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Du Y, Di Y, Yang S, Mo F, Cui G, Chen D, Li Y. Association of myopia and astigmatism with postoperative ocular high order aberration after small incision lenticule extraction. BMC Ophthalmol 2024; 24:211. [PMID: 38741093 DOI: 10.1186/s12886-024-03475-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/02/2024] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVE To investigate the correlation between higher-order aberrations (HOA) after small incision lenticule extraction (SMILE) and the severity of myopia and astigmatism, along with the relevant factors. These findings will provide valuable insights for decreasing the occurrence of HOA after SMILE and enhancing visual quality. METHODS A total of 75 patients (150 eyes) with myopia and astigmatism who underwent SMILE were categorized into four groups based on the severity of myopia and astigmatism: Myopia Group 1 (Group M1, spherical diopter ranged from -1.00 D to -4.00 D), Myopia Group 2 (Group M2, spherical diopter ranged from -4.10 D to -10.00 D), Astigmatism Group 1 (Group A1, cylindrical diopter ranged from 0 D to -1.00 D), and Astigmatism Group 2 (Group A2, cylindrical diopter ranged from -1.10 D to -3.00 D). A comprehensive assessment was performed to examine the association between HOA and various relevant factors, including a detailed analysis of the subgroups. RESULTS Group M1 had significantly lower levels of total eye coma aberration (CA), corneal total HOA (tHOA), internal tHOA, and vertical CA ( Z 3 - 1 ) after SMILE than Group M2 (P < 0.05). Similarly, Group A1 had significantly lower levels of total eye tHOA, CA, trefoil aberration (TA), corneal tHOA, TA, and vertical TA ( Z 3 - 3 ) after SMILE than Group A2 (P < 0.05). Pearson correlation analysis indicated a statistically significant positive relationship between the severity of myopia/astigmatism and most HOA (P < 0.05). Subgroup evaluations demonstrated a notable increase in postoperative HOA associated with myopia and astigmatism in Groups M2 and A2 compared with the control group. Lenticule thickness, postoperative central corneal thickness (CCT), postoperative uncorrected distance visual acuity (UDVA), and postoperative corneal Km and Cyl were strongly correlated with most HOA. Age, eyes, and postoperative intraocular pressure (IOP) were only associated with specific HOA. CONCLUSION HOA positively correlated with the severity of myopia and astigmatism after SMILE. However, this relationship was not linear. HOA after SMILE was influenced by various factors, and additional specialized investigations are required to establish its clinical importance.
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Affiliation(s)
- Yifan Du
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Yu Di
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Shan Yang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Fei Mo
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Ge Cui
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Di Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Ying Li
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.
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Du Y, Di Y, Yang S, Mo F, Cui G, Chen D, Li Y. Differences in ocular high order aberrations before and after small incision lenticule extraction for correction of myopia: a systematic review and meta-analysis. Front Med (Lausanne) 2024; 11:1274101. [PMID: 38601117 PMCID: PMC11004322 DOI: 10.3389/fmed.2024.1274101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 03/13/2024] [Indexed: 04/12/2024] Open
Abstract
Objective To examine the causes and factors that lead to high order aberration (HOA) during the treatment of myopia using small incision lenticule extraction (SMILE), as well as the differences between SMILE and other corneal refractive surgeries through a systematic review and meta-analysis. Methods A systematic search was conducted from January 2015 to February 2023 in Pubmed, Embase, Web of Science, and Google Scholar databases to gather relevant studies on SMILE and HOA. Studies meeting specific criteria were chosen, and clinical data was retrieved for analysis. Results This meta-analysis resulted in the inclusion of 19 studies involving 1,503 eyes. Pooled results showed significant induction of total HOA (tHOA, d = -0.21, p < 0.001), spherical aberration (SA, d = -0.11, p < 0.001) and coma aberration (CA, d = -0.18, p < 0.001) after SMILE compared to pre-SMILE, while no significant change in trefoil aberration (TA) was observed (d = -0.00, p = 0.91). There was a significantly lower induction of tHOA after SMILE compared to femtosecond laser-assisted in situ keratomileusis (FS-LASIK, d = 0.04, p < 0.001), and no significant difference was observed compared to wavefront aberration-guided (WFG) refractive surgery (d = 0.00, p = 0.75). There was also a significant association between different levels of myopia and astigmatism, duration of follow-up, lenticule thickness, and preoperative central corneal thickness (CCT) on the induction of tHOA after SMILE (p < 0.05), while the higher preoperative myopia group (sphere > -5D), lower preoperative astigmatism group (cylinder ≤ -1D), larger lenticule thickness group (lenticule thickness > 100 μm), shorter follow-up group (follow-up 1 month postoperatively) and the thicker CCT group (CCT > 550 μm) brought a significant induction of tHOA compared to the opposite comparison group (p < 0.001). Conclusion While SMILE can induce HOA significantly, it induces less HOA than FS-LASIK. Postoperative HOA following SMILE can be affected by factors such as myopia, astigmatism, lenticule thickness, CCT, and duration of follow-up. Future research should continue to explore techniques to decrease the induction of HOA by using this methodology. Systematic review registration https://www.crd.york.ac.uk/prospero/.
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Affiliation(s)
| | | | | | | | | | | | - Ying Li
- Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Choi SH, Won YK, Na SJ, Nam D, Lim DH. Limitations of and Solutions to Using 6 mm Corneal Spherical Aberration and Q Value after Laser Refractive Surgery. Bioengineering (Basel) 2024; 11:190. [PMID: 38391676 PMCID: PMC10886312 DOI: 10.3390/bioengineering11020190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/02/2024] [Accepted: 02/14/2024] [Indexed: 02/24/2024] Open
Abstract
This study aimed to evaluate the spherical aberration (SA) in different corneal areas before and after femtosecond laser-assisted in situ keratomileusis (fLASIK) and transepithelial photorefractive keratectomy (tPRK), with the goal of identifying the limitations of and potential improvements in using SA within a 6 mm area. The study included 62 patients who underwent fLASIK and tPRK. Complete eye examinations including keratometry, corneal epithelial thickness, central corneal thickness, and topography were performed preoperatively and postoperatively. Anterior, posterior, and total corneal aberrations were measured preoperatively and three months postoperatively, with pupil diameters ranging from 2 to 8 mm. In the fLASIK group, compared to the preoperative SA, the anterior and total SA increased postoperatively in the 6 and 7 mm areas. In the tPRK group, meanwhile, the anterior and total SA of the 5 mm or larger areas increased postoperatively. An area of 6 mm or larger showed an increase in correlation with the changes in Q value and refractive correction. As the corneal SA and asphericity in the 6 mm zone cannot specifically demonstrate the status of areas smaller than 6 mm or changes in the optical zone after laser refractive surgery, comparison with normal values in various areas of the cornea is necessary.
