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Yao Y, Zhao J, Yu J, He W, Wei L, Zhou X, Lu Y, Zhu X. The influence of corneal ablation patterns on prediction error after cataract surgery in post-myopic-LASIK eyes. EYE AND VISION 2022; 9:23. [PMID: 35773703 PMCID: PMC9248133 DOI: 10.1186/s40662-022-00295-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 06/04/2022] [Indexed: 11/21/2022]
Abstract
Purpose To evaluate the influence of corneal ablation patterns on the prediction error after cataract surgery in post-myopic-LASIK eyes. Methods Eighty-three post-myopic-LASIK eyes of 83 patients that underwent uneventful cataract surgery were retrospectively included. Predicted postoperative spherical equivalence (SE) was calculated for the implanted lens using the Haigis-L and Barrett True-K formula. Prediction error at one month postsurgery was calculated as actual SE minus predicted SE. For each eye, area and decentration of the ablation zone was measured using the tangential curvature map. The associations between prediction errors and corneal ablation patterns were investigated. Results The mean prediction error was − 0.83 ± 1.00 D with the Haigis-L formula and − 1.00 ± 0.99 D with the Barrett True-K formula. Prediction error was positively correlated with keratometry (K) value and negatively correlated with ablation zone area using either formula, and negatively correlated with decentration of the ablation zone using the Barrett True-K formula (all P < 0.05). In the K < 37.08 D group, prediction error was negatively correlated with decentration of the ablation zone with both formulas (all P < 0.05). Multivariate analysis showed that with the Haigis-L formula, prediction error was associated with axial length (AL), K value and decentration, and with the Barrett True-K formula, prediction error was associated with AL and decentration (all P < 0.05). Conclusion A flatter cornea, larger corneal ablation zone and greater decentration will lead to more myopic prediction error after cataract surgery in post-myopic-LASIK eyes.
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Deng WQ, Fang YH, Lin SH, Li YJ. Dynamic distribution and correlation analysis of the angle kappa in myopia patients undergoing femtosecond-assisted laser in situ keratomileusis. Medicine (Baltimore) 2022; 101:e29425. [PMID: 35713451 PMCID: PMC9276180 DOI: 10.1097/md.0000000000029425] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 04/19/2022] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To explore the offset distribution of pupillary centres, the offset between the pupil centre and the coaxially sighted corneal light reflex (P-Dist) and their correlation in femtosecond laser combined with excimer laser in situ keratomileusis. METHODS Randomly selected 194 patients (398 eyes) who underwent femtosecond-assisted laser in situ keratomileusis with preoperative use of WaveLight Allegro Topolyzer Corneal Topography (WaveLight Laser Technologies AG, Erlangen, Germany) to measure the pupil size and centre position. The P-Dist of the patients was recorded by the X and Y axis eyeball tracking adjustment program of the WaveLight Eagle Vision EX500 excimer laser system. RESULTS The P-Dist was 0.214 ± 0.092 mm in the right eyes and 0.228 ± 0.105 mm in the left eyes (P = .041). Under scotopic conditions, the pupil centre of left eye X-axis was -0.046 ± 0.091 mm, the right eye was -0.152 ± 0.084 mm, with significant differences (P = .015), and the Y-axis direction showed no significant changes (P = .062). The white to white was positively correlated with changes of pupil diameter (scotopic pupil diameter-photopic pupil diameter) (r = 0.270, P < .001). The equivalent spherical mirror and measured centroid shift were negatively correlated (r = -0.214, P = .002). CONCLUSION The angle kappa of the right eye is smaller than that of the left eye and from scotopic to photopic condition, the pupil centroid shift of both eyes to the nasal inferior side. If the cornea is too large, the low illumination environment should be maintained during the operation to improve the efficiency of pupil matching.
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Affiliation(s)
- Wen-Qing Deng
- Department of Ophthalmology, Fuyang People's Hospital of Anhui Medical University, Fuyang, Anhui, China
- Department of Ophthalmology, Affiliated Hospital of Yanbian University, Yanji, Jilin, China
| | - Yu-Hui Fang
- Department of Dermatology, Fuyang People's Hospital of Anhui Medical University, Fuyang, Anhui, China
| | - Shu-Hua Lin
- Department of Ophthalmology, Affiliated Hospital of Yanbian University, Yanji, Jilin, China
| | - Ying-Jun Li
- Department of Ophthalmology, Fuyang People's Hospital of Anhui Medical University, Fuyang, Anhui, China
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Ding Y, Zhang Z, Min X, Xia X, Hu S. Changes of angle Kappa and corneal morphology changes in myopic patients after Sub -Bowman -Keratomileusis. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2021; 46:162-168. [PMID: 33678653 PMCID: PMC10929785 DOI: 10.11817/j.issn.1672-7347.2021.190472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To investigate angle Kappa and diopter distribution in myopic patients and the changes of angle Kappa and corneal morphology after Sub-Bowman-Keratomileusis (SBK), and to analyze the effects of the surgery on corneal morphologic changes and the patients' near fixation characteristics. METHODS The clinical data of 134 myopic patients (268 eyes) undergoing SBK from August 2015 to August 2016 were retrospectively analyzed. Angle Kappa, corneal curvature in the central corneal region of 3 mm, and post-corneal Diff value were measured by Orbscan IIz Corneal Topography System before operation, 1 month and 6 months after operation. According to the values of angle Kappa before SBK, the patients were divided into 2 groups: the large K group (angle Kappa≥5°, 71 eyes) and the small K group (angle Kappa<5°, 197 eyes). Correlation analysis of the factors influencing angle Kappa at 6 months after operation was performed. RESULTS In the large K group, angle Kappa was (5.67±0.65)°, spherical equivalent was (-4.84±2.32) D, and angle Kappa was decreased after operation (both P<0.05) with the increased decreasing range over time. In the small K group, angle Kappa was (3.51±1.08)°, spherical equivalent was (-5.78±2.63) D, angle Kappa was increased after operation with decreased increasing range over time, and the difference was statistically significant between 6 months after operation and before operation (P<0.05).The post-corneal Diff value of the 2 groups was increased after operation (all P<0.001), and was decreased from 1 month to 6 months after surgery. The corneal curvature in the central corneal region of 3 mm of the 2 groups 1 month after operation was decreased significantly (both P<0.001). From 1 month to 6 months after operation, the corneal curvature of the large K group tended to be stable, while the corneal curvature of the small K group tended to increase. There was no significant correlation between the changes of angle Kappa 6 months after operation and the changes of the corneal central curvature or the post-corneal Diff value (both P>0.05), but the changes of angle Kappa 6 months after operation was positively correlated with corneal cutting thickness (rlarge K group=0.398, rsmall K group=0.218, both P<0.05) and it was negatively correlated with preoperative diopter (rlarge K group=-0.283, rsmall K group=-0.233, both P<0.05). CONCLUSIONS The angle Kappa is decreased in low-moderate myopia patients with large angle Kappa, while is increased in high myopia patients with small angle Kappa after SBK. Myopia patients after SBK will look for the new balance of the binocular accommodation and vergence function for improving the comfort in the near-work situations.
