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Chen H, Wang Z, Li K, Wang Y, Li X, Du L, Lin M, Savini G, Wang Q, Yu A, Chen S. Agreement Between Predicted and Actual Measured Ablation Depth After FS-LASIK Using Different Rotating Scheimpflug Cameras and OCT. Front Med (Lausanne) 2022; 9:907334. [PMID: 35665335 PMCID: PMC9160334 DOI: 10.3389/fmed.2022.907334] [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: 03/29/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeTo compare the predicted ablation depth (AD) with the postoperatively measured corneal ablation depth (postop-AD) at central, paracentral, and midperipheral locations using two rotating Scheimpflug analyzers and a Fourier-domain optical coherence tomographer in eyes that underwent femtosecond laser-assisted LASIK (FS-LASIK).MethodsThe values of corneal thickness were measured preoperatively and postoperatively at one and three months. The difference between preoperative and postoperative was defined as postop-AD. Measurements were performed at the corneal vertex and mid-peripheral area. The mid-peripheral corneal thickness was measured at the superior, inferior, nasal, and temporal locations at a distance of 1.0 or 2.5 mm from the corneal vertex. The predicted AD was calculated by ORK-CAM software (Schwind eye tech-solutions GmbH, Kleinostheim, Germany), and the difference between the predicted AD and postop-AD was defined as Δ-AD. Paired t-test analysis was employed to evaluate the differences, agreement was assessed by the Bland-Altman method.ResultsForty-two eyes of 42 patients were investigated. At one month, the predicted AD in the central and paracentral areas was underestimated by the Pentacam HR (Oculus, Wetzlar, Germany), Sirius (Costruzione Strumenti Oftalmici, Florence, Italy) and RTVue OCT (Optovue Inc., Freemont, CA, United States), whereas Δ-AD was negative as established by all devices and predominantly statistically significant. The Δ-AD values approximated zero at three months. The mean difference of Δ-AD at three months at the corneal vertex was 0.67 ± 9.39 mm, −7.92 ± 9.05 mm and −1.36 ± 8.31 mm, respectively. The mid-peripheral measurements had positive values at one month and even more highly positive at three months (with statistically significant differences in most of the cases). The agreement between the predicted and postop-AD was moderate with all devices, but slightly better with RTVue.ConclusionThe predicted AD seems to be underestimated in the central and paracentral corneal area and overestimated in the mid-periphery.Translational RelevanceThe study could help to partly explain and prevent the refractive errors after FS-LASIK.
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Affiliation(s)
- Hao Chen
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Ziqian Wang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Kunke Li
- Shenzhen Eye Hospital, Shenzhen Key Ophthalmic Laboratory, Jinan University, Shenzhen, China
| | - Yiran Wang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xin Li
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Lan Du
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Meimin Lin
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | | | - Qinmei Wang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Qinmei Wang,
| | - Ayong Yu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Ayong Yu,
| | - Sisi Chen
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
- Sisi Chen,
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Wu F, Yin H, Yang Y. Evaluation of the Difference between Predicted and Measured Central Corneal Thickness Reduction after SMILE and Femtosecond Laser-assisted LASIK for Myopia. Curr Eye Res 2021; 46:1089-1095. [PMID: 33494622 DOI: 10.1080/02713683.2021.1877310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the agreement between the predicted and measured central corneal thickness (CCT) reduction after the small incision lenticule extraction (SMILE) surgery and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) surgery. METHODS A total 165 patients were enrolled in this prospective study. Eighty patients with a mean spherical equivalent (SE) of -4.72 ± 1.80 Diopters (D) were treated with the FS-LASIK procedure and Eighty-five patients with a mean SE of -4.78 ± 1.63 D were treated with SMILE procedure. One eye for each patient was randomly selected and included for statistical analysis. Ultrasound pachymetry measurement and Scheimpflug camera corneal topography were performed preoperatively and 3 months postoperatively. The measured CCT reduction was calculated by comparing the preoperative examinations with postoperative examinations. Comparative statistics and linear regression analyses were performed. RESULTS The mean predicted CCT reduction was 95.02 ± 21.39 μm in FS-LASIK group and 103.49 ± 22.87 μm in SMILE group (P = .015). The prediction of laser platform was found to overestimate the measured CCT reduction for both FS-LASIK group (ultrasound 13.20 ± 9.34 μm) and SMILE group (ultrasound 13.12 ± 8.68 μm). The prediction of laser platform was found to systematically overestimate the measured CCT reduction in FS-LASIK group. In SMILE group, the difference between predicted and measured CCT reduction were found significantly related with the predicted CCT reduction (P < .001 for ultrasound; and P = .004 for Pentacam). CONCLUSION A systematic overestimation of measured CCT reduction in FS-LASIK group did not influence the refractive precision of FS-LASIK. Due to the different biomechanical distributions in post-SMILE cornea, the measured CCT reduction was influenced as the changes in refractive correction. Nomogram adjustment for high myopic correction needs further research.
