1
|
Guclu H, Sattarpanah S, Gurlu V. Association of Changes in Thickness of Limbal Epithelial and Stroma with Corneal Scars Detected by High-Resolution Anterior Segment Optic Coherence Tomography. Klin Monbl Augenheilkd 2024; 241:744-750. [PMID: 35504299 DOI: 10.1055/a-1842-2683] [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: 10/18/2022]
Abstract
AIM To investigate the corneal central and limbal thickness in cornea scar patients using high-resolution anterior segment optical coherence tomography (AS-OCT) and to determine the changes in the limbal region due to the corneal scar. Also, to evaluate tear film parameters in scar patients. METHODS Thirty patients with central corneal scar and 30 control subjects. The control subjects were healthy individuals who came to our clinic for routine ophthalmological examination. They were enrolled in this matched case-control study. Central epithelial thickness (ET), stromal thickness (ST), limbal epithelial thickness (LET), and limbal stromal thickness (LST) were analyzed using high-resolution AS-OCT. For evaluation of the ocular surface, the following techniques were used: tear break-up time (BUT) employing standard sterile strips of fluorescein sodium, Schirmer test-I (SCH), and the Ocular Surface Disease Index (OSDI) Questionnaire. RESULTS The mean central ET of the patient group was 51.5 ± 12.4 µm, while the mean central ET of the control group was 59.2 ± 9.0 µm. There was a statistically significant difference between patients and controls (p = 0.008). The mean LST of the patients was 747.9 ± 115.7 µm, and the mean LST of the controls was 726.3 ± 79.7 µm. There was a statistically significant difference between patients and controls according to BUT (p = 0.009) and SCH (p = 0.04). However, there was no significant difference between OSDI results of patients and controls (p = 0.08). CONCLUSION Corneal monitoring with high-resolution AS-OCT is a simple, noninvasive, useful technique for corneal scar patients. Cornea scars cause decreased ET. This result could be associated with lower tear film parameters in scar patients. The scar length is associated with higher intraocular pressure (IOP) values. Decreased LET and increased LST were detected in scar patients.
Collapse
Affiliation(s)
- Hande Guclu
- Ophthalmology, Trakya University, Faculty of Medicine, Edirne, Turkey
| | | | - Vuslat Gurlu
- Ophthalmology, Trakya University, Faculty of Medicine, Edirne, Turkey
| |
Collapse
|
2
|
Janiszewska-Bil D, Czarnota-Nowakowska B, Kuciel-Polczak I, Dobrowolski D, Grabarek BO, Lyssek-Boroń A, Wylęgała E, Wierzbowska J. Assessment of Changes in Cap and Residual Stromal Thickness Values during a 6-Month Observation after Refractive Lenticule Extraction Small Incision Lenticule Extraction. J Clin Med 2024; 13:2148. [PMID: 38610913 PMCID: PMC11012741 DOI: 10.3390/jcm13072148] [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: 02/29/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
Background: In this study, the changes in corneal cap and residual stromal thickness (RST) values during a 180-day observation period after refractive lenticule extraction small incision lenticule extraction (ReLEx SMILE) were assessed. Methods: Fifty patients underwent ReLEx SMILE using the VisuMax 500 femtosecond laser, with corneal imaging conducted pre and post procedure via anterior segment optical coherence tomography (AS-OCT). Cap thickness in the center and 1.5 mm from the center in four meridians was measured at various intervals. Results: The results showed a significant decrease in cap thickness 180 days post procedure compared to earlier intervals (p < 0.05). Similarly, RST decreased gradually and significantly post procedure (p < 0.05). Notably, changes in cap thickness within the central 1.5 mm area were more dynamic than RST changes during the 6-month observation period following SMILE. Conclusions: The corneal cap thickness measured with swept-source AS-OCT within the central 1.5 mm area underwent more dynamic changes than the residual stromal thickness during the 6-month observation following SMILE.
Collapse
Affiliation(s)
- Dominika Janiszewska-Bil
- Department of Ophthalmology, Trauma Centre, St. Barbara Hospital, 41-200 Sosnowiec, Poland; (I.K.-P.); (D.D.); (A.L.-B.)
- Optegra Clinic in Katowice, 40-101 Katowice, Poland
- Collegium Medicum, WSB University, 41-300 Dabrowa Gornicza, Poland;
| | | | - Izabela Kuciel-Polczak
- Department of Ophthalmology, Trauma Centre, St. Barbara Hospital, 41-200 Sosnowiec, Poland; (I.K.-P.); (D.D.); (A.L.-B.)
| | - Dariusz Dobrowolski
- Department of Ophthalmology, Trauma Centre, St. Barbara Hospital, 41-200 Sosnowiec, Poland; (I.K.-P.); (D.D.); (A.L.-B.)
- Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland;
- Department of Ophthalmology, District Railway Hospital, 40-760 Katowice, Poland
| | | | - Anita Lyssek-Boroń
- Department of Ophthalmology, Trauma Centre, St. Barbara Hospital, 41-200 Sosnowiec, Poland; (I.K.-P.); (D.D.); (A.L.-B.)
