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Abing AA, Oh A, Ong LF, Marvasti AH, Tran DB, Lee JK. Surgical options and clinical outcomes for high myopia. Curr Opin Ophthalmol 2024; 35:284-291. [PMID: 38700946 DOI: 10.1097/icu.0000000000001053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
PURPOSE OF REVIEW Higher degrees of myopia are currently being treated with refractive surgery. However, there is limited characterization and outcomes data for this cohort. This article aims to review the literature on highly myopic patients who had refractive surgery and present a retrospective analysis of 149 patients (270 eyes) with high to extreme myopia (≤-5.0D SE) who underwent refractive surgery [laser-assisted subepithelial keratomileusis (LASIK), photorefractive keratectomy (PRK), or implantable collamer lense (ICL)] at a single practice. RECENT FINDINGS There is substantial literature on the efficacy of LASIK, PRK, and phakic intraocular lenses for refractive error correction, but a dearth of studies on patients with high to extreme myopia undergoing different types of refractive surgery. Our study reveals that this cohort of patients has excellent outcomes with minimal complications. SUMMARY Our study reveals that the average preoperative myopia was highest in ICL patients (-10.03D), followed by PRK (-7.21D), and LASIK (-7.04D) patients. Not surprisingly, eyes with high myopia and thin corneas were offered and elected ICLs for their procedure. Highly myopic patients achieved outcomes consistent with data reported in the literature- average postoperative uncorrected visual acuity was 20/20 for LASIK and ICL eyes and 20/25 for PRK eyes.
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Affiliation(s)
| | - Alyce Oh
- Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
| | - Lauren F Ong
- California Northstate University College of Medicine, Elk Grove, California, USA
| | | | - Dan B Tran
- Coastal Vision Medical Group, Orange, California
| | - Jimmy K Lee
- Coastal Vision Medical Group, Orange, California
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Zhou H, Jin Y, Tong G, Zhao G, Wu H. Comparison of the efficacy and safety of removing bandage contact lenses on the fourth and seventh postoperative day after transepithelial photorefractive keratectomy. Heliyon 2023; 9:e21129. [PMID: 37886779 PMCID: PMC10597848 DOI: 10.1016/j.heliyon.2023.e21129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
Purpose To compare the differences in the removal of bandage contact lenses (BCLs) at 4 and 7 days after transepithelial photorefractive keratectomy (TransPRK) in term of visual rehabilitation, eye discomfort, and postoperative complications. Methods This retrospective cohort study included patients with myopia undergoing TransPRK; in Group 1, the BCLs were removed on the 4th postoperative day, while in Group 2, the BCLs were removed on the 7th postoperative day. All patients underwent a 6-month follow-up, including slit-lamp examination and visual acuity assessment. Subjective evaluations of pain and eye discomfort were recorded after the BCLs removal. Results In total, 376 eyes of 191 patients in Group 1 and 346 eyes of 177 patients in Group 2 were enrolled. The two groups were matched for sex, age, preoperative corrected distance visual acuity, and tear film break-up time. Patients in Group 1 exhibited slightly lower levels of myopia, resulting in a shallower ablation depth and shorter ablation time than those in Group 2. No statistically significant differences in visual acuity recovery, haze severity, and incidence of infectious keratitis were observed within 6 months after surgery between the two groups. However, patients in Group 2 experienced significantly fewer discomfort symptoms (discharge, foreign body sensation, and blurred vision) after BCLs removal than patients in Group 1 and had fewer postoperative complications (recurrent corneal epithelial erosion). Conclusion Delayed removal of the BCLs one week after TransPRK effectively alleviated early discomfort symptoms and reduced the risk of recurrent corneal epithelial erosion without increasing the likelihood of infectious keratitis.
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Affiliation(s)
- Hangshuai Zhou
- Department of Ophthalmology, Dongyang People's Hospital, Dongyang, China
| | - Yanhua Jin
- Department of Ophthalmology, Dongyang People's Hospital, Dongyang, China
| | - Gengmin Tong
- Department of Ophthalmology, Dongyang People's Hospital, Dongyang, China
| | - Guangjin Zhao
- Department of Ophthalmology, Dongyang People's Hospital, Dongyang, China
| | - Hongyan Wu
- Department of Ophthalmology, Dongyang People's Hospital, Dongyang, China
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Liu Z, Zhao Y, Sun S, Wu Y, Wang G, Zhao S, Huang Y. Effect of preoperative pupil offset on corneal higher-order aberrations after femtosecond laser-assisted in situ keratomileusis. BMC Ophthalmol 2023; 23:247. [PMID: 37264322 DOI: 10.1186/s12886-023-02960-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/04/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND This study aimed to investigate the relationship between multiple higher-order aberrations (HOAs) subgroups and pupil offset, as well as to analyze the factors affecting postoperative corneal HOAs in patients with different degrees of refractive errors. METHODS We enrolled 160 patients (316 eyes) aged ≥ 18 years who had undergone femtosecond laser-assisted in situ keratomileusis (FS-LASIK) treatment. Based on the relationship between the preoperative pupil offset and the postoperative ΔHOAs, all patients were divided into two groups: group I (pupil offset ≤ 0.20 mm) and group II (pupil offset > 0.20 mm). All of the eyes had low to high myopia with or without astigmatism (manifest refraction spherical equivalent (MRSE) < -10.00 D). Uncorrected distance visual acuity, corrected distance visual acuity, MRSE, pupil offset, central corneal thickness, corneal HOAs, vertical coma (Z3-1), horizontal coma (Z31), spherical aberration (Z40), trefoil 0° (Z33), and trefoil 30° (Z3-3) over a 6 mm diameter central corneal zone diameter were evaluated preoperatively and at 1 and 3 months postoperatively. RESULTS Our result revealed significant differences in postoperative corneal total root mean square (RMS) HOAs, RMS vertical coma, RMS horizontal coma, RMS spherical aberration, and RMS trefoil 30° between group I and group II. ΔMRSE was found to be an effective factor for ΔRMS HOAs (R2 = 0.383), ΔRMS horizontal coma (R2 = 0.205), and ΔRMS spherical aberration (R2 = 0.397). In group II, multiple linear regression analysis revealed a significant correlation between preoperative pupillary offset and Δtotal RMS HOAs (R2 = 0.461), ΔRMS horizontal coma (R2 = 0.040), and ΔRMS trefoil 30°(R2 = 0.089). The ΔRMS vertical coma effect factor is the Y-component, and the factor influencing ΔRMS spherical aberration was ΔMRSE (R2 = 0.256). CONCLUSION A small pupil offset was associated with a lower induction of postoperative corneal HOAs. Efforts to optimize centration are critical for improving surgical outcomes in patients with FS-LASIK.
