14,166 results on '"lasik"'
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2. Accuracy of recent intraocular lens power calculation methods in post-myopic LASIK eyes.
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Gettinger, Kate, Masui, Sachiko, Omoto, Miki, Torii, Hidemasa, Yotsukura, Erisa, Nishi, Yasuyo, Ayaki, Masahiko, Hayashi, Ken, and Negishi, Kazuno
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CATARACT surgery , *LASIK , *REFRACTIVE errors , *UNIVERSITY hospitals , *FORECASTING , *INTRAOCULAR lenses - Abstract
This retrospective study compared postoperative prediction errors of recent formulas using standard- or total keratometry (K or TK) for intraocular lens (IOL) power calculation in post-myopic LASIK patients. It included 56 eyes of 56 patients who underwent uncomplicated cataract surgery, with at least 1-month follow-up at Keio University Hospital in Tokyo or Hayashi Eye Hospital in Yokohama, Japan. Prediction errors, absolute errors, and percentage of eyes with prediction errors within ± 0.25 D, ± 0.50 D, and ± 1.00 D were calculated using nine formulas: Barrett True-K, Barrett True-K TK, Haigis-L, Haigis TK, Pearl-DGS, Hoffer QST, Hoffer QST PK, EVO K, and EVO PK. Statistical comparisons utilized Friedman test, Conover's all-pairs post-hoc, Cochran's Q, and McNemar post-hoc testing. Root-Mean-Square Error (RMSE) was compared with heteroscedastic testing. Barrett True-K TK had the lowest median predicted refractive error (-0.01). EVO PK had the smallest median absolute error (0.20). EVO PK had the highest percentage of eyes within ± 0.25 D of the predicted value (58.9%), significantly better than Haigis-L (p = 0.047). EVO PK had the lowest mean RMSE value (0.499). The EVO PK formula yielded the most accurate IOL power calculation in post-myopic LASIK eyes, with TK/PK values enhancing accuracy. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Keratorefractive Lenticule Extraction Using the Ziemer FEMTO LDV Z8 Platform (CLEAR): One-Year Results.
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Bteich, Yara, Assaf, Jad F., Gendy, Jeremiah E., and Awwad, Shady T.
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VISUAL acuity ,LASIK ,REFRACTIVE errors ,CATARACT surgery ,MYOPIA - Abstract
Purpose: To present the outcomes and detail the surgical procedure employed in the initial 102 eyes treated with keratorefractive lenticule extraction (KLEx) using the FEMTO LDV Z8 platform (Ziemer Ophthalmic Systems). Methods: This was a retrospective analysis of 102 eyes of 53 patients treated with KLEx at the American University of Beirut Medical Center. Visual, refractive, topographic, and aberrometric parameters were evaluated 1 week and 1, 3, 6, and 12 months postoperatively. Results: Mean preoperative spherical equivalent refraction (SEQ) was −4.11 ± 1.82 diopters (D) (range: −10.00 to −1.625 D) and mean preoperative cylinder was −0.75 ± 0.65 D (range: −3.00 to 0.00 D). Postoperatively, the mean SEQ was 0.06 ± 0.54 D (range: −2.88 to +1.00 D) at 1 week and −0.04 ± 0.26 D at 12 months and was within ±0.50 D in 95.6% and ±1.00 D in 100% of eyes. A total of 96.7% of eyes had an uncorrected distance visual acuity (UDVA) of 20/20 at 12 months postoperatively. Fifty percent gained one or more lines of corrected distance visual acuity (CDVA), 5 eyes (5.4%) lost one line, and none lost two or more lines. No suction losses were encountered and all extracted lenticules were intact without tears. Conclusions: The application of KLEx using the FEMTO LDV Z8 platform yields safe and effective outcomes, aligning comparably with established modes of lenticule extraction and femtosecond laser–assisted laser in situ keratomileusis procedures previously employed and accepted within the field of refractive surgery. [J Refract Surg. 2024;40(11):e898–e905.] [ABSTRACT FROM AUTHOR]
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- 2024
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4. Clinical safety and efficacy of elliptical thin-flap LASIK using a low-pulse energy femtosecond laser.
- Author
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Lin, Hung-Yuan, Chuang, Ya-Jung, Chang, Steven Wei-Hsin, and Lin, Pi-Jung
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OPTICAL coherence tomography , *COHERENCE (Optics) , *SURGICAL complications , *LASIK , *VISUAL acuity , *FEMTOSECOND lasers - Abstract
This study assessed the clinical safety and efficacy of elliptical thin-flap LASIK with a low–pulse energy femtosecond laser in 3 thickness subgroups (85, 90, and 100 μm). A total of 80 patients who underwent bilateral LASIK surgery at Taiwan between April and September 2019 were retrospectively enrolled. Elliptical corneal flaps with wide temporal hinges and inverted-angled side cuts were created. Target flap thickness was calculated on the basis of residual stromal bed thickness and percent tissue altered. Before flap creation, an optical coherence tomography image for visualization of the precut flap position was obtained with the built-in camera. At postoperative month 1, the overall mean logMAR uncorrected distance visual acuity (UDVA) was − 0.04 ± 0.07 (20/18 Snellen), with 96% of eyes achieving UDVA of 20/20 or better. Postoperative mean manifest spherical equivalent was − 0.37 ± 0.42 D at 1 month. The visual and refractive outcomes in each of the 3 subgroups were similar. The achieved flap thicknesses were found to be highly predictable and consistent in the respective thickness subgroups. Optical coherence tomography–guided thin-flap LASIK performed with the low–pulse energy femtosecond laser was found to be safe with no intraoperative or postoperative complications. [ABSTRACT FROM AUTHOR]
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- 2024
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5. First report of uncommon mycobacteria in post LASIK keratitis: Mycobacterium wolinskyi.
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van Delden, Sébastien, Buvelot, Hélène, Bravetti, Giorgio Enrico, Pham, Truong-Thanh, Thumann, Gabriele, and Massa, Horace
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SURGICAL complications , *KERATITIS , *MYCOBACTERIUM , *LASIK , *INFECTION prevention , *MYCOBACTERIA - Abstract
Laser assisted in situ keratomileusis (LASIK) surgery is the leading and most performed refractive surgery nowadays. A possible complication of LASIK surgery is infectious keratitis which can lead to disastrous corneal damage and result in permanent loss of vision. LASIK procedures have become increasingly accessible, and the demand for refractive surgery has risen among patients, challenging the medical field to improve the prevention of post-operative infections. Nevertheless, a wide range of pathogens have been described as responsible for post-LASIK keratitis. However, non-tuberculous mycobacterial keratitis remains an infrequent occurrence and is poorly described in the literature. To the best of our knowledge, this is the first ever reported case of post-LASIK keratitis caused by Mycobacterium wolinskyi. We describe the clinical and microbial characteristics, leading to its challenging treatment choice. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Femtosecond laser assisted cataract surgery in a cataract patient with low vaulted ICL following LASIK: a case report.
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You, Yuxia, Cao, Xiangrong, Wang, Jing, and Zhao, Bo
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CRYSTALLINE lens ,REFRACTIVE errors ,FEMTOSECOND lasers ,INTRAOCULAR lenses ,VISION disorders ,LASIK ,LASER surgery - Abstract
Background: Apart from the conventional utilization of ICL implantation for the correction of refractive errors, its recent applications extend to correcting refractive errors post laser refractive surgery. Notably, the development of cataracts stands out as a prevalent postoperative complication, often associated with low vault. Previous cases have demonstrated successful management of cataracts with ICL through the combination of FLACS and ICL removal coupled with IOL implantation, resulting in favorable postoperative visual outcomes. Herein, we present a case of cataract with low vault ICL following LASIK and its subsequent management. Case presentation: A 46-year-old male presented with vision loss in the right eye for 9 months, and he had undergone LASIK 22 years prior and had ICL implantation in both eyes 2 years ago to correct refractive error. One day after ICL implantation, both eyes exhibited the UDVA of 1.2 and 1.0, well-positioned ICLs, and approximate vault of 150 μm and 200 μm. Six months ago, the patient became aware of blurred vision in the right eye for a duration of 3 months. Examination revealed cloudy lens cortex in the right eye. During the current review, the UDVA of the right eye was 0.6, where nasal wedge-shaped clouding was evident and worsened, while the left eye lens remained transparent. AS-OCT demonstrated the vault of 54 μm in the right eye and 83 μm in the left eye. Considering the patient's history of LASIK and the presence of right eye cataract, a monovision approach was adopted. The patient underwent FLACS combined with ICL extraction and monofocal IOL lens implantation in the right eye. At 10 days postoperatively, the patient exhibited the UDVA of 1.0. Conclusions: Our report confirms the feasibility of FLACS in managing cataracts in patients with low vault ICL following LASIK. This procedure does not pose significantly greater challenges than in typical cataract cases, although meticulous care remains essential throughout every step of the surgery, particularly during laser scanning and positioning. With adequate preoperative preparation and precise calculation of the IOL power, surgical outcomes can meet expectations fully. [ABSTRACT FROM AUTHOR]
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- 2024
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7. To Investigate the Changes in Corneal Curvature and Its Correlation with Corneal Epithelial Remodeling After Trans-PRK and FS-LASIK.
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Yang, Fan, Yang, Zheng, Zhao, Shaozhen, and Huang, Yue
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LASIK , *OPTICAL coherence tomography , *PHOTOREFRACTIVE keratectomy , *CORNEAL topography , *CORNEA , *CURVATURE , *EPITHELIUM - Abstract
Purpose: To evaluate curvature changes in different regions and their correlation with corneal epithelial remodeling in myopic patients undergoing femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and transepithelial refractive keratectomy (Trans-PRK) after surgery. Methods: One hundred and sixty-three patients (163 right eyes) undergoing Trans-PRK and LASIK were evaluated for up to 6 months using anterior segment optical coherence tomography (OCT) to measure the epithelial thickness and corneal topography to measure corneal curvature in different areas (2 mm, 5 mm, and 7 mm). We calculated the curvature ΔK (ΔK = preoperative - postoperative), ΔK5-2 (ΔK5-2 = K5mm - K2mm), ΔK7-5 (ΔK7-5 = K7mm - K5mm), and the epithelial thickness ΔET5-2 (ΔET5-2 = ET5mm - ET2mm) and ΔET7-5 (ΔET7-5= ET7mm - ET5mm). Results: Corneal curvature flattened in each region of the two groups (all p < 0.001) and gradually steepened during the follow-up period. The Trans-PRK group flattened more significantly within 2 mm and 5 mm, while the FS-LASIK group at 7 mm. Both groups of ΔK decreased over time. Both groups of ΔK5-2 and ΔK7-5 gradually decreased during the follow-up period (P5-2=0.025 and P7-5 < 0.001 for Trans-PRK, P5-2 = 0.011 and P7-5 < 0.001 for FS-LASIK). The corneal epithelium of the two groups gradually thickened during the follow-up period, with Trans-PRK significantly thickening in the central and peripheral regions and FS-LASIK in the central and paracentral regions. There is a significant correlation between the ΔK5-2 and ΔET5-2, ΔK7-5 and ΔET7-5 (all r > 0.37, p < 0.001). Conclusions: All groups showed significant curvature flattening after surgery and gradually steepening during the follow-up period. The corneal epithelium thickness in both groups of 17 regions became thicker,. In contrast, Trans-PRK group showed more significant thickening to the periphery and the central 5 mm area of the FS-LASIK. This study indicates a significant positive correlation between differences in epithelial thickening in different regions and differences in curvature changes in the corresponding areas PRK, FS-LASIK, curvature, corneal epithelial thickness [ABSTRACT FROM AUTHOR]
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- 2024
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8. Clinical Performance of an Extended Range of Vision Intraocular Lens After LASIK.
- Author
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Carreras, Humberto, Reñones, Josefina, Carreras, María del Rosario, Cantó, Carlos, and Piñero, David P.