- Optegra Clinic in Katowice, 40-101 Katowice, Poland
- Optegra Clinic in Krakow, 30-347 Krakow, Poland
| | - Edward Wylęgała
- Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-760 Katowice, Poland;
- Department of Ophthalmology, District Railway Hospital, 40-760 Katowice, Poland
| | - Joanna Wierzbowska
- Department of Ophthalmology, Central Clinical Hospital of the Ministry of National Defense, Military Institute of Medicine in Warsaw, 04-141 Warsaw, Poland
- Optegra Clinic in Warszawa, 02-366 Warszawa, Poland
| |
Collapse
|
3
|
Curcă PF, Tătaru CI, Sima G, Burcea M, Tătaru CP. Advances in Transepithelial Photorefractive Keratectomy versus Laser-Assisted In Situ Keratomileusis. Diagnostics (Basel) 2024; 14:481. [PMID: 38472953 DOI: 10.3390/diagnostics14050481] [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: 12/05/2023] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
(1) Background: Laser-assisted refractive surgery is a safe and effective surgical correction of refractive error. For most patients, both the newer Trans-PRK and the established LASIK technique can produce the required surgical correction, sparking the question of which technique should be opted for. (2) Methods: The study prospectively evaluated 121 patients (230 eyes) for at least one month postoperatively; 66 patients (126 eyes) and 45 patients (85 eyes) returned for 6 months and 1 year follow-up. (3) Results: No statistical difference was recorded at 1 week or 1 month post-operation. At 6 months, a difference was found for spherical diopters (Trans-PRK -0.0476 ± 0.7012 versus FS-LASIK +0.425 ± 0.874, p = 0.004) and spherical equivalent (Trans-PRK -0.1994 ± 0.0294 versus FS-LASIK +0.225 ± 0.646, p = 0.025) but not for CYL D (Trans-PRK -0.3036 ± 0.5251 versus FS-LASIK -0.4 ± 0.820, p = 0.499). Uncorrected visual acuity was better for Trans-PRK 6 months post-operation (UCVA logMAR 0.02523 versus 0.0768 logMAR; p = 0.015 logMAR). At 1-year, Trans-PRK was favored for spherical diopters (Trans-PRK -0.0294 ± 0.6493 versus FS-LASIK +0.646 ± 0.909, p < 0.001) and spherical equivalent (Trans-PRK -0.218 ± 0.784 versus FS-LASIK 0.372 ± 1.08, p = 0.007). Overall speed in visual recovery, variance of results and surgically induced astigmatism were in favor of Trans-PRK. (4) Conclusions: The study reported improvements for Trans-PRK patients, with both techniques found to be safe and effective.
Collapse
Affiliation(s)
- Paul Filip Curcă
- Clinical Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania
| | - Cătălina Ioana Tătaru
- Clinical Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania
- Alcor Clinic, 030829 Bucharest, Romania
| | - George Sima
- Clinical Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Alcor Clinic, 030829 Bucharest, Romania
| | - Marian Burcea
- Clinical Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania
| | - Călin Petru Tătaru
- Clinical Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania
- Alcor Clinic, 030829 Bucharest, Romania
| |
Collapse
|
4
|
Abtahi MA, Beheshtnejad AH, Latifi G, Akbari-Kamrani M, Ghafarian S, Masoomi A, Sonbolastan SA, Jahanbani-Ardakani H, Atighechian M, Banan L, Nouri H, Abtahi SH. Corneal Epithelial Thickness Mapping: A Major Review. J Ophthalmol 2024; 2024:6674747. [PMID: 38205099 PMCID: PMC10776199 DOI: 10.1155/2024/6674747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 06/27/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
The corneal epithelium (CE) is the outermost layer of the cornea with constant turnover, relative stability, remarkable plasticity, and compensatory properties to mask alterations in the underlying stroma. The advent of quantitative imaging modalities capable of producing epithelial thickness mapping (ETM) has made it possible to characterize better the different patterns of epithelial remodeling. In this comprehensive synthesis, we reviewed all available data on ETM with different methods, including very high-frequency ultrasound (VHF-US) and spectral-domain optical coherence tomography (SD-OCT) in normal individuals, corneal or systemic diseases, and corneal surgical scenarios. We excluded OCT studies that manually measured the corneal epithelial thickness (CET) (e.g., by digital calipers) or the CE (e.g., by confocal scanning or handheld pachymeters). A comparison of different CET measuring technologies and devices capable of producing thickness maps is provided. Normative data on CET and the possible effects of gender, aging, diurnal changes, refraction, and intraocular pressure are discussed. We also reviewed ETM data in several corneal disorders, including keratoconus, corneal dystrophies, recurrent epithelial erosion, herpes keratitis, keratoplasty, bullous keratopathy, carcinoma in situ, pterygium, and limbal stem cell deficiency. The available data on the potential role of ETM in indicating refractive surgeries, planning the procedure, and assessing postoperative changes are reviewed. Alterations in ETM in systemic and ocular conditions such as eyelid abnormalities and dry eye disease and the effects of contact lenses, topical medications, and cataract surgery on the ETM profile are discussed.
Collapse
Affiliation(s)
| | | | - Golshan Latifi
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sadegh Ghafarian
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Masoomi
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Laleh Banan
- Sunshine Coast University Hospital, Brisbane, Queensland, Australia
| | - Hosein Nouri
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed-Hossein Abtahi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
5
|
Reinstein DZ, Sekundo W, Archer TJ, Stodulka P, Ganesh S, Cochener B, Blum M, Wang Y, Zhou X. SMILE for Hyperopia With and Without Astigmatism: Results of a Prospective Multicenter 12-Month Study. J Refract Surg 2022; 38:760-769. [PMID: 36476297 DOI: 10.3928/1081597x-20221102-02] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE To investigate the safety and effectiveness of small incision lenticule extraction (SMILE) in patients who have hyperopia with or without astigmatism. METHODS This was a prospective multicenter trial including 374 eyes of 199 patients treated by SMILE for hyperopia using the VisuMax femtosecond laser (Carl Zeiss Meditec AG). Inclusion criteria were sphere up to +6.00 diopters (D), cylinder up to 5.00 D, and maximum hyperopic meridian up to +7.00 D, with preoperative corrected distance visual acuity (CDVA) of 20/25 or better. The optical zone was 6.3 mm with a transition zone of 2 mm. The minimum lenticule thickness was set at 25 µm in the center and at 10 µm at the edge. Patients were examined at 1 day, 1 week, and 1, 3, 6, 9, and 12 months after surgery. Standard refractive surgery outcomes analysis was performed. RESULTS The preoperative spherical equivalent was +3.20 ± 1.48 D (range: +0.25 to +6.50 D). At the 12-month follow-up visit, 81% of eyes treated were within ±0.50 D and 93% of eyes were within ±1.00 D of intended correction. A total of 1.2% of eyes lost two or more lines of CDVA at the 12-month follow-up visit, and 83% were at least 20/20, corresponding to a safety index of 1.005 at 12 months. Of the 219 eyes with plano target, 68.8% had an uncorrected distance visual acuity of 20/20 or better and 88% were at least 20/25 uncorrected at 12 months. There were no statistically significant changes in contrast sensitivity. CONCLUSIONS SMILE was found to be an effective treatment method for the correction of compound hyperopic astigmatism, demonstrating a high level of efficacy, predictability, safety, and stability. [J Refract Surg. 2022;38(12):760-769.].
