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1.
Transl Vis Sci Technol ; 11(6): 13, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35696132

RESUMO

Purpose: The purpose of this study was to explore the characteristics of pupil offset in young Asian adults with myopia. Methods: In total, 1200 eyes (600 young adults, 18-35 years old) were divided into mild-moderate and high groups according to equivalent spherical diopters (SEQ). The pupil offset and its X and Y components were compared between the groups. Linear correlation was analyzed among pupil offset, X and Y components, and SEQ. Multiple linear regression analysis was conducted for pupil offset and eye parameters. Results: The mean age of all subjects was 22.5 ± 4.8 years. The mean magnitude of the pupil offset (0.18 ± 0.09 mm vs. 0.15 ± 0.08 mm) and Y component (0.12 ± 0.08 mm vs. 0.10 ± 0.07 mm) were larger in the high group than in the mild-moderate group (P < 0.05). The magnitude of pupil offset, X and Y components, and SEQ were positively correlated. The pupil center (PC) of the right eye in the mild-moderate group was mainly superotemporal to the corneal vertex and mainly superonasal for the left eye and both eyes in the high group. Multiple linear regression analysis revealed that the magnitude of pupil offset correlated with central corneal thickness, intraocular pressure, and mean corneal curvature (P < 0.05). Conclusions: The magnitude of the pupil offset that correlated with partial eye parameters and its X and Y components increased as the SEQ increased, and the PC gradually shifted toward the superonasal direction in young Asian adults with myopia. Translational Relevance: Subjects with high myopia with a larger pupil offset should be considered for better postoperative visual quality during refractive surgery.


Assuntos
Ceratomileuse Assistida por Excimer Laser In Situ , Miopia , Adolescente , Adulto , Córnea/cirurgia , Humanos , Miopia/diagnóstico , Miopia/cirurgia , Pupila , Acuidade Visual , Adulto Jovem
2.
Medicine (Baltimore) ; 101(24): e29425, 2022 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-35713451

RESUMO

PURPOSE: To explore the offset distribution of pupillary centres, the offset between the pupil centre and the coaxially sighted corneal light reflex (P-Dist) and their correlation in femtosecond laser combined with excimer laser in situ keratomileusis. METHODS: Randomly selected 194 patients (398 eyes) who underwent femtosecond-assisted laser in situ keratomileusis with preoperative use of WaveLight Allegro Topolyzer Corneal Topography (WaveLight Laser Technologies AG, Erlangen, Germany) to measure the pupil size and centre position. The P-Dist of the patients was recorded by the X and Y axis eyeball tracking adjustment program of the WaveLight Eagle Vision EX500 excimer laser system. RESULTS: The P-Dist was 0.214 ±â€Š0.092 mm in the right eyes and 0.228 ±â€Š0.105 mm in the left eyes (P = .041). Under scotopic conditions, the pupil centre of left eye X-axis was -0.046 ±â€Š0.091 mm, the right eye was -0.152 ±â€Š0.084 mm, with significant differences (P = .015), and the Y-axis direction showed no significant changes (P = .062). The white to white was positively correlated with changes of pupil diameter (scotopic pupil diameter-photopic pupil diameter) (r = 0.270, P < .001). The equivalent spherical mirror and measured centroid shift were negatively correlated (r = -0.214, P = .002). CONCLUSION: The angle kappa of the right eye is smaller than that of the left eye and from scotopic to photopic condition, the pupil centroid shift of both eyes to the nasal inferior side. If the cornea is too large, the low illumination environment should be maintained during the operation to improve the efficiency of pupil matching.


Assuntos
Ceratomileuse Assistida por Excimer Laser In Situ , Miopia , Córnea/cirurgia , Topografia da Córnea , Humanos , Lasers de Excimer , Miopia/cirurgia , Refração Ocular
3.
J Refract Surg ; 38(6): 348-354, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35686714

RESUMO

PURPOSE: To report the long-term clinical experience following femtosecond intrastromal lenticule implantation (FILI) for the management of moderate to high hyperopia. METHODS: Eligible patients who underwent FILI for moderate to high hyperopia from July 2013 to October 2020 were included. A donor small incision lenticule extraction lenticule, matched for refractive error, was implanted into the recipient's corneal pocket created using a femtosecond laser at 160 µm depth. Visual and refractive outcomes and long-term complications were evaluated at the end of a mean follow-up of 68 ± 17.28 months (5.6 years). RESULTS: Forty-two eyes of 25 patients (mean age: 27.29 ± 5.52 years) were analyzed. The mean spherical equivalent reduced significantly from +5.50 ± 1.96 to +0.66 ± 1.17 diopters (D) at last follow-up visit. Thirty eyes (71%) were within ±1.00 D of spherical equivalent correction. Cumulative uncorrected distance visual acuity of 20/40 or better was achieved in 34 eyes (81%). Efficacy and safety indices were 0.86 ± 0.19 and 1.17 ± 0.39, respectively. There was a significant increase in mean keratometry (Kmean) anterior, central corneal thickness, Q-value, and corneal higher order aberrations and a decrease in Kmean posterior 2 weeks postoperatively, without any significant change in these parameters thereafter (P > .05). Four eyes of 3 patients underwent enhancement and another 4 eyes underwent explantation of the lenticule followed by exchange (2 eyes) and hyperopic laser in situ keratomileusis (2 eyes). No eye lost more than one line of CDVA. CONCLUSIONS: At 5 years of follow-up, FILI for moderate to high hyperopia showed good safety, efficacy, and reversibility. Modification of nomograms and surgical planning may be employed for further refinement of the outcomes. [J Refract Surg. 2022;38(6):348-354.].