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LASIK ,INTRAOCULAR lenses ,PATIENT reported outcome measures ,CATARACT surgery ,PATIENT satisfaction - Abstract
Purpose: To evaluate the clinical and patient-reported outcomes (PROMs) of cataract surgery with implantation of a wavefront-shaping extended depth of focus (EDOF) intraocular lens (IOL) in eyes with previous laser in situ keratomileusis (LASIK) for myopia correction. Methods: This prospective observational study enrolled 50 eyes with previous LASIK from 25 patients (age: 46 to 70 years) who underwent cataract surgery with implantation of the AcrySof IQ Vivity IOL (Alcon Laboratories, Inc). Visual and refractive outcomes were evaluated during a 3-month follow-up. PROMs were evaluated with the Intraocular Lens Satisfaction (IOLSAT; Alcon Vision, LLC) (general satisfaction), Catquest-9SF (difficulty in doing vision-related activities), and Questionnaire for Visual Disturbances (QUVID; Alcon Vision, LLC) (photic phenomena) questionnaires. Results: Mean 3-month postoperative binocular uncorrected distance, intermediate, and near visual acuities were 0.02 ± 0.11, −0.02 ± 0.09, and 0.14 ± 0.13 logarithm of the minimum angle of resolution (logMAR), respectively. Mean binocular distance-corrected intermediate and near visual acuities were 0.05 ± 0.11 and 0.32 ± 0.14 logMAR, respectively. All eyes had a postoperative spherical equivalent within ±0.75 diopters (D). The mean defocus curve showed visual acuity values better than 0.20 logMAR for defocus levels from +0.50 to −1.50 D. Most patients (92.0%) confirmed that they had no vision-related difficulties limiting their normal daily life. Perception of starbursts, halos, glare, hazy vision, blurry vision, and double vision was referred by 24%, 24%, 28%, 28%, 8%, and 4% of patients, respectively. Most of symptoms were described as mild and not or a little bothersome. Conclusions: The wavefront-shaping EDOF IOL evaluated provides efficacious distance, intermediate, and near visual restoration in eyes with previous LASIK, with minimal photic phenomena associated. [J Refract Surg. 2024;40(10):e742–e753.] [ABSTRACT FROM AUTHOR]
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- 2024
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9. Photorefractive Keratectomy: Technical Evolution, Refractive Outcomes, Corneal Wound Healing Response, and Complications.
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Torricelli, André A. M., Giglio, Veronica B., Garcia, Renato, Santhiago, Marcony R., Bechara, Samir J., Wilson, Steven E., and Monteiro, Mario Luiz R.
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PHOTOREFRACTIVE keratectomy ,WOUND healing ,SURGICAL complications ,LASIK ,POSTOPERATIVE period - Abstract
Photorefractive keratectomy (PRK) was the first excimer laser procedure developed to treat refractive errors. The safety and efficacy of PRK established it as one of the most performed corneal refractive procedures worldwide. With the introduction of laser in situ keratomileusis (LASIK), and more recently keratorefractive lenticule extraction (KLEx) procedures, many corneal surgeons favor these newer corneal procedures as the first choice due to faster visual rehabilitation and less discomfort during the early postoperative period. Importantly, however, PRK remains a viable alternative for most corneal refractive candidates and there are many situations in which PRK remains the refractive procedure of choice. This review addresses the technical evolution of PRK—mechanical epithelial debridement versus alcohol-assisted epithelial removal versus excimer laser-assisted epithelial debridement (transepithelial) PRK—and reports the PRK refractive outcomes compared to other keratorefractive laser procedures. The corneal wound response associated with each PRK technique and the indications, limitations, and complications of PRK are reviewed to aid refractive surgeons to best position PRK in their overall practice. [J Refract Surg. 2024;40(10):e754–e767.] [ABSTRACT FROM AUTHOR]
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- 2024
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10. Corneal Epithelial Remodeling Following Cylinder Correction With SMILE or FS-LASIK: A Contralateral Comparative Study.
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Chen, Pei, Hou, Xiangtao, Yu, Na, Ye, Yiming, Wei, Han, Zhuang, Jing, and Yu, Keming
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LASIK ,ASTIGMATISM ,BINOCULAR vision ,OPTICAL coherence tomography ,EPITHELIUM - Abstract
Purpose: To compare the corneal epithelial remodeling in eyes with high astigmatism that had small incision lenticule extraction (SMILE) and femtosecond laser–assisted laser in situ keratomileusis (FS-LASIK). Methods: Seventy-four patients with myopic astigmatism of greater than −2.00 diopters (D) and little binocular difference in spherical equivalent were included in this contralateral comparative study. All patients received SMILE in one eye and FS-LASIK in the other eye randomly. The corneal epithelial remodeling pattern was mapped using the latest RTVue spectral-domain optical coherence tomographer (Optovue) by region. Results: Satisfactory refractive correction was achieved in all enrolled eyes with either SMILE or FS-LASIK. The corneal epithelium gradually thickened following surgical cylinder correction, distributing mainly along the flat medium. The corneal epithelium proliferation is milder centrally but more pronounced in the mid-peripheral area after SMILE, compared with FS-LASIK. The flat-steep difference in corneal epithelial thickness (CET) is evident in the mid-peripheral and peripheral areas, which is more obvious in SMILE. Residual cylinder was positively correlated with CET in eyes that had FS-LASIK, but not SMILE. More importantly, these epithelial changes were positively correlated with the ablation depth and higher order aberrations following surgical refractive correction. Conclusions: The postoperative CET map varied between SMILE and FS-LASIK. In eyes with high astigmatism, SMILE surgery is followed by milder and more stable corneal epithelial thickening. Moreover, the corneal epithelium is sensitive to stromal ablation and corneal remodeling is crucial to the postoperative visual quality. This study rigorously distinguished the CET difference between SMILE and FS-LASIK in astigmatic eyes and shed light on subsequent research. [J Refract Surg. 2024;40(10);e728–e741.] [ABSTRACT FROM AUTHOR]
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- 2024
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11. Visual Improvements After Excimer Laser Multiple Light Redirection in Eyes With Central Visual Loss From Macular Degeneration and Geographic Atrophy: First Report of Cases.
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Serdarevic, Olivia N. and Yavitz, Edward Q.
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MACULAR degeneration ,VISION ,CONTRAST sensitivity (Vision) ,LASIK ,EXCIMER lasers ,VISUAL acuity - Abstract
Purpose: To analyze outcomes after multiple light redirection (MLR) by photoablation of a small paracentral portion of Bowman's layer in each corneal quadrant using standard myopic laser in situ keratomileusis (LASIK) software with non-customized fenestrated MLR corneal light shields (Excimer-MLR) without postoperative visual training or magnification in pseudophakic eyes with central visual loss from age-related macular degeneration (AMD) with geographic atrophy (GA). Methods: Retrospective analysis of two cases. Results: Outcomes after Excimer-MLR in the worse-seeing eyes of an 86-year-old and a 65-year-old pseudophakic man with AMD and GA revealed corrected distance/near visual acuity gains of 6.0/6.0 and 11.8/10.0 lines within 12 days and 5.0/5.0 and 12.2/9.8 lines at 9 months, respectively, with improved Amsler grids, no distance or near glasses change, no complications, and no adverse events related to Excimer-MLR. Contrast sensitivity and stereopsis, measured in case 2, improved postoperatively. Conclusions: This first report showed that Excimer-MLR safely produced large improvements in visual function up to 9 months postoperatively in two eyes with central visual loss from AMD. [Journal of Refractive Surgery Case Reports. 2024;4(4):e29–e35.] [ABSTRACT FROM AUTHOR]
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- 2024
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12. Comparative Analysis of Corneal Wound Healing: Differential Molecular Responses in Tears Following PRK, FS-LASIK, and SMILE Procedures.
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Janiszewska-Bil, Dominika, Grabarek, Beniamin Oskar, Lyssek-Boroń, Anita, Kiełbasińska, Aleksandra, Kuraszewska, Bernadeta, Wylęgała, Edward, and Krysik, Katarzyna
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LASIK ,SMALL-incision lenticule extraction ,REVERSE transcriptase polymerase chain reaction ,VASCULAR endothelial growth factors ,PHOTOREFRACTIVE keratectomy ,ENZYME-linked immunosorbent assay - Abstract
Background/Objectives: In this study, we aimed to analyze the changes in the expression profiles of selected messenger RNAs (mRNAs) and their encoded proteins in the tears of patients undergoing photorefractive keratectomy (PRK), femtosecond-assisted laser in situ keratomileusis (FS-LASIK), and small-incision lenticule extraction (SMILE) procedures. Methods: A total of 120 patients were divided into three groups based on the laser vision correction (LVC) procedure: PRK, FS-LASIK, or SMILE. Tear samples were collected preoperatively and at 1, 7, 30, and 180 days postoperatively. The expression levels of selected messenger RNAs (mRNAs) and proteins were analyzed by using reverse transcription quantitative polymerase chain reaction (RT-qPCR) and enzyme-linked immunosorbent assay (ELISA), respectively. Results: PRK and FS-LASIK elicited significantly stronger biological responses than SMILE. Interleukin-15 (IL-15) expression increased notably in the PRK and FS-LASIK groups, with mRNA levels reaching fold changes of 4.65 ± 0.65 and 4.99 ± 0.28, respectively, on day 1, compared with only 2.09 ± 0.23 in the SMILE group. Vascular endothelial growth factor A (VEGFA) levels were also elevated in the PRK (2.98 ± 0.23 fold change) and FS-LASIK groups (3.45 ± 1.09 fold change) on day 1, while the SMILE group showed minimal fluctuations. The protein concentration analysis based on the ELISA confirmed these trends, with IL-15 levels peaking at 54.2 ± 2.5 pg/mL in the PRK group and 52.8 ± 3.1 pg/mL in the FS-LASIK group, compared with 32.4 ± 1.9 pg/mL in the SMILE group on day 1. Similarly, VEGFA protein concentrations were the highest in the PRK (72.4 ± 4.1 pg/mL) and FS-LASIK patients (69.5 ± 3.8 pg/mL) on day 1 but remained low in the SMILE patients (45.6 ± 2.3 pg/mL). By day 180, gene expression and protein levels in all groups had stabilized, returning to near-preoperative values. Conclusions: PRK and FS-LASIK induced more pronounced molecular and protein-level changes during corneal wound healing than the less invasive SMILE procedure, indicating stronger biological responses. These findings suggest that tailored postoperative care based on the specific procedure could optimize healing and patient outcomes. However, further research with larger sample sizes and longer follow-ups is needed to confirm these observations and develop personalized treatment strategies. [ABSTRACT FROM AUTHOR]
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- 2024
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13. Factors predicting slow visual recovery following microkeratome‐assisted myopic LASIK.
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Safir, Margarita, Sorkin, Nir, Kaiserman, Igor, Sela, Tzahi, Munzer, Gur, Spierer, Oriel, and Mimouni, Michael
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VISUAL acuity , *ASTIGMATISM , *LOGISTIC regression analysis , *REFRACTIVE lamellar keratoplasty , *MYOPIA , *LASIK - Abstract
Purpose Design Methods Results Conclusion To identify factors predicting slow visual recovery following myopic microkeratome assisted in situ keratomileusis (LASIK).Retrospective study.This study included consecutive patients who underwent microkeratome‐assisted myopic LASIK between January 2005 and December 2019 at Care Vision Laser Center, Tel Aviv, Israel. Patients were divided into three groups according to whether they experienced normal recovery of visual acuity (1 week visit), slow visual recovery (1 month visit) or very slow recovery (>1 month). Normal visual recovery was defined as achieving an efficacy index of 0.9 or greater. Efficacy index was calculated as postoperative uncorrected visual acuity/preoperative best corrected visual acuity. A comparison of baseline and intraoperative parameters was performed.Overall, 10 439 eyes were included. Mean age was 30.8 ± 8.7 years and 47.1% were females. The slower visual recovery groups (slow 11.4%, n = 1191; very slow 8.4%, n = 875) were of older age (p < 0.001), steeper preoperative steep keratometry (p = 0.002) and larger refractive astigmatism (p < 0.001). In binary logistic regression older age (p < 0.001), female gender (p = 0.001), larger astigmatism (p < 0.001) and high myopia (p < 0.001) remained significant predictors of slow visual recovery.Slow visual recovery was observed in 19.8% of patients following myopic LASIK. Older age, female gender, larger astigmatism and high myopia were associated with slow visual recovery. Patients may be advised accordingly. [ABSTRACT FROM AUTHOR]
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- 2024
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14. Full range of vision and visual quality after mini-monovision FS-LASIK in high myopic patients with presbyopia.
