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Long Term Follow-Up Safety and Effectiveness of Myopia Refractive Surgery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238729. [PMID: 33255392 PMCID: PMC7727822 DOI: 10.3390/ijerph17238729] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/18/2020] [Accepted: 11/22/2020] [Indexed: 12/19/2022]
Abstract
(1) Background: Refractive surgery is an increasingly popular procedure for decreasing spectacle or contact lens dependency. The two most common surgical techniques to correct myopia are photorefractive keratectomy (PRK) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK). This study demonstrates the long-term effectiveness, safety, and predictability of both techniques for the refractive surgery of myopia. (2) Methods: A retrospective non-randomized study was performed. We followed 509 PRK eyes and 310 FS-LASIK surgeries for ten years. Patients were followed-up after 3 months and after 1, 2, 5, and 10 years, gathering data on their uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA). The safety index of both procedures was defined as the quotient between the postoperative BCVA and the preoperative BCVA. We defined a procedure as safe if this quotient was equal to or greater than 1. The effectiveness index was calculated as the quotient between postoperative UCVA divided by the preoperative BCVA. (3) Results: The safety index was higher than 1 (1.09) and an effectiveness index of 0.82 after ten years of surgery in both groups was found. (4) Conclusion: These data demonstrated excellent safety and effectiveness indices for both techniques, although FS-LASIK is a technique with better safety and effectiveness indices than PRK.
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Ozulken K, Gokce SE. Evaluation of the effect of optic zone diameter selection on high-order aberrations in photorefractive keratectomy excimer laser treatment. Lasers Med Sci 2020; 35:1543-1547. [DOI: 10.1007/s10103-020-02948-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 01/02/2020] [Indexed: 11/29/2022]
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Özülken K, Kaderli A. The effect of different optical zone diameters on the results of high-order aberrations in femto-laser-assisted in situ keratomileusis. Eur J Ophthalmol 2019; 30:1272-1277. [PMID: 31353955 DOI: 10.1177/1120672119865688] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate the postoperative high-order aberration differences of femto-LASIK surgery in 6.5 and 7 mm optic zones. PATIENTS AND METHODS We retrospectively reviewed 80 eyes of 40 patients with myopia or myopia with astigmatism who underwent femtosecond LASIK surgery. Q values, z3, 3 (h. trefoil), z3, -3 (v. trefoil), z3, 1 (h. coma), z3, -1 (vertical coma), z4, 0 (spherical aberration), z5, -1 (second other v. coma), aberration coefficients were evaluated 3 months after surgery. Central corneal thicknesses, intraocular pressures, patient ages and genders, optical zone diameters and ablation depths are collected from patients' medical records. RESULTS The mean age was 28.4 ± 0.69 years (range, 20-47 years). Lower z4, 0 spherical aberrations and aberration coefficient values were associated with larger optical zones (7 mm) (z4, 0 spherical aberrations = 1.25, p = 0.01; coefficient value = -1.21, p < 0.01). Although a smaller optical zone (6.5 mm) was associated with an increase in most of the wave-front aberration variables, measurements were not statistically different between the two groups other than z4, 0 spherical aberrations and aberration coefficients. DISCUSSION LASIK treatment with 6.5 and 7 mm optical zones is safe and effective for correcting myopia and myopic astigmatism and has statistically similar visual outcomes. Moreover, larger optical zone (7 mm) was found to be associated with lower spherical aberration induction and smaller aberration coefficient values compared to 6.5 mm optical zone. This can be important for decision-making in femto-LASIK surgery for better postoperative results.
