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.
ABSTRACT
PURPOSE: To compare factors affecting patient satisfaction after femtosecond laser in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE) for myopia in the real-life situation study. METHODS: The SMILE group included 100 eyes (51 patients) and the FS-LASIK group 200 eyes (102 patients). In addition to clinical examination, dry eye symptoms and patient satisfaction with far and near vision were reported and graded on the visual analog scale preoperatively and one month after the operation. Case-control pairs were selected for the SMILE patients from FS-LASIK-treated patients to ensure the homogeneity in spherical equivalent refraction, preoperative dry eye, and visual satisfaction. RESULTS: Eighty percent of SMILE eyes and 83% of FS-LASIK eyes achieved an uncorrected distance visual acuity of 20/20 or better. Predictability (±0.5 D of mean target spherical equivalent refraction) was 91% in SMILE and 93.5% in FS-LASIK. No eyes lost two or more Snellen lines of corrected distance visual acuity. Based on case-control pairs, dry eye symptoms remained the same after one month in the FS-LASIK-treated eyes (P=0.87) but decreased in the SMILE-treated eyes (P=0.01) compared with the preoperative situation. Patient satisfaction with far vision improved significantly in both groups (P<0.001), but satisfaction with near vision improved significantly only in FS-LASIK (P<0.001) and not in SMILE (P=0.58). There was more postoperative astigmatism in SMILE in comparison with FS-LASIK (P=0.002). CONCLUSIONS: In a real-life situation, patients with preoperative dry eye experience were often directed to the SMILE operation, which resulted in beneficial decrease in their dry eye symptoms. Patient satisfaction with far vision decreased with increasing dry eye symptoms and postoperative astigmatism in both SMILE- and FS-LASIK-treated emmetropic patients. Safety, efficacy, and predictability were comparable in both treatments.
ABSTRACT
PURPOSE: To present the outcomes of laser-assisted in situ keratomileusis (LASIK) operations performed with the new three-dimensional, transportable FEMTO LDV Z6 I femtosecond laser (Ziemer Ophthalmic Systems, Port, Switzerland) and the Allegretto Wave Concerto 500 Hz excimer laser (Wavelight AG, Erlangen, Germany) in terms of accuracy, reproducibility and safety of flap creation. METHODS: This is a retrospective study of 309 consecutive eyes of 160 patients treated with the FEMTO LDV Z6 I for corneal flap creation. The target flap thickness was 90 µm. The size of the suction ring varied from 9.5 to 10.0 mm and target flap diameter from 9.3 to 9.6 mm, respectively. The target hinge length was 4.0 mm. RESULTS: The FEMTO LDV Z6 I produced the 90-µm targeted flaps very consistently (mean 90.1 ± 2.7 µm, range 78-100). Mean flap diameter with the 9.3-mm target flap diameter was 9.3 ± 0.1 mm (range 9.0-9.6) and with the 9.6-mm target flap diameter 9.6 ± 0.1 mm (range 9.0-9.8). Mean hinge length was 3.9 ± 0.1 mm (range 3.3-4.2). Minor complications were reported in 15 (5%) eyes, but none of them prevented refractive laser treatment. The most common complications were bubbles in the conjunctiva (n = 7, 2%) and an opaque bubble layer inside the flap margin (n = 6, 2%). None of the eyes lost two Snellen lines of corrected distance visual acuity during 1-month follow-up. CONCLUSIONS: In the hands of an experienced surgeon, the transfer from the Classic FEMTO LDV to Z6 I was a safe and straight forward process yielding accurate and reproducible flaps.