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Affiliation(s)
- Zhanglin Liu
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin, 300384, China
| | - Yang Zhao
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin, 300384, China
| | - Shengshu Sun
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin, 300384, China
| | - Yuan Wu
- Aier Eye Hospital, Shanxi, 030006, China
| | - Guiqin Wang
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin, 300384, China
| | - Shaozhen Zhao
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin, 300384, China
| | - Yue Huang
- Tianjin Medical University Eye Hospital, Eye Institute and School of Optometry, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin, 300384, China.
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Alhawsawi A, Alhariri J, Aljindan M, Alburayk K, Alotaibi HA. Outcomes of Single-Step Transepithelial Photorefractive Keratectomy Compared With Alcohol-Assisted Photorefractive Keratectomy Using Wave-Light EX500 Platform. Cureus 2023; 15:e36872. [PMID: 37123747 PMCID: PMC10147053 DOI: 10.7759/cureus.36872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 03/31/2023] Open
Abstract
Purpose To compare the visual outcome of transepithelial photorefractive keratectomy (PRK) against alcohol-assisted PRK in treating low-to-moderate myopia with or without astigmatism. Setting Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia. Design This is a retrospective study. Methods Forty eyes of 22 patients with myopia from -0.75 to -6.00 diopters (D) with or without astigmatism from 0 to -3D were included in this study. Preoperative and postoperative data of 20 eyes from 11 patients who underwent transepithelial PRK were compared with 20 eyes from 11 patients who underwent alcohol-assisted PRK were collected and analyzed. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest spherical equivalence (SE), manifest cylinder, vector analysis of astigmatism, and efficacy and safety indices were compared between the groups at a mean follow-up of one year postoperatively. Results Baseline characteristics were similar between groups, except the transepithelial PRK group had lower cylinder values than the alcohol-assisted PRK group by 0.69D. Regression analysis was used to control for the difference in the cylinder in all outcome parameters. Both groups had similar mean UDVA (p=0.73), CDVA (p=0.98), the proportion of eyes in either group achieved (20/20, 20/25, and 20/30) UDVA (p=0.72, 0.68 and 0.31 respectively) and percentage of eyes lost two lines of CDVA (p=1.0). There was no statistically significant difference between the two groups in regard to both efficacy and safety indices (p=0.55 and 0.67, respectively). Both groups had similar residual SE (p=0.72), the proportion of eyes within ±0.5D of SE (p=0.29), and residual refractive astigmatism (p=0.87). Both groups had similar difference vectors, surgically induced astigmatism, and correction index (p=0.82, 0.10, and 0.26, respectively). However, the transepithelial PRK group had lower target-induced astigmatism (TIA; p=0.01), higher magnitude of error (ME; p=0.05), and higher angle of error (AE; p=0.02) than the alcohol-assisted PRK group. Conclusion Transepithelial PRK had similar visual and refractive outcomes as alcohol-assisted PRK. This approach was considered as safe and effective as alcohol-assisted PRK in treating patients with low-to-moderate myopia with or without astigmatism.
