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Jiang D, Guo N, Lv X, Li Y, Han Y, Yuan M, Zhai C, Zhang W, Zhang F. Association between Fundus Tessellation and Contrast Sensitivity in Myopic Eyes. Curr Eye Res 2024; 49:188-196. [PMID: 37846084 DOI: 10.1080/02713683.2023.2269612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 10/07/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE To assess the association of fundus tessellation with contrast sensitivity, Quality of Vision questionnaire, and other factors at five years postcorneal refractive surgery. METHODS This is a cross-sectional study. Both eyes of 98 subjects (196 eyes) who received femtosecond laser in situ keratomileusis (FS-LASIK) or small incision lenticular extraction (SMILE) five years prior were enrolled in this study. Fundus tessellation was imaged using wide-angle fundus photographs and graded into four categories with the assistance of the ETDRS grid. Photopic and mesopic contrast sensitivity were measured under the best correction. The Quality of Vision (QoV) questionnaire was used to assess visual symptoms. RESULTS Fundus tessellation was classified as follows: 19 eyes were grade 0 (9.7%), 28 eyes were grade 1 (14.3%), 59 eyes were grade 2 (30.1%), and 90 eyes were grade 3 (45.9%). Higher degrees of fundus tessellation were associated with lower photopic contrast sensitivity, a significant difference was observed at spatial frequencies of 6cpd (p = 0.030, grade 1 >grade 3 p = 0.011). Higher degrees of fundus tessellation were also associated with lower mesopic contrast sensitivity, a significant difference was observed at spatial frequencies of 18cpd (p = 0.011, grade 0 >grade 3 p = 0.012). The preoperative degree of myopia was positively associated with fundus tessellation grade (p < 0.001). However, in linear mixed-effect model analysis, no significant influence of parameters (contrast sensitivity, preoperative myopia, and QoV scores) upon different tessellation grades was found (p > 0.05). CONCLUSIONS Patients with moderate and high myopia were more likely to have higher grades of fundus tessellation. Higher degree of fundus tessellation associates with lower contrast sensitivity. Patients with moderate and high myopia should be concerned with retinal-choroidal changes. Contrast sensitivity could be a clinical sign for progression of tessellation and used to screen for early retinal-choroidal changes to prevent pathologic myopia.
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Affiliation(s)
- Dianjun Jiang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China
| | - Ning Guo
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China
| | - Xiaotong Lv
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China
| | - Yu Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China
| | - Yu Han
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China
| | - Mingzhen Yuan
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China
| | - Changbin Zhai
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China
| | - Wei Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China
| | - Fengju Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Lab, Beijing, China
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Pradhan KR, Arba Mosquera S. Comparing high and low energy outcomes on day one for SmartSight myopic-astigmatism treatments with the SCHWIND ATOS: a retrospective case series. BMC Ophthalmol 2023; 23:328. [PMID: 37464345 DOI: 10.1186/s12886-023-03076-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/12/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Impact of low energy asymmetric spacings vs. high energy symmetric spacings on the immediate/early (postoperative day 1 (POD1)) outcomes of SmartSight lenticule extraction for myopic astigmatism with a new femtosecond laser system. METHODS The first 112 eyes of 56 patients consecutively treated using low energy asymmetric spacings (Group A; Study group) were compared at POD1 to the last 112 eyes of 56 patients consecutively treated using high energy symmetric spacings (Group S; Controls). Mean age of the patients was 28 ± 5 years with a mean spherical equivalent of -4.41 ± 1.76 diopters (D) and a mean magnitude of refractive astigmatism of 0.89 ± 0.82 D. RESULTS Laser Energy was -25 ± 1nJ lower for asymmetric treatments (p < .0001); Spot and Track distances were + 0.7 ± 0.1 µm larger and -0.8 ± 0.1 µm tighter for asymmetric treatments, respectively (p < .0001 for both). At POD1, astigmatism was -0.08 ± 0.02D lower for asymmetric treatments (p < .0003); uncorrected and corrected visual acuities (UDVA and CDVA, respectively) were -0.03 ± 0.01logMAR better for asymmetric treatments (p < .0007); differences between postop UDVA and preop CDVA along with change in CDVA were + 0.3 ± 0.1lines better for asymmetric treatments (p < .0003). CONCLUSIONS Lenticule extraction treatment using SmartSight is safe and efficacious already at POD1. Findings suggest that low energy asymmetric spacings may further improve the immediate and short-term outcomes of SmartSight lenticule extraction in the treatment of myopic astigmatism compared to conventional settings (high energy symmetric spacings).
