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Jiang Y, Cai Y, Zhang X, Chen L, Zhou X, Chen Y. A Two-Decade Bibliometric Analysis of Laser in Ophthalmology: From Past to Present. Clin Ophthalmol 2024; 18:1313-1328. [PMID: 38765459 PMCID: PMC11100493 DOI: 10.2147/opth.s458840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 04/26/2024] [Indexed: 05/22/2024] Open
Abstract
Background Laser therapy has been proven as an effective technique for managing ophthalmological disorders. To guide future research, we conducted a bibliometric analysis of laser applications in eye diseases from 1990 to 2022, aiming to identify key themes and trends. Methods We retrieved 3027 publications from the Web of Science Core Collection (WoSCC). Bibliometrix was used for science mapping of the literature, while VOSviewer and CiteSpace were applied to visualize co-authorship, co-citation, co-occurrence, and bibliographic coupling networks. Results From a co-citation reference network, we identified 52 distinct clusters. Our analysis uncovered three main research trends. The first trend revolves around the potential evolution of corneal laser surgery techniques, shifting from the treatment of refractive errors to broader applications in biomedical optics. The second trend illustrates the advancement of laser applications in treating a range of disorders, from retinal and ocular surface diseases to glaucoma. The third trend focuses on the innovative uses of established technologies. Conclusion This study offers significant insights into the evolution of laser applications in ophthalmology over the past 30 years, which will undoubtedly assist scientists in directing further research in this promising field.
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Affiliation(s)
- Yaping Jiang
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Yuying Cai
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Xin Zhang
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Li Chen
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Institute for Medical and Engineering Innovation, Eye & ENT Hospital, Fudan University; NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, People’s Republic of China
| | - Yihui Chen
- Department of Ophthalmology, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
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Yang F, Dong Y, Bai C, Alzogool M, Wang Y. Bibliometric and visualized analysis of myopic corneal refractive surgery research: from 1979 to 2022. Front Med (Lausanne) 2023; 10:1141438. [PMID: 37575980 PMCID: PMC10416457 DOI: 10.3389/fmed.2023.1141438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 07/14/2023] [Indexed: 08/15/2023] Open
Abstract
Background Myopic corneal refractive surgery is one of the most prevalent ophthalmic procedures for correcting ametropia. This study aimed to perform a bibliometric analysis of research in the field of corneal refractive surgery over the past 40 years in order to describe the current international status and to identify most influential factors, while highlighting research hotspots. Methods A bibliometric analysis based on the Web of Science Core Collection (WoSCC) was used to analyze the publication trends in research related to myopic corneal refractive surgery. VOSviewer v.1.6.10 was used to construct the knowledge map in order to visualize the publications, distribution of countries, international collaborations, author productivity, source journals, cited references, keywords, and research hotspots in this field. Results A total of 4,680 publications on myopic corneal refractive surgery published between 1979 and 2022 were retrieved. The United States has published the most papers, with Emory University contributing to the most citations. The Journal of Cataract and Refractive Surgery published the greatest number of articles, and the top 10 cited references mainly focused on outcomes and wound healing in refractive surgery. Previous research emphasized "radial keratotomy (RK)" and excimer laser-associated operation methods. The keywords containing femtosecond (FS) laser associated with "small incision lenticule extraction (SMILE)" and its "safety" had higher burst strength, indicating a shift of operation methods and coinciding with the global trends in refractive surgery. The document citation network was clustered into five groups: (1) outcomes of refractive surgery: (2) preoperative examinations for refractive surgery were as follows: (3) complications of myopic corneal refractive surgery; (4) corneal wound healing and cytobiology research related to photorefractive laser keratotomy; and (5) biomechanics of myopic corneal refractive surgery. Conclusion The bibliometric analysis in this study may provide scholars with valuable to information and help them better understand the global trends in myopic corneal refractive surgery research frontiers. Two stages of rapid development occurred around 1991 and 2013, shortly after the innovation of PRK and SMILE surgical techniques. The most cited articles mainly focused on corneal wound healing, clinical outcomes, ocular aberration, corneal ectasia, and corneal topography, representing the safety of the new techniques.
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Affiliation(s)
- Fang Yang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Department of Ophthalmology, Renmin Hospital, Hubei University of Medicine, Shiyan, China
| | - Yi Dong
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Nankai University Affiliated Eye Hospital, Tianjin, China
| | - Chen Bai
- Department of General Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Mohammad Alzogool
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Nankai University Affiliated Eye Hospital, Tianjin, China
- School of Medicine, Nankai University, Tianjin, China
| | - Yan Wang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Nankai University Affiliated Eye Hospital, Tianjin, China
- Nankai Eye Institute, Nankai University, Tianjin, China
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Castro-Luna G, Sánchez-Liñán N, Alaskar H, Pérez-Rueda A, Nievas-Soriano BJ. Comparison of Iris-Claw Phakic Lens Implant versus Corneal Laser Techniques in High Myopia: A Five-Year Follow-Up Study. Healthcare (Basel) 2022; 10:healthcare10101904. [PMID: 36292351 PMCID: PMC9601292 DOI: 10.3390/healthcare10101904] [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: 08/16/2022] [Revised: 09/19/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
Background. This study aimed to compare the efficacy and safety of Femto-LASIK, PRK, and Artiflex/Artisan phakic lens implantation in the surgical correction of myopia at different moments of postoperative follow-up; to propose a linear predictive model of visual acuity without correction at five years of refractive procedures; and to evaluate its validity. Methods. A retrospective observational analysis was performed. Patients were clinically reviewed after three months, one year, two years, and five years. Univariate and bivariate analyses and a multivariate linear regression model were performed. Results. Six hundred seventy-nine eyes were analyzed: 18.9% Artiflex, 2.8% Artisan, 42.3% Femto-LASIK, and 36.1% PRK. There were significant differences in effectiveness and safety after five years when comparing Artiflex/Artisan versus PRK and Femto-LASIK (p < 0.01). The linear regression model explained 30.32% of the patients’ visual acuity variability after five years. Conclusions. PRK surgery, Femto-Lasik, and Artiflex/Artisan type phakic lens implantation are effective, safe, and predictable techniques with stable refractive results. Phakic lenses magnify myopic patients who improve their UCVA and BCVA. Concerning phakic lens implantation, corneal endothelial cells remain stable. The predictive model calculated that surgery with a phakic lens increased the UCVA result at five years, and surgery with PRK slightly decreased the long-term results.
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Affiliation(s)
- Gracia Castro-Luna
- Department of Nursing, Physiotherapy, and Medicine, University of Almería, 04009 Almería, Spain
- Correspondence: (G.C.-L.); (B.J.N.-S.)
| | - Noelia Sánchez-Liñán
- Department of Nursing, Physiotherapy, and Medicine, University of Almería, 04009 Almería, Spain
| | - Hazem Alaskar
- Department of Ophthalmology, Poniente Hospital, 04700 Almería, Spain
| | - Antonio Pérez-Rueda
- Department of Ophthalmology, University Torrecardenas Hospital, 04009 Almería, Spain
| | - Bruno José Nievas-Soriano
- Department of Nursing, Physiotherapy, and Medicine, University of Almería, 04009 Almería, Spain
- Correspondence: (G.C.-L.); (B.J.N.-S.)
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Kamiya K, Shimizu K, Igarashi A, Kitazawa Y, Kojima T, Nakamura T, Ichikawa K, Fukuoka S, Fujimoto K. Posterior chamber phakic intraocular lens implantation after laser in situ keratomileusis. EYE AND VISION (LONDON, ENGLAND) 2022; 9:15. [PMID: 35418146 PMCID: PMC9008970 DOI: 10.1186/s40662-022-00282-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 02/17/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND To assess the multicenter outcomes of posterior chamber phakic intraocular lens implantation with a central hole (EVO-ICL, STAAR Surgical) for patients undergoing previous laser in situ keratomileusis (LASIK). METHODS This case series enrolled 31 eyes of 21 consecutive patients undergoing EVO-ICL implantation to correct residual refractive errors after LASIK at 7 nationwide major surgical sites. We investigated safety, efficacy, predictability, stability, and adverse events at 1 week, 1, 3, and 6 months postoperatively, and at the final visit. RESULTS The mean observation period was 1.6 ± 1.8 years. Uncorrected and corrected visual acuities were - 0.14 ± 0.11 and - 0.22 ± 0.09 logMAR at 6 months postoperatively. At 6 months postoperatively, 81% and 100% of eyes were within ± 0.5 D and ± 1.0 D, respectively, of the targeted correction. We found neither significant manifest refraction changes of 0.05 ± 0.38 D from 1 week to 6 months nor apparent intraoperative or postoperative complications in any case. CONCLUSIONS Our multicenter study confirmed that the EVO-ICL provided good outcomes in safety, efficacy, predictability, and stability, even in post-LASIK eyes. Therefore, EVO-ICL implantation may be a viable surgical option, even for correcting residual refractive errors after LASIK. Trial registration University Hospital Medical Information Network Clinical Trial Registry (000045295).
