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Igras E, Czarnota-Nowakowska B, O’Caoimh R. Comparison of the Clinical Effectiveness of Correcting Different Types of Astigmatism with Small Incision Lenticule Extraction. J Clin Med 2023; 12:6941. [PMID: 37959406 PMCID: PMC10648579 DOI: 10.3390/jcm12216941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Few studies have reported the differential outcomes of Small Incision Lenticule Extraction (SMILE) on myopic astigmatism. Given this, we examined the effectiveness of SMILE for up to one year, comparing with-the-rule (WTR), against-the-rule (ATR), and oblique astigmatism, conducting a retrospective review of patients who underwent correction of myopic astigmatism using the 500-kHz VisuMax femtosecond laser (Carl Zeiss Meditec) at two refractive clinics in Poland between 2016-2017. Patients were aged ≥21 with stable refractive errors between -0.5 and -10.0 diopter (D) with astigmatism up to 5D. The mean age of the 209 patients (355 eyes) available was 32 years; 58.4% were female. Of these, 247 had WTR, 62 oblique, and 46 ATR astigmatism. The mean pre-operative spherical equivalent (SE) was -5.4 ± 2.57D and the cylinder -1.7 ± 1.0D. The mean SE for WTR reduced from -5.60 ± 2.37D to -0.31 ± 0.67D at 2 months and -0.38 ± 0.70D at 12 months; the mean cylinder improved from -1.90 ± 1.10D to -0.31 ± 0.39D and -0.36 ± 0.43D, respectively. Eyes with oblique astigmatism also improved from a mean SE of -5.8 ± 3.4 D to -0.82 ± 1.50D and -0.69 ± 1.15D and a cylinder of -1.4 ± 0.73D to -0.17 ± 0.33D at 2 months and -0.1 ± 0.32D at 12. For ATR, the mean SE improved from -4.0 ± 1.8D to -0.08 ± 0.22D and -0.04 ± 0.12D; and the mean cylinder from -1.25 ± 0.53 to -0.02 ± 0.09D -0.08 ± 0.21D at 2 and 12 months, respectively. There were statistically significant improvements in SE, manifest sphere and cylinder refraction, and UDVA and CDVA scores for each cylinder type at 2 months with ATR cylinders having better outcomes. Although missing data limited interpretation at one year, differences were maintained. The magnitude of error calculations suggests that WTR was more prone to under-correction, particularly for high astigmatism (>1.5D). SMILE for myopic astigmatism reliably corrects SE, irrespective of the subtype of astigmatism.
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Affiliation(s)
- Estera Igras
- Estera Igras, Optegra Eye Health Care Laser Clinic, Mickiewicza Street 140, 71-153 Szczecin, Poland
| | | | - Rónán O’Caoimh
- Department of Geriatric Medicine, Mercy University Hospital, Grenville Place, T12 WE28 Cork, Ireland;
- Clinical Research Facility Cork, University College Cork, Mercy University Hospital, T12 WE28 Cork, Ireland
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Adib-Moghaddam S, Soleyman-Jahi S, Salmanian B, Omidvari AH, Adili-Aghdam F, Noorizadeh F, Eslani M. Single-step transepithelial photorefractive keratectomy in myopia and astigmatism: 18-month follow-up. J Cataract Refract Surg 2018; 42:1570-1578. [PMID: 27956283 DOI: 10.1016/j.jcrs.2016.08.029] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 08/01/2016] [Accepted: 08/16/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the long-term quantitative and qualitative optical outcomes of 1-step transepithelial photorefractive keratectomy (PRK) to correct myopia and astigmatism. SETTING Bina Eye Hospital, Tehran, Iran. DESIGN Prospective interventional case series. METHODS Eyes with myopia with or without astigmatism were evaluated. One-step transepithelial PRK was performed with an aberration-free aspheric optimized profile and the Amaris 500 laser. Eighteen-month follow-up results for refraction, visual acuities, vector analysis, higher-order aberrations, contrast sensitivity, postoperative pain, and haze grade were assessed. RESULTS The study enrolled 146 eyes (74 patients). At the end of follow-up, 93.84% of eyes had an uncorrected distance visual acuity of 20/20 or better and 97.94% of eyes were within ±0.5 diopter of the targeted spherical refraction. On vector analysis, the mean correction index value was close to 1 and the mean index of success and magnitude of error values were close to 0. The achieved correction vector was on an axis counterclockwise to the axis of the intended correction. Photopic and mesopic contrast sensitivities and ocular and corneal spherical, cylindrical, and corneal coma aberrations significantly improved (all P < .001). A slight amount of trefoil aberration was induced (P < .001, ocular aberration; P < .01, corneal aberration). No eye lost more than 1 line of corrected distance visual acuity. No eye had a haze grade of 2+ degrees or higher throughout the follow-up. CONCLUSIONS Eighteen-month results indicate the efficacy and safety of transepithelial PRK to correct myopia and astigmatism. It improved refraction and quality of vision. FINANCIAL DISCLOSURE None of the authors has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Soheil Adib-Moghaddam
- From the Bina Eye Hospital (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), theTransPRK Research Center (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), and the Universal Council of Ophthalmology (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), Universal Scientific Education and Research Network, Tehran, Iran; the Department of Ophthalmology and Visual Sciences (Eslani), University of Illinois at Chicago, Chicago, Illinois, USA.