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Abdel-Radi M, Rateb M, Saleh MGA, Aly MOM. Twelve-month outcomes of single-step transepithelial photorefractive keratectomy for moderate hyperopia and hyperopic astigmatism. EYE AND VISION (LONDON, ENGLAND) 2023; 10:7. [PMID: 36855211 PMCID: PMC9976533 DOI: 10.1186/s40662-023-00327-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/08/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND Conventional mechanical or alcohol-assisted photorefractive keratectomy (PRK) techniques for correction of hyperopia and hyperopic astigmatism were associated with inconsistent results. The aim of this study is to evaluate the 12-month visual and refractive outcomes of the relatively new single-step transepithelial photorefractive keratectomy (TE-PRK) for moderate hyperopia and hyperopic astigmatism. METHODS This is a prospective interventional study. Forty-eight eyes of 30 patients with moderate hyperopia or hyperopic astigmatism with a cycloplegic spherical equivalent refraction (SEQ) between 2.0 and 4.5 diopters (D) underwent single-step StreamLight® TE-PRK using EX500 excimer laser (Alcon Laboratories, USA). The main outcome measures were recorded at 6 and 12 months postoperatively including assessment of logarithm of the minimum angle resolution (logMAR) uncorrected and corrected distance visual acuity (UDVA, CDVA), cycloplegic refraction, corneal topographic changes as well as post-PRK peripheral haze grading. RESULTS The mean preoperative cycloplegic SEQ was significantly reduced from 3.21 ± 0.61 D to 0.35 ± 0.04 D and 0.41 ± 0.04 D at 6 and 12 months, respectively (P < 0.001). The mean preoperative UDVA significantly improved from 0.53 ± 0.02 logMAR to 0.07 ± 0.01 logMAR and 0.08 ± 0.01 logMAR at 6 and 12 months, respectively (P < 0.001) while the mean preoperative logMAR CDVA showed non-significant change over time throughout the study (P = 0.135). At the end of the study, 41 eyes (85.4%) achieved UDVA of 20/25 or better and no eye lost any lines of CDVA. Thirty-eight eyes (79.1%) had a postoperative cycloplegic cylinder of 0.5 D or less at 12 months. The mean preoperative mean keratometry showed significant increase at 6 and 12 months postoperatively (P < 0.001) while there was no significant change between the two postoperative visits denoting topographic stability (P = 0.058). The mean postoperative Q value at 6 and 12 months showed a significant prolate shift (P < 0.001). No haze was observed in 62.5% and 85.4% of the enrolled eyes at 6 and 12 months, respectively. CONCLUSIONS Single-step StreamLight® TE-PRK for moderate hyperopia and hyperopic astigmatism achieved acceptable visual and refractive outcomes. TRIAL REGISTRATION (Clinicaltrials.gov): NCT05261685, 2 March 2022, retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05261685.
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Affiliation(s)
- Mahmoud Abdel-Radi
- Department of Ophthalmology, Assiut University, Assiut University Hospital, 6th Floor, 71516, Assiut, Egypt.
| | - Mahmoud Rateb
- grid.411437.40000 0004 0621 6144Department of Ophthalmology, Assiut University, Assiut University Hospital, 6th Floor, 71516 Assiut, Egypt
| | - Mohamed G. A. Saleh
- grid.411437.40000 0004 0621 6144Department of Ophthalmology, Assiut University, Assiut University Hospital, 6th Floor, 71516 Assiut, Egypt
| | - Mohamed Omar M. Aly
- grid.411437.40000 0004 0621 6144Department of Ophthalmology, Assiut University, Assiut University Hospital, 6th Floor, 71516 Assiut, Egypt
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Janiszewska-Bil D, Czarnota-Nowakowska B, Grabarek BO, Dobrowolski D, Wylęgała E, Lyssek-Boroń A. Comparison of Vision Correction and Corneal Thickness at 180-Day Follow-Up After Femtosecond Laser-Assisted In-Situ Keratomileusis (FS-LASIK), Photorefractive Keratectomy (PRK), and Small Incision Lenticule Extraction (SMILE): A Study from a Single Center in Poland of 120 Patients with Myopia. Med Sci Monit 2023; 29:e939099. [PMID: 36793199 PMCID: PMC9942428 DOI: 10.12659/msm.939099] [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: 02/01/2023] Open
Abstract
BACKGROUND This study from a single center in Poland included 120 patients with myopia, and the aim was to compare vision correction and corneal thickness at the 180-day follow-up after femtosecond laser-assisted in-situ keratomileusis (FS-LASIK), photorefractive keratectomy (PRK), or small incision lenticule extraction (SMILE). MATERIAL AND METHODS The effectiveness and safety of laser vision correction (LVC) procedures were evaluated by determining pre- and post-procedure uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) values on the Snell chart. Twenty patients with diagnosed mild myopia (sphere maximum -3.0 diopters D; cylinder maximum 0.5 D) were qualified for PRK surgery. Fifty patients with diagnosed intolerance (sphere maximum -6.0 D; cylinder maximum 5.0 D) were eligible for the FS-LASIK procedure. Fifty patients with diagnosed myopia (sphere maximum -6.0 D cylinder 3.5 D) were qualified for the SMILE procedure. RESULTS Regardless of which procedure was performed, both UDVA and CDVA improved significantly postoperatively (P<0.05). In addition, the UDVA and CDVA values were similar in the postoperative period (P>0.05). For each procedure, the EI was no less than 0.94. Regardless of which type of LVC procedure was performed, CET at the center and 1.5 mm from the center in 4 meridians thickened, and this change was not statistically significant over the observation period (P>0.05). CONCLUSIONS Our analysis demonstrated similar effectiveness of the 3 methods - PRK, FS-LASIK, and SMILE - in patients with mild and moderate myopia.