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Affiliation(s)
- Yi Ding
- Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha 410008.
| | - Zhipei Zhang
- Department of Ophthalmology, First People's Hospital of Changde City, Changde Hunan 415003, China
| | - Xiaoshan Min
- Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha 410008.
| | - Xiaobo Xia
- Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha 410008
| | - Shengfa Hu
- Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha 410008
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Theoretical Effect of Coma and Spherical Aberrations Translation on Refractive Error and Higher Order Aberrations. PHOTONICS 2020. [DOI: 10.3390/photonics7040116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
(1) Background: The purpose of the study is to present a simple theoretical account of the effect of translation of coma and spherical aberrations (SA) on refractive error and higher order aberrations. (2) Methods: A computer software algorithm was implemented based on previously published methods. The effect of translation (0 to +1 mm) was analyzed for SA (0 to +2 µm) and coma (0 to +2 µm) for a circular pupil of 6 mm, without any rotation or scaling effect. The relationship amongst Zernike representations of various aberrations was analyzed under the influence of translation. (3) Results: The translation of +0.40 µm of SA (C[4,0]) by +0.25 mm with a pupil diameter of 6mm resulted in induction of tilt (C[1,1]), −0.03D defocus (C[2,0]), +0.03D astigmatism (C[2,2]) and +0.21 µm coma (C[3,1]). The translation of +0.4 µm of coma (C[3,1]) by +0.25 mm with a pupil diameter of 6 mm resulted in induction of tilt (C[1,1]), −0.13D defocus (C[2,0]) and +0.13D astigmatism (C[2,2]). A theoretical quantitative relationship between SA, coma, astigmatism and defocus is presented under the influence of translation. (4) Conclusion: The results can act as a guide for the clinician, in order to readily assess theoretical impact of wavefront map translation from pupil center to the visual axis. The resultant refractive coupling has to be taken into consideration especially when treating eyes with an abnormal corneal shape and/or large pupil center to corneal vertex chord.
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Huang J, Zhou X, Qian Y. Decentration following femtosecond laser small incision lenticule extraction (SMILE) in eyes with high astigmatism and its impact on visual quality. BMC Ophthalmol 2019; 19:151. [PMID: 31315595 PMCID: PMC6637638 DOI: 10.1186/s12886-019-1153-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 06/25/2019] [Indexed: 11/23/2022] Open
Abstract
Background To measure the decentration following SMILE in eyes with high myopic astigmatism and investigate its impact on visual quality. Methods The prospective study was conducted to analyze patients who underwent SMILE for correction of myopia and myopic astigmatism ≥2.5D (high astigmatism group, HA) at the ophthalmology department, Eye and ENT hospital, Shanghai, China.. Patients with myopic astigmatism < 1.5D served as controls (low astigmatism group, LA). Decentration was measured using a Scheimpflug camera with a difference map of the tangential curvature at 12 months postoperatively. Also the associations between decentration from the coaxial sighted corneal light reflex (CSCLR) and the visual outcomes, correction efficacy of astigmatism, wavefront aberrations and objective scatter index (OSI) were analyzed. Results No significant differences were observed in the decentered distance between HA and LA in either eyes (OD: HA: 0.18 ± 0.10 mm, LA: 0.20 ± 0.14 mm, P = 0.659; OS: HA: 0.22 ± 0.11 mm, LA: 0.20 ± 0.11 mm, P = 0.637). The analysis across the three levels of decentration (< 0.1 mm, 0.1–0.2 mm, and > 0.2 mm) showed no significant association between decentration and visual outcomes of predictability, efficiency, safety, MTF cutoff, OSI, SR and OVs in both groups. Also no significant association was observed between decentration and postoperative astigmatism in either group. A significant relationship between the magnitude of decentration and induced coma and spherical aberration was observed in HA. Conclusions The amount of decentration between HA and LA groups showed no differences. Decentration > 0.20 mm from CSCLR resulted in greater induction of coma and SA after SMILE in eyes with HA.
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Affiliation(s)
- Jia Huang
- Department of Ophthalmology, EYE & ENT Hospital of Fudan University, Shanghai, People's Republic of China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, People's Republic of China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, People's Republic of China
| | - Xingtao Zhou
- Department of Ophthalmology, EYE & ENT Hospital of Fudan University, Shanghai, People's Republic of China.,NHC Key Laboratory of Myopia (Fudan University), Shanghai, People's Republic of China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, People's Republic of China
| | - Yishan Qian
- Department of Ophthalmology, EYE & ENT Hospital of Fudan University, Shanghai, People's Republic of China. .,NHC Key Laboratory of Myopia (Fudan University), Shanghai, People's Republic of China. .,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, People's Republic of China.
