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Mostafa MM, Abdelmotaal H, Abdelazeem K, Goda I, Abdel-Radi M. Q-value customized versus wavefront-optimized ablation in femtosecond laser-assisted LASIK for myopia and myopic astigmatism: a prospective contralateral comparative study. EYE AND VISION (LONDON, ENGLAND) 2022; 9:43. [PMID: 36320050 PMCID: PMC9628024 DOI: 10.1186/s40662-022-00312-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 10/11/2022] [Indexed: 11/05/2022]
Abstract
Background Corneal refractive surgery for myopia results in an oblate shift with increased postoperative aberrations inversely affecting the quality of vision. Aspheric ablation profiles have been introduced to minimize such a problem. The aim of this study was to compare changes in corneal asphericity, central and mid-peripheral pachymetry between the Q-value customized and the wavefront-optimized (WFO) ablation profiles.
Methods A prospective, comparative non-randomized fellow eye study was conducted. Eighty eyes of 40 eligible patients underwent femtosecond laser-assisted laser in situ keratomileusis for myopia and myopic astigmatism. In each patient, the more myopic eye was included in the custom-Q ablation experimental group and the other less myopic eye was included in the WFO control group. For the custom-Q group, the target asphericity was set to the preoperative Q-value. Corneal asphericity, central and mid-peripheral pachymetric changes and the root mean square of corneal higher-order aberrations (RMSh) were assessed 6 months following surgery. Visual and refractive outcomes were also evaluated in both platforms 6 months postoperatively. Results The mean preoperative refractive spherical equivalent was significantly more myopic in the custom-Q group than in the WFO group (P = 0.001). The mean Q-value changed from − 0.2 ± 0.1 to 0.6 ± 0.7 and from − 0.2 ± 0.1 to 0.4 ± 0.5 in the custom-Q and WFO groups, respectively. The oblate shift in corneal asphericity was not significantly different between both treatment groups (P = 0.094). The mean ablation depth at the pupillary center was significantly greater in the custom-Q group (P = 0.011), while there was no significant difference at the mid-peripheral pachymetry (P = 0.256). The RMSh significantly increased in both treatment profiles (P < 0.001) with no significant difference between the two groups (P = 0.06). The uncorrected distance visual acuity (UDVA) and the manifest refraction spherical equivalents (MRSE) significantly improved in both treatment groups (P < 0.001). Conclusions The custom-Q treatment profile with target asphericity set at the preoperative Q-value achieved comparable outcomes vs. the WFO profile in terms of postoperative corneal asphericity and mid-peripheral pachymetry despite the greater amount of ablation, the smaller optical zone, and the resulting increase in postoperative corneal flattening in the custom-Q group. Trial registration (Clinicaltrials.gov): NCT04738903, 4 February 2021- Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04738903
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Affiliation(s)
- Magdi Mohammad Mostafa
- Department of Ophthalmology, Assiut University Hospital, Assiut University, Sixth Floor, Assiut, 71516, Egypt
| | - Hazem Abdelmotaal
- Department of Ophthalmology, Assiut University Hospital, Assiut University, Sixth Floor, Assiut, 71516, Egypt
| | - Khaled Abdelazeem
- Department of Ophthalmology, Assiut University Hospital, Assiut University, Sixth Floor, Assiut, 71516, Egypt
| | - Islam Goda
- Department of Ophthalmology, Assiut University Hospital, Assiut University, Sixth Floor, Assiut, 71516, Egypt
| | - Mahmoud Abdel-Radi
- Department of Ophthalmology, Assiut University Hospital, Assiut University, Sixth Floor, Assiut, 71516, Egypt.
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He Y, Liu L, Vincent SJ. Compression Factor and Visual Performance in Adults Treated With Orthokeratology. Eye Contact Lens 2021; 47:413-419. [PMID: 33974574 DOI: 10.1097/icl.0000000000000796] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To investigate the effect of compression factor on visual performance in orthokeratology (ortho-k). METHODS Myopic adults were fitted with ortho-k lenses with either a 0.75 diopter (D) or 1.75 D compression factor. Higher-order aberrations (HOAs), corneal topography, and responses to the National Eye Institute/Refractive Error Quality of Life Instrument-42 questionnaire were measured at baseline and 6-month and 12-month follow-up along with a satisfaction questionnaire. Subjective refraction, high-contrast, and low-contrast visual acuity were measured at baseline and 1-day, 1-week, 6-month, and 12-month follow-up. RESULTS Forty-four myopic (mean spherical equivalent refraction: -3.66±0.84 D) adults (median age 25 years) completed the 12-month follow-up. After ortho-k lens wear, levels of satisfaction of vision after waking were significantly higher than vision before sleep for both compression factors (both P<0.01). The increased compression factor (ICF) resulted in less myopia at the 1-week visit (P=0.04) and better high-contrast unaided visual acuity at the 1-day visit (P=0.03) compared with the conventional compression factor (CCF). No other significant differences were observed for the compression factor for treatment zone diameter, lens decentration, or any subjective measurements. Individual HOA terms , , , and were significantly higher in the CCF group (0.75 D) (all P<0.05). The HOA visual Strehl ratio decreased significantly after lens wear (P<0.001) but did not vary with the compression factor. CONCLUSIONS An ICF did not result in clinically significant differences in subjective refraction, visual acuity, unaided vision, or the total ocular HOA profile compared with a CCF (0.75 D) in myopic adults after long-term ortho-k lens wear.
