Laser in situ keratomileusis and surface ablation in pregnancy.

PURPOSE: Although corneal refractive surgery is contraindicated during pregnancy, some patients are unaware that they are pregnant when they undergo surgery. Our objectives were to determine the functional outcomes of corneal refractive surgery during pregnancy and to compare the results with those of nonpregnant women. METHODS: We performed a multicenter, retrospective, interventional case series review of patients who were pregnant and who underwent laser in situ keratomileusis (LASIK) or surface ablation (photorefractive keratectomy, PRK) from September 11, 2002 to December 12, 2020 (group 1, n=82 eyes). Patients were included consecutively. Findings were compared with those of nonpregnant women (group 2, n=164 eyes). Functional (visual and refractive) outcomes are described. Follow-up was at least 550 days (control group, median [IQR], 990 days [715-1496]; study group, 895 days [709-1310]). The setting was Clínica Baviera, Spain, (AIER Eye Hospital Group). RESULTS: A statistically significant difference was found between the groups in terms of efficacy index (EI). No complications of pregnancy or labor were reported. Similarly, a search of medical records revealed no adverse effects in the infants. CONCLUSIONS: To the best of our knowledge, this is the first case series on pregnancy and refractive surgery. We do not recommend performing LASIK or surface ablation on pregnant women. Our objective in the present study was to present relevant scientific data obtained from women who underwent refractive surgery while unaware that they were pregnant.

Resultados visuales, independencia de gafas e insatisfacción tras implante de una lente intraocular difractiva trifocal / Visual outcomes, spectacle independence and satisfaction after diffractive trifocal intraocular lens implantation

OBJETIVO: Evaluar los resultados visuales, la independencia de gafas y la satisfacción tras el implante de una lente intraocular trifocal. MÉTODOS: Estudio retrospectivo de 5.186 sujetos intervenidos de facoemulsificación con implante de la lente trifocal difractiva FineVision Micro F12 (PhysIOL, Liège, Bélgica). RESULTADOS: La queratometría media preoperatoria fue 43,61±1,55 D y el cilindro queratométrico medio -0,86 ± 0,66 D. A los 3 meses, cambiaron a 43,59±1,56 y −0,71±0,46 D respectivamente. La esfera media pasó de 2,04±2,60 a 0,14±0,38 D y el equivalente esférico medio de 1,64±2,61 a −0,05±0,36 D. Más del 60% alcanzaron una mejor agudeza visual corregida de lejos. La mayoría presentó un defecto residual final (predictibilidad) menor de 1 D (99,1%). El 14,3% precisó un ajuste refractivo, el 2,2% capsulotomía posterior y se recolocó la lente intraocular en 5 casos. Un porcentaje elevado estaba satisfecho en términos de visión e independencia de gafas en todas las distancias. Aunque un 2% refirió un empeoramiento en la visión nocturna, únicamente un 2% estaba poco satisfecho y 20 pacientes insatisfechos. Las causas fueron: visión borrosa (7 casos), necesidad de gafas (10), disfotopsias (7) y sequedad ocular (4). CONCLUSIONES: La implantación de esta lente permite obtener buenos resultados visuales en las 3 distancias así como un alto grado de independencia de gafas y de satisfacción

PURPOSE: To investigate visual outcomes, spectacle independence, and patient satisfaction after trifocal intraocular lens implantation. METHODS: A retrospective study conducted on 5,186 patients who underwent phacoemulsification and were implanted with a diffractive trifocal intraocular lens (FineVision Micro F, PhysIOL SA, Liège, Belgium). RESULTS: The mean pre-operative keratometry was 43.61±1.55 D, and mean keratometric cylinder was -0.86±0.66 D. At 3 months post-operatively, values changed to 43.59±1.56 and -0.71±0.46 D, respectively. Mean sphere varied from 2.04±2.60 to 0.14±0.38 D, and mean spherical equivalent from 1.64±2.61 to -0.05±0.36 D. More than 60% of the patients achieved better corrected distance visual acuity. The majority had a final residual refractive error (predictability) lower than 1 D (99.1%), with 14.3% needing optical adjustment (bioptics). Posterior capsulotomy was performed in 2.2%, and the lens was replaced in 5 patients. A high percentage of patients were satisfied in terms of vision and spectacle independence at all distances. Although 2% referred to worsening of night vision quality, only 2% were not very satisfied and 20 patients were dissatisfied. The causes were: blurred vision (7 cases), spectacle dependence (10), dysphotopsia (7), and dry eye (4). CONCLUSIONS: The implantation of this model provided good visual performance in all distances, as well as high levels of spectacle independence and satisfaction

Visual outcomes, spectacle independence and satisfaction after diffractive trifocal intraocular lens implantation. / Resultados visuales, independencia de gafas e insatisfacción tras implante de una lente intraocular difractiva trifocal.

