Sutureless Lyophilized Amniotic Membrane Grafting for Corneal Epithelial Defects.

OBJECTIVES: To report the tolerability, safety, and efficacy of the lyophilized amniotic membrane (AM) Visio-AMTRIX placed under a bandage contact lens (BCL) in treating persistent epithelial defects (PEDs). METHODS: This retrospective study included consecutive patients with PEDs treated with a lyophilized AM placed under the BCL. Patients with PEDs who did not respond to medical treatment were included. Patients with a follow-up time less than 3 months were excluded. RESULTS: Eleven eyes of 11 patients (mean age, 61.6±15.9 years) were included. Time from PED presentation to AM transplantation (AMT) was 27.7±4.9 days, with the mean PED area of 13.2±11.3 mm2. Complete resolution was achieved in 8 of 11 eyes after a single AM graft. The epithelial defect persisted after the first AMT in three eyes (27.3%), and a second graft was necessary to achieve complete healing. The corneal epithelial defect healed in an average of 11.0±4.4 days after grafting. After PED resolution, the best-corrected visual acuity significantly improved from 0.66±0.30 logMAR (20/91 Snellen) to 0.58±0.24 logMAR (20/77 Snellen) (P=0.036) compared with baseline. The AM resorbed within 2 weeks in all cases. No complication or recurrence was observed. CONCLUSIONS: A sutureless lyophilized AM under the BCL can resolve PEDs with a significant improvement in vision.

Presbyopic LASIK using the Supracor algorithm and micromonovision in presbyopic myopic patients: 12-month visual and refractive outcomes.

PURPOSE: To evaluate the visual and refractive outcomes for presbyopia and myopia treatment using the Teneo 317 M2 platform and the myopic Supracor algorithm. SETTING: Percy Military Hospital and Private Laser Victor Hugo Center, Paris, France. DESIGN: Observational retrospective nonrandomized study. METHODS: 50 eyes (25 patients) treated with bilateral myopic Supracor and micromonovision using the Teneo 317 M2 platform and followed up for 12 months. Study outcomes included binocular and monocular visual acuities (without correction for distance and near vision), the spherical equivalent, predictability, stability, safety, optical aberrations, and complications. RESULTS: The mean age was 50.6 ± 2.7 years, and the mean preoperative spherical equivalent was -2.6 ± 1.4 diopters. At 12 months postoperatively, the mean binocular uncorrected distance visual acuity was 0.02 ± 0.03 logMAR, and 24 patients (96%) achieved an acuity of 20/25 or better. The binocular uncorrected near visual acuity was equal to Jaeger 1 in 18 patients (72%) and Jaeger 2 or better in 23 patients (92%). 12 eyes (24%) had lost 1 Snellen line, and 1 eye (2%) had lost 2 Snellen lines of monocular corrected distance visual acuity. No cases required retreatment; however, 1 eye (2%) underwent revision surgery because of diffuse lamellar keratitis. CONCLUSIONS: This study suggests that Supracor using the Teneo 317 M2 platform is a safe and effective technique for myopia and presbyopia treatment. Supracor is therefore a viable alternative to monovision for presbyopia and myopia. However, a careful patient selection is essential to satisfy realistic expectations.

PresbyPRK vs presbyLASIK using the SUPRACOR algorithm and micromonovision in presbyopic hyperopic patients: visual and refractive results at 12 months.

PURPOSE: To compare the visual outcome and refractive results between presbyopic photorefractive keratectomy (presbyPRK) and presbyopic laser in situ keratomileusis (presbyLASIK) in presbyopic hyperopic patients using micromonovision and the SUPRACOR algorithm. SETTING: Percy Military Hospital and private Laser Victor Hugo Center, France. DESIGN: Observational retrospective nonrandomized. METHODS: Twenty-three patients who had undergone presbyPRK or presbyLASIK were included and followed up for 12-months. Far and near visual acuity without correction in monocular and binocular, measurement of distance visual acuity with correction in monocular, evaluation of spherical equivalent (SE), aberrometry, and patient satisfaction were measured and analyzed in this study. RESULTS: The study included 26 eyes of 13 patients in the presbyLASIK group and 20 eyes of 10 patients in the presbyPRK group. The mean age was 55.43 ± 4.6 years. Uncorrected binocular distance visual acuity was 0.030 ± 0.05 logMAR in the presbyLASIK group and 0 logMAR in the presbyPRK group (P = .066). Binocular near visual acuity without correction was 0.21 ± 0.11 logMAR in the presbyLASIK group and 0.30 ± 0.15 logMAR in the presbyPRK group (P = .0398). For the dominant eyes, the SE was -0.08 ± 0.48 diopters (D) in the presbyLASIK group and 0.16 ± 0.82 D in the presbyPRK group (P = .3995). For nondominant eyes, the SE was -0.44 ± 0.50 D in the presbyLASIK group and 0.12 ± 0.65 D in the presbyPRK group (P = .0254). CONCLUSIONS: PresbyPRK and presbyLASIK were comparable in efficacy, stability, predictability, and safety. PresbyPRK could be a safe and effective surgical alternative for the hyperopic presbyopic patient.