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Zhang, Ruiyu, Yuan, Yifei, Zhang, Yu, and Chen, Yueguo
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LASIK ,VISUAL acuity ,CONTRAST sensitivity (Vision) ,PRESBYOPIA ,MYOPIA ,SATISFACTION ,VISION - Abstract
Background: To evaluate clinical outcomes and visual quality 3 months after mini-monovision (spherical equivalent [SE] between − 0.25 D and − 0.50 D) femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for correction of high myopia in patients with presbyopia. Methods: Patients who had mini-monovision FS-LASIK for high myopia (SE < -6.0 D) and aged between 40 and 50 years were included. At the 3-month postoperative visit, we evaluated full range of visual acuity; defocus curve; optical quality; accommodation function, contrast sensitivity and stereopsis. Binocular tests were done twice, once in mini-monovision condition and once with the residual myopia in the non-dominant eye corrected. Subjective visual quality was evaluated with questionnaire postoperatively with mini-monovision correction. Results: Clinical data of 31 cases were analyzed. The average patient age was 42.58 ± 3.06 years. At the 3-month follow-up, the mean uncorrected binocular visual acuity at distance, intermediate, and near was − 0.11 ± 0.07, -0.06 ± 0.10, and 0.04 ± 0.11 logMAR separately. In comparison, patients with binocular full distance correction achieved better uncorrected distance visual acuity (UDVA), and they achieved superior uncorrected near visual acuity (UNVA, P = 0.04) with mini-monovision correction. FS-LASIK induced significant increases in higher-order aberrations (HOAs) (P < 0.001). For accommodative function, only the negative relative accommodation (NRA) improved significantly after surgery (P < 0.001). A slight decrease in contrast sensitivity was observed at low spatial frequency with mini-monovision correction (P < 0.05). Questionnaire demonstrated high satisfaction with near vision and visual quality. Conclusion: FS-LASIK with mini-monovision (SE between − 0.25 D and − 0.50 D) appeared to be safe and effective in treating high myopia combined with presbyopia to get satisfying visual quality at distant and at near. [ABSTRACT FROM AUTHOR]
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- 2024
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15. Comparing clinical outcomes of trifocal intraocular lens in patients with and without prior history of laser in situ keratomileusis for myopia.
- Author
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Cao, Xinfang, Zhang, Jun, Shao, Jie, and Han, Wei
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PATIENT satisfaction ,CONTRAST sensitivity (Vision) ,INTRAOCULAR lenses ,VISUAL acuity ,CONTINUOUS groups ,LASIK - Abstract
Background: To compare clinical outcomes of trifocal intraocular lens in patients with and without prior history of laser in situ keratomileusis (LASIK). Methods: A retrospective study included patients who underwent bilateral cataract surgery and PanOptix trifocal intraocular lens (IOLs) implantation. Patients were grouped: Group A for patients with history of LASIK and Group B for patients without history of LASIK. Postoperative outcome measures comprised distance, intermediate, and near visual acuity, manifest refraction, defocus curve, contrast sensitivity, visual quality, patient satisfaction, and the rate of spectacle independence. Results: A total of 288 eyes (144 patients) were included: 132 eyes in Group A and 156 eyes in Group B. At 6 months post-surgery, patients of both groups achieved a continuous satisfying visual acuity from 33 cm to distance. 73% of eyes in Group A and 75% of eyes in Group B were within ± 0.50 D of emmetropia (P > 0.05). The percentages of eyes within ± 1.00 D of emmetropia were 98% for Group A and 96% for Group B (P > 0.05). The total scores of satisfaction were 52.58 ± 3.46 for Group A and 53.23 ± 3.46 for Group B (P > 0.05). Most of patients (98% for Group A, 99% for Group B) were able to be spectacle independence for daily living. 53% of patients in Group A and 51% in Group B experiencd mild to moderate negative visual symptoms, which made it a little or moderate difficult to drive at night. Conclusions: Cataract patients with and without history of LASIK could safely undergo implantation of the PanOptix IOLs, which results in precise refractive outcomes and satisfactory visual acuity. Although contrast sensitivity decreased and some negative visual symptoms were observed, patients' satisfaction was generally high due to the high rate of spectacles independence. There were no statistically significant differences between the study groups. [ABSTRACT FROM AUTHOR]
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- 2024
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16. TRPV1 corneal neuralgia mutation: Enhanced pH response, bradykinin sensitization, and capsaicin desensitization.
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Gualdani, Roberta, Barbeau, Solène, Jun-Hui Yuan, Jacobs, Deborah S., Gailly, Philippe, Dib-Hajj, Sulayman D., and Waxman, Stephen G.
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LASIK , *MEMBRANE potential , *PHOTOREFRACTIVE keratectomy , *TRP channels , *INFLAMMATORY mediators - Abstract
The factors that contribute to pain after nerve injury remain incompletely understood. Laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) are common surgical techniques to correct refractive errors. After LASIK or PRK, a subset of patients suffers intense and persistent pain, of unknown origin, described by patients as feeling like shards of glass in their eye. Here, we evaluated a TRPV1 variant, p.V527M, found in a 49-y-old woman who developed corneal pain after LASIK and subsequent PRK enhancement, reporting an Ocular Surface Disease Index score of 100. Using patch-clamp and Ca2+ imaging, we found that the V527M mutation enhances the response to acidic pH. Increasing proton concentration induced a stronger leftward shift in the activation curve of V527M compared to WT, resulting in channel activity of the mutant in acidic pH at more physiological membrane potentials. Finally, comparing the responses to consecutive applications of different agonists, we found in V527M channels a reduced capsaicin-induced desensitization and increased sensitization by the arachidonic acid metabolite 12-hydroxyeicosatetraenoic acid (12-HETE). We hypothesize that the increased response in V527M channels to protons and enhanced sensitization by 12-HETE, two inflammatory mediators released in the cornea after tissue damage, may contribute to the pathogenesis of corneal neuralgia after refractive surgery. [ABSTRACT FROM AUTHOR]
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- 2024
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17. The effect of femtosecond laser-assisted in situ keratomileusis on contrast sensitivity.
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Pinqing Yue, Xiang Wang, Zeng Wang, Ying Li, Di Wu, Hua Zhang, and Pan Zhang
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CONTRAST sensitivity (Vision) ,PEARSON correlation (Statistics) ,VISUAL acuity ,LASIK ,NOISE control ,ANALYSIS of variance - Abstract
The benefits of femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for correcting vision, particularly in terms of spherical equivalent (SE) and visual acuity (VA), have gained broad recognition. Nevertheless, it has remained uncertain whether FS-LASIK has a positive impact on contrast sensitivity (CS). In this study, we measured CS on seven participants by the quick contrast sensitivity function (qCSF) and compared CS before and after the surgery at two time points (1 day and 7 days after) by the repeated measures analysis of variance (ANOVA). Then, we clarified the underlying mechanisms using the perceptual template model (PTM). Furthermore, we investigated the relationship among SE, VA, and CS employing the Pearson correlation test. We found that (1) CS exhibited significant improvements on postoperative day 1, with further enhancements observed up to postoperative day 7, (2) CS improvements were dependent on spatial frequency (SF) and external noise, (3) CS improvements were attributed to the reduction of internal noise and the enhancement of the perceptual template, (4) VA and SE demonstrated significant improvement postsurgery, and (5) no significant correlations were observed among SE, VA, and CS, possibly due to limitations in sample size and lighting conditions. These findings contribute to our comprehension of FS-LASIK and provide a great indicator for assessing the outcomes of visual surgery. [ABSTRACT FROM AUTHOR]
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- 2024
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18. Study of corneal and retinal thicknesses at five years after FS-LASIK and SMILE for myopia.
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Li, Jiayu, Qin, Jie, Lv, Xiaotong, Xu, Yushan, Jiang, Dianjun, Yuan, Mingzhen, Sun, Mingshen, and Zhang, Fengju
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SMALL-incision lenticule extraction ,LASIK ,PROPENSITY score matching ,SATISFACTION ,VISUAL acuity ,NERVE fibers - Abstract
Background: This study aimed to observe corneal and retinal thicknesses at 5 years after femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE) for myopia, investigate the effect of epithelial remodeling on refractive status and visual quality, and compare retinal thicknesses among fundus tessellation grades. Methods: Patients who received FS-LASIK or SMILE 5 years before were enrolled in this cross-sectional study. After 1:1 propensity score matching, each surgical group obtained 177 patients (177 eyes). Examinations including visual acuity, refraction, corneal and retinal thicknesses, corneal higher-order aberrations (HOAs), and fundus photography were performed in this visit at 5 years after surgery. The Quality of Vision (QoV) questionnaire was used to assess visual symptoms and overall satisfaction. Corneal and retinal thicknesses between groups were compared, contributing factors were analyzed, and correlations with postoperative refractive status, HOAs, QoV scores and overall satisfaction were evaluated. Results: The discrepancy of epithelial thickness between central and pericentral zones in FS-LASIK group was larger than that in SMILE group, which was negatively correlated with postoperative spherical equivalent (SE), positively correlated with spherical aberration (all P < 0.05), but not correlated with QoV scores and overall satisfaction (all P > 0.05) in both surgical groups. There was no statistical difference in stromal thickness and total corneal thickness (all P > 0.05). Most annuluses of epithelial and stromal thicknesse were linearly related to preoperative SE (all P < 0.05). The macular thickness, ganglion cell complex thickness, and retinal nerve fiber layer thickness exhibited comparable values between two surgical groups and four fundus tessellation grades, with no significant association observed with postoperative SE (all P > 0.05). Conclusion: The tendency that epithelial thickness in central zone was thicker than peripheral zone was more obvious at 5 years after FS-LASIK compared to SMILE. This uneven distribution of epithelial thickness might play a role in myopic regression and the changes in HOAs, especially in patients with high myopia, but it had little effect on patients' subjective visual quality and satisfaction. Retinal thicknesses were not affected by these two surgical methods, and they did not appear to be the clinical indicators for myopic regression or fundus tessellation progression. [ABSTRACT FROM AUTHOR]
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- 2024
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19. Comparison of long-term changes in the effective optical zone following SMILE and FS-LASIK for moderate and high myopia.
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Huang, Yangyi, Han, Tian, Wang, Yuliang, Peng, Xiaoliao, Ten, Weijung, Zhou, Xingtao, and Xu, Ye
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SMALL-incision lenticule extraction ,LASIK ,SMILING ,REFRACTIVE lamellar keratoplasty ,MYOPIA ,CORNEA - Abstract
Background: Visual quality after corneal refractive surgery is linked to the postoperative effective optical zone (EOZ). This study aims to compare long-term changes in the EOZ following small incision lenticule extraction (SMILE) and femtosecond laser-assisted in-situ keratomileusis (FS-LASIK) for moderate and high myopia. Methods: This study included 42 patients (72 eyes) who underwent either SMILE (36 eyes) or FS-LASIK (36 eyes). A custom software program based on the tangential curvature difference map of the Pentacam HR (Oculus Optikgeräte GmbH) was used to define the EOZ at 3 and 7 years postoperatively. The EOZ, its chronological changes compared to the programmed optical zone (POZ), and the corneal wavefront aberrations following SMILE and FS-LASIK were analyzed. Correlations between the EOZ changes and relevant parameters were evaluated. Results: Three years postoperatively, EOZ following SMILE and FS-LASIK were 5.13 ± 0.27 mm and 4.70 ± 0.24 mm (P < 0.001), respectively. Seven years postoperatively, EOZ following SMILE and FS-LASIK decreased to 5.03 ± 0.28 mm and 4.63 ± 0.23 mm (P < 0.001), respectively. At postoperative 7 years, the percentages of EOZ/POZ were negatively correlated with Q-value changes (β = -5.120, P = 0.009) following SMILE and positively correlated with the cylinder correction (β = 1.184, P = 0.004) following FS-LASIK. The induced spherical aberrations in the SMILE group were less than those in the FS-LASIK group (P < 0.05) and were negatively correlated with the EOZ/POZ (β = -16.653, P < 0.001). Conclusions: The EOZ following SMILE was larger than that following FS-LASIK in the long postoperative term for moderate and high myopia. Furthermore, a continual reduction in the EOZ was noted after both surgical modalities. [ABSTRACT FROM AUTHOR]
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- 2024
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20. Incidence and Risk Factors of Refractive Regression following LASIK Surgery: A Systematic Review and Meta-Analysis.