Assuntos
Hiperopia , Ceratomileuse Assistida por Excimer Laser In Situ , Adulto , Substância Própria/cirurgia , Oftalmopatias Hereditárias , Humanos , Hiperopia/cirurgia , Refração Ocular , Adulto Jovem
4.
J Refract Surg ; 38(5): 288-297, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35536710

RESUMO

PURPOSE: To report 6-month visual and refractive outcomes following PRESBYOND Laser Blended Vision (Carl Zeiss Meditec) treatment using non-linear aspheric micro-anisometropia laser in situ keratomileusis (LASIK) for the correction of myopic and hyperopic presbyopia. METHODS: A retrospective, non-comparative study of 139 consecutive patients with a mean age of 53.13 ± 5.84 years (range: 42 to 70 years) treated with LASIK-induced micro-anisometropia using the MEL 90 excimer laser and VisuMax femtosecond laser (both Carl Zeiss Meditec). The target refraction was plano for distance eyes (dominant eye) and between -0.50 and -1.50 diopters (D) for near eyes. Patients were observed for 6 months. RESULTS: A total of 278 eyes (78 myopic and 200 hyperopic) from 139 patients completed the study. Mean preoperative spherical equivalent (SE) was -3.40 ± 1.83 D (range: -0.50 to -8.25 D) for myopic eyes and +1.61 ± 0.98 D (range: -1.25 to +4.63 D) for hyperopic eyes. Mean postoperative SE refraction of distance eyes was +0.20 ± 0.35 D (range: -0.38 to +1.00 D) and -0.14 ± 0.42 D (range: -1.38 to +0.88 D) for myopic and hyperopic eyes, respectively. Mean postoperative SE refraction of near eyes was -0.90 ± 0.44 D (range: -0.13 to -2.25 D) and -1.21 ± 0.48 D (range: -0.13 to -2.25 D) for myopic and hyperopic eyes, respectively. Mean binocular uncorrected near visual acuity was 0.70 ± 0.28 logMAR (range: 0.32 to 1.00 logMAR) and 0.79 ± 0.27 logMAR (range: 0.25 to 1.00 logMAR) for myopic and hyperopic eyes, respectively. Mean binocular uncorrected distance visual acuity was 1.19 ± 0.18 logMAR (range: 0.63 to 1.25 logMAR) and 1.14 ± 0.26 logMAR (range: 0.40 to 1.25 logMAR) for myopic and hyperopic eyes, respectively. Stereoacuity was better than 100 seconds of arc in 79% of myopic eyes and 85% of hyperopic eyes and all vision quality scores were greater than 90 of 100. No eyes lost two or more lines. CONCLUSIONS: The non-linear aspheric micro-anisometropia protocol resulted in safe and effective visual outcomes in patients with both myopic and hyperopic presbyopia. [J Refract Surg. 2022;38(5):288-297.].


Assuntos
Anisometropia , Hiperopia , Ceratomileuse Assistida por Excimer Laser In Situ , Miopia , Presbiopia , Anisometropia/cirurgia , Topografia da Córnea , Humanos , Hiperopia/cirurgia , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Lasers de Excimer/uso terapêutico , Pessoa de Meia-Idade , Miopia/cirurgia , Presbiopia/cirurgia , Refração Ocular , Estudos Retrospectivos , Resultado do Tratamento
5.
Sci Rep ; 12(1): 7357, 2022 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-35513494

RESUMO

To compare the predictive refractive accuracy of intraoperative aberrometry (ORA) to the preoperative Barrett True-K formula in the calculation of intraocular lens (IOL) power in eyes with prior refractive surgery undergoing cataract surgery at the Loma Linda University Eye Institute, Loma Linda, California, USA. We conducted a retrospective chart review of patients with a history of post-myopic or hyperopic LASIK/PRK who underwent uncomplicated cataract surgery between October 2016 and March 2020. Pre-operative measurements were performed utilizing the Barrett True-K formula. Intraoperative aberrometry (ORA) was used for aphakic refraction and IOL power calculation during surgery. Predictive refractive accuracy of the two methods was compared based on the difference between achieved and intended target spherical equivalent. A total of 97 eyes (69 patients) were included in the study. Of these, 81 eyes (83.5%) had previous myopic LASIK/PRK and 16 eyes (16.5%) had previous hyperopic LASIK/PRK. Median (MedAE)/mean (MAE) absolute prediction errors for preoperative as compared to intraoperative methods were 0.49 D/0.58 D compared to 0.42 D/0.51 D, respectively (P = 0.001/0.002). Over all, ORA led to a statistically significant lower median and mean absolute error compared to the Barrett True-K formula in post-refractive eyes. Percentage of eyes within ± 1.00 D of intended target refraction as predicted by the preoperative versus the intraoperative method was 82.3% and 89.6%, respectively (P = 0.04). Although ORA led to a statistically significant lower median absolute error compared to the Barrett True-K formula, the two methods are clinically comparable in predictive refractive accuracy in patients with prior refractive surgery.