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Affiliation(s)
- Dominika Janiszewska-Bil
- Department of Ophthalmology, Trauma Centre, St. Barbara Hospital, Sosnowiec, Poland,Department of Ophthalmology, Faculty of Medicine in Zabrze, Academy of Silesia, Zabrze, Poland,Optegra Clinic in Katowice, Katowice, Poland
| | | | - Beniamin Oskar Grabarek
- Department of Histology, Cytophysiology and Embryology, Faculty of Medicine, Academy of Silesia, Zabrze, Poland
| | - Dariusz Dobrowolski
- Department of Ophthalmology, Trauma Centre, St. Barbara Hospital, Sosnowiec, Poland,Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, The Medical University of Silesia in Katowice, Katowice, Poland,Department of Ophthalmology, District Railway Hospital, Katowice, Poland
| | - Edward Wylęgała
- Chair and Clinical Department of Ophthalmology, Division of Medical Science in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Anita Lyssek-Boroń
- Department of Ophthalmology, Trauma Centre, St. Barbara Hospital, Sosnowiec, Poland,Department of Ophthalmology, Faculty of Medicine in Zabrze, Academy of Silesia, Zabrze, Poland,Optegra Clinic in Cracow, Cracow, Poland
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Transepithelial Photorefractive Keratectomy Compared to Conventional Photorefractive Keratectomy: A Meta-Analysis. J Ophthalmol 2022; 2022:3022672. [PMID: 36051276 PMCID: PMC9427238 DOI: 10.1155/2022/3022672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/30/2022] [Indexed: 12/01/2022] Open
Abstract
This meta-analysis review compares the primary and secondary outcomes of transepithelial photorefractive keratectomy (TPRK) to the conventional photorefractive keratectomy (PRK), in terms of efficacy, predictability, safety, and patient perspectives. A total of 1711 eyes with PRK (811 eyes) and TPRK (900 eyes) from 12 studies were included through bibliographic searches. The main outcomes were efficacy, predictability, and safety parameters, and the secondary outcomes included visual and patient-reported parameters. The effect measures were weighted mean differences with 95% confidence intervals (CI) which were derived from the random-effects model of the meta-analysis to account for possible heterogeneity. TPRK procedure presents a comparable status in the main outcome and a very dominant significance in all the secondary outcomes in this meta-analysis. This study updates the evidence of the accuracy of TPRK procedure for surgical correction of all refractive errors and was deemed safer with less surgical time required and an early healing time.
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Tananuvat N, Winaikosol P, Niparugs M, Chaidaroon W, Tangmonkongvoragul C, Ausayakhun S. Twelve-Month Outcomes of the Wavefront-Optimized Photorefractive Keratectomy for High Myopic Correction Compared with Low-to-Moderate Myopia. Clin Ophthalmol 2022; 15:4775-4785. [PMID: 35221669 PMCID: PMC8866998 DOI: 10.2147/opth.s346992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/07/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the 12-months outcomes of photorefractive keratectomy (PRK) in patients with high myopia (≥ 6.0 diopters, D) compared with low-to-moderate myopia (< 6.0 D). Patients and Methods Records of 46 patients (69 eyes) who underwent PRK for myopic and astigmatic correction between October 2015 and December 2018 were reviewed. High myopic eyes (29 eyes) were compared with low-to-moderate myopic eyes (40 eyes). All surgeries were adjunct with 0.02% mitomycin C intraoperatively. Measured outcomes included postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent, corneal haze rate, and any complications. Results At 12 months post-PRK, 26 eyes (89.7%) in the high myopia and 39 eyes (97.5%) in the low-to-moderate myopia group had UDVA ≥ 20/20, (p=0.30). Average postoperative logMAR UDVA at 12 months was −0.04 (20/18) and −0.11 (20/15) for the high myopia and low-to-moderate myopia groups, respectively. No eyes in either group had residual refractive errors >1 D. No eyes in both groups developed significant corneal haze at month 12. No eyes had a loss of greater than two Snellen lines of CDVA at 12 months post-surgery. The efficacy and safety indices at 12 months post-surgery were not significantly different between groups (1.06±0.26 vs.1.14±0.27, p =0.25 and 1.14±0.27 vs 1.17±0.26, p=0.60 for low-to-moderate myopia vs high myopia groups, respectively). Conclusion PRK with high myopic correction provides excellent refractive outcomes and is safe, compared to those of low-to-moderate myopic correction.
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Affiliation(s)
- Napaporn Tananuvat
- Chiang Mai University LASIK Center, Center for Medical Excellence, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pawara Winaikosol
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Muanploy Niparugs
- Chiang Mai University LASIK Center, Center for Medical Excellence, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Winai Chaidaroon
- Chiang Mai University LASIK Center, Center for Medical Excellence, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chulaluck Tangmonkongvoragul
- Chiang Mai University LASIK Center, Center for Medical Excellence, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Somsanguan Ausayakhun
- Chiang Mai University LASIK Center, Center for Medical Excellence, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Giral JB, Bloch F, Sot M, Zevering Y, El Nar A, Vermion JC, Goetz C, Lhuillier L, Perone JM. Efficacy and safety of single-step transepithelial photorefractive keratectomy with the all-surface laser ablation SCHWIND platform without mitomycin-C for high myopia: A retrospective study of 69 eyes. PLoS One 2021; 16:e0259993. [PMID: 34874947 PMCID: PMC8651116 DOI: 10.1371/journal.pone.0259993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 10/30/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Studies suggest that transepithelial photorefractive keratectomy (TransPRK) with the all-surface laser ablation (ASLA)-SCHWIND platform is effective and safe for both low-moderate myopia and high myopia. In most studies, mitomycin-C is administered immediately after surgery to prevent corneal opacification (haze), which is a significant complication of photorefractive keratectomy in general. However, there is evidence that adjuvant mitomycin-C induces endothelial cytotoxicity. Moreover, a recent study showed that omitting adjuvant mitomycin-C did not increase haze in low-moderate myopia. The present case-series study examined the efficacy, safety, and haze rates of eyes with high myopia that underwent ASLA-SCHWIND TransPRK without adjuvant mitomycin-C. METHODS All consecutive eyes with high myopia (≤-6 D) that were treated in 2018-2020 with the SCHWIND Amaris 500E® TransPRK excimer laser without adjuvant mitomycin-C in a tertiary-care hospital (France) and were followed up for 6 months were identified. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and spherical equivalent (SE) were recorded before and after surgery. Postoperative haze was graded using the 4-grade Fantes scale. Efficacy rate (frequency of eyes with 6-month UCVA ≤0.1 logMAR), safety rate (frequency of eyes that lost <2 BSCVA lines), predictability (frequency of eyes with 6-month SE equal to target SE±0.5 D), efficacy index (mean UCVA at 6 months/preoperative BSCVA), and safety index (BSCVA at 6 months/preoperative BSCVA) were computed. RESULTS Sixty-nine eyes (38 patients) were included. Mean preoperative and 6-month SE were -7.44 and -0.05 D, respectively. Mean 6-month UCVA and BSCVA were 0.00 and -0.02 logMAR, respectively. Efficacy rate and index were 95.7% and 1.08, respectively. Safety rate and index were 95.7% and 1.13, respectively. Predictability was 85.5%. Grade 3-4 haze never arose. At 6 months, the haze rate was zero. CONCLUSIONS ASLA-SCHWIND TransPRK without mitomycin-C appears to be safe as well as effective and accurate for high myopia.