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Alamri, Abdulrahman, Almugharrid, Rayan Mohammed S., Almousa, Mohammed Saeed M., Alshabab, Saud Qasem A., Ahmed Mushari, Fahad Yahya, AlQarni, Fawaz Naif M., Ogran, Mohammed Abdulrahman H., Namri, Saif Tawfig M., Alzuhairi, Abdulmohsin Mohammed S., and Hejazi, Faris Hatem A.
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RANDOM effects model , *REFRACTIVE lamellar keratoplasty , *REFRACTIVE errors , *REGRESSION analysis , *PUBLISHED articles , *LASIK , *PHOTOREFRACTIVE keratectomy - Abstract
Background: laser in situ keratomileusis (LASIK) is a widely used technique for myopia. However, regression of refraction is a common complication after long follow up periods. This study aims to evaluate the incidence and risk factors of refractor regression after LASIK surgery. Methods: A systematic search on four databases (PubMed, Cochrane, Web of Science, and Scopus) retrieved all published articles till April 2024. The studies included if they were reported in English, assessing refractive regression after LASIK. Meta-analysis was conducted using OpenMeta analyst using the random effect model with 95% confidence interval (CI). Further meta regression analysis was conducted to test the correlation between the mean regression and some risk factors like spherical equivalent and age. Results: The search yielded seven articles with 327 participants of 482 eyes. The analysis included 127 males and 159 females. The pooled analysis indicated significant regression occurs after refractive surgery P <0.001). additionally, the analysis indicated the significant association between the mean regression and spherical equivalent which mean that patients with higher degrees of myopia, more negative spherical equivalent, have higher regression of their nearsightedness following LASIK. Conclusion: This systematic review and meta-analysis is the first to provide comprehensive assessment of myopic regression following LASIK surgery. Our analysis indicated a higher incidence of refractive regression following LASIK. Also, the spherical equivalent is a significant risk factor for regression after long follow-up. Further research with more standardized protocols, with control arm, and long follow-up periods are important to investigate a wider range of risk factors that might increase the susceptibility of regression occurrence. [ABSTRACT FROM AUTHOR]
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- 2024
21. Changes in cataract and refractive surgery practice patterns among JSCRS members over the past 20 years.
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Sato, Masaki, Kamiya, Kazutaka, Hayashi, Ken, Tabuchi, Hitoshi, Kojima, Takashi, Goto, Norihito, Hatsusaka, Natsuko, Torii, Hidemasa, Nagata, Mayumi, and Miyata, Kazunori
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OPERATIVE surgery , *INTRAOCULAR lenses , *CATARACT surgery , *PHYSICIAN practice patterns , *LASIK ,SURGERY practice - Abstract
Purpose: To evaluate changes in cataract and refractive surgery practice patterns among members of the Japanese Society of Cataract and Refractive Surgery (JSCRS) over the past 20 years. Study design: Questionnaire survey study. Subjects and methods: Clinical surveys were conducted annually between February and April from 2004 to 2023. Survey questions covered various areas, including cataract surgical techniques, anesthesia, endophthalmitis prophylaxis, toric and presbyopia-correcting intraocular lenses (IOLs), complications, and refractive surgery. Results: The highest (n=554 [36.8%]) and lowest (n=316 [19.1%]) numbers of responses were collected in 2012 and 2016, respectively. In perioperative management, the intraoperative use of polyvinyl alcohol-iodine solution and topical antibiotic prescription 3 days before surgery has increased. The use of intracameral injection at the end of surgery has also significantly increased, although it has not been established as common practice. In anesthesia, there is a clear polarization between the use of topical drops and tenon injection. The use of toric IOLs and presbyopia-correcting IOLs has significantly increased from 2010 to 2023. In the latter, the use of trifocal IOLs has particularly increased. Regarding IOL power calculations, the Barrett True K and the Barrett Universal II formulas are rapidly gaining popularity for application with and without post-laser vision correction, respectively. In refractive surgery, phakic IOLs and corneal refractive therapy have attracted considerable interest, followed by laser in situ keratomileusis. Conclusions: Evaluation of annual clinical survey data over the past two decades provided valuable insights into the shifting practice patterns and clinical opinions among JSCRS members. [ABSTRACT FROM AUTHOR]
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- 2024
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22. Lens Factor Choice in IOL Power Calculation after Laser Refractive Surgery: The Right Constant for Advanced Lens Measurement Approach (ALMA).
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Cione, Ferdinando, De Bernardo, Maddalena, Di Stasi, Margherita, De Luca, Martina, Albano, Rosa, and Rosa, Nicola
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PHOTOREFRACTIVE keratectomy , *LASER surgery , *CATARACT surgery , *LASIK , *REFRACTIVE errors , *BIOMETRY - Abstract
Background/Objectives: To evaluate the advanced lens measurement approach (ALMA) formula accuracy using different lens constants available on the user group for laser interference biometry (ULIB) and IOL Con platforms. Methods: In this retrospective, comparative, case-series study, 150 eyes of 160 patients with previous myopic Photorefractive Keratectomy (PRK) or laser-assisted in situ keratomileusis (LASIK), who underwent uneventful cataract surgery and IOL implantation, were examined. The ALMA formula was evaluated to calculate the refractive prediction error (PE), analysing four different categories of lens constants: both nominal and optimized A-Constant for SRKT, which are available on the ULIB and IOL Con platforms. An additional analysis was carried out in this study, evaluating if a decreased ULIB optimized constant (DUOC) with different fixed factors (−1.2 −1.3 −1.4 −1.5) could improve refractive outcomes. Median absolute error (MedAE) and percentage of eyes within ±0.50 and ±1.00 diopters (D) of prediction error were measured as the main outcomes. Results: Comparing the lens factors available on ULIB and IOL Con platforms, the ALMA formula reported a lower MedAE and higher percentages of eyes with a refractive PE within 1.0 D using ULIB nominal constants (all p < 0.05). Using DUOC (−1.3), and there was a statistically significant improvement of both MedAE and of the percentages of eyes with PE within ±0.50 D with the ALMA method compared to nominal ULIB constants (all p < 0.05). Conclusions: The impact of different lens factors in the IOL power calculation after myopic LRS should be carefully evaluated. The ALMA formula, in the absence of optimized constants by zeroing the mean error, should be used by subtracting 1.3 from the optimized ULIB constants available on the IOL Con website. This finding suggests further studies to test which of these constants could work better with the other post-refractive surgery formulas. [ABSTRACT FROM AUTHOR]
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- 2024
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23. High hyperopic LASIK with reduction of corneal prolateness to control-induced spherical aberration.
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Salah-Mabed, Imene, Debellemanière, Guillaume, Rampat, Radhika, Dubois, Mathieu, and Gatinel, Damien
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LASIK , *CORNEA , *EXCIMER lasers , *CLINICAL trials , *VISUAL acuity - Abstract
Purpose: To evaluate visual outcomes of high hyperopic laser in situ keratomileusis (LASIK), using corneal aspherization to control the induced spherical aberration. Setting: Fondation Ophtalmologique Adolphe de Rothschild, Paris, France. Design: Prospective interventional case series. Methods: Prospective interventional study of consecutive high hyperopes (≥+3 diopters [D] of spherical equivalent [SE]) undergoing LASIK with the WaveLight FS200 femtosecond and EX500 excimer laser platform. An aspheric ablation profile (planned change in corneal asphericity DQ = +0.2) was delivered using the Custom-Q nomogram on an optical zone of ≥6.5 mm centered near the corneal vertex. Uncorrected corrected distance visual acuity (UDVA) and corrected distance visual acuity, as well as changes in SE, corneal asphericity (DQ), and higher-order aberrations, were analyzed preoperatively and on day 1, 1, 3, 6, and 12 months. Results: 117 eyes of 63 patients (mean age of 30.1 ± 5.6 years) were included. Preoperatively and at 12 months postoperatively, the mean SE was 5.1 ± 1.1 D and 0.00 ± 0.7 D, respectively. 88% of eyes achieved 0 logMAR or better UDVA at 12 months. 1 month postoperatively, there was a statistically significant induction of positive spherical aberration decreasing progressively and significantly until the last visit (preop SA4 = 0.09 ± 0.11 mm, day 1 SA4 = 0.30 ± 0.32 mm, 12 months SA4 = 0.08 ± 0.21 mm, P = .056). 2 eyes needed enhancement at 12 months. Conclusions: LASIK for high levels of hyperopia showed good outcomes mainly due to aspheric-customized ablation profile with a change of DQ = +0.2 in corneal asphericity. [ABSTRACT FROM AUTHOR]
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- 2024
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24. Refractive outcomes using Barrett formulas and patient characteristics of cataract surgery patients with and without prior LASIK/PRK.
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Fonteh, Cheryl N., Patnaik, Jennifer L., Grove, Nathan C., Lynch, Anne M., Pantcheva, Mina B., and Christopher, Karen L.
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CATARACT surgery , *TYPE 2 diabetes , *REFRACTIVE errors , *MENTAL illness , *PEOPLE with mental illness , *LASIK , *PHOTOREFRACTIVE keratectomy - Abstract
Purpose: The goal of this study is to describe characteristics of cataract surgery patients who previously underwent laser in situ keratomileusis/photorefractive keratectomy (LASIK/PRK) in comparison to non-LASIK/PRK cataract surgery patients including psychiatric comorbidities, as well as describe refractive prediction error after cataract surgery while accounting for axial length (AL) using the Barrett True-K and Barrett Universal II formulas. Methods: This was a retrospective study of patients from the University of Colorado Cataract Outcomes Registry. The primary outcomes were refraction prediction error (RPE), mean absolute RPE, and median absolute RPE. Outcomes were stratified by five axial length groups. Univariate and multivariate models for RPE were stratified by the AL group. Results: Two hundred eighty-one eyes with prior LASIK/PRK and 3101 eyes without are included in the study. Patients with prior LASIK/PRK were significantly younger: 67.0 vs 69.9 years, p < 0.0001. The LASIK/PRK group had significantly better mean pre-operative BCVA in comparison to the non-LASIK group, logMAR 0.204 vs logMAR 0.288, p = 0.003. The LASIK/PRK group had significantly lower rates of cardiovascular disease (18.5% vs 29.3%, p < 0.001), hypertension (49.1% vs 59.3%, p < 0.012), and type 2 diabetes (10.7% vs 26.0%, p < 0.001), and no significant difference in psychiatric disease. The absolute RPE was higher for the LASIK group for all ALs, but only significantly higher for eyes with AL less than 25 mm. Conclusion: Patient eyes with prior LASIK/PRK surgery undergoing cataract surgery were significantly younger, had significantly less comorbidities, and a significantly better pre-operative BCVA. Using the Barrett formulas, absolute prediction error for eyes with longer ALs was not significantly worse for LASIK/PRK eyes than those without and the difference was smaller for eyes with longer AL. [ABSTRACT FROM AUTHOR]
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- 2024
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25. Current paradigms in refractive surgery.
