1
|
Tran EM, Manche EE. Refractive Surgery Patient Characteristics Associated With Satisfaction Scores. J Refract Surg 2024; 40:e539-e543. [PMID: 39120021 DOI: 10.3928/1081597x-20240611-02] [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: 08/10/2024]
Abstract
PURPOSE To determine factors influencing patient satisfaction scores in recipients of refractive surgery. METHODS In this prospective survey-based study, patients who had refractive surgery at an outpatient refractive clinic completed a survey of selected questions from the Press Ganey survey and the National Eye Institute Visual Function Questionnaire-25. Correlation between patient-specific variables and survey questions were assessed using Student's t-tests. RESULTS Fifty-three patients were recruited over a 3-year period. Most were male (55%) and middle aged (mean age: 34 years). Eleven percent underwent photorefractive keratectomy surgery and the rest had laser in situ keratomileusis, with no complications. Twenty-four percent of surveyed patients reported mild to moderate eye pain postoperatively, with the rest reporting no pain. All patients reported a full score for overall satisfaction. CONCLUSIONS This study found persistent high patient satisfaction score across a variation of characteristics, suggesting that optimal scores are mainstay after refractive surgery procedures with excellent visual outcomes, independent of patient clinical and sociodemographic characteristics. [J Refract Surg. 2024;40(8):e539-e543.].
Collapse
|
2
|
Sella R, Sorkin N, Safir M, Beylin Y, Sela T, Munzer G, Kaiserman I, Mimouni M. Hyperopic LASIK and postoperative corneal steepness: revisiting the 49-diopter limit. J Cataract Refract Surg 2024; 50:550-557. [PMID: 38305328 PMCID: PMC11146188 DOI: 10.1097/j.jcrs.0000000000001411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 01/10/2024] [Accepted: 01/28/2024] [Indexed: 02/03/2024]
Abstract
PURPOSE To compare corrected distance visual acuity (CDVA) outcomes of hyperopic laser in situ keratomileusis (LASIK) with a postoperative corneal steepness above vs below 49 diopters (D). SETTING Care-Vision Laser Centers, Tel-Aviv, Israel. DESIGN Retrospective study. METHODS This study included consecutive patients who underwent hyperopic LASIK between January 2013 and December 2019. Hyperopic patients were divided into 2 groups based on postoperative corneal steepness with steep corneas defined >49.0 D and the control group ≤49.0 D. Adjustments were performed to account for differences in baseline and intraoperative parameters. RESULTS Overall, 1703 eyes of 1703 patients were included. Mean age was 48.3 ± 10.0 years, and 45.3% were male. Preoperatively, the steep group (2.4%, n = 41/1703) had steeper mean (44.6 D vs 43.1 D, P < .001) and steep (45.1 D vs 43.5 D, P < .001) keratometry, worse logMAR CDVA (0.07 vs 0.04, P = .02), and higher sphere (4.9 D vs 2.9 D, P < .001). Intraoperatively, they had a higher spherical treatment (4.6 D vs 2.8 D, P < .001). After hyperopic LASIK, the steep group had worse logMAR CDVA (0.10 vs 0.06, P = .01). However, after accounting for differences in baseline and spherical treatment, no significant differences were found in postoperative logMAR CDVA (0.06 vs 0.06, P = .99). The factors that remained associated with worse postoperative CDVA were higher spherical treatment (0.01 logMAR per 1 D, P < .001) and preoperative CDVA (0.60 logMAR per 1.00 logMAR, P < .001). CONCLUSIONS Postoperative corneal steepness greater than 49 D is not associated with worse visual outcomes after hyperopic LASIK. However, lower preoperative visual potential and higher spherical treatment applied are associated with worse outcomes. The 49 D cutoff should be revisited.
Collapse
Affiliation(s)
- Ruti Sella
- From the Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel (Sella); Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (Sella, Sorkin); Care Vision Laser Centers, Tel-Aviv, Israel (Sella, Sela, Munzer, Kaiserman, Mimouni); Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv, Israel (Sorkin); Department of Ophthalmology, Itzhak Shamir Medical Center, Beer Yaakov, Israel (Safir); Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (Beylin, Mimouni); Department of Ophthalmology, Barzilai Medical Center, Ashkelon and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel (Kaiserman); Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel (Mimouni)
| | - Nir Sorkin
- From the Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel (Sella); Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (Sella, Sorkin); Care Vision Laser Centers, Tel-Aviv, Israel (Sella, Sela, Munzer, Kaiserman, Mimouni); Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv, Israel (Sorkin); Department of Ophthalmology, Itzhak Shamir Medical Center, Beer Yaakov, Israel (Safir); Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (Beylin, Mimouni); Department of Ophthalmology, Barzilai Medical Center, Ashkelon and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel (Kaiserman); Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel (Mimouni)
| | - Margarita Safir
- From the Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel (Sella); Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (Sella, Sorkin); Care Vision Laser Centers, Tel-Aviv, Israel (Sella, Sela, Munzer, Kaiserman, Mimouni); Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv, Israel (Sorkin); Department of Ophthalmology, Itzhak Shamir Medical Center, Beer Yaakov, Israel (Safir); Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (Beylin, Mimouni); Department of Ophthalmology, Barzilai Medical Center, Ashkelon and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel (Kaiserman); Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel (Mimouni)
| | - Yonatan Beylin
- From the Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel (Sella); Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (Sella, Sorkin); Care Vision Laser Centers, Tel-Aviv, Israel (Sella, Sela, Munzer, Kaiserman, Mimouni); Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv, Israel (Sorkin); Department of Ophthalmology, Itzhak Shamir Medical Center, Beer Yaakov, Israel (Safir); Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (Beylin, Mimouni); Department of Ophthalmology, Barzilai Medical Center, Ashkelon and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel (Kaiserman); Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel (Mimouni)
| | - Tzahi Sela
- From the Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel (Sella); Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (Sella, Sorkin); Care Vision Laser Centers, Tel-Aviv, Israel (Sella, Sela, Munzer, Kaiserman, Mimouni); Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv, Israel (Sorkin); Department of Ophthalmology, Itzhak Shamir Medical Center, Beer Yaakov, Israel (Safir); Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (Beylin, Mimouni); Department of Ophthalmology, Barzilai Medical Center, Ashkelon and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel (Kaiserman); Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel (Mimouni)
| | - Gur Munzer
- From the Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel (Sella); Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (Sella, Sorkin); Care Vision Laser Centers, Tel-Aviv, Israel (Sella, Sela, Munzer, Kaiserman, Mimouni); Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv, Israel (Sorkin); Department of Ophthalmology, Itzhak Shamir Medical Center, Beer Yaakov, Israel (Safir); Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (Beylin, Mimouni); Department of Ophthalmology, Barzilai Medical Center, Ashkelon and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel (Kaiserman); Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel (Mimouni)
| | - Igor Kaiserman
- From the Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel (Sella); Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (Sella, Sorkin); Care Vision Laser Centers, Tel-Aviv, Israel (Sella, Sela, Munzer, Kaiserman, Mimouni); Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv, Israel (Sorkin); Department of Ophthalmology, Itzhak Shamir Medical Center, Beer Yaakov, Israel (Safir); Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (Beylin, Mimouni); Department of Ophthalmology, Barzilai Medical Center, Ashkelon and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel (Kaiserman); Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel (Mimouni)
| | - Michael Mimouni
- From the Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel (Sella); Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (Sella, Sorkin); Care Vision Laser Centers, Tel-Aviv, Israel (Sella, Sela, Munzer, Kaiserman, Mimouni); Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv, Israel (Sorkin); Department of Ophthalmology, Itzhak Shamir Medical Center, Beer Yaakov, Israel (Safir); Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (Beylin, Mimouni); Department of Ophthalmology, Barzilai Medical Center, Ashkelon and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheba, Israel (Kaiserman); Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel (Mimouni)
| |
Collapse
|
3
|
Zhong T, Yi H, Gou J, Li J, Liu M, Gao X, Chen S, Guan H, Liang S, He Q, Lin R, Long Z, Wang Y, Shi C, Zhan Y, Zhang Y, Xing L, Zhong J, Xue X. A wireless battery-free eye modulation patch for high myopia therapy. Nat Commun 2024; 15:1766. [PMID: 38409083 PMCID: PMC10897479 DOI: 10.1038/s41467-024-46049-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 02/12/2024] [Indexed: 02/28/2024] Open
Abstract
The proper axial length of the eye is crucial for achieving emmetropia. In this study, we present a wireless battery-free eye modulation patch designed to correct high myopia and prevent relapse. The patch consists of piezoelectric transducers, an electrochemical micro-actuator, a drug microneedle array, μ-LEDs, a flexible circuit, and biocompatible encapsulation. The system can be wirelessly powered and controlled using external ultrasound. The electrochemical micro-actuator plays a key role in precisely shortening the axial length by driving the posterior sclera inward. This ensures accurate scene imaging on the retina for myopia eye. The drug microneedle array delivers riboflavin to the posterior sclera, and μ-LEDs' blue light induces collagen cross-linking, reinforcing sclera strength. In vivo experiments demonstrate that the patch successfully reduces the rabbit eye's axial length by ~1217 μm and increases sclera strength by 387%. The system operates effectively within the body without the need for batteries. Here, we show that the patch offers a promising avenue for clinically treating high myopia.
Collapse
Affiliation(s)
- Tianyan Zhong
- School of Physics, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Hangjin Yi
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610054, China
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiacheng Gou
- School of Information and Communication Engineering, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Jie Li
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Miao Liu
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xing Gao
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Sizhu Chen
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Hongye Guan
- School of Physics, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Shan Liang
- School of Physics, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Qianxiong He
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610054, China
| | - Rui Lin
- School of Physics, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Zhihe Long
- Department of Mechanical Engineering, City University of Hong Kong, Hong Kong SAR, 999077, China
| | - Yue Wang
- School of Information and Communication Engineering, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Chuang Shi
- School of Information and Communication Engineering, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Yang Zhan
- Brain Cognition and Brain Disease Institute, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Yan Zhang
- School of Physics, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Lili Xing
- School of Physics, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Jie Zhong
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610054, China.