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Affiliation(s)
- Jean Baptiste Giral
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Florian Bloch
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Maxime Sot
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Yinka Zevering
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Arpine El Nar
- Clinical Research Support Unit, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Jean Charles Vermion
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Christophe Goetz
- Clinical Research Support Unit, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Louis Lhuillier
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Jean-Marc Perone
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
- * E-mail:
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Gab-Alla AA. SmartSurfACE transepithelial photorefractive keratectomy with mitomycin C enhancement after small incision lenticule extraction. EYE AND VISION 2021; 8:28. [PMID: 34963489 PMCID: PMC8895781 DOI: 10.1186/s40662-021-00254-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/27/2021] [Indexed: 11/16/2022]
Abstract
Background To evaluate predictability, stability, efficacy, and safety of transepithelial photorefractive keratectomy (TPRK) using smart pulse technology (SPT) (SmartSurface procedure) of Schwind Amaris with mitomycin C for correction of post small incision lenticule extraction (SMILE) myopic residual refractive errors. Method This study is a prospective, non-comparative case series conducted at a private eye centre in Ismailia, Egypt, on eyes with post-SMILE myopic residual refractive errors because of undercorrection or suction loss (suction loss occurred after the posterior lenticular cut and the creation of side-cuts; redocking was attempted, and the treatment was completed in the same session with the same parameters) with myopia or myopic astigmatism. The patients were followed up post-SMILE for six months before the SmartSurface procedure, and then they were followed up for one year after that. TPRK were performed using Amaris excimer laser at 500 kHz. The main outcomes included refractive predictability, stability, efficacy, safety and any reported complications. Results This study included 68 eyes of 40 patients out of 1920 total eyes (3.5%) with post-SMILE technique myopic residual refractive errors. The average duration between the SMILE surgery and TPRK was 6.7 ± 0.4 months (range 6 to 8 months). The mean refractive spherical equivalent (SE) was within ± 0.50 D of plano correction in 100% of the eyes at 12 months post-TPRK. Astigmatism of < 0.50 D was achieved in 100% of the eyes. The mean of the residual SE error showed statistically significant improvement from preoperative − 1.42 ± 0.52 D to 0.23 ± 0.10 D (P < 0.0001). Uncorrected distance visual acuity (UDVA) (measured by Snellen's chart and averaged in logMAR units) was improved significantly to 0.1 ± 0.07 (P < 0.0001). UDVA was 0.2 logMAR or better in 100% of the eyes, 0.1 logMAR or better in 91.2% of the eyes, and 0.0 logMAR in 20.6% of the eyes. Corrected distance visual acuity (CDVA) remained unchanged in 79.4% of eyes. 14.7% of eyes gained one line of CDVA (Snellen). 5.9% of eyes gained two lines of CDVA (Snellen). Conclusion Transepithelial photorefractive keratectomy using smart pulse technology with mitomycin C enhancement after SMILE is a safe, predictable, stable, and effective technique.
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Wangtiraumnuay N, Trichaiyaporn S, Lueangaram S, Surukrattanaskul S, Wongkittirux K. Prevalence of Prescription Glasses in the First-Grade Thai Students (7-8 Years Old). CLINICAL OPTOMETRY 2021; 13:235-242. [PMID: 34377043 PMCID: PMC8349202 DOI: 10.2147/opto.s323999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/21/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE To study the prevalence of the prescription glasses given to first-grade students due to the "Good Sight for Thai Children" (GSTC) policy. METHODS This was a cross-sectional study that examined all prescription glasses given to first-grade students throughout Thailand, after visual screening due to the GSTC policy between 2016 and 2017. Trained class teachers screened their students' visual acuity and referred children who had less than 20/40 visual acuity in either eye to a hospital for an eye examination and prescription glasses. RESULTS A total of 786,729 students were screened. Of these, 20,401 (2.59%) students were referred to hospital. However, only 9867 (48.37%) students presented to a hospital. Glasses were prescribed for 5324 (53.96%) students following cycloplegic refraction by ophthalmologists or trained refractionists. The mean spherical equivalent was -1.08 (-19.00 to +10.00, SD 2.32) diopters. There were 1626 (30.54%) children at amblyopic risk without glasses. A 5.49% had high myopia (< -6 diopters), 5.22% had high hyperopia (> +5 diopters) and 27.82% had high astigmatism (>2 diopters). A cylindrical lens analysis showed that 81.53% had with-the-rule astigmatism, 4.07% had against-the-rule astigmatism, and 14.40% had oblique astigmatism. CONCLUSION Although the reliable prevalence of refractive error cannot be estimated, the prevalence of visual impairment may be estimated. There were a number of students who required glasses. The astigmatism was the most common refractive error on prescription glasses for first-grade children. With-the-rule astigmatism was the most prevalent. The visual screening program of school children proved to be valuable and should be continued and developed.