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Zhou J, Xu Y, Li M, Knorz MC, Zhou X. Preoperative refraction, age and optical zone as predictors of optical and visual quality after advanced surface ablation in patients with high myopia: a cross-sectional study. BMJ Open 2018; 8:e023877. [PMID: 29866738 PMCID: PMC5988164 DOI: 10.1136/bmjopen-2018-023877] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To investigate the factors associated with optical and visual quality of advanced surface ablation in high myopia. DESIGN A cross-sectional study of high myopic eyes treated with laser epithelial keratomileusis (LASEK)/epipolis laser in situ keratomileusis (Epi-LASIK). SETTING6: Eye and ENT Hospital of Fudan University in Shanghai. METHODS One hundred and thirty-eight high myopic eyes (138 patients) (myopia -6 D or more) were examined more than 12 months after LASEK or Epi-LASIK with advanced surface ablation on the MEL 80 excimer laser (Zeiss AG, Jena, Germany). Refraction, higher order aberrations (HOAs) and contrast sensitivity before and after surgery were evaluated. Factors including preoperative refraction, age, gender, central corneal thickness, pupil size, optical diameter, ablation depth and flap creation method were analysed for association with postoperative high-order aberration, contrast and glare sensitivities, and different analytic diameters. RESULTS HOAs increased significantly postoperatively (p<0.05), with the most significant change found in Z(spherical aberration). At a 5 mm analysis diameter, increased coma was associated with age; increased spherical aberration difference was associated with age, optical zone diameter and method of epithelial flap creation. At a 3 mm analysis diameter, none of the factors contributed to changes in HOAs. Higher preoperative refractive error was associated with decreased contrast and glare sensitivity at each spatial frequency. CONCLUSION A larger optical zone diameter design is recommended to achieve better visual quality in advanced surface ablation for high myopia correction. Age and preoperative refraction may help predict postoperative visual quality.
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Affiliation(s)
- Jiaqi Zhou
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
| | - Ye Xu
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
| | - Meiyan Li
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
| | - Michael C Knorz
- FreeVis LASIK Zentrum, Universitätsmedizin Mannheim, Mannheim, UK
| | - Xingtao Zhou
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
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Kataoka T, Nishida T, Murata A, Ito M, Isogai N, Horai R, Kojima T, Yoshida Y, Nakamura T. Control-matched comparison of refractive and visual outcomes between small incision lenticule extraction and femtosecond laser-assisted LASIK. Clin Ophthalmol 2018; 12:865-873. [PMID: 29785082 PMCID: PMC5953304 DOI: 10.2147/opth.s161883] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Purpose This retrospective case-matched study aimed to compare visual and refractive outcomes between small incision lenticule extraction (SMILE) and LASIK. Patients and methods Patients who underwent SMILE (34 eyes of 23 patients) or LASIK (34 eyes of 24 patients) were enrolled and matched according to preoperative manifest refractive spherical equivalents. The mean preoperative manifest refractive spherical equivalent was −4.69±0.6 and −4.67±0.64 D in the SMILE and LASIK groups, respectively. The safety, efficacy, and predictability were compared 3 months after surgery. Changes in corneal refractive power from the center to peripheral points and their maintenance ratios were analyzed and compared between the two groups. Results In the SMILE and LASIK groups, 82.4% and 85.3% of patients, respectively, achieved 20/13 or better uncorrected distance visual acuity (p=1.00). There were no eyes that lost two or more lines of corrected distance visual acuity in either group. The maintenance ratios of corneal refractive power changes at the peripheral points in the SMILE group were significantly higher than those in the LASIK group (p<0.05). Conclusion Both groups achieved similar high efficacy and safety. SMILE surgery resulted in higher refractive power correction in the peripheral cornea than LASIK surgery.
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Affiliation(s)
| | | | | | | | | | | | - Takashi Kojima
- Nagoya Eye Clinic, Nagoya, Japan.,Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
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Hashmani N, Hashmani S, Ramesh P, Rajani H, Ahmed J, Kumar J, Kumar A, Jamali M. A Comparison of Visual Outcomes and Patient Satisfaction Between Photorefractive Keratectomy and Femtosecond Laser-Assisted In Situ Keratomileusis. Cureus 2017; 9:e1641. [PMID: 29119072 PMCID: PMC5665689 DOI: 10.7759/cureus.1641] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Purpose To compare visual outcomes and satisfaction among patients of photorefractive keratectomy (PRK; Wavelight EX 500, Alcon, Ft Worth, TX, USA) and femtosecond laser-assisted in situ keratomileusis (FAL; Wavelight FS 200 laser and Wavelight EX 500, Alcon, Ft Worth, TX, USA). Methods We performed a retrospective study of 409 eyes in 207 patients that underwent either PRK (n=90) or FAL (n=117) at the two centers of Hashmanis Hospital, Karachi, Pakistan. The included refractive outcomes were sphere diopters (D), cylinder D, and spherical equivalent D. Additionally, visual acuities were included. All of these were assessed preoperatively and at the one-month postoperative check-up. Patient satisfaction was gauged at the time of chart review by contacting the patient. Results When looking at the postoperative outcomes, we found all values to be statistically significant (p<0.001) with superior outcomes in the FAL cohort. Additionally, 90% and 15% of eyes achieved a postoperative uncorrected visual acuity (UCVA) of 20/20 in FAL and PRK, respectively. Furthermore, the efficacy indexes of the FAL and PRK arms were 1.00 and 0.82, respectively. The predictability of the procedures were 92.1% and 64.9%, respectively. Lastly, 93.3% of patients were satisfied with FAL and 95.7% with PRK. Conclusion Our study shows superior visual outcomes in patients undergoing FAL. However, we found a higher satisfaction rate in those that underwent PRK, perhaps due to the higher cost of FAL.