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Affiliation(s)
- Kazutaka Kamiya
- Visual Physiology, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0373, Japan.
| | - Kimiya Shimizu
- Department of Ophthalmology, Sanno Hospital, Tokyo, Japan
| | | | | | - Takashi Kojima
- Department of Ophthalmology, Keio University, Tokyo, Japan
| | | | | | - Sachiko Fukuoka
- Department of Ophthalmology, Tane Memorial Eye Hospital, Osaka, Japan
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KARADAĞ MF. Comparison of visual and refractive outcomes between femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and photorefractive keratectomy (PRK): a long-term outcomes analysis. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1011444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Anders P, Anders LM, Barbara A, Szentmary N, Langenbucher A, Gatzioufas Z. Intraocular lens power calculation in eyes with previous corneal refractive surgery. Ther Adv Ophthalmol 2022; 14:25158414221118524. [PMID: 36061972 PMCID: PMC9434667 DOI: 10.1177/25158414221118524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 07/12/2022] [Indexed: 12/05/2022] Open
Abstract
Intraocular lens (IOL) power calculation after corneal refractive surgery (CRS)
becomes an expanding challenge for ophthalmologists as more and more cataract
surgeries after CRS are required. These patients typically also have high
expectations as to visual performance. Conventional IOL power calculation
schemes frequently provide inaccurate results in these cases. This review aims
to summarize and recommend currently available IOL power calculation methods for
eyes with the most common CRS methods: radial keratotomy (RK), photorefractive
keratectomy (PRK), laser in situ keratomileusis (LASIK), and
small incision lenticule extraction (SMILE). To this end, biometry measuring
methods and IOL formulas will be explained and combinations of both are
proposed. In synopsis, it is evident that the latest generation of vergence
formulas exhibit favorable IOL power prediction accuracy in post-CRS eyes, even
though the predictive precision of methods in eyes without CRS is not attained.
Ray tracing computation, intraoperative aberrometry, and machine learning–based
formulas hold potential to further improve refractive outcomes in post-CRS
eyes.
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Affiliation(s)
- Philipp Anders
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
- Department of Ophthalmology, University of Basel, Basel, Switzerland
| | - Lisa-Marie Anders
- Institute of Molecular and Clinical Ophthalmology Basel, 4031 Basel, Switzerland
- Department of Ophthalmology, University of Basel, Basel, Switzerland
| | | | - Nora Szentmary
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research, Saarland University, Homburg, Germany
| | | | - Zisis Gatzioufas
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
- Department of Ophthalmology, University of Basel, Basel, Switzerland
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7
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[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.
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Kim JY, Lee H, Joo CK, Hyon JY, Kim TI, Kim JH, Kim JK, Cho EY, Choi JE, Lee NR, Tchah HW. Three-Year Follow-Up of Laser In Situ Keratomileusis Treatments for Myopia: Multi-Center Cohort Study in Korean Population. J Pers Med 2021; 11:jpm11050419. [PMID: 34065718 PMCID: PMC8156820 DOI: 10.3390/jpm11050419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/03/2021] [Accepted: 05/08/2021] [Indexed: 11/16/2022] Open
Abstract
This multi-center cohort study included 3401 myopic laser in situ keratomileusis (LASIK) procedures conducted in 1756 myopia patients between 2002 and 2005. Pre- and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and manifest refraction spherical equivalent (SE) were recorded. Factors predicting low postoperative efficacy (defined as a postoperative UCVA < 0.5) were identified using univariate and multivariate logistic regression analysis. Compared with 1 month postoperatively, logMAR UCVA at 3 months postoperatively was significantly decreased (p = 0.002) and that at 2 and 3 years was significantly increased (p < 0.001). LogMAR BCVA at 2 years postoperatively was significantly decreased compared with 1 month postoperatively (p = 0.008). Over the 3-year postoperative period, overall refractive predictability within ±1.00 D and ±0.50 D ranged from 69.0% to 86.2% and from 43.3% to 67.8%, respectively. This also decreased from 1 month to 6 months postoperatively (p < 0.005). Multivariate logistic regression analysis using generalized estimating equations, revealed that higher preoperative SE (odds ratio [OR], 2.58 and 7.23; p < 0.001) and lower preoperative BCVA (OR, 2.44; p = 0.003) were predictive of a low postoperative efficacy. In summary, myopic LASIK can be effective and safe with a high refractive predictability in a Korean population, but myopic regression occurs over time. Higher preoperative SE and lower preoperative BCVA are predictive of a low postoperative efficacy.
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Affiliation(s)
- Jae-Yong Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-Y.K.); (H.L.)
| | - Hun Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-Y.K.); (H.L.)
| | - Choun-Ki Joo
- Department of Ophthalmology and Visual Science, Kangnam St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Joon-Young Hyon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea;
| | - Tae-Im Kim
- Department of Ophthalmology, Institute of Vision Research, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul 03722, Korea;
| | - Jin-Hyoung Kim
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University of Korea, Koyang 10380, Korea;
| | - Jin-Kuk Kim
- B&VIIT Eye Center, Seoul 06615, Korea; (J.-K.K.); (E.-Y.C.)
| | - Eun-Young Cho
- B&VIIT Eye Center, Seoul 06615, Korea; (J.-K.K.); (E.-Y.C.)
| | - Ji-Eun Choi
- National Evidence-Based Healthcare Collaborating Agency, Seoul 04554, Korea; (J.-E.C.); (N.-R.L.)
| | - Na-Rae Lee
- National Evidence-Based Healthcare Collaborating Agency, Seoul 04554, Korea; (J.-E.C.); (N.-R.L.)
| | - Hung-Won Tchah
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea; (J.-Y.K.); (H.L.)
- Correspondence:
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Afsharpaiman S, Zare M, Yasemi M, Jamialahmadi T, Sahebkar A. The Prevalence of Infectious Keratitis after Keratorefractive Surgery: A Systematic Review and Meta-Analysis Study. J Ophthalmol 2020; 2020:6329321. [PMID: 32774907 PMCID: PMC7407012 DOI: 10.1155/2020/6329321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 04/24/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The keratorefractive surgeries (KRS) are one of the most common ocular surgeries. One of the dangerous complications of these surgeries is infectious keratitis (IK), which is the second cause of blindness after cataract surgery. The purpose of this study was to estimate the prevalence of IK after KRS in different parts of the world. METHODS In order to obtain relevant studies, all national and international databases including IranMedex, SID, Magiran, IranDoc, Medlib, ScienceDirect, PubMed, Scopus, Cochrane, Embase, Web of Science, and Google Scholar were searched using standard keywords. RESULTS IK prevalence after KRS was 0.000496% (0.000145% for the left eye and 0.000149% for the right eye). IK prevalence after KRS in the United States, Europe, and Asia was 0.000667%, 0.000473%, and 0.000045%, respectively, in all of which the common microorganisms were Staphylococci. Meta-regression showed no significant association between IK after KRS and either sample size or publication year of the studies. IK prevalence after KRS in the right eye was more than that in the left one. Also, the probability of IK incidence after LASIK surgery was more than PRK and LASEK. In the evaluation of continents, IK after KRS in the United States was more frequent compared with Europe and Asia. CONCLUSIONS This study provided data as to the overall prevalence of IK following KRS and its variations according to the types of eye, surgery, pathogenic microorganism, and geographical location.