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Affiliation(s)
- Nutsuchar Wangtiraumnuay
- Department of Ophthalmology, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
| | - Sumalin Trichaiyaporn
- Department of Ophthalmology, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
| | - Sirin Lueangaram
- Department of Ophthalmology, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
| | - Supawan Surukrattanaskul
- Department of Ophthalmology, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
| | - Kwanjai Wongkittirux
- Department of Ophthalmology, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
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Efficacy, safety, and predictability of transepithelial photorefractive keratectomy: meta-analysis. J Cataract Refract Surg 2021; 47:634-640. [PMID: 33252562 DOI: 10.1097/j.jcrs.0000000000000487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 10/08/2020] [Indexed: 01/27/2023]
Abstract
PURPOSE To evaluate the efficacy, safety, and predictability of transepithelial photorefractive keratectomy (TransPRK) for correcting myopia, astigmatism, and hyperopia. SETTING Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany. DESIGN Meta-analysis of retrospective or prospective studies. METHODS Relevant studies were collected from Medline and included when meeting the following predefined criteria: randomized controlled trials, at least 1 of the main outcome measures as efficacy, safety, or predictability, and 1 common TransPRK laser (Schwind Amaris). The parameters estimates and 95% CI were derived from random-effects meta-analysis to account for possible heterogeneity. RESULTS Because hyperopia studies did not meet the inclusion criteria, the results are centered on myopia and astigmatism. Sixteen studies with a total of 1924 treated eyes were included in the meta-analysis. The mean efficacy, safety, and predictability had a probability of 94% (CI, 0.86-0.97), 0% (CI, 0.00-0.03), and 89% (CI, 0.82-0.93), respectively. The mean correction index, difference vector, and index of success had a value of 1.01 (CI, 1.01-1.02), 0.20 (CI, 0.06-0.34), and 0.12 (CI, 0.07-0.18), respectively. CONCLUSIONS This summary estimate showed that TransPRK was highly effective, safe, and predictable in correcting myopia and/or astigmatism.
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Reitblat O, Gershoni A, Mimouni M, Livny E, Nahum Y, Bahar I. Transepithelial photorefractive keratectomy on the same day of the initial consultation for the correction of myopia. Eur J Ophthalmol 2021; 32:1448-1456. [PMID: 34269097 DOI: 10.1177/11206721211033484] [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: 11/17/2022]
Abstract
PURPOSE To examine the clinical outcomes, efficacy, safety, and predictability of transepithelial photorefractive keratectomy (Trans-PRK) operations performed on the day of the first screening visit in comparison with operations scheduled at a following appointment. METHODS Data of consecutive patients with myopia of various degrees, who underwent Trans-PRK, were retrospectively analyzed. Findings were compared between patients who underwent Trans-PRK on the same day of first consultation to patients that underwent surgery at subsequent visits, following initial consultation on a different day. RESULTS The study included 599 eyes treated on the initial visit day and 1936 eyes treated on a subsequent visit. Mean final spherical equivalent was close to emmetropia in both groups (p = 0.183). Efficacy indices were 0.928 ± 0.192 in the initial-visit group and 0.945 ± 0.163 in the second-visit group (p = 0.152). Safety indices were 0.954 ± 0.156 and 0.955 ± 0.151 (p = 0.707), respectively. No differences between the groups were seen in uncorrected visual acuity (UDVA) of ⩾20/20, ⩾20/25, and ⩾20/32. Only the sub-analysis of patients reaching UDVA of 20/40 or better was slightly lower in the first-visit (95.5%) compared with the second-visit group (97.9%, p = 0.001). Results of attempted correction within ±0.50 D were: 63.3% and 69.0%, respectively (p = 0.009). Complications profiles in the two groups were comparable. CONCLUSIONS Trans-PRK completed on the day of the first screening appointment demonstrated a similar safety outcome compared with subsequent-visits procedures, and slightly lower, yet comparable, results regarding efficacy and predictability.