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
| | - Xinyu Xue
- School of Physics, University of Electronic Science and Technology of China, Chengdu, 611731, China.
| |
Collapse
|
4
|
Dong Y, Hou J, Zhang J, Lei Y, Yang X, Sun F. Epithelial thickness remodeling after small incision lenticule intrastromal keratoplasty in correcting hyperopia measured by RTVue OCT. BMC Ophthalmol 2024; 24:13. [PMID: 38191381 PMCID: PMC10773066 DOI: 10.1186/s12886-023-03272-x] [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: 09/14/2023] [Accepted: 12/20/2023] [Indexed: 01/10/2024] Open
Abstract
PURPOSE To characterize the in vivo corneal epithelial thickness (CET) remodeling profile in a population of eyes after small incision lenticule intrastromal keratoplasty (SMI-LIKE) for hyperopia. METHODS The CET profile was measured by RTVue-100 Fourier-domain OCT system across the central 6-mm diameter of the cornea of 17 eyes from 12 subjects (five males and seven females) who accepted corneal stromal lens implantation surgery for correcting hyperopia. The CET were measured at positions with a radius of 0-1.0 mm, 1.0-2.5 mm (divided into eight quadrants) and 2.5-3.0 mm (divided into eight quadrants) from the corneal center. Corneal maximum simulated keratometry (Km) was measured by Pentacam HR anterior segment analyzer to analyze CET changes. The examination data of subjects were collected in four time periods, which were preoperative, short-term postoperative (one week after surgery), mid-term postoperative (the last review within 3-6 months after surgery), and long-term postoperative (the last review over 1-2.5 years after surgery). The changes of CET were compared and analyzed in the four time periods. RESULTS Mean CET in 0-1.0 mm, 1.0-2.5 mm and 2.5-3.0 mm of the cornea decreased in one week after surgery, respectively, as compared to CET in the preoperative period, which turned from 55.06 ± 0.82 μm、54.42 ± 0.75 μm、53.46 ± 0.60 μm to 51.18 ± 1.05 μm (P = 0.005), 49.38 ± 0.70 μm (P = 0.000), 51.29 ± 0.59 μm (P = 0.025). In the mid-term postoperative period, mean CET in 0-1.0 mm and 1.0-2.5 mm areas kept thinner than mean CET in the preoperative period, CET in 0-1.0 mm is 50.59 ± 0.76 μm (P = 0.000),CET in 1.0-2.5 mm is 50.23 ± 0.57 μm (P = 0.000), while mean CET in 2.5-3.0 mm area recovered to the same thickness as the preoperative level, which is 54.36 ± 0.66 μm (P = 1.000), until the long-term period, CET stabilized in the above doughnut pattern. CONCLUSIONS After stromal lenticule implantation for hyperopia, CET showed a remodeled form of thinning in the 0-2.5 mm area and thickening in the 2.5-3.0 mm area, and remained stable within one year after surgery.
Collapse
Affiliation(s)
- Yahui Dong
- Jinan Mingshui Eye Hospital, Number 5601, Longquan Road, Zhangqiu District, Jinan, 250200, China
| | - Jie Hou
- Jinan Mingshui Eye Hospital, Number 5601, Longquan Road, Zhangqiu District, Jinan, 250200, China
| | - Jing Zhang
- Jinan Mingshui Eye Hospital, Number 5601, Longquan Road, Zhangqiu District, Jinan, 250200, China
| | - Yulin Lei
- Jinan Mingshui Eye Hospital, Number 5601, Longquan Road, Zhangqiu District, Jinan, 250200, China.
| | - Xinghua Yang
- Jinan Mingshui Eye Hospital, Number 5601, Longquan Road, Zhangqiu District, Jinan, 250200, China
| | - Fangfang Sun
- Jinan Mingshui Eye Hospital, Number 5601, Longquan Road, Zhangqiu District, Jinan, 250200, China
| |
Collapse
|
5
|
Moshirfar M, Stoakes IM, Bruce EG, Ali A, Payne CJ, Furhiman D, Ronquillo YC, Hoopes PC. Allogenic Lenticular Implantation for Correction of Refractive Error and Ectasia: Narrative Review. Ophthalmol Ther 2023; 12:2361-2379. [PMID: 37516716 PMCID: PMC10442033 DOI: 10.1007/s40123-023-00765-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/26/2023] [Indexed: 07/31/2023] Open
Abstract
INTRODUCTION Intrastromal lenticule implantation is a promising treatment option for corneal pathologies, from refractive error to ectasia. In this narrative review, we intend to feature up-to-date literature supporting the use of lenticular tissue, a compelling method that can be customized for a variety of applications, providing an additional source of donor tissue for treating corneal diseases. METHODS We searched databases PubMed, Mendeley, and Scopus last accessed 10 May 2023, for literature on stromal lenticules and narrowed based on relevance. Review articles, animal studies, ex vivo studies, and book chapters were excluded, while assessable and relevant articles published in English were included. RESULTS Storage methods from using fresh lenticules to dehydration have proven successful, with cryopreservation maintaining structure and cellular viability for up to 10 years. Successful use of lenticules for treatment of numerous pathologies including corneal ectasias, hyperopia, and presbyopia with additional insight into the treatment of corneal ulcers and perforations are highlighted in this narrative review. CONCLUSION Lenticular implantation is an innovative and advantageous treatment for various ocular pathologies, offering increased bioavailability, flexibility, and customization for patients. They can treat previously untreatable diseases and serve as a replacement for synthetic implants, with promising outcomes worldwide. Lenticular implantation has the potential to become a leading approach in ophthalmologic surgery. Further studies should aim to provide evidentiary support for a standardization of lenticule banking.
Collapse
Affiliation(s)
- Majid Moshirfar
- HDR Research Center, Hoopes Vision, Draper, UT, USA.
- John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA.
- Utah Lions Eye Bank, Murray, UT, USA.
| | - Isabella M Stoakes
- HDR Research Center, Hoopes Vision, Draper, UT, USA
- Pacific Northwest University of Health Sciences, Yakima, WA, USA
| | | | - Amir Ali
- University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Carter J Payne
- HDR Research Center, Hoopes Vision, Draper, UT, USA
- Case Western Reserve School of Medicine, Cleveland, OH, USA
| | | | | | | |
Collapse
|
6
|
Asroui L, Arba-Mosquera S, Torbey J, Ahmed MA, Fattah MA, Koaik M, Awwad ST. Long-term results of hyperopic ablations using alcohol-assisted PRK and FS-LASIK: comparative study. J Cataract Refract Surg 2023; 49:716-723. [PMID: 36913543 DOI: 10.1097/j.jcrs.0000000000001183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 03/04/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE To evaluate the long-term visual and refractive outcomes of hyperopic excimer ablation using alcohol-assisted photorefractive keratectomy (PRK) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK). SETTING American University of Beirut Medical Center, Beirut, Lebanon. DESIGN Retrospective, matched comparative study. METHODS Eyes that underwent alcohol-assisted PRK were compared to matched eyes that underwent FS-LASIK. All patients were followed up for at least 3 years after surgery. The refractive and visual outcomes of each group were compared at different postoperative time points. The main outcome measures were spherical equivalent deviation from target (SEDT), manifest refraction, and visual acuity. RESULTS 83 eyes underwent alcohol-assisted PRK and 83 matched eyes underwent FS-LASIK. Preoperative manifest refraction spherical equivalent was 2.44 ± 1.18 diopters (D) and 2.20 ± 0.87 D ( P = .133) in the PRK and FS-LASIK groups, respectively. Preoperative manifest cylinder was -0.77 ± 0.89 D and -0.61 ± 0.59 D ( P = .175) for the PRK and LASIK groups, respectively. 3 years postoperatively, SEDT was 0.28 ± 0.66 D and 0.40 ± 0.56 D for the PRK and LASIK groups, respectively ( P = .222), whereas manifest cylinder was -0.55 ± 0.49 D and -0.30 ± 0.34 D for PRK and LASIK, respectively ( P < .001). The mean difference vector was 0.59 ± 0.46 for PRK and 0.38 ± 0.32 for LASIK ( P < .001). 13.3% of PRK eyes and 0% of LASIK eyes had >1 D of manifest cylinder ( P = .003). CONCLUSIONS Both alcohol-assisted PRK and FS-LASIK are safe and effective for the treatment of hyperopia. PRK induces slightly more postoperative astigmatism than LASIK. Larger optical zones and recently introduced ablation profiles that lead to a smoother ablation surface might improve the clinical results of hyperopic PRK.
Collapse
Affiliation(s)
- Lara Asroui
- From the Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon (Asroui, Torbey, Ahmed, Fattah, Koaik, Awwad); Department of Research and Development, SCHWIND eye-tech-solutions GmbH & Co. KG, Kleinostheim, Germany (Arba-Mosquera)
| | | | | | | | | | | | | |
Collapse
|
7
|
Feng Y, He R, Qu M, Ma Q, Tian H. Sub-Bowman keratomileusis versus femtosecond laser in situ keratomileusis on the long-term visual recovery: A comparative study. Indian J Ophthalmol 2023; 71:1899-1903. [PMID: 37203052 PMCID: PMC10391504 DOI: 10.4103/ijo.ijo_1543_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 explore the long-term visual quality of the same subjects after sub-Bowman keratomileusis (SBK) or femtosecond laser in situ keratomileusis (FS-LASIK). Methods This prospective study included patients screened for corneal refractive surgery at the Refractive Surgery Center of our Hospital between November 2017 and March 2018. One eye underwent SBK, while the other eye underwent FS-LASIK. Total higher-order aberrations, coma aberrations, and clover aberrations were evaluated before and at 1 month and 3 years after the procedure. The visual satisfaction of both eyes was investigated, respectively. The participants completed a surgical satisfaction questionnaire. Results Thirty-three patients were included. There were no significant differences in total higher-order aberrations, coma aberrations, and clover aberrations between the two procedures before and 1 month and 3 years after surgery (all P > 0.05), except for the total coma aberrations in FS-LASIK were significantly higher compared with the SBK group at 1 month after surgery [0.51 (0.18, 0.93) vs. 0.77 (0.40, 1.22), P = 0.019]. The surgical satisfaction questionnaire scores of the SBK group and the FS-LASIK group were 9.8 ± 0.8 and 9.8 ± 0.8, respectively, at 1 month, and 9.7 ± 0.9 and 9.7 ± 1.0, respectively, at 3 years (all P > 0.05). Conclusion There were no differences in corneal aberrations and satisfaction between SBK and FS-LASIK procedures at 1 month and 3 years.
Collapse
Affiliation(s)
- Yi Feng
- Shanxi Eye Hospital, Shanxi Eye Hospital, Taiyuan, China
| | - Rui He
- Shanxi Eye Hospital, Shanxi Eye Hospital, Taiyuan, China
| | - Min Qu
- Shanxi Eye Hospital, Shanxi Eye Hospital, Taiyuan, China
| | - Qiuxia Ma
- Shanxi Eye Hospital, Shanxi Eye Hospital, Taiyuan, China
| | - Huiqin Tian
- Shanxi Eye Hospital, Shanxi Eye Hospital, Taiyuan, China
| |
Collapse
|
8
|
Hu X, Wei R, Liu C, Wang Y, Yang D, Sun L, Xia F, Liu S, Li M, Zhou X. Recent advances in small incision lenticule extraction (SMILE)-derived refractive lenticule preservation and clinical reuse. ENGINEERED REGENERATION 2023. [DOI: 10.1016/j.engreg.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
|
9
|
Reinstein DZ, Archer TJ, Vida RS. Epithelial thickness mapping for corneal refractive surgery. Curr Opin Ophthalmol 2022; 33:258-268. [PMID: 35779050 DOI: 10.1097/icu.0000000000000867] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW As more devices become available that offer corneal epithelial thickness mapping, this is becoming more widely used for numerous applications in corneal refractive surgery. RECENT FINDINGS The epithelial thickness profile is nonuniform in the normal eye, being thinner superiorly than inferiorly and thinner temporally than nasally. Changes in the epithelial thickness profile are highly predictable, responding to compensate for changes in the stromal curvature gradient, using the eyelid as an outer template. This leads to characteristic changes that can be used for early screening in keratoconus, postoperative monitoring for early signs of corneal ectasia, and for determining whether further steepening can be performed without the risk of apical syndrome following primary hyperopic treatment. Compensatory epithelial thickness changes are also a critical part of diagnosis in irregular astigmatism as these partially mask the stromal surface irregularities. The epithelial thickness map can then be used to plan a trans-epithelial PRK treatment for cases of irregularly irregular astigmatism. Other factors can also affect the epithelial thickness profile, including dry eye, anterior basement membrane dystrophy and eyelid ptosis. SUMMARY Epithelial thickness mapping is becoming a crucial tool for refractive surgery, in particular for keratoconus screening, ectasia monitoring, hyperopic treatment planning, and therapeutic diagnosis and treatment.
