1
|
Lee CY, Jeng YT, Yang SF, Huang CT, Chao CC, Lian IB, Huang JY, Chang CK. Topographic and Surgical Risk Factors for Early Myopic Regression between Small Incision Lenticule Extraction and Laser In Situ Keratomileusis. Diagnostics (Basel) 2024; 14:1275. [PMID: 38928690 PMCID: PMC11202549 DOI: 10.3390/diagnostics14121275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/06/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
Our objective was to evaluate the topographic and surgical factors of early myopic regression between laser in situ keratomileusis (LASIK) and small-incision lenticule extraction (SMILE). A retrospective case-control study was conducted, and 368 and 92 eyes were enrolled in the LASIK and SMILE groups via propensity score matching (PSM). Visual acuity, refractive status, axial length, and topographic/surgical parameters were collected. Multiple linear regression was applied to the yield coefficient and the 95% confidence interval (CI) of the parameters. The cumulative incidence of early myopic regression was higher in the LASIK group (p < 0.001). In the SMILE group, a lower central corneal thickness (CCT) thinnest value and a higher corneal cylinder associated with early myopic regression were observed; meanwhile, in the LASIK group, a lower CCT thinnest value, a higher steep corneal curvature, a larger optic zone, and a lower flap thickness related to early myopic regression were observed (all p < 0.05). In the SMILE group, a higher CCT difference correlated with early myopic regression was observed compared to the LASIK group (p = 0.030), and higher steep corneal curvature and lower cap/flap thickness (both p < 0.05) correlated with early myopic regression were observed in the LASIK group compared to the SMILE group. In conclusion, CCT differences significantly influence early myopic regression in the SMILE group; meanwhile, corneal curvature and flap thickness affect early myopic regression principally in the LASIK group.
Collapse
Affiliation(s)
- Chia-Yi Lee
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Nobel Eye Institute, Taipei 115, Taiwan
- Department of Ophthalmology, Jen-Ai Hospital Dali Branch, Taichung 412, Taiwan
| | - Yu-Ting Jeng
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Chin-Te Huang
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung 402, Taiwan
- Department of Ophthalmology, School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
| | - Chen-Cheng Chao
- Nobel Eye Institute, Taipei 115, Taiwan
- Department of Optometry, MacKay Junior College of Medicine, Nursing, and Management, Taipei 112, Taiwan
| | - Ie-Bin Lian
- Institute of Statistical and Information Science, National Changhua University of Education, Changhua 500, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Chao-Kai Chang
- Nobel Eye Institute, Taipei 115, Taiwan
- Department of Optometry, Da-Yeh University, Chunghua 515, Taiwan
| |
Collapse
|
2
|
Lee CY, Jeng YT, Chao CC, Lian IB, Huang JY, Yang SF, Chang CK. Refraction and topographic risk factors for early myopic regression after small-incision lenticule extraction surgery. Sci Rep 2024; 14:8732. [PMID: 38627567 PMCID: PMC11021515 DOI: 10.1038/s41598-024-59327-6] [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: 09/19/2023] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
We sought to evaluate the topographic risk factors for early myopic regression after small-incision lenticule extraction (SMILE). A retrospective case‒control study was conducted, and individuals who underwent SMILE surgery were enrolled. Among them, 406 and 14 eyes were categorized into the nonregression and regression groups, respectively. The preoperative and postoperative parameters in the two groups were collected, including spherical refraction (SE), axial length (AXL) and topographic data. A generalized linear model was adopted to analyze the difference in each parameter between the two groups. After 6 months, UCVA decreased in the regression group, and SE increased in the regression group (both P < 0.05). The increase in the CCT at the thinnest point (P = 0.044), flat corneal curvature (P = 0.012) and TCRP (P = 0.001) were significantly greater in the regression group. Regarding the risk factors for myopic regression, preoperative SE, preoperative sphere power, preoperative AXL, preoperative flat corneal curvature, preoperative SA, early postoperative SE, early postoperative sphere power, early postoperative AXL and early postoperative CCT difference were significantly greater in the regression group (all P < 0.05). The SE, sphere power, AXL, preoperative flat corneal curvature, preoperative SA, and postoperative CCT difference correlate with early myopic regression after SMILE.