PURPOSE: To investigate visual outcomes, spectacle independence, and patient satisfaction after trifocal intraocular lens implantation. METHODS: A retrospective study conducted on 5,186 patients who underwent phacoemulsification and were implanted with a diffractive trifocal intraocular lens (FineVision Micro F, PhysIOL SA, Liège, Belgium). RESULTS: The mean pre-operative keratometry was 43.61±1.55 D, and mean keratometric cylinder was -0.86±0.66 D. At 3 months post-operatively, values changed to 43.59±1.56 and -0.71±0.46 D, respectively. Mean sphere varied from 2.04±2.60 to 0.14±0.38 D, and mean spherical equivalent from 1.64±2.61 to -0.05±0.36 D. More than 60% of the patients achieved better corrected distance visual acuity. The majority had a final residual refractive error (predictability) lower than 1 D (99.1%), with 14.3% needing optical adjustment (bioptics). Posterior capsulotomy was performed in 2.2%, and the lens was replaced in 5 patients. A high percentage of patients were satisfied in terms of vision and spectacle independence at all distances. Although 2% referred to worsening of night vision quality, only 2% were not very satisfied and 20 patients were dissatisfied. The causes were: blurred vision (7 cases), spectacle dependence (10), dysphotopsia (7), and dry eye (4). CONCLUSIONS: The implantation of this model provided good visual performance in all distances, as well as high levels of spectacle independence and satisfaction.

Implantación de lente fáquica para corrección de miopía en pacientes con leucoma corneal / Implantable collamer lens for correction of ametropia in eyes with corneal scarring

CASOS: Comunicamos 2 casos en los que la implantación de una lente fáquica corrige defectos refractivos en ojos con leucoma. Ambos sufrieron un accidente hace años, quedando un leucoma lineal central en uno de sus ojos. El primero presentaba la lesión en su ojo izquierdo. Su agudeza visual corregida de lejos fue de 0,3 (−7,75; −4×160°). Tras implantar la lente fáquica alcanzó una agudeza visual no corregida de lejos de 0,3. El segundo mostraba en su ojo derecho una lesión oblicua con agudeza visual corregida de 0,25 (−8,75; −1,25×8°). Tras la intervención alcanzó una agudeza visual no corregida de 0,25. Discusión: Las indicaciones de la implantación de una lente fáquica son susceptibles de ser revisadas y, posiblemente, ampliadas

CASES: Two cases are reported in which implantation of a collagen copolymer phakic intraocular lens (implantable collamer lens) corrected refractive errors in eyes with corneal scarring. A previous accident, in both cases, resulted in a central linear scar on the surface of the cornea of one eye. In the first patient, a corneal scar was visible in the left eye. The distance corrected visual acuity was 0.3 (-7.75 -4×160°). An uncorrected distance visual acuity of 0.25 was obtained by implanting an implantable collamer lens. In the second patient an oblique corneal scar was visible in the right eye. The distance corrected visual acuity was 0.25 (-8.75 -1.25×8°), and after implantation of the implantable collamer lens, uncorrected distance visual acuity was 0.25. Discussion: The indications of the implantable collamer lens should be reviewed and possibly expanded

Implantable collamer lens for correction of ametropia in eyes with corneal scarring. / Implantación de lente fáquica para corrección de miopía en pacientes con leucoma corneal.

CASES: Two cases are reported in which implantation of a collagen copolymer phakic intraocular lens (implantable collamer lens) corrected refractive errors in eyes with corneal scarring. A previous accident, in both cases, resulted in a central linear scar on the surface of the cornea of one eye. In the first patient, a corneal scar was visible in the left eye. The distance corrected visual acuity was 0.3 (-7.75 -4×160°). An uncorrected distance visual acuity of 0.25 was obtained by implanting an implantable collamer lens. In the second patient an oblique corneal scar was visible in the right eye. The distance corrected visual acuity was 0.25 (-8.75 -1.25×8°), and after implantation of the implantable collamer lens, uncorrected distance visual acuity was 0.25. DISCUSSION: The indications of the implantable collamer lens should be reviewed and possibly expanded.

LASIK y ablación de superficie en pacientes tratados con amiodarona / LASIK and surface ablation in patients treated with amiodarone

OBJETIVO: Determinar los resultados anatómicos y funcionales de los pacientes intervenidos con cirugía refractiva corneal que estaban en tratamiento con amiodarona, la cual ha sido considerada como una posible contraindicación en estas intervenciones. MATERIAL Y MÉTODOS: Se ha realizado un estudio observacional retrospectivo. Los pacientes se incluyeron consecutivamente. Se incluyó a todos los pacientes que tomaban amiodarona y fueron operados mediante LASIK o ablación de superficie entre enero de 2003 y diciembre de 2014. Se pretenden describir los resultados funcionales (visuales y refractivos). RESULTADOS: Se incluyó a un total de 20 pacientes (33 ojos). No se encontraron complicaciones intraoperatorias o postoperatorias significativas. CONCLUSIONES: En nuestra experiencia los pacientes tratados con amiodarona e intervenidos mediante LASIK o ablación de superficie no presentaron complicaciones clínicas significativas. La contraindicación absoluta por tomar determinadas medicaciones sistémicas debería ser reconsiderada

OBJECTIVE: To determine the anatomical and functional outcomes of corneal refractive surgery in patients on amiodarone, a drug listed as being contraindicated in patients undergoing this procedure. MATERIAL AND METHODS: A retrospective observational study was conducted on all consecutive patients who took amiodarone and who underwent LASIK or surface ablation from January 2003 to December 2014. Functional (visual and refractive) outcomes are described. RESULTS: A total of 20 patients (33 eyes) were included. No significant intraoperative or postoperative complications were found. CONCLUSIONS: In our experience, LASIK and surface ablation did not produce significant clinical complications in selected patients taking amiodarone. The absolute exclusion of certain systemic medications should be reconsidered

LASIK and surface ablation in patients treated with amiodarone. / LASIK y ablación de superficie en pacientes tratados con amiodarona.