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Hindman HB, DeMagistris M, Callan C, McDaniel T, Bubel T, Huxlin KR. Impact of topical anti-fibrotics on corneal nerve regeneration in vivo. Exp Eye Res 2019; 181:49-60. [PMID: 30660507 PMCID: PMC6443430 DOI: 10.1016/j.exer.2019.01.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 01/11/2019] [Accepted: 01/14/2019] [Indexed: 12/12/2022]
Abstract
Recent work in vitro has shown that fibroblasts and myofibroblasts have opposing effects on neurite outgrowth by peripheral sensory neurons. Here, we tested a prediction from this work that dampening the fibrotic response in the early phases of corneal wound healing in vivo could enhance reinnervation after a large, deep corneal injury such as that induced by photorefractive keratectomy (PRK). Since topical steroids and Mitomycin C (MMC) are often used clinically for mitigating corneal inflammation and scarring after PRK, they were ideal to test this prediction. Twenty adult cats underwent bilateral, myopic PRK over a 6 mm optical zone followed by either: (1) intraoperative MMC (n = 12 eyes), (2) intraoperative prednisolone acetate (PA) followed by twice daily topical application for 14 days (n = 12 eyes), or (3) no post-operative treatment (n = 16 eyes). Anti-fibrotic effects of MMC and PA were verified optically and histologically. First, optical coherence tomography (OCT) performed pre-operatively and 2, 4 and 12 weeks post-PRK was used to assess changes in corneal backscatter reflectivity. Post-mortem immunohistochemistry was then performed at 2, 4 and 12 weeks post-PRK, using antibodies against α-smooth muscle actin (α-SMA). Finally, immunohistochemistry with antibodies against βIII-tubulin (Tuj-1) was performed in the same corneas to quantify changes in nerve distribution relative to unoperated, control cat corneas. Two weeks after PRK, untreated corneas exhibited the greatest amount of staining for α-SMA, followed by PA-treated and MMC-treated eyes. This was matched by higher OCT-based stromal reflectivity values in untreated, than PA- and MMC-treated eyes. PA treatment appeared to slow epithelial healing and although normal epithelial thickness was restored by 12 weeks-post-PRK, intra-epithelial nerve length only reached ∼1/6 normal values in PA-treated eyes. Even peripheral cornea (outside the ablation zone) exhibited depressed intra-epithelial nerve densities after PA treatment. Stromal nerves were abundant under the α-SMA zone, but appeared to largely avoid it, creating an area of sub-epithelial stroma devoid of nerve trunks. In turn, this may have led to the lack of sub-basal and intra-epithelial nerves in the ablation zone of PA-treated eyes 4 weeks after PRK, and their continuing paucity 12 weeks after PRK. Intra-operative MMC, which sharply decreased α-SMA staining, was followed by rapid restoration of nerve densities in all corneal layers post-PRK compared to untreated corneas. Curiously, stromal nerves appeared unaffected by the development of large, stromal, acellular zones in MMC-treated corneas. Overall, it appears that post-PRK treatments that were most effective at reducing α-SMA-positive cells in the early post-operative period benefited nerve regeneration the most, resulting in more rapid restoration of nerve densities in all corneal layers of the ablation zone and of the corneal periphery.
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Affiliation(s)
- Holly B Hindman
- The Flaum Eye Institute, University of Rochester, Rochester, NY, 14642, USA; Center for Visual Science, University of Rochester, Rochester, NY, 14627, USA
| | | | - Christine Callan
- The Flaum Eye Institute, University of Rochester, Rochester, NY, 14642, USA
| | - Thurma McDaniel
- The Flaum Eye Institute, University of Rochester, Rochester, NY, 14642, USA
| | - Tracy Bubel
- Center for Visual Science, University of Rochester, Rochester, NY, 14627, USA
| | - Krystel R Huxlin
- The Flaum Eye Institute, University of Rochester, Rochester, NY, 14642, USA; Center for Visual Science, University of Rochester, Rochester, NY, 14627, USA.
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Yu M, Chen M, Liu W, Dai J. Comparative study of wave-front aberration and corneal Asphericity after SMILE and LASEK for myopia: a short and long term study. BMC Ophthalmol 2019; 19:80. [PMID: 30894159 PMCID: PMC6425702 DOI: 10.1186/s12886-019-1084-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 03/06/2019] [Indexed: 11/16/2022] Open
Abstract
Background The study compares the wave-front aberration and corneal asphericity from multiple perspectives after Small Incision Lenticule Extraction and Laser-assisted Subepithelial Keratomileusis for mild to moderate myopia in a short and long time period. Methods This prospective and comparative study included 32 eyes in the SMILE group, with a mean spherical equivalent (SE) of − 4.1 ± 0.9D and 32 eyes in the LASEK group, with a mean SE of − 3.7 ± 1.0D. Visual acuity, refractive error, wave-front aberration, corneal Q value and corneal refractive power were analyzed pre-, 3 months and 3 years post-operatively. Results There was no significant difference in refractive error, wave-front aberration, corneal Q value and corneal refractive power before treatment. Three months postoperative, Q value within 6 mm (SMILE: 0.46 ± 0.27, LASEK: 0.63 ± 0.28, p = 0.02), the relative peripheral corneal power (5-8 mm: p < 0.05), change of higher order aberration (SMILE: 0.10 ± 0.16, LASEK: 0.24 ± 0.20, p = 0.004) and spherical aberration (SA, SMILE: -0.07 ± 0.30, LASEK: -0.41 ± 0.40, p < 0.001) were significantly lower in the SMILE than in LASEK group. The visual acuity, refractive error, coma, peripheral Q value, central corneal power had no significant difference between the two groups. Three years post-operation, the corneal power distribution results and SA were similar to that of 3-month, while the Q value had no significant difference between the two groups. Conclusion In the early stage after SMILE, the HOAs was lower, the corneal refractive power from central to periphery was more uniform than after LASEK; and in the long-term run, SMILE still preceded LASEK in the corneal asphericity and aberration. Electronic supplementary material The online version of this article (10.1186/s12886-019-1084-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Manrong Yu