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Affiliation(s)
- Sung Ho Choi
- First Samsung Eye Clinic, Seoul 06621, Republic of Korea
| | - Yeo Kyoung Won
- Department of Ophthalmology, Samsung Medical Center School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Sung Jin Na
- First Samsung Eye Clinic, Seoul 06621, Republic of Korea
| | - DeokJo Nam
- First Samsung Eye Clinic, Seoul 06621, Republic of Korea
| | - Dong Hui Lim
- Department of Ophthalmology, Samsung Medical Center School of Medicine, Sungkyunkwan University, Seoul 06351, Republic of Korea
- Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul 06351, Republic of Korea
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Du Y, Zhou Y, Ding M, Zhang M, Guo Y. Changes in relative peripheral refraction and optical quality in Chinese myopic patients after small incision lenticule extraction surgery. PLoS One 2023; 18:e0291681. [PMID: 37792813 PMCID: PMC10550148 DOI: 10.1371/journal.pone.0291681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/02/2023] [Indexed: 10/06/2023] Open
Abstract
PURPOSE To observe changes in retinal refraction difference values (RDV) and aberrations after small incision lenticule extraction (SMILE) surgery and evaluate their correlations. METHODS This study recruited 112 patients (112 eyes) who underwent SMILE for myopia. Participants were classified into the Low and Moderate Myopia group (LM, -0.50 to -6.0 D) and High Myopia group (HM, >-6.0 D) according to the central spherical equivalent (SE). RDVs in the five retinal eccentricities from 0° to 10°, 10° to 20°, 20° to 30°, 30° to 40°, and 40° to 53° are recorded as RDV-(0-10), RDV-(10-20), RDV-(20-30), RDV-(30-40), and RDV-(40-53), respectively; additionally, RDVs have four sectors, i.e., RDV-Superior (RDV-S), RDV-Inferior (RDV-I), RDV-Temporal (RDV-T), and RDV-Nasal (RDV-N). With a 3-month follow-up, changes in RDV (ΔRDV) and changes in aberrations [Δtrefoil, Δcoma, Δspherical aberration (SA), and Δtotal higher-order aberrations (HOA)] after surgery were recorded. RESULTS No significant differences were observed in total RDV (TRDV), RDV-(0-53), RDV-S, RDV-I, RDV-N, trefoil, coma, and SA between the two groups before SMILE surgery. However, after SMILE, hyperopic defocus values [TRDV, RDV-(20-53), RDV-S, RDV-T, and RDV-N] in the LM group and hyperopic defocus values [TRDV, RDV-(20-53), RDV-S, and RDV-N] in the HM group were significantly lower at 3 months postoperatively than preoperatively, and the RDV-(40-53), RDV-S, and RDV-N were lower in the HM group than in the LM group. Aberrations [trefoil (vertical), coma, and HOA] in the LM group and aberrations (trefoil, coma, SA, and HOA) in the HM group were significantly higher at 3 months postoperatively than preoperatively, and the coma, trefoil(horizontal), SA, and HOA were higher in the HM group than in the LM group. In the multivariate analysis, ΔRDV-(40-53) was significantly correlated with ΔSA, and ΔRDV-T and ΔRDV-N were significantly correlated with Δcoma (horizontal). CONCLUSIONS Our findings suggest that SMILE reduces retinal peripheral hyperopic defocus but introduces some higher-order aberrations, especially in people with high myopia refractive errors.
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Affiliation(s)
- Yuqin Du
- Eye School of Chengdu University of TCM, In eye Hospital of Chengdu University of TCM, Chengdu, China
- Beijing Ming Vision and Ophthalmology, Dongcheng District, Beijing, China
| | - Yuehua Zhou
- Eye School of Chengdu University of TCM, In eye Hospital of Chengdu University of TCM, Chengdu, China
- Beijing Ming Vision and Ophthalmology, Dongcheng District, Beijing, China
| | - Mingwei Ding
- Eye School of Chengdu University of TCM, In eye Hospital of Chengdu University of TCM, Chengdu, China
- Beijing Ming Vision and Ophthalmology, Dongcheng District, Beijing, China
| | - Mingxu Zhang
- Eye School of Chengdu University of TCM, In eye Hospital of Chengdu University of TCM, Chengdu, China
- Beijing Ming Vision and Ophthalmology, Dongcheng District, Beijing, China
| | - Yujuan Guo
- Eye School of Chengdu University of TCM, In eye Hospital of Chengdu University of TCM, Chengdu, China
- Beijing Ming Vision and Ophthalmology, Dongcheng District, Beijing, China
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Salvá L, García S, García-Delpech S, Martínez-Espert A, Ferrando V. Optical Performance of a Segmented Extended-Depth-of-Focus Intraocular Lens under the Influence of Different Values of Spherical Aberration Generated by Refractive Surgery. J Clin Med 2023; 12:4758. [PMID: 37510871 PMCID: PMC10381419 DOI: 10.3390/jcm12144758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/14/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Corneal refractive surgery induces high-order aberrations, specifically spherical aberration (SA). These aberrations can have implications when patients later develop cataracts and require the implantation of multifocal intraocular lenses (MIOLs). MIOLs with asymmetric designs pose challenges in predicting outcomes, particularly in these cases. The aim of this study was to evaluate how different values of SA, resulting from various types of refractive surgeries, affect the optical performance of the FEMTIS Comfort intraocular lens. METHODS The through-focus modulation transfer function (TF-MTF) curve and high-contrast images of tumbling E were used as parameters to assess the optical performance of the MIOL. These parameters were measured using an adaptive optics visual simulator. RESULTS Increasingly negative values of SA make the MIOL more bifocal, moderating its extended-depth-of-focus characteristic. Conversely, higher positive SA values cause the TF-MTF curve to shift towards positive vergences, leading to worsened distance vision in the +1.00 to +2.00 D range, but improved vision in the +0.50 D to +1.00 D range. CONCLUSIONS Assessing SA in patients prior to implanting MIOLs with asymmetric designs is necessary for predicting outcomes and making informed decisions based on the visual requirements of patients.
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Affiliation(s)
- Luís Salvá
- Oftalmedic Salvà, 07013 Palma de Mallorca, Spain
| | - Scott García
- Oftalmedic Salvà, 07013 Palma de Mallorca, Spain
| | | | - Anabel Martínez-Espert
- Departamento de Óptica y Optometría y Ciencias de la Visión, Universitat de València, 46100 Valencia, Spain
| | - Vicente Ferrando
- Centro de Tecnologías Físicas, Universitat Politècnica de València, 46022 Valencia, Spain
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Small Incision Lenticule Extraction (SMILE) Versus Laser Assisted Stromal In Situ Keratomileusis (LASIK) for Astigmatism Corrections: A Systematic Review and Meta-analysis. Am J Ophthalmol 2023; 247:181-199. [PMID: 36410469 DOI: 10.1016/j.ajo.2022.11.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/30/2022] [Accepted: 11/07/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE To compare small incision lenticule extraction (SMILE) and laser assisted stromal in situ keratomileusis (LASIK) for astigmatism correction. DESIGN Systematic review and meta-analysis METHODS: We reviewed published studies comparing outcomes after LASIK and SMILE for astigmatism correction by querying PubMed, EMBASE, Cochrane, and Web of Science, with a cut-off date of September 3, 2022. We also compared the changes in visual acuity, refraction, and high-order aberrations between the surgeries. Astigmatism correction outcomes in the low-to-moderate group (less than or equal to -2.00 D) and high group (greater than -2.00 D) were evaluated using vector analysis. The Cochrane risk of bias tool in RevMan software was used for randomized studies (RCT), and Risk Of Bias In Nonrandomized Studies - of Interventions (ROBINS-I) was used for the nonrandomized studies (NRSs). RESULTS There were 17 studies (5 randomized studies and 12 cohort studies), including 1,985 eyes. A statistically significant difference was found in the correction index (mean difference [MD] = -0.02, 95% confidence interval [CI] = -0.04 to -0.01, P =0.01), although there was no significant difference in the index of success (MD = 0.01, 95% CI = -0.03 to 0.05, P =0.51), different vector (MD = 0.07, 95% CI = 0.00 to 0.13, P =0.04), and angle of error (MD = 0.56, 95% CI = -0.34 to 1.45, P =0.22) between SMILE and LASIK. However, for low-to-moderate astigmatism correction, SMILE exhibited a smaller correction index (MD = -0.08, 95% CI= -0.13 to -0.02, P =0.008) and a larger difference vector (MD = 0.18, 95% CI = 0.09 to 0.27, P <0.0001) than LASIK. There was no significant difference between the different procedures in visual acuity and refraction (spherical equivalent: MD = -0.04, 95% CI = -0.08 to 0.01, P =0.15) or high-order aberration (MD = -0.01, 95% CI = -0.07 to 0.04, P =0.67), except spherical aberration (MD = -0.12, 95% CI = -0.23 to -0.01, P =0.04). The risk of bias was moderate in most studies because of poor reporting of several bias domains for RCTs, and because of confounding and selective outcome reporting for NRSs. CONCLUSIONS When used to treat severe astigmatism, both SMILE and LASIK provide effective and predictable results and generally have equivalent outcomes. However, evidence reveals a tendency toward undercorrection in the SMILE groups for astigmatism correction. In addition, LASIK has a greater probability of causing postoperative spherical aberration.