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Namdev, Vaibhav, Kaur, Manpreet, Sharma, Vijay K., Mulay, Akanksha, Raj, Rishav, and Titiyal, Jeewan S.
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PHOTOREFRACTIVE keratectomy ,INTRAOCULAR lenses ,FEMTOSECOND lasers ,PATIENT satisfaction ,REFRACTIVE errors ,LASIK - Abstract
Refractive surgeries have evolved from the archaic incisional corneal procedures to the use of sophisticated femtosecond lasers and new-generation phakic intraocular lenses (pIOL) for surgical correction of refractive errors. The armamentarium of modern-day refractive surgery includes corneal-based procedures such as photorefractive keratectomy, laser-assisted in situ keratomileusis and keratorefractive lenticule extraction, as well as lensbased pIOL implantation. The current procedures are associated with a high index of efficacy and predictability, with enhanced safety and a significant reduction in sight-threatening complications. Patient counselling and case selection is imperative to achieve optimal visual outcomes and patient satisfaction. This review article provides a comprehensive overview of current refractive surgery procedures, with an emphasis on decision-making. Evolving frontiers in refractive surgeries like customised corneal ablation and presbyopia correcting pIOL are also discussed. [ABSTRACT FROM AUTHOR]
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- 2024
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26. Low Contrast Acuity Outcomes After SMILE and LASIK.
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Sia, Rose K., Eaddy, Isabel, Beydoun, Hind, Eaddy, Jennifer B., Hogan, Alexis, and Skurski, Zachary P.
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LASIK ,VISUAL acuity ,MILITARY personnel ,NIGHT vision ,WAVEFRONTS (Optics) - Abstract
Purpose: To compare early visual quality of small incision lenticule extraction (SMILE) versus laser in situ keratomileusis (LASIK) in terms of low contrast acuity. Methods: A secondary analysis was performed using a harmonized dataset derived from two completed prospective cohort studies on active-duty military service members undergoing either SMILE (n = 37), wavefront-guided (WFG) LASIK (n = 51), or wavefront-optimized (WFO) LASIK (n = 56). Night vision and photopic and mesopic low contrast visual acuity (LCVA) up to 3 months postoperatively were compared between groups. Results: Compared to SMILE-treated eyes, WFG LASIK–treated eyes had significantly better night vision and photopic LCVA at 1 month postoperatively (beta = −0.039, P =.016; beta = −0.043, P =.007, respectively). WFO LASIK–treated eyes had significantly better photopic LCVA at 1 month postoperatively (beta = −0.039, P =.012) but had worse mesopic LCVA at 3 months postoperatively (beta = 0.033, P =.015) versus SMILE-treated eyes. Conclusions: SMILE and LASIK, on either a WFG or WFO laser platform, yielded excellent outcomes, but LCVA seemed to recover quicker following LASIK compared to SMILE. [J Refract Surg. 2024;40(9):e667–e671.] [ABSTRACT FROM AUTHOR]
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- 2024
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27. Effect of Posterior Keratometry and Corneal Radius Ratio on the Accuracy of Intraocular Lens Formulas After Myopic LASIK/PRK.
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Zheng, Yuxing, Zhang, Jiaqing, Han, Xiaotong, Huang, Ruoxuan, Wen, Ling, Ye, Jinfeng, Huang, Yiguo, Qiu, Xiaozhang, Chen, Xiaoyun, Tan, Xuhua, and Luo, Lixia
- Subjects
LASIK ,PHOTOREFRACTIVE keratectomy ,OPHTHALMIC surgery ,CATARACT ,MYOPIA treatment - Abstract
Purpose: To investigate the impact of back-to-front corneal radius ratio (B/F ratio) and posterior keratometry (PK) on the accuracy of intraocular lens power calculation formulas in eyes after myopic laser in situ keratomileusis (LASIK)/photorefractive keratectomy (PRK) surgery. Methods: A retrospective, consecutive case series study included 101 patients (132 eyes) with cataract after myopic LASIK/PRK. Mean prediction error (PE), mean absolute PE (MAE), median absolute error (MedAE), and the percentage of eyes within ±0.25, ±0.50, and ±1.00 diopters (D) of PE were determined. Results: The Barrett True K-TK formula exhibited the lowest MAE (0.59 D) and MedAE (0.48 D) and the highest percentage of eyes within ±0.50 D of PE (54.55%) in total. In eyes with a B/F ratio of 0.70 or less and PK of −5.70 D or greater, the Potvin-Hill formula displayed the lowest MAE (0.46 to 0.67 D). Conclusions: The Barrett True-TK exhibited the highest prediction accuracy in eyes after myopic LASIK/PRK overall. However, for eyes with a low B/F ratio and flat PK, the Potvin-Hill performed best. [J Refract Surg. 2024;40(9):e635–e644.] [ABSTRACT FROM AUTHOR]
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- 2024
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28. 12-Month Visual and Refractive Outcomes of Topography-guided Femtosecond Laser–Assisted LASIK for Myopia and Myopic Astigmatism.
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Saleh, Solin, Epp, Liam J., Tran, Elaine My Tien, and Manche, Edward E.
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FEMTOSECOND lasers ,LASIK ,MYOPIA ,ASTIGMATISM ,REFRACTION (Optics) - Abstract
Purpose: To report 12-month visual and refractive outcomes following topography-guided femtosecond laser–assisted laser in situ keratomileusis (LASIK) for myopia and compound myopic astigmatism correction. Methods: This prospective, single-center observational study was conducted in an outpatient clinical practice at the Stanford University Byers Eye Institute in Palo Alto, California. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity, 5% and 25% contrast sensitivity CDVA, and manifest refraction following topography-guided femtosecond laser–assisted LASIK were assessed. Refractive measurements were used to perform a vector analysis. Results: Sixty eyes of 30 patients (mean age: 32.8 ± 7.0 years; range: 23 to 52 years) undergoing topography-guided LASIK for the correction of myopia and compound myopic astigmatism were analyzed. Mean postoperative UDVA was −0.09 ± 0.10 logarithm of the minimum angle of resolution (logMAR) at 12 months. Mean preoperative CDVA was −0.09 ± 0.09 and −0.13 ± 0.08 logMAR at postoperative 12 months. At 12 months, 26.9% of eyes had gained one or more lines of postoperative UDVA compared to baseline CDVA. Mean pre-operative 5% contrast sensitivity CDVA was 0.68 ± 0.07 and 0.64 ± 0.12 logMAR at 12 months (P =.014) following LASIK. Conclusions: Topography-guided LASIK for myopia and myopic astigmatism correction provided excellent visual and refractive outcomes that were predictable, precise, and stable up to 12 months postoperatively. [J Refract Surg. 2024;40(9):e595–e603.] [ABSTRACT FROM AUTHOR]
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- 2024
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29. Pseudo Corneal Ectasia Due to Corneal Endothelial Disease.
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Zaman, Michele, Martin, Rachel Ann, and Johnson, Davin
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LASIK ,REFRACTIVE lamellar keratoplasty ,CORNEA - Abstract
Purpose: To describe two patients referred for presumed ectasia after laser in situ keratomileusis (LASIK) based on increasing myopia and corneal steepening years after LASIK. In both patients, further testing confirmed endothelial disease with central corneal edema as the cause of topographic changes. Methods: Two patients showing symptoms similar to post-LASIK ectasia were assessed with Scheimpflug imaging (Pentacam; Oculus Optikgeräte GmbH) and subsequently treated with endothelial keratoplasty. Results: Case 1 was a 66-year-old woman with increasing myopia after LASIK that was initially diagnosed as post-LASIK ectasia. Pentacam imaging revealed central corneal steep-ening with central corneal edema, and the clinical presence of guttata was consistent with Fuch's endothelial dystrophy. Case 2 was a 49-year-old man who also had increasing myopia and corneal steepening after LASIK, but no guttata. Pentacam imaging showed a similar pattern of central corneal swelling. Both patients underwent endothelial keratoplasty with reversal of corneal steepening. Conclusions: Several conditions can mimic corneal ectasia, necessitating thorough clinical examination and tomography. This report describes two cases of central corneal edema resulting in myopia and corneal steepening that mimicked corneal ectasia. [Journal of Refractive Surgery Case Reports. 2024;4(3):e24–e29.] [ABSTRACT FROM AUTHOR]
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- 2024
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30. Clinical outcomes of topography-guided versus wavefront-optimized LASIK for correction of myopia and compound myopic astigmatism
- Author
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Deeksha Rani, Sudarshan Khokhar, Aishwarya Rathod, Venkatesh Nathiya, Amar Pujari, and Tavish Gupta
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aaa lasik ,lasik ,topo-guided lasik ,Ophthalmology ,RE1-994 - Abstract
Purpose: To compare the safety, efficacy, and visual outcomes of topography-guided (TG) LASIK ablation versus advanced ablation algorithm (AAA) on Zeiss Mel 90 on virgin eyes. Setting: A tertiary care hospital in north India. Design: A retrospective comparative study. Methods: Case sheets of 30 patients who underwent TG LASIK and 45 patients who underwent AAA LASIK between January 2021 and September 2022 were retrieved and reviewed. The TG group included 60 eyes of 30 patients, and the AAA group included age- and sex-matched 90 eyes of 45 patients. Both groups were compared for visual outcomes, residual refraction, and root-mean-square higher-order aberrations (rms HOA) at 1 week, 1 month, 3 months, and 6 months postoperatively and using unpaired t-test and Mann-Whitney U test. Results: The mean preoperative spherical equivalent in the TG group and AAA group was − 3.12 (1.67) and − 3.19 (1.61), respectively. The safety and efficacy of the treatment were 100% in both groups. The postoperative increase in rms HOA was comparable in both groups (P = 0.55). The ablation duration was significantly longer in topo-guided LASIK (P = 0.001). Conclusion: AAA LASIK on MEL 90 is comparable to topography-guided LASIK for the management of low myopia and myopic astigmatism.
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- 2024
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31. First report of uncommon mycobacteria in post LASIK keratitis: Mycobacterium wolinskyi
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Sébastien van Delden, Hélène Buvelot, Giorgio Enrico Bravetti, Truong-Thanh Pham, Gabriele Thumann, and Horace Massa
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Mycobacterium wolinskyi ,Keratitis ,Mycobacteria keratitis ,LASIK ,Refractive surgery ,Cornea ,Ophthalmology ,RE1-994 - Abstract
Abstract Laser assisted in situ keratomileusis (LASIK) surgery is the leading and most performed refractive surgery nowadays. A possible complication of LASIK surgery is infectious keratitis which can lead to disastrous corneal damage and result in permanent loss of vision. LASIK procedures have become increasingly accessible, and the demand for refractive surgery has risen among patients, challenging the medical field to improve the prevention of post-operative infections. Nevertheless, a wide range of pathogens have been described as responsible for post-LASIK keratitis. However, non-tuberculous mycobacterial keratitis remains an infrequent occurrence and is poorly described in the literature. To the best of our knowledge, this is the first ever reported case of post-LASIK keratitis caused by Mycobacterium wolinskyi. We describe the clinical and microbial characteristics, leading to its challenging treatment choice.
