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Moshirfar M, Omidvarnia S, Christensen MT, Porter KB, Theis JS, Olson NM, Stoakes IM, Payne CJ, Hoopes PC. Comparative Analysis of Corneal Higher-Order Aberrations after Laser-Assisted In Situ Keratomileusis, Photorefractive Keratectomy, and Small Incision Lenticule Extraction with Correlations to Change in Myopic Q-Value and Spherical Equivalent with and without Astigmatism. J Clin Med 2024; 13:1906. [PMID: 38610671 PMCID: PMC11012266 DOI: 10.3390/jcm13071906] [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: 02/05/2024] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
Background: This retrospective chart review compared the higher-order aberrations (HOAs) among photorefractive keratectomy (PRK), laser-assisted in situ keratomileusis (LASIK), and small incision lenticule extraction (SMILE) alongside changes in spherical equivalent (SEQ) and corneal shape (Q-value). Methods: Analyzing 371 myopic eyes, including 154 LASIK, 173 PRK, and 44 SMILE cases, Pentacam imaging was utilized pre-operatively and at one-year post-operative visits. Results: All procedures resulted in 100% of patients achieving an uncorrected distance visual acuity (UDVA) of 20/40 or better, with 87% of LASIK and PRK, and 91% of SMILE patients having 20/20 or better. Significant increases in HOAs were observed across all procedures (p < 0.05), correlating positively with SEQ and Q-value changes (LASIK (0.686, p < 0.05), followed by PRK (0.4503, p < 0.05), and SMILE (0.386, p < 0.05)). Vertical coma and spherical aberration (SA) were the primary factors for heightened aberration magnitude among the procedures (p < 0.05), with the largest contribution in SMILE, which is likely attributed to the centration at the corneal apex. Notably, PRK showed insignificant changes in vertical coma (-0.197 µm ± 0.0168 to -0.192 µm ± 0.0198, p = 0.78), with an increase in oblique trefoil (p < 0.05). Conclusions: These findings underscore differences in HOAs among PRK, LASIK, and SMILE, helping to guide clinicians.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, 11820 S. State St., Ste. 200, Draper, UT 84020, USA; (I.M.S.); (C.J.P.); (P.C.H.)
- John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
- Utah Lions Eye Bank, Murray, UT 84107, USA
| | | | | | - Kaiden B. Porter
- School of Medicine, University of Arizona, Phoenix, AZ 85004, USA; (K.B.P.); (J.S.T.)
| | - Josh S. Theis
- School of Medicine, University of Arizona, Phoenix, AZ 85004, USA; (K.B.P.); (J.S.T.)
| | - Nathan M. Olson
- College of Osteopathic Medicine, Rocky Vista University, Ivins, UT 84738, USA;
| | - Isabella M. Stoakes
- Hoopes Vision Research Center, Hoopes Vision, 11820 S. State St., Ste. 200, Draper, UT 84020, USA; (I.M.S.); (C.J.P.); (P.C.H.)
- School of Osteopathic Medicine, Pacific Northwest University of Health Sciences, Yakima, WA 98901, USA
| | - Carter J. Payne
- Hoopes Vision Research Center, Hoopes Vision, 11820 S. State St., Ste. 200, Draper, UT 84020, USA; (I.M.S.); (C.J.P.); (P.C.H.)
- School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Phillip C. Hoopes
- Hoopes Vision Research Center, Hoopes Vision, 11820 S. State St., Ste. 200, Draper, UT 84020, USA; (I.M.S.); (C.J.P.); (P.C.H.)