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Liu M, Jin C, Lu L, Yuan Y, Chen C, Zhao T, Ke B. The Impact of Corneal Epithelial Thickening and Inhomogeneity on Corneal Aberrations After Small Incision Lenticule Extraction. J Refract Surg 2023; 39:23-32. [PMID: 36630428 DOI: 10.3928/1081597x-20221109-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE To investigate the corneal epithelial remodeling profile after small incision lenticule extraction (SMILE), the correlated explanatory variables, and its potential impact on corneal higher order aberrations (HOAs). METHODS This single-center study prospectively evaluated 75 right eyes of 75 patients scheduled for SMILE. An anterior segment optical coherence tomography device was used to automatically obtain central 6-mm corneal epithelial thickness (ET), total corneal HOAs, and individual Zernike components before and after surgery. The ET inhomogeneity over the central 3- and 6-mm cornea was quantified with coefficient of variance (CV). RESULTS Both ET and CV significantly increased 1 month postoperatively (all P < .05). The stepwise multiple regression analysis showed that ET and CV were significantly correlated with preoperative ET and CV, respectively (all P < .01). The corrected spherical equivalent also significantly influenced ET and CV (all P < .01). Over the central 6-mm zone, the alterations of total corneal HOAs and individual Zernike components such as vertical coma (Z7) and spherical aberration (Z12, Z24) were significantly correlated with ET and CV (all P < .05). CONCLUSIONS The SMILE-induced epithelial remodeling involved both ET and ET inhomogeneity. The modulation was associated with preoperative and treatment parameters, and exerted a significant impact on corneal HOA alterations especially over the central 6-mm cornea. Together with the amount of correction and corneal curvature gradient change, preoperative assessment of ET and ET inhomogeneity might help predict postoperative epithelial remodeling. [J Refract Surg. 2023;39(1):23-32.].
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Ning R, Gao R, Piñero DP, Zhang J, Gao Q, Jin Y, Wang Y, Wang C, Huang J. Repeatability and reproducibility of corneal higher-order aberrations measurements after small incision lenticule extraction using the Scheimpflug-Placido topographer. EYE AND VISION 2022; 9:1. [PMID: 34983674 PMCID: PMC8728949 DOI: 10.1186/s40662-021-00274-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 11/24/2021] [Indexed: 11/18/2022]
Abstract
Background To evaluate the precision of corneal higher-order aberrations measurements after small incision lenticule extraction (SMILE) using the Sirius Scheimpflug-Placido topographer (CSO, Italy). Methods Seventy-five eyes from 75 postoperative subjects were included in this prospective study. Three consecutive corneal aberrometric measurements were obtained with the Scheimpflug-Placido topographer by two experienced operators to assess intra- and inter-observer reproducibility. The within-subject standard deviation (Sw), test-retest repeatability (TRT) and the intraclass correlation coefficient (ICC) were calculated. Results For intraobserver repeatability of anterior and total corneal aberrations, all ICCs were more than 0.922, except for trefoil (0.722 to 0.768). The ICCs of total root mean square (RMS), coma Z (3, ± 1), and spherical aberration Z (4, 0) were over 0.810 while higher-order RMS, trefoil Z (3, ± 3), and astigmatism II Z (4, ± 2) were below 0.634 for posterior corneal surface aberrations. All Sw values for all types of aberrations were equal to or below 0.07 μm. Regarding interobserver reproducibility, all TRT values were no more than 0.12 μm, 0.05 μm, and 0.11 μm for anterior, posterior, and total corneal aberrations, respectively. The ICC values ranged from 0.875 to 0.989, from 0.686 to 0.976 and over 0.834 for anterior, posterior, and total corneal aberrations, respectively. Conclusions The repeatability of measurements of anterior and total corneal aberrations with the Sirius system in corneas after SMILE surgery was high, except for trefoil. There was some variability in posterior corneal aberrometric measurements. High reproducibility of corneal aberrometric measurements was observed between measurements of both examiners, except for trefoil, with poor to moderate reproducibility.
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Jiang X, Wang Y, Yuan H, Li Y, Wang H, An Z, Li X. Influences of SMILE and FS-LASIK on Corneal Sub-basal Nerves: A Systematic Review and Network Meta-analysis. J Refract Surg 2022; 38:277-284. [PMID: 35412925 DOI: 10.3928/1081597x-20220127-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare postoperative corneal sub-basal nerve density and number between small incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK). METHODS A search was made in PubMed, EMBASE, and the Cochrane library for prospective comparative studies. The analysis was divided into two parts: network meta-analysis and traditional meta-analysis of the studies directly comparing two surgical groups. Stata 16 (Stata Corporation) and Rev-Man 5.4 (Cochrane) software were used to analyze the data. RESULTS Twelve studies (n = 775) were included. In the network meta-analysis, the SMILE group showed a significant increase compared with the FS-LASIK group in corneal nerve density at 1 month postoperatively (mean: 4.23; 95% CI: 0.06 to 8.39, P < .05), and in the number of corneal nerve trunks at 6 months postoperatively (mean: 13.25; 95% CI: 10.20 to 16.30, P < .05). In the traditional meta-analysis, the SMILE group showed significant improvement compared with the FS-LASIK group in corneal nerve density at 1 (weighted mean difference [WMD]: -2.05, 95% CI: -3.11 to -1.00, P < .05) and 3 (WMD: -0.90, 95% CI: -1.30 to -0.50, P < .05) months postoperatively, and in the number of corneal nerve trunks (WMD: -2.52, 95% CI: -4.91 to -0.14, P < .05) and corneal nerve branches (WMD: -2.80, 95% CI: -3.41 to -2.19, P < .05) at 1 month postoperatively. CONCLUSIONS The corneal nerve injury in the FS-LASIK group was worse than that in the SMILE group. The corneal nerve recovery in the SMILE group was better at 3 months postoperatively. However, there was no significant difference in corneal nerve density and number between the two groups at 6 months postoperatively. [J Refract Surg. 2022;38(4):277-284.].
