cavitation injuries]. Vestn Oftalmol 2023; 139:119-125. [PMID: 37379118 DOI: 10.17116/oftalma2023139031119] [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: 06/30/2023]
Abstract
Modern approach to refractive laser surgery features three main types of lamellar surgery. Two of them are types of open laser keratomileusis (LASIK and femtosecond laser-assisted LASIK), and the third - closed (SMILE). All of these techniques allow achieving good clinical outcomes but differ in possible complications. This article reviews the complications of femto-LASIK and specifically the post-operative cavitation injuries, describes the mechanism of their occurrence, variants of their course, and presents the prevention measures.
Collapse
Affiliation(s)
- Yu N Yusef
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - S V Ermakova
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
| | | | - L Alkharki
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
| |
Collapse
|
3
|
Lauzirika G, Arranz-Marquez E, Garcia-Gonzalez M, Hernández-Verdejo JL, Teus MA. Impact of femtosecond laser-assisted in situ keratomileusis on retinal ganglion cell function. Eur J Ophthalmol 2021; 32:1441-1447. [PMID: 34313139 DOI: 10.1177/11206721211035633] [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: 11/17/2022]
Abstract
PURPOSE To analyse the effect of femtosecond laser-assisted in situ keratomileusis (FS-LASIK) on the electrical response of retinal ganglion cells using pattern electroretinography (pERG). METHODS This was a longitudinal, prospective, observational pilot study. We included consecutive myopic patients who underwent FS-LASIK to correct up to 6 dioptres of myopia and up to 2 dioptres of astigmatism. Patients with excessive blinking or tearing and those with Snellen uncorrected visual acuity less than 0.9 dec on postop day 1 were excluded. Diopsys NOVA® (Diopsys Inc., NJ) pERG records, using high- and low-contrast patterns, were obtained 16 h and 1 month after FS-LASIK was performed. Magnitude (μV), Magnitude D (μV), Magnitude D/Magnitude ratio and signal-to-noise ratio (dB) were analysed. Wilcoxon test for nonparametric paired data was employed. RESULTS pERG data from 24 eyes were analysed from 24 patients who underwent FS-LASIK. Mean age was 35.79 ± 9.86 years. Mean preoperative refraction was -2.69 ± 7.6 D (spherical) and -0.38 ± 0.40 D (cylinder). Mean surgical time was 56.88 ± 7.6 s. No statistically significant differences were obtained for any of the studied parameters when comparing 16 h with 1 month after FS-LASIK, with the exception of Magnitude with low contrast, which increased from 1.21 ± 0.2 to 1.39 ± 0.29 µV at 16 h and 1 month postoperatively, respectively (p = 0.03). CONCLUSIONS FS-LASIK seems to induce a mild and transitory defect in retinal ganglion cell function. Only a mild decrease was detected in the magnitude value for low-contrast stimuli when pERG was performed 16 h postoperatively, and it returned to normal 1 month after surgery.
Collapse
Affiliation(s)
- Gorka Lauzirika
- Department of Ophthalmology, Rey Juan Carlos University Hospital, Móstoles, Madrid, Spain.,Novovisión Clinic, Madrid, Spain
| | - Esther Arranz-Marquez
- Department of Ophthalmology, Rey Juan Carlos University Hospital, Móstoles, Madrid, Spain.,Novovisión Clinic, Madrid, Spain
| | | | | | - Miguel A Teus
- Novovisión Clinic, Madrid, Spain.,Department of Ophthalmology, Principe de Asturias University Hospital, Madrid, Spain.,Medicine Faculty, Alcalá University, Alcalá de Henares, Madrid, Spain
| |
Collapse
|
4
|
Lauzirika G, Garcia-Gonzalez M, Bolivar G, Hernández-Verdejo JL, Blázquez Sánchez V, Gros-Otero J, Teus MA. Measurement of the Intraocular Pressure Elevation During Laser-Assisted In Situ Keratomileusis Flap Creation Using a Femtosecond Laser Platform. Transl Vis Sci Technol 2021; 10:9. [PMID: 34003943 PMCID: PMC7961108 DOI: 10.1167/tvst.10.3.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 01/25/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to measure the intraocular pressure (IOP) elevation during laser assisted in situ keratomileusis (LASIK) flap creation using the WaveLight FS200 femtosecond (FS) laser platform. Methods We conducted an ex vivo experimental study in an animal model. The WaveLight FS200 FS laser platform was used to perform the corneal LASIK flap in freshly enucleated porcine eyes. We measured the changes in IOP from the application of the suction ring (suctioning phase) through the creation of the lamellar corneal flap (cutting phase). The IOP was recorded using a manometric technique with direct cannulation to the anterior chamber. Results Nine freshly enucleated porcine eyes were included in the study. The mean baseline IOP before the procedure was 20.33 ± 5.9 mm Hg. The mean IOP increase over baseline IOP was 32.33 ± 11.3 mm Hg at the suctioning phase, and 38.22 ± 11.3 mm Hg at the cutting phase. The total surgical time needed to complete the procedure was 29.5 ± 4.4 seconds. Conclusions The WaveLight FS200 FS laser platform produces a low to moderate increase in IOP during LASIK flap creation. Translational Relevance The WaveLight FS200 is a safe FS laser platform because it induces a low to moderate IOP increase during LASIK flap creation.