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Affiliation(s)
- Fang Wu
- Eye Center, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Houfa Yin
- Eye Center, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yabo Yang
- Eye Center, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Janbatian H, Drake R, Melki S, Brenner J. The effect of low predicted/calculated postoperative keratometry on corrected distance visual acuity after LASIK. J Cataract Refract Surg 2019; 45:1770-1776. [PMID: 31856988 DOI: 10.1016/j.jcrs.2019.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 06/06/2019] [Accepted: 08/01/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Hrag Janbatian
- Boston Eye Group, Brookline, Massachusetts, USA; Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Ryan Drake
- Boston Eye Group, Brookline, Massachusetts, USA; Boston University School of Medicine, Boston, Massachusetts, USA
| | - Samir Melki
- Boston Eye Group, Brookline, Massachusetts, USA; Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Jason Brenner
- Boston Eye Group, Brookline, Massachusetts, USA; Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
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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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Mifflin MD, Betts BS, Nguyen J, Pouly S. High myopic photorefractive keratectomy outcomes with the Alcon Wavelight ® EX500 excimer laser. Clin Ophthalmol 2018; 12:1041-1048. [PMID: 29922033 PMCID: PMC5995275 DOI: 10.2147/opth.s164110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To present refractive outcomes from consecutive cases with the Alcon Wavelight® EX500 excimer laser using photorefractive keratectomy (PRK) in patients with high myopia. Methods A retrospective chart review of consecutive cases of high myopic eyes (≥6.0 Diopters [D]) undergoing PRK with the Alcon Wavelight EX500 excimer laser (Alcon Laboratories, Fort Worth, TX, USA) was done. Moderately high myopic eyes (6.0 to <8.0 D [6 D]) were compared with high myopic eyes (8.0 D or greater [8 D]). Outcomes measured included pre- and postoperative refractive error, uncorrected distance visual acuity (UDVA), corrected distance visual acuity, spherical equivalent correction (SEQ), haze incidence, and intraocular pressure (IOP). Results One hundred eighteen eyes of 63 patients were evaluated, with 59 eyes having 12 months of follow-up. Thirty-one eyes of 19 patients had 8.0 D or more of myopia. Twelvemonth average LogMAR UDVA was -0.06 (20/17) for the 6 D group and -0.08 (20/16) for the 8 D group. Average 12-month SEQ was -0.18 D and preoperatively was -7.52 D for the 6 D group and -0.09 and -9.02 in the 8 D group. Sixty-five eyes (86%) and 24 eyes (96%) had an SEQ within 0.50 D of emmetropia at 3 months in the 6 and 8 D groups, respectively. One eye had visually significant haze developed at 8 months. Three eyes had IOP elevation that resolved with addition of short-term topical IOP-lowering medication. Conclusion High myopic PRK with the Alcon Wavelight EX500 excimer laser yields excellent refractive outcomes with a low incidence of complications.
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Affiliation(s)
- Mark D Mifflin
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA
| | | | - Jason Nguyen
- Department of Ophthalmology, West Virginia University School of Medicine, Morgantown, WV, USA
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Mifflin MD, Betts BS, Frederick PA, Feuerman JM, Fenzl CR, Moshirfar M, Zaugg B. Efficacy and safety of a 3-month loteprednol etabonate 0.5% gel taper for routine prophylaxis after photorefractive keratectomy compared to a 3-month prednisolone acetate 1% and fluorometholone 0.1% taper. Clin Ophthalmol 2017; 11:1113-1118. [PMID: 28652697 PMCID: PMC5476723 DOI: 10.2147/opth.s138272] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the outcome of photorefractive keratectomy (PRK) and complications in patients treated with either loteprednol etabonate 0.5% gel or prednisolone acetate 1% suspension and fluorometholone (fml) 0.1% suspension. Setting John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA. Design Prospective, randomized, partially masked trial. Methods PRK was performed on 261 eyes of 132 participants. Patients were randomized to a postoperative corticosteroid regimen of either loteprednol etabonate 0.5% gel (loteprednol) or prednisolone 1% acetate suspension followed by fluorometholone 0.1% suspension (prednisolone/fml). Primary outcome measures included incidence and grade of postoperative corneal haze and incidence of increased intraocular pressure of 10 mmHg above baseline, or any intraocular pressure over 21 mmHg. Secondary outcome measures included uncorrected distance visual acuity, best corrected distance visual acuity, and manifest refraction spherical equivalent. Results The incidence of haze in the first 3 months was 2.6% (3/114 eyes) in the loteprednol group and 4.8% (7/147 eyes) in the prednisolone/fml group and was not statistically significant between groups (P=0.37). The incidence of elevated intraocular pressure was 1.8% (2/114 eyes) in the loteprednol group and 4.1% (6/147 eyes) in the prednisolone/fml group, and was not statistically significant between the groups (P=0.12). The mean 3-month postoperative logMAR uncorrected visual acuity was −0.078±0.10 and −0.075±0.09 in the loteprednol and prednisolone/fml groups, respectively (P=0.83). Conclusion Postoperative corneal haze and elevated intraocular pressure were uncommon in both treatment arms. There was no statistically significant difference between each postoperative regimen. Refractive results were similar and excellent in both treatment arms. A tapered prophylactic regimen of loteprednol 0.5% gel is equally effective to prednisolone 1%/fml 0.1% after PRK.
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Affiliation(s)
- Mark D Mifflin
- Department of Ophthalmology and Visual Sciences, John A Moran Eye Center, University of Utah, Salt Lake City, UT
| | - Brent S Betts
- Department of Ophthalmology and Visual Sciences, John A Moran Eye Center, University of Utah, Salt Lake City, UT
| | | | | | | | - Majid Moshirfar
- Department of Ophthalmology and Visual Sciences, John A Moran Eye Center, University of Utah, Salt Lake City, UT.,Hoopes Vision, Draper, UT, USA
| | - Brian Zaugg
- Department of Ophthalmology and Visual Sciences, John A Moran Eye Center, University of Utah, Salt Lake City, UT
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Savini G, Cummings AB, Balducci N, Barboni P, Huang J, Lombardo M, Serrao S, Ducoli P. Agreement Between Predicted and Measured Ablation Depth After Femtosecond Laser-Assisted LASIK for Myopia. J Refract Surg 2016; 32:164-70. [DOI: 10.3928/1081597x-20160121-03] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 12/03/2015] [Indexed: 11/20/2022]
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