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On the Relationship between Corneal Biomechanics, Macrostructure, and Optical Properties. J Imaging 2021; 7:jimaging7120280. [PMID: 34940747 PMCID: PMC8706034 DOI: 10.3390/jimaging7120280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 11/16/2022] Open
Abstract
Optical properties of the cornea are responsible for correct vision; the ultrastructure allows optical transparency, and the biomechanical properties govern the shape, elasticity, or stiffness of the cornea, affecting ocular integrity and intraocular pressure. Therefore, the optical aberrations, corneal transparency, structure, and biomechanics play a fundamental role in the optical quality of human vision, ocular health, and refractive surgery outcomes. However, the inter-relationships of those properties are not yet reported at a macroscopic scale within the hierarchical structure of the cornea. This work explores the relationships between the biomechanics, structure, and optical properties (corneal aberrations and optical density) at a macro-structural level of the cornea through dual Placido–Scheimpflug imaging and air-puff tonometry systems in a healthy young adult population. Results showed correlation between optical transparency, corneal macrostructure, and biomechanics, whereas corneal aberrations and in particular spherical terms remained independent. A compensation mechanism for the spherical aberration is proposed through corneal shape and biomechanics.
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Gomes JRM, Franco SMDB. Near Vision Tasks and Optical Quality of the Eye. J Ophthalmic Vis Res 2021; 16:620-630. [PMID: 34840685 PMCID: PMC8593549 DOI: 10.18502/jovr.v16i4.9753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 10/28/2020] [Indexed: 12/04/2022] Open
Abstract
Purpose To study the effect of near-vision reading task on optical quality of the eye when performed on a computer monitor and on printed paper, and to identify which of the two results in greater changes. Methods Two groups of subjects performed a 30-min reading task in two different conditions: on a computer monitor and on printed paper. Ocular, corneal, and internal wavefront aberrations (Zernike coefficients up to 6 th order), root-mean-square of low- and high-order aberrations, spherical equivalent, vectoral components of ocular astigmatism (J45 and J0), and the compensation factor between internal and corneal aberrations were measured before and after the tasks. Their changes were analyzed in each group and between groups. Results Statistically significant changes in wavefront aberrations and in root mean square of low- and high-order aberrations were observed in both groups which was significantly greater when the task was performed on printed paper. Partial loss of compensation mechanism and variation in spherical equivalent in a negative direction occurred after both reading tasks; however, it was statistically significant only with printed paper reading task. The vectoral components of ocular astigmatism did not show statistically significant changes in either groups. Conclusion Near-vision reading tasks can change the optical quality of the eye, especially when the task is performed on printed paper.
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Fu Y, Yin Y, Wu X, Li Y, Xiang A, Lu Y, Fu Q, Hu T, Du K, Wen D. Clinical outcomes after small-incision lenticule extraction versus femtosecond laser-assisted LASIK for high myopia: A meta-analysis. PLoS One 2021; 16:e0242059. [PMID: 33556075 PMCID: PMC7870077 DOI: 10.1371/journal.pone.0242059] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/27/2020] [Indexed: 11/19/2022] Open
Abstract
AIM To compare postoperative clinical outcomes of high myopia after small-incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK). METHODS From March 2018 to July 2020, PubMed, MEDLINE, Embase, the Cochrane Library, and several Chinese databases were comprehensively searched. The studies meeting the criteria were selected and included; the data were extracted by 2 independent authors. The clinical outcome parameters were analyzed with RevMan 5.3. RESULTS This meta-analysis included twelve studies involving 766 patients (1400 eyes: 748 receiving SMILE and 652 receiving FS-LASIK). Pooled results revealed no significant differences in the following outcomes: the logarithm of the mean angle of resolution (logMAR) of postoperative uncorrected distance visual acuity (weighted mean difference (WMD) = -0.01, 95% confidence interval (CI): -0.02 to 0.00, I2 = 0%, P = 0.07 at 1 mo; WMD = -0.00, 95% CI: -0.01 to 0.01, I2 = 0%, P = 0.83 at 3 mo; WMD = -0.00, 95% CI: -0.01 to 0.00, I2 = 32%, P = 0.33 in the long term), and the postoperative mean refractive spherical equivalent (WMD = -0.03, 95% CI: -0.09 to 0.03, I2 = 13%, P = 0.30). However, the SMILE group had significantly better postoperative corrected distance visual acuity (CDVA) than the FS-LASIK group (WMD = -0.04, 95% CI, -0.05 to -0.02, I2 = 0%, P<0.00001). In the long term, postoperative total higher-order aberration (WMD = -0.09, 95% CI: -0.10 to -0.07, I2 = 7%, P<0.00001) and postoperative spherical aberration (WMD = -0.15, 95% CI: -0.19 to -0.11, I2 = 29%, P<0.00001) were lower in the SMILE group than in the FS-LASIK group; a significant difference was also found in postoperative coma (WMD = -0.05, 95% CI: -0.06 to -0.03, I2 = 30%, P<0.00001). CONCLUSION For patients with high myopia, both SMILE and FS-LASIK are safe, efficacious and predictable. However, the SMILE group demonstrated advantages over the FS-LASIK group in terms of postoperative CDVA, while SMILE induced less aberration than FS-LASIK. It remains to be seen whether SMILE can provide better visual quality than FS-LASIK; further comparative studies focused on high myopia are necessary.
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Affiliation(s)
- Yanyan Fu
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Changsha, Hunan, China
| | - Yewei Yin
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Changsha, Hunan, China
| | - Xiaoying Wu
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Changsha, Hunan, China
| | - Yuanjun Li
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Changsha, Hunan, China
| | - Aiqun Xiang
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Changsha, Hunan, China
| | - Ying Lu
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Changsha, Hunan, China
| | - Qiuman Fu
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Changsha, Hunan, China
| | - Tu Hu
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Changsha, Hunan, China
| | - Kaixuan Du
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Changsha, Hunan, China
| | - Dan Wen
- Department of Ophthalmology, XiangYa Hospital, Central South University, Changsha, Hunan, China
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Ophthalmology, Changsha, Hunan, China
- * E-mail:
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Zhang X, Ma JH, Xi X, Guan L. Characteristics of corneal high-order aberrations in adolescents with mild to moderate myopia. BMC Ophthalmol 2020; 20:465. [PMID: 33243174 PMCID: PMC7690177 DOI: 10.1186/s12886-020-01727-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 11/09/2020] [Indexed: 01/16/2023] Open
Abstract
Background This study investigated the characteristics of corneal higher-order aberrations (HOAs) of the anterior surface, posterior surface, and total cornea in adolescents with mild to moderate myopia. Methods A total of 183 patients with myopia (183 eyes) aged 8 to 18 years were enrolled in this study. The axial length (AL) of the eyes was measured by an IOL-Master, and corneal curvatures (K-values) and HOAs were measured by a Pentacam anterior segment diagnostic analyzer. Results Results of this study showed that the anterior, posterior and total corneal horizontal coma Z31 were − 0.1249 ± 0.105 μm, 0.0009 ± 0.001 μm, and − 0.1331 ± 0.116 μm, respectively; the anterior, posterior and total corneal vertical coma Z3− 1 were − 0.0212 ± 0.164 μm, 0.0003 ± 0.043 μm, and − 0.0216 ± 0.168 μm, respectively; and spherical aberration (SA) Z40 values were 0.2244 ± 0.091 μm, 0.1437 ± 0.029 um, and 0.1889 ± 0.090 μm, respectively. Total corneal Z31 was statistically correlated with posterior corneal astigmatism (K2b − K1b) (p = 0.038). Total corneal Z3− 1 was correlated with anterior corneal astigmatism (K2f − K1f) (p = 0.027). Anterior, posterior, and total corneal Z40 were correlated with anterior and posterior corneal curvature (K1f, K2f, K1b, K2b) (p = 0.001). Posterior corneal Z40b was also significantly correlated with AL. Conclusions In adolescents with mild to moderate myopia, the posterior corneal surface shape may play a compensatory role in the balance of corneal aberrations, and the posterior corneal SA tended to become less negative as the AL increased. The corneal coma may also play a compensatory role in posterior corneal surface astigmatism, which was valuable for the treatment for improving visual quality. This conclusion still needs to be verified.