Collapse
|
6
|
Reinstein DZ, Archer TJ, Vida RS. Epithelial thickness mapping for corneal refractive surgery. Curr Opin Ophthalmol 2022; 33:258-268. [PMID: 35779050 DOI: 10.1097/icu.0000000000000867] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW As more devices become available that offer corneal epithelial thickness mapping, this is becoming more widely used for numerous applications in corneal refractive surgery. RECENT FINDINGS The epithelial thickness profile is nonuniform in the normal eye, being thinner superiorly than inferiorly and thinner temporally than nasally. Changes in the epithelial thickness profile are highly predictable, responding to compensate for changes in the stromal curvature gradient, using the eyelid as an outer template. This leads to characteristic changes that can be used for early screening in keratoconus, postoperative monitoring for early signs of corneal ectasia, and for determining whether further steepening can be performed without the risk of apical syndrome following primary hyperopic treatment. Compensatory epithelial thickness changes are also a critical part of diagnosis in irregular astigmatism as these partially mask the stromal surface irregularities. The epithelial thickness map can then be used to plan a trans-epithelial PRK treatment for cases of irregularly irregular astigmatism. Other factors can also affect the epithelial thickness profile, including dry eye, anterior basement membrane dystrophy and eyelid ptosis. SUMMARY Epithelial thickness mapping is becoming a crucial tool for refractive surgery, in particular for keratoconus screening, ectasia monitoring, hyperopic treatment planning, and therapeutic diagnosis and treatment.
Collapse
Affiliation(s)
- Dan Z Reinstein
- Reinstein Vision
- London Vision Clinic, London, UK
- Department of Ophthalmology, Columbia University Medical Center, New York, USA
- Sorbonne Université, Paris, France
- School of Biomedical Sciences, University of Ulster, Coleraine, UK
| | | | | |
Collapse
|
7
|
Russo A, Reinstein DZ, Filini O, Archer TJ, Boldini A, Cardin G, Festa G, Morescalchi F, Salvalai C, Semeraro F. Visual and Refractive Outcomes Following Laser Blended Vision With Non-linear Aspheric Micro-anisometropia (PRESBYOND) in Myopic and Hyperopic Patients. J Refract Surg 2022; 38:288-297. [PMID: 35536710 DOI: 10.3928/1081597x-20220323-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To report 6-month visual and refractive outcomes following PRESBYOND Laser Blended Vision (Carl Zeiss Meditec) treatment using non-linear aspheric micro-anisometropia laser in situ keratomileusis (LASIK) for the correction of myopic and hyperopic presbyopia. METHODS A retrospective, non-comparative study of 139 consecutive patients with a mean age of 53.13 ± 5.84 years (range: 42 to 70 years) treated with LASIK-induced micro-anisometropia using the MEL 90 excimer laser and VisuMax femtosecond laser (both Carl Zeiss Meditec). The target refraction was plano for distance eyes (dominant eye) and between -0.50 and -1.50 diopters (D) for near eyes. Patients were observed for 6 months. RESULTS A total of 278 eyes (78 myopic and 200 hyperopic) from 139 patients completed the study. Mean preoperative spherical equivalent (SE) was -3.40 ± 1.83 D (range: -0.50 to -8.25 D) for myopic eyes and +1.61 ± 0.98 D (range: -1.25 to +4.63 D) for hyperopic eyes. Mean postoperative SE refraction of distance eyes was +0.20 ± 0.35 D (range: -0.38 to +1.00 D) and -0.14 ± 0.42 D (range: -1.38 to +0.88 D) for myopic and hyperopic eyes, respectively. Mean postoperative SE refraction of near eyes was -0.90 ± 0.44 D (range: -0.13 to -2.25 D) and -1.21 ± 0.48 D (range: -0.13 to -2.25 D) for myopic and hyperopic eyes, respectively. Mean binocular uncorrected near visual acuity was 0.70 ± 0.28 logMAR (range: 0.32 to 1.00 logMAR) and 0.79 ± 0.27 logMAR (range: 0.25 to 1.00 logMAR) for myopic and hyperopic eyes, respectively. Mean binocular uncorrected distance visual acuity was 1.19 ± 0.18 logMAR (range: 0.63 to 1.25 logMAR) and 1.14 ± 0.26 logMAR (range: 0.40 to 1.25 logMAR) for myopic and hyperopic eyes, respectively. Stereoacuity was better than 100 seconds of arc in 79% of myopic eyes and 85% of hyperopic eyes and all vision quality scores were greater than 90 of 100. No eyes lost two or more lines. CONCLUSIONS The non-linear aspheric micro-anisometropia protocol resulted in safe and effective visual outcomes in patients with both myopic and hyperopic presbyopia. [J Refract Surg. 2022;38(5):288-297.].
Collapse
|
8
|
Brar S, Ganesh S, Sriganesh SS, Dorennavar L. Long-term Outcomes of Bowman's Membrane Relaxation for Enhancement of Femtosecond Intrastromal Lenticule Implantation Performed for the Management of High Hyperopia. J Refract Surg 2022; 38:134-141. [DOI: 10.3928/1081597x-20211215-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
9
|
Reinstein DZ. The Time Has Come for Refractive Surgery to Be Included in the Fight Against Global Visual Impairment Due to Uncorrected Refractive Error. J Refract Surg 2022; 38:6-8. [PMID: 35020541 DOI: 10.3928/1081597x-20211109-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
10
|
[Regression and ablation profiles in corneal refractive surgery]. J Fr Ophtalmol 2021; 44:1059-1075. [PMID: 34148702 DOI: 10.1016/j.jfo.2020.08.041] [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: 05/15/2020] [Revised: 08/16/2020] [Accepted: 08/24/2020] [Indexed: 11/21/2022]
Abstract
Regression after corneal refractive surgery is a complex phenomenon which seems inevitable. The choice of surgical technique has very little influence on regression for low myopia or myopic astigmatism. However, LASIK and SMILE are the two techniques of choice in the correction of high myopia. LASIK is also better for the correction of hyperopia, hyperopic astigmatism and mixed astigmatism. Intraoperatively, the choice of a wide optical zone and adherence to a thick residual stromal bed provide stability. Regression may also be reduced by modulating anti-inflammatory therapy, treating dry eye, and using mitomycin C in PKR. In all cases, obtaining keratometry during patient follow-up helps to identify the cause of the regression. The objective of this review is to synthesize recent data from the literature on regression in refractive surgery as a function of the ablation profiles used.