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, No. 83 Fenyang Road, Shanghai, 200031, China.,NHC Key Laboratory of Myopia (Fudan University) and Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Minjie Chen
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, No. 83 Fenyang Road, Shanghai, 200031, China.,NHC Key Laboratory of Myopia (Fudan University) and Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Wangyuan Liu
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, No. 83 Fenyang Road, Shanghai, 200031, China.,NHC Key Laboratory of Myopia (Fudan University) and Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
| | - Jinhui Dai
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, No. 83 Fenyang Road, Shanghai, 200031, China. .,NHC Key Laboratory of Myopia (Fudan University) and Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
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Chan TCY, Wan KH, Kang DSY, Tso THK, Cheng GPM, Wang Y. Effect of corneal curvature on optical zone decentration and its impact on astigmatism and higher-order aberrations in SMILE and LASIK. Graefes Arch Clin Exp Ophthalmol 2018; 257:233-240. [DOI: 10.1007/s00417-018-4165-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/29/2018] [Accepted: 10/15/2018] [Indexed: 10/28/2022] Open
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Mohammadi SF, Nabovati P, Mirzajani A, Ashrafi E, Vakilian B. Risk factors of regression and undercorrection in photorefractive keratectomy: a case-control study. Int J Ophthalmol 2015; 8:933-7. [PMID: 26558204 DOI: 10.3980/j.issn.2222-3959.2015.05.14] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 01/30/2015] [Indexed: 11/02/2022] Open
Abstract
AIM To determine risk factors of regression and undercorrection following photorefractive keratectomy (PRK) in myopia or myopic astigmatism. METHODS A case-control study was designed in which eyes with an indication for re-treatment (RT) were defined as cases; primary criteria for RT indication, as assessed at least 9mo postoperatively, included an uncorrected distance visual acuity (UDVA) of 20/30 or worse and a stable refraction for more than 3mo. Additional considerations included optical quality symptoms and significant higher order aberrations (HOAs). Controls were chosen from the same cohort of operated eyes which had complete post-operative follow up data beyond 9mo and did not need RT. The cohort included patients who had undergone PRK by the Tissue-Saving (TS) ablation profile of Technolas 217z100 excimer laser (Bausch & Lomb, Rochester, NY, USA). Mitomycin C had been used in all of the primary procedures. RESULTS We had 70 case eyes and 158 control eyes, and they were comparable in terms of age, sex and follow-up time (P values: 0.58, 1.00 and 0.89, respectively). Pre-operative spherical equivalent of more than -5.00 diopter (D), intended optical zone (OZ) diameter of less than 6.00 mm and ocular fixation instability during laser ablation were associated with RT indications (all P values <0.001). These factors maintained their significance in the multiple logistic regression model with odd ratios of 6.12, 6.71 and 7.89, respectively. CONCLUSION Higher refractive correction (>-5.00 D), smaller OZ (<6.00 mm) and unstable fixation during laser ablation of PRK for myopia and myopic astigmatism were found to be strong predictors of undercorrection and regression.
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Affiliation(s)
- Seyed-Farzad Mohammadi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Payam Nabovati
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran ; Department of Optometry, School of Rehabilitation, Iran University of Medical Sciences, Tehran 1676666431, Iran
| | - Ali Mirzajani
- Department of Optometry, School of Rehabilitation, Iran University of Medical Sciences, Tehran 1676666431, Iran
| | - Elham Ashrafi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
| | - Banafsheh Vakilian
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran 1336616351, Iran
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Savage DE, Brooks DR, DeMagistris M, Xu L, MacRae S, Ellis JD, Knox WH, Huxlin KR. First demonstration of ocular refractive change using blue-IRIS in live cats. Invest Ophthalmol Vis Sci 2014; 55:4603-12. [PMID: 24985471 DOI: 10.1167/iovs.14-14373] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To determine the efficacy of intratissue refractive index shaping (IRIS) using 400-nm femtosecond laser pulses (blue light) for writing refractive structures directly into live cat corneas in vivo, and to assess the longevity of these structures in the eyes of living cats. METHODS Four eyes from two adult cats underwent Blue-IRIS. Light at 400 nm with 100-femtosecond (fs) pulses were tightly focused into the corneal stroma of each eye at an 80-MHz repetition rate. These pulses locally increased the refractive index of the corneal stroma via an endogenous, two-photon absorption process and were used to inscribe three-layered, gradient index patterns into the cat corneas. The optical effects of the patterns were then tracked using optical coherence tomography (OCT) and Shack-Hartmann wavefront sensing. RESULTS Blue-IRIS patterns locally changed ocular cylinder by -1.4 ± 0.3 diopters (D), defocus by -2.0 ± 0.5 D, and higher-order root mean square (HORMS) by 0.31 ± 0.04 μm at 1 month post-IRIS, without significant changes in corneal thickness or curvature. Refractive changes were maintained for the duration they were tracked, 12 months post-IRIS in one eye, and just more than 3 months in the remaining three eyes. CONCLUSIONS Blue-IRIS can be used to inscribe refractive structures into live cat cornea in vivo that are stable for at least 12 months, and are not associated with significant alterations in corneal thicknesses or radii of curvature. This result is a critical step toward establishing Blue-IRIS as a promising technique for noninvasive vision correction.