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Affiliation(s)
- Xu Zhang
- Baoding Yinghua Eye Hospital, Baoding, 071000, China
| | - Jin-Hui Ma
- Department of endocrinology, Affiliated Hospital of Hebei University, Baoding, 071000, China
| | - Xin Xi
- Central Laboratory, Affiliated Hospital of Hebei University, No 212. Yuhuadong Road, Lianchi District, Baoding, 071000, China.
| | - Lin Guan
- Department of mathematics, Hebei Agricultural University, Baoding, 071000, China
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Arba Mosquera S, Verma S. A review of clinical outcomes following SMILE for the treatment of astigmatism. EXPERT REVIEW OF OPHTHALMOLOGY 2020. [DOI: 10.1080/17469899.2020.1810017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Samuel Arba Mosquera
- Biomedical Engineering Office, Research and Development, SCHWIND Eye-tech-solutions GmbH, Kleinostheim, Germany
| | - Shwetabh Verma
- Biomedical Engineering Office, Research and Development, SCHWIND Eye-tech-solutions GmbH, Kleinostheim, Germany
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Kayhan B, Coskunseven E, Sahin O, Pallikaris I. The effects of implantable collamer lens implantation on higher order aberrations. Int J Ophthalmol 2019; 12:1848-1852. [PMID: 31850167 DOI: 10.18240/ijo.2019.12.05] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 04/30/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate the changes in higher order aberrations (HOAs) after implantable collamer lens (ICL; Staar Surgical, Nidau, Switzerland) implantation. METHODS Totally 30 eyes of 18 patients with myopia were included in this study with an average age of 25.77y (min: 21, max: 40). Refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), HOAs (entire, corneal and internal) were evaluated preoperatively and three months postoperatively. Ocular aberrations were measured by using iTrace (Tracey Technology, Houston, Texas, USA). SPSS (IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp) was used for the statistical analysis and the interpretation of the data. P values of less than 0.05 were considered statistically significant. RESULTS The preoperative mean spherical power was -9.01 D (min: -5.00, max: -13.00) and the mean cylindrical error was -2.40 D (min: -0.50, max: -4.75). The postoperative mean residual spherical power was -0.73 D (min: -0.20, max: -1.75) and the mean cylindrical error was -0.89 D (min: -0.18, max: -2.09). Analyses were made on root mean square (RMS) values of total HOAs (tHOAs), spherical aberration, coma and trefoil as entire, corneal and internal components. The differences in entire tHOAs and in internal tHOAs were significant. There was no significant change found in spherical aberrations. The differences in entire coma and in internal coma were significant. There was no significant change found in corneal coma. With respect to trefoil, the only significant difference was in internal trefoil. CONCLUSION The ICL implantation corrects the refractive error successfully and changes entire and internal HOAs of the eye.
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Affiliation(s)
- Belma Kayhan
- Dunyagoz Hospital Group, Istanbul 34337, Turkey.,Department of Ophthalmology, Sultan Abdulhamid Han Training and Research Hospital, the University of Saglik Bilimleri, Istanbul 34668, Turkey
| | | | - Onurcan Sahin
- Dunyagoz Hospital Group, Istanbul 34337, Turkey.,Institute of Vision and Optics, University of Crete, Heraklion 70013, Greece
| | - Ioannis Pallikaris
- Dunyagoz Hospital Group, Istanbul 34337, Turkey.,Institute of Vision and Optics, University of Crete, Heraklion 70013, Greece
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Correlations of Corneal Spherical Aberration with Astigmatism and Axial Length in Cataract Patients. J Ophthalmol 2019; 2019:4101256. [PMID: 31583126 PMCID: PMC6754902 DOI: 10.1155/2019/4101256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 08/03/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose To clarify the distribution of corneal spherical aberrations (SAs) in cataract patients with different corneal astigmatism and axial length. Setting Department of Ophthalmology and Vision Science of the Eye and ENT Hospital of Fudan University, Shanghai, China. Design Retrospective case series. Methods The axial length, corneal SAs, and other corneal biometrics were collected in cataract patients with Pentacam HR and IOLMaster 500. The statistical analysis of the corneal SAs was based on the stratification of axial length and anterior corneal astigmatism. Results In total, 6747 eyes of 6747 patients were recruited, with 2416 eyes (58.17 ± 16.81 years old) in the astigmatism group (anterior corneal astigmatism ≥1 D) and others (61.82 ± 12.64 years old) in the control group. In patients with astigmatism <2 D, the total and anterior SAs decreased as the axial length increased (P < 0.001). The total corneal SAs of patients with astigmatism of 2-3 D stabilized at around 0.29 μm, whereas those of patients with anterior corneal astigmatism ≥3 D tended to be variable. Age and anterior corneal astigmatism had positive and negative effects, respectively, on SA in the regression model. Conclusions Axial length has a negative effect on the anterior and total corneal SAs, which stabled around 0.33 μm and 0.30 μm in patients with axial length of ≥26 mm, respectively. Individualized SA adjustments are essential for patients undergoing aspheric toric IOL implantation with preoperative anterior corneal astigmatism of 1-2 D or ≥3 D. Toric IOLs with a negative SA of −0.20 μm are recommended for patients with anterior corneal astigmatism of 2-3 D if no customized therapy is warranted.
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Zhang J, Zheng L, Zhao X, Sun Y, Feng W, Yuan M. Corneal aberrations after small-incision lenticule extraction versus Q value-guided laser-assisted in situ keratomileusis. Medicine (Baltimore) 2019; 98:e14210. [PMID: 30702573 PMCID: PMC6380743 DOI: 10.1097/md.0000000000014210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Previous studies compared ocular aberration and visual quality after small-incision lenticule extraction (SMILE) and Q value-guided femtosecond laser-assisted in situ keratomileusis (Q-FS-LASIK), but anterior corneal surface aberration properties are poorly known. This study aimed to compare the changes in anterior corneal surface aberration after SMILE versus Q-FS-LASIK.This was a prospective, observational cohort study. Patients with myopia and myopic astigmatism underwent SMILE or Q-FS-LASIK at Hangzhou MSK Eye Hospital between January 2015 and November 2015. High order aberration (HOA), primary spherical aberration (PSA), primary coma aberration (PCA), primary vertical coma aberration (PVCA), and primary horizontal coma aberration (PHCA) were assessed using pre- and postoperative Sirius scanning.Both surgery were associated with significant increases in postoperative HOA, PSA, and PCA (both groups P < .01). In the SMILE group (n = 51), the variations in HOA, PSA, and PCA were no longer significant after postoperative week 2 (P > .05). In the Q-FS-LASIK group (n = 73), the variations in HOA and PCA were no longer significant after postoperative day 1 (P > .05). In the SMILE group, the 3-month changes in PCA were not correlated with spherical, spherical equivalent (SE), and spherical plus cylinder measurements. Cylinder measurements were not correlated with HOA, PSA, and PCA. In the Q-FS-LASIK group, the 3-month changes in PCA correlated with spherical, SE, and spherical plus cylinder measurements.Both SMILE and Q-FS-LASIK resulted in an increase in HOA, PSA, and PCA at postoperative day 1, but Q-FS-LASIK introduced lower HOA and showed better stability. Spherical measurement was related to PSA.