| | - Saeed Soleyman-Jahi
- From the Bina Eye Hospital (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), theTransPRK Research Center (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), and the Universal Council of Ophthalmology (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), Universal Scientific Education and Research Network, Tehran, Iran; the Department of Ophthalmology and Visual Sciences (Eslani), University of Illinois at Chicago, Chicago, Illinois, USA
| | - Bahram Salmanian
- From the Bina Eye Hospital (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), theTransPRK Research Center (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), and the Universal Council of Ophthalmology (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), Universal Scientific Education and Research Network, Tehran, Iran; the Department of Ophthalmology and Visual Sciences (Eslani), University of Illinois at Chicago, Chicago, Illinois, USA
| | - Amir-Houshang Omidvari
- From the Bina Eye Hospital (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), theTransPRK Research Center (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), and the Universal Council of Ophthalmology (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), Universal Scientific Education and Research Network, Tehran, Iran; the Department of Ophthalmology and Visual Sciences (Eslani), University of Illinois at Chicago, Chicago, Illinois, USA
| | - Fatemeh Adili-Aghdam
- From the Bina Eye Hospital (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), theTransPRK Research Center (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), and the Universal Council of Ophthalmology (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), Universal Scientific Education and Research Network, Tehran, Iran; the Department of Ophthalmology and Visual Sciences (Eslani), University of Illinois at Chicago, Chicago, Illinois, USA
| | - Farsad Noorizadeh
- From the Bina Eye Hospital (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), theTransPRK Research Center (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), and the Universal Council of Ophthalmology (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), Universal Scientific Education and Research Network, Tehran, Iran; the Department of Ophthalmology and Visual Sciences (Eslani), University of Illinois at Chicago, Chicago, Illinois, USA
| | - Medi Eslani
- From the Bina Eye Hospital (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), theTransPRK Research Center (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), and the Universal Council of Ophthalmology (Adib-Moghaddam, Soleyman-Jahi, Salmanian, Omidvari, Adili-Aghdam, Noorizadeh), Universal Scientific Education and Research Network, Tehran, Iran; the Department of Ophthalmology and Visual Sciences (Eslani), University of Illinois at Chicago, Chicago, Illinois, USA
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Qian Y, Huang J, Chu R, Zhou X, Olszewski E. Influence of intraocular astigmatism on the correction of myopic astigmatism by laser-assisted subepithelial keratectomy. J Cataract Refract Surg 2014; 40:558-63. [PMID: 24581997 DOI: 10.1016/j.jcrs.2013.09.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 08/20/2013] [Accepted: 09/14/2013] [Indexed: 11/15/2022]
Abstract
PURPOSE To assess the influence of the origin of astigmatism on the correction of myopic astigmatism by laser-assisted subepithelial keratectomy (LASEK). SETTING Ophthalmology Department, Eye and ENT Hospital, Shanghai, China. DESIGN Prospective study. METHODS Patients having LASEK to correct myopia or myopic astigmatism were divided into 2 groups according to their ocular residual astigmatism (ORA). Patients were examined preoperatively and 1 and 3 months postoperatively. The efficacy of LASEK was compared between those with and those without a significant amount of intraocular astigmatism. RESULTS The study comprised 54 eyes of 54 patients. The mean index of success (ratio of magnitude of remaining uncorrected astigmatism to that of initial preoperative astigmatism) in the high ORA group (n=21) and low ORA group (n=33) was 0.85 and 0.48, respectively, 1 month after surgery (t=2.17, P=.04) and 0.88 and 0.32, respectively, 3 months after surgery (t=2.18, P=.04). The Zernike coefficient of horizontal coma, Z(3,+1), increased more after surgery in the high ORA group than in the low ORA group (1 month versus preoperative, t=2.32, P=.024; 3 months versus preoperative, t=2.07, P=.048). CONCLUSIONS Nine percent and 2% of the eyes had minimal corneal haze at 1 month and 3 months, respectively. Laser-assisted subepithelial keratectomy was less effective in correcting myopic astigmatism when astigmatism was mainly located at the internal optics. Horizontal coma increased more after LASEK in patients with higher ORA. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Yishan Qian
- From the Department of Ophthalmology (Qian, Huang, Chu, Zhou), Eye and ENT Hospital, Fudan University, and the Key Laboratory of Myopia of State Health Ministry (Qian, Huang, Chu, Zhou), Shanghai, China; the Department of Surgery (Olszewski), Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Jia Huang
- From the Department of Ophthalmology (Qian, Huang, Chu, Zhou), Eye and ENT Hospital, Fudan University, and the Key Laboratory of Myopia of State Health Ministry (Qian, Huang, Chu, Zhou), Shanghai, China; the Department of Surgery (Olszewski), Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Renyuan Chu
- From the Department of Ophthalmology (Qian, Huang, Chu, Zhou), Eye and ENT Hospital, Fudan University, and the Key Laboratory of Myopia of State Health Ministry (Qian, Huang, Chu, Zhou), Shanghai, China; the Department of Surgery (Olszewski), Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Xingtao Zhou
- From the Department of Ophthalmology (Qian, Huang, Chu, Zhou), Eye and ENT Hospital, Fudan University, and the Key Laboratory of Myopia of State Health Ministry (Qian, Huang, Chu, Zhou), Shanghai, China; the Department of Surgery (Olszewski), Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA.
| | - Emily Olszewski
- From the Department of Ophthalmology (Qian, Huang, Chu, Zhou), Eye and ENT Hospital, Fudan University, and the Key Laboratory of Myopia of State Health Ministry (Qian, Huang, Chu, Zhou), Shanghai, China; the Department of Surgery (Olszewski), Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
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