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Affiliation(s)
- Daniel E Savage
- The Institute of Optics, University of Rochester, Rochester, New York, United States Center for Visual Science, University of Rochester, Rochester, New York, United States
| | - Daniel R Brooks
- The Institute of Optics, University of Rochester, Rochester, New York, United States
| | - Margaret DeMagistris
- Flaum Eye Institute, University of Rochester, Rochester, New York, United States
| | - Lisen Xu
- The Institute of Optics, University of Rochester, Rochester, New York, United States
| | - Scott MacRae
- Center for Visual Science, University of Rochester, Rochester, New York, United States Flaum Eye Institute, University of Rochester, Rochester, New York, United States
| | - Jonathan D Ellis
- The Institute of Optics, University of Rochester, Rochester, New York, United States Department of Mechanical Engineering, University of Rochester, Rochester, New York, United States
| | - Wayne H Knox
- The Institute of Optics, University of Rochester, Rochester, New York, United States Center for Visual Science, University of Rochester, Rochester, New York, United States
| | - Krystel R Huxlin
- Center for Visual Science, University of Rochester, Rochester, New York, United States Flaum Eye Institute, University of Rochester, Rochester, New York, United States
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11
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Huxlin KR, Hindman HB, Jeon KI, Bühren J, MacRae S, DeMagistris M, Ciufo D, Sime PJ, Phipps RP. Topical rosiglitazone is an effective anti-scarring agent in the cornea. PLoS One 2013; 8:e70785. [PMID: 23940641 PMCID: PMC3733781 DOI: 10.1371/journal.pone.0070785] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Accepted: 06/25/2013] [Indexed: 12/12/2022] Open
Abstract
Corneal scarring remains a major cause of blindness world-wide, with limited treatment options, all of which have side-effects. Here, we tested the hypothesis that topical application of Rosiglitazone, a Thiazolidinedione and ligand of peroxisome proliferator activated receptor gamma (PPARγ), can effectively block scar formation in a cat model of corneal damage. Adult cats underwent bilateral epithelial debridement followed by excimer laser ablation of the central corneal stroma to a depth of ~160 µm as a means of experimentally inducing a reproducible wound. Eyes were then left untreated, or received 50 µl of either 10 µM Rosiglitazone in DMSO/Celluvisc, DMSO/Celluvisc vehicle or Celluvisc vehicle twice daily for 2 weeks. Cellular aspects of corneal wound healing were evaluated with in vivo confocal imaging and post-mortem immunohistochemistry for alpha smooth muscle actin (αSMA). Impacts of the wound and treatments on optical quality were assessed using wavefront sensing and optical coherence tomography at 2, 4, 8 and 12 weeks post-operatively. In parallel, cat corneal fibroblasts were cultured to assess the effects of Rosiglitazone on TGFβ-induced αSMA expression. Topical application of Rosiglitazone to cat eyes after injury decreased αSMA expression and haze, as well as the induction of lower-order and residual, higher-order wavefront aberrations compared to vehicle-treated eyes. Rosiglitazone also inhibited TGFβ-induced αSMA expression in cultured corneal fibroblasts. In conclusion, Rosiglitazone effectively controlled corneal fibrosis in vivo and in vitro, while restoring corneal thickness and optics. Its topical application may represent an effective, new avenue for the prevention of corneal scarring with distinct advantages for pathologically thin corneas.
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Affiliation(s)
- Krystel R Huxlin
- Flaum Eye Institute, University of Rochester, Rochester, New York, United States of America.
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Park DY, Lee SB. Influences of Cylindrical Correction Amount of PRK on Accuracy of Geometric Corneal Center-Adjusted Ablation Centration. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2012. [DOI: 10.3341/jkos.2012.53.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Dae-Young Park
- Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea
| | - Sang-Bumm Lee
- Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea
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Rosolen SG, Lamory B, Harms F, Sahel JA, Picaud S, LeGargasson JF. Cellular-resolution in vivo imaging of the feline retina using adaptive optics: preliminary results. Vet Ophthalmol 2011; 13:369-76. [PMID: 21182721 DOI: 10.1111/j.1463-5224.2010.00829.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To perform cellular-level in vivo imaging of the feline retina using an adaptive optics flood illumination fundus camera (AO FIFC) designed for the human eye. MATERIALS AND METHODS Cellular-level images were obtained from three eyes of two normal sedated cats. Ocular aberrations were corrected using an AO system based on a 52-acuator electromagnetic deformable mirror and a 1024 lenslet Hartmann-Shack sensor (both Imagine Eyes, Orsay, France). A square 3°×3° area of the ocular fundus was flood-illuminated by a pulsed LED emitting at 850 nm and imaged onto a low-noise, high-resolution CCD camera. The animal's pupils were dilated and the effective pupil size was set to 7.5 mm. Conjunctival atraumatic clips were used to avoid eyeball movements and eyelid closure. The cornea was artificially hydrated throughout the experiments. Each acquisition consisted of 20 consecutive images, out of which 10 were numerically averaged to produce an enhanced final image. RESULTS The total amount of ocular aberrations was greatly reduced by the AO correction, from 2.4 to 0.21 microns root mean square on average. The resulting images presented white dots distributed at a density similar to that of cone photoreceptors and they allowed us to visualize small blood vessels and nerve fiber bundles at a higher resolution than classically obtained with conventional fundus photography. CONCLUSION Retinal imaging with cellular resolution was feasible in cats under sedation using an AO FIFC designed for human eyes without any optical modification. The AO FIFC technology could find new applications in clinical, pharmacological, and toxicological investigations.
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Affiliation(s)
- Serge G Rosolen
- Clinique Veterinaire Voltaire, 119 Boulevard Voltaire, Asnières, France
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Mirshahi A, Wesemann W, Bühren J, Kohnen T. Factors influencing the reliability of autorefractometry after LASIK for myopia and myopic astigmatism. Am J Ophthalmol 2010; 150:774-9. [PMID: 20951976 DOI: 10.1016/j.ajo.2010.06.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 06/18/2010] [Accepted: 06/19/2010] [Indexed: 11/25/2022]
Abstract
PURPOSE To study the factors influencing the reliability (accuracy) of autorefractometry before and after laser in situ keratomileusis (LASIK) for myopia and myopic astigmatism. DESIGN Retrospective case series. METHODS A total of 250 consecutive eyes (132 patients, mean age 37 years) were included from the Department of Ophthalmology, J.W. Goethe University, Frankfurt, Germany. The mean preoperative spherical equivalent of the subjective refraction (SR) was -6.59 diopters (D) (-1.38 to -15.13). The patient data were reviewed before and 1 month after LASIK, including SR, objective automated refraction (AR), and visual acuity. Subgroup analysis was performed with regard to the preoperative myopia and the excimer laser optical zone (OZ). The Holm-Sidak and Wilcoxon matched-pairs tests were used for statistical analysis. RESULTS The correlation coefficient between AR und SR is r = 0.98 before LASIK versus r = 0.79 afterwards (P < .001). The mean difference between the spherical equivalents (DSE) is +0.13 ± 0.51 D preoperatively versus -0.30 ± 0.58 D after LASIK (P < .001). With a small optical zone size (5.0-5.5 mm) the postoperative difference is -0.61 D, versus -0.36 D for OZ 5.6-6.0, versus -0.16 for OZ 6.1-7.0 mm. With a rising preoperative amount of myopia, the postoperative AR results become increasingly more myopic than the SR. CONCLUSIONS Following LASIK, autorefractometry is less accurate than in nonoperated eyes. The reliability of the AR is influenced by the OZ and the preoperative amount of myopia, with a small OZ and high myopia resulting in a greater difference between AR and SR and with the AR determining more myopic results.