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Affiliation(s)
- Shahla Afsharpaiman
- Health Research Center, Life Style Institute, Bagiyatallah University of Medical Sciences, Tehran, Iran
| | - Musa Zare
- Department of Ophthalmology, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Masoud Yasemi
- Health Research Center, Life Style Institute, Bagiyatallah University of Medical Sciences, Tehran, Iran
| | - Tannaz Jamialahmadi
- Department of Food Science and Technology, Quchan Branch, Islamic Azad University, Quchan, Iran
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Halal Research Center of IRI, FDA, Tehran, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Fischinger I, Wendelstein J, Bolz M, Tetz M. Calzone-Like Traumatic Flap Dislocation Four Years after Laser in situ Keratomileusis. Case Rep Ophthalmol 2019; 10:281-286. [PMID: 31692604 PMCID: PMC6760352 DOI: 10.1159/000502283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 07/21/2019] [Indexed: 12/03/2022] Open
Abstract
A 46-year-old patient presented with a flip-folded partially dislocated flap after trauma caused by a sheet of paper, four years after a reportedly uneventful laser in situ keratomileusis procedure using microkeratome. Flap re-lift, mechanical debridement, and flap stretching were performed in a first interventional approach. Due to epithelial ingrowth two month after the first intervention, a flap re-lift and mechanical removal of epithelial cells from the stroma bed and flap were performed. In addition, triamcinolone was applied subconjunctivally. Thereafter, best corrected visual acuity of 20/20 was regained and no more epithelial ingrowth was observed. Only few cases of flap dislocation with epithelial ingrowth have been described in the literature following trauma, though none of a permanently inward folded flap. The use of subconjunctival triamcinolone is a new approach to prevent recurrent epithelial ingrowth.
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Affiliation(s)
- Isaak Fischinger
- Department of Ophthalmology, Augentagesklinik Spreebogen, Berlin, Germany.,Department of Ophthalmology, Johannes Kepler Universität, Kepler Universitätsklinikum, Linz, Austria
| | - Jascha Wendelstein
- Department of Ophthalmology, Johannes Kepler Universität, Kepler Universitätsklinikum, Linz, Austria
| | - Matthias Bolz
- Department of Ophthalmology, Johannes Kepler Universität, Kepler Universitätsklinikum, Linz, Austria
| | - Manfred Tetz
- Department of Ophthalmology, Augentagesklinik Spreebogen, Berlin, Germany
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11
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Lin DTC, Holland SP, Verma S, Hogden J, Arba-Mosquera S. Immediate and short term visual recovery after SmartSurf ACE photorefractive keratectomy. JOURNAL OF OPTOMETRY 2019; 12:240-247. [PMID: 31473174 PMCID: PMC6978587 DOI: 10.1016/j.optom.2019.04.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 04/15/2019] [Accepted: 04/23/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE To investigate immediate and short-term visual recovery in a large cohort of 2093 myopic eyes (with or without astigmatism) treated with SmartSurfACE procedure, a combination of Transepithelial Photo Refractive Keratectomy (PRK) and Smart Pulse Technology (SPT, SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany). METHODS In this retrospective case series, post-operative outcomes were evaluated immediately after the surgery (Day 0), at day 1 and 3 months postoperatively, after myopic SmartSurfACE treatment with mean pre-operative spherical equivalent -4.65±2.53D and range from -16.13D to -0.13D. In all cases, pre and postoperative standard examinations were performed. The analysis evaluated preoperative Corrected and Uncorrected Distance Visual Acuity (CDVA and UDVA, respectively), and postoperative UDVA, monocularly and binocularly, immediately after the surgery, at day 1 and 3 month follow up. RESULTS Sixty-two percent eyes achieved monocular UDVA 20/40 or better immediately after the surgery, while 82% patients achieved binocular UDVA 20/32 or better immediately after the surgery. At 3-month postoperatively, monocular UDVA 20/25 or better was achieved in 94% eyes. Treated eyes achieved immediately after the surgery or by the next day mean UDVA 20/41±8. UDVA improved significantly from Day 1 to 3-months follow up (p<0.0001 for both OS and OD) to mean UDVA 20/21±5 (equal to preoperative CDVA 20/21±8). CONCLUSION Immediate and short-term visual recovery after SmartSurfACE PRK in our large cohort was rapid, providing functional binocular UDVA immediately after the surgery.
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Affiliation(s)
- David T C Lin
- Pacific Laser Eye Centre, 1401 W Broadway, Fifth Fl, Vancouver, BC V6H 1H6, Canada.
| | - Simon P Holland
- Pacific Laser Eye Centre, 1401 W Broadway, Fifth Fl, Vancouver, BC V6H 1H6, Canada
| | - Shwetabh Verma
- Research and Development, SCHWIND Eye-Tech-Solutions, Kleinostheim, Germany; Experimental Radiation Oncology, University Medical Center Mannheim, Heidelberg University, Germany; Interdisciplinary Center for Scientific Computing (IWR), Heidelberg University, Germany; Central Institute for Computer Engineering (ZITI), Heidelberg University, Germany
| | - John Hogden
- Pacific Laser Eye Centre, 1401 W Broadway, Fifth Fl, Vancouver, BC V6H 1H6, Canada
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12
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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: 164] [Impact Index Per Article: 32.8] [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.
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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.
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Very late-onset flap margin corneal ulcer following laser in situ keratomileusis. Int Ophthalmol 2019; 39:2533-2538. [PMID: 30982142 DOI: 10.1007/s10792-019-01100-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 04/01/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To report and characterize cases of very late onset (5 years or more after surgery) flap margin corneal ulcers after laser in situ keratomileusis (LASIK) procedure. METHODS A retrospective case series of consecutive patients who were diagnosed with very late flap margin corneal ulcers following LASIK, between January 2014 and July 2017. All patients were treated with topical antibiotics and were followed up until complete resolution. RESULTS A total of eight patients, with a mean age of 46.5 ± 11 years, (range 31-64 years), were included in this study. All patients underwent uneventful myopic LASIK 13.3 ± 3 (range 10-20) years before presentation. Patients best corrected visual acuity (BCVA) at presentation was 0.20 ± 0.15 logMAR compared to a final BCVA of 0.10 ± 0.10 logMAR (p = 0.28). The ulcer was located in the bottom two clock hours of the flap margin (5-7 o'clock) in six (75%) patients and superior (11 o'clock) in the remaining two patients (p = 0.048). Seven patients (87.5%) suffered from blepharitis, and only one did not. CONCLUSIONS LASIK may be associated with an increased risk of late-onset corneal ulcer occurring years after the procedure. Instability of the flap margin, blepharitis and dry eye are possible causes of epithelial disturbance and may account for this complication.
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Epi-Bowman Blunt Keratectomy Versus Diluted EtOH Epithelial Removal in Myopic Photorefractive Keratectomy: A Prospective Contralateral Eye Study. Cornea 2019; 38:612-616. [DOI: 10.1097/ico.0000000000001863] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kim DG, Choi JH, Kim SW, Choi TH, Choe CM. Comparison of Hyperopic Photorefractive Keratectomy and LASIK. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.6.528] [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)
| | | | - Sung Won Kim
- Department of Mathematics and Statistics, Johns Hopkins University, Baltimore, MD, USA
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Faria-Correia F, Ribeiro S, Monteiro T, Lopes BT, Salomão MQ, Ambrósio R. Topography-Guided Custom Photorefractive Keratectomy for Myopia in Primary Eyes With the WaveLight EX500 Platform. J Refract Surg 2018; 34:541-546. [PMID: 30089184 DOI: 10.3928/1081597x-20180705-03] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/03/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the outcomes after topography-guided ablation treatment (T-CAT) for the correction of myopia and myopic astigmatism with photorefractive keratectomy (PRK). METHODS This was a retrospective, non-comparative case series study of 25 patients (40 eyes) with low to moderate myopia with or without astigmatism who underwent topography-guided custom PRK with the Wave-Light EX500 excimer laser platform (Alcon Laboratories, Inc., Fort Worth, TX). The customized treatment plan was based on Topolyzer Vario topography system (Alcon Laboratories, Inc.) data. The patients were observed for 6 months after the procedure. RESULTS The surgery significantly reduced the manifest refractive spherical equivalent (MRSE), sphere, and cylinder (P < .05) at 6 months of follow-up. Compared with the preoperative corrected distance visual acuity (CDVA), 8 (20%) and 10 (25%) of 40 eyes gained one or more lines of postoperative uncorrected distance visual acuity at 3 and 6 months, respectively. Only 1 eye presented loss of one line of CDVA at 6 months postoperatively, which was due to delayed epithelial healing. Ten patients (15 eyes) reported symptoms related to dry eye and the vision of 21 patients (17 eyes) fluctuated during the first month. CONCLUSIONS The T-CAT custom PRK procedure provided good early outcomes for treating patients with low to moderate myopia with or without astigmatism. [J Refract Surg. 2018;34(8):541-546.].