Collapse
Affiliation(s)
- Chia-Yi Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Nobel Eye Institute, No. 13-5, Gongyuan Rd., Zhongzheng Dist., Taipei, 100008, Taiwan
- Department of Ophthalmology, Jen-Ai Hospital Dali Branch, Taichung, Taiwan
| | - Yu-Ting Jeng
- Nobel Eye Institute, No. 13-5, Gongyuan Rd., Zhongzheng Dist., Taipei, 100008, Taiwan
| | - Chen-Cheng Chao
- Nobel Eye Institute, No. 13-5, Gongyuan Rd., Zhongzheng Dist., Taipei, 100008, Taiwan
- Department of Optometry, MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Ie-Bin Lian
- Institute of Statistical and Information Science, National Changhua University of Education, Changhua, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan.
| | - Chao-Kai Chang
- Nobel Eye Institute, No. 13-5, Gongyuan Rd., Zhongzheng Dist., Taipei, 100008, Taiwan.
- Department of Optometry, Da-Yeh University, Chunghua, Taiwan.
| |
Collapse
|
3
|
Zhang Z, Xiang LX, Wu Y, Li Q, Ke SH, Liu LQ. Factors affecting long-term myopic regression after corneal refractive surgery for civilian pilots in southwest China. BMC Ophthalmol 2024; 24:145. [PMID: 38561680 PMCID: PMC10985992 DOI: 10.1186/s12886-024-03399-5] [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: 11/19/2023] [Accepted: 03/15/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The purpose of this study was to analyze myopic regression after corneal refractive surgery (CRS) in civilian pilots and to explore the factors that may cause long-term myopic regression. METHODS We included civilian pilots who had undergone CRS to correct their myopia and who had at least 5 years of follow-up. We collected retrospective data and completed eye examinations and a questionnaire to assess their eye habits. RESULTS A total of 236 eyes were evaluated in this study. 211 eyes had Intrastromal ablations (167 eyes had laser in situ keratomileusis, LASIK, 44 eyes had small incision lenticule extraction, SMILE) and 25 eyes had subepithelial ablations (15 eyes had laser epithelial keratomileusis, LASEK and 10 eyes had photorefractive keratectomy, PRK). The mean preoperative spherical equivalent (SE) was - 2.92 ± 1.11 D (range from - 1.00 to -5.00 D). A total of 56 eyes (23.6%) suffered from myopic regression after CRS. Comparisons of individual and eye characteristics between the regression and non-regression groups revealed statistically significant differences in age, cumulative flight time, postoperative SE (at 6 months and current), uncorrected visual acuity (UCVA), accommodative amplitude (AA), positive relative accommodation (PRA), postoperative period, types of CRS and eye habits. Generalized propensity score weighting (GPSW) was used to balance the distribution of covariates among different age levels, types of CRS, cumulative flying time, postoperative period and continuous near-work time. The results of GPS weighted logistic regression demonstrated that the associations between age and myopic regression, types of CRS and myopic regression, continuous near-work time and myopic regression were significant. Cumulative flying time and myopic regression, postoperative period and myopic regression were no significant. Specifically, the odds ratio (OR) for age was 1.151 (P = 0.022), and the OR for type of CRS was 2.769 (P < 0.001). The OR for continuous near-work time was 0.635 with a P value of 0.038. CONCLUSIONS This is the first report to analyze myopic regression after CRS in civilian pilots. Our study found that for each year increase in age, the risk of civilian pilots experiencing myopic regression was increased. Intrastromal ablations had a lower risk of long-term myopia regression than subepithelial ablations. There is a higher risk of myopic progression with continuous near-work time > 45 min and poor accommodative function may be related factors in this specific population.
Collapse
Affiliation(s)
- Zhen Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, 37 Guoxue Xiang, Chengdu, Sichuan Province, 610041, PR China
- Department of Ophthalmology, Chengdu Civil Aviation Medical Center, Chengdu, Sichuan Province, PR China
| | - Lan Xi Xiang
- Department of Ophthalmology, Chengdu Civil Aviation Medical Center, Chengdu, Sichuan Province, PR China
| | - Ye Wu
- Department of Ophthalmology, West China Hospital, Sichuan University, 37 Guoxue Xiang, Chengdu, Sichuan Province, 610041, PR China
| | - Qi Li
- Department of Internal, Chengdu Civil Aviation Medical Center, Chengdu, Sichuan Province, PR China
| | - Shan Hua Ke
- Department of Ophthalmology, Chengdu Civil Aviation Medical Center, Chengdu, Sichuan Province, PR China
| | - Long Qian Liu
- Department of Ophthalmology, West China Hospital, Sichuan University, 37 Guoxue Xiang, Chengdu, Sichuan Province, 610041, PR China.