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- 2024
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32. Comparing clinical outcomes of trifocal intraocular lens in patients with and without prior history of laser in situ keratomileusis for myopia
- Author
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Xinfang Cao, Jun Zhang, Jie Shao, and Wei Han
- Subjects
Trifocal intraocular lens ,Cataract surgery ,LASIK ,Ophthalmology ,RE1-994 - Abstract
Abstract Background To compare clinical outcomes of trifocal intraocular lens in patients with and without prior history of laser in situ keratomileusis (LASIK). Methods A retrospective study included patients who underwent bilateral cataract surgery and PanOptix trifocal intraocular lens (IOLs) implantation. Patients were grouped: Group A for patients with history of LASIK and Group B for patients without history of LASIK. Postoperative outcome measures comprised distance, intermediate, and near visual acuity, manifest refraction, defocus curve, contrast sensitivity, visual quality, patient satisfaction, and the rate of spectacle independence. Results A total of 288 eyes (144 patients) were included: 132 eyes in Group A and 156 eyes in Group B. At 6 months post-surgery, patients of both groups achieved a continuous satisfying visual acuity from 33 cm to distance. 73% of eyes in Group A and 75% of eyes in Group B were within ± 0.50 D of emmetropia (P > 0.05). The percentages of eyes within ± 1.00 D of emmetropia were 98% for Group A and 96% for Group B (P > 0.05). The total scores of satisfaction were 52.58 ± 3.46 for Group A and 53.23 ± 3.46 for Group B (P > 0.05). Most of patients (98% for Group A, 99% for Group B) were able to be spectacle independence for daily living. 53% of patients in Group A and 51% in Group B experiencd mild to moderate negative visual symptoms, which made it a little or moderate difficult to drive at night. Conclusions Cataract patients with and without history of LASIK could safely undergo implantation of the PanOptix IOLs, which results in precise refractive outcomes and satisfactory visual acuity. Although contrast sensitivity decreased and some negative visual symptoms were observed, patients’ satisfaction was generally high due to the high rate of spectacles independence. There were no statistically significant differences between the study groups.
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- 2024
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33. Recent Advances in Refractive Surgery: An Overview
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Gurnani B and Kaur K
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.refractive surgery ,lasik ,prk ,smile ,wavefront-guided lasik ,Ophthalmology ,RE1-994 - Abstract
Bharat Gurnani,1 Kirandeep Kaur2 1Department of Cataract, Cornea and Refractive Surgery, Gomabai Netralaya and Research Centre, Neemuch, Madhya Pradesh, India; 2Department of Cataract, Pediatric Ophthalmology and Strabismus, Gomabai Netralaya and Research Centre, Neemuch, Madhya Pradesh, IndiaCorrespondence: Bharat Gurnani, Department of Cataract, Cornea and Refractive Surgery, Gomabai Netralaya and Research Centre, Neemuch, Madhya Pradesh, 458441, India, Tel +919080523059, Email drgurnanibharat25@gmail.comAbstract: Refractive surgery has experienced substantial advancements over the past few years, driven by innovative techniques and continuous technological progress aimed at enhancing visual outcomes and patient satisfaction. Refractive errors such as myopia, hyperopia, and astigmatism affect a significant portion of the global population, impacting quality of life and productivity. Recent advancements have been fueled by a deeper understanding of ocular biomechanics and visual optics, leading to more precise and effective treatments. Traditional methods such as LASIK and PRK have been refined, and new procedures like SMILE (Small Incision Lenticule Extraction) have been introduced, expanding the range of treatable refractive errors and improving safety and predictability. Customized treatments, such as wavefront-guided LASIK and topography-guided PRK, allow for individualized plans tailored to each patient’s unique corneal characteristics, enhancing visual acuity and reducing higher-order aberrations. The use of femtosecond lasers in procedures like Femto-LASIK and femtosecond laser-assisted cataract surgery (FLACS) offers unparalleled precision, reducing surgical risks and improving outcomes. Implantable Collamer Lenses (ICLs) and corneal crosslinking (CXL) have emerged as effective options for specific patient groups. Advanced diagnostic tools like optical coherence tomography (OCT) and Scheimpflug imaging have improved surgical planning and complication management. As research and technology continue to evolve, these advancements promise even greater improvements in refractive surgery, addressing the visual needs of the global population.Keywords: refractive surgery, LASIK, PRK, SMILE, wavefront-guided LASIK
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- 2024
34. Comparison between 80-microns versus 100-microns flap femtosecond LASIK for correction of myopia and myopic astigmatism
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Sudarshan Khokhar, Deeksha Rani, Hemant Jhajharia, Saumya Kumar, Aishwarya Rathod, and Sarika Rajput
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80 microns ,lasik ,thin flap ,Ophthalmology ,RE1-994 - Abstract
Purpose: This study aimed to compare the safety, efficacy, and visual outcomes of 80-microns LASIK versus 100-microns LASIK in managing myopia and myopic astigmatism. The study was conducted at a tertiary care hospital in North India. Methods: This was a prospective contralateral eye study that included patients with myopia and myopic astigmatism seeking refractive correction. The eligibility criteria included normal corneal topography, an epithelial thickness less than 60 microns, a calculated percentage tissue ablation (with 100-microns flap) less than 40%, a calculated residual stromal bed thickness (with 100-microns flap) more than 300 microns, and willingness to participate and follow up. Patients with glaucoma, cataracts, other visually disabling ocular pathologies, and a history of past ocular surgery were excluded. All patients underwent LASIK with 80-microns LASIK in one eye and 100-microns LASIK in the other eye. The patients were followed up for 6 months, and the results were analyzed. Results: The study included 216 eyes of 108 patients. The mean preoperative spherical equivalent in the 80-microns group and the 100-microns group was -3.53 ± 1.81 and -3.69 ± 1.32 diopters, respectively (P = 0.78). The mean 6 months decimal postoperative UCVA was 0.98 ± 0.13 in the 80-microns group and 0.97 ± 0.14 in the 100-microns group (P = 0.99). The postoperative change in the higher-order aberration profile was comparable in both groups (P = 0.78). The percentage tissue ablation was significantly lower in the 80-microns group (P = 0.002). The incidence of flap micro striae and OBL was higher in the 80-microns group, while neither of these had any visual implications. Conclusion: The study concluded that 80-microns LASIK is an efficacious and safe alternative to 100-micron LASIK, especially useful in patients with higher myopia.
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- 2024
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35. Posterior corneal surface stability after femtosecond laser-assisted in situ keratomileusis in patients with myopia and myopic astigmatism
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Adeline Low, Azida Juana Kadir, Zi Yun Chow, Tsung Fei Khang, and Sujaya Singh
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lasik ,myopia ,posterior cornea stability ,Ophthalmology ,RE1-994 - Abstract
Purpose: To evaluate the variation and stability of the posterior cornea surface parameters (posterior cornea curvature [PCC], posterior cornea astigmatism [PCA], and posterior cornea elevation [PCE]) after femtosecond laser-assisted in situ keratomileusis (LASIK) in patients with myopia and myopic astigmatism over a period of 6 months or longer. Methods: This retrospective study comprised 284 right eyes. Patients aged 18 years or older with myopia up to -12.00 D and/or astigmatism up to -6.00 DC and who underwent femtosecond LASIK were recruited. Patients were divided into three subgroups: low myopia (-0.50 to -3.00 D), moderate myopia (>-3.00 to ≤-6.00 D), and high myopia (>-6.00 D), according to their pre-LASIK spherical equivalent (SE). The variables included for analysis were PCC (central 0–3.0 mm, pericentral 3.0–6.0 mm, and peripheral region 6.0–9.0 mm), PCE, PCA, internal anterior chamber depth, intraocular pressure, and central cornea thickness at the pre- and post-LASIK stages. Results: The central PCC remained unchanged across all three myopia subgroups at 1 month when compared to the pre-LASIK stage and remained stable at 6 months. The pericentral regions became flatter across all myopia subgroups at 1 month postsurgery (P < 0.001) and remained unchanged at 6 months. This trend was not seen in the peripheral cornea regions, which remained unchanged at 1 and 6 months post-LASIK when compared to pre-LASIK mean readings. There were minimal changes in post-LASIK posterior cornea astigmatism throughout follow-up. There was no incidence of post-LASIK surgery ectasia in this study population. Conclusion: Post-LASIK, the different cornea subregions behaved differently. Overall, the posterior cornea surface remained stable post-LASIK across all myopia subgroups throughout follow-up.
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- 2024
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36. Comparison of intraocular lens power prediction by American Society of Cataract and Refractive Surgery formulas and Barrett True-K TK in eyes with prior laser refractive surgery
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Naren Shetty, Priyanka Sathe, Aishwarya, Mathew Francis, and Rohit Shetty
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american society of cataract and refractive surgery ,barrett true-k tk ,intraocular lens calculator ,lasik ,prk ,Ophthalmology ,RE1-994 - Abstract
Purpose: To evaluate the prediction accuracy of various intraocular lens (IOL) power calculation formulas on American Society of Cataract and Refractive Surgery (ASCRS) calculator and Barrett True-K total keratometry (TK) in eyes with previous laser refractive surgery for myopia. Methods: This retrospective study included eyes with history of myopic laser refractive surgery, which have undergone clear or cataractous lens extraction by phacoemulsification followed by IOL implantation. Those who underwent uneventful crystalline lens extraction were included. Eyes with any complication of refractive surgery or those with eventful lens extraction procedure and those who were lost to follow-up were excluded. Formulas compared were Wang–Koch–Maloney, Shammas, Haigis-L, Barrett True-K no-history formula, ASCRS average power, ASCRS maximum power on the ASCRS post-refractive calculator and the IOLMaster 700 Barrett True-K TK. Prediction error was calculated as the difference between the implanted IOL power and the predicted power by various formulae available on ASCRS online calculator. Results: Forty post-myopic laser-refractive surgery eyes of 26 patients were included. Friedman’s test revealed that Shammas formula, Barrett True-K, and ASCRS maximum power were significantly different from all other formulas (P < 0.00001 for each). Median absolute error (MedAE) was the least for Shammas and Barrett True-K TK formulas (0.28 [0.14, 0.36] and 0.28 [0.21, 0.39], respectively) and the highest for Wang–Koch–Maloney (1.29 [0.97, 1.61]). Shammas formula had the least variance (0.14), while Wang–Koch–Maloney formula had the maximum variance (2.66). Conclusion: In post-myopic laser refractive surgery eyes, Shammas formula and Barrett True-K TK no-history formula on ASCRS calculator are more accurate in predicting IOL powers.
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- 2024
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37. Three-Month Comprehensive Outcomes of Topography-Guided LASIK Versus Keratorefractive Lenticule Extraction (KLEx): A Prospective Contralateral Study
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Kayvon A. Moin, Garrett N. Manion, Srujay Pandiri, Phillip C. Hoopes, and Majid Moshirfar
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Contoura ,WaveLight ,Topography-guided ,LASIK ,SMILE ,KLEx ,Ophthalmology ,RE1-994 - Abstract
Abstract Introduction The aim of this study was to compare outcomes of topography-guided laser-assisted in situ keratomileusis (TG-LASIK) and small incision lenticule extraction (SMILE®) for correcting myopia and myopic astigmatism. Methods In this prospective, randomized contralateral study, 34 patients (68 eyes) received TG-LASIK in one eye, and SMILE in their fellow eye. Efficacy, safety, predictability, higher-order aberrations, corneal tomography, biomechanics, and patient-reported outcomes (PROs) were assessed preoperatively and up to 3 months postoperatively. Results Both platforms showed comparable efficacy at 3 months (TG-LASIK 1.08 ± 0.19; SMILE 0.98 ± 0.17, p = 0.055). However, TG-LASIK demonstrated quicker visual recovery, with 63% and 89% achieving uncorrected distance visual acuity (UDVA) of 20/16 or better at 1 day and 1 week, respectively, compared to SMILE (34% and 63%; p 0.05). Reported symptoms of glare, halos, rings, starbursts, or dry eye did not significantly differ between groups at 3 months (p > 0.05). Overall, 59% of patients preferred their TG-LASIK treated eye at 1 month, but 65% of patients had no specific eye preference at 3 months. Conclusion TG-LASIK and SMILE demonstrate excellent and comparable efficacy, safety, and predictability at 3 months, but TG-LASIK offers faster postoperative visual recovery at 1 day and 1 week. TG-LASIK induces fewer HOAs than SMILE, but both procedures affect corneal biomechanics similarly. Trial Registration ClincialTrials.gov identifier, NCT05611294.
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- 2024
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38. Pressure-Induced Stromal Keratopathy after Surface Ablation Surgery
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Jaime Guedes, Rodrigo Vilares-Morgado, Rodrigo Brazuna, Alexandre Costa Neto, Denisse Josefina Mora-Paez, Marcella Q. Salomão, Fernando Faria-Correia, and Renato Ambrósio Jr.
