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Tamimi A, Sheikhzadeh F, Ezabadi SG, Islampanah M, Parhiz P, Fathabadi A, Poudineh M, Khanjani Z, Pourmontaseri H, Orandi S, Mehrabani R, Rahmanian M, Deravi N. Post-LASIK dry eye disease: A comprehensive review of management and current treatment options. Front Med (Lausanne) 2023; 10:1057685. [PMID: 37113611 PMCID: PMC10126282 DOI: 10.3389/fmed.2023.1057685] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 03/14/2023] [Indexed: 04/29/2023] Open
Abstract
Laser-assisted in situ keratomileusis (LASIK) is a unique corneal stromal laser ablation method that uses an excimer laser to reach beneath corneal dome-shaped tissues. In contrast, surface ablation methods, such as photorefractive keratectomy, include removing epithelium and cutting off the Bowman's layer and the stromal tissue of the anterior corneal surface. Dry eye disease (DED) is the most common complication after LASIK. DED is a typical multi-factor disorder of the tear function and ocular surface that occurs when the eyes fail to produce efficient or adequate volumes of tears to moisturize the eyes. DED influences quality of life and visual perception, as symptoms often interfere with daily activities such as reading, writing, or using video display monitors. Generally, DED brings about discomfort, symptoms of visual disturbance, focal or global tear film instability with possible harm to the ocular surface, the increased osmolarity of the tear film, and subacute inflammation of the ocular surface. Almost all patients develop a degree of dryness in the postoperative period. Detection of preoperative DED and committed examination and treatment in the preoperative period, and continuing treatments postoperatively lead to rapid healing, fewer complications, and improved visual outcomes. To improve patient comfort and surgical outcomes, early treatment is required. Therefore, in this study, we aim to comprehensively review studies on the management and current treatment options for post-LASIK DED.
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Affiliation(s)
- Atena Tamimi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Sajjad Ghane Ezabadi
- Students’ Scientific Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Peyman Parhiz
- Student Research Committee, Zahedan Medical Sciences Branch, Islamic Azad University, Zahedan, Iran
| | - Amirhossein Fathabadi
- Student Research Committee, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Zahra Khanjani
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Pourmontaseri
- Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
- Bitab Knowledge Enterprise, Fasa University of Medical Sciences, Fasa, Iran
| | - Shirin Orandi
- Department of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reyhaneh Mehrabani
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Mohammad Rahmanian
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niloofar Deravi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- *Correspondence: Niloofar Deravi,
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Anders P, Anders LM, Barbara A, Szentmary N, Langenbucher A, Gatzioufas Z. Intraocular lens power calculation in eyes with previous corneal refractive surgery. Ther Adv Ophthalmol 2022; 14:25158414221118524. [PMID: 36061972 PMCID: PMC9434667 DOI: 10.1177/25158414221118524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 07/12/2022] [Indexed: 12/05/2022] Open
Abstract
Intraocular lens (IOL) power calculation after corneal refractive surgery (CRS)
becomes an expanding challenge for ophthalmologists as more and more cataract
surgeries after CRS are required. These patients typically also have high
expectations as to visual performance. Conventional IOL power calculation
schemes frequently provide inaccurate results in these cases. This review aims
to summarize and recommend currently available IOL power calculation methods for
eyes with the most common CRS methods: radial keratotomy (RK), photorefractive
keratectomy (PRK), laser in situ keratomileusis (LASIK), and
small incision lenticule extraction (SMILE). To this end, biometry measuring
methods and IOL formulas will be explained and combinations of both are
proposed. In synopsis, it is evident that the latest generation of vergence
formulas exhibit favorable IOL power prediction accuracy in post-CRS eyes, even
though the predictive precision of methods in eyes without CRS is not attained.
Ray tracing computation, intraoperative aberrometry, and machine learning–based
formulas hold potential to further improve refractive outcomes in post-CRS
eyes.