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Affiliation(s)
- Olga Reitblat
- Ophthalmology Division, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Assuta Optic Laser Center, Assuta Medical Center, Tel Aviv, Israel
| | - Assaf Gershoni
- Ophthalmology Division, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Assuta Optic Laser Center, Assuta Medical Center, Tel Aviv, Israel
| | - Michael Mimouni
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel.,Ruth and Bruce Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Eitan Livny
- Ophthalmology Division, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Assuta Optic Laser Center, Assuta Medical Center, Tel Aviv, Israel
| | - Yoav Nahum
- Ophthalmology Division, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Assuta Optic Laser Center, Assuta Medical Center, Tel Aviv, Israel
| | - Irit Bahar
- Ophthalmology Division, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Assuta Optic Laser Center, Assuta Medical Center, Tel Aviv, Israel
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Ma J, Li L, Mo Y. Efficacy and safety of Bu Jing Yi Shi tables for high myopia: A protocol of systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24130. [PMID: 33546024 PMCID: PMC7837955 DOI: 10.1097/md.0000000000024130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 12/09/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND High myopia is a kind of ametropia with diopter more than -6.00D or axial length ≥26 mm. With the change of the modern environment, the incidence rate is increasing year by year. At present, the pathogenesis of high myopia is not clear. Some current studies indicate that it may be related to the environment and genetics. A Chinese patent medicine named Bu Jing Yi Shi Tablets (BJYST) has many functions including anti-oxidation, expansion of blood vessels, anti-inflammatory, immune regulation, inhibition of retinal photoreceptor cell apoptosis, and promotion of retinal repair. A large number of existing studies have shown that this prescription can relieve the clinical manifestations of high myopia and its complications, but its true efficacy and safety are still unclear. To certify this point, a protocol for a systematic review and meta-analysis of BJYST for high myopia will be performed. METHODS AND ANALYSIS Articles that have been identified by electronically searching of 9 English and 5 Chinese databases from their inception to December 4, 2020 will be incorporated into the study. This study only adopts Chinese and English. Two researchers will take charge of completing the selection of research, the extraction of data as well as the assessment of research quality independently. The primary outcomes will be an average change in refractive error measured in diopters and an average change in axial length measured in millimeters. Data analysis will be performed via the RevMan 5.3 software, and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) will help to assess the evidence level. RESULTS The results of this study will be published in a peer-reviewed journal. CONCLUSION This study will conclude whether BJYST is safe and effective in treating high myopia on the basis of evidence-based medicine. REGISTRATION The Open Science Framework (OSF) registration number is osf.io/dpk5b.
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Affiliation(s)
- Jie Ma
- Chengdu University of Traditional Chinese Medicine
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Linzhi Li
- Chengdu University of Traditional Chinese Medicine
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ya Mo
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Gershoni A, Reitblat O, Mimouni M, Livny E, Nahum Y, Bahar I. Femtosecond laser assisted in situ keratomileusis (FS-LASIK) yields better results than transepithelial photorefractive keratectomy (Trans-PRK) for correction of low to moderate grade myopia. Eur J Ophthalmol 2020; 31:2914-2922. [PMID: 33307790 DOI: 10.1177/1120672120980346] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The purpose of this study was to compare the outcomes of transepithelial photorefractive keratectomy (Trans-PRK) with femtosecond laser assisted in situ keratomileusis (FS-LASIK) for the correction of low to moderate myopia. METHODS A retrospective cohort study design was used. The study group included patients with myopia less than -6.0 D, with or without concomitant astigmatism under 2.0 D, who were treated with FS-LASIK or Trans-PRK in 2013 through 2014. Background, clinical and outcome data were collected from the patient files. A comparison between eyes treated with FS-LASIK or Trans-PRK was performed. RESULTS The Trans-PRK group was comprised of 1793 eyes and the FS-LASIK group of 666 eyes. Mean ± SD spherical equivalent (SE) refraction prior to surgery was -3.43 ± 1.27 D in the Trans-PRK group and -3.18 ± 1.34 D in the FS-LASIK group (p < 0.001). Efficacy index values were 0.95 ± 0.14 in the Trans-PRK group and 0.98 ± 0.12 in the FS-LASIK group (p < 0.001), and corresponding safety index values were 0.96 ± 0.13 and 0.99 ± 0.12 (p < 0.001). Distance from target refraction was 0.45 ± 0.42 D in Trans-PRK group and 0.43 ± 0.38 D in the FS-LASIK group (p = 0.537); 71.6% and 74.2% of eyes were within ±0.5 D of attempted correction, respectively (p = 0.193). CONCLUSIONS Both Trans-PRK and FS-LASIK demonstrated excellent results, mostly comparable with the current literature. FS-LASIK achieved better results than Trans-PRK surgery in the efficacy and safety parameters.
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Affiliation(s)
- Assaf Gershoni
- Assuta Optic Laser Center, Assuta Medical Center, Tel Aviv, Israel.,Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Olga Reitblat
- Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michael Mimouni
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
| | - Eitan Livny
- Assuta Optic Laser Center, Assuta Medical Center, Tel Aviv, Israel.,Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yoav Nahum
- Assuta Optic Laser Center, Assuta Medical Center, Tel Aviv, Israel.,Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Irit Bahar
- Assuta Optic Laser Center, Assuta Medical Center, Tel Aviv, Israel.,Department of Ophthalmology, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Dhami NB, Dhami A, Dhami GS. Anterior uveitis after transepithelial photorefractive keratectomy: Demographics and clinical characteristics - a one-year analysis. Eur J Ophthalmol 2020; 31:2932-2937. [PMID: 33238750 DOI: 10.1177/1120672120974946] [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: 11/16/2022]
Abstract
PURPOSE To report a case series of anterior uveitis after Transepithelial Photorefractive Keratectomy (TransPRK) and determine its incidence, demographics and associated clinical features over a study period of 1 year. METHODS This retrospective case series comprised of 200 eyes (100 patients) which underwent elective TransPRK surgery for ametropia correction at a tertiary eye care center by two refractive surgeons over 1 year. TransPRK was performed on Streamlight software (EX500, Alcon Wavelight, Inc.). Postoperatively, all patients received topical antibiotic and steroid eye drops and tapered over 4 weeks. RESULTS The mean age of study patients was 25.76 ± 4.29 years with a pre-operative mean refractive spherical equivalent (MRSE) of -3.49 ± 2.12 diopter (D); 11.76% eyes had simple myopia and 88.23% had compound myopic astigmatism, mean ablation depth of 61.99 ± 24.27 um. Four patients (seven eyes) developed anterior uveitis with mean age of 25 ± 3.53 years, mean MRSE -2.91 ± 0.32 D, ablation depth 44.75 ± 5.29 um with a mean onset at 33.28 days postoperatively after surgery and 5.28 days after the routine postoperative topical steroid withdrawal. Laboratory and immunological tests were negative in all four patients. The incidence of TransPRK-related anterior uveitis was 3.5% over 1 year. CONCLUSION Anterior uveitis after TransPRK is infrequent. It could be due to intraocular transmittance of high frequency excimer laser beams used for longer durations to provide continuous, single step ablation in this novel type of PRK surgery. Further studies are needed to investigate the mechanisms of this association.