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surface ablation ,lasik ,stromal keratopathy ,goldmann applanation tonometry ,corneal biomechanics ,Ophthalmology ,RE1-994 - Abstract
Introduction: The purpose of this clinical report was to describe an unprecedented case of bilateral pressure-induced stromal keratopathy (PISK) following corneal photorefractive keratectomy, associated with presumed herpetic keratitis, and to present tomographic and biomechanical findings before and after appropriate treatment. Case Presentation: A 33-year-old male patient was referred to our clinic with suspected delayed corneal epithelial healing 3 weeks after an uncomplicated PRK. A central layer of corneal opacity with a presumed fluid-filled interface area was observed upon slit lamp biomicroscopy. Scheimpflug images from the Pentacam® revealed a hyperreflective area beneath the central cornea. Scheimpflug-based corneal tomography, biomechanical assessment using the Pentacam® AXL Wave, and the Corvis ST® were conducted. Goldmann applanation tonometry measured 23/13 mm Hg, while noncontact tonometry intraocular pressure measured with the Corvis ST® (Corvis ST IOPnct) was 40.5/43.5 mm Hg. Treatment with oral valacyclovir, combined with ocular hypotensive therapy, led to a significant reduction in IOP and improved corneal deformation parameters after 1 month. Conclusion: Surgeons should be aware of the inaccuracy of Goldmann applanation tonometry in PISK, which can occur after LASIK or surface ablation.
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- 2024
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39. Basics of Diagnosis and Treatment of Dry Eye Syndrome During Refractive Surgery
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V. N. Trubilin, E. G. Polunina, A. V. Trubilin, V. V. Kurenkov, E. V. Shiryaeva, and V. S. Zakatianskii
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ophthalmology ,lasik ,smile ,refractive surgery ,dry eye syndrome ,ocular surface ,diagnosis of dry eye syndrome ,Ophthalmology ,RE1-994 - Abstract
Given the prevalence of refractive surgery in modern ophthalmological practice, when preparing a patient for this type of surgery, it is important to understand the multifactorial mechanism of the development of dry eye syndrome in this group of patients. Analysis of the literature data made it possible to identify key factors in the disruption of the tear formation process after refractive surgery, which include the intersection of the nerve endings of the cornea, which in turn reduces the frequency of blinking and the distribution of the tear film over the ocular surface, and also causes a violation regarding neurotrophic factors secreted by the nerve endings of the cornea . The presence of a postoperative inflammatory reaction, which has a specific course, manifested in a change in the biochemical properties of the tear, damage to the goblet cells of the conjunctiva during the creation of a vacuum during LASIK and SMILE, leading to a subsequent deficiency of mucin in the tear, changes in the curvature of the cornea caused by laser refractive surgery are factors influencing the development of dry eye syndrome after refractive surgery. When preparing a patient for refractive surgery, to reduce the risk of developing severe forms of dry eye syndrome, including corneal ulceration, it is necessary to take into account a history of systemic diseases and allergic reactions, especially in patients with high myopia. The influence of cosmetic procedures, such as eyelash extensions, eyelid tattooing, blepharoplasty, and the use of botulinum toxin in the periorbital area on the course of the postoperative period during refractive surgery, has been poorly studied. Research in this area opens up a new range of opportunities to reduce the incidence of dry eye syndrome in patients after refractive surgery and improve the quality of life of patients and patient satisfaction with the surgical intervention.
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- 2024
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40. Optimization of Ray-Tracing-Guided LASIK Outcomes: A Prospective Comparative Study of ZZ InnovEyes Strategy versus Automated Strategy
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Cao X, Zhang J, Shao J, Zhang Y, and Zheng L
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lasik ,refractive surgery ,ray-tracing ,higher-order aberrations ,visual acuity ,Ophthalmology ,RE1-994 - Abstract
Xinfang Cao, Jun Zhang, Jie Shao, Yonggang Zhang, Li Zheng Department of Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, People’s Republic of ChinaCorrespondence: Jun Zhang, Email zhangjun@mskyk.onaliyun.comPurpose: To evaluate the effectiveness of Zhang and Zheng’s InnovEyes (ZZ InnovEyes) strategy for optimizing outcomes of ray-tracing-guided laser in situ keratomileusis (LASIK) compared to the standard automated strategy.Methods: A total of 38 patients (71 eyes) undergoing therapeutic refractive surgery at Hangzhou MSK Eye Hospital were randomly assigned to the ZZ InnovEyes and automated groups using double-masked randomization. The study assessed visual acuity, refractive outcomes, and higher-order aberrations preoperatively and at 1-day, 2-week, 1-month, and 3-month follow-ups. Statistical analysis was done with Microsoft Excel and SPSS 19.0.Results: The exposure and control groups comprised 36 and 35 eyes, respectively. The ZZ InnovEyes group demonstrated significant advantages in manifest refraction spherical equivalent (MRSE) correction compared to the automated approach group (0.13 ± 0.30 D vs 0.62 ± 0.40 D, p < 0.001), achieving 97.22% uncorrected distance visual acuity (UDVA) of 20/16 or better compared to 85.71% in the automated group at the 3-month follow-up (p = 0.08), and achieving 50.00% UDVA of 20/12.5 or better compared to 28.57% in the automated group at the 3-month follow-up (p = 0.06). Loss lines from preoperative corrected distance visual acuity to postoperative UDVA were lower in the ZZ InnovEyes group (0.00%) than the automated group (8.57%; p = 0.07). Both groups exhibited similar astigmatism corrections and higher-order aberrations.Conclusion: The ZZ InnovEyes strategy, which incorporates manifest and wavefront refraction for ray-tracing-guided LASIK, demonstrated superior MRSE correction and potential advantages in visual acuity outcomes compared to the standard automated strategy. This study highlights the need for ongoing optimization and research in refractive surgery.Clinical Trial Registration Number: ChiCTR2300078709.Keywords: LASIK, refractive surgery, ray-tracing, higher-order aberrations, visual acuity
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- 2024
41. A Comparative Study of the Effect of Femtosecond Laser-Assisted Cataract Surgery on Corneal Astigmatism in Post-LASIK Eyes and Virgin Eyes
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Cao X, Zhang J, and Han W
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lasik ,femtosecond laser-assisted ,cataract surgery ,corneal astigmatism ,surgically induced astigmatism ,Ophthalmology ,RE1-994 - Abstract
Xinfang Cao,1,2 Jun Zhang,2 Wei Han1 1Eye Centre, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China; 2Department of Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, Zhejiang Province, People’s Republic of ChinaCorrespondence: Wei Han, Eye Centre, Second Affiliated Hospital, School of Medicine, Zhejiang University, 1 Westlake Avenue, Hangzhou, Zhejiang Province, 310000, People’s Republic of China, Tel +86 13777451900, Email hanweidr@zju.edu.cnPurpose: To evaluate and compare the effect of femtosecond laser-assisted cataract surgery on corneal astigmatism in post-LASIK eyes and virgin eyes.Patients and Methods: Patients who underwent femtosecond laser-assisted cataract surgery were included in the study and categorized into two groups: Group A, consisting of patients with post-LASIK eyes, and Group B, consisting of patients with virgin eyes. Visual acuity, corneal astigmatism, and surgically induced astigmatism (SIA) were evaluated. Additionally, the correlation between SIA and preoperative corneal astigmatism, mean corneal curvature, and central corneal thickness was also analyzed.Results: A total of 168 eyes were enrolled in this study, with 62 eyes in Group A and 106 eyes in Group B. Significant differences in corneal astigmatism and SIA were observed between the two groups in the early postoperative period following cataract surgery (P< 0.05). However, there was no significant difference at 6 months postoperatively (P> 0.05). Corneal astigmatism demonstrated an against-The-rule shift in both groups postoperatively. No significant correlation was identified between SIA and preoperative corneal astigmatism, corneal curvature or corneal thickness. Additionally, there was no significant difference observed between the two groups in terms of uncorrected distance visual acuity (UDVA) at 6 months postoperatively.Conclusion: The effect of femtosecond laser-assisted cataract surgery on corneal astigmatism in post-LASIK eyes and virgin eyes was different in the early postoperative period. However, there was no significant difference at 6 months postoperatively. The post-LASIK eyes exhibited a delayed recovery compared to the virgin eyes.Keywords: LASIK, femtosecond laser-assisted, cataract surgery, corneal astigmatism, surgically induced astigmatism
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- 2024
42. Repeatability and reproducibility of a new method for centration analysis via optical zone tangent points after corneal refractive surgery.
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Wu, Xuejuan, Wu, Jing, Zhang, Chuanwei, Xu, Yan, Chen, Qian, Chen, Qing, and Li, Kai
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SMALL-incision lenticule extraction ,INTRACLASS correlation ,STATISTICAL reliability ,STANDARD deviations ,CORNEA ,LASIK - Abstract
Purpose: To investigate the repeatability and reproducibility of a new method for centration analysis after small incision lenticule extraction (SMILE) and femtosecond laser-assisted LASIK (FS-LASIK). Methods: This study comprised 29 eyes treated with SMILE and 24 with FS-LASIK. Decentrations were analyzed using tangential and pachymetry difference maps respectively. Both difference maps were generated with a Scheimpflug tomographer (Pentacam) for each eye, using preoperative and 3-month postoperative scans. Repeatability and reproducibility were evaluated by calculating the intraclass correlation coefficient (ICC), within-subject standard deviation (Sw), and coefficient of repeatability (CR). Results: ICC, Sw, and CR showed good to excellent repeatability in locating the coordinates of the optical zone (OZ) center on both maps, with values ranging from 0.84 to 0.96, 0.03 to 0.13, and 0.08 to 0.36 respectively. The repeatability of the total decentration from the preoperative corneal vertex on the tangential curvature difference maps( d TC ) and the pachymetry difference maps( d PC ) were moderate and good, respectively. The ICC, Sw, and CR of d TC were 0.63, 0.09, and 0.25, respectively. The ICC, Sw, and CR of d PC were 0.77, 0.10, and 0.28, respectively. The reproducibility of the OZ center measurements was excellent for the tangential difference maps (ICC ≥ 0.97 ) and good for the pachymetry difference maps (ICC ≥ 0.86). ICC, Sw, and CR showed excellent reproducibility of d TC , with values of 0.95, 0.03, and 0.08, respectively. ICC, Sw, and CR showed good reproducibility of d PC , with values of 0.89, 0.06, and 0.17, respectively. Conclusion: The centration analysis method used in this study showed good to excellent repeatability and reproducibility in locating the coordinates of the center of the OZ on the tangential and pachymetry difference maps. [ABSTRACT FROM AUTHOR]
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- 2024
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43. Analysis after posterior chamber phakic intraocular lens implantation: 17- to 19-year follow-up study.
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Sáanchez-Ventosa, Álvaro, Cano-Ortiz, Antonio, González Cruces, Timoteo, González, Marta Villalba, Membrillo, Alberto, and Villarrubia, Alberto
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- *
LASIK , *ANGLE-closure glaucoma , *PHOTOREFRACTIVE keratectomy , *IMMUNOLOGIC diseases , *OCULAR hypertension , *CRYSTALLINE lens - Abstract
This article presents the findings of a long-term study on the clinical outcomes, safety, and efficacy of the Visian implantable collamer lens (ICL) for myopia correction. The study followed patients for a mean duration of 17.52 years and found that the ICL procedure resulted in favorable visual outcomes with a low risk of complications. The study also found that the ICL did not cause a significant loss of endothelial cell density and had an optimal vaulting range to minimize complications. However, a small number of cases experienced complications such as angle-closure glaucoma and cataracts. The study concludes that the Visian ICL is a safe and effective long-term solution for myopia correction. [Extracted from the article]
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- 2024
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44. Refractive Surgery in Myopic Children.