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Affiliation(s)
- Philipp Anders
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
- Department of Ophthalmology, University of Basel, Basel, Switzerland
| | - Lisa-Marie Anders
- Institute of Molecular and Clinical Ophthalmology Basel, 4031 Basel, Switzerland
- Department of Ophthalmology, University of Basel, Basel, Switzerland
| | | | - Nora Szentmary
- Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research, Saarland University, Homburg, Germany
| | | | - Zisis Gatzioufas
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
- Department of Ophthalmology, University of Basel, Basel, Switzerland
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Parapuram SK, Hodge W. The integrin needle in the stromal haystack: emerging role in corneal physiology and pathology. J Cell Commun Signal 2014; 8:113-24. [PMID: 24604397 DOI: 10.1007/s12079-014-0230-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 02/14/2014] [Indexed: 01/22/2023] Open
Abstract
Several studies have established the role of activated corneal keratocytes in the fibrosis of the cornea. However, the role of keratocytes in maintaining the structural integrity of a normal cornea is less appreciated. We focus on the probable functions of integrins in the eye and of the importance of integrin-mediated keratocyte interactions with stromal matrix in the maintenance of corneal integrity. We point out that further understanding of how keratocytes interact with their matrix could establish a novel direction in preventing corneal pathology including loss of structural integrity as in keratoconus or as in fibrosis of the corneal stroma.
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Affiliation(s)
- Sunil K Parapuram
- Department of Ophthalmology, University of Western Ontario, London, Ontario, N6A 4V2, Canada,
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Nowroozzadeh MH, Kalantari Z, Namvar K, Meshkibaf MH. Ocular refractive and biometric characteristics in patients with thalassaemia major. Clin Exp Optom 2011; 94:361-6. [PMID: 21323733 DOI: 10.1111/j.1444-0938.2010.00579.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Thalassaemia major is associated with characteristic findings in craniofacial bony structures and thereby may render abnormal bony orbit and subsequently distinctive ocular biometry. The purpose of the present study was to evaluate the ocular refractive and biometric characteristics in patients with thalassaemia major. METHODS This case-controlled study comprised 94 eyes of 47 patients with thalassaemia major and 88 eyes of 44 age- and sex-matched healthy control subjects. All participants had a complete ocular examination including slitlamp biomicroscopy, fundoscopy, ocular biometry, keratometry, refraction and analysis using Fourier transformation. RESULTS There were no significant differences in spherical equivalent (p = 0.66) and total astigmatism (p = 0.83) between groups. Mean uncorrected vision and visual acuities (logMar) were similar (p = 0.32 and p = 0.71, respectively). Compared with controls, thalassaemic patients had a shorter axial length (23.01 ± 0.12 [SEM] mm versus 23.46 ± 0.12 mm, p = 0.035), thicker crystalline lens (4.01 ± 0.11 mm versus 3.87 ± 0.1 mm, p = 0.046) and steeper average keratometry (44.02 ± 0.24 D versus 43.44 ± 0.24, p = 0.03). Fifty-seven per cent of thalassaemic patients had against-the-rule astigmatism (total), while 64.6 per cent of controls showed a with-the-rule pattern (p < 0.05). These patterns were also found for corneal astigmatism. The magnitudes of total, corneal and lenticular astigmatism were similar among groups. Regression analysis showed significant correlation between corneal (J0 and J45) and total (J0 and J45) astigmatism. The correlations were less prominent between lenticular and total J0 and J45. The mean intraocular pressure was 14.68 ± 0.27 mmHg and 13.3 ± 0.26 mmHg in the thalassaemia and control groups, respectively (p < 0.001). Six eyes (12.8 per cent) of four patients in the thalassaemia group had posterior subcapsular cataract, while the condition had not been observed in controls (p = 0.049). CONCLUSIONS Shorter axial length, thicker lens, steeper corneal curvature and more against-the-rule pattern were characteristic findings in patients with thalassaemia major.
