Topography-guided CATz versus conventional LASIK for myopia with the NIDEK EC-5000: A bilateral eye study.

PURPOSE: To evaluate the difference in visual acuity, subjective night vision glare, and higher order aberrations in eyes with myopia with or without astigmatism operated with topography-guided customized corneal LASIK and conventional LASIK. METHODS: This contralateral study includes 46 eyes (23 patients) that underwent topography-guided corneal customized LASIK using the customized aspheric treatment zone (CATz) ablation profile in one eye and conventional LASIK using the NIDEK EC-5000 Advanced Vision Excimer laser system (NAVEX) in the other eye for myopia with or without astigmatism. Patients were masked to which eye underwent topography-guided CATz or conventional LASIK. Postoperative glare and root-mean-square (RMS) values for total higher order aberrations were measured at 1 and 3 months and compared between the two eyes. RESULTS: No significant difference was noted in uncorrected visual acuity between the two groups at 1 and 3 months postoperatively. Of all patients, 81% stated glare was higher in conventionally treated eyes than in the CATz-treated eyes at 1 and 3 months postoperatively. The RMS values for total coma (0.2385 vs 0.1522) and spherical aberration (0.2381 vs 0.1058) in conventionally treated and CATz-treated eyes were significantly higher in conventionally treated eyes (P=.029 and P=.004, respectively) at 3-month follow-up. CONCLUSIONS: Topography-guided corneal customized LASIK with the CATz profile gave better night vision quality as compared to conventional LASIK with expanded treatment zone. Better night vision quality was associated with less induced spherical aberrations and coma postoperatively in the CATz treatment group.

Frequency of retinal detachment after cataract surgery in highly myopic patients.

OBJECTIVE: To determine the potential risk factors for retinal detachment after cataract surgery. METHODS: In this retrospective cohort study, medical records of patients operated on between 2000 and 2010 at the Department of Ophthalmology, King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia were retrospectively reviewed for both demographic and clinical data. Cases were identified as having an ocular axial length >/=25 mm, while a control group of 500 eyes (axial length range; 22-24 mm) was sampled. Data were analyzed to compare both groups, and to assess potential risk factors for post-cataract retinal detachment. RESULTS: We reviewed 852 eyes of 721 patients; 352 eyes with documented high myopia were compared with 500 control eyes. After a mean follow up of 45.1 +/- 27.9 months, the postoperative mean LogMAR visual acuity significantly differed; 0.51 +/- 0.48 for cases and 0.38 +/- 0.41 for controls (p<0.0001). Controls showed significantly better postoperative vision as measured by LogMAR (0.92 +/- 0.7) than cases (0.71 +/- 0.61) (p<0.0001). Twelve eyes (1.4%) had retinal detachments postoperatively. The RD prevalence was significantly higher among cases (10 [2.8%]) than controls (2 [0.4%]) (p=0.007). High axial length was the only significant risk factor for retinal detachment (p=0.005) even after multivariate adjustment (p=0.019). CONCLUSION: High axial length among myopic cataract patients may increase the risk of postoperative retinal detachment.