Collapse
Affiliation(s)
- Dan Z Reinstein
- Reinstein Vision
- London Vision Clinic, London, UK
- Department of Ophthalmology, Columbia University Medical Center, New York, USA
- Sorbonne Université, Paris, France
- School of Biomedical Sciences, University of Ulster, Coleraine, UK
| | | | | |
Collapse
|
10
|
Asena BS, Donmez O. The impact of learning curve on flap thickness outcome in femtosecond laser assisted LASIK performed with new LenSx dual platform. KOREAN JOURNAL OF OPHTHALMOLOGY 2022; 36:202-209. [PMID: 35067019 PMCID: PMC9194732 DOI: 10.3341/kjo.2021.0154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/30/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the effect of learning curve on flap thickness (FT) outcome in femtosecond (FS) laser-assisted laser in situ keratomileusis (LASIK) operation for myopia performed with recently introduced LenSx dual platform using curved applanation cone. Methods Seventy eyes of 36 patients with myopia or myopic astigmatism operated with FS laser-assisted LASIK with recently introduced LenSx dual platform were evaluated in this retrospective study. Operations were divided into two groups: first 20 operations (20 eyes of 10 patients) and next 50 operations (50 eyes of 26 patients). Data on patient demographics, preoperative and postoperative keratometric and aberrometric parameters, and FT related outcome, including mean central FT, mean total FT, intra-FT range, and FT homogeneity were compared in study groups. Results Except for significantly lower preoperative steepest keratometry values in the next 50 operations versus first 20 operations (p = 0.033), no significant difference was noted between study groups in terms of preoperative and postoperative parameters. When compared to first 20 operations, next 50 operations were associated with significantly higher values for mean central FT (median, 123 μm vs. 114 μm; p = 0.007) and mean total FT (median, 123 μm vs. 113 μm; p = 0.015), whereas significantly lower intra-FT range (median, 4.0 μm vs. 4.5 μm; p = 0.003). Conclusions In conclusion, our findings related to FS laser-assisted LASIK surgery for myopia with new LenSx dual platform using curved applanation cone revealed significant impact of learning curve on the corneal FT outcome in terms of closer FT to the intended value and lower intra-flap range.
Collapse
Affiliation(s)
| | - Oya Donmez
- Department of Ophthalmology, Tinaztepe Galen Hospital, Izmir,
Turkey
| |
Collapse
|
11
|
Liu S, Wei R, Choi J, Li M, Zhou X. Visual Outcomes After Implantation of Allogenic Lenticule in a 100-µm Pocket for Moderate to High Hyperopia: 2-Year Results. J Refract Surg 2021; 37:734-740. [PMID: 34756142 DOI: 10.3928/1081597x-20210730-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate 2-year visual outcomes, stability, and predictability after allogenic lenticule implantation in a 100-µm pocket for moderate to high hyperopia correction. METHODS In this prospective case series, 14 eyes of 9 patients with moderate to high hyperopia ranging from +3.00 to +8.00 diopters sphere were included between March and September 2018. Allogenic lenticules extracted from myopic small incision lenticule extraction were implanted into a pocket created by femtosecond laser at a 100-µm depth in recipients with hyperopia. All patients were followed up for 2 years. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity, manifest refraction, corneal topography, Fourier-domain optical coherence tomography, and in vivo confocal microscopy were examined. RESULTS At postoperative 2 years, 2 eyes (14.3%) gained one line of CDVA, 11 eyes (78.6%) had unchanged CDVA, and 1 eye (7.1%) lost one line of CDVA. No eyes lost two or more lines of CDVA. Twelve of the treated eyes (85.7%) had postoperative uncorrected near visual acuity equal to or better than pre-operative values. The spherical equivalent decreased from +5.53 ± 1.45 D preoperatively to -0.60 ± 1.20 D at postoperative year 2 (P < .001). The anterior mean keratometric readings increased from 42.41 ± 1.03 D preoperatively to 48.38 ± 1.98 D at postoperative year 2 (P < .001). Of 14 treated eyes, 10 eyes (71.4%) had spherical equivalent within ±1.00 D. CONCLUSIONS The findings suggest that allogenic lenticule transplantation may be a promising option for the correction of moderate to high hyperopia. [J Refract Surg. 2021;37(11):734-740.].
Collapse
|
12
|
[Regression and ablation profiles in corneal refractive surgery]. J Fr Ophtalmol 2021; 44:1059-1075. [PMID: 34148702 DOI: 10.1016/j.jfo.2020.08.041] [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: 05/15/2020] [Revised: 08/16/2020] [Accepted: 08/24/2020] [Indexed: 11/21/2022]
Abstract
Regression after corneal refractive surgery is a complex phenomenon which seems inevitable. The choice of surgical technique has very little influence on regression for low myopia or myopic astigmatism. However, LASIK and SMILE are the two techniques of choice in the correction of high myopia. LASIK is also better for the correction of hyperopia, hyperopic astigmatism and mixed astigmatism. Intraoperatively, the choice of a wide optical zone and adherence to a thick residual stromal bed provide stability. Regression may also be reduced by modulating anti-inflammatory therapy, treating dry eye, and using mitomycin C in PKR. In all cases, obtaining keratometry during patient follow-up helps to identify the cause of the regression. The objective of this review is to synthesize recent data from the literature on regression in refractive surgery as a function of the ablation profiles used.
Collapse
|
13
|
Delbarre M, Le HM, Boucenna W, Froussart-Maille F. [Refractive surgery for hyperopia]. J Fr Ophtalmol 2021; 44:723-729. [PMID: 33836914 DOI: 10.1016/j.jfo.2020.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 11/16/2020] [Indexed: 10/21/2022]
Abstract
Hyperopia is a refractive error in which light is focused behind, instead of on, the retina. Clear vision can be obtained by accommodation, but in the long run, this results in eye strain. Hyperopia can be classified as low [≤2.00 diopters (D)], moderate (2.00-4.00 D) and high (>4.00 D). Detailed preoperative evaluation is necessary and essential to obtain good postoperative results. Various surgical techniques can be proposed to correct this ametropia. The main techniques used act either by modifying the corneal curvature with the Excimer laser or by implanting a phakic intraocular lens. The anatomical peculiarities of the hyperopic eye (small corneal diameter, short axial length, narrow anterior chamber or large kappa angle) make refractive surgery for hyperopia a considerable challenge. Large optical ablation zones now allow correction of high hyperopia by reducing the risks of optical aberrations and regression. The patient must be informed and understand the postoperative course, which differs from that of surgery for myopia.
Collapse
Affiliation(s)
- M Delbarre
- Service d'ophtalmologie, Hôpital d'instruction des Armées Percy, 101, avenue Henri-Barbusse, BP 406, 92141 Clamart cedex, France.
| | - H M Le
- Département d'ophtalmologie, Centre hospitalier intercommunal de Créteil, 40, avenue de Verdun, 94000 Créteil, France
| | - W Boucenna
- Service d'ophtalmologie, CHU Amiens-Picardie, 1, rond-point du Professeur-Christian-Cabrol, 80054 Amiens, France
| | - F Froussart-Maille
- Service d'ophtalmologie, Hôpital d'instruction des Armées Percy, 101, avenue Henri-Barbusse, BP 406, 92141 Clamart cedex, France; École du Val-de-Grâce, 1, place Alphonse-Laveran, 75230 Paris cedex 05, France
| |
Collapse
|
14
|
Schallhorn JM, Schallhorn SC, Hannan SJ. Impact of Refractive Outcomes on Bias in Follow-up and Completion of Patient-Reported Outcome Measures after Laser Vision Correction. Ophthalmology 2021; 128:1284-1291. [PMID: 33545171 DOI: 10.1016/j.ophtha.2021.01.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 01/15/2021] [Accepted: 01/27/2021] [Indexed: 10/22/2022] Open
Abstract
PURPOSE To examine factors contributing to completion of a patient-reported outcome (PRO) measure in patients undergoing laser vision correction. DESIGN Retrospective, population-based study. PARTICIPANTS All patients who underwent primary laser vision correction with a target of plano from July 1, 2014, to June 30, 2016, at a large refractive surgery center. METHODS Patients were asked to complete a PRO measure at the time of their preoperative and months 1 and 3 postoperative visits. Characteristics between patients who attended and did not attend the follow-up visits and completed and did not complete the PRO measure were compared. A logistic regression was performed to identify factors associated with likelihood of follow-up and completion of PRO measure. An inverse probability censoring weighted model was created to account for selective loss to follow-up and used to adjust the PRO satisfaction measure. MAIN OUTCOME MEASURE Completion of the PRO measure at 1 and 3 months. RESULTS A total of 37 043 patients were identified. Of these, 20 501 completed a 1-month postoperative PRO measure and 10 474 completed a 3-month postoperative PRO measure. Patients completing a PRO measure were more likely to be older, be female, have had photorefractive keratectomy (PRK), have completed a preoperative PRO measure, and have had a preoperative hyperopic correction (P < 0.001 for all comparisons). For every line of postoperative uncorrected acuity worse than 20/16, the odds ratio of completing a PRO measure was 1.33 (95% confidence interval [CI], 1.30-1.36, P < 0.001) at 1 month and 1.29 (95% CI, 1.26-1.33, P < 0.001) at 3 months. At 1 month, there was no difference between the raw and model-adjusted rates of satisfaction with vision, but at 3 months the adjusted rate was significantly higher than the raw rate. CONCLUSIONS Patients with worse objective visual outcomes were more likely to complete PRO measures in this population-based study. In a setting with loss to follow-up, PRO measures require methods to address missing data for correct interpretation.
Collapse
Affiliation(s)
- Julie M Schallhorn
- Department of Ophthalmology, University of California, San Francisco, California; F.I. Proctor Foundation, University of California, San Francisco, California.
| | - Steven C Schallhorn
- Department of Ophthalmology, University of California, San Francisco, California; Carl Zeiss Meditec, Dublin, California
| | | |
Collapse
|
15
|
Femtosecond-LASIK outcomes using the VisuMax ®-MEL ® 80 platform for hyperopia and hyperopic astigmatism refractive surgery. Exp Ther Med 2021; 21:288. [PMID: 33603895 PMCID: PMC7851669 DOI: 10.3892/etm.2021.9719] [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: 11/11/2020] [Accepted: 12/11/2020] [Indexed: 12/03/2022] Open
Abstract
The present study evaluated the efficacy, the safety and the predictability of the Femtosecond laser-assisted in situ keratomileusis (Femto-LASIK) procedure for hyperopia and hyperopic astigmatism. We retrospectively analyzed the postoperative 12-month evolution of 593 eyes with hyperopia and hyperopic astigmatism that underwent Femto-LASIK treatment. The procedure was predictable and effective. No eye lost 2 lines of corrected distance visual acuity (CDVA), demonstrating a safety profile of the procedure. Nine percent of the eyes gained at least one line of CDVA. The accuracy of the spherical equivalent after 12 months was 74% within ±1.0 diopter (D) of emmetropia. The refractive outcomes were stable during the follow-up period. There were no significant complications during the procedure. Femto-LASIK using the VisuMax®-MEL® 80 platform was demonstrated to be a suitable option to correct selected cases of hyperopia and hyperopic astigmatism. A longer follow-up period is required to better assess the refractive results and to detect any further regression.