| |
Collapse
|
4
|
Lee CY, Shen JH, Chao CC, Lian IB, Huang JY, Yang SF, Chang CK. Topographic and surgical risk factors for high postoperative residual astigmatism after small incision lenticule extraction in patients with different degrees of myopia: a retrospective cohort study. BMC Ophthalmol 2024; 24:45. [PMID: 38287289 PMCID: PMC10826184 DOI: 10.1186/s12886-024-03296-x] [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: 09/19/2023] [Accepted: 01/15/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND To evaluate the possible topographic and surgical risk factors for high postoperative residual astigmatism in patients who undergo small-incision lenticule extraction (SMILE) surgery and have different myopia degrees. METHODS A retrospective cohort study was conducted, and patients who underwent SMILE surgery were enrolled. A total of 80 and 150 eyes from 40 to 75 individuals, respectively, were selected as the low myopia and high myopia groups. The demographic data, visual acuity, refraction, topographic parameters and surgical settings were recorded. Multiple linear regression with interaction tests were performed to survey the risk factors for high postoperative residual astigmatism in each group. RESULTS Five (6.25%) and 9 (6.00%) eyes presented with high postoperative residual astigmatism in the low myopia and high myopia groups, respectively, but these differences were not significant (P = 0.569). A steep corneal curvature was correlated with a greater risk of high postoperative residual astigmatism in the low myopia group (P = 0.015), while a higher degree of cycloplegic cylinder power, steeper corneal curvature, greater topographic cylinder power, smaller optic zone and longer incision length were associated with a high rate of postoperative residual astigmatism in the high myopia group (all P < 0.05). In addition, the interaction effects of cycloplegic and topographic cylinder power and longer incision length on the incidence of high postoperative residual astigmatism development were more evident in the high myopia group than in the low myopia group (all P < 0.05). CONCLUSIONS A steep corneal curvature correlates with a high risk of high postoperative residual astigmatism after SMILE surgery, and a higher degree of cycloplegic and topographic cylinder and longer incision are associated with high postoperative residual astigmatism in individuals with high myopia.
Collapse
Affiliation(s)
- Chia-Yi Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Nobel Eye Institute, No. 13-5, Gongyuan Rd., Zhongzheng Dist, 100008, Taipei, Taiwan
- Department of Ophthalmology, Jen-Ai Hospital Dali Branch, Taichung, Taiwan
| | - Jen-Hsiang Shen
- Nobel Eye Institute, No. 13-5, Gongyuan Rd., Zhongzheng Dist, 100008, Taipei, Taiwan
| | - Chen-Cheng Chao
- Nobel Eye Institute, No. 13-5, Gongyuan Rd., Zhongzheng Dist, 100008, Taipei, Taiwan
- Department of Optometry, Nursing, and Management, MacKay Junior College of Medicine, Taipei, Taiwan
| | - Ie-Bin Lian
- Institute of Statistical and Information Science, National Changhua University of Education, Changhua, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chao-Kai Chang
- Nobel Eye Institute, No. 13-5, Gongyuan Rd., Zhongzheng Dist, 100008, Taipei, Taiwan.
- Department of Optometry, Da-Yeh University, Changhua, Taiwan.
| |
Collapse
|
5
|
Meng C, Zhang Y, Wang S. Changes in accommodation and convergence function after refractive surgery in myopic patients. Eur J Ophthalmol 2023; 33:29-34. [PMID: 36203367 DOI: 10.1177/11206721221128993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
In recent years, with the gradual maturation of myopia correction surgery, the changes in binocular visual function after surgery have attracted widespread attention. The accommodation of facility, the amplitude of accommodation, relative accommodation, and accommodation convergence/accommodation assembly are essential parameters for assessing binocular visual function. The changes in these parameters are significant for guiding patients in the design of the preoperative surgical approach and alleviating postoperative visual fatigue. This paper aims to guide the preoperative assessment, design, and postoperative visual training of refractive surgery in myopic patients from the perspective of changes in binocular visual function before and after myopia and surgery, which can improve accommodation and convergence function in patients after refractive surgery.