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Myopia and myopic astigmatism photorefractive keratectomy: applying an advanced multiple regression-derived nomogram. Graefes Arch Clin Exp Ophthalmol 2018; 257:225-232. [DOI: 10.1007/s00417-018-4101-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 08/04/2018] [Accepted: 08/13/2018] [Indexed: 10/28/2022] Open
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Mehlan J, Linke SJ, Skevas C, Steinberg J, Giannakakis K, Katz T. Safety and complications after three different surface ablation techniques with mitomycin C: a retrospective analysis of 2757 eyes. Graefes Arch Clin Exp Ophthalmol 2018; 257:217-223. [PMID: 30076471 DOI: 10.1007/s00417-018-4077-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 07/18/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND To evaluate the safety and spectrum of complications of three excimer laser surface ablation techniques (SATs) with an intraoperative application of mitomycin C (MMC) 0.02%. A retrospective, non-comparative large case series. METHODS SATs were performed on 2757 eyes with a preoperative spherical equivalent (SE) of - 4.41 ± 2.44 and a Wavelight Allegretto 200 platform. Ablation zone diameters between 6.0 and 7.0 mm were used according to mesopic pupil size. All patients were treated with an intraoperative application of MMC for 30 to 90 s depending on refractive error. The mean follow-up time was > 3 months (107 ± 24 days). Complication range and incidence were analyzed retrospectively and safety index was calculated. RESULTS Two thousand seven hundred and fifty-seven eyes met the inclusion criteria for surface ablation. Two thousand five hundred and seventy-three eyes were assigned to alcohol-assisted photorefractive keratectomy (APRK), 135 eyes to transepithelial photorefractive keratectomy (TPRK), and 49 eyes to off-flap epithelial laser in situ keratomileusis (EpiLASIK/EpiK). Overall, the safety index was 1.06 ± 0.28. Haze was graded according to the Fantes scale. Haze incidence rates were highest in the TPRK group (14.81%) and comparably low in APRK (2.95%) and EpiK (4.08%) groups. CONCLUSIONS Intraoperative topical application of MMC (0.02%) results in good safety and no severe side effects. However, highest incidence of haze was observed after TPRK. The more frequent peripheral localization of haze might be attributed to large ablation zones and the wavefront optimized ablation profile especially in the PTK modus of the laser platform.
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Affiliation(s)
- Juliane Mehlan
- Department of Ophthalmology, UKE - University Clinic Hamburg-Eppendorf, 52 Martinistrasse, 20246, Hamburg, Germany.
| | - Stephan Johannes Linke
- Department of Ophthalmology, UKE - University Clinic Hamburg-Eppendorf, 52 Martinistrasse, 20246, Hamburg, Germany.,Care-Vision Germany, 52 Martinistrasse, 20246, Hamburg, Germany.,zentrumsehstärke, 64 Martinistrasse, 20246, Hamburg, Germany
| | - Christos Skevas
- Department of Ophthalmology, UKE - University Clinic Hamburg-Eppendorf, 52 Martinistrasse, 20246, Hamburg, Germany
| | - Johannes Steinberg
- Care-Vision Germany, 52 Martinistrasse, 20246, Hamburg, Germany.,zentrumsehstärke, 64 Martinistrasse, 20246, Hamburg, Germany
| | - Konstantinos Giannakakis
- Augenarztpraxis Dr. med. Wilhelm Kröncke & Albrecht Zwick, 7 Grashoffstrasse, 27570, Bremerhaven, Germany
| | - Toam Katz
- Department of Ophthalmology, UKE - University Clinic Hamburg-Eppendorf, 52 Martinistrasse, 20246, Hamburg, Germany.,Care-Vision Germany, 52 Martinistrasse, 20246, Hamburg, Germany
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Erdélyi B, Csákány B, Németh J. Reproducibility of Keratometric Measurements Decreases with Time after Blinking. Eur J Ophthalmol 2018; 16:371-5. [PMID: 16761237 DOI: 10.1177/112067210601600303] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The reproducibility of keratometry measurements was investigated in relation to the elapsed time after blinking. METHODS Thirty ophthalmologically healthy subjects were examined, using a standard corneal topographic instrument (17 women, 13 men, age 25.7+/-5.6 years). Photographs were taken in series of four: at 5, 15, 30, and 60 seconds after a complete blink. The series was repeated three times in each individual. The main outcome measures were the mean values, the standard deviation, and the reproducibility error of the simulated keratometric values (K1, K2), the surface regularity index (SRI), and the surface asymmetry index (SAI). RESULTS The mean of K 1 and K 2 values did not change (p=0.684 and p=0.982); however, the measurement error increased significantly for K1 (p=0.007) and for K2 (p=0.038). The mean values of SRI changed significantly (p=0.034) during the 1-minute pause in blinking together with a non-significant change in the standard deviation (p=0.106), without elevation of the measurement error (p=0.619). The elevation of SAI with time was not significant (p=0.093). CONCLUSIONS The break-up phenomenon of the tear film at the ocular surface induces significant deterioration of the reliability of keratometric measurements on prolonged gaze without blinking. The created error can exceed 0.6 D, which is unacceptably high in practice. Therefore care should be taken to avoid such circumstances during the examination.
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Affiliation(s)
- B Erdélyi
- Department of Ophthalmology, Semmelweis University, Budapest--Hungary
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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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Wen D, McAlinden C, Flitcroft I, Tu R, Wang Q, Alió J, Marshall J, Huang Y, Song B, Hu L, Zhao Y, Zhu S, Gao R, Bao F, Yu A, Yu Y, Lian H, Huang J. Postoperative Efficacy, Predictability, Safety, and Visual Quality of Laser Corneal Refractive Surgery: A Network Meta-analysis. Am J Ophthalmol 2017; 178:65-78. [PMID: 28336402 DOI: 10.1016/j.ajo.2017.03.013] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 03/09/2017] [Accepted: 03/10/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the postoperative efficacy, predictability, safety, and visual quality of all major forms of laser corneal refractive surgeries for correcting myopia. DESIGN Systematic review and network meta-analysis. METHODS Search of MEDLINE, EMBASE, Cochrane Library, and the US trial registry was conducted up to November 2015. Randomized controlled trials (RCT) reporting in accordance with the eligibility criteria were included in this review. We performed a Bayesian random-effects network meta-analysis. RESULTS Forty-eight RCTs were identified. For efficacy (uncorrected visual acuity [UCVA]), there were no statistically significant differences between any pair of treatments analyzed. The SUCRA (surface under the cumulative ranking curve) ranking (from best to worst) was femtosecond-based laser in situ keratomileusis (FS-LASIK), LASIK, small-incision lenticule extraction, femtosecond lenticule extraction (FLEx), photorefractive keratectomy (PRK), laser epithelial keratomileusis (LASEK), epipolis (Epi)-LASIK, transepithelial PRK (T-PRK). For predictability (refractive spherical equivalent [SE]), a statistically significant difference was found when FS-LASIK was compared with LASIK (odds ratio [OR] 2.29, 95% credible interval [CrI] 1.20-4.14), PRK (OR 2.16, 95% CrI 1.15-4.03), LASEK (OR 2.09, 95% CrI 1.08-4.55), and Epi-LASIK (OR 2.74, 95% CrI 1.11-6.20). The SUCRA ranking (from best to worst) was FS-LASIK, T-PRK, LASEK, PRK, LASIK, Epi-LASIK. There were no statistically significant differences in the safety (best spectacle-corrected visual acuity) comparisons. For both postoperative higher-order aberrations (HOAs) and contrast sensitivity (CS), there were no statistically significant differences between any pair of treatments analyzed. The SUCRA ranking results show that some corneal surface ablation techniques (PRK and LASEK) rank highest. CONCLUSIONS This network meta-analysis shows that there were no statistically significant differences in either visual outcomes (efficacy and safety) or visual quality (HOAs and CS). FS-LASIK behaved better in predictability than any other type of surgeries.