Collapse
|
16
|
Wu J, Xiong L, Wang Z, Reinstein DZ, Vida RS, Archer TJ. Correction of Moderate to High Hyperopia With Implantation of an Allogeneic Refractive Lenticule. J Refract Surg 2020; 36:772-779. [DOI: 10.3928/1081597x-20200826-01] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 08/19/2020] [Indexed: 11/20/2022]
|
17
|
Valdez-García JE, Hernandez-Camarena JC, Loya-García D, Lopez-Montemayor P, Ortiz-Morales G, Merayo-Lloves J. Safety and Efficacy of Myopic LASIK performed on Thin Corneas. Open Ophthalmol J 2020. [DOI: 10.2174/1874364102014010033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose:
The aim was to report on the visual outcomes and safety of myopic LASIK performed in patients with corneas of central thickness below average(<540μm) and normal topography.
Methods:
This is a retrospective cohort study conducted at a private practice setting on Mexican Hispanic patients who underwent myopic LASIK between January 2014 and January 2015. An analysis of records of patients >18 years-old with previous normal topography, stable refraction, corrected visual acuity ≥ 20/20 (Snellen), Central Corneal Thickness (CCT) < 540μm and at least 12 months follow up after surgery was conducted. The main outcome measures were standard visual outcomes (efficacy, safety, refractive stability) and Percent Tissue Altered (PTA) analysis was conducted.
Results:
A total of 51 patients (102 eyes) were included; 56% (n=57) were female. The mean age was 26.52 ± 8.06 (range 18-55 years) with a mean follow up of 13.9 ± 1.2 months. Preoperative CCT was 515.44 ± 17.87μm (range 452- 540μm), with a mean refractive spherical equivalent (SEQ): -4.08 ± 2.17 D (range -0.75 to -9.75 D), and mean refractive cylinder: -1.44 ± 1.29 D (range 0.00 to -6.00 D). Mean predictability of postoperative SEQ was -0.20 ± 0.40 D (range -1.25 to +1.25). Postoperative SEQ was ±0.50 D in 71%, ±1.00 D in 93% of the eyes. Postoperative uncorrected distance visual acuity was ≥20/20 in 78% and ≥20/25 in 95%. One line of CDVA was lost in 3% of the eyes, no eyes lost ≥2 lines. No ectasia cases were observed during follow-up.
Conclusion:
LASIK surgery in Mexican Hispanic patients with thinner than “normal” corneas (<540 μm) is safe, efficient and predictable at 1 year follow up for myopic refractive corrections with no evidence of postoperative keratectasia.
Collapse
|
18
|
Zhang J, He FL, Liu Y, Fan XQ. Comparison of choroidal thickness in high myopic eyes after FS-LASIK versus implantable collamer lens implantation with swept-source optical coherence tomography. Int J Ophthalmol 2020; 13:773-781. [PMID: 32420225 DOI: 10.18240/ijo.2020.05.12] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 03/15/2020] [Indexed: 01/22/2023] Open
Abstract
AIM To investigate the changes in choroidal thickness (CT) in high myopic eyes after femtosecond laser-assisted in situ keratomileusis (FS-LASIK) surgery or central hole implantable collamer lens (ICL V4c) implantation using swept-source optical coherence tomography (SS-OCT). METHODS We examined the right eyes of 116 patients with high myopia who were candidates for FS-LASIK surgery and ICL implantation. Sixty eyes underwent ICL V4c implantation and 56 eyes were subjected to FS-LASIK surgery. The CT was measured with SS-OCT. All data were recorded preoperatively and 2h, 1wk, 1 and 3mo postoperatively. Other demographic information was collected, including age, sex, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical equivalent (SE), intraocular pressure (IOP) and axial length (AL). RESULTS The UCVA improved in both groups and showed no significant differences between groups. There also were no significant differences between the two groups in postoperative BCVA and SE (P=0.581 and 0.203, respectively). The foveal CTs, inner nasal and outer nasal CTs were significantly thicker at 2h postoperatively in both groups (P<0.05) but returned to baseline levels in 1wk; after 1mo, no significant differences were found relative to the preoperative values. At 3mo in each group, nine regions showed variations in the CT as compared with preoperative thickening, but only the foveal and nasal area CTs preoperative differences were statistically significant (P<0.05). In addition, there was no significant difference in 9 regions of CT between the two groups at all follow-up times (P>0.05). CONCLUSION The CTs after ICL implantation and FS-LASIK surgery are significantly thicker than those before operation, especially in the foveal and nasal areas, but there is no significant difference between the two methods.
Collapse
Affiliation(s)
- Jing Zhang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.,Shanghai Key Laboratory of Orbital Disease and Ocular Oncology, Shanghai 200011, China
| | - Fang-Lin He
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.,Shanghai Key Laboratory of Orbital Disease and Ocular Oncology, Shanghai 200011, China
| | - Yan Liu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.,Shanghai Key Laboratory of Orbital Disease and Ocular Oncology, Shanghai 200011, China
| | - Xian-Qun Fan
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China.,Shanghai Key Laboratory of Orbital Disease and Ocular Oncology, Shanghai 200011, China
| |
Collapse
|
19
|
Utility of regional epithelial thickness measurements in corneal evaluations. Surv Ophthalmol 2020; 65:187-204. [DOI: 10.1016/j.survophthal.2019.09.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 09/10/2019] [Accepted: 09/16/2019] [Indexed: 11/19/2022]
|
20
|
Riau AK, Liu YC, Yam GH, Mehta JS. Stromal keratophakia: Corneal inlay implantation. Prog Retin Eye Res 2020; 75:100780. [DOI: 10.1016/j.preteyeres.2019.100780] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/28/2019] [Accepted: 09/02/2019] [Indexed: 12/31/2022]
|
21
|
Schallhorn JM, Schallhorn SC, Teenan D, Hannan SJ, Pelouskova M, Venter JA. Incidence of Intraoperative and Early Postoperative Adverse Events in a Large Cohort of Consecutive Laser Vision Correction Treatments. Am J Ophthalmol 2020; 210:97-106. [PMID: 31634446 DOI: 10.1016/j.ajo.2019.10.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the incidence of adverse events (AE) following laser vision correction. DESIGN Retrospective case series. METHODS Optical Express, UK. Patients/study population: patients who underwent laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) between July 1, 2014, and June 30, 2016. Intervention/observation procedures: all AEs recorded in the electronic medical record were extracted and retrospectively reviewed. The total incidence of AE and serious adverse events (SAE) was calculated. Loss of 2 or more lines of corrected distance visual acuity (CDVA) was calculated for the entire cohort of patients that attended a minimum of 3 months follow-up. MAIN OUTCOME MEASURES AEs; Preoperative and last available postoperative clinical data. RESULTS A total of 31,921 (61,833 eyes) were included in the study for LASIK and 5,016 (9,467 eyes) for PRK. The total number of AE was 850 for LASIK (occurring in 783 eyes of 657 patients; incidence of 1.3% or 1:79 eyes) and 227 for PRK (occurring in 218 eyes of 170 patients; incidence of 2.3% or 1:43 eyes). In the LASIK group, there were 287 SAEs (271 eyes of 226 patients; incidence of 0.4% or 1:228 eyes), and the number of SAEs in PRK group was 65 (65 eyes of 39 patients; incidence 0.7% or 1:146 eyes). Combining LASIK and PRK data, the loss of 2 or more lines of CDVA was recorded in 0.37% of eyes. CONCLUSIONS Contemporary LASIK and PRK are safe procedures with a low incidence of serious adverse events.
Collapse
|
22
|
Human allograft refractive lenticular implantation for high hyperopiccorrection. J Cataract Refract Surg 2020; 46:305-311. [DOI: 10.1097/j.jcrs.0000000000000011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
23
|
Biscevic A, Bohac M, Pjano MA, Grisevic S, Patel S, Pidro A. Treatment of High Astigmatism with WaveLight Allegretto Eye-Q Excimer Laser Platform. Acta Inform Med 2019; 27:177-180. [PMID: 31762574 PMCID: PMC6853724 DOI: 10.5455/aim.2019.27.177-180] [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] [Indexed: 11/03/2022] Open
Abstract
Introduction The WaveLight Allegretto Eye-Q is a flying-spot excimer laser, with a pulse repetition rate of 400Hz, with two galvanometric scanners for positioning laser pulses. The system has an infrared high speed camera operating at 400Hz to track the patient's eye movements that either compensates for changes in eye position or interrupts the treatment if the eye moves outside a preset predetermined range. Aim The purpose of this study was to investigate WaveLight Allegretto Eye-Q 400Hz laser delivery platform aimed to correct astigmatism by subjecting the pre and postoperative astigmatic values to vector analysis. Methods Patients were divided into two groups, depending on the type of astigmatism. Astigmatism was between 2 and 7 diopters (D). A total of 188 eyes (110 patients), 127 eyes (71 patients) with myopic astigmatism and 61 eyes (39 patients) with mixed astigmatism underwent unremarkable LASIK correction on WaveLight Allegretto Eye-Q 400Hz. The preoperative and postoperative sphere, negative cylinder [C] and axis (ø) of manifest refractions were subjected to vector analysis by calculations of the standard J0 (cos [4π(ø-90)/360]xC/2) and J45 (sin[4π(ø-90)/ 360]xC/2). Results Reporting the key results, we found that J0 significantly reduced after LASIK (p<0.001) but not J45. There was no significant association between individual pairs of pre and postoperative J0 &J45 values. Conclusion WaveLight Allegretto 400Hz showed excellent results for treating patients with high astigmatism, regardless whether it is mixed or myopic astigmatism. The J45 did not reduce significantly possibly because of the low number of eyes with oblique astigmatism. There was no genuine difference postoperatively between groups treated on WaveLight Allegretto platform according to the vector analyses.