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Tian G, Chen T, Liu X, Lin Y, Li N, Gao H, Liu M. Comparison of central corneal thickness treated with small incision lenticule extraction, femtosecond laser-assisted in situ keratomileusis, or laser-assisted subepithelial keratomileusis for myopia. Lasers Med Sci 2023; 38:198. [PMID: 37656340 DOI: 10.1007/s10103-023-03862-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023]
Abstract
To compare the central corneal thickness (CCT) treated with small incision lenticule extraction (SMILE), femtosecond laser-assisted in situ keratomileusis (FS-LASIK), or laser-assisted subepithelial keratomileusis (LASEK) for myopia correction. This was a retrospective case series study. Patients who had completed 1-year follow-up after receiving SMILE, FS-LASIK, or LASEK at our hospital from January 2019 to July 2021 were included. Pentacam pachymetry was performed to measure the CCT. The predicted CCT reduction was obtained through laser platform. The measured CCT reduction was defined as the difference between the preoperative and postoperative CCT using Pentacam pachymetry. There were 100 eyes treated by SMILE, 100 eyes by FS-LASIK, and 100 eyes by LASEK. There was a significant difference in predicted CCT reduction among the three surgeries (P < 0.001), but no significant difference in measured CCT reduction postoperatively (PGroup = 0.373). At 1 year postoperatively, the CCT reduction was overestimated by 17.85 ± 5.36 µm in the SMILE group, underestimated by 4.31 ± 7.08 µm in the FS-LASIK group, and underestimated by 7.60 ± 8.28 µm in the LASEK group (PGroup < 0.001, PTime < 0.001). In the FS-LASIK group, the difference between predicted and measured CCT reduction was not related to the predicted CCT reduction (P = 0.095). The laser platform may overestimate the CCT reduction for SMILE and underestimate it for FS-LASIK and LASEK. FS-LASIK has a much higher level of accuracy in CCT reduction, which is not influenced by refractive correction.
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Affiliation(s)
- Ge Tian
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, 372 Jingsi Road, Jinan, 250021, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Tong Chen
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, 372 Jingsi Road, Jinan, 250021, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Xin Liu
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, 372 Jingsi Road, Jinan, 250021, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Yue Lin
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, 372 Jingsi Road, Jinan, 250021, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Na Li
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, 372 Jingsi Road, Jinan, 250021, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Hua Gao
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, 372 Jingsi Road, Jinan, 250021, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Mingna Liu
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, 372 Jingsi Road, Jinan, 250021, China.
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China.
- School of Ophthalmology, Shandong First Medical University, Jinan, China.
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Castro C, Sousa P, Abreu AC, Monteiro S, Pinto MDC. Refractive Management of Surgical-Induced Presbyopia in a Young Patient with Vision-Related Quality of Life Complaints: A Case Report. Case Rep Ophthalmol 2023; 14:602-606. [PMID: 37942232 PMCID: PMC10629854 DOI: 10.1159/000534431] [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: 06/08/2023] [Accepted: 10/02/2023] [Indexed: 11/10/2023] Open
Abstract
Visual difficulties can negatively impact life quality. Our purpose was to report the refractive surgical planning and outcomes of a young patient with mixed astigmatism and phacoemulsification-induced presbyopia due to congenital cataracts who was unsatisfied with her vision-related quality of life. A 32-year-old woman, submitted to phacoemulsification with implantation of a monofocal intraocular lens (IOL) and Nd:YAG laser posterior capsulotomy 3 years before, due to congenital cataracts, was referred to the Refractive Surgery Unit of Centro Hospitalar Universitário de Santo António. She had mixed astigmatism (+1.00-4.00 × 10° in the right eye [RE] and +0.50-1.75 × 180° in the left eye [LE]) and surgical-induced presbyopia, was intolerant to contact lenses, and felt that her vision significantly impaired her life quality. A trifocal Sulcoflex® (Rayner) IOL was implanted to correct the spherical and near refractive errors. In a second surgical time, a photorefractive keratectomy was performed to correct the residual astigmatism (-3.50 × 10° in the RE and -1.50 × 170° in the LE). In the last visit, distance and near uncorrected visual acuity were 20/20 (Snellen) and Jaeger 1, respectively, in both eyes, and the patient was very satisfied. When assessing the surgical options of young, working-age patients, clinicians should, when possible, consider alternative solutions to monofocal IOLs. In this patient, the combination of corneal and intraocular procedures allowed the correction of both the distance and near refractive errors, with a subsequent significant improvement in the patient's quality of life.