Collapse
|
11
|
Incidence, Risk, and Visual Outcomes after Repositioning of Acute Non-Traumatic Flap Dislocations Following Femtosecond-Assisted LASIK. J Clin Med 2021; 10:jcm10112478. [PMID: 34204958 PMCID: PMC8199895 DOI: 10.3390/jcm10112478] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 12/20/2022] Open
Abstract
Although the use of femtosecond lasers instead of mechanical devices has decreased the incidence of flap complications following laser-assisted in situ keratomileusis (LASIK), dislocations and striae still occur. Flap repositioning is an effective intervention to improve visual outcomes after acute flap complications in both microkeratome-assisted and femtosecond-assisted LASIK. This retrospective case series included patients undergoing flap repositioning secondary to acute flap dislocation and/or visually significant striae within the first two weeks following femtosecond LASIK (FS-LASIK) from 2015 to 2020 at a single institution. Preoperative, intraoperative, and postoperative de-identified data were analyzed for incidence, risk factors, and visual acuity outcomes. The incidence of flap repositioning was 0.35% in 21,536 eyes (n = 70). Indications for repositioning included acute flap dislocation (35.7%) and visually significant striae (64.3%). High myopia (OR = 3.04, p = 0.001) and patient age over 50 years (OR = 3.69, p = 0.001) were the strongest risk factors for these complications. Prior to flap repositioning, uncorrected distance visual acuity (UDVA) of 20/20 or better and 20/40 or better occurred in 19% and 57% of eyes, respectively. After repositioning, a final UDVA of 20/20 or better and 20/40 or better occurred in 78% and 98% of eyes, respectively. After repositioning, one line of UDVA was lost in two eyes (2.8%) and two lines were lost in one eye (1.4%). Risk factors for acute flap dislocation included high myopia and age over 50 years. Flap repositioning was effective in salvaging visual outcomes.
Collapse
|
12
|
Moshirfar M, Megerdichian A, West WB, Miller CM, Sperry RA, Neilsen CD, Tingey MT, Hoopes PC. Comparison of Visual Outcome After Hyperopic LASIK Using a Wavefront-Optimized Platform Versus Other Excimer Lasers in the Past Two Decades. Ophthalmol Ther 2021; 10:547-563. [PMID: 34009511 PMCID: PMC8319246 DOI: 10.1007/s40123-021-00346-1] [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: 03/11/2021] [Accepted: 04/10/2021] [Indexed: 11/08/2022] Open
Abstract
Introduction Laser-assisted in-situ keratomileusis (LASIK) for the correction of hyperopia and hyperopic astigmatism is challenging and has been less studied than for the correction of myopia and myopic astigmatism. The aim of this study was to analyze the refractive outcomes of LASIK in hyperopia and hyperopic astigmatic eyes using a wave-front optimized laser platform (the Allegretto EX500 laser) and perform a historical comparison with other excimer lasers within the past two decades. Methods A one-center (Tertiary Refractive Center, Draper, Utah), retrospective, non-comparative study was conducted on 379 eyes treated with LASIK for hyperopia and hyperopic astigmatism. The data retrieved on these eyes were analyzed using uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and spherical equivalents. A literature search of excimer platforms in use in the past 20 years and a comparison of US Federal Drug Administration-approved platforms for hyperopia were performed. Results At 3 and 12 months postoperatively, 142 (66%) and 81 (69%) eyes had a UDVA of 20/20 or better and 207 (96%) and 114 (97%) eyes had a UDVA of 20/40 or better, respectively. The mean refractive spherical equivalent was − 0.52 ± 0.78 D at 3 months and − 0.46 ± 0.79 D at 12 months. At 12 months, 181 (96%) eyes achieved a spherical equivalent within ± 1.00 D of the intended target. Studies published before 2005 reported lower rates of UDVA 20/20 or better (32%) compared to those published after (68%); however, this discrepancy was less evident for UDVA 20/40 or better. A similar trend towards improved accuracy was noted in the literature with postoperative manifest refractive spherical equivalent within ± 0.50 D before and after 2005. Conclusion There has been significant improvement in safety, efficacy, stability, and accuracy of LASIK treatment for hyperopia and hyperopic astigmatism within the past two decades. Newer excimer lasers meet industry standards and in particular, the Allegretto EX500 used in this study exceeded industry standards.
Collapse
Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Draper, UT, USA. .,Moran Eye Center University of Utah, Salt Lake City, UT, USA. .,Utah Lions Eye Bank, Murray, UT, USA.