Collapse
Affiliation(s)
- Alma Biscevic
- Eye Clinic Svjetlost Sarajevo, Sarajevo, Bosnia and Herzegovina.,University Eye Clinic Svjetlost Zagreb, Zagreb, Croatia
| | - Maja Bohac
- University Eye Clinic Svjetlost Zagreb, Zagreb, Croatia
| | | | - Senad Grisevic
- Eye Clinic Svjetlost Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Sudi Patel
- NHS National Services Scotland, Edinburgh, United Kingdom
| | - Ajla Pidro
- Eye Clinic Svjetlost Sarajevo, Sarajevo, Bosnia and Herzegovina
| |
Collapse
|
24
|
Francone A, Lemanski N, Charles M, Borboli-Gerogiannis S, Chen S, Robert MC, Pineda R. Retrospective comparative analysis of intraocular lens calculation formulas after hyperopic refractive surgery. PLoS One 2019; 14:e0224981. [PMID: 31697752 PMCID: PMC6837514 DOI: 10.1371/journal.pone.0224981] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 10/25/2019] [Indexed: 12/28/2022] Open
Abstract
Purpose To compare the intraocular lens calculation formulas and evaluate postoperative refractive results of patients with previous hyperopic corneal refractive surgery. Design Retrospective, comparative, observational study. Setting Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA. Methods Clinical charts and optical biometric data of 39 eyes from 24 consecutive patients diagnosed with previous hyperopic laser vision correction and cataract surgery were reviewed and analyzed. The Intraocular lens (IOL) power calculation using the Holladay 2 formula (Lenstar) and the American Society of Cataract and Refractive Surgery (ASCRS) Post-Refractive IOL Calculator (version 4.9, 2017) were compared to the actual manifest refractive spherical equivalent (MRSE) following cataract surgery. No pre-Lasik / PRK or post-Lasik / PRK information was used in any of the calculations. The IOL prediction error, the mean IOL prediction error, the median absolute refractive prediction error, and the percentages of eyes within ±0.50 diopter (D) and ±1.00 D of the predicted refraction were calculated. Results The Holladay 2 formula produced a mean arithmetic IOL prediction error significantly different from zero (P = 0.003). Surprisingly, the mean arithmetic IOL prediction errors generated by Shammas, Haigis-L and Barret True K No History formulas were not significantly different from zero (P = 0.14, P = 0.49, P = 0.81, respectively).There were no significant differences in the median absolute refractive prediction error or percentage of eyes within ± 0.50 D or ± 1.00 D of the predicted refraction between formulas or methods. Conclusion In eyes with previous hyperopic LASIK/PRK and no prior data, there were no significant differences in the accuracy of IOL power calculation between the Holladay 2 formula and the ASCRS Post-refractive IOL calculator.
Collapse
Affiliation(s)
- Anibal Francone
- Centro Oftalmológico Dr. Charles Sociedad Anónima, Buenos Aires, Argentina
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
| | - Nicole Lemanski
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Martin Charles
- Centro Oftalmológico Dr. Charles Sociedad Anónima, Buenos Aires, Argentina
| | - Sheila Borboli-Gerogiannis
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Sherleen Chen
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Marie-Claude Robert
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Roberto Pineda
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, United States of America
| |
Collapse
|
25
|
Sheludchenko VM, Osipyan GA, Yusef NY, Khraystin K, Alharki L, Dzhalili RA. [Bandage lamellar-optical keratoplasty for post-excimer laser keratectasia]. Vestn Oftalmol 2019; 135:171-176. [PMID: 31691656 DOI: 10.17116/oftalma2019135052171] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION According to various sources, occurrence rate of keratectasia (KE) after Laser in situ Keratomileusis (LASIK) ranges from 0.04 to 0.2%. No known technique for keratorefractive surgery eliminates the probability. Neither corneal cross-linking, nor implantation of polymeric segments can completely prevent its development. PURPOSE To treat KE after LASIK with bandage lamellar-optical keratoplasty (BLOK) surgery and to evaluate the results. MATERIAL AND METHODS The study included 22 patients with KE after LASIK divided into two groups. The first group consisted of 6 patients; they underwent BLOK surgery using a segment transplant 1.5 mm in width and 180-220 µm in thickness. The second group included 16 patients who underwent BLOK surgery using 2.75 mm wide, 290-350 µm thick allogeneic transplant of individual length. The follow-up lasted 4 years. RESULTS In the first group, uncorrected visual acuity (UCVA) improved by 0.4±007, in the second group - by 0.46±0.15. After two years, two patients had their transplant exchanged for a wider one due to ectasia progression. Corneal refraction was stable at 45.36±1.47 Diopters in all other patients of the first group. In the second group, it was consistently between 40.6 and 45.7 Diopters. The main complication of the BLOK surgery was displacement of the edge of the corneal flap formed during LASIK - occurred in 4 patients. CONCLUSION Bandage lamellar-optical keratoplasty proved effective in treating patients with KE after LASIK, leading to improvement of visual acuity, strengthening of the cornea and normalization of its surface; it slows further progression of ectasia.
Collapse
Affiliation(s)
- V M Sheludchenko
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - G A Osipyan
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021; Center Vision Recovery, 108 Lobachevskogo St., Moscow, Russian Federation, 119361
| | - N Yu Yusef
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021; Center Vision Recovery, 108 Lobachevskogo St., Moscow, Russian Federation, 119361
| | - Kh Khraystin
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - L Alharki
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
| | - R A Dzhalili
- Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021
| |
Collapse
|
26
|
Plaza-Puche AB, Vargas V, Yébana P, Arba-Mosquera S, Alio JL. Stability of corneal topography and aberrometry after hyperopic laser in situ keratomileusis with a 500-Hz excimer laser platform: A 3-year follow-up study. Eur J Ophthalmol 2019; 30:1238-1245. [PMID: 31514537 DOI: 10.1177/1120672119875358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The aim of this study is to analyze the long-term stability of the corneal topography, the functional optical zone, and the refractive stability throughout 3 years following laser in situ keratomileusis surgery for hyperopia using a 500-Hz excimer laser system. METHODS This retrospective consecutive observational case series study comprised 66 eyes that underwent laser in situ keratomileusis to correct hyperopia with a postoperative follow-up of 3 years. Laser in situ keratomileusis procedures were performed using the SCHWIND Amaris 500-Hz excimer laser. Main outcomes measured were stability of the functional optical zone at corneal topography and corneal aberrometry. RESULTS Statistically significant differences were found in simulated keratometry (K2 (steep meridian) and Km (mean keratometry)) between 3 and 36 months postoperatively (p ⩽ 0.01); these differences disappeared at 12 and 36 months (p ⩾ 0.18). No statistically significant changes were observed in the horizontal and vertical diameter of the functional optical zone throughout the whole follow-up (p ⩾ 0.07). A statistically significant difference was found in the spherical aberration between 3 and 36 months (p = 0.02); this difference disappeared when compared between 12 and 36 months (p = 0.72). Statistically significant correlations were detected between the vertical functional optical zone and coma root mean square (r = -0.510, p < 0.01) and between the vertical functional optical zone and spherical aberration (r = 0.441, p = 0.02) 36 months after surgery. CONCLUSION Following 3 years of hyperopic laser in situ keratomileusis with a 500-Hz Amaris excimer laser, keratometry, functional optical zone, and corneal aberrations remain stable from 1 year after surgery. Topographical regression is not observed in hyperopic laser in situ keratomileusis with this excimer laser technology from 1 year after surgery.
Collapse
Affiliation(s)
| | | | | | | | - Jorge L Alio
- Vissum Corporation, Alicante, Spain.,Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
| |
Collapse
|
27
|
Six-Month Outcomes After High Hyperopia Correction Using Laser-Assisted In Situ Keratomileusis With a Large Ablation Zone. Cornea 2019; 38:1147-1153. [PMID: 31169605 DOI: 10.1097/ico.0000000000002011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate refractive and visual outcomes of laser-assisted in situ keratomileusis (LASIK) to treat high hyperopia using an aberration-neutral profile and large ablation zone. METHODS This was a retrospective, consecutive observational case series at Helios Ophtalmologie, St. Jean-de-Luz, France. One hundred forty-six consecutive eyes of 77 patients who underwent LASIK with mechanical microkeratome to correct hyperopia with correction in the maximum hyperopic meridian strictly higher than +5 D (mean + 6.6 ± 1.0 D) were included. Procedures were performed with an Amaris 750S excimer laser (Schwind eye-tech-solutions GmbH, Kleinostheim, Germany) using an aberration-neutral profile, a 6.7 ± 0.1 mm optical zone, and a 9.2 ± 0.1 mm total ablation zone. Refractive results, predictability, safety, and efficacy were evaluated at 6 months postoperatively. RESULTS At 6 months postsurgery, the mean manifest refraction spherical equivalent was -0.06 ± 0.83 D and the mean cylinder was 0.42 ± 0.35 D. Sixty-six percent of eyes were within ±0.50 D of the attempted spherical equivalent correction. Six months postoperatively, 60% of eyes achieved an uncorrected distance visual acuity of 20/20 or better. Ten percent of eyes lost 1 line of corrected distance visual acuity and 4% gained a line. No eyes lost more than 2 Snellen lines of corrected distance visual acuity at any follow-up. CONCLUSIONS High hyperopia correction with LASIK using an aberration-neutral profile and large ablation zone provides good efficacy, safety, predictability, and visual outcomes.
Collapse
|
28
|
Kim TI, Alió Del Barrio JL, Wilkins M, Cochener B, Ang M. Refractive surgery. Lancet 2019; 393:2085-2098. [PMID: 31106754 DOI: 10.1016/s0140-6736(18)33209-4] [Citation(s) in RCA: 171] [Impact Index Per Article: 34.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/29/2018] [Accepted: 12/11/2018] [Indexed: 01/19/2023]
Abstract
Refractive surgery has evolved beyond laser refractive techniques over the past decade. Laser refractive surgery procedures (such as laser in-situ keratomileusis), surface ablation techniques (such as laser epithelial keratomileusis), and photorefractive keratectomy have now been established as fairly safe procedures that produce excellent visual outcomes for patients with low-to-moderate amounts of ametropia. Additionally, a broader selection of options are now available to treat a wider range of refractive errors. Small incision lenticule extraction uses a femtosecond laser to shape a refractive lenticule, which is removed through a small wound. The potential advantages of this procedure include greater tectonic strength and less dry eye. In the future, intracorneal implants could be used to treat hyperopia or presbyopia. Phakic intraocular implants and refractive lens exchange might be useful options in carefully selected patients for correcting high degrees of ametropia. Thus, physicians are now able to provide patients with the appropriate refractive corrective option based on the individual's risk-benefit profile.
Collapse
Affiliation(s)
- Tae-Im Kim
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Jorge L Alió Del Barrio
- Cornea, Cataract and Refractive Surgery Unit, Research & Development Department VISSUM Innovation Alicante, Alicante, Spain; Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain
| | - Mark Wilkins
- Department of Ophthalmology, Moorfields Eye Hospital, London, UK
| | - Beatrice Cochener
- Department of Ophthalmology, University Hospital Morvan, Brest, France
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Ophthalmology and Visual Science, Duke-NUS Graduate Medical School, Singapore.
| |
Collapse
|
29
|
Sella R, Zangwill LM, Weinreb RN, Afshari NA. Repeatability and Reproducibility of Corneal Epithelial Thickness Mapping With Spectral-Domain Optical Coherence Tomography in Normal and Diseased Cornea Eyes. Am J Ophthalmol 2019; 197:88-97. [PMID: 30240724 DOI: 10.1016/j.ajo.2018.09.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 09/07/2018] [Accepted: 09/08/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To evaluate the performance of the epithelial thickness mapping (ETM) of the iVue spectral-domain optical coherence tomography (SD-OCT) device (Optovue Inc, Fremont, California, USA) in normal and diseased cornea eyes. DESIGN Reliability and validity analysis. METHODS Sixty eyes of 60 subjects were recruited for the study, which included normal subjects (n = 12) and patients with corneal diseases (12 patients each: dry eye syndrome [DES], contact lens wear, post-laser refractive surgery, and keratoconus). Three repeated scans were acquired on 3 iVue SD-OCTs with device-designated operators from consented subjects. Each subject was scanned on each device. Repeatability (based on random error of repeated scans) and reproducibility (including the random error and the instrument/operator variability) were assessed based on spatial zones derived from a 6-mm-diameter corneal ETM centered on the pupil and compared between the groups. RESULTS Fifty-nine eyes qualified for final analysis. Seventy-one of 598 acquired scans (11.9%) were excluded owing to scan quality concerns. The percentage of disqualified scans was similar across normal (10.7%) and diseased eyes (12.1%). Of 527 qualified scans, 40 (7.6%) scans required manual edits of the segmentation lines. Repeatability and reproducibility results were similar, indicating minimal device/operator variability for both groups. Repeatability and reproducibility were similar in all subgroups of cornea patients, excluding the DES group, for which reproducibility was significantly lower (range 3.2%-5.5% for DES patients and 1.1%-2.9% for normal subjects). CONCLUSIONS The iVue SD-OCT provides good corneal ETM repeatability and reproducibility in normal and diseased cornea eyes through all map zones.