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Affiliation(s)
| | | | | | - Hina Rajani
- Student, Dow Medical College, Karachi, Pakistan
| | - Junaid Ahmed
- Dow University of Health Sciences, Civil hospital karachi
| | - Jaish Kumar
- Student, Dow Medical College, Karachi, Pakistan
| | - Arun Kumar
- Student, Dow Medical College, Karachi, Pakistan
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Comparison of the visual acuity after photorefractive keratectomy using Early Treatment Diabetic Retinopathy Study Chart and E-chart. J Curr Ophthalmol 2016; 28:188-193. [PMID: 27830202 PMCID: PMC5093851 DOI: 10.1016/j.joco.2016.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 04/12/2016] [Accepted: 04/13/2016] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To compare the visual responses of post refractive surgery's patients using Early Treatment Diabetic Retinopathy Study Chart (ETDRS) and E-chart with and without color filters. METHODS The uncorrected Logarithm of the Minimum Angle of Resolution Visual Acuity (LogMAR VA) of 70 patients with a mean age of 26.2 ± 3.76 years (from 19 to 34 years) who had undergone Photorefractive Keratectomy (PRK) (the range of post operation refractive error: ±0.5 D) was measured under the light conditions of with and without asymmetrical glare by using red, green, and yellow filters and ETDRS chart and E-chart. RESULTS In both light conditions of with and without glare, the mean visual acuity of the three filters in the right and left eyes was significantly better with the E-chart versus the ETDRS chart (P < 0.0001). Only in the glare light condition, the mean visual acuity of the left eye showed no significant difference between the two charts using the red filter (P = 0.30). CONCLUSIONS Visual acuity measurements were different with ETDRS chart and E-chart. These two charts cannot be used interchangeably.
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Sajjadi V, Ghoreishi M, Jafarzadehpour E. Refractive and Aberration Outcomes after Customized Photorefractive Keratectomy in Comparison with Customized Femtosecond Laser. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2015; 4:136-141. [PMID: 27800501 PMCID: PMC5087100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
To compare the refractive and visual outcomes and higher order aberrations in patients with low to moderate myopia who underwent customized photorefractive keratectomy (PRK) or femtosecond laser in situ keratomileusis (Femto-LASIK) this research performed. This study includes data of 120 consecutive eyes of 60 patients with myopia between -3.00 D and -7.00 D with or without astigmatism in two surgery groups: PRK and Femto-LASIK. Refractive, visual, and aberration outcomes of the two methods of surgery were compared after 6 months of follow-up. After six months of follow-up, sphere and cylinder were found significantly decreased and there was no statistically significant difference between the two groups. The mean of uncorrected distance visual acuity in LogMar format for the PRK and Femto-LASIK groups was -0.03±0.07 and -0.01±0.08, respectively, which was not significantly different between the two groups. Higher orders and spherical aberrations increased in both groups significantly, while total aberrations decreased in both groups. After surgery, no differences were observed between the two groups in the amount of aberrations. In conclusion, Both PRK and Femto-LASIK are effective and safe in correcting myopia. In this study PRK induced more spherical and higher order aberrations than Femto-LASIK.
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Affiliation(s)
- Valleh Sajjadi
- Department of Optometry, School of Rehabilitation Science, Iran University of Medical Sciences
| | - Mohammad Ghoreishi
- Department of Ophthalmology, School of Medicine, Esfahan University of Medical Sciences
| | - Ebrahim Jafarzadehpour
- Department of Optometry, School of Rehabilitation Science, Iran University of Medical Sciences
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Tabbara KF. Corneal ectasia following LASIK. Saudi J Ophthalmol 2011; 25:211-2. [DOI: 10.1016/j.sjopt.2011.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2011] [Accepted: 05/06/2011] [Indexed: 10/18/2022] Open
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