| | - Alin Megerdichian
- College of Medicine, California Northstate University, Sacramento, CA, USA
| | - William B West
- School of Medicine, University of Utah, Salt Lake City, UT, USA
| | | | | | | | | | | |
Collapse
|
13
|
Zhou W, Stojanovic F, Reinstein DZ, Archer TJ, Chen X, Feng Y, Stojanovic A. Coma Influence on Manifest Astigmatism in Coma-Dominant Irregular Corneal Optics. J Refract Surg 2021; 37:274-282. [PMID: 34038660 DOI: 10.3928/1081597x-20210119-02] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the influence of coma on manifest refractive cylinder (MRC) in eyes with coma-dominated corneal optics and suggest alternative guidelines for surgical planning of astigmatism correction in topography-guided ablation and toric intraocular lens (IOL) exchange surgery. METHODS Twelve eyes with coma-dominant corneal optics and low lenticular astigmatism were selected. The astigmatism remaining after subtraction of total corneal astigmatism (TCA) and lenticular astigmatism from MRC, termed discrepant astigmatism, was calculated and correlated to corneal coma at the anterior surface. Refractive and topography data were then used to simulate topography-guided refractive surgery (topography-guided group) in 7 eyes and lenticular exchange surgery with toric intraocular lens (IOL) implantation (toric IOL group) in 5 eyes. The estimated postoperative MRC after correction of TCA or MRC for each group was compared. RESULTS The axis and amplitude of discrepant astigmatism correlated strongly with the axis and amplitude of coma. In the topography-guided group, where topography-guided ablation eliminated corneal higher order aberrations (HOAs), TCA-based correction led to less estimated postoperative manifest astigmatism than MRC-based correction. In the toric IOL group, where removal of the crystalline lens did not affect corneal HOAs, MRC-based correction via toric IOL implantation led to less estimated postoperative astigmatism than TCA-based correction. CONCLUSIONS Discrepant astigmatism in eyes with coma-dominant corneal optics correlates with coma. In such eyes, treating TCA, along with corneal HOAs, instead of MRC, seems appropriate in topography-guided treatments, whereas treating MRC may be a better choice in lenticular exchange surgery with toric IOL implantation, where corneal HOAs are not treated. [J Refract Surg. 2021;37(4):274-282.].
Collapse
|
14
|
December consultation #4. J Cataract Refract Surg 2020; 46:1688. [DOI: 10.1097/01.j.jcrs.0000725132.26710.2b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
15
|
Wu J, Xiong L, Wang Z, Reinstein DZ, Vida RS, Archer TJ. Correction of Moderate to High Hyperopia With Implantation of an Allogeneic Refractive Lenticule. J Refract Surg 2020; 36:772-779. [DOI: 10.3928/1081597x-20200826-01] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 08/19/2020] [Indexed: 11/20/2022]
|
16
|
Biscevic A, Bohac M, Ahmedbegovic-Pjano M, Pidro A, Bejdic N, Patel S. The relationship between patient age and residual refractive error after uneventful laser in situ keratomileusis for moderate-to-high hyperopia. Eur J Ophthalmol 2020; 31:1725-1732. [PMID: 32597207 DOI: 10.1177/1120672120937658] [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: 11/15/2022]
Abstract
PURPOSE To determine if the manifest sphero-cylindrical residual refractive error, at various time points over a 12-month postop period after laser in situ keratomileusis (LASIK) was associated with patient age at time of surgery. METHODS Patients with moderate to high hyperopia (3.00-7.00 DS) and astigmatism ⩽2 DC underwent LASIK using Wavelight Allegretto Eye Q (400 Hz). Treatments were centered on corneal vertex, flaps were made with Moria M2 mechanical microkeratome. Pre-and postoperative uncorrected and corrected distant visual acuity, best corrected spherical equivalent (SEQ) were measured. Measurements were taken at 1 week, 1, 3, 6, and 12 months after the surgery. Target refraction was emmetropia. Total of 161 patients were treated. In binocular cases, data from the right eyes were included for analysis. In this article, we report on refraction data only. Raw data were subjected to several permutations to elicit any links between refractive outcomes and patient age. RESULTS The key findings were as follows y = postop SEQ (diopters), x = patient age (years), ln(x) = natural logarithm of patient age: At 1 month, y = x[0.049 -0.011.ln(x)] (R = -0.205, p = 0.001, n = 161). At 3 months, y = x[0.077 -0.017.ln(x)] (R = -0.355, p < 0.001, n = 161). At 6 months, y = x[0.088 -0.020.ln(x)] (R = -0.382, p < 0.001, n = 161). At 12 months, y = x[0.093 -0.021.ln(x)] (R = -0.409, p < 0.001, n = 161). There was no significant association between x and y at 1 week (p > 0.05). CONCLUSION Residual postop refractive error after LASIK for hyperopia has a logarithmic association with patient age at time of surgery. In younger patients there is tendency toward undercorrection, the opposite occurs in older patients and this persists 1 year after treatment.
Collapse
Affiliation(s)
- Alma Biscevic
- Eye Clinic "Svjetlost," Sarajevo, Bosnia and Herzegovina.,University Eye Hospital "Svjetlost" Zagreb, School of Medicine University of Rijeka, Zagreb, Croatia
| | - Maja Bohac
- Eye Clinic "Svjetlost," Sarajevo, Bosnia and Herzegovina.,University Eye Hospital "Svjetlost" Zagreb, School of Medicine University of Rijeka, Zagreb, Croatia
| | | | - Ajla Pidro
- Eye Clinic "Svjetlost," Sarajevo, Bosnia and Herzegovina
| | - Nita Bejdic
- Eye Clinic "Svjetlost," Sarajevo, Bosnia and Herzegovina
| | - Sudi Patel
- Eye Clinic "Svjetlost," Sarajevo, Bosnia and Herzegovina.,University Eye Hospital "Svjetlost" Zagreb, School of Medicine University of Rijeka, Zagreb, Croatia
| |
Collapse
|
17
|
Utility of regional epithelial thickness measurements in corneal evaluations. Surv Ophthalmol 2020; 65:187-204. [DOI: 10.1016/j.survophthal.2019.09.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 09/10/2019] [Accepted: 09/16/2019] [Indexed: 11/19/2022]
|
18
|
Abstract
Aim: To evaluate safety and efficacy of Laser in situ Keratomileusis (LASIK) procedure for the correction of high hypermetropia. Methods: Retrospective study of 160 patients (266 eyes) who underwent LASIK procedure for the correction of hypermetropia between +3.00 and +7.00 diopters(D) and cylinder up to 2.00D from January 2013 and August 2015. All ablations were performed with Wavelight Allegretto Eye-Q400Hzexcimer laser (Alcon, Forth Worth, TX, USA) with aberration free module and were centered on a corneal vertex. All flaps were made with Moria M2 (Moria, Antony, France) mechanical microkeratome (90μm head). Preoperative and postoperative uncorrected and corrected distant visual acuity (UDVA, CDVA), spherical equivalent (SE) and a berrometry for 5mm pupil were measured. Measurements were taken at 1 week, 1,3,6 and 12 months after the surgery. Wilcoxon Signed Ranks Test was used for statistical analysis. Results: Postoperative UDVA was lower than preoperative CDVA at 1 week(p=0.001), at 1 month there was no difference (p=0.099), and at 3,6 and 12 months UDVA was better (p<0.0001). Preoperative SE was 4.69±1.20D (+3.75 to +7.50D). At 1 week SE was 0.03±0.67D (-0.50 to +0.63D), while at 1 year regressed to 0.58±0.56D (+0.25 to +0.88D). Sphere shifted from negative values targeted in treatment planning to compensate for regression to positive values. There was significant difference in SE at every time point (p<0.0005). There was a significant increase in coma (p<0.0001), trefoil (p<0.0001, p=0.0006) and spherical aberration (p=0.022, p=0.0052) at 1 week and 1 month postoperatively, without change throughout the rest of follow up. Conclusion: LASIK for high hypermetropia showed satisfactory results in postoperative refraction with reasonable regression without significant loss of lines of visual acuity. However, more test are necessary to asses optical quality.