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Affiliation(s)
- Kishore Raj Pradhan
- Matrika Eye Center, Dhunge Dhara Marg, Ward number 9, Kathmandu, 44600, Nepal
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Liang S, Ji S, Liu X, Chen M, Lei Y, Hou J, Li M, Zou H, Peng Y, Ma Z, Liu Y, Jhanji V, Wang Y. Applying Information Gain to Explore Factors Affecting Small-Incision Lenticule Extraction: A Multicenter Retrospective Study. Front Med (Lausanne) 2022; 9:837092. [PMID: 35592861 PMCID: PMC9110865 DOI: 10.3389/fmed.2022.837092] [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: 12/16/2021] [Accepted: 03/28/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose This retrospective study aimed to identify the key factors influencing postoperative refraction after small-incision lenticule extraction (SMILE) using information gain. Methods This study comprised 2,350 eyes of 1,200 patients who underwent SMILE using a Visumax 500-kHz femtosecond laser (Carl Zeiss Meditec AG) in three ophthalmic centers: Tianjin Eye Hospital (center A), Jinan Mingshui Eye Hospital (center B), and Qingdao Eye Hospital (center C). Anterior segment features, including corneal curvature and central corneal thickness (CCT), were obtained from Pentacam HR (Oculus, Wetzlar, Germany). Information gain was calculated to analyze the importance of features affecting postoperative refraction. Results Preoperative and postoperative mean spherical equivalent (SE) refraction were −5.00 (−6.13, −3.88) D and 0.00 (−0.25, 0.13) D, respectively. None of the patients lost more than two lines of corrected distance visual acuity. The safety index was 1.32 ± 0.24, 1.03 ± 0.08, and 1.13 ± 0.16 in centers A, B, and C, respectively. The efficacy index was 1.31 ± 0.25, 1.02 ± 0.08, and 1.13 ± 0.17 in centers A, B, and C, respectively. At least 95% of the eyes were within ±1.00 D of the attempted correction. Postoperative refraction was related to preoperative spherical diopter refraction (r = 0.369, p < 0.001), preoperative SE (r = 0.364, p < 0.001), maximum lenticule thickness (r = −0.311, p < 0.001), preoperative uncorrected distance visual acuity (r = 0.164, p < 0.001), residual stromal thickness (r = 0.139, p < 0.001), preoperative mean anterior corneal curvature (r = −0.127, p < 0.001), preoperative flattest anterior corneal curvature (r = −0.122, p < 0.001), nomogram (r = −0.100, p < 0.001) and preoperative CCT (r = −0.058, p = 0.005). Conclusions SMILE was considered a safe and effective procedure for correcting myopia. Based on information gain, postoperative refraction was influenced by preoperative mean anterior corneal curvature, CCT, refraction, and residual stromal thickness.
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Affiliation(s)
- Shuang Liang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Shufan Ji
- School of Computer Science and Engineering, Beijing University of Aeronautics and Astronautics, Beijing, China
| | - Xiao Liu
- School of Computer Science and Engineering, Beijing University of Aeronautics and Astronautics, Beijing, China
| | - Min Chen
- Qingdao Eye Hospital, Shandong First Medical University, Qingdao, China
| | - Yulin Lei
- Jinan Mingshui Eye Hospital, Jinan, China
| | - Jie Hou
- Jinan Mingshui Eye Hospital, Jinan, China
| | - Mengdi Li
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Haohan Zou
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Yusu Peng
- Qingdao Eye Hospital, Shandong First Medical University, Qingdao, China
| | - Zhixing Ma
- Jinan Mingshui Eye Hospital, Jinan, China
| | - Yuanyuan Liu
- Department of Health Statistics, College of Public Health, Tianjin Medical University, Tianjin, China
| | - Vishal Jhanji
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Yan Wang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China.,Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin Eye Institute, Nankai University Affiliated Eye Hospital, Tianjin, China
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Brar S, Ganesh S, Gautam M, Devi RC. Comparison of Clinical Outcomes and Visual Quality Using a Medium Versus Small Contact Glass in Patients Undergoing SMILE With Large Corneal Diameters. J Refract Surg 2021; 37:150-157. [PMID: 34038297 DOI: 10.3928/1081597x-20201222-02] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the clinical outcomes and visual quality using a small (S) versus medium (M) size contact glass in eyes with large white-to-white (WTW) distance undergoing bilateral small incision lenticule extraction (SMILE) for myopia correction. METHODS This contralateral eye study involved 60 eyes of 30 patients (mean age: 27.20 years) undergoing bilateral SMILE for myopia/myopic astigmatism with a WTW distance of 12 mm or greater in both eyes, which were randomized to receive treatment with an S-contact glass in one eye and an M-contact glass in the fellow eye. Opaque bubble layer (OBL) was graded using a new grading system. On postoperative 1 day, 2 weeks, and 3 months, UDVA, CDVA, contrast sensitivity, Objective Scatter Index, and modulation transfer function cut-off values were compared between the two groups. RESULTS The mean OBL score was significantly lower in the S-contact glass group (28.18%) compared to the M-contact glass group (67.13%) (P < .01). At 1 day postoperatively, the UDVA, Objective Scatter Index score, and contrast sensitivity values for all spatial frequencies were significantly better in eyes treated with the S-contact glass compared to the M-contact glass (P ⩽ .05). At 3 months postoperatively, however, the UDVA, Objective Scatter Index score, modulation transfer function cut-off, and contrast sensitivity values were comparable for both groups. No eye in either group had intraoperative complications such as suction loss, incision/lenticule tears, or lenticule retention. CONCLUSIONS In corneas with a WTW distance of 12 mm or greater, docking with the S-contact glass resulted in significantly better immediate visual results due to less OBL formation and smoother tissue dissection compared to the M-contact glass. [J Refract Surg. 2021;37(3):150-157.].