Collapse
Affiliation(s)
- Can Meng
- Corneal Refraction Department, 154454The Second Hospital of Jilin University, Changchun, China
| | - Yan Zhang
- Corneal Refraction Department, 154454The Second Hospital of Jilin University, Changchun, China
| | - Shurong Wang
- Corneal Refraction Department, 154454The Second Hospital of Jilin University, Changchun, China
| |
Collapse
|
6
|
Long Y, Li X, Zhou T, Ye B, Guo D, Shen Y. Short-term Evaluation of Visual Quality, Amplitude of Accommodation, and Stereoacuity Between Patients With Moderate-to-High Myopia Who Underwent ICLV4c Implantation and SMILE. J Refract Surg 2022; 38:632-640. [DOI: 10.3928/1081597x-20220919-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
7
|
Song J, Lee H, Jung MS, Kim JH. Simple method of measuring ocular rotation in supine position during small incision lenticule extraction. Int J Ophthalmol 2022; 15:1331-1337. [PMID: 36017038 DOI: 10.18240/ijo.2022.08.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 05/31/2022] [Indexed: 11/23/2022] Open
Abstract
AIM To introduce a novel measurement method of static cyclotorsion in small incision lenticule extraction (SMILE) and to investigate the effect of preoperative parameters on cyclotorsion and the effect of cyclotorsion on postoperative outcomes. METHODS The medical records of 242 patients and 484 eyes who underwent SMILE surgery were retrospectively reviewed. Preoperative intraocular pressure, refractive error, and corneal thickness were investigated. Refractive values and visual acuity were measured at 1d, 1, 3, and 6mo. Ocular cyclotorsion in the supine position was measured by calculating the location and angle of the incision site of the cornea in the anterior slit photograph taken after surgery. RESULTS Of the total 484 eyes in 242 patients, preoperative mean spherical equivalent (SE) was -4.10±1.64 D, and the mean astigmatism was -0.82±0.74 D. Uncorrected distance visual acuity (UCVA) and SE improved significantly after the surgery. Moreover, 219 (45.2%) eyes had excyclotorsion, 235 (48.6%) eyes had incyclotorsion, and 30 (6.2%) eyes had no torsion. The right eyes tended to be excyclotorted, and the left eyes tended to be incyclotorted (P<0.01). The mean cyclotorsion was 1.18°±3.69°, and the mean absolute value of cyclotorsion was 3.14°±2.26°. The range of cyclotorsion was 0.5°-11.4°. It was found that the smaller the preoperative sphere, the higher the amount of cyclotorsion (r=0.11, P=0.016). There was no significant association between the amount of cyclotorsion and preoperative astigmatism. There was no correlation between sex, preoperative corneal thickness, preoperative intraocular pressure, amount of cyclotorsion, and direction of cyclotorsion. The ratio of right eye excyclotorsion and left eye incyclotorsion on 1d was higher than that at 1, 3, and 6mo (all P<0.01). There was no difference between the 1, 3, and 6mo results in the right and left eyes (P=0.15, P=0.16, respectively). CONCLUSION The newly devised ocular cyclotorsion measurement method can be used to evaluate ocular cyclotorsion after SMILE. Preoperative SE is associated with the amount of cyclotorsion, however, cyclotorsion doesn't have a significant effect on the results of SMILE surgery.