Collapse
Affiliation(s)
- Gorka Lauzirika
- Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
- Clínica Novovisión, Madrid, Spain
| | | | - Gema Bolivar
- Hospital Universitario Príncipe Asturias, Alcalá de Henares, Madrid, Spain
| | | | | | | | - Miguel A. Teus
- Clínica Novovisión, Madrid, Spain
- Hospital Universitario Príncipe Asturias, Alcalá de Henares, Madrid, Spain
- Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| |
Collapse
|
5
|
Parafita-Fernandez A, Garcia-Gonzalez M, Gros-Otero J, Alvarez-Rementería Capelo L, Blázquez Sánchez V, Teus M. Evolution of visual acuity, flap thickness, and optical density after laser in situ keratomileusis performed with a femtosecond laser. J Cataract Refract Surg 2021; 46:260-266. [PMID: 32126040 DOI: 10.1097/j.jcrs.0000000000000008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe the postoperative evolution of visual acuity, flap morphology, and stromal optical density femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK). SETTING Clínica Rementería, Madrid, Spain. DESIGN Prospective case series. METHODS The study comprised 44 consecutive eyes that had FS-LASIK performed with the WaveLight FS200 and the Allegretto excimer laser to correct myopia. Visual outcomes, flap thickness, and stromal optical density were assessed 1 day, 1 week, 1 month, and 3 months postoperatively. RESULTS A statistically significant improvement in the mean uncorrected distance visual acuity at 1 day (0.94 ± 0.2) and 1 week (0.93 ± 0.2) to 1 month (1.04 ± 0.2) and 3 months (1.11 ± 0.1) postoperatively (P < .05). At 3 months postoperatively, the femtosecond laser had good outcomes in efficacy (0.98 ± 0.1), safety (0.98 ± 0.1), and predictability (100% of eyes were within ± 0.5 D of emmetropia). The femtosecond-created flaps were slightly thicker than intended, the mean SD intraflap was 7.1 μm, the range between the thickest and thinnest points in each flap was 25.4 μm, and the mean flap thickness homogeneity was 7.6 μm at 3 months postoperatively. A progressive decrease in the optical density of the flap stroma and the residual stromal bed was detected during follow-up. CONCLUSIONS The femtosecond laser study appears to be a safe, effective, and predictable platform to obtain LASIK flaps. The flaps were planar and homogeneous but slightly thicker than intended. The optical density of the flap stroma was slightly higher at early follow-up and decreased over time.
Collapse
Affiliation(s)
- Alberto Parafita-Fernandez
- From Complexo Hospitalario Universitario de Pontevedra (Parafita-Fernandez), Pontevedra, Clínica Oftalmológica Dr Parafita (Parafita-Fernandez), Ribeira, Clínica Rementería (Garcia-Gonzalez, Gros-Otero, Alvarez-Rementería Capelo; Blázquez Sánchez), Madrid, Clínica Novovisión (Garcia-Gonzalez, Teus), Madrid, Universidad Europea de Madrid (Garcia-Gonzalez), Madrid, Universidad Complutense de Madrid, Madrid (Blázquez Sánchez), and Hospital Universitario Príncipe de Asturias, University of Alcalá (Teus), Alcalá de Henares, Madrid, Spain
| | | | | | | | | | | |
Collapse
|
6
|
Gros-Otero J, Ketabi S, Cañones-Zafra R, Garcia-Gonzalez M, Parafita-Fernandez A, Villa-Collar C, Casado S, Teus M. Analysis of corneal stromal roughness after iFS 150 kHz and LenSx femtosecond LASIK flap creation in porcine eyes. Graefes Arch Clin Exp Ophthalmol 2019; 257:2665-2670. [PMID: 31650272 DOI: 10.1007/s00417-019-04497-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/20/2019] [Accepted: 09/23/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To describe and compare the stromal bed roughness obtained after laser in situ keratomileusis (LASIK) flap creation using a corneal femtosecond laser platform (iFS 150) and a "dual" femtosecond (FS) laser platform (LenSx). METHODS This ex vivo experimental study was conducted in an animal model using 12 freshly enucleated porcine eyes, six with each femtosecond laser. The standard laser treatment parameters were used for the experiment. After LASIK flap creation, the corneal stromal roughness was assessed using atomic force microscopy (AFM) in contact mode immersed in liquid. In each sample, surface measurements were obtained in 60 regions of six eyes per FS laser in 10 20 × 20-micron areas of the central corneal stroma at 512 × 512-point resolution. The surface roughness was measured and the root-mean-square (RMS) values of the roughness were obtained. RESULTS The mean RMS ± standard deviation values were 430 ± 150 nm for the corneal femtosecond laser platform and 370 ± 100 nm for the dual FS laser platform (P < 0.011). CONCLUSIONS In this experimental study with AFM, we found smoother stromal beds after LASIK flap creation with LenSx compared to iFS 150 kHz. Further studies are needed to understand visual implications of the differences found.
Collapse
Affiliation(s)
- Juan Gros-Otero
- Clínica Rementería, Calle Almagro, 36, 28010, Madrid, Spain. .,Universidad CEU San Pablo, Madrid, Spain.
| | - Samira Ketabi
- Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | | | - Montserrat Garcia-Gonzalez
- Clínica Rementería, Calle Almagro, 36, 28010, Madrid, Spain.,Clínica Novovisión, Madrid, Spain.,Universidad Europea de Madrid, Madrid, Spain
| | | | | | - Santiago Casado
- Facultad de Ciencia e Ingeniería de Alimentos, Universidad Técnica de Ambato, Ambato, Ecuador.,IMDEA Nanociencia, Madrid, Spain
| | - Miguel Teus
- Hospital Universitario Príncipe de Asturias, Madrid, Spain.,Clínica Novovisión, Madrid, Spain
| |
Collapse
|