Assuntos
Catarata , Hiperopia , Ceratomileuse Assistida por Excimer Laser In Situ , Lentes Intraoculares , Miopia , Facoemulsificação , Aberrometria/métodos , Biometria/métodos , Humanos , Hiperopia/cirurgia , Miopia/cirurgia , Óptica e Fotônica , Refração Ocular , Estudos Retrospectivos
6.
BMC Ophthalmol ; 22(1): 234, 2022 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-35606707

RESUMO

BACKGROUND: To compare the quantitative and qualitative optical outcomes of single-step transepithelial photorefractive keratectomy (TPRK) and off-flap epipolis-laser in situ keratomileusis (Epi-LASIK) in moderate to high myopia. METHODS: In this prospective self-control study, we included patients with moderate to high myopia who were randomized to undergo TPRK in one eye and Epi-LASIK in the other eye. Twelve-month follow-up results for visual acuity, refraction, ocular high-order aberrations, contrast sensitivity, postoperative pain, epithelial healing, and haze grade were assessed. RESULTS: A total of 64 eyes (32 patients) were enrolled in the study. More eyes completed re-epithelialization in the TPRK group than in the Off-flap Epi-LASIK group 3-4 days postoperatively, while all eyes completed re-epithelialization by 7 days. More eyes achieved a visual acuity (both UDVA and CDVA) of better than 20/20 in the TPRK group than in the Off-flap Epi-LASIK group. The ±0.50 D predictability for correction of the spherical equivalent (SE) was higher in the eyes of the TPRK group (91%) than in those of the off-flap Epi-LASIK group (80%) 12 months after surgery. No significant differences in ocular aberrations, including coma, spherical, and trefoil, were found between the two groups at 12 months. There were also no significant differences in visual acuity, contrast sensitivity, pain, and haze grading between the two groups. CONCLUSIONS: Both TPRK and off-flap Epi-LASIK are safe, effective, and predictable treatments for moderate to high myopia with comparable surgical outcomes. TRIAL REGISTRATION: This study was retrospectively registered on ClinicalTrial.gov ( NCT05060094 , 17/09/2021).


Assuntos
Ceratomileuse Assistida por Excimer Laser In Situ , Miopia , Ceratectomia Fotorrefrativa , Seguimentos , Humanos , Hiperplasia , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Lasers de Excimer/uso terapêutico , Miopia/cirurgia , Estudos Prospectivos , Refração Ocular , Resultado do Tratamento
7.
Cornea ; 41(5): 604-608, 2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35383617

RESUMO

PURPOSE: The purpose of this article was to evaluate the prognosis of traumatic flap dislocation or avulsion in a large series of laser-assisted in situ keratomileusis (LASIK) cases. METHODS: Retrospective, consecutive, noncomparative case series analyzes the visual and anatomical results after flap dislocation or avulsion, caused by trauma occurred at least 1 month after LASIK. RESULTS: A total of 37,315 eyes of 19,602 patients were reviewed. A traumatic flap complication was observed in 9 eyes of 9 patients, with a maximum interval of 37 months after surgery. Flap dislocation with central full-thickness folds was found in 5 cases; flap lifting and repositioning achieved a full recovery of uncorrected visual acuity. In another case, a partially detached flap was repositioned by a microsponge without lifting; self-limiting localized epithelial ingrowth followed. In 3 eyes, a complete flap avulsion occurred and, after epithelialization, a moderate refractive change was observed, comprised between -0.25 and -1 diopters (D) of spherical equivalent, with astigmatism <1 D; in 1 eye, the resulting myopia was corrected by repeat femtosecond LASIK. CONCLUSIONS: Traumatic flap complications after femtosecond LASIK are rare but can occur even in the long term; they have a favorable anatomic and visual prognosis.