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Montorio D, Cennamo G, Menna F, Donna P, Napolitano P, Breve MA, Fiore U, Cennamo G, Rosa N. Evaluation of corneal structures in myopic eyes more than twenty-two years after photorefractive keratectomy. JOURNAL OF BIOPHOTONICS 2020; 13:e202000138. [PMID: 32668101 DOI: 10.1002/jbio.202000138] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/05/2020] [Accepted: 07/12/2020] [Indexed: 06/11/2023]
Abstract
The aim of this study is to evaluate corneal epithelial thickness (CET), corneal densitometry (CD) in 84 myopic eyes (57 patients) more than 22 years after photorefractive keratectomy, using anterior segment-optical coherence tomography (AS-OCT) and Scheimpflug imaging system. The CET was significantly higher in all operated eyes than in unoperated eyes in central sector. A statistically significant increase in CD in corneal anterior layer of central sector was shown in groups of operated eyes with greater ablation depth respect to unoperated eyes. While there was no significant difference in CD between the operated eyes groups with lower ablation depth and unoperated eyes. A significant trend toward higher values in anterior CD with deeper ablations in central sector was found. These noninvasive imaging techniques allow to better understand the corneal remodeling process after photoablation and to monitor the patients over time.
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Affiliation(s)
- Daniela Montorio
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Gilda Cennamo
- Eye Clinic, Public Health Department, University of Naples Federico II, Naples, Italy
| | - Feliciana Menna
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Piero Donna
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Pasquale Napolitano
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Maria Angelica Breve
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Ugo Fiore
- Department of Management and Quantitative Studies, Parthenope University, Naples, Italy
| | - Giovanni Cennamo
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Nicola Rosa
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
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Zhang J, Feng Q, Ding W, Peng Y, Long K. Comparison of clinical results between trans-PRK and femtosecond LASIK for correction of high myopia. BMC Ophthalmol 2020; 20:243. [PMID: 32560634 PMCID: PMC7304146 DOI: 10.1186/s12886-020-01515-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 06/12/2020] [Indexed: 11/17/2022] Open
Abstract
Background To compare the clinical outcomes of transepithelial photorefractive keratectomy (TPRK) with femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for correction of high myopia. Methods In this prospective, non-randomised, cohort study, 85 eyes of 46 patients treated with TPRK and 80 eyes of 42 patients treated with FS-LASIK were included. All eyes were highly myopic (spherical equivalent refraction <− 6.00 diopters). Both TPRK and FS-LASIK were performed by Schwind Amaris 750S excimer laser. Visual acuity, refraction, corneal high order aberration (HOA) and other variables were analyzed before and at 1, 3, 6, 12 months after surgery. Results At 12 months after surgery, uncorrected logMAR distance visual acuity (UDVA) in the TPRK and FS-LASIK groups was − 0.04 ± 0.04 and − 0.01 ± 0.08, respectively (P = 0.039). Corrected logMAR distance visual acuity (CDVA) was − 0.06 ± 0.05 and − 0.04 ± 0.05 in both groups (P = 0.621). For UDVA, 86% of eyes in the TPRK group and 80% in the FS-LASIK group remained unchanged or improved one or more logMAR lines (P = 0.314), compared to preoperative CDVA. For CDVA, 97% of eyes in the TPRK group and 90% in the FS-LASIK group remained unchanged or improved one or more lines (P = 0.096), compared to preoperative CDVA. Spherical equivalent refraction was − 0.05 ± 0.39 and − 0.26 ± 0.47 in both groups (P = 0.030). 87% of eyes in the TPRK group and 73% in the FS-LASIK group achieved ±0.50 D target refraction (P = 0.019). All 85 eyes (100%) in the TPRK group and 75 eyes (92%) in the FS-LASIK group were within ±1.00 D of target (P = 0.003). Root mean square (RMS) of corneal total HOA and vertical coma in the TPRK group were lower compared with the FS-LASIK group (P < 0.001 for both variables). Conclusions TPRK and FS-LASIK showed good safety, efficacy and predictability for correction of high myopia. Clinical outcomes of TPRK were slightly better than FS-LASIK.
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Affiliation(s)
- Jiafan Zhang
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, Shandong Province, China
| | - Qingqing Feng
- Qingdao Center Hospital, the Second Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Wenzhi Ding
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, Shandong Province, China
| | - Yusu Peng
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, Shandong Province, China
| | - Keli Long
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, Shandong Province, China.
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