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Mori Y, Miyata K, Ono T, Yagi Y, Kamiya K, Amano S. Comparison of laser in situ ketatomileusis and photorefractive keratectomy for myopia using a mixed-effects model. PLoS One 2017; 12:e0174810. [PMID: 28362808 PMCID: PMC5375153 DOI: 10.1371/journal.pone.0174810] [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: 09/06/2016] [Accepted: 03/15/2017] [Indexed: 11/18/2022] Open
Abstract
Purpose To compare the results of laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) for myopia using a mixed-effects model. Methods This comparative retrospective study was conducted in 1,127 eyes of 579 patients after LASIK and 270 eyes of 144 patients after PRK who had two or more postoperative follow-ups after 3 months. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refractive spherical equivalent (MRSE), percentage of eyes within ± 0.5 diopters (D) and ± 1.0 D of targeted refraction, and central corneal thickness were compared between PRK and LASIK groups using a mixed-effects model. Results Compared with the LASIK group, UCVA in the PRK group was significantly worse in the initial year but was significantly better after 4 years. The average BSCVA was not significantly different between the LASIK and PRK groups after 4 years. The average gain of BSCVA in the PRK group was significantly larger than that of the LASIK group after 2 years. MRSE in the LASIK and PRK groups showed a gradual myopic shift until 6 years after surgery. After 6 years, MRSE in the PRK group remained stable whereas MRSE in the LASIK group continued a myopic shift. The percentages of eyes within ± 0.5 D or ± 1.0 D in the LASIK group were significantly higher than those in the PRK group at 3 months but were significantly lower than those in the PRK group at 10 years. Conclusions PRK for myopia shows better efficacy than LASIK for myopia after 4 years.
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Affiliation(s)
| | | | | | | | - Kazutaka Kamiya
- Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
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Abstract
PURPOSE To evaluate the predictability and accuracy of refractive surgery among adults with myopic anisometropia. METHODS Consecutive cases of myopic eyes that underwent bilateral laser-assisted in situ keratomileusis (LASIK) or bilateral photorefractive keratectomy (PRK) during a 12-year period in a single center were included. Myopic anisometropia was defined as a difference greater than 1.5 D in spherical equivalent between eyes preoperative. RESULTS A total of 10,046 paired, operated nonamblyopic eyes of 5023 patients were analyzed. Of these, 472 eyes of 236 (4.7%) patients had myopic anisometropia without amblyopia, and 9574 eyes of 4787 patients served as isometropic controls. After refractive surgery, in the anisometropic group the more myopic eye was corrected by +0.47 ± 0.78 (D) more than the contralateral eye (P < 0.0001). Relative to the target refraction, the more myopic eye was overcorrected by 0.21 ± 0.79 D compared with an undercorrection of 0.16 ± 0.60 D in the less myopic contralateral eye (P < 0.0001) and compared with an undercorrection of 0.15 ± 0.62 D in the isometropic controls (P < 0.0001). Additionally, the variability in the correction of the more myopic eyes was significantly higher compared with the less myopic contralateral eyes and isometropic controls (P < 0.0001). These trends were evident both in PRK and LASIK treatments. The effect of anisometropia was found to be independent of the magnitude of preoperative myopia or surgeon identity. CONCLUSIONS The more myopic eye of anisometropes undergoing refractive surgery has lower predictability and accuracy and tends to be overcorrected, whereas the less myopic eye has outcome similar to isometropic controls. These results suggest that refractive surgery nomograms should take into account anisometropia.
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Chan TCY, Yu MCY, Ng ALK, Cheng GPM, Zhang J, Wang Y, Jhanji V. Short-term Variance of Refractive Outcomes After Simultaneous LASIK and High-Fluence Cross-linking in High Myopic Correction. J Refract Surg 2016; 32:664-670. [DOI: 10.3928/1081597x-20160728-01] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 07/05/2016] [Indexed: 11/20/2022]
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Chan TCY, Yu MCY, Mak S, Jhanji V. Longitudinal comparison of femtosecond-assisted sub-Bowman keratomileusis versus photorefractive keratectomy for high myopia. Br J Ophthalmol 2016; 101:275-282. [DOI: 10.1136/bjophthalmol-2016-308642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/04/2016] [Accepted: 05/15/2016] [Indexed: 11/04/2022]
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Mechanisms of Corneal Pain and Implications for Postoperative Pain After Laser Correction of Refractive Errors. Clin J Pain 2016; 32:450-8. [DOI: 10.1097/ajp.0000000000000271] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Fischinger I, Seiler TG, Zapp D, Seiler T. Very Late-Onset Corneal Scarring After Photorefractive Keratectomy Induced by Cataract Surgery. J Refract Surg 2016; 32:266-8. [PMID: 27070234 DOI: 10.3928/1081597x-20160121-06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 01/06/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To report two cases with very late-onset scarring of the cornea after photorefractive keratectomy (PRK) induced by cataract surgery. METHODS Case report and literature review. RESULTS Two patients presented with a subepithelial corneal scar more than 20 years after PRK. Scarring occurred within the first few months after cataract surgery. Scar tissue was successfully removed by laser-assisted anterior lamellar keratoplasty. CONCLUSIONS A few cases of late-onset corneal scarring after PRK have been described in the literature following trauma or ophthalmic surgery. Due to the need for cataract surgery in an aging population with previous PRK, this might become a more common problem.
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Park YM, Park YK, Lee JE, Lee JS. Effect of orthokeratology in patients with myopic regression after refractive surgery. Cont Lens Anterior Eye 2015; 39:167-71. [PMID: 26604052 DOI: 10.1016/j.clae.2015.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 08/30/2015] [Accepted: 10/08/2015] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate the clinical effect of orthokeratology (ortho-K) lenses and to introduce the fitting steps of ortho-K lens for myopic regression after keratorefractive surgery. METHODS Twenty-one eyes from 12 patients with myopic regression after keratorefractive surgery were fitted with ortho-K lenses and followed up for 12.11±3.68 months. The mean K value of the peripheral cornea was used to speculate preoperative central corneal K value, estimated K. After dispensing the lenses according to estimated K, biomicroscopic examination including fluorescein staining and over-refraction were performed to determine the final K and final lens power. RESULTS LogMAR uncorrected visual acuity was 0.48±0.39 before and 0.00±0.00 after wearing ortho-K lenses (p<0.001). Pre-fitted refractive error was -1.87±1.05 diopters (D) in myopia, 0.54±0.42 D in astigmatism, and spherical equivalent of -2.14±1.01 D. At the final visit myopia level and spherical equivalent significantly decreased to -0.73±0.84 D (p<0.001) and -1.01±0.87 D (p<0.001), respectively. Estimated K was 8.07±0.36 mm, and final K used for ortho-K prescription was 8.19±0.30 mm. Final K significantly correlated with K value of pre-fitted peripheral cornea (r=0.737, p<0.001) and estimated K (r=0.721, p<0.001), respectively. There was no correlation between pre-fitted degree of myopia and the Final lens power (r=0.429, p=0.053). CONCLUSIONS Ortho-K lenses may be an effective solution for patients with myopic regression following keratorefractive surgery. Estimated K value can be used as reference value in ortho-K prescription.
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Affiliation(s)
- Young Min Park
- Department of Ophthalmology, Pusan National University School of Medicine & Medical Research Institute, Pusan National University Hospital, Yangsan, South Korea
| | | | - Ji-Eun Lee
- Department of Ophthalmology, Pusan National University School of Medicine & Medical Research Institute, Pusan National University Hospital, Yangsan, South Korea
| | - Jong Soo Lee
- Department of Ophthalmology, Pusan National University School of Medicine & Medical Research Institute, Pusan National University Hospital, Pusan, South Korea.
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Choi SH, Kim SJ, Kim MK, Wee WR. Short-Term Clinical Results of Hyperopic LASEK in Korean Patients. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.10.1527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Se Hyun Choi
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Seong Joon Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Seoul Artificial Eye Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Won Ryang Wee
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
- Seoul Artificial Eye Center, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
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Tan J, Lytle GE, Marshall J. Consecutive laser in situ keratomileusis and accelerated corneal crosslinking in highly myopic patients: preliminary results. Eur J Ophthalmol 2014; 25:0. [PMID: 25588591 DOI: 10.5301/ejo.5000543] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE To report the preliminary results of an evaluation of the safety and predictability of Lasik Xtra, a technique combining laser in situ keratomileusis (LASIK) and accelerated corneal crosslinking, in highly myopic patients. METHODS In this consecutive comparative case series, 70 consecutive eyes undergoing LASIK for correction of high myopia (-8.00 D to -19.00 D manifest refractive spherical equivalent) were prospectively recruited and treated with Lasik Xtra and compared with a retrospective consecutive control group of 64 eyes who had undergone LASIK alone for correction of high myopia. The follow-up was 3 months. Outcome measures included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and refraction. RESULTS A total of 61% of LASIK only eyes achieved UDVA of 20/25 or better, compared to 98% of Lasik Xtra eyes (p<0.001) at 3 months. A greater percentage of eyes were within ±0.50 of the intended correction in the Lasik Xtra group (88%) than in the LASIK only group (65%) at 3 months (p = 0.005). Linear regression of the scatterplot of attempted versus achieved correction reveals a coefficient of determination of 0.83 in the LASIK only group vs 0.99 in the Lasik Xtra group. A trend (p = 0.051) towards greater refractive drift in the LASIK group (-0.13 D) vs the Lasik Xtra group (-0.04 D) was observed. No adverse events were observed in either group. CONCLUSIONS Lasik Xtra did not reduce the refractive accuracy of the LASIK procedure. The addition of crosslinking may induce early stabilization of the cornea after LASIK, improving the predictability of refractive outcomes in highly myopic subjects.