Collapse
|
30
|
Under-the-Flap Crosslinking and LASIK in Early Ectasia with Hyperopic Refractive Error. J Ophthalmol 2018; 2018:4342984. [PMID: 30581603 PMCID: PMC6276485 DOI: 10.1155/2018/4342984] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 10/15/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose To present safety, efficacy, and early results of a new combinational treatment for early corneal ectasia with hyperopic refractive error aimed to reinstate emmetropia and stabilize cornea. Method This is a retrospective case series. All surgeries were performed at the Beirut Eye Specialist Hospital, Lebanon. Surgical procedure consisted of (1) lifting flap (post-LASIK ectasia)/creation of corneal flap (keratoconus), (2) application of excimer laser ablation to correct refractive error, (3) loose repositioning of flap, (4) under-the-flap irrigation with riboflavin 0.1% dextran solution, and (5) application of UVA light. Results A total of 7 eyes (4 patients; mean age 24.25 years; all male) were included. 2 patients had early keratoconus, and 2 patients had early post-LASIK ectasia. Pretreatment vs. last postoperative follow-up visit (mean 11.25 months; range 6–15 months) UDVA (logMAR), spherical equivalent (SE) (D), astigmatism (D), and central pachymetry (µm) were 0.35 ± 0.18 vs. 0.05 ± 0.07, p=0.017; −0.81 ± 0.67 vs. −0.46 ± 0.57, p=0.078; 2.46 ± 0.53 vs. 0.68 ± 0.28, p=0.018; and 547 ± 58 vs. 536 ± 49, p=0.07, respectively. In all eyes, BCVA was 0.1 logMAR or better before and after treatment. No eye showed a decrease in BCVA. Two eyes of one patient had an epithelial ingrowth, which was removed in one case. Follow-up results showed no major complications and no progression of corneal ectasia. Conclusion Early results showed that under-the-flap CXL with excimer laser correction is an effective treatment for early hyperopic keratectasia, with the advantage of rapid recovery, postoperative corneal stability, and no epithelial healing complications. The procedure seems to bear a risk for postoperative epithelial growth into the flap interface.
Collapse
|
31
|
Parafita-Fernández A, García-Gonzalez M, Katsanos A, Gros-Otero J, Teus M. Two Femtosecond Laser LASIK Platforms: Comparison of Evolution of Visual Acuity, Flap Thickness, and Stromal Optical Density. Cornea 2018; 38:98-104. [DOI: 10.1097/ico.0000000000001784] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
32
|
Roesler C, Kohnen T. Changes of Functional Optical Zone After LASIK for Hyperopia and Hyperopic Astigmatism. J Refract Surg 2018; 34:476-481. [PMID: 30001451 DOI: 10.3928/1081597x-20180515-03] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 05/07/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate which factors may influence the size of the postoperative functional optical zone after hyperopic LASIK. METHODS Thirty-three eyes with a mean spherical equivalent of +3.55 ± 1.28 diopters (D) underwent LASIK with a Technolas 217 C-LASIK laser (Bausch & Lomb Surgical, Munich, Germany). After 1 week and 1, 4, and 12 months, the authors examined refraction, corneal refractive power by means of computerized videokeratography (Technomed C-Scan; Baesweiler, Germany), and uncorrected/corrected distance visual acuity (UDVA/CDVA). According to the degree of hyperopia, they were divided into low hyperopia (spherical equivalent ≤ 3.00 D) and high hyperopia (spherical equivalent > 3.00 D) groups. RESULTS One year postoperatively, 82% of all eyes had a UDVA of 0.5 or better; in 88%, the spherical equivalent did not deviate more than 1.00 D from the attempted value. Three eyes were slightly undercorrected. After an initial overcorrection (-0.27 D) with subsequent regression, the refraction remained stable at +0.17 D from the fourth postoperative month (low hyperopia group: +0.14 D; high hyperopia group: +0.19 D after 1 year). After 1 year, the functional optical zone diminished by 32%; the reduction was more pronounced in eyes with higher hyperopia: -1.85 ± 1.09 mm (range: +0.5 to -3.4 mm) in the low hyperopia group (P < .0001) and -2.25 ± 1.24 mm (range: +1 to -3.9 mm) in the high hyperopia group (P < .0001). Preoperative spherical equivalent and preoperative corneal refractive power affected the postoperative size of the functional optical zone additively. CONCLUSIONS An expected small functional optical zone in high hyperopia may not be regarded as a compelling exclusion criterion, but can induce possible side effects such as glare and halos. [J Refract Surg. 2018;34(7):476-481.].
Collapse
|
33
|
Peng MY, Hannan S, Teenan D, Schallhorn SJ, Schallhorn JM. Monovision LASIK in emmetropic presbyopic patients. Clin Ophthalmol 2018; 12:1665-1671. [PMID: 30233129 PMCID: PMC6130303 DOI: 10.2147/opth.s170759] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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 evaluate the efficacy and patient satisfaction of laser in situ keratomileusis (LASIK) monovision correction in presbyopic emmetropic patients. Methods A retrospective review of 294 patients who underwent LASIK for monovision was conducted. All patients had preoperative uncorrected distance visual acuity in each eye of 20/25 or better in both eyes and underwent primary LASIK treatment in one eye with a near target; 82 patients underwent surgery in the distant eye for hypermetropia. Patients completed a patient-reported-outcome questionnaire at their one-month postoperative visit. Analysis was performed on a per patient basis with a logistic regression model. Results Patients achieved a postoperative mean spherical equivalent of -0.05 diopters (D) in the distant eye and -1.92 D in the near eye. Prior to surgery, 64.7% (n=178) of patients reported they were satisfied or very satisfied with their vision; postoperatively, this increased to 85.4% (n=251). The greatest predictor of dissatisfaction after surgery was severe patient-reported visual phenomena (glare, halos, starbursts, ghosting) (odds ratio 1.18, P=0.001). Conclusions LASIK monovision for presbyopic patients with low refractive error and good preoperative uncorrected distance visual acuity is both safe and effective with high patient satisfaction. Patients who were dissatisfied in the postoperative period tended to be those with postoperative visual symptoms.
Collapse
Affiliation(s)
- Michelle Y Peng
- Department of Ophthalmology, University of California, San Francisco, CA, USA,
| | | | | | - Steven J Schallhorn
- Department of Ophthalmology, University of California, San Francisco, CA, USA, .,Carl Zeiss Meditec, CA, USA
| | - Julie M Schallhorn
- Department of Ophthalmology, University of California, San Francisco, CA, USA, .,F.I. Proctor Foundation, University of California, San Francisco, CA, USA,
| |
Collapse
|
34
|
Cabral-Macias J, García-De la Rosa G, Rodríguez-Matilde DF, Vela-Barrera ID, Ledesma-Gil J, Ramirez-Miranda A, Graue-Hernandez EO, Navas A. Pressure-induced stromal keratopathy after laser in situ keratomileusis: Acute and late-onset presentations. J Cataract Refract Surg 2018; 44:1284-1290. [PMID: 30107965 DOI: 10.1016/j.jcrs.2018.06.053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 06/21/2018] [Accepted: 06/22/2018] [Indexed: 12/17/2022]
Abstract
We present a series of 4 cases of pressure-induced stromal keratopathy after laser in situ keratomileusis (LASIK). Four patients (5 eyes) with previous LASIK presented for poor visual acuity and ocular pain because of ocular hypertension. At examination, all cases revealed corneal haze and a space filled with fluid between the surgical flap and the residual stroma. All cases were managed with topical hypotensive treatment and one of them was also treated with a valve drainage device. Topical steroids restriction was indicated in all cases. Intraocular pressure (IOP) was normalized in all cases with subsequent interface fluid resolution and significant improvement of vision in most cases. Early recognition and appropriate treatment for pressure-induced stromal keratopathy is essential to avoid complications associated with prolonged elevated IOP. It is extremely important to measure the IOP in the peripheral cornea because IOP in the central cornea can be incorrectly measured with the characteristic interface fluid developed in this entity.
Collapse
Affiliation(s)
- Jesus Cabral-Macias
- From the Department of Cornea and Refractive Surgery (Cabral-Macias, García-De la Rosa, Rodríguez-Matilde, Vela-Barrera, Ramirez-Miranda, Graue-Hernandez, Graue-Hernandez) and the Department of Glaucoma (Ledesma-Gil), Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico
| | - Guillermo García-De la Rosa
- From the Department of Cornea and Refractive Surgery (Cabral-Macias, García-De la Rosa, Rodríguez-Matilde, Vela-Barrera, Ramirez-Miranda, Graue-Hernandez, Graue-Hernandez) and the Department of Glaucoma (Ledesma-Gil), Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico
| | - Diana F Rodríguez-Matilde
- From the Department of Cornea and Refractive Surgery (Cabral-Macias, García-De la Rosa, Rodríguez-Matilde, Vela-Barrera, Ramirez-Miranda, Graue-Hernandez, Graue-Hernandez) and the Department of Glaucoma (Ledesma-Gil), Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico
| | - Ivan Daryl Vela-Barrera
- From the Department of Cornea and Refractive Surgery (Cabral-Macias, García-De la Rosa, Rodríguez-Matilde, Vela-Barrera, Ramirez-Miranda, Graue-Hernandez, Graue-Hernandez) and the Department of Glaucoma (Ledesma-Gil), Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico
| | - Jasbeth Ledesma-Gil
- From the Department of Cornea and Refractive Surgery (Cabral-Macias, García-De la Rosa, Rodríguez-Matilde, Vela-Barrera, Ramirez-Miranda, Graue-Hernandez, Graue-Hernandez) and the Department of Glaucoma (Ledesma-Gil), Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico
| | - Arturo Ramirez-Miranda
- From the Department of Cornea and Refractive Surgery (Cabral-Macias, García-De la Rosa, Rodríguez-Matilde, Vela-Barrera, Ramirez-Miranda, Graue-Hernandez, Graue-Hernandez) and the Department of Glaucoma (Ledesma-Gil), Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico
| | - Enrique O Graue-Hernandez
- From the Department of Cornea and Refractive Surgery (Cabral-Macias, García-De la Rosa, Rodríguez-Matilde, Vela-Barrera, Ramirez-Miranda, Graue-Hernandez, Graue-Hernandez) and the Department of Glaucoma (Ledesma-Gil), Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico
| | - Alejandro Navas
- From the Department of Cornea and Refractive Surgery (Cabral-Macias, García-De la Rosa, Rodríguez-Matilde, Vela-Barrera, Ramirez-Miranda, Graue-Hernandez, Graue-Hernandez) and the Department of Glaucoma (Ledesma-Gil), Instituto de Oftalmología Conde de Valenciana, Mexico City, Mexico.