Assuntos
Ceratomileuse Assistida por Excimer Laser In Situ , Miopia , Substância Própria/cirurgia , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Miopia/cirurgia , Complicações Pós-Operatórias/cirurgia , Refração Ocular , Estudos Retrospectivos , Resultado do Tratamento
8.
Cornea ; 41(5): 640-643, 2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35383619

RESUMO

PURPOSE: The purpose of this study was to report an isolated case of 2 siblings who developed central toxic keratopathy (CTK) after undergoing laser-assisted keratomileusis (LASIK) on the same day. METHODS: This was a case report and literature review. RESULTS: Two sisters with no significant medical history underwent uncomplicated LASIK on the same day. Postoperative day 1 slitlamp examination findings were unremarkable. One week later, both patients returned for routine examination and were found to have a reduction in visual acuity, hyperopic shift, bilateral central opacification at the interface, and characteristic posterior stromal "mud cracks" or macrostriae most consistent with the entity CTK. The patients reported only mild ocular discomfort with minimal signs of inflammation. None of the other LASIK patients from the same surgery day nor any previous or following days thereafter developed any complications. The siblings were closely followed and treated with a short course of prophylactic topical antibiotics and rapid steroid taper, along with aggressive lubrication and long-term systemic treatment including oral doxycycline, vitamin C, and coenzyme Q10. Three months later, both patients had resolution of CTK with an uncorrected visual acuity of 20/20 or better in both eyes. CONCLUSIONS: CTK is a rare, noninflammatory but potentially sight-threatening entity most commonly associated with excimer laser ablation procedures. Its pathophysiology is poorly understood but likely multifactorial. Its isolated presentation in this case of 2 siblings suggests a possible underlying genetic predisposition, which has not been previously described. With careful monitoring and early supportive treatment, patients can have a complete and rapid resolution.


Assuntos
Hiperopia , Ceratomileuse Assistida por Excimer Laser In Situ , Miopia , Humanos , Hiperopia/cirurgia , Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Lasers de Excimer/efeitos adversos , Miopia/cirurgia , Complicações Pós-Operatórias/etiologia , Refração Ocular , Estudos Retrospectivos , Irmãos , Resultado do Tratamento
9.
BMC Ophthalmol ; 22(1): 189, 2022 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-35468752

RESUMO

BACKGROUND: Wavefront-optimized laser-assisted in situ keratomileusis (LASIK) ablation is the most commonly performed procedure in refractive surgery, but new technologies have become available. Our goal was to compare topography-guided (Contoura) and asphericity-guided (Custom-Q) customized ablation treatments for the correction of myopia with or without astigmatism. METHODS: This prospective, randomized, double-blind, contralateral eye study included 60 eyes of 30 patients with myopia or myopic astigmatism requiring femtosecond LASIK (FemtoLASIK) treatment. For each patient, one eye was randomized to undergo Contoura treatment, and the other underwent Custom-Q abaltion. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refractive spherical equivalent (MRSE), sphere (SPH), cylinder (CYL), 6.0-mm total corneal aberration root mean square (RMS), coma (COMA), trefoil (TREF), and spherical aberration (SA) were measured and analysed after a 1-year follow-up. RESULTS: The UDVA was - 0.08 ± 0.06 logMAR in Contoura eyes and - 0.08 ± 0.05 logMAR in Custom-Q eyes (p = 0.309) after 12 months. Twenty-five eyes (83%) in the Contoura group and twenty-six eyes (87%) in the Custom-Q group had a UDVA of 20/16 at the end of 12 months, and 100% of eyes in both groups reached a UDVA of 20/25 or better. Ninety and 100% of eyes in the Contoura and Custom-Q groups, respectively, achieved a residual CYL ≤0.50 D (p = 0.237). No statistically significant difference was observed between the surgical techniques in the preoperative to 1-year postoperative changes for any of the parameters evaluated (MRSE, CYL, RMS, DEF, COMA, TREF, and SA). CONCLUSIONS: The Contoura and Custom-Q techniques yielded excellent visual and refractive results, but the evidence did not reveal any clear differences between these two methods after 1 year of follow-up. TRIAL REGISTRATION: ReBEC - Registro Brasileiro de Ensaios Clínicos [Internet]: Rio de Janeiro (RJ): Instituto de Informação Científica e Tecnológica em Saúde (Brazil); 2010 -. Identifier RBR-8rs5kt Myopia and Astigmatism Topography-guided Refractive Surgery by Contoura Method Versus Customized by Asphericity in Contralateral Eyes: A prospective Double blind Randomized Study. Available from https://ensaiosclinicos.gov.br/rg/RBR-8rs5kt Date of registration: 02/03/2020 (dd/mm/yyyy). CAAE:96778718.9.0000.5192. Issuing authority: Plataforma Brasil. CEP:2.979.279. Issuing authority: HUOC.


Assuntos
Astigmatismo , Ceratomileuse Assistida por Excimer Laser In Situ , Miopia , Astigmatismo/cirurgia , Brasil , Topografia da Córnea/métodos , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Lasers de Excimer/uso terapêutico , Miopia/cirurgia , Estudos Prospectivos , Refração Ocular , Resultado do Tratamento
10.
J Refract Surg ; 38(4): 270-276, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35412921