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Ide T, Toda I, Fukumoto T, Watanabe J, Tsubota K. Outcome of a 10-year follow-up of laser in situ laser keratomileusis for myopia and myopic astigmatism. Taiwan J Ophthalmol 2014. [DOI: 10.1016/j.tjo.2014.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Lee YW, Kim YJ, Kim JM, Bae JH, Choi CY. Efficacy and Safety of Transdermal Fentanyl in the Control of Postoperative Pain After Photorefractive Keratectomy. J Ocul Pharmacol Ther 2014; 30:783-9. [DOI: 10.1089/jop.2013.0125] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Yong Woo Lee
- Department of Ophthalmology, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yang Jae Kim
- Department of Ophthalmology, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Joon Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jeong Hun Bae
- Department of Ophthalmology, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chul Young Choi
- Department of Ophthalmology, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Ortega-Usobiaga J, Llovet-Osuna F, Djodeyre MR, Llovet-Rausell A, Beltran-Sanz J, Baviera-Sabater J. [Post-lasik corneal ectasia in patients with significant differences in keratometry readings between both eyes]. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2014; 89:99-103. [PMID: 24461264 DOI: 10.1016/j.oftal.2013.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 11/11/2013] [Accepted: 11/18/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVES A study is made on the incidence of corneal ectasia after laser in situ keratomileusis (LASIK) in patients with large differences in mean keratometry (MK) readings between both eyes (OU). Visual outcomes were also evaluated. METHODS The medical records of 164,603 patients (315,259 eyes) who underwent LASIK from January 2003 to December 2011 were reviewed in order to identify patients with a difference in MK of ≥ 1.25 D between OU. The main outcome measures were incidence of ectasia after LASIK, and visual outcome. RESULTS A total of 35 eyes that met the inclusion criteria were found. Functional and visual results were those expected for myopia studies. After a minimum follow-up of 2 years, no corneal ectasia was found in 3 eyes (2 patients). CONCLUSIONS The possibility of finding a patient with an asymmetry in MK and normal topography is low (0.021%), and it does not seem to be a contraindication of LASIK. Although no corneal ectasia was found in this case series, and as it is a potentially sight-threatening complication, patients with very different MK between OU should be studied carefully before undergoing LASIK.
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Affiliation(s)
- J Ortega-Usobiaga
- Departamento de Catarata y Cirugía Refractiva, Clínica Baviera, Bilbao, España.
| | - F Llovet-Osuna
- Departamento de Catarata y Cirugía Refractiva, Clínica Baviera, Bilbao, España
| | - M R Djodeyre
- Departamento de Catarata y Cirugía Refractiva, Clínica Baviera, Bilbao, España
| | - A Llovet-Rausell
- Departamento de Catarata y Cirugía Refractiva, Clínica Baviera, Bilbao, España
| | - J Beltran-Sanz
- Departamento de Investigación y Desarrollo, Clínica Baviera, Valencia, España
| | - J Baviera-Sabater
- Departamento de Catarata y Cirugía Refractiva, Clínica Baviera, Bilbao, España
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Kang H, Choe CM, Choi TH, Kim SK. Comparison of Clinical Results between Transepithelial Photorefractive Keratectomy and Brush Photorefractive Keratectomy. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2014. [DOI: 10.3341/jkos.2014.55.9.1284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Schumer DJ, Bains HS, Brown KL. Dark-adapted Pupil Sizes in a Prospective Evaluation of Laser in situ Keratomileusis Patients. J Refract Surg 2013; 16:S239-41. [PMID: 24364384 DOI: 10.3928/1081-597x-20000302-08] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE This study presents the results of scotopic pupil size measurement in a group of laser in situ keratomileusis (LASIK) patients and the implications this value has for night vision symptoms and treatment zones. METHODS This was a prospective study measuring the dark-adapted pupil of 218 patients using a handheld pupillometer. RESULTS The mean scotopic pupil size was 5.66 mm with a standard deviation of 1.04 mm. Pupils ranged in size from 3.00 mm to 9.00 mm. CONCLUSION Results suggest that a number of patients may have seotopic pupil size well beyond the treatment zones commonly used or available in refractive laser systems. Treating with an ablation zone that is smaller than the mesopic pupil will often result in night vision disturbances. Next generation technology such as the Nidek EC-5000 excimer laser can incorporate larger treatment diameters in order to reduce the incidence of halos and glare at night. [J Refract Surg 2000; 16(suppl):S239-S241].
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Vestergaard AH, Hjortdal JØ, Ivarsen A, Work K, Grauslund J, Sjølie AK. Long-term Outcomes of Photorefractive Keratectomy for Low to High Myopia: 13 to 19 Years of Follow-Up. J Refract Surg 2013; 29:312-9. [DOI: 10.3928/1081597x-20130415-02] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 02/25/2013] [Indexed: 11/20/2022]
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Shortt AJ, Allan BDS, Evans JR. Laser-assisted in-situ keratomileusis (LASIK) versus photorefractive keratectomy (PRK) for myopia. Cochrane Database Syst Rev 2013:CD005135. [PMID: 23440799 DOI: 10.1002/14651858.cd005135.pub3] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Myopia (also known as short-sightedness or near-sightedness) is an ocular condition in which the refractive power of the eye is greater than is required, resulting in light from distant objects being focused in front of the retina instead of directly on it. The two most commonly used surgical techniques to permanently correct myopia are photorefractive keratectomy (PRK) and laser-assisted in-situ keratomileusis (LASIK). OBJECTIVES To compare the effectiveness and safety of LASIK and PRK for correction of myopia by examining post-treatment uncorrected visual acuity, refractive outcome, loss of best spectacle-corrected visual acuity, pain scores, flap complications in LASIK, subepithelial haze, adverse events, quality of life indices and higher order aberrations. SEARCH METHODS We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 11), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to November 2012), EMBASE (January 1980 to November 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to November 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 15 November 2012. We also searched the reference lists of the studies and the Science Citation Index. SELECTION CRITERIA We included randomised controlled trials comparing LASIK and PRK for the correction of any degree of myopia. DATA COLLECTION AND ANALYSIS Two authors independently assessed trial quality and extracted data. We summarised data using the odds ratio and mean difference. We combined odds ratios using a random-effects model after testing for heterogeneity. MAIN RESULTS We included 13 trials (1135 participants, 1923 eyes) in this review. Nine of these trials randomised eyes to treatment, two trials randomised people to treatment and treated both eyes, and two trials randomised people to treatment and treated one eye. None of the paired trials reported an appropriate paired analysis. We considered the overall quality of evidence to be low for most outcomes because of the risk of bias in the included trials. There was evidence that LASIK gives a faster visual recovery than PRK and is a less painful technique. Results at one year after surgery were comparable: most analyses favoured LASIK but they were not statistically significant. AUTHORS' CONCLUSIONS LASIK gives a faster visual recovery and is a less painful technique than PRK. The two techniques appear to give similar outcomes one year after surgery. Further trials using contemporary techniques are required to determine whether LASIK and PRK as currently practised are equally safe. Randomising eyes to treatment is an efficient design, but only if analysed properly. In future trials, more efforts could be made to mask the assessment of outcome.
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Affiliation(s)
- Alex J Shortt
- The Moorfields Eye Hospital/UCL Institute of Ophthalmology National Institute for Health Research Biomedical Research Centre,London, UK.