| |
Collapse
|
35
|
Garcia-Gonzalez M, Iglesias-Iglesias M, Drake Rodriguez-Casanova P, Gros-Otero J, Teus MA. Femtosecond Laser-Assisted LASIK With and Without the Adjuvant Use of Mitomycin C to Correct Hyperopia. J Refract Surg 2018; 34:23-28. [PMID: 29315438 DOI: 10.3928/1081597x-20171116-01] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 11/09/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the visual and refractive results of femtosecond laser-assisted LASIK (FS-LASIK) with and without the adjuvant use of mitomycin C (MMC) to correct hyperopia. METHODS A total of 152 consecutive hyperopic eyes were included in this retrospective, observational cohort study, comparing 76 eyes treated with FS-LASIK + MMC with 76 age- and refraction-matched eyes treated with FS-LASIK without MMC. Visual and refractive results were evaluated 1 day, 1 week, and 1, 3, 6, and 15 months postoperatively. RESULTS Preoperative mean spherical equivalent was +3.27 diopters (D) versus +3.50 D in the MMC and no MMC groups, respectively (P > .05). Three months postoperatively, uncorrected distance visual acuity was significantly better in the MMC group (0.93 ± 0.2) than in the no MMC group (0.87 ± 0.2) (P = .01). The residual spherical equivalent was significantly lower in the MMC group (+0.18 ± 0.40 D) than in the no MMC group (+0.42 ± 0.50 D) (P = .01). Fifteen months postoperatively, including re-treated eyes, no significant differences were found in uncorrected distance visual acuity, corrected distance visual acuity, and residual refraction. Slightly better outcomes were found in the MMC group in terms of efficacy, safety, and predictability; however, these small differences were not statistically significant. The incidence of re-treatments during the 15-month follow-up was significantly lower in the MMC group than in the no MMC group (6.6% vs 10.5%, respectively) (P = .01). CONCLUSIONS FS-LASIK with or without the intraoperative use of MMC is safe and effective to correct hyperopia. However, slightly better refractive outcomes and a lower incidence of re-treatments were observed when intraoperative MMC was used, at least in a 15-month follow-up. [J Refract Surg. 2018;34(1):23-28.].
Collapse
|
36
|
Reinstein DZ, Carp GI, Archer TJ, Buick T, Gobbe M, Rowe EL, Jukic M, Brandon E, Moore J, Moore T. LASIK for the Correction of High Hyperopic Astigmatism With Epithelial Thickness Monitoring. J Refract Surg 2018; 33:314-321. [PMID: 28486722 DOI: 10.3928/1081597x-20170111-04] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE To evaluate outcomes of high hyperopic LASIK using the MEL 80 excimer laser (Carl Zeiss Meditec, Jena, Germany). METHODS Retrospective analysis of 830 consecutive high hyperopic LASIK procedures using the MEL 80 excimer laser and either the VisuMax femtosecond laser (Carl Zeiss Meditec) or zero compression Hansatome microkeratome (Bausch & Lomb, Rochester, NY). Inclusion criteria were attempted hyperopic correction of +4.00 diopters [D] or higher in one axis and corrected distance visual acuity (CDVA) of 20/20 or better. Patients were observed for a minimum of 1 year. Epithelial thickness monitoring by Artemis very high-frequency (VHF) digital ultrasound (ArcScan Inc., Morrison, CO) was used to evaluate potential for further steepening as a re-treatment. RESULTS One-year data were available for 785 eyes. Mean attempted spherical equivalent refraction (SEQ) was +4.52 ± 0.84 D (range: +2.00 to +6.96 D) for the primary treatment and mean cylinder was 1.05 ± 0.86 D (range: 0.00 to 5.25 D). Mean age was 50 ± 12 years (range: 18 to 70 years) and 61% were women. Postoperative SEQ was ±0.50 D in 50% and ±1.00 D in 77% of eyes after primary treatment. After re-treatment, 67% of eyes were within ±0.50 D and 89% were within ±1.00 D. Uncorrected distance visual acuity was 20/20 or better in 76% of eyes after final treatment. One line of CDVA was lost in 25% of eyes and two lines were lost in 0.4%. There was a clinically insignificant but statistically significant decrease (P < .05) in contrast sensitivity (CSV-1000) by less than 1 log unit at 3 and 6 cycles per degree (cpd) and by 1 log unit at 12 and 18 cpd. Diurnal fluctuation in refraction was identified in 2 eyes, proven by VHF digital ultrasound to be due to diurnal epithelial remodeling overnight and unrelated to maximum postoperative keratometry induced. CONCLUSIONS LASIK for hyperopia by cumulative treatment of up to +8.33 D with the MEL 80 excimer laser was found to satisfy accepted criteria for safety, efficacy, and stability when applying specialized protocols, including epithelial monitoring. [J Refract Surg. 2017;33(5):314-321.].
Collapse
|
37
|
Corneal Stability following Hyperopic LASIK with Advanced Laser Ablation Profiles Analyzed by a Light Propagation Study. J Ophthalmol 2018; 2018:3060939. [PMID: 29785300 PMCID: PMC5896223 DOI: 10.1155/2018/3060939] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 01/23/2018] [Indexed: 11/17/2022] Open
Abstract
Purpose To assess anterior corneal surface stability 12 months following hyperopic LASIK correction with a light propagation algorithm. Setting Vissum Instituto Oftalmológico de Alicante, Universidad Miguel Hernández, Alicante, Spain. Methods This retrospective consecutive observational study includes 37 eyes of 37 patients treated with 6th-generation excimer laser platform (Schwind Amaris). Hyperopic LASIK was performed in all of them by the same surgeon (JLA) and completed 12-month follow-up. Corneal topography was analyzed with a light propagation algorithm, to assess the stability of the corneal outcomes along one year of follow-up. Results Between three and twelve months postoperatively, an objective corneal power (OCP) regression of 0.39 D and 0.41 D was found for 6 mm and 9 mm central corneal zone, respectively. Subjective outcomes at the end of the follow-up period were as follows: 65% of eyes had spherical equivalent within ±0.50 D. 70% of eyes had an uncorrected distance visual acuity 20/20 or better. 86% of eyes had the same or better corrected distance visual acuity. In terms of stability, 0.14 D of regression was found. No statistically significant differences were found for all the study parameters evaluated at different postoperative moments over the 12-month period. Conclusions Light propagation analysis confirms corneal surface stability following modern hyperopic LASIK with a 6th-generation excimer laser technology over a 12-month period.
Collapse
|
38
|
Vinciguerra P, Camesasca FI, Morenghi E, Azzolini C, Pagano L, Trazza S, Vinciguerra R. Corneal Apical Scar After Hyperopic Excimer Laser Refractive Surgery: Long-term Follow-up of Treatment With Sequential Customized Therapeutic Keratectomy. J Refract Surg 2018; 34:113-120. [DOI: 10.3928/1081597x-20171214-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 12/08/2017] [Indexed: 11/20/2022]
|
39
|
Hashmani S, Hashmani N, Haroon H, Hashmi Y. Visual and Refractive Outcomes of Topography-guided Laser-assisted In Situ Keratomileusis in Virgin Eyes. Cureus 2018; 10:e2131. [PMID: 29610714 PMCID: PMC5878097 DOI: 10.7759/cureus.2131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Introduction We wanted to assess the efficacy, predictability, and stability of topography-guided, laser-assisted in situ keratomileusis (TGL) on normal untreated eyes with a preoperative best corrected visual acuity (BCVA) of 20/20. Methods This was a retrospective, non-randomized, and single arm study evaluating the outcomes of TGL in eyes with a preoperative BCVA of 20/20. We included 50 eyes of 50 patients who presented to the Hashmanis Hospital, Pakistan and were followed for six months postoperatively. All eyes underwent treatment using the Alcon Wavelight Allegro Topolyzer (Alcon Laboratories, Inc., TX, USA). Results The mean preoperative sphere, cylinder, and spherical equivalent (SE) values were -4.3 ± 1.6 dioptres (D), -1.0 ± 0.8 D, and -4.8 ± 1.8 D. On day one these values were 0.2 ± 0.8 D, -0.5 ± 0.3, and 0.3 ± 0.8, respectively, and on month six they were -0.1 ± 0.6, -0.5 ± 0.3, and -0.4 ± 0.6 D, respectively. On postoperative day one and month six, 86% and 94% of eyes had a UCVA of 20/20 or better, respectively. Two eyes (4%) had an SE change of greater than 0.5 D from three to six months. Conclusion Our study demonstrates good efficacy, predictability, and stability of eyes undergoing TGL with a follow-up of six months.
Collapse
Affiliation(s)
- Sharif Hashmani
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital
| | - Nauman Hashmani
- Department of Ophthalmology and Visual Sciences, Hashmanis Hospital
| | | | | |
Collapse
|
40
|
Fan R, Chan TCY, Prakash G, Jhanji V. Applications of corneal topography and tomography: a review. Clin Exp Ophthalmol 2018; 46:133-146. [DOI: 10.1111/ceo.13136] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 12/10/2017] [Accepted: 12/14/2017] [Indexed: 12/25/2022]
Affiliation(s)
- Rachel Fan
- Faculty of Medicine; The University of Hong Kong; Hong Kong
| | - Tommy CY Chan
- Department of Ophthalmology & Visual Sciences; The Chinese University of Hong Kong; Hong Kong
| | - Gaurav Prakash
- NMC Eye Care; NMC Specialty Hospital; Abu Dhabi United Arab Emirates
| | - Vishal Jhanji
- Department of Ophthalmology & Visual Sciences; The Chinese University of Hong Kong; Hong Kong
- Department of Ophthalmology; University of Pittsburgh School of Medicine; Pittsburgh Pennsylvania USA
- Centre for Eye Research Australia; University of Melbourne; Melbourne Victoria Australia
| |
Collapse
|
41
|
Garcia-Gonzalez M, Bouza-Miguens C, Parafita-Fernandez A, Gros-Otero J, Cañones-Zafra R, Villa-Collar C, Teus MA. Comparison of visual outcomes and flap morphology using 2 femtosecond-laser platforms. J Cataract Refract Surg 2018; 44:78-84. [DOI: 10.1016/j.jcrs.2017.10.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 10/18/2017] [Accepted: 10/20/2017] [Indexed: 10/17/2022]
|
42
|
The quality of systematic reviews about interventions for refractive error can be improved: a review of systematic reviews. BMC Ophthalmol 2017; 17:164. [PMID: 28870179 PMCID: PMC5584039 DOI: 10.1186/s12886-017-0561-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 08/30/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Systematic reviews should inform American Academy of Ophthalmology (AAO) Preferred Practice Pattern® (PPP) guidelines. The quality of systematic reviews related to the forthcoming Preferred Practice Pattern® guideline (PPP) Refractive Errors & Refractive Surgery is unknown. We sought to identify reliable systematic reviews to assist the AAO Refractive Errors & Refractive Surgery PPP. METHODS Systematic reviews were eligible if they evaluated the effectiveness or safety of interventions included in the 2012 PPP Refractive Errors & Refractive Surgery. To identify potentially eligible systematic reviews, we searched the Cochrane Eyes and Vision United States Satellite database of systematic reviews. Two authors identified eligible reviews and abstracted information about the characteristics and quality of the reviews independently using the Systematic Review Data Repository. We classified systematic reviews as "reliable" when they (1) defined criteria for the selection of studies, (2) conducted comprehensive literature searches for eligible studies, (3) assessed the methodological quality (risk of bias) of the included studies, (4) used appropriate methods for meta-analyses (which we assessed only when meta-analyses were reported), (5) presented conclusions that were supported by the evidence provided in the review. RESULTS We identified 124 systematic reviews related to refractive error; 39 met our eligibility criteria, of which we classified 11 to be reliable. Systematic reviews classified as unreliable did not define the criteria for selecting studies (5; 13%), did not assess methodological rigor (10; 26%), did not conduct comprehensive searches (17; 44%), or used inappropriate quantitative methods (3; 8%). The 11 reliable reviews were published between 2002 and 2016. They included 0 to 23 studies (median = 9) and analyzed 0 to 4696 participants (median = 666). Seven reliable reviews (64%) assessed surgical interventions. CONCLUSIONS Most systematic reviews of interventions for refractive error are low methodological quality. Following widely accepted guidance, such as Cochrane or Institute of Medicine standards for conducting systematic reviews, would contribute to improved patient care and inform future research.