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Affiliation(s)
- Yuanhao He
- Department of Optometry and Visual Science (Y.H.), West China School of Medicine, Sichuan University, Chengdu, China; Department of Ophthalmology (L.L.), West China Hospital, Sichuan University, Chengdu, China; and Contact Lens and Visual Optics Laboratory (S.J.V.), Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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Accuracy of the posterior corneal elevation values of Pentacam HR from different reference surfaces in early ectasia diagnosis. Int Ophthalmol 2020; 41:629-638. [PMID: 33095345 DOI: 10.1007/s10792-020-01618-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Detecting the accuracy of various posterior elevation (PE) indices of Pentacam HR, and correlating them with some possibly related factors or parameters, in a cohort with early keratoconus (KC). METHODS A cross sectional study that was conducted at Eye World Hospital, Egypt. One hundred and two corneas were enrolled, including two groups; group 1 (50 corneas) having forme fruste or early KC, and group 2 (52 corneas) for healthy controls. Corneas were scanned using Pentacam HR (Oculus, Wetzlar, Germany). The investigated PE parameters were: PE from best fit sphere (BFS), PE from best fit toric ellipsoid (BFTE), PE from exclusion map of Belin Ambrosio's display (BAD), and PE from difference map of BAD. The four PE values were correlated to age, thinnest corneal thickness "TCT," posterior aberrations, and posterior Q value. RESULTS All the investigated indices were significantly different in group 1 compared to group 2 (p < 0.001). Accuracy of PE parameters revealed the highest AUROC for PE from BFTE (AUROC = 0.989, and best cutoff > 4 um with sensitivity 96.00% and specificity 96.15%). PE from difference map was the least accurate. Correlation coefficients showed a significant correlation between all the studied PE parameters and some of the posterior aberrations (root mean square of higher order aberrations, vertical coma, and spherical aberrations), besides a significant correlation with posterior Q value. CONCLUSION PE indices are sensitive detectors of early ectasia. PE from BFTE had the highest deduced AUROC. Alterations in PE values can significantly alter many posterior corneal aberrations and the posterior Q.
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Xiong Y, Li J, Wang N, Liu X, Wang Z, Tsai FF, Wan X. The analysis of corneal asphericity (Q value) and its related factors of 1,683 Chinese eyes older than 30 years. PLoS One 2017; 12:e0176913. [PMID: 28545078 PMCID: PMC5436654 DOI: 10.1371/journal.pone.0176913] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 04/19/2017] [Indexed: 11/20/2022] Open
Abstract
Purpose To determine corneal Q value and its related factors in Chinese subjects older than 30 years. Design Cross sectional study. Methods 1,683 participants (1,683 eyes) from the Handan Eye Study were involved, including 955 female and 728 male with average age of 53.64 years old (range from 30 to 107 years). The corneal Q values of anterior and posterior surfaces were measured at 3.0, 5.0 and 7.0mm aperture diameters using Bausch & Lomb Orbscan IIz (software version 3.12). Age, gender and refractive power were recorded. Results The average Q values of the anterior surface at 3.0, 5.0 and 7.0mm aperture diameters were -0.28±0.18, -0.28±0.18, and -0.29±0.18, respectively. The average Q value of the anterior surface at the 5.0mm aperture diameter was negatively correlated with age (B = -0.003, p<0.01) and the refractive power (B = -0.013, p = 0.016). The average Q values of the posterior surface at 3.0, 5.0, and 7.0mm were -0.26±0.216, -0.26±0.214, and -0.26±0.215, respectively. The average Q value of the posterior surface at the 5.0mm aperture diameter was positively correlated with age (B = 0.002, p = 0.036) and the refractive power (B = 0.016, p = 0.043). Conclusion The corneal Q value of the elderly Chinese subjects is different from that of previously reported European and American subjects, and the Q value appears to be correlated with age and refractive power.
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Affiliation(s)
- Ying Xiong
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jing Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Ophthalmology and Visual Science, Capital Medical University, Beijing, China
| | - Xue Liu
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Ophthalmology and Visual Science, Capital Medical University, Beijing, China
| | - Zhao Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Frank F. Tsai
- Sharp Rees-Stealy Medical Group, San Diego, CA, United States of America
| | - Xiuhua Wan
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Ophthalmology and Visual Science, Capital Medical University, Beijing, China
- * E-mail:
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Pahuja NK, Shetty R, Sinha Roy A, Thakkar MM, Jayadev C, Nuijts RMMA, Nagaraja H. Laser Vision Correction with Q Factor Modification for Keratoconus Management. Curr Eye Res 2016; 42:542-548. [DOI: 10.1080/02713683.2016.1221978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Rohit Shetty
- Narayana Nethralaya Eye Institute, Rajajinagar, Bangalore, Karnataka, India
| | - Abhijit Sinha Roy
- Imaging, Biomechanics and Mathematical Modeling Solutions, Narayana Nethralaya Foundation, Bangalore, India
| | | | - Chaitra Jayadev
- Narayana Nethralaya Eye Institute, Rajajinagar, Bangalore, Karnataka, India
| | - Rudy MMA Nuijts
- Academic Hospital, Maastricht University, MD, Maastricht, The Netherlands
| | - Harsha Nagaraja
- Narayana Nethralaya Eye Institute, Rajajinagar, Bangalore, Karnataka, India
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