Collapse
Affiliation(s)
- Jiho Song
- Seoul Daabom Eye Center, Cheongju, Chungbuk 28396, Republic of Korea
| | - Hwanho Lee
- Department of Ophthalmology, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, Republic of Korea
| | - Moon Sun Jung
- Department of Ophthalmology, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, Republic of Korea
| | - Jae-Hyung Kim
- Seoul Daabom Eye Center, Cheongju, Chungbuk 28396, Republic of Korea
| |
Collapse
|
8
|
Narang P. Commentary: Nearwork-induced transient myopia - Is this the game changer? Indian J Ophthalmol 2021; 69:1711-1712. [PMID: 34146012 PMCID: PMC8374808 DOI: 10.4103/ijo.ijo_1168_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Purvasha Narang
- Cornea, Refractive and Ocular Surface Services, L.J. Eye Institute, Ambala, Haryana, India
| |
Collapse
|
9
|
Natarajan R, Dandapani SA, Hussaindeen JR. Comparison of Binocular Vision Parameters Pre- and Post-EPILASIK Laser Vision Correction Surgery for Myopia in a Pilot Study - Can Vision Therapy Augment Refractive Results? Br Ir Orthopt J 2021; 17:1-7. [PMID: 34278211 PMCID: PMC8269787 DOI: 10.22599/bioj.158] [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: 07/25/2020] [Accepted: 11/30/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose: To analyze the changes in the binocular vision parameters after bilateral Epilasik laser vision correction surgery (LVCS). Setting: Medical Research Foundation, Tamil Nadu, India. Study design: Prospective cohort study. Methods: Subjects with a best corrected visual acuity of ≤ 0.0 Log MAR scale and refractive error: < 6.00DS of myopia, < 0.75D of astigmatism, and < 1D of anisometropia were included in the study. All subjects underwent a comprehensive eye examination, LVCS workup which included corneal topography, tomography, aberrometry, and dry eye assessment prior to binocular vision assessment. Complete Binocular vision assessment which included stereopsis, fusion for distance and near, near point of convergence, phoria measurement, vergence amplitudes and facility, accommodative amplitudes, response, and facility was performed with the best corrected vision prior to LVCS, one month and six months after the surgery. Results: Twenty-five subjects of age 23.8 ± 2.9 years were included. Age ranged from 20 to 32 years. Ten were female and 15 were male. The median spherical power was –2.00DS with an inter quartile range (IQR) of –1.50DS to –3.00DS for both eyes. The median cylindrical power was plano with IQR –0.50DC to –1.00DC for both eyes. There was a statistically significant decrease in monocular and binocular accommodative amplitudes (accounting for age-related changes) as well as positive fusional vergence recovery for near between baseline and one month after surgery (p < 0.05). Conclusion: Though subjects were asymptomatic post LVCS, still there is an indication that myopic LVCS could precipitate or aggravate an existing non-strabismic binocular vision anomaly. Comprehensive binocular vision assessment and appropriate management is recommended before and after LVCS.
Collapse
|
10
|
Gyldenkerne A, Aagaard N, Jakobsen M, Toftelund C, Hjortdal J. Changes in accommodative function following small-incision lenticule extraction for high myopia. PLoS One 2020; 15:e0244602. [PMID: 33378342 PMCID: PMC7773189 DOI: 10.1371/journal.pone.0244602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 12/12/2020] [Indexed: 12/02/2022] Open
Abstract
Purpose To examine whether the amplitude of accommodation, the accommodative response, and the accommodative facility is affected and correlated with changes in higher-order aberrations for patients with high myopia surgically treated with small-incision lenticule extraction (SMILE). Methods 35 highly myopic eyes (myopic spherical equivalent of at least 6 diopters) of 35 patients treated with SMILE were included. Assessments were made before and 3 months after surgery. Donders push-up-method was used to measure the amplitude of accommodation. The accommodative response was assessed using an open-field autorefractor”Grand Seiko WAM-5500” (Grand Seiko Co. Ltd., Hiroshima, Japan) in combination with a Badal optometer and stimuli of accommodation at 0.0, 0.5, 1.25, 2.0, 3.0, and 4.0 D, respectively. Accommodative facility was measured at 40 cm with ±2,00D flipper lenses. All measurements of accommodation were performed monocularly with the refractive error corrected with soft contact lenses. Results The amplitude of accommodation did not change statistically significantly (mean difference -0.24 D (SD 0.98), 95% CI of mean difference -0.58 D to 0.11 D, paired-sample t(34) = -1.39; P = 0.17). The accommodative responses at 0.0, 0.5, 1.25, 2.0, 3.0, and 4.0 D did not statistically significantly change either (F(6,29) = 1.15; P = .36). Finally, the accommodative facility was also unchanged with a mean difference of 1.11 cycles per minute (SD 5.11, 95% CI of mean difference -0.64 to 2.87, paired-sample t(34) = 1.29; P = 0.21). No clinically significant associations between changes in accommodation and higher-order aberrations were found. Conclusions SMILE does not alter the amplitude of accommodation, the accommodative response, nor the accommodative facility for highly myopic patients, and the surgically induced corneal higher-order aberrations do not affect the accommodative function.