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Lihua F, Xingdao H, Fengying C. Theoretical analysis of wavefront aberration from treatment decentration with oblique incidence after conventional laser refractive surgery. OPTICS EXPRESS 2010; 18:22418-22431. [PMID: 20941142 DOI: 10.1364/oe.18.022418] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Analysis of induced wavefront aberration after refractive surgery is important in the design of vision correction and the development of visual correction technology. Based on a mathematical model of the anterior corneal surface, the influence of treatment decentration on induced wavefront aberrations was studied by considering oblique incidence. The results revealed that significant coma was induced from the treatment translation, and it was nearly proportional to the translation or corrected refraction of vision correction. The induced aberrations from the lateral translation correlated with the angle formed by the position vector and the astigmatism axis of myopia astigmatism correction. The induced spherical aberration did not relate to a lateral translation of the center of the pupil, but was determined only by the corrected refraction. Additionally, no significant higher-order aberrations were induced from eye cyclotorsion for pure myopia or myopia astigmatism correction. Oblique incidence played an important role in the impact of treatment decentration on the induced aberrations in refractive surgery. The induced coma without considering the oblique incidence was obviously larger than that with it. In order to achieve the best postoperative visual performance, the effect of oblique incidence in refractive surgery should be taken into account, and treatment decentration should be minimized by all means, particularly for high myopia.
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Affiliation(s)
- Fang Lihua
- 1Key Laboratory of Nondestructive Test Ministry of Education, Nanchang Hangkong University, Nanchang 330063, China
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Keir N, Simpson T, Fonn D. Visual and optical performance of silicone hydrogel contact lenses for moderate myopia. JOURNAL OF OPTOMETRY 2010; 3:149-157. [PMCID: PMC3974284 DOI: 10.1016/s1888-4296(10)70021-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Accepted: 09/07/2010] [Indexed: 06/10/2023]
Abstract
Purpose To compare the short-term visual and optical performance of silicone hydrogel contact lenses for myopia ≥ −3.00D. Methods This was a short-term, non-dispense, double-masked, randomized study investigating Night&Day (ND), PureVision (PV), O2 Optix (O2), Biofinity (BF), Acuvue Advance (AA) and Acuvue OASYS for myopia ≥ −3.00D. Testing was conducted under scotopic conditions. Measures (one eye only) included: high- and low-contrast visual acuity (HCVA/LCVA), contrast sensitivity, subjective clarity of vision ratings (0-100 scale using reference images, with test image representing grade 50) and ocular aberrations (up to the 4th order, analyzed across individual scotopic pupil sizes). Results Three males and 27 females participated, with a mean (± SD) age of 24.9 ± 7.7 yrs (range 19 to 53 yrs), sphere of −5.30 ± 1.73D (range −3.00 to −10.75D) and cylinder −0.36 ± 0.23D (range 0 to −0.75D). Mean (± SEM) logMAR HCVA ranged from 0.06 (PV) to 0.10 (AA) (± 0.02), LCVA from 0.33 (BF) to 0.40 (AA) (± 0.02) and contrast sensitivity from 2.33 (BF) to 2.53 (ND) (± 0.15) (differences not statistically significant; all p > 0.05). Subjective ratings for the test image ranged from 59 (PV) to 64 (ND) (± 4) and 56 (AA) to 65 (ND) (± 4), for monochromatic and polychromatic reference images, respectively (all p > 0.05). There was a statistically significant impact on ocular aberrations with all study lenses compared to no lens. Between-lens differences were statistically significant for defocus (Z02), horizontal coma (Z 13) and spherical aberration (Z04). Conclusions Despite some differences in ocular aberrations, there were no significant differences in HCVA, LCVA, contrast sensitivity or subjective ratings across lenses.
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Affiliation(s)
- Nancy Keir
- Centre for Contact Lens Research, University of Waterloo, Waterloo, ON, Canada
| | - Trefford Simpson
- School of Optometry, University of Waterloo, Waterloo, ON, Canada
| | - Desmond Fonn
- Centre for Contact Lens Research, University of Waterloo, Waterloo, ON, Canada
- School of Optometry, University of Waterloo, Waterloo, ON, Canada
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Bühren J, Yoon G, MacRae S, Huxlin K. Contribution of optical zone decentration and pupil dilation on the change of optical quality after myopic photorefractive keratectomy in a cat model. J Refract Surg 2010; 26:183-90. [PMID: 20229950 DOI: 10.3928/1081597x-20100224-04] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Accepted: 03/11/2009] [Indexed: 11/20/2022]
Abstract
PURPOSE To simulate the simultaneous contribution of optical zone decentration and pupil dilation on retinal image quality using wavefront error data from a myopic photorefractive keratectomy (PRK) cat model. METHODS Wavefront error differences were obtained from five cat eyes 19+/-7 weeks (range: 12 to 24 weeks) after spherical myopic PRK for -6.00 diopters (D) (three eyes) and -10.00 D (two eyes). A computer model was used to simulate decentration of a 6-mm sub-aperture relative to the measured wavefront error difference. Changes in image quality (visual Strehl ratio based on the optical transfer function [VSOTF]) were computed for simulated decentrations from 0 to 1500 mum over pupil diameters of 3.5 to 6.0 mm in 0.5-mm steps. For each eye, a bivariate regression model was applied to calculate the simultaneous contribution of pupil dilation and decentration on the pre- to postoperative change of the log VSOTF. RESULTS Pupil diameter and decentration explained up to 95% of the variance of VSOTF change (adjusted R(2)=0.95). Pupil diameter had a higher impact on VSOTF (median beta=-0.88, P<.001) than decentration (median beta=-0.45, P<.001). If decentration-induced lower order aberrations were corrected, the impact of decentration further decreased (beta=-0.26) compared to the influence of pupil dilation (beta=-0.95). CONCLUSIONS Both pupil dilation and decentration of the optical zone affected the change of retinal image quality (VSOTF) after myopic PRK with decentration exerting a lower impact on VSOTF change. Thus, under physiological conditions pupil dilation is likely to have more effect on VSOTF change after PRK than optical zone decentration.
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Affiliation(s)
- Jens Bühren
- University of Rochester Eye Institute, University of Rochester Medical Center, Rochester, NY, USA.