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Srinivasan S, Ting DSJ, Lyall DAM. Implantation of a customized toric intraocular lens for correction of post-keratoplasty astigmatism. Eye (Lond) 2013; 27:531-7. [PMID: 23348728 DOI: 10.1038/eye.2012.300] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To report visual and refractive outcomes, and endothelial cell loss following primary and secondary 'piggyback' toric intraocular lens (IOL) implantation in patients with high post-penetrating keratoplasty (PK) astigmatism. METHODS Prospective case series. Nine eyes of nine patients with post-PK astigmatism were consecutively recruited for implantation of a customized toric IOL. Six underwent simultaneous phacoemulsification (PE) and three pseudophakic eyes had a secondary 'piggyback' toric IOL implanted in the ciliary sulcus. Mean follow-up time was 17.2±7.7 months. Pre- and post-operative uncorrected (UDVA) and best-corrected (BDVA) distance visual acuities and refractive errors were collected for comparison. Cartesian astigmatic vectors were calculated to identify a change in the magnitude of astigmatism pre- compared to postoperatively. Pre- and post-operative endothelial cell counts were also collected for analysis. RESULTS UDVA (logMAR) improved from 1.13±0.51 preoperatively to 0.48±0.24 postoperatively (P-value=0.003). There was no significant change in BDVA (P-value=0.905) from 0.31±0.27 to 0.26±0.19. Corneal astigmatism preoperatively was 6.57±4.40 diopters (D). Post-operative refractive cylinder was 0.83±1.09 D compared to 3.89±4.01 D preoperatively (P=0.039). Analysis of astigmatic Cartesian x and y coordinates found a significant reduction postoperatively compared to preoperatively (P=0.005 and P=0.002), respectively. Mean endothelial cell loss was 9.9%. CONCLUSION Implantation of a customized primary or secondary 'piggyback' toric IOL serves as an effective modality in treating patients with high post-PK astigmatism.
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Affiliation(s)
- S Srinivasan
- Department of Ophthalmology, University Hospital Ayr, Ayr, Scotland, UK.
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Ghoreishi M, Masjedi A, Nasrollahi K, Rahgozar A, Jenab K, Fesharaki H. Artiflex versus STAAR implantable contact lenses for correction of high myopia. Oman J Ophthalmol 2012; 4:116-9. [PMID: 22279398 PMCID: PMC3263163 DOI: 10.4103/0974-620x.91266] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Purpose: To compare two phakic intraocular lenses, Artiflex and STAAR® implantable contact lens (ICL), in high myopia. Setting: Isfahan Ophthalmology Clinic, Iran. Materials and Methods: In a randomized, prospective clinical trial study, 40 eyes of 20 patients who came to Isfahan ophthalmology clinic to correct their refractive error were examined. Artiflex was inserted in 20 eyes and ICL in the other 20 eyes. After 1 year, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), contrast sensitivity, intraocular pressure (IOP), and specular microscopy of corneal endothelium were assessed in both the groups. Results: In this study, there was no statistical difference between UCVA, BCVA, IOP, cataract incidence, contrast sensitivity, and specular microscopy, 1 year after surgery. 40% of eyes in the Artiflex group developed anterior chamber cell and flare reaction 1 year postoperatively, but no patient in the ICL group developed the same. So, there is obvious difference in the rate of anterior chamber cell and flare reaction between these two groups. Conclusion: These two lenses have similar outcomes except in the incidence rate of anterior chamber cell and flare reaction that is greater in the Artiflex group. So, these two lenses are safe with predictable outcome in treating high myopia.
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Affiliation(s)
- Mohammad Ghoreishi
- Department of Ophthalmology, Isfahan University of Medical Sciences, Persian Eye Clinic, Isfahan, Iran
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Durrie DS, Brinton JP, Avila MR, Stahl ED. Evaluating the Speed of Visual Recovery Following Thin-flap LASIK With a Femtosecond Laser. J Refract Surg 2012; 28:620-4. [DOI: 10.3928/1081597x-20120815-06] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 07/06/2012] [Indexed: 11/20/2022]
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Ayanniyi AA, Adepoju FG, Ayanniyi RO, Morgan RE. Challenges, attitudes and practices of the spectacle wearers in a resource-limited economy. Middle East Afr J Ophthalmol 2011; 17:83-7. [PMID: 20543943 PMCID: PMC2880380 DOI: 10.4103/0974-9233.61223] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose: To evaluate challenges, attitudes and practices among spectacle wearers to effect positive change when necessary, and determine positive change in a resource-limited economy. Materials and Methods: A multi-hospital descriptive, cross sectional survey of spectacle wearers was conducted between May 2007 and December 2008 in Nigeria. Results: A total of 214 wearers comprising 43.5% males and 56.5% females aged 18-84 years were surveyed. The majority of subjects (92.6%) had at least secondary education. The wearers’ challenges included expensive spectacles (43.0%), falling/scratched/broken lenses (29.4%) and fear that spectacles would damage the eyes (23.8%). The wearers’ attitudes were comprised of consultations with ‘road side dispensers’ (7%) and permitting other individuals to select spectacle frames for them (26%). Care and maintaince practices included use of handkerchief, tissue paper, fingers and water to clean spectacles (49.5%) and placing spectacles inside spectacle cases (30.4%). There were no associations (P > 0.05) between gender or literacy levels and who selected the frames for the subjects, caregivers consulted for spectacles, and cleaning materials for spectacles. The placement of spectacles when not in use was significantly associated (P < 0.05) with the wearers’ gender and literacy levels but not with the length of spectacle wear. Conclusion: Attitudes and practices requiring positive change crossed gender and educational levels among spectacle wearers. The cost of spectacles should be regulated and availability of standard eye care practices would reduce challenges including lens-related defects and quackery. During consultation with a recognized eye care professional, counseling of wearers on positive attitudes/practices as well as allaying fear of spectacle wear is required.
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Almahmoud T, Munger R, Jackson WB. Effects of advanced surface ablations and intralase femtosecond LASIK on higher order aberrations and visual acuity outcome. Saudi J Ophthalmol 2011; 25:275-80. [PMID: 23960936 DOI: 10.1016/j.sjopt.2011.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 04/15/2011] [Accepted: 04/17/2011] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND/AIMS To study the changes in wavefront (ocular) and corneal higher order aberrations (HOAs) and visual acuity (VA) outcome following wavefront-guided advanced surface ablation (ASA) techniques and intralase femtosecond LASIK (iLASIK) in myopia treatment. METHODS Ocular aberration and corneal topography of 240 eyes in the ASA techniques (this was equally divided into a flap-on group where the epithelial flap was preserved and reapplied to the photoablated stromal bed and a flap-off group when the epithelial flap was discarded during the procedure), and 138 eyes in the iLASIK group were obtained before and 3 months following treatment. The correlation of aberrations with best spectacle-corrected visual acuity was analyzed. RESULTS At 3 months, there was statistically significant (P < 0.001) surgically induced increase in spherical aberration (SA) in each of the techniques for both ocular and corneal analysis. iLASIK induced significantly less ocular and corneal HOAs (P < 0.001). The mean manifest refractive spherical equivalent was closer to attempted correction compared to other groups (P < 0.001). Eighty-three eyes (70%) of flap-on, 80 (67%) flap-off and 94 eyes (68%) in the iLASIK group achieved 20/20 uncorrected VA. Fifteen eyes (11%) accomplished 20/12.5 or better in iLASIK compared to 4 (3%) for flap-on and 7 (6%) for flap-off ASA group. Only the flap-off treatment showed a consistent correlation between the corrected aberrations and visual performance. CONCLUSION At 3 months, all procedures resulted in a significant increase in HOAs and SA. All had comparable 20/20 VA and 11% of iLASIK patients achieved 20/12.5 or better level.