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18
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Jin HY, Wan T, Yu XN, Wu F, Yao K. Corneal higher-order aberrations of the anterior surface, posterior surface, and total cornea after small incision lenticule extraction (SMILE): high myopia versus mild to moderate myopia. BMC Ophthalmol 2018; 18:295. [PMID: 30419871 PMCID: PMC6233489 DOI: 10.1186/s12886-018-0965-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 10/30/2018] [Indexed: 11/23/2022] Open
Abstract
Background To investigate corneal higher-order aberrations (HOAs) of the anterior surface, posterior surface, and total cornea after small incision lenticule extraction (SMILE) in high myopic and mild to moderate myopic patients. Methods This retrospective study included 197 eyes (101 patients) undergoing SMILE surgery. According to the preoperative spherical equivalent (SE), treated eyes were divided into two groups: a high myopic group (more than − 6.0 D, Group H) and a mild to moderate myopic group (less than − 6.0 D, Group M). Corneal HOAs of the anterior surface, posterior surface, and total cornea were measured using a Scheimpflug camera preoperatively and 3 months postoperatively. Pearson’s correlation analysis was conducted to determine relationships between corneal aberrations and the SE. Results There were no significant differences in third-order to eight-order aberrations (RMS HOAs) of the anterior surface, posterior surface, and total corneal between the two groups before SMILE surgery. However, after SMILE, anterior and total corneal HOAs, especially vertical coma and spherical aberrations, significantly increased in both groups (p < 0.0167), whereas posterior corneal HOAs remained relatively stable (p > 0.0167). The induction of HOAs was significantly greater in Group H than Group M postoperatively (p < 0.0167). Changes in anterior surface and total corneal HOAs, especially vertical coma and spherical aberrations, were related to the SE (p < 0.05). Conclusions Anterior and total corneal HOAs, particularly vertical coma and spherical aberrations, significantly increased after SMILE in both groups, whereas posterior corneal HOAs remained stable. Aberration changes were related to SE. Trial registration Retrospectively registered. ChiCTR-ORC-17011040. Registered 1 April 2017. Name of registry: The observation of clinical results after corneal refractive surgery. Data of enrolment of the first participant to the trial: 15 December 2016.
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Affiliation(s)
- Hong-Ying Jin
- Eye Center, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China.
| | - Ting Wan
- Eye Center, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Xiao-Ning Yu
- Eye Center, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Fang Wu
- Eye Center, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Ke Yao
- Eye Center, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
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Zhang M, Jing Q, Chen J, Jiang Y. Analysis of corneal higher-order aberrations in cataract patients with high myopia. J Cataract Refract Surg 2018; 44:1482-1490. [PMID: 30274843 DOI: 10.1016/j.jcrs.2018.07.048] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 06/24/2018] [Accepted: 07/29/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate the differences in corneal higher-order aberrations (HOAs) between cataract patients with high axial myopia and normal cataract patients, and to identify the associated factors. SETTING Department of Ophthalmology and Vision Science of the Eye and ENT Hospital of Fudan University, Shanghai, China. DESIGN Retrospective case series. METHODS Corneal aberrations and axial lengths (ALs) were measured using a rotating Scheimpflug camera (Pentacam) and partial coherence interferometry (IOLMaster) in the high myopia group and the control group. RESULTS The study comprised 287 patients (520 eyes). There were 194 eyes in the high myopia group and 326 eyes in the control group. The 5 anterior corneal aberrations-vertical coma, vertical trefoil, horizontal coma, oblique trefoil, and primary spherical aberration-in the high myopia group were 0.07 μm ± 0.38 (SD), -0.11 ± 0.23 μm, 0.07 ± 0.28 μm, -0.02 ± 0.18 μm, and 0.39 ± 0.19 μm, respectively. No negative primary spherical aberrations of the total or anterior corneal surface were found in the high myopia group. Differences between the 2 groups were found in terms of central corneal thickness, astigmatism, primary spherical aberration, vertical coma, and oblique trefoil; however, these differences were not consistent between different age subgroups. Higher-order aberrations were correlated with age. Posterior corneal vertical coma was correlated with AL (Pearson correlation = -0.188, P = .047). CONCLUSIONS Negative primary spherical aberrations of the anterior or total corneal surface were not found in the high myopia group. Age showed a strong relationship with HOAs. For cataract patients with high myopia, aspheric intraocular lens implantation is recommended.
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Affiliation(s)
- Min Zhang
- From the Department of Ophthalmology and Vision Science (Zhang, Jing, Chen, Jiang), Eye and ENT Hospital of Fudan University, Key Laboratory of Myopia of State Health Ministry (Zhang, Jing, Chen, Jiang), and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| | - Qinghe Jing
- From the Department of Ophthalmology and Vision Science (Zhang, Jing, Chen, Jiang), Eye and ENT Hospital of Fudan University, Key Laboratory of Myopia of State Health Ministry (Zhang, Jing, Chen, Jiang), and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| | - Jiahui Chen
- From the Department of Ophthalmology and Vision Science (Zhang, Jing, Chen, Jiang), Eye and ENT Hospital of Fudan University, Key Laboratory of Myopia of State Health Ministry (Zhang, Jing, Chen, Jiang), and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China
| | - Yongxiang Jiang
- From the Department of Ophthalmology and Vision Science (Zhang, Jing, Chen, Jiang), Eye and ENT Hospital of Fudan University, Key Laboratory of Myopia of State Health Ministry (Zhang, Jing, Chen, Jiang), and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, China.
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Wang J, Ren Y, Liang K, Jiang Z, Tao L. Changes of corneal high-order aberrations after femtosecond laser-assisted in situ keratomileusis. Medicine (Baltimore) 2018; 97:e0618. [PMID: 29718869 PMCID: PMC6392645 DOI: 10.1097/md.0000000000010618] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Femtosecond laser-assisted in situ keratomileusis (FS-LASIK) has gained widespread popularity as a safe, effective and predictable treatment for correcting myopia and myopic astigmatism.However, complications such as biomechanical changes, structural weakness, dry eye and induction of high-order aberrations (HOAs) have been associated with FS laser excision. The induction of HOAs has been reported to reduce quality of vision, leading to increased glare, halos, starburst and deterioration of contrast function corneal HOAs play a significant role in whole-eye aberration. Thus, it is necessary to investigate the changes of corneal high-order aberrations after FS-LASIK. METHODS One hundred thirty-four eyes from 68 consecutive patients with myopia or myopic astigmatism were enrolled in this study. Corneal topography and visual acuity were measured preoperatively and at 1, 3, 6, and 12 months after FS-LASIK. Wavefront errors from the whole cornea, anterior cornea, and posterior cornea were measured by Pentacam. RESULTS Corneal aberrations on the posterior surface were less affected by FS-LASIK compared with those on the anterior surface and the whole cornea. The high-order aberrations (HOAs) on the whole and anterior corneal surfaces increased significantly at 1 month after surgery (P = .000, P = .000), while HOAs on the posterior surface did not significantly change (P = 1.000). The spherical aberration on the whole corneal and anterior corneal surfaces were significantly increased at 1 and 3 months postoperatively (P = .000 and P = .000, respectively), along with the vertical coma on the whole and anterior corneal surfaces at 1 and 3 months (P = .000 and P = .000, respectively). There was no significant difference in horizontal coma or trefoil on the whole, anterior and posterior corneal surfaces after surgery compared with preoperatively (all P = 1.000). CONCLUSION After FS-LASIK changes in corneal aberration occurred mainly on the anterior surface, which may have a significant effect on visual quality.