RESUMO

PURPOSE: To evaluate safety and efficacy in the management of flap displacement after laser in situ keratomileusis (LASIK) and subsequent complications. METHODS: This was a retrospective study performed using data recorded at the center's database from October 2002 to August 2021. Efficacy and safety were both converted to binary outcomes (loss of one or more lines and no change or gain in lines of visual acuity). The effects of time from surgery to complication and from complication to repair were assessed and the odds ratios and probabilities were calculated. The same procedure was applied to investigate the effect of these temporal variables on complications. RESULTS: A total of 66 eyes with late traumatic LASIK flap displacements were studied. Efficacy remained unchanged in 48 patients (64 eyes, 75%), and safety remained unchanged in 53 patients (59 eyes, 90%). Sixty-six patients (64 eyes, 100%) achieved visual acuity values of 20/40 and 45 patients (64 eyes, 70.3%) achieved values of 20/20. The flap displacement was resolved in the first 24 hours (SD ± 0.1 days). Surgery was performed in 58 patients (65 eyes, 90%). Epithelial ingrowth was the most frequent complication. Patients who underwent surgery tended not to lose lines (P = .05). The risk of developing epithelial ingrowth increases with time after LASIK surgery until traumatic flap displacement (odds ratio: 1.001; P < .001). The prevalence of dislocation during the study period was 0.012%. CONCLUSIONS: Visual safety values were favorable after resolution of the flap complication. Immediate surgical management leads to better visual efficacy, and the time between LASIK and trauma increases the risk of epithelial ingrowth after flap displacement. [J Refract Surg. 2022;38(4):270-276.].


Assuntos
Ceratomileuse Assistida por Excimer Laser In Situ , Substância Própria/cirurgia , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Complicações Pós-Operatórias/cirurgia , Estudos Retrospectivos , Retalhos Cirúrgicos , Resultado do Tratamento
11.
J Refract Surg ; 38(4): 277-284, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35412925

RESUMO

PURPOSE: To compare postoperative corneal sub-basal nerve density and number between small incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK). METHODS: A search was made in PubMed, EMBASE, and the Cochrane library for prospective comparative studies. The analysis was divided into two parts: network meta-analysis and traditional meta-analysis of the studies directly comparing two surgical groups. Stata 16 (Stata Corporation) and Rev-Man 5.4 (Cochrane) software were used to analyze the data. RESULTS: Twelve studies (n = 775) were included. In the network meta-analysis, the SMILE group showed a significant increase compared with the FS-LASIK group in corneal nerve density at 1 month postoperatively (mean: 4.23; 95% CI: 0.06 to 8.39, P < .05), and in the number of corneal nerve trunks at 6 months postoperatively (mean: 13.25; 95% CI: 10.20 to 16.30, P < .05). In the traditional meta-analysis, the SMILE group showed significant improvement compared with the FS-LASIK group in corneal nerve density at 1 (weighted mean difference [WMD]: -2.05, 95% CI: -3.11 to -1.00, P < .05) and 3 (WMD: -0.90, 95% CI: -1.30 to -0.50, P < .05) months postoperatively, and in the number of corneal nerve trunks (WMD: -2.52, 95% CI: -4.91 to -0.14, P < .05) and corneal nerve branches (WMD: -2.80, 95% CI: -3.41 to -2.19, P < .05) at 1 month postoperatively. CONCLUSIONS: The corneal nerve injury in the FS-LASIK group was worse than that in the SMILE group. The corneal nerve recovery in the SMILE group was better at 3 months postoperatively. However, there was no significant difference in corneal nerve density and number between the two groups at 6 months postoperatively. [J Refract Surg. 2022;38(4):277-284.].


Assuntos
Lesões da Córnea , Ceratomileuse Assistida por Excimer Laser In Situ , Miopia , Ferida Cirúrgica , Lesões da Córnea/cirurgia , Substância Própria/cirurgia , Humanos , Lasers de Excimer/uso terapêutico , Miopia/cirurgia , Metanálise em Rede , Estudos Prospectivos
12.
J Refract Surg ; 38(4): 235-242, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35412929

RESUMO

PURPOSE: To compare the clinical outcomes after topography-guided and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) planned with the Phorcides Analytic Engine (PAE) algorithm system and Sirius tomography data for correction of myopia and myopic astigmatism when the ocular residual astigmatism (ORA) was great or not. METHODS: In this retrospective study, a total of 163 eyes with myopia and myopic astigmatism (99 patients) were included. Eyes with myopic astigmatism and high ORA of 0.75 diopters (D) or greater were assigned to the high ORA group and the others to the low ORA group. All surgeries were performed by topography-guided FS-LASIK planned with a PAE algorithm system. PAE took anterior and posterior corneal negative cylinder of the 5-mm zone from the Sirius combined topography and tomography. Refractive and visual outcomes, vector analysis, and corneal aberrations were compared between the two groups. RESULTS: At 6 months postoperatively, the uncorrected distance visual acuity of 20/16 or better was measured in 59% of eyes in the high ORA group and 66% of eyes in the low ORA group (P = .307). Postoperative corrected distance visual acuity, manifest refractive spherical equivalent, refractive astigmatism, target induced astigmatism, surgically induced astigmatism, and difference vector were similar between the two groups (P > .05). The postoperative corneal astigmatism was significantly higher in the high ORA group (P = .008), and the high ORA group over-corrected astigmatism with the rule and showed a higher correction index (P = .003) compared with the low ORA group. CONCLUSIONS: Topography-guided FS-LASIK with PAE algorithm and Sirius combined topography and tomography data for correction of myopia and myopic astigmatism achieved the predicted surgical outcomes and there was a tendency to have a similar clinical outcome for PAE when the ORA was great or not. However, the PAE with high ORA overcorrected astigmatism with-the-rule and showed a higher correction index compared with the low ORA group. [J Refract Surg. 2022;38(4):235-242.].