OBJECTIVE: To determine the anatomical and functional outcomes of corneal refractive surgery in patients on amiodarone, a drug listed as being contraindicated in patients undergoing this procedure. MATERIAL AND METHODS: A retrospective observational study was conducted on all consecutive patients who took amiodarone and who underwent LASIK or surface ablation from January 2003 to December 2014. Functional (visual and refractive) outcomes are described. RESULTS: A total of 20 patients (33 eyes) were included. No significant intraoperative or postoperative complications were found. CONCLUSIONS: In our experience, LASIK and surface ablation did not produce significant clinical complications in selected patients taking amiodarone. The absolute exclusion of certain systemic medications should be reconsidered.

Ectasia corneal post-LASIK en pacientes con diferencias significativas en las lecturas queratométricas de ambos ojos / Post-lasik corneal ectasia in patients with significant differences in keratometry readings between both eyes

OBJETIVOS: Investigar la incidencia de ectasia corneal tras queratomileusis in situ asistida por láser excímer (LASIK) en pacientes con diferencias significativas en la lectura queratométrica media (KM) entre ambos ojos (AO). Además se evalúan los resultados visuales. MÉTODOS: Se han revisado las historias clínicas de 164.603 pacientes (315.259 ojos) intervenidos con LASIK de enero de 2003 a diciembre de 2011 para identificar pacientes con una diferencia de KM ≥ 1,25 D entre AO. Además de este criterio, debían ser pacientes miopes con topografía corneal normal. Las principales variables de estudio fueron la incidencia de ectasia tras LASIK y el resultado visual. RESULTADOS: Un total de 35 ojos de 20 pacientes cumplieron con los criterios de inclusión y exclusión. Los resultados funcionales y visuales fueron los esperados para las refracciones estudiadas. No se encontraron ectasias en la serie estudiada tras un seguimiento mínimo de 2 años. CONCLUSIONES: La posibilidad de encontrar en un paciente asimetría de KM y topografía normal es pequeña (0,021%) y no parece ser una contraindicación para realizar LASIK. A pesar de no encontrarse ectasias en la serie estudiada, ya que esta es una complicación potencialmente grave para la visión, los pacientes con elevadas diferencias en la KM entre AO deben ser estudiados cuidadosamente antes de ser intervenidos mediante LASIK

OBJECTIVES: A study is made on the incidence of corneal ectasia after laser in situ keratomileusis (LASIK) in patients with large differences in mean keratometry (MK) readings between both eyes (OU). Visual outcomes were also evaluated. METHODS: The medical records of 164,603 patients (315,259 eyes) who underwent LASIK from January 2003 to December 2011 were reviewed in order to identify patients with a difference in MK of ≥ 1.25 D between OU. The main outcome measures were incidence of ectasia after LASIK, and visual outcome. RESULTS: A total of 35 eyes that met the inclusion criteria were found. Functional and visual results were those expected for myopia studies. After a minimum follow-up of 2 years, no corneal ectasia was found in 3 eyes (2 patients). CONCLUSIONS: The possibility of finding a patient with an asymmetry in MK and normal topography is low (0.021%), and it does not seem to be a contraindication of LASIK. Although no corneal ectasia was found in this case series, and as it is a potentially sight-threatening complication, patients with very different MK between OU should be studied carefully before undergoing LASIK

[Post-lasik corneal ectasia in patients with significant differences in keratometry readings between both eyes]. / Ectasia corneal post-LASIK en pacientes con diferencias significativas en las lecturas queratométricas de ambos ojos.

OBJECTIVES: A study is made on the incidence of corneal ectasia after laser in situ keratomileusis (LASIK) in patients with large differences in mean keratometry (MK) readings between both eyes (OU). Visual outcomes were also evaluated. METHODS: The medical records of 164,603 patients (315,259 eyes) who underwent LASIK from January 2003 to December 2011 were reviewed in order to identify patients with a difference in MK of ≥ 1.25 D between OU. The main outcome measures were incidence of ectasia after LASIK, and visual outcome. RESULTS: A total of 35 eyes that met the inclusion criteria were found. Functional and visual results were those expected for myopia studies. After a minimum follow-up of 2 years, no corneal ectasia was found in 3 eyes (2 patients). CONCLUSIONS: The possibility of finding a patient with an asymmetry in MK and normal topography is low (0.021%), and it does not seem to be a contraindication of LASIK. Although no corneal ectasia was found in this case series, and as it is a potentially sight-threatening complication, patients with very different MK between OU should be studied carefully before undergoing LASIK.