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Tay E, Bajpai R. Visual recovery after small incision lenticule extraction (SMILE) in relation to pre-operative spherical equivalent. Graefes Arch Clin Exp Ophthalmol 2020; 259:1053-1060. [PMID: 33047249 DOI: 10.1007/s00417-020-04954-8] [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] [Received: 08/13/2020] [Revised: 09/16/2020] [Accepted: 09/25/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To assess visual recovery after small incision lenticule extraction (SMILE) in relation to pre-operative spherical equivalent. METHODS Two hundred fourteen eyes of 107 patients were enrolled. Following surgery, patients were examined pre-operatively, 1 day, 2 weeks, 1 month and 3 months later. High myopia was defined as pre-operative spherical equivalent ≤ - 5 D. A linear mixed-effects model was used. RESULTS Mean ± standard deviation pre-operative spherical equivalent was - 5.30 ± 1.36 D that reduced significantly to 0.04 ± 0.70 D (p < 0.001) at 1 month and - 0.02 ± 0.66 D (p < 0.001) at 3 months. Mean pre-operative LogMAR uncorrected distance visual acuity ± SD was 0.97 ± 0.09 that improved significantly to 0.04 ± 0.06 at 2 weeks (p < 0.001), 0.01 ± 0.04 at 1 month (p < 0.001) and 0.01 ± 0.04 at 3 months (p < 0.001). Eighty-eight eyes (41.2%) had uncorrected distance visual acuities of 0.0 at 1 day, 154 eyes (72.0%) at 2 weeks,194 eyes (90.7%) at 1 month and 199 eyes (93.0%) at 3 months. Significantly more eyes with low myopia (> - 5 D) achieved acuities of 0.0 at 1 day and 2 weeks (p = 0.041 and p < 0.001). Post-operative acuities were not associated with refractive targets, laser cut energy settings or other variables. Two hundred nine eyes (97.7%) were within ± 0.5 D of target and 213 eyes (99.5%) were within ± 1 D. CONCLUSIONS SMILE for low myopia had faster visual recovery in the early post-operative period with no significant differences between groups detected by 1 and 3 months.
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Affiliation(s)
- Eugene Tay
- Singapore Eye Research Institute, The Academia, 20 College Road, Singapore, 169856, Singapore.