Collapse
Affiliation(s)
- Alma Biscevic
- Eye Clinic "Svjetlost Sarajevo", Sarajevo, Bosnia and Herzegovina
| | - Ajla Pidro
- Eye Clinic "Svjetlost Sarajevo", Sarajevo, Bosnia and Herzegovina
| | | | - Senad Grisevic
- Eye Clinic "Svjetlost Sarajevo", Sarajevo, Bosnia and Herzegovina
| | - Nina Ziga
- Eye Clinic "Svjetlost Sarajevo", Sarajevo, Bosnia and Herzegovina
| | - Maja Bohac
- University Eye Clinic "Svjetlost" Zagreb, Zagreb, Croatia
| |
Collapse
|
19
|
Plaza-Puche AB, Vargas V, Yébana P, Arba-Mosquera S, Alio JL. Stability of corneal topography and aberrometry after hyperopic laser in situ keratomileusis with a 500-Hz excimer laser platform: A 3-year follow-up study. Eur J Ophthalmol 2019; 30:1238-1245. [PMID: 31514537 DOI: 10.1177/1120672119875358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The aim of this study is to analyze the long-term stability of the corneal topography, the functional optical zone, and the refractive stability throughout 3 years following laser in situ keratomileusis surgery for hyperopia using a 500-Hz excimer laser system. METHODS This retrospective consecutive observational case series study comprised 66 eyes that underwent laser in situ keratomileusis to correct hyperopia with a postoperative follow-up of 3 years. Laser in situ keratomileusis procedures were performed using the SCHWIND Amaris 500-Hz excimer laser. Main outcomes measured were stability of the functional optical zone at corneal topography and corneal aberrometry. RESULTS Statistically significant differences were found in simulated keratometry (K2 (steep meridian) and Km (mean keratometry)) between 3 and 36 months postoperatively (p ⩽ 0.01); these differences disappeared at 12 and 36 months (p ⩾ 0.18). No statistically significant changes were observed in the horizontal and vertical diameter of the functional optical zone throughout the whole follow-up (p ⩾ 0.07). A statistically significant difference was found in the spherical aberration between 3 and 36 months (p = 0.02); this difference disappeared when compared between 12 and 36 months (p = 0.72). Statistically significant correlations were detected between the vertical functional optical zone and coma root mean square (r = -0.510, p < 0.01) and between the vertical functional optical zone and spherical aberration (r = 0.441, p = 0.02) 36 months after surgery. CONCLUSION Following 3 years of hyperopic laser in situ keratomileusis with a 500-Hz Amaris excimer laser, keratometry, functional optical zone, and corneal aberrations remain stable from 1 year after surgery. Topographical regression is not observed in hyperopic laser in situ keratomileusis with this excimer laser technology from 1 year after surgery.
Collapse
Affiliation(s)
| | | | | | | | - Jorge L Alio
- Vissum Corporation, Alicante, Spain.,Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
| |
Collapse
|
20
|
Pradhan KR, Reinstein DZ, Carp GI, Archer TJ, Dhungana P. Small Incision Lenticule Extraction (SMILE) for Hyperopia: 12-Month Refractive and Visual Outcomes. J Refract Surg 2019; 35:442-450. [DOI: 10.3928/1081597x-20190529-01] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 05/27/2019] [Indexed: 11/20/2022]
|
21
|
Mäkinen P, Huhtala A, Pietilä J, Nättinen J, Rajala T, Salmenhaara K, Udratov M, Uusitalo H. Patient satisfaction and self-reported dry eye symptoms in hyperopic patients treated with femtosecond laser in situ keratomileusis. Clin Ophthalmol 2019; 13:741-754. [PMID: 31114152 PMCID: PMC6487895 DOI: 10.2147/opth.s195991] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Purpose To study self-reported patient satisfaction and dry eye symptoms in hyperopic correction with femtosecond laser-assisted in situ keratomileusis (FS-LASIK). Patients and methods Ninety-eight eyes (53 patients) were treated with FS-LASIK for hyperopia. Patients’ self-reported dry eye symptoms and satisfaction with near and far vision were graded on the visual analog scale (VAS) preoperatively and 1 month postoperatively. Results Ninety-one percent of the eyes with the plano target (54 eyes) achieved an uncorrected distance visual acuity of 20/20 or better. Predictability, defined as spherical equivalent refraction within ±0.5 D of target, was 88% of all eyes. None of the eyes lost two or more Snellen lines of corrected distance visual acuity. There was no significant change in the self-reported dry eye sensation (VAS score from 2.7±2.0 to 2.8±2.0; P=0.66). In 44 monovision patients, satisfaction with both far vision (from 71.2±19.8 to 89.2±8.7; P<0.0001) and near vision (from 51.7±26.2 to 89.3±13.2; P<0.0001) increased significantly. In nine emmetropic patients, satisfaction with neither far vision nor near vision was significantly improved, although there was a clear tendency (from 73.7±23.7 to 86.9±15.3; P=0.22, and from 58.9±29.1 to 81.6±17.4; P=0.11, respectively). In the monovision patient group, far vision satisfaction decreased when dry eye symptoms increased. Monovision patients, as predicted, were more satisfied with their near vision, when postoperative spherical equivalent from target was on the myopic side. Conclusion FS-LASIK correction of hyperopia significantly improved patient satisfaction with both near and far vision in monovision patients. Hyperopic patients had no significant changes in postoperative dry eye symptoms compared to preoperative values.