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Affiliation(s)
- Tahra Almahmoud
- Department of Surgery, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Chen CC, Liou SW, Chen CC, Chen WC, Hu FR, Wang IJ, Lin SJ. Coenzyme Q10 reduces ethanol-induced apoptosis in corneal fibroblasts. PLoS One 2011; 6:e19111. [PMID: 21556371 PMCID: PMC3083429 DOI: 10.1371/journal.pone.0019111] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Accepted: 03/27/2011] [Indexed: 11/18/2022] Open
Abstract
Dilute ethanol (EtOH) is a widely used agent to remove the corneal epithelium during the modern refractive surgery. The application of EtOH may cause the underlying corneal fibroblasts to undergo apoptosis. This study was designed to investigate the protective effect and potential mechanism of the respiratory chain coenzyme Q(10) (CoQ(10)), an electron transporter of the mitochondrial respiratory chain and a ubiquitous free radical scavenger, against EtOH-induced apoptosis of corneal fibroblasts. Corneal fibroblasts were pretreated with CoQ(10) (10 µM) for 2 h, followed by exposure to different concentrations of EtOH (0.4, 2, 4, and 20%) for 20 s. After indicated incubation period (2-12 h), MTT assay was used to examine cell viability. Treated cells were further assessed by flow cytometry to identify apoptosis. Reactive oxygen species (ROS) and the change in mitochondrial membrane potential were assessed using dichlorodihydrofluorescein diacetate/2',7'-dichlorofluorescein (DCFH-DA/DCF) assays and flow-cytometric analysis of JC-1 staining, respectively. The activity and expression of caspases 2, 3, 8, and 9 were evaluated with a colorimetric assay and western blot analysis. We found that EtOH treatment significantly decreased the viability of corneal fibroblasts characterized by a higher percentage of apoptotic cells. CoQ(10) could antagonize the apoptosis inducing effect of EtOH. The inhibition of cell apoptosis by CoQ(10) was significant at 8 and 12 h after EtOH exposure. In EtOH-exposed corneal fibroblasts, CoQ(10) pretreatment significantly reduced mitochondrial depolarization and ROS production at 30, 60, 90, and 120 min and inhibited the activation and expression of caspases 2 and 3 at 2 h after EtOH exposure. In summary, pretreatment with CoQ(10) can inhibit mitochondrial depolarization, caspase activation, and cell apoptosis. These findings support the proposition that CoQ(10) plays an antiapoptotic role in corneal fibroblasts after ethanol exposure.
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Affiliation(s)
- Chun-Chen Chen
- Department of Ophthalmology, Taipei City Hospital Renai Branch, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shiow-Wen Liou
- Department of Ophthalmology, Taipei City Hospital Renai Branch, Taipei, Taiwan
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
- Taipei Medical University, Taipei, Taiwan
| | - Chi-Chih Chen
- Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wen-Chung Chen
- Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fung-Rong Hu
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - I-Jong Wang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
- * E-mail: (IJW); (SJL)
| | - Shing-Jong Lin
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
- Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
- Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
- * E-mail: (IJW); (SJL)
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Abstract
PURPOSE OF REVIEW Ametropia and astigmatism following successful penetrating keratoplasty can seriously impact a patient's quality of vision. Similar limitations can result following anterior lamellar keratoplasty (ALK) and Descemet's stripping endothelial keratoplasty (DSEK). These patients often suffer from aniseikonia and can be intolerant of spectacles and contact lenses. Refractive surgery can correct both ametropia and astigmatism following corneal transplantation and improve a patient's final visual outcome. The same methods used to correct naturally occurring refractive errors are being used with increasing success in patients who have undergone corneal transplants. RECENT FINDINGS Many refractive options are available to treat ametropia following penetrating keratoplasty. Incisional keratotomies have been employed to treat high amounts of astigmatism. Photorefractive keratectomy (PRK) and laser in-situ keratomileusis (LASIK) are also used to treat myopia, hyperopia and astigmatism. LASIK has been shown to have an overall better outcome compared to PRK; however, the use of mitomycin-C with PRK has improved results. Phakic and pseudophakic piggyback intraocular lenses are also being used to treat high degrees of ametropia and astigmatism; however, the long-term results are somewhat limited. SUMMARY Refractive surgery can improve the final visual outcome of patients who have undergone successful corneal transplantation. Currently available modalities provide many options for patients who are intolerant of spectacles and contact lenses. Continued advances and research will enable surgeons to optimize visual quality in postkeratoplasty patients.
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Yuen LH, Chan WK, Koh J, Mehta JS, Tan DT. A 10-year prospective audit of LASIK outcomes for myopia in 37,932 eyes at a single institution in Asia. Ophthalmology 2010; 117:1236-1244.e1. [PMID: 20153899 DOI: 10.1016/j.ophtha.2009.10.042] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Revised: 10/25/2009] [Accepted: 10/26/2009] [Indexed: 11/16/2022] Open
Abstract
PURPOSE This study evaluates the efficacy, predictability and safety of LASIK surgery as a treatment for myopia performed as part of a large-scale, prospective clinical audit spanning 10 years in an Asian study population and to evaluate the outcomes and trends. DESIGN Prospective, nonrandomized, single-center, multisurgeon study. PARTICIPANTS We included 37,932 eyes of 19,753 patients that underwent myopic LASIK at the Singapore National Eye Centre between 1998 and 2007. METHODS All eyes underwent LASIK as a treatment for myopia. Pre- and postoperative refractions, uncorrected visual acuity (UCVA), and best-corrected visual acuity (BCVA) were documented. MAIN OUTCOMES MEASURES Safety, efficacy, refractive predictability, treatment trends, retreatment rates, and complications for mild, moderate, and high myopia according to spherical equivalence (SE) of less than -5.00 diopters (D), -5.00 D or more to less than -10.0 D, and -10.00 D or more, respectively. RESULTS Patients' median age was 32 years (mean, 33.0+/-7.9 years); there were 6832 males (34.6%) and 12,921 females included. Patients were predominantly ethnic Chinese (90.5%). Mean follow-up time was 68.8 days. The mean spherical error corrected was -5.90+/-2.57 D (median, -5.625 D), and outcomes were categorized into low, moderate, or high myopia. The UCVA achieving > or =20/40 has been consistently above 90% since 2000, with 72.8% achieving > or =20/20. More than 93.0% of eyes achieved within +/-1.00 D target in the last 4 years. An improvement in safety was observed since the start of the study, with the best outcomes observed in 2007; loss of 1 and 2 Snellen line BCVA postoperatively was 2.4% and 0.1%, respectively. The overall retreatment rate was 3.8%; 91% of retreated eyes achieved UCVA of > or =20/30. Between 1998 and 2007, there was a significant improvement in postoperative UCVA and BCVA (P<0.001). CONCLUSIONS Myopic LASIK performed in Asian eyes within a comprehensive LASIK clinical program with appropriate clinical audit governance can be safe and effective, with high refractive predictability. Improvements in the nomograms to prevent undercorrection and to compensate for myopic regression have led to better efficacy after LASIK, with an increasing percentage of patients achieving 20/15 visual acuity postoperatively.
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Affiliation(s)
- Leonard H Yuen
- Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore
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Lee JH, Ahn K, Chung ES, Chung TY. Predictable Factors of Postoperative Pain Following LASEK. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2010. [DOI: 10.3341/jkos.2010.51.9.1203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jung-Hye Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | - Eui-Sang Chung
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Tae-Young Chung
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Rosman M, Alió JL, Ortiz D, Perez-Santonja JJ. Comparison of LASIK and Photorefractive Keratectomy for Myopia From −10.00 to −18.00 Diopters 10 Years After Surgery. J Refract Surg 2010; 26:168-76. [DOI: 10.3928/1081597x-20100224-02] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2008] [Accepted: 02/18/2009] [Indexed: 11/20/2022]
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Ivarsen A, Møller-Pedersen T. LASIK Induces Minimal Regrowth and No Haze Development in Rabbit Corneas. Curr Eye Res 2009; 30:363-73. [PMID: 16020267 DOI: 10.1080/02713680590964848] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To quantify central corneal regrowth and haze development after LASIK in rabbits. METHODS New Zealand White rabbits received an 89 microm (-8 diopters) myopic LASIK and were evaluated during 4 months using slit-lamp and in vivo confocal microscopy to monitor changes in central corneal morphology, epithelial and stromal thickness, flap and bed thickness, and corneal light backscattering (haze). At various time-points, corneas were processed for histology. RESULTS Using in vivo confocal microscopy, LASIK induced no detectable morphological changes besides a slightly elevated light backscattering at the interface. Correspondingly, all corneas remained clear with no haze development by slit-lamp biomicroscopy. Corneal thickness was stable by 8 weeks after an increase of 17 +/- 4 microm that consisted of a 13 +/- 3 microm stromal regrowth and a 4 +/- 2 microm epithelial hyperplasia. At the LASIK interface, less than 4 microm new extracellular matrix was deposited. Accordingly, all LASIK flaps were easily pulled off by 6 months. CONCLUSIONS LASIK induces a minimal wound healing response in rabbit corneas with no haze development and a regrowth (regression) of only 17 microm of an 89-microm photoablation. Three main factors contributed to the observed regrowth: epithelial hyperplasia (approximately 4 microm), matrix deposition at the LASIK interface (approximately 4 microm), and stromal growth outside the interface within the flap and wound bed (approximately 9 microm).
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Affiliation(s)
- Anders Ivarsen
- Department of Ophthalmology, Aarhus University Hospital, Denmark
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