Collapse
Affiliation(s)
- Anders Gyldenkerne
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
- * E-mail:
| | - Nicolaj Aagaard
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Malene Jakobsen
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Carina Toftelund
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Jesper Hjortdal
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| |
Collapse
|
11
|
Muthu S, Jethani J, Annavajjhala S, Gupta S, Gupta K, Khamar P. Integrating binocular vision assessment in refractive surgery work-up: Proposition and protocol. Indian J Ophthalmol 2020; 68:2835-2846. [PMID: 33229659 PMCID: PMC7856975 DOI: 10.4103/ijo.ijo_2724_20] [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] [Indexed: 11/24/2022] Open
Abstract
Refractive surgeries are one of most commonly performed surgeries for correcting visual impairment due to refractive errors. With the increase in demand for refractive surgeries, there is an enormous strain on the operating surgeon for delivering ideal outcomes i.e 20/20 visual acuity. Regression, under-correction and ectasia are the most dreaded complications post-refractive correction, for the surgeon as well as the patient. They have significant effects on the quantity of the vision and most importantly on the quality of life of the patient. With the advent of digital era and jobs requiring the eyes being glued to the screen for hours there has been a surge in the patients presenting with complaints of asthenopia, glare, halos, and difficulty in focusing; pointing towards diagnosis of non-strabismic binocular vision anomalies (NSBVA). NSBVA in a postrefractive surgery patient may masquerade as regression or under-correction. However, timely diagnosis of NSBVA in such patients would prevent the greater harm caused by wrongful re-correction. Home- and office-based vision therapy results in improvement in visual acuity in a large majority of these patients. This preferred practice pattern intends to guide the refractive surgeons to diagnose and treat the postrefractive surgery NSBVA following a case-based and algorithmic approach. It also emphasizes the inclusion of the binocular vision assessment as a part of the pre-operative workup for patients undergoing refractive procedures.
Collapse
Affiliation(s)
- Sumitha Muthu
- Department of Pediatric Ophthalmology and Strabismus, Narayana Nethralaya, Bangalore, Karnataka, India,, India
| | - Jitendra Jethani
- Director, Baroda Children Eyecare and Squint Clinic, Vadodara, Gujarat, India
| | - Sriram Annavajjhala
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, Karnataka, India,, India
| | - Sneha Gupta
- Department of Cataract and Refractive Surgery, Narayana Nethralaya, Bangalore, Karnataka, India,, India
| | - Krati Gupta
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, Karnataka, India,, India
| | - Pooja Khamar
- Department of Cataract and Refractive Surgery, Narayana Nethralaya, Bangalore, Karnataka, India,, India
| |
Collapse
|
12
|
Chen M, Long Q, Gu H, Hong J. Accommodation changes after visian implantable collamer lens with central hole for high myopia: A STROBE-compliant article. Medicine (Baltimore) 2019; 98:e16434. [PMID: 31305467 PMCID: PMC6641841 DOI: 10.1097/md.0000000000016434] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To characterize the accommodative changes in high-myopic patients after the implantation of the Visian implantable collamer lens with a central hole (ICL V4c).This prospective study enrolled 30 patients (60 eyes) with uneventful surgery of ICL V4c implantation. Parameters including amplitude of accommodation (AA), monocular and binocular facility of accommodation (FA), positive relative accommodation (PRA), negative relative accommodation (NRA), near point convergence (NPC), accommodative response, and accommodation convergence/accommodation (AC/A) ratio were assessed before surgery, at 1 and 3 months postoperatively.Mean preoperative SE was -10.86 ± 3.87 diopter (D) (range, -6.5D to -22D), which improved to 0.27 ± 0.51D at 1 month and 0.09 ± 0.47D at 3 months after surgery (P <.001). Significant improvements in AA, NRA, PRA, NPC, monocular, and binocular FA were seen at 1 month and 3 months postoperatively compared to the values before surgery (P <.05), but the difference between 1 month and 3 months were not obvious (P >.05) except for binocular FA (P = .002). However, no significant changes were seen in either AC/A ratio or accommodative response at any postoperative follow-ups in contrast to those before surgery (P >.05). Similar changes in accommodative function were found in patients with less myopia (> -10.00D) and those with more myopia (≤10.00D) (P >.05).The accommodative function of eyes after the implantation of ICL V4c is enhanced and stabilizes at 1 month, except for the AC/A ratio and accommodative response. The clearer vision and increased amount of accommodation for near target account for the majority of the improvement.