Assuntos
Astigmatismo , Ceratomileuse Assistida por Excimer Laser In Situ , Miopia , Algoritmos , Astigmatismo/cirurgia , Topografia da Córnea/métodos , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Lasers de Excimer/uso terapêutico , Miopia/cirurgia , Refração Ocular , Estudos Retrospectivos , Tomografia , Resultado do Tratamento
13.
Zhonghua Yan Ke Za Zhi ; 58(4): 303-308, 2022 Apr 11.
Artigo em Chinês | MEDLINE | ID: mdl-35391518

RESUMO

Small incision lenticule extraction (SMILE) is a new technique that exhibits excellent efficacy, safety and predictability for the correction of myopia and myopic astigmatism. However, one potential limitation of this technique is that the centration during femtosecond laser cutting might be subject to the surgeon's experience and patient's cooperation. To achieve accurate centration in SMILE is the key to obtaining good postoperative visual outcomes. This review summarizes relevant research results and discusses the centration methods and the influencing factors in SMILE, so as to provide reference for clinical practice of SMILE.


Assuntos
Astigmatismo , Cirurgia da Córnea a Laser , Ceratomileuse Assistida por Excimer Laser In Situ , Astigmatismo/cirurgia , Substância Própria/cirurgia , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Lasers de Excimer , Refração Ocular , Resultado do Tratamento , Acuidade Visual
14.
BMC Ophthalmol ; 22(1): 157, 2022 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-35382779

RESUMO

BACKGROUND: The purpose of this study was to compare the astigmatic correction by vector analysis in patients with high myopic astigmatism after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) with cyclotorsion compensation or small-incision lenticule extraction (SMILE) with stringent head positioning. SETTING: Beijing Aier-Intech Eye Hospital, Beijing, China. DESIGN: A retrospective case series. METHODS: Patients who had correction of myopic astigmatism of 2 diopters (D) or more treated with either FS-LASIK with cyclotorsion compensation or SMILE with stringent head positioning were included. The results of vision and refraction were analyzed and compared between groups with the right eye. RESULTS: The study enrolled 94 patients (41eyes in an FS-LASIK with compensation of cyclotorsion group and 53 eyes in a SMILE with stringent head positioning control group. The mean preoperative manifest cylinder was -2.65 ± 0.77D in the FS-LASIK group and 2.51 ± 0.56D in the SMILE group (P = 0.302). At 12 months, there was no significant between-group difference in uncorrected distance visual acuity (UDVA, P = 0.274) and postoperative spherical equivalent (SEQ) (P = 0.107). 46.3% and 24.5% of eyes in the FS-LASIK and SMILE groups were within 0.25 D were within 0.25D postoperative cylinder, respectively, and 78% and 66% of eyes in these two groups were within 0.5 D postoperative cylinder (P = 0.027, P = 0.202). The vector analysis showed comparable between-group target-induced astigmatism (TIA) (P = 0.114), surgically induced astigmatism (SIA) (P = 0.057), difference vector (DV, P = 0.069), and the angle of error (AE) (P = 0 .213) values. The index of success (IOS) was 0.18 in the FS-LASIK group and 0.24 in the SMILE group (P = 0.024), with a significant difference between the two groups. CONCLUSION: FS-LASIK with compensation of cyclotorsion showed a favorable correction of high myopic astigmatism (≥ 2.0 D) compared to SMILE with stringent head positioning at 12 months.


Assuntos
Astigmatismo , Ceratomileuse Assistida por Excimer Laser In Situ , Astigmatismo/cirurgia , Substância Própria/cirurgia , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Lasers de Excimer/uso terapêutico , Refração Ocular , Estudos Retrospectivos
15.
Klin Monbl Augenheilkd ; 239(4): 382-385, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35320865

RESUMO

BACKGROUND: To evaluate 10-year long-term refractive visual stability and participants' satisfaction in the refractive treatment of myopic eyes undergoing topography-guided transepithelial surface ablation using a 1KHz excimer laser. PATIENTS AND METHODS: This single-center prospective survey assessed participants' satisfaction 10 years after the treatment using a non-validated questionnaire with regards to visual outcome, dry eye, and visual disturbance symptoms. Pre- and postoperative visual and refractive data were evaluated. RESULTS: Of 106 participants (54% females) with a mean patient age of 36 (± 8.6) years, 166 eyes were included. Mean preoperative spherical equivalent (SE) was - 4.23 (± 2.48) diopters (D). Uncorrected distant visual acuity (UCVA) after 10 years was ≥ 1.0 (Snellen) in 92% of the eyes. Manifest SE was within ± 1.0 D of the desired refraction in 86% of the eyes after 10 years. Mean quality of life (QOL) improvement was high (9.15 out of 10 points). Dry eye symptoms were reported by 35 out of 104 (34%) patients. Visual symptoms like halos or starbursts were reported by 24 out of 101 (24%) and 12 out of 100 (12%) patients, respectively. CONCLUSIONS: Topography-guided transepithelial surface ablation for myopia provided stable long-term results in terms of UCVA and SE. Participant satisfaction was high, with only low rates of dry eye or visual symptoms.