Collapse
|
43
|
Kamiya K, Igarashi A, Hayashi K, Negishi K, Sato M, Bissen-Miyajima H. A Multicenter Retrospective Survey of Refractive Surgery in 78,248 Eyes. J Refract Surg 2017; 33:598-602. [PMID: 28880334 DOI: 10.3928/1081597x-20170621-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 05/24/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To retrospectively evaluate the current practice, trends, and outcomes of refractive surgery in Japan. METHODS This multicenter survey comprised 78,248 eyes of 39,727 consecutive patients who underwent refractive surgery at 45 major institutions in Japan. The corresponding ophthalmologists responded to a selfadministered questionnaire. The authors especially evaluated the safety, efficacy, predictability, stability, and adverse events of LASIK and phakic intraocular lens (IOL) implantation 3 months postoperatively. RESULTS The most common refractive surgery was LASIK (90.9%), followed by corneal inlay (5.0%), posterior chamber phakic IOL implantation (1.3%), laser-assisted subepithelial keratomileusis (1.0%), refractive lens exchange (0.9%), photorefractive keratectomy (0.3%), and refractive lenticule extraction (0.2%). For subgroup analysis, 69,987 eyes (99.5%) and 67,512 eyes (95.9%) achieved corrected and uncorrected distance visual acuity of 20/20 or better, respectively, after LASIK, and 935 eyes (98.8%) and 890 eyes (94.1%), respectively, after phakic IOL implantation. There were 69,176 eyes (98.3%) and 908 eyes (96.0%) within ±1.00 diopter (D) of the attempted correction after LASIK and phakic IOL implantation, respectively. There were 1,926 eyes (2.7%) and 1 eye (0.1%) with changes in refraction of 1.00 D or less from 1 week to 3 months after LASIK and phakic IOL implantation, respectively. No vision-threatening complications occurred in any case. CONCLUSIONS According to this survey, LASIK remains the most prevalent surgical technique in Japan. Both LASIK and phakic IOL implantation offered good safety and efficacy outcomes, yielding predictable and stable results. [J Refract Surg. 2017;33(9):598-602.].
Collapse
|
44
|
Induced De Novo Astigmatism After Hyperopic LASIK Versus Myopic LASIK Surgery in Nonastigmatic Eyes. Cornea 2017; 36:1040-1043. [PMID: 28777775 DOI: 10.1097/ico.0000000000001253] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To compare the astigmatism induced surgically (SIA) by spherical hyperopic laser in situ keratomileusis (H-LASIK) versus myopic laser in situ keratomileusis (M-LASIK) in nonastigmatic eyes. METHODS A retrospective study of patients who underwent LASIK surgery between 2005 and 2014 at the Care-Vision Laser Center, Israel. We calculated the mean absolute SIA and performed risk factor analysis for induced astigmatism. Differences between H-LASIK and M-LASIK were analyzed. RESULTS Eyes of 3877 patients who underwent M-LASIK and of 549 patients who underwent H-LASIK were nonastigmatic preoperatively and received a nonastigmatic treatment. Three months after surgery, hyperopic treatment induced more SIA (0.49 ± 0.48 D) than did myopic treatment (0.36 ± 0.4 D) (P < 0.001). In the H-LASIK group, the risk factors for induced astigmatism of >0.5 D were a higher preoperative refractive error (P = 0.003) and larger optical zone (7 vs. 6 mm). In the M-LASIK group, eyes with SIA >0.5 D tended to have steeper corneas preoperatively (43.8 ± 1.5 vs. 43.6 ± 1.4 D; P = 0.001), a higher spherical equivalent (-3.43 ± 1.53 Vs. -3.07 ± 1.45 P < 0.001), and smaller treatment zones (6 vs. 7 mm). In H-LASIK, the mean induced astigmatic axis was at 74.6 degrees. CONCLUSIONS There was a consistent trend toward more SIA in H-LASIK and in higher refractive error correction. In H-LASIK larger optical zones induce more SIA and in M-LASIK smaller ones caused it.
Collapse
|
45
|
|
46
|
Efficacy and perioperative timing of bromfenac in the management of ocular discomfort after femtosecond laser-assisted laser in situ keratomileusis. J Cataract Refract Surg 2017; 43:183-188. [PMID: 28366364 DOI: 10.1016/j.jcrs.2016.11.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 10/17/2016] [Accepted: 11/14/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the safety, efficacy, and appropriate perioperative timing of the use of topical bromfenac ophthalmic solution 0.07% after femtosecond laser-assisted laser in situ keratomileusis (LASIK). SETTING Keil LASIK Vision Center, Grand Rapids, Michigan, USA. DESIGN Prospective case series. METHODS Ocular discomfort was assessed 1, 2, and 5 hours postoperatively and the following morning using the Ocular Comfort Grading Assessment in patients treated with topical bromfenac 0.07% or artificial tears just before, just after, or before and after femtosecond laser-assisted LASIK. Visual outcomes and complications were noted up to 24 hours. RESULTS The study enrolled 64 patients (120 eyes). Patients who were treated with bromfenac 0.07% just before or before and after femtosecond laser-assisted LASIK showed the greatest statistically significant decrease in several discomfort scores within the first few hours in comparison with the control group. Two hours after surgery, the majority of patients who were treated before and after LASIK were sleeping comfortably. There were no significant differences in visual acuity; 1 day postoperatively, the uncorrected distance visual acuity was 20/20 in 106 eyes (89%) and 20/25 or better in 116 eyes (97%). At 3 months, all patients had binocular distance visual acuity of 20/20 or better and 86% of patients had 20/15 or better. CONCLUSION Ocular discomfort after femtosecond laser-assisted LASIK was reduced with a single dose of topical bromfenac 0.07% given immediately before surgery or given just before and after surgery and was typically minimal in all groups the morning after surgery.
Collapse
|
47
|
El-Naggar MT, Hovaghimian DG. Assessment of refractive outcome of femtosecond-assisted LASIK for hyperopia correction. Electron Physician 2017; 9:3958-3965. [PMID: 28461870 PMCID: PMC5407228 DOI: 10.19082/3958] [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: 10/02/2016] [Accepted: 02/18/2017] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Laser vision correction for hyperopia is challenging. The purpose of the study was to assess the refractive outcomes of femtosecond-assisted laser in situ keratomileusis (LASIK) for hyperopic correction using wavefront-optimized ablation profiles. METHODS This retrospective case series study included 20 Egyptian patients (40 eyes) with hyperopia or hyperopic astigmatism with a mean manifest refraction spherical equivalent (MRSE) of +2.55D±1.17 (range from +1.00 to +6.00) who had uneventful femtosecond-a assisted LASIK with wavefront-optimized aspheric ablation profile using refractive surgery suite (WaveLight FS200 Femtosecond Laser and WaveLight EX500 Excimer Laser) performed in the Research Institute of Ophthalmology and International Eye Hospital, Giza, Egypt. Statistical analysis was done using Microsoft Excel (Microsoft Corporation, Seattle, WA, USA). RESULTS The procedure significantly reduced the MRSE and cylinder post-operatively (95% were ± 0.50D and 100% ± 1.00 D), with stability of refraction and UDVA over the follow-up period (up to 12 months) after surgery. No eye lost any line of the CDVA, which reflects the excellent safety profile of the procedure; on the other hand, one eye (5%) gained one line and one eye (5%) even gained two lines. There were no significant complications during the procedure. CONCLUSIONS Femtosecond-assisted laser in situ keratomileusis for hyperopia showed predictable, effective, and safe refractive outcomes that were stable through 12 months. Longer follow-up period is required to detect any further regression.
Collapse
|
48
|
Role of percent peripheral tissue ablated on refractive outcomes following hyperopic LASIK. PLoS One 2017; 12:e0170559. [PMID: 28151939 PMCID: PMC5289449 DOI: 10.1371/journal.pone.0170559] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 01/06/2017] [Indexed: 11/19/2022] Open
Abstract
Objectives To determine the effect of hyperopic laser in situ keratomileusis (H-LASIK) on corneal integrity, by investigating relationships between proportionate corneal tissue ablated and refractive outcomes at 3 months. Methods 18 eyes of 18 subjects treated with H-LASIK by Technolas 217c Excimer Laser were included in the study. Orbscan II Topography System was used to determine corneal volume and pachymetry 3mm temporally (3T). The volume of corneal tissue ablated was determined from the laser nomogram. Univariate associations between age, treatment, corneal volume, overall proportion of tissue removed, proportion of tissue removed at 3T, residual bed thickness at 3T and refractive outcomes 3 months post-LASIK were examined and independent factors associated with refractive outcomes determined using linear regression models. Results At 3 months post-LASIK, the mean difference to expected refractive outcome was -0.20 ± 0.64 (Range -2.00 to +1.00). In univariate analysis, difference to expected refractive outcome was associated with proportion of tissue removed at 3T (P<0.01, r = -0.605) and total number of pulses (P< 0.05, r = -0.574). In multivariable analysis, difference to expected refractive outcome was associated with the proportion of tissue removed at 3T only. Conclusion Subjects undergoing H-LASIK, may present as either over or under-corrected at 3 months. The proportion of tissue removed at 3T was the single significant determinant of this outcome, suggesting unexpected biomechanical alterations resulting in corneal steepening. Future hyperopic LASIK procedures could consider proportionate volume of corneal tissue removed at 3T in addition to laser nomograms to achieve improved refractive outcomes.
Collapse
|
49
|
Jo J, Park JH, Tchah HW, Kim MJ. Management of Complication after Hyperopic Laser-assisted in-situKeratomileusis. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.3.337] [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)
- Jaehyuck Jo
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Hyoung Park
- MISOEYE Clinic, Seoul, Korea
- Biomedical Research Center, Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, Korea
| | - Hung Won Tchah
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Myoung Joon Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
50
|
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]
|