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Dehghani C, Nowroozzadeh MH, Shankar S, Razeghinejad MR. Ocular refractive and biometric characteristics in patients with tilted disc syndrome. ACTA ACUST UNITED AC 2010; 81:688-94. [DOI: 10.1016/j.optm.2010.03.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2009] [Revised: 02/08/2010] [Accepted: 03/03/2010] [Indexed: 10/18/2022]
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Ferrara G, Cennamo G, Marotta G, Loffredo E. New Formula to Calculate Corneal Power After Refractive Surgery. J Refract Surg 2004; 20:465-71. [PMID: 15523958 DOI: 10.3928/1081-597x-20040901-09] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the validity of intraocular lens (IOL) power calculations utilizing a theoretical variable refractive index correlated to axial length after myopic photorefractive keratectomy (PRK) in a clinical simulation and in patients who underwent cataract surgery after PRK for myopia. METHODS Our study included 374 eyes of 300 patients who had PRK for myopia (-2.00 to -12.00 D, mean -4.83 +/- 2.57 D), divided into three groups: Group I had 44 eyes with small ablation zones of 5 to 5.5 mm; Group II had 49 eyes with large ablation zones of 6 to 7 mm; Group III was the control group of 281 eyes (201 patients; 87 males and 114 females) with small and large ablation zones. PRK was performed using the Aesculap-Meditec MEL 60/94 and MEL 70 lasers, and the corneal power was acquired by corneal topography (EyeSys 2000) and a Nidek KM-800 keratometer. RESULTS There was a higher correlation between corneal power and both the change in refraction and axial length when calculated using keratometric measurements. IOL power calculated using keratometric postoperative PRK power was underestimated. The difference between the mean calculated and actual IOL power for emmetropia was 4.30 +/- 2.34 D. A theoretical variable refractive index (obtained from eyes treated with large PRK ablation zones) that correlated with axial length provided the correct keratometric postoperative PRK power: difference between mean calculated and mean actual IOL power was 0.42 +/- 1.23 D. CONCLUSIONS We propose a theoretical variable refractive index that is correlated to axial length. Utilizing this keratometric correct power, we calculated IOL power similar to that for emmetropia.
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Affiliation(s)
- Giuseppe Ferrara
- University of Naples Federico II, Eye Department, Naples, Italy.
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Gündüz A, Evereklioglu C, Er H, Hepşen IF. Lenticular astigmatism in tilted disc syndrome. J Cataract Refract Surg 2002; 28:1836-40. [PMID: 12388038 DOI: 10.1016/s0886-3350(02)01424-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate whether an abnormal optic disc shape in patients with tilted disc syndrome (TDS) is associated with an abnormal configuration of the crystalline lens measured as lenticular astigmatism. SETTING Department of Ophthalmology, Inönü University Medical Faculty, Turgut Ozal Medical Center, Malatya, Turkey. METHODS This cross-sectional masked case-control study comprised 32 eyes of 32 patients with established TDS (13 men, 19 women; mean age 21.31 years +/- 7.05 [SD]) and 20 age- and sex-matched healthy control subjects (8 men, 12 women; mean age 22.65 +/- 7.11 years) with a comparable amount of myopic astigmatism (spherical equivalent) without TDS. The optic disc was morphometrically analyzed by planimetric evaluation of optic disc photographs. The total refractive and keratometric corneal astigmatism was obtained, and lenticular astigmatism was calculated by vector analysis. The Mann-Whitney U test was used for statistical analysis; 1 eye of each patient was evaluated in both groups. A P value less than 0.05 was considered statistically significant. RESULTS The mean spherical equivalent refraction was comparable in TDS patients (-4.73 +/- 1.12 diopters [D]) and controls (-4.28 +/- 1.29 D) (P =.210). The mean total astigmatism was higher in TDS patients (-2.96 +/- 1.04 D) than in the controls (-2.51 +/- 1.09 D), but the difference was not significant (P =.151). The mean corneal astigmatism was comparable in TDS patients (-2.07 +/- 0.83 D) and controls (-2.28 +/- 0.87 D) (P =.454), but the calculated mean lenticular astigmatism was significantly higher in TDS patients (-1.31 +/- 0.98 D and -0.20 +/- 0.35 D, respectively) (P <.001). Twenty-nine of 32 TDS patients (90.6%) had lenticular astigmatism; in 16 (50%), it was greater than -1.00 D. Lenticular astigmatism was present in 7 controls (35%); in 2 (10%), it was greater than -1.00 D. The mean keratometry was significantly higher in TDS patients (43.84 +/- 1.06 D) than in the controls (42.75 +/- 1.45 D) (P =.011). CONCLUSIONS Clinically significant lenticular astigmatism was present in TDS patients. If an abnormal optic disc shape is found on ophthalmoscopy, lenticular astigmatism as well as corneal astigmatism should be carefully evaluated to prevent an unsatisfactory refractive outcome, especially in refractive surgery candidates.
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Affiliation(s)
- Abuzer Gündüz
- Department of Ophthalmology, Inönü University Medical Faculty, Turgut Ozal Medical Center, Research Hospital, Malatya, Turkey
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