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Corneal Irregular Astigmatism and Curvature Changes After Small Incision Lenticule Extraction: Three-Year Follow-Up. Cornea 2018; 37:875-880. [DOI: 10.1097/ico.0000000000001532] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Yan H, Gong LY, Huang W, Peng YL. Clinical outcomes of small incision lenticule extraction versus femtosecond laser-assisted LASIK for myopia: a Meta-analysis. Int J Ophthalmol 2017; 10:1436-1445. [PMID: 28944205 DOI: 10.18240/ijo.2017.09.17] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 06/07/2017] [Indexed: 12/31/2022] Open
Abstract
AIM To evaluate the possible differences in visual quality between small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK) for myopia. METHODS A Meta-analysis was performed. Patients were from previously reported comparative studies treated with SMILE versus FS-LASIK. The PubMed, EMBASE, Cochrane, Web of Science and Chinese databases (i.e. WANFANG and CNKI) were searched in Nov. of 2016 using RevMan 5.1 version software. The differences in visual acuity, aberration and biomechanical effects within six months postoperatively were showed. Twenty-seven studies including 4223 eyes were included. RESULTS No significant differences were observed between SMILE and FS-LASIK in terms of the proportion of eyes that lost one or more lines of corrected distance visual acuity after surgery (P=0.14), the proportion of eyes achieving an uncorrected distance visual acuity of 20/20 or better (P=0.43), the final refractive spherical equivalent (P=0.89), the refractive spherical equivalent within ±1.00 diopter of the target values (P=0.80), vertical coma (P=0.45) and horizontal coma (P=0.06). Compared with the FS-LASIK group, total higher-order aberration (P<0.001) and spherical aberration (P<0.001) were higher and the decrease in corneal hysteresis (P=0.0005) and corneal resistance factor (P=0.02) were lower in the SMILE group. CONCLUSION SMILE and FS-LASIK are comparable in efficacy, safety and predictability for correcting myopia. However, the aberration in the SMILE group is superior to that in the FS-LASIK group, and the loss of biomechanical effects may occur less frequently after SMILE than after FS-LASIK.
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Affiliation(s)
- Huan Yan
- Department of Ophthalmology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing 400010, China
| | - Li-Yan Gong
- Department of Ophthalmology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing 400010, China
| | - Wei Huang
- Department of Ophthalmology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing 400010, China
| | - Yan-Li Peng
- Department of Ophthalmology, Chongqing Aier-Mega Eye Hospital, Aier Eye Hospital Group, Chongqing 400060, China.,Aier School of Ophthalmology, Central South University, Changsha 410000, Hunan Province, China
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Ji YW, Kim M, Kang DSY, Reinstein DZ, Archer TJ, Choi JY, Kim EK, Lee HK, Seo KY, Kim TI. Lower Laser Energy Levels Lead to Better Visual Recovery After Small-Incision Lenticule Extraction: Prospective Randomized Clinical Trial. Am J Ophthalmol 2017; 179:159-170. [PMID: 28499707 DOI: 10.1016/j.ajo.2017.05.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 04/27/2017] [Accepted: 05/01/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE To determine the effect of lowering laser energy on clinical outcomes in small-incision lenticule extraction (SMILE). DESIGN Prospective randomized clinical trial. METHODS A total of 151 patients (151 eyes) with moderate myopia scheduled for SMILE were included: 58 eyes received SMILE with low energy (100, 105, and 110 nJ; L-SMILE group) and 93 with conventional energy (115-150 nJ; C-SMILE group). Patients received complete ophthalmic examinations preoperatively and over 3 months postoperatively. RESULTS Uncorrected distance visual acuity (logMAR UDVA) 1 day and 1 week postoperatively was significantly better in L-SMILE than in C-SMILE (P < .001 and P = .005, respectively). There was no significant difference between the groups at 1 and 3 months. L-SMILE induced significantly fewer corneal aberrations compared with C-SMILE at 1 week and 1 month postoperatively (both P < .01), but there were no significant differences at 3 months. Though there was no difference in logMAR UDVA over the postoperative period between the 100, 105, and 110 nJ subgroups, there was a significant difference in logMAR UDVA on postoperative day 1 between L-SMILE and each subgroup in which an energy level of 115 nJ or higher was used. Furthermore, logMAR UDVA on postoperative day 1 showed a significant correlation with laser energy (r = 0.451, P < .001) and multiple linear regression analysis revealed that energy level was the only independent factor associated with logMAR UDVA on postoperative day 1 (P < .001). CONCLUSIONS SMILE using femtosecond energy of less than 115 nJ facilitates better visual acuity with less induction of corneal aberrations in the early postoperative period.
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Tian Y, Jiang HB, Jiang J, Wen D, Xia XB, Song WT. Comparison of Implantable Collamer Lens Visian ICL V4 and ICL V4c for high myopia: A cohort study. Medicine (Baltimore) 2017; 96:e7294. [PMID: 28640145 PMCID: PMC5484253 DOI: 10.1097/md.0000000000007294] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The aim of this study was to investigate the visual quality of the 2 kinds of intraocular lens: Visian implantable collamer lens (ICL) V4 and Visian ICL V4c implantations for high myopia.Twenty cases (20 eyes) with high myopia who received Visian ICL V4 implantation and 18 cases (18 eyes) with high myopia who received Visian ICL V4c implantation in our hospital from April 1, 2014 to November 31, 2016 were enrolled. In 1-month follow-up, near vision, best corrected distant visual acuity (BCVA), uncorrected distant visual acuity (UDVA), and wavefront aberrations were measured, and compensation factor was calculated.Near vision, UDVA, and BCVA showed no significant difference between ICL V4 implantation and ICL V4c implantation (P >.05). However, high-order aberrations and spherical aberrations were higher in ICL V4c implantation than in ICL V4 implantation (P <.05). Low-order aberrations (defocus and astigmatism), coma, and subjective visual quality had no significant difference between ICL V4 implantation and ICL V4c implantation (P >.05).The 2 kinds of ICL Visian ICL V4 and Visian ICL V4c had similar efficacy of visual quality for high myopia. The presence of the central hole of Visian ICL V4c has no significant effect on visual quality.