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Arbelaez MC, Arba Mosquera S. The SCHWIND AMARIS Total-Tech Laser as An All-Rounder in Refractive Surgery. Middle East Afr J Ophthalmol 2010; 16:46-53. [PMID: 20142960 PMCID: PMC2813579 DOI: 10.4103/0974-9233.48868] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To describe and argument an overview of the main features and unique technical points of AMARIS Total-Tech Laser, coupled with patient outcomes supporting the decision to perform LASIK treatments with maximised outcomes. SETTINGS Dr. M.C. Arbelaez, Muscat Eye Laser Center, Muscat, Sultanate of Oman. METHODS The findings collected during 18-month experience using SCHWIND AMARIS Total-Tech Laser have been reviewed to provide arguments for supporting the decision to perform LASIK treatments with maximised outcomes. For updated clinical outcomes, the last 100 myopic astigmatism treatments, the last 100 hyperopic astigmatism treatments, the last 30 ocular-wavefront-guided treatments, and the last 30 corneal-wavefront-guided treatments, all with 6-month follow-up, were included. For all those, LDV femtosecond system was used to prepare the flaps, and AMARIS flying spot system was used to perform ablations. Clinical outcomes were evaluated in terms of predictability, refractive outcome, safety, wavefront aberration, and contrast sensitivity. RESULTS 6-month postoperatively, mean defocus was -0.14+/-0.31D and astigmatism 0.25+/-0.37D. 70+/- eyes were within +/-0.25D of emmetropia. 43+/- eyes gained lines of best spectacle-corrected visual acuity. For Aberration-Free treatments, none of the aberration metrics changed from pre- to postoperative values in a clinically relevant amount. For ocular-wavefront-guided treatments, the surgery did not change coma or spherical aberration, and reduced trefoil (p<0.005). For corneal-wavefront-guided treatments, the trefoil, coma, and spherical aberrations, as well as the total root-mean-square values of higher order aberration, were significantly reduced (p<.05) when the pre-existing aberrations were greater than the repeatability and the biological noise. CONCLUSIONS Although this review does not allow for evidence-based conclusions, following our strategy, LASIK results were excellent. LASIK surgery with AMARIS system yield excellent outcomes. Refractions were reduced to subclinical values with no induction of High-Order-Aberrations. Neither adverse events nor complications were observed.
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Bühren J, Nagy L, Yoon G, MacRae S, Kohnen T, Huxlin KR. The effect of the asphericity of myopic laser ablation profiles on the induction of wavefront aberrations. Invest Ophthalmol Vis Sci 2010; 51:2805-12. [PMID: 20042646 DOI: 10.1167/iovs.09-4604] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To compare the effects of laser profile asphericity on the induction of wavefront aberrations, susceptibility to decentration, and depth of focus in a polymethylmethacrylate (PMMA) model. METHODS Four PMMA lenses received an excimer laser ablation of -6 D with a 6-mm optical zone and different amounts of primary spherical aberration (Z(4)(0)): 0, -0.346, -1.038, and -2.076 microm. The curvature of each lens was measured by using surface profilometry, and wavefront changes were computed from curvature differences. Changes in optical quality were compared by treatment simulation of 13 real myopic eyes. The influence of pupil diameter, ablation decentration, and defocus on retinal image quality was measured by using the optical transfer function-based visual Strehl ratio (VSOTF). RESULTS Aspheric ablation profiles induced significantly less primary but higher secondary spherical aberration (Z(6)(0)) than did the standard profile; however, Z(4)(0) compensation was incomplete. Simulated treatments with aspheric profiles resulted in significantly better retinal image quality and higher decentration tolerance than did the standard profile. Optical depth of focus was not affected with a 3-mm pupil, whereas with a 6-mm pupil, there was a small but statistically significant decrease in depth of focus. CONCLUSIONS Aspheric laser profiles showed theoretical optical benefits over standard ablation profiles for the treatment of myopia, including terms of decentration tolerance. However, there remained profound induction and thus, undercorrection of Z(4)(0), due to loss of laser ablation efficiency in the lens periphery.
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Affiliation(s)
- Jens Bühren
- University of Rochester Eye Institute, Rochester, New York, USA
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Hindman HB, Swanton JN, Phipps RP, Sime PJ, Huxlin KR. Differences in the TGF-{beta}1-induced profibrotic response of anterior and posterior corneal keratocytes in vitro. Invest Ophthalmol Vis Sci 2009; 51:1935-42. [PMID: 19907023 DOI: 10.1167/iovs.09-3823] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose. To characterize phenotypic differences between anterior and posterior corneal keratocytes after stimulation with the profibrotic agent transforming growth factor-beta1 (TGF-beta1) in vitro. Methods. Sixteen corneas from healthy felines were obtained immediately after death. Lamellar dissection was performed to separate the anterior and posterior stroma at approximately 50% depth either manually (n = 2) or with a Moria microkeratome (300-mum head; n = 14). Cells from the anterior and posterior stroma were cultured separately but under identical conditions. Using immunohistochemistry and Western blot techniques, Ki-67 staining and relative expression of Thy-1, alpha smooth muscle actin (alpha-SMA), and fibronectin were assessed after stimulation with different TGF-beta1 concentrations. In addition, anterior and posterior cells cultured in different concentrations of TGF-beta1 were wounded with a razor blade, and the wound area and time to closure were determined. Results. Stimulation by all concentrations of TGF-beta1 increased the proportion of Ki-67-positive cells in anterior and posterior cell cultures, but this increase was noted earlier in posterior cells than in anterior cells. Increasing TGF-beta1 concentration also increased the relative expression of Thy-1, alpha-SMA, and fibronectin in anterior and posterior fibroblasts. However, anterior cells expressed these fibrotic markers at lower TGF-beta1 concentrations than did posterior keratocytes. After mechanical wounding, posterior cells closed the wound area faster than did anterior cells at all concentrations of TGF-beta1. Conclusions. The present experiments show that anterior and posterior corneal keratocytes exhibit different sensitivities to the profibrotic growth factor TGF-beta1. This heterogeneity of keratocyte response may impact wound closure after mechanical wounding.