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Affiliation(s)
- Catarina Castro
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Paulo Sousa
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Ana Carolina Abreu
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Sílvia Monteiro
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Maria do Céu Pinto
- Department of Ophthalmology, Centro Hospitalar Universitário de Santo António, Porto, Portugal
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Vieira R, Marta A, Abreu AC, Monteiro S, Brochado MDC. Quality of Vision After LASIK, PRK and FemtoLASIK: An Analysis Using the Double Pass Imaging System HD AnalyzerTM ®. Clin Ophthalmol 2022; 16:3351-3359. [PMID: 36237491 PMCID: PMC9553308 DOI: 10.2147/opth.s373448] [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: 05/19/2022] [Accepted: 07/13/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose Analyze and compare the quality of vision of Photorefractive keratectomy (PRK), LASER in situ keratomileusis with mechanical microkeratome (LASIK) and femtosecond-assisted LASIK (FS-LASIK) using the double-pass imaging system HD AnalyzerTM®. Setting Ophthalmology department of Centro Hospitalar Universitário do Porto (CHUPorto). Design Retrospective, non-randomized, single center study. Methods Analysis of three equivalent groups of patients submitted to PRK, LASIK and FS-LASIK at our department. The objective quality of vision assessment included the objective scatter index (OSI), the modular transfer function cutoff frequency (MTF) and the predicted visual acuity within the 100% (PVA), 20% (PVA20) and 9% contrast levels (PVA9) that were evaluated at baseline, 1st week, 1 and 6 months after surgery. Results 118 eyes were included: 40 underwent LASIK, 43 FS-LASIK and 35 PRK. The mean age was 30.6±4.6 years old and 56% were female. There was a significant impact concerning the type of procedure in the objective quality of vision analysis (Repeated measures ANOVA): the FS-LASIK group showed lower OSI values overtime [F(1,2)=4.566, p=0.012, OSI 0.83±0.53 (FS-LASIK) vs 0.87±0.47 (PRK) and 1.21±1.44 (LASIK)], higher MTF values [F(1,2)=6.569, p=0.002, MTF 40.17±8.33 vs 32.37±11.4 (PRK) and 30.26±10.28 (LASIK)], higher PVA 100% [F(1,2)=10.871, p<0.001], PVA 20% [F(1,2)=9.737, p<0.001] and PVA 9% [F(1,2)=6.335), p=0.003]. Conclusion In our study, FS-LASIK showed an excellent optical performance through the HD AnalyzerTM technology, with significantly lower OSI and higher MTF, PVA100, PVA20 and PVA9 values. According to our results, this procedure seems to be superior to PRK and LASIK regarding visual quality objective parameters.
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Affiliation(s)
- Rita Vieira
- Refractive Surgery Unit of Ophthalmology Department of Centro Hospitalar Universitário do Porto (CHUPorto), Oporto, Portugal,Correspondence: Rita Vieira, Tel +351 913748812, Email
| | - Ana Marta
- Refractive Surgery Unit of Ophthalmology Department of Centro Hospitalar Universitário do Porto (CHUPorto), Oporto, Portugal
| | - Ana Carolina Abreu
- Refractive Surgery Unit of Ophthalmology Department of Centro Hospitalar Universitário do Porto (CHUPorto), Oporto, Portugal
| | - Sílvia Monteiro
- Refractive Surgery Unit of Ophthalmology Department of Centro Hospitalar Universitário do Porto (CHUPorto), Oporto, Portugal
| | - Maria do Céu Brochado
- Refractive Surgery Unit of Ophthalmology Department of Centro Hospitalar Universitário do Porto (CHUPorto), Oporto, Portugal
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