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Cai WT, Liu QY, Ren CD, Wei QQ, Liu JL, Wang QY, Du YR, He MM, Yu J. Dry eye and corneal sensitivity after small incision lenticule extraction and femtosecond laser-assisted in situ keratomileusis: a Meta-analysis. Int J Ophthalmol 2017; 10:632-638. [PMID: 28503439 DOI: 10.18240/ijo.2017.04.21] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 02/06/2017] [Indexed: 11/23/2022] Open
Abstract
AIM To assess the corneal sensitivity and the incidences of dry eye after small incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK). METHODS The Meta-analysis was performed using RevMan 5.3. We searched on PubMed from inception to March 2016. Summary weighted mean difference (WMD) and 95% confidence intervals (CIs) were used to analyze the datum. Random-effects or fixed-effects models were chosen up to between-study heterogeneity. The main outcomes were composed of the Ocular Surface Disease Index (OSDI) scores, tear film break-up time (TBUT), Schirmer Test and corneal sensitivity. RESULTS Eight eligible studies including 772 eyes (386 in SMILE group and 386 in FS-LASIK group) were identified. The parameters have no significiant difference heterogeneity between SMILE and FS-LASIK group preoperatively. There were significant differences between the two groups in OSDI scores at one and three months postoperatively, in TBUT at one and three months postoperatively, in corneal sensitivity at one week, about one month and three months postoperatively. However, there was no significant difference observed in Schirmer Test at the follow-up periods. CONCLUSION Compare to FS-LASIK, dry eye and the corneal sensitivity recover better in the SMILE group, in first three months after the surgery.
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Affiliation(s)
- Wen-Ting Cai
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai 200072, China
| | - Qing-Yu Liu
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai 200072, China
| | - Cheng-Da Ren
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai 200072, China
| | - Qing-Quan Wei
- Nanchang University, Nanchang 330031, Jiangxi Province, China
| | - Jun-Ling Liu
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai 200072, China
| | - Qian-Yi Wang
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai 200072, China
| | - Ya-Ru Du
- Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
| | - Meng-Mei He
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai 200072, China
| | - Jing Yu
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai 200072, China
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Chen X, Wang Y, Zhang J, Yang SN, Li X, Zhang L. Comparison of ocular higher-order aberrations after SMILE and Wavefront-guided Femtosecond LASIK for myopia. BMC Ophthalmol 2017; 17:42. [PMID: 28388896 PMCID: PMC5384151 DOI: 10.1186/s12886-017-0431-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 03/31/2017] [Indexed: 11/17/2022] Open
Abstract
Background To compare changes in higher-order aberrations (HOAs) following small incision lenticule extraction (SMILE) and wavefront-guided femtosecond laser-assisted in situ keratomileusis (WFG FS-LASIK), and to investigate correlations between preoperative spherical equivalence (SE) and components of HOAs affecting visual quality. Methods Sixty-five myopic eyes from 38 patients were enrolled in the study retrospectively, either having undergone SMILE or WFG FS-LASIK. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive error, and individual Zernike coefficients of 3rd- to 6th-order HOAs were measured before and 3 months after the surgeries and were compared using the Mann-Whitney test or Student’s t-test. Additional generalized estimating equation analyses (GEE) were used to control for within-subject biases in individual Zernike coefficients between the right and left eyes of the same patients. Results There was no significant difference in UDVA or CDVA after WFG FS-LASIK (Mean ± SD: −0.02 ± 0.07 and −0.04 ± 0.22 respectively, in logMAR) and after SMILE (−0.01 ± 0.06 and −0.04 ± 0.04 respectively). However, greater vertical coma aberration was found after SMILE (p = 0.036). Preoperative SE was correlated to induced horizontal coma (r = −0.608, p = 0.001) in WFG FS-LASIK, and correlated to induced vertical coma (r = −0.459, p = 0.003) in SMILE. Conclusions Both SMILE and WFG FS-LASIK can achieve planned visual outcomes in correcting myopia and myopic astigmatism. However, higher vertical coma was shown in SMILE than WFG FS-LASIK which might be a potentially impact factor for patients’ vision under certain lighting conditions and needs further investigation.
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Affiliation(s)
- Xiaoqin Chen
- Tianjin Eye Hospital & Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Medical University, No 4. Gansu Rd, Heping District, Tianjin, 300020, China
| | - Yan Wang
- Tianjin Eye Hospital & Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Medical University, No 4. Gansu Rd, Heping District, Tianjin, 300020, China.
| | - Jiamei Zhang
- Tianjin Eye Hospital & Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Medical University, No 4. Gansu Rd, Heping District, Tianjin, 300020, China
| | - Shun-Nan Yang
- Vision Performance Institute, Pacific University College of Optometry, Forest Grove, OR, USA
| | - Xiaojing Li
- First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China
| | - Lin Zhang
- Tianjin Eye Hospital & Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Medical University, No 4. Gansu Rd, Heping District, Tianjin, 300020, China
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Chan C, Lawless M, Sutton G, Versace P, Hodge C. Small incision lenticule extraction (SMILE) in 2015. Clin Exp Optom 2016; 99:204-12. [PMID: 27156103 DOI: 10.1111/cxo.12380] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 11/11/2015] [Accepted: 11/19/2015] [Indexed: 11/30/2022] Open
Abstract
Small incision lenticule extraction (SMILE) represents a recent addition to the refractive surgeon's range of procedures. Although there remains a number of similarities to existing techniques in terms of patient selection and treatment parameters, consideration is required to optimise patient outcomes and satisfaction. Here, we review the selection criteria, contraindications, indications and existing published safety and efficacy outcomes.
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Affiliation(s)
- Colin Chan
- Vision Eye Institute, Chatswood, New South Wales, Australia
| | - Michael Lawless
- Vision Eye Institute, Chatswood, New South Wales, Australia.,Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Gerard Sutton
- Vision Eye Institute, Chatswood, New South Wales, Australia.,Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | | | - Chris Hodge
- Vision Eye Institute, Chatswood, New South Wales, Australia.,University of New South Wales, Kensington, New South Wales, Australia
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Mir TA, Woreta FA, Bower KS. The role of the posterior corneal surface in surgical planning. EXPERT REVIEW OF OPHTHALMOLOGY 2015. [DOI: 10.1586/17469899.2015.1116386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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de Jong T, Canovas C, Weeber H, Jansonius NM. From corneal shape to ocular wavefront in eyes with aspheric IOLs: the feasibility of IOL customisation. Ophthalmic Physiol Opt 2015; 36:43-50. [PMID: 26489033 DOI: 10.1111/opo.12258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 09/08/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE To determine if it is possible to predict the ocular wavefront aberrations of eyes with an aspheric IOL from the corneal shape and other readily available eye characteristics. A reliable prediction is a prerequisite for future IOL customisation. METHODS Sixty pseudophakic eyes with aspheric IOLs of 60 patients were included. The corneal shape and the ocular wavefront aberrations were measured postoperatively with a Scheimpflug camera and an aberrometer, respectively. The elevation data of the anterior corneal surface were fitted by Zernike polynomials. Linear regression models for the Zernike coefficients describing the ocular wavefront aberrations up till the fourth order were determined, with as independent variables the Zernike coefficients describing the corneal shape, the eye (right/left), IOL power, and axial length. RESULTS Linear regression equations with an explained variance (adjusted R-square) above 0.50 were found for five Zernike aberration terms: defocus (z(2,0); adjusted R-square 0.90), the astigmatism terms (0.81 for oblique astigmatism [z(2,-2)] and 0.88 for regular astigmatism [z(2,2)]), vertical coma (z(3,-1); 0.52), and spherical aberration (z(4,0); 0.71). CONCLUSION The defocus, astigmatism, vertical coma, and spherical aberration terms of the ocular wavefront are strongly associated with the corneal shape in pseudophakic eyes and may thus be predicted from the corneal shape and other eye characteristics.
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Affiliation(s)
- Tim de Jong
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Henk Weeber
- AMO Groningen B.V., Groningen, the Netherlands
| | - Nomdo M Jansonius
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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