Assuntos
Astigmatismo , Ceratomileuse Assistida por Excimer Laser In Situ , Miopia , Ceratectomia Fotorrefrativa , Adulto , Astigmatismo/cirurgia , Feminino , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Lasers de Excimer , Masculino , Miopia/diagnóstico , Miopia/cirurgia , Ceratectomia Fotorrefrativa/métodos , Estudos Prospectivos , Qualidade de Vida , Refração Ocular , Resultado do Tratamento
16.
Eye Contact Lens ; 48(6): 239-241, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35333788

RESUMO

OBJECTIVES: To assess the impact of posterior corneal asphericity on postoperative calculation error using the Haigis-L and the Barrett formulas for eyes after laser in situ keratomileusis or photorefractive keratectomy (PRK). METHODS: We assessed the mean absolute error (MAE) of two power calculation formulas, Barrett true-K and Haigis-L formulas, in a retrospective analysis of 34 eyes of 34 patients who underwent cataract surgery. We performed a regression analysis between corneal parameters (anterior and posterior Q values, Kmax, K1, and K2) and the MAE of each formula. RESULTS: In the cohort, 11 eyes were of women and 23 of men. The average age of the study population was 66.5±8.6 years. The mean axial length was 24±4.7 mm, the mean anterior chamber depth was 3.27±0.7 mm, and the mean posterior Q-value was -0.15±0.28. The MAE of Haigis-L and Barrett true-K formulas were 0.72 and 0.68, respectively (P=0.54). The regression analysis showed a statistically significant relationship only between the error in refraction prediction and the posterior Q-value regardless of the formula used. The coefficient of determination was higher for the Barrett true-K formula (r=0.52; R2=0.28; P<0.05), compared with the Haigis-L (r=0.49; R2=0.25; P<0.05). CONCLUSIONS: Posterior corneal surface asphericity influences the refractive error of calculation using both Haigis-L and Barrett true-K formulas for eyes after a myopic PRK or laser-assisted in situ keratomileusis surgery.


Assuntos
Ceratomileuse Assistida por Excimer Laser In Situ , Lentes Intraoculares , Miopia , Facoemulsificação , Ceratectomia Fotorrefrativa , Idoso , Feminino , Humanos , Implante de Lente Intraocular , Masculino , Pessoa de Meia-Idade , Miopia/cirurgia , Óptica e Fotônica , Refração Ocular , Estudos Retrospectivos
17.
J Refract Surg ; 38(3): 184-190, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35275003

RESUMO

PURPOSE: To investigate optical zone decentration following femtosecond laser-assisted lenticule intrastromal keratoplasty (FS-LIKE) or small incision lenticule intrastromal keratoplasty (SMI-LIKE) for correcting hyperopia. METHODS: This study analyzed decentration values obtained from optical coherence tomography (OCT) and tangential topography difference maps of 23 eyes (18 patients) undergoing FS-LIKE (n = 12) or SMI-LIKE (n = 11) via the concentric centration method. Total higher order aberrations (HOAs) and component aberrations were measured preoperatively and 6 months postoperatively. RESULTS: The mean optical zone decentration was 0.27 ± 0.08 and 0.39 ± 0.16 mm for the FS-LIKE and SMI-LIKE groups, respectively (P = .039). A significant difference was noted in lenticule decentration between the two groups (0.18 vs 0.37 mm), whereas no significant difference was observed in stromal bed (pocket) decentration between the two groups (0.10 vs 0.12 mm). Six months after surgery, the spherical equivalent showed a reduction of 6.14 ± 2.44 and 6.10 ± 1.79 diopters (D) for the two groups, respectively (P = .971), whereas the surgically induced astigmatism was 0.68 ± 0.49 and 1.56 ± 0.78 D for the two groups, respectively (P = .004). Furthermore, induction of HOAs in the SMI-LIKE group was significantly larger than that in the FS-LIKE group (P = .013). CONCLUSIONS: FS-LIKE can yield improved treatment centration and less induction of total HOAs. [J Refract Surg. 2022;38(3):184-190.].