Collapse
Affiliation(s)
- Petri Mäkinen
- Silmäasema Eye Hospital, Tampere, Finland, .,Silmäasema Eye Hospital, Helsinki, Finland,
| | - Anne Huhtala
- Silmäasema Eye Hospital, Tampere, Finland, .,Silmäasema Eye Hospital, Helsinki, Finland,
| | - Juhani Pietilä
- Silmäasema Eye Hospital, Tampere, Finland, .,Silmäasema Eye Hospital, Helsinki, Finland,
| | - Janika Nättinen
- SILK, Department of Ophthalmology, School of Medicine, University of Tampere, Tampere, Finland
| | | | | | | | - Hannu Uusitalo
- SILK, Department of Ophthalmology, School of Medicine, University of Tampere, Tampere, Finland.,TAUH Eye Centre, Tampere University Hospital, Tampere, Finland
| |
Collapse
|
22
|
Reinstein DZ, Pradhan KR, Carp GI, Archer TJ, Day AC, Sekundo W, Dhungana P. Small Incision Lenticule Extraction for Hyperopia: 3-Month Refractive and Visual Outcomes. J Refract Surg 2019; 35:24-30. [PMID: 30633784 DOI: 10.3928/1081597x-20181025-01] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 10/22/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate visual and refractive outcomes of small incision lenticule extraction (SMILE) for hyperopia. METHODS This prospective study of vertex-centered hyperopic SMILE used the VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany). Inclusion criteria were maximum attempted hyperopic meridian of between +1.00 and +7.00 diopters (D) and corrected distance visual acuity (CDVA) of 20/40 or better. Lenticule parameters were 6.3- to 6.7-mm diameter, 2-mm transition zone, 30-µm minimum thickness, and 120-µm cap thickness. Standard outcomes analysis was performed for the 3-month data, including contrast sensitivity using the Functional Vision Analyzer. RESULTS For 93 eyes treated, 3-month data were available for 82 (88%). Attempted spherical equivalent refraction was +5.62 ± 1.20 D (range: +1.00 to +6.90 D) and cylinder was -0.91 ± 0.68 D (range: 0.00 to -3.50 D). For eyes targeted for emmetropia (n = 36), uncorrected distance visual acuity was 20/40 or better in 89%. Spherical equivalent refraction relative to target was -0.17 ± 0.85 D (range: -2.20 to +3.00 D), with 59% within ±0.50 D and 76% within ±1.00 D. There was one line loss of CDVA in 17% of eyes, and one eye lost three lines (1.2%) but recovered to one line lost at 9 months. There was no clinically significant change in contrast sensitivity. CONCLUSIONS Refractive and visual outcomes 3 months after SMILE for hyperopia were promising, given the high degree of hyperopia corrected and relatively reduced CDVA in this population. Undercorrection of more than 1.00 D in 5 eyes might be partly explained by latent hyperopia in these young patients. [J Refract Surg. 2019;35(1):24-30.].
Collapse
|
23
|
Reinstein DZ, Carp GI, Archer TJ, Day AC, Vida RS. Outcomes for Hyperopic LASIK With the MEL 90 ® Excimer Laser. J Refract Surg 2019; 34:799-808. [PMID: 30540362 DOI: 10.3928/1081597x-20181019-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 10/10/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To report the outcomes of laser in situ keratomileusis (LASIK) for hyperopia using the Triple-A ablation profile with the MEL 90 excimer laser (Carl Zeiss Meditec, Jena, Germany). METHODS This retrospective analysis included 1,383 eyes treated by LASIK for hyperopia using the Triple-A ablation profile with the MEL 90 at London Vision Clinic, London, United Kingdom, between September 2013 and December 2016. Inclusion criteria were attempted hyperopic correction of +0.25 diopters (D) or higher and corrected distance visual acuity (CDVA) of 20/40 or better. Patients were observed for 1 year after surgery. Standard outcomes analysis was performed. RESULTS One-year data were available for 1,350 (97%) eyes. Mean attempted spherical equivalent refraction (SEQ) was +2.77 ± 1.34 D (range: +0.13 to +6.50 D) and mean cylinder was -0.67 ± 0.66 D (range: 0.00 to -5.00 D). Mean age was 54 ± 11 years (range: 21 to 75 years), and 57% were female. Postoperative spherical equivalent was ±0.50 D in 73% and ±1.00 D in 93% of eyes. Uncorrected distance visual acuity was 20/20 or better in 75% of eyes, relative to 93% with preoperative CDVA of 20/20 or better. One line of CDVA was lost in 17% of eyes and two lines were lost in 0.6% of eyes. There was a clinically insignificant but statistically significant increase (P < .01) in contrast sensitivity at 3 and 6 cycles per degree (cpd) and no change for 12 and 18 cpd. CONCLUSIONS LASIK for hyperopia with the MEL 90 excimer laser was found to satisfy accepted criteria for safety, efficacy, and stability. [J Refract Surg. 2018;34(12):799-808.].