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Affiliation(s)
- Holly B Hindman
- Flaum Eye Institute, University of Rochester Medical Center, Rochester, New York, USA.
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Arbelaez MC, Vidal C, Arba-Mosquera S. Clinical outcomes of corneal wavefront customized ablation strategies with SCHWIND CAM in LASIK treatments. Ophthalmic Physiol Opt 2009; 29:549-556. [PMID: 19602143 DOI: 10.1111/j.1475-1313.2009.00650.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the clinical outcomes of aspheric corneal wavefront (CW) ablation profiles in LASIK treatments. METHODS Thirty eyes treated with CW ablation profiles were included after a follow-up of 6 months. In all cases, standard examinations including preoperative and postoperative wavefront analysis with a CW topographer (Optikon Keratron Scout) were performed. Custom Ablation Manager (CAM) software was used to plan corneal wavefront customized aspheric treatments, and the ESIRIS flying spot excimer laser system was used to perform the ablations (both SCHWIND eye-tech-solutions, Kleinhostheim, Germany). Clinical outcomes were evaluated in terms of predictability, refractive outcome, safety, and wavefront aberration. RESULTS In general, the postoperative uncorrected visual acuity and the best corrected visual acuity improved (p < 0.001). In particular, the trefoil, coma, and spherical aberrations, as well as the total root-mean-square values of higher order aberrations, were significantly reduced (p < 0.05) when the pre-existing aberrations were greater than the repeatability and the biological noise. CONCLUSIONS The study results indicate that the aspheric corneal wavefront customized CAM approach for planning ablation volumes yields visual, optical, and refractive results comparable to those of other wavefront-guided customized techniques for correction of myopia and myopic astigmatism. The CW customized approach shows its strength in cases where abnormal optical systems are expected. Apart from the risk of additional ablation of corneal tissue, systematic wavefront-customized corneal ablation can be considered as a safe and beneficial method.
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Novel Objective Method for Comparing Ablation Centration With and Without Pupil Tracking Following Myopic Laser In Situ Keratomileusis Using the Bausch & Lomb Technolas 217A. Cornea 2009; 28:616-25. [DOI: 10.1097/ico.0b013e31819ba450] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bühren J, Nagy L, Swanton JN, Kenner S, MacRae S, Phipps RP, Huxlin KR. Optical effects of anti-TGFbeta treatment after photorefractive keratectomy in a cat model. Invest Ophthalmol Vis Sci 2009; 50:634-43. [PMID: 18952913 PMCID: PMC2753416 DOI: 10.1167/iovs.08-2277] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To assess the contribution of corneal myofibroblasts to optical changes induced by photorefractive keratectomy (PRK) in a cat model. METHODS The transforming growth factor (TGF)-beta-dependence of feline corneal keratocyte differentiation into alpha-smooth muscle actin (alphaSMA)-positive myofibroblasts was first tested in vitro. Twenty-nine eyes of 16 cats were then treated with -10 D PRK in vivo and divided into two postoperative treatment groups that received either 100 microg anti-TGFbeta antibody for 7 days, followed by 50 microg dexamethasone for another 7 days to inhibit myofibroblast differentiation, or vehicle solution for 14 days (control eyes). Corneal thickness and reflectivity were measured by optical coherence tomography. Wavefront sensing was performed in the awake-behaving state before surgery and 2, 4, 8, and 12 weeks after surgery. Wound healing was monitored using in vivo confocal imaging and postmortem alphaSMA immunohistochemistry. RESULTS In culture, TGFbeta caused cat corneal keratocytes to differentiate into alphaSMA-positive myofibroblasts, an effect that was blocked by coincubation with anti-TGFbeta antibody. In vivo, anti-TGFbeta treatment after PRK resulted in less alphaSMA immunoreactivity in the subablation stroma, lower corneal reflectivity, less stromal regrowth, and lower nonspherical higher order aberration induction than in control eyes. However, there were no intergroup differences in epithelial regeneration or lower order aberration changes. CONCLUSIONS Anti-TGFbeta treatment reduced feline corneal myofibroblast differentiation in vitro and after PRK. It also decreased corneal haze and fine-grained irregularities in ocular wavefront after PRK, suggesting that attenuation of the differentiation of keratocytes into myofibroblast can significantly enhance optical quality after refractive surface ablations.
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Affiliation(s)
- Jens Bühren
- University of Rochester Eye Institute, University of Rochester, Rochester NY
| | - Lana Nagy
- University of Rochester Eye Institute, University of Rochester, Rochester NY
- Center for Visual Science, University of Rochester, Rochester NY
| | - Jennifer N. Swanton
- University of Rochester Eye Institute, University of Rochester, Rochester NY
| | - Shawn Kenner
- University of Rochester Eye Institute, University of Rochester, Rochester NY
- Institute for Optics, University of Rochester, Rochester NY
| | - Scott MacRae
- University of Rochester Eye Institute, University of Rochester, Rochester NY
- Center for Visual Science, University of Rochester, Rochester NY
| | - Richard P. Phipps
- University of Rochester Eye Institute, University of Rochester, Rochester NY
- Department for Environmental Medicine, University of Rochester, Rochester NY
| | - Krystel R. Huxlin
- University of Rochester Eye Institute, University of Rochester, Rochester NY
- Center for Visual Science, University of Rochester, Rochester NY
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Bühren J, Kohnen T. [Application of wavefront analysis in clinical and scientific settings. From irregular astigmatism to aberrations of a higher order--Part II: examples]. Ophthalmologe 2008; 104:991-1006; quiz 1007-8. [PMID: 18030477 DOI: 10.1007/s00347-007-1648-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In recent years, wavefront analysis has ceased to be purely a laboratory application and emerged as a method used in ophthalmological diagnosis. This development has been promoted mainly by the widespread use of wavefront-guided LASIK (laser in situ keratomileusis). However, aberrometry is still not a common diagnostic technique, and for many ophthalmologists interpretation of the results is difficult. The second part of this serial paper reviews findings that are relevant for the ophthalmological community and highlights current scientific applications in this area.
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Affiliation(s)
- J Bühren
- Advanced Physiological Optics Lab, Department of Ophthalmology, University of Rochester Medical Center, Rochester, NY, USA
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