Assuntos
Transplante de Córnea , Aberrações de Frente de Onda da Córnea , Hiperopia , Ceratomileuse Assistida por Excimer Laser In Situ , Substância Própria/cirurgia , Aberrações de Frente de Onda da Córnea/cirurgia , Humanos , Hiperopia/cirurgia , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Lasers de Excimer/uso terapêutico , Acuidade Visual
18.
Transl Vis Sci Technol ; 11(2): 13, 2022 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-35133403

RESUMO

PURPOSE: To compare the functional optical zone (FOZ) and visual quality after small-incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) in correcting high myopia. METHODS: Ninety-two eyes of 46 high myopic patients with the same programmed optical zone (POZ) received SMILE in one eye and FS-LASIK in the contralateral eye. FOZ was calculated using a refractive power method. The decentration, visual outcomes, wavefront aberrations, contrast sensitivity, and quality of vision (QoV) questionnaire were analyzed at 6 months postoperatively. RESULTS: The postoperative visual and refractive outcomes were comparable between SMILE and FS-LASIK. The FOZ for SMILE (5.62 ± 0.31 mm) was larger than for FS-LASIK (5.35 ± 0.28 mm; P < 0.001). Moreover, the total decentration for SMILE (0.29 ± 0.14 mm) was greater than in FS-LASIK (0.22 ± 0.11 mm; P < 0.001). The induced change in spherical aberration was less for SMILE than for FS-LASIK (P < 0.001). There was better contrast sensitivity under the mesopic condition with glare for SMILE than for FS-LASIK (P = 0.024). However, no significant difference was found in QoV scores between the two groups. CONCLUSIONS: SMILE created a larger FOZ and greater decentration than FS-LASIK when the same POZ was designed in high myopia. Objective and subjective visual symptoms were comparable between SMILE and FS-LASIK. TRANSLATIONAL RELEVANCE: The differences in FOZ and decentration between SMILE and FS-LASIK have little effect on vision outcomes. Surgeons should consider the FOZ and decentration in surgical options in high myopia.


Assuntos
Astigmatismo , Aberrações de Frente de Onda da Córnea , Ceratomileuse Assistida por Excimer Laser In Situ , Miopia , Astigmatismo/cirurgia , Substância Própria/cirurgia , Aberrações de Frente de Onda da Córnea/cirurgia , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ/métodos , Lasers de Excimer , Miopia/cirurgia , Estudos Prospectivos , Acuidade Visual
19.
Semin Ophthalmol ; 37(4): 531-537, 2022 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-35188852

RESUMO

PURPOSE: To conduct a bibliometric analysis of the 100 most cited publications on LASIK using the Scientific Information (ISI) Web of Knowledge database. METHODS: This analysis used keyword-specific searches within the Web of Science database to isolate the 100 most frequently cited LASIK articles published between 1996 and 2019 (T100). Number of citations per article and per year were quantified from 1996 to 2019. Title, authors (as well as affiliated institutions and countries of origin), journal, year of publication, and citation frequency were variables analyzed. RESULTS: Of the T100 articles, each article was cited between 103 to 411 times with a mean of 167 citations. Between 0-11 articles in the T100 were published every year on average with a median of 5 publications per year. The highest concentration of T100 publications occurred between 2003 and 2008 at 51%. A decrease in the annual publication rate of influential articles was observed after 2010 at 23%; 39.1% of these articles compared LASIK to newer refractive surgical approaches. The highest number of T100 articles were from the Journal of Refractive Surgery. The University of California System produced the highest number of T100 articles. The author with the most articles in the T100 is Dan Z. Reinstein. Most T100 articles originated from the United States. CONCLUSION: The peak of influential LASIK research occurred between 2000-2010, likely due to topics such as postprocedural corneal ectasia and the femtosecond laser approach. While newer surgical techniques such as SMILE may have contributed to the decline in the annual rate of LASIK-related publication, the underlying cause for this decline is unclear.


Assuntos
Doenças da Córnea , Ceratomileuse Assistida por Excimer Laser In Situ , Oftalmologia , Bibliometria , Doenças da Córnea/cirurgia , Bases de Dados Factuais , Humanos , Estados Unidos
20.
BMJ Case Rep ; 15(2)2022 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-35135801

RESUMO

A man aged 26 years presented with complaints of diminution of vision in his right eye for 1 year following a fist injury. He had a history of laser-assisted in situ keratomileusis in both eyes 5 years earlier. On examination, his uncorrected distance visual acuity (UDVA) in the right eye was 1.0 logMAR. Slit-lamp examination of the right eye revealed a superotemporal dislocation of the flap with coexisting epithelial ingrowth encroaching the pupillary area. Due to the presence of long-standing fixed flap folds, a flap amputation was performed along with removal of the epithelial ingrowth using 0.02% mitomycin C as adjunct. Postoperatively, the UDVA was 0.3 logMAR on day 1, which improved to 0.2 logMAR at 1 week. At 1 year, the UDVA was 0.2 logMAR improving to 0.1 logMAR with refraction, with minimal paracentral corneal haze and no signs of corneal ectasia.


Assuntos
Epitélio Corneano , Ceratomileuse Assistida por Excimer Laser In Situ , Adulto , Amputação , Epitélio Corneano/cirurgia , Humanos , Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos , Masculino , Complicações Pós-Operatórias , Refração Ocular , Retalhos Cirúrgicos
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