Collapse
|
24
|
Kaluzny BJ, Piotrowiak-Slupska I, Kaszuba-Modrzejewska M, Stachura J, Arba-Mosquera S, Verma S. Three-year outcomes after high hyperopia correction using photorefractive keratectomy with a large ablation zone. Br J Ophthalmol 2018; 103:849-854. [DOI: 10.1136/bjophthalmol-2017-311694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 06/14/2018] [Accepted: 07/07/2018] [Indexed: 11/04/2022]
Abstract
AimTo evaluate refractive and visual outcomes of photorefractive keratectomy (PRK) to treat high hyperopia using an aberration-neutral profile and large ablation zone.MethodsThis was a retrospective, consecutive observational case series at the Oftalmika Eye Hospital, Bydgoszcz, Poland. We included 51 consecutive eyes of 34 patients who underwent alcohol-assisted PRK to correct hyperopia within the range of +3.6 to +6.15 D (mean+4.61±0.67 D). Procedures were performed with an Amaris 750S excimer laser (Schwind eye-tech-solutions GmbH, Kleinostheim, Germany) using an aberration-neutral profile and a 10 mm total ablation zone. Refractive results, predictability, safety and efficacy were evaluated 3 years postoperatively.ResultsAt 1-year postsurgery, the mean manifest refraction spherical equivalent (MRSE) was −0.002±0.43 D and mean cylinder was −0.181±0.31 D, while the values were +0.09±0.46 D and −0.15±0.26 D, respectively, at 2 years (MRSE p<0.001) and +0.15±0.44 D and −0.15±0.26 D, respectively, at 3 years (MRSE p<0.001). 78% of eyes were within ±0.50 D of the attempted spherical equivalent correction. Three years postoperatively, 22% of eyes lost one line of corrected distance visual acuity and 27% gained a line or two. The change in the mean corneal spherical aberrations for the 6 mm zone was from 0.27±0.07 to 0.08±0.13 µm.ConclusionsHigh hyperopia correction with PRK using an aberration-neutral profile and large ablation zone provides good efficacy, safety, predictability and visual outcomes. Relatively low change of corneal spherical aberrations and low increase of hyperopia in the first three postoperative years were observed.
Collapse
|
25
|
Frings A, Intert E, Steinberg J, Druchkiv V, Linke SJ, Katz T. Outcomes of retreatment after hyperopic laser in situ keratomileusis. J Cataract Refract Surg 2017; 43:1436-1442. [PMID: 29223233 DOI: 10.1016/j.jcrs.2017.08.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 08/01/2017] [Accepted: 08/04/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE To evaluate the efficacy, predictability, and safety of laser in situ keratomileusis (LASIK) retreatment in eyes with hyperopia. SETTING Multicenter refractive surgery centers and University Hospital, Germany. DESIGN Retrospective case series. METHODS This multicenter study included hyperopic patients with a preoperative difference between cycloplegic and manifest refraction of 1.00 diopter (D) or less who had LASIK retreatment based on manifest refraction. The refractive outcome was analyzed according to standard graphs for reporting the efficacy, predictability, and safety of refractive surgery. RESULTS One hundred thirteen eyes of 113 consecutive hyperopic patients were enrolled. Efficacy (P < .001) and safety (P = .004) were statistically significantly improved by retreatment without being negatively influenced by preoperative manifest spherical equivalent (SE), manifest cylinder, or keratometry. In cases still showing a trend toward undercorrection, retreatment resulted in 88 eyes (78.0%) being within ±0.50 D of the attempted correction. The optical zone (OZ) diameter of the retreatment did not correlate with efficacy, predictability, or safety. CONCLUSIONS Retreatment after hyperopic LASIK resulted in high efficacy, predictability, and safety outcomes. The efficacy and safety of the retreatment were not affected by preoperative manifest SE, manifest cylinder, keratometry, or OZ diameter.
Collapse
Affiliation(s)
- Andreas Frings
- From the Department of Ophthalmology (Frings), Heinrich-Heine-University Düsseldorf, Düsseldorf, the Department of Ophthalmology (Intert, Steinberg, Druchkiv, Linke, Katz), University Medical Centre Hamburg-Eppendorf, zentrumsehstärke (Steinberg, Linke) Hamburg, and Care Vision (Steinberg, Druchkiv, Linke, Katz), Hamburg, Germany.
| | - Elisa Intert
- From the Department of Ophthalmology (Frings), Heinrich-Heine-University Düsseldorf, Düsseldorf, the Department of Ophthalmology (Intert, Steinberg, Druchkiv, Linke, Katz), University Medical Centre Hamburg-Eppendorf, zentrumsehstärke (Steinberg, Linke) Hamburg, and Care Vision (Steinberg, Druchkiv, Linke, Katz), Hamburg, Germany
| | - Johannes Steinberg
- From the Department of Ophthalmology (Frings), Heinrich-Heine-University Düsseldorf, Düsseldorf, the Department of Ophthalmology (Intert, Steinberg, Druchkiv, Linke, Katz), University Medical Centre Hamburg-Eppendorf, zentrumsehstärke (Steinberg, Linke) Hamburg, and Care Vision (Steinberg, Druchkiv, Linke, Katz), Hamburg, Germany
| | - Vasyl Druchkiv
- From the Department of Ophthalmology (Frings), Heinrich-Heine-University Düsseldorf, Düsseldorf, the Department of Ophthalmology (Intert, Steinberg, Druchkiv, Linke, Katz), University Medical Centre Hamburg-Eppendorf, zentrumsehstärke (Steinberg, Linke) Hamburg, and Care Vision (Steinberg, Druchkiv, Linke, Katz), Hamburg, Germany
| | - Stephan J Linke
- From the Department of Ophthalmology (Frings), Heinrich-Heine-University Düsseldorf, Düsseldorf, the Department of Ophthalmology (Intert, Steinberg, Druchkiv, Linke, Katz), University Medical Centre Hamburg-Eppendorf, zentrumsehstärke (Steinberg, Linke) Hamburg, and Care Vision (Steinberg, Druchkiv, Linke, Katz), Hamburg, Germany
| | - Toam Katz
- From the Department of Ophthalmology (Frings), Heinrich-Heine-University Düsseldorf, Düsseldorf, the Department of Ophthalmology (Intert, Steinberg, Druchkiv, Linke, Katz), University Medical Centre Hamburg-Eppendorf, zentrumsehstärke (Steinberg, Linke) Hamburg, and Care Vision (Steinberg, Druchkiv, Linke, Katz), Hamburg, Germany
| |
Collapse
|
26
|
Reinstein DZ, Pradhan KR, Carp GI, Archer TJ, Gobbe M, Sekundo W, Khan R, Dhungana P. Small Incision Lenticule Extraction (SMILE) for Hyperopia: Optical Zone Diameter and Spherical Aberration Induction. J Refract Surg 2017; 33:370-376. [DOI: 10.3928/1081597x-20170331-01] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/09/2017] [Indexed: 11/20/2022]
|