| | - Ram Bajpai
- School of Primary, Community and Social Care, Keele University, Keele, Staffordshire, ST5 5BG, UK
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Arba Mosquera S, Verma S. A review of clinical outcomes following SMILE for the treatment of astigmatism. EXPERT REVIEW OF OPHTHALMOLOGY 2020. [DOI: 10.1080/17469899.2020.1810017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Samuel Arba Mosquera
- Biomedical Engineering Office, Research and Development, SCHWIND Eye-tech-solutions GmbH, Kleinostheim, Germany
| | - Shwetabh Verma
- Biomedical Engineering Office, Research and Development, SCHWIND Eye-tech-solutions GmbH, Kleinostheim, Germany
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Wang Y, Zhang J, Qin M, Miao J, Chen W, Huang Y, Wu J, Guan Y, Guan H. Comparison of optical quality and distinct macular thickness in femtosecond laser-assisted versus phacoemulsification cataract surgery. BMC Ophthalmol 2020; 20:42. [PMID: 32007086 PMCID: PMC6995244 DOI: 10.1186/s12886-020-1319-3] [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: 09/03/2019] [Accepted: 01/17/2020] [Indexed: 11/12/2022] Open
Abstract
Background Optical quality and macular thickness changing optical quality is rarely reported after femtosecond laser-assisted cataract surgery (FLACS). In current research, we evaluated optical quality recovery and distinct macular thickness changes after FLACS and phacoemulsification cataract surgery (PCS). Methods A total of 100 cataract patients (100 eyes) were included (50 eyes for the FLACS group and 50 eyes for the PCS group). Modulation transfer function (MTF), point spread function (PSF) and dysfunctional lens index (DLI) were measured by a ray-tracing aberrometer (iTrace). Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were also assessed pre-operation,1 week and 1 month after surgery. The MTF values at spatial frequencies of 5, 10, 15, 20, 25 and 30 cycles/degree (c/d) were selected. We used optical coherence tomography (OCT) to assess the macular thickness of different regions pre-operatively and1month after the surgery. Results In PCS group, we found the statistically significant differences between pre-operation and post-operation in DLI (p < 0.0001), PSF (strehl ratio, SR) (p = 0.027) and MTF (p = 0.028), but not intraocular pressure (IOP) (p = 0.857). The differences between pre-operation and post-operation for DLI (p = 0.031), SR (p = 0.01) and IOP (p = 0.03), but not MTF (p = 0.128) were also found in FLACS group. The differences were statistically significant when the spatial frequencies were at 5, 10 and 25 (p = 0.013, 0.031 and 0.048) between pre-operation and post-operation in PCS group but not FLACS group at 1 month. In PCS group, we found the differences between pre-operation and post-operation in nasal inter macular ring thickness (NIMRT) (p = 0.03), foveal volume (FV) (p = 0.034) and average retinal thickness (ART) (p = 0.025) but not FLACS group at 1 month. Conclusion FLACS is safe that did not cause significant increase of macular thickness in current study. However, it also cannot produce better optical quality. In contrast, PCS can produce macular thickness changes, but better optical quality recovery. The slightly retinal change may not affect optical quality.
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Affiliation(s)
- Yong Wang
- Department of Ophthalmology, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China.,Nantong University, Nantong, Jiangsu, China
| | - Jinling Zhang
- Department of Ophthalmology, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China
| | - Miaomiao Qin
- Department of Ophthalmology, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China
| | - Jianguo Miao
- Department of Ophthalmology, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China
| | - Wei Chen
- Department of Ophthalmology, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China
| | - Yemeng Huang
- Department of Ophthalmology, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China
| | - Jian Wu
- Department of Ophthalmology, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China
| | - Yu Guan
- Department of Ophthalmology, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China
| | - Huaijin Guan
- Department of Ophthalmology, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, Jiangsu, China.
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Fluctuation in straylight measurements during the visual recovery phase after small incision lenticule extraction. Eye (Lond) 2019; 34:366-373. [PMID: 31399702 DOI: 10.1038/s41433-019-0552-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 05/11/2019] [Accepted: 06/14/2019] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To investigate the postoperative straylight changes during the visual recovery phase after small incision lenticule extraction (SMILE) and their association. METHODS Seventy consecutive eyes from 37 patients with a mean age of 30.92 ± 7.26 years and a mean preoperative spherical equivalent of -5.24 ± 1.90 dioptres undergoing myopic or myopic astigmatism SMILE correction were included in this prospective study. Patients were followed up at days 1, 3, 7, 14, 21 and 28 after standard SMILE. Straylight was measured using the C-Quant straylight meter (Oculus GmbH, Germany) preoperatively and at each postoperative visit. RESULTS Preoperatively, the mean straylight measurement was 1.16 ± 0.16. After SMILE, the mean straylight values were 1.12 ± 0.14 and 1.13 ± 0.13 at days 7 and 14, which were significantly reduced compared to preoperative values (p ≤ 0.028). Straylight returned to baseline by week 3 (p = 0.160) and remained stable onwards (p = 0.651). A lower ablation ratio was associated with less straylight level at days 1, 3, 14 and 21 (p ≤ 0.0497) in the multivariable regression model. Likewise, better visual acuity was associated with lower straylight at days 7, 14 and 28 postoperatively (p ≤ 0.038). A small proportion of eyes (range: 0-12.86%) had ≥0.30 log(s) increase in postoperative straylight within the first month after SMILE. CONCLUSIONS SMILE induced a temporary decrease in straylight. It gradually returned to the preoperative level, which could be related to a number of dynamic processes during corneal healing. In the small proportion of patients with an increase in straylight postoperatively, this can affect their visual recovery during the early postoperative period.
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