Collapse
Affiliation(s)
- Minjie Chen
- Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou
| | - Qiurong Long
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
| | - Hao Gu
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China
| | - Jiaxu Hong
- Department of Ophthalmology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou
| |
Collapse
|
13
|
García‐Montero M, Albarrán Diego C, Garzón‐Jiménez N, Pérez‐Cambrodí RJ, López‐Artero E, Ondategui‐Parra JC. Binocular vision alterations after refractive and cataract surgery: a review. Acta Ophthalmol 2019; 97:e145-e155. [PMID: 30218490 DOI: 10.1111/aos.13891] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 07/18/2018] [Indexed: 11/29/2022]
Abstract
To review binocular and accommodative disorders documented after corneal or intraocular refractive surgery, in normal healthy prepresbyopic patients. A bibliographic revision was performed; it included works published before 1st July 2017 where accommodation and/or binocularity was assessed following any type of refractive surgical procedure. The search in Pubmed yielded 1273 papers, 95 of which fulfilled the inclusion criteria. Few publications reporting binocular vision and/or accommodative changes after refractive surgery in normal subjects were found. The reduction in fusional vergence is the most frequently reported alteration. Anisometropia is an important risk factor for postoperative binocular vision-related complaints. Most diplopia-related visual complaints, irrespective of the surgical procedure, were in fact misdiagnosed preoperative disorders. The preoperative evaluation of patients seeking spectacle/contact lens independence should include a complete binocular and accommodation assessment where parameters such as the phoric posture, accommodative amplitude and facility, near point of convergence, fusional reserves and accommodative convergence/accommodation coefficient are measured. This would allow the identification of risk factors that could compromise the success of the refractive surgery and cause clinical symptoms.
Collapse
Affiliation(s)
- María García‐Montero
- Optics II Department Faculty of Optics and Optometry Complutense University of Madrid Madrid Spain
| | - César Albarrán Diego
- Optics, Optometry and Visión Sciences Department Faculty of Physics University of Valencia Burjassot Spain
- Baviera Clinic Castellón de la Plana Spain
| | - Nuria Garzón‐Jiménez
- Optics II Department Faculty of Optics and Optometry Complutense University of Madrid Madrid Spain
- IOA Madrid Innova Ocular Madrid Spain
| | | | | | - Juan Carlos Ondategui‐Parra
- Centre of Development of systems, instrumentation and sensors (CD6) Universitat Politécnica de Catalunya Terrasa Spain
| |
Collapse
|
14
|
Anterior Chamber Angle and Volume Do Not Change after Myopic Laser-Assisted In Situ Keratomileusis in Young Patients. J Ophthalmol 2019; 2018:8646275. [PMID: 30647966 PMCID: PMC6311827 DOI: 10.1155/2018/8646275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 11/07/2018] [Accepted: 11/19/2018] [Indexed: 12/05/2022] Open
Abstract
Purpose We aimed to investigate whether anterior chamber angle, depth, and volume change after myopic laser-assisted in situ keratomileusis (LASIK) in young patients. Methods This retrospective study included 29 eyes of 29 patients (15 females and 14 males) between the ages of 18 and 39 years who underwent LASIK for the treatment of myopia. In addition to complete ophthalmic examination, anterior chamber angle (ACA), central anterior chamber depth (ACD), and anterior chamber volume (ACV) were measured by using a Sirius rotating Scheimpflug camera combined with Placido disc corneal topography (CSO, Florence, Italy). Preoperative and postoperative values were compared using paired t-tests. Linear regression was used to evaluate the relationship between changes in refraction and changes in ACA, ACD, and ACV as well as between attempted maximum ablation depth and changes in ACA, ACD, and ACV. Results The mean age of the study population was 25.5 ± 6.2 years. The mean preoperative and postoperative spherical equivalent values were −3.30 ± 1.92 D and −0.18 ± 0.29 D, respectively. ACV and ACA were not significantly changed after surgery; however, central ACD was significantly decreased (preoperatively = 3.366 ± 0.316 mm vs postoperatively = 3.3 ± 0.298 mm) with a mean difference of 0.066 ± 1.121 mm. There were no significant relationships between changes in refraction and anterior segment dimensions or between attempted maximum ablation depth and anterior segment dimensions. Conclusion Measurements with Sirius showed that ACA and ACV did not change; however, central ACD significantly decreased after myopic LASIK in young patients, indicating that the preoperative central ACD value should not be used interchangeably with the postoperative central ACD value.
Collapse
|