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Urban, Beata and Bakunowicz-Łazarczyk, Alina
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INTRAOCULAR lenses , *PEDIATRIC surgery , *CHILD patients , *OPERATIVE surgery , *AGE groups , *LASIK , *PHOTOREFRACTIVE keratectomy - Abstract
In this paper, we summarize the current knowledge on refractive surgery performed in the myopic pediatric population. We describe the main concerns about refractive surgery in myopic children and the indications for refractive surgery in this age group. We present a range of surgical procedures that are being used for the management of unilateral/bilateral myopia in children: corneal refractive surgery (PRK, LASEK, LASIK, FS-LASIK and SMILE) and intraocular refractive surgery (phakic intraocular lens implantation, refractive lens exchange or clear lens extraction), with both their advantages and drawbacks. We also describe the various complications and measures to prevent them. [ABSTRACT FROM AUTHOR]
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- 2024
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45. Three-Month Comprehensive Outcomes of Topography-Guided LASIK Versus Keratorefractive Lenticule Extraction (KLEx): A Prospective Contralateral Study.
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Moin, Kayvon A., Manion, Garrett N., Pandiri, Srujay, Hoopes, Phillip C., and Moshirfar, Majid
- Subjects
- *
LASIK , *SMALL-incision lenticule extraction , *LONGITUDINAL method - Abstract
Introduction: The aim of this study was to compare outcomes of topography-guided laser-assisted in situ keratomileusis (TG-LASIK) and small incision lenticule extraction (SMILE®) for correcting myopia and myopic astigmatism. Methods: In this prospective, randomized contralateral study, 34 patients (68 eyes) received TG-LASIK in one eye, and SMILE in their fellow eye. Efficacy, safety, predictability, higher-order aberrations, corneal tomography, biomechanics, and patient-reported outcomes (PROs) were assessed preoperatively and up to 3 months postoperatively. Results: Both platforms showed comparable efficacy at 3 months (TG-LASIK 1.08 ± 0.19; SMILE 0.98 ± 0.17, p = 0.055). However, TG-LASIK demonstrated quicker visual recovery, with 63% and 89% achieving uncorrected distance visual acuity (UDVA) of 20/16 or better at 1 day and 1 week, respectively, compared to SMILE (34% and 63%; p < 0.05). Safety index at 3 months did not significantly differ between TG-LASIK and SMILE (p = 0.223). TG-LASIK and SMILE had 44% and 56% of eyes within 0.13 D of spherical equivalent (SEQ) target, respectively. SMILE induced more total higher-order aberrations (HOAs), vertical coma, and oblique trefoil than TG-LASIK at 3 months (p < 0.05). Both platforms showed similar increases in epithelial remodeling, but SMILE induced thicker epithelium than TG-LASIK at the 7.0-mm nasal zonal area. No significant differences were found in corneal hysteresis (CH) or corneal resistance factor (CRF) at 3 months (p > 0.05). Reported symptoms of glare, halos, rings, starbursts, or dry eye did not significantly differ between groups at 3 months (p > 0.05). Overall, 59% of patients preferred their TG-LASIK treated eye at 1 month, but 65% of patients had no specific eye preference at 3 months. Conclusion: TG-LASIK and SMILE demonstrate excellent and comparable efficacy, safety, and predictability at 3 months, but TG-LASIK offers faster postoperative visual recovery at 1 day and 1 week. TG-LASIK induces fewer HOAs than SMILE, but both procedures affect corneal biomechanics similarly. Trial Registration: ClincialTrials.gov identifier, NCT05611294. [ABSTRACT FROM AUTHOR]
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- 2024
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46. Clinical outcomes after topography-guided FS-LASIK for myopia with nonastigmatic eyes.
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Yuan, Yifei, Zhao, Xiaorui, Dong, Ruilan, Zhang, Ruiyu, Wang, Zizhen, and Chen, Yueguo
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LASIK ,VISUAL acuity ,FEMTOSECOND lasers ,ASTIGMATISM ,MYOPIA ,CORNEA - Abstract
Background: To analyze the clinical outcomes after topography-guided femtosecond laser–assisted laser in situ keratomileusis (FS-LASIK) with Phorcides Analytic Engine (PAE) algorithm or Custom-Q FS-LASIK for myopia with nonastigmatic eyes. Methods: In this retrospective study, a total of 90 eyes with myopia without manifest astigmatism (82 patients) were included. All surgeries were performed by topography-guided FS-LASIK planned with a PAE algorithm (42 eyes) or Custom-Q system (48 eyes). Refractive, visual outcomes and corneal aberrations were compared between the two groups. Results: At 6 months postoperatively, the postoperative uncorrected distance visual acuity (UDVA) was 20/20 or better in 42 eyes (100%) in the PAE compared with 44 eyes (92%) in Custom-Q (P =.120). The postoperative UDVA of 20/16 or better was measured in 92% of eyes in the PAE group and 81% of eyes in the Custom Q group (P =.320). Postoperative corrected distance visual acuity, manifest refractive spherical equivalent and refractive astigmatism were similar between the two groups (P >.05). The postoperative optical path difference (OPD) and Strehl ratio (SR) were significantly better in the PAE group compared with the Custom Q group. Conclusions: Topography-guided FS-LASIK with PAE algorithm or Custom Q demonstrated similar refractive efficacy and predictability. PAE for the patients with zero manifest astigmatism demonstrated better results in correcting corneal aberrations. [ABSTRACT FROM AUTHOR]
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- 2024
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47. Comparison of visual quality after wavefront-guided LASIK in patients with different levels of preoperative total ocular higher-order aberrations: a retrospective study.
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Zhang, Yu, Du, Yangrui, He, Ming, Zhang, Youdan, and Du, Zhiyu
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ROOT-mean-squares ,PREOPERATIVE period ,PATIENT selection ,POSTOPERATIVE period ,LASIK ,VISUAL acuity ,CONTRAST sensitivity (Vision) - Abstract
Purpose: To compare the visual quality after wavefront-guided femtosecond LASIK (WFG FS-LASIK) in patients with different levels of preoperative total ocular higher-order aberrations to guide clinical decision-making regarding patient selection and treatment strategies. Methods: This study included 112 right eyes of 112 patients who previously underwent WFG FS-LASIK for correcting myopia and myopic astigmatism. The patients were divided into two groups based on the mean values of preoperative total ocular HOAs (0.30 ± 0.09 µm): HOA ≤ 0.3 and > 0.3 groups. The visual acuity, manifest refraction, corneal Strehl ratio (SR), root mean square (RMS) of corneal and ocular aberrations, and area under the log contrast sensitivity function (AULCSF) of both groups were compared preoperatively and at 1, 3, 6, and 12 months postoperatively. Results: The induced ocular HOAs and coma (Δ = 1 mo − Preop) were significantly lower in the HOAs > 0.3 group than in the HOAs ≤ 0.3 group (ΔHOAs: 0.39 ± 0.19 vs. 0.29 ± 0.18 μm, t = 2.797, P = 0.006; Δ coma: 0.30 ± 0.19 vs. 0.20 ± 0.21 μm, t = 2.542, P = 0.012). In the HOAs > 0.3 group, ΔHOAs were negatively correlated with the preoperative ocular HOAs (r = −0.315, P = 0.019). In the HOAs ≤ 0.3 group, the regression equation for Δ HOAs = 0.098 + 0.053 |SE| (F = 21.756, P < 0.001). In the HOAs > 0.3 group, the regression equation for ΔHOAs = 0.534 − 1.081 HOAs + 0.038|Sphere| (F = 7.954, P = 0.001). The postoperative uncorrected distance visual acuity, spherical equivalent, corneal aberrations, SR and AULCSF of both groups were similar (all P > 0.05). Furthermore, the ocular aberrations were not significantly different between both groups at 3, 6, and 12 months postoperatively (all P > 0.05). In addition, compared with the preoperative period, the AULCSF of both groups were significantly increased in the postoperative period (all P < 0.05). Conclusions: The induced ocular HOAs and coma in HOAs > 0.3 group were lower. However, both groups achieved equivalent and excellent visual quality after WFG FS-LASIK. WFG FS-LASIK may provide significant visual benefits for a wider range of patients. [ABSTRACT FROM AUTHOR]
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- 2024
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48. LASIK Versus PRK Based on Increased Risk of Corneal Haze: Assessing Current Decision-Making Capabilities of Six Artificial Intelligence Models in Refractive Surgery.
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Moshirfar, Majid, Moin, Kayvon A., Omidvarnia, Soroush, Moulton, Spencer D., Willey, Preston B., Stoakes, Isabella M., and Hoopes, Phillip C.
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ARTIFICIAL intelligence ,LASIK ,PHOTOREFRACTIVE keratectomy ,KELOIDS ,MYOPIA - Abstract
Purpose: To investigate the current decision-making capabilities of 6 different artificial intelligence (AI) models by assessing their refractive surgery recommendations (laser in-situ keratomileusis [LASIK] or photorefractive keratectomy [PRK]) for a theoretical patient with a history of keloid formation. Methods: Claude-2 (Anthropic, 2023), GPT-4 (OpenAI, 2023), GPT-3.5 (OpenAI, 2022), Gemini 1.0 (Google DeepMind, 2023), Microsoft Copilot (Microsoft AI, 2023), and Google-PaLM (Google AI, 2022) underwent three systematic queries to determine the most appropriate surgical plan (LASIK or PRK) for a theoretical patient with an increasing manifest refraction of −3.50, −5.00, and −7.00 diopters (D) in both eyes, an uncomplicated ocular examination, and history of keloid formation. They were then tasked with providing published scientific references to support their responses. The AI models' recommendations were compared to those of a group of 6 experienced ophthalmologists, serving as a benchmark. Results: The group of ophthalmologists unanimously recommended LASIK (6/6 ophthalmologists), in contrast to the unanimous initial recommendation for PRK from the AI models (6/6 models). Of the 42 references provided by the AI models, 55% were fictitious and 45% were authentic. Only 1 of the 6 models altered its initial recommendation to LASIK when presented with the same patient with a history of keloid formation but with increasing severity of myopia (−3.50 to 5.00 to 7.00 D). Discussion: It is evident that current AI models lack the critical-thinking abilities required to accurately analyze and assess apparent risk factors in clinical scenarios, such as the risk of corneal haze after PRK at higher levels of myopia, particularly in cases with a history of keloid formation. [J Refract Surg. 2024;40(8):e533–e538.] [ABSTRACT FROM AUTHOR]
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- 2024
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49. Safety and Effectiveness of Laser in Situ Keratomileusis Using the Teneo 317 Model 2 for Correcting Myopia and Myopic Astigmatism: Results of the U.S. FDA Clinical Trial.
- Author
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Waring IV, George O., Stonecipher, Karl, Lobanoff, Mark, Chu, Y. Ralph, Endl, Michael, Feinerman, Gregg, Hosten, Lester O., and Kumar, Nisha
- Subjects
MYOPIA ,ASTIGMATISM ,LASIK ,EXCIMER lasers ,VISUAL acuity - Abstract
Purpose: To evaluate the safety and effectiveness of a new aspheric ablation profile for correcting myopia and myopic astigmatism. Methods: This prospective, multicenter study included patients who underwent laser in situ keratomileusis (LASIK) using a new aspheric ablation profile of the Technolas Teneo 317 (Model 2) excimer laser (version 1.28 US SW) by Technolas Perfect Vision, Bausch+Lomb, Inc. No nomogram adjustments were made, and the patient's manifest refraction was entered into the laser (for treatment). Postoperative assessments included visual and refractive outcomes. Patients were asked to complete the Patient-Reported Outcomes With LASIK (PROWL) questionnaire preoperatively and postoperatively. Results: A total of 333 eyes from 168 patients with a mean age of 33 ± 7 years were included. At postoperative 9 months, uncorrected and corrected distance visual acuities of 20/25 or better were seen in 97.8% and 100% of eyes, respectively. None of the eyes lost two or more lines of corrected distance visual acuity. The mean manifest spherical refraction improved from −5.67 ± 2.52 diopters (D) preoperatively to −0.04 ± 0.32 D postoperatively, with 92.7% of eyes achieving residual refractive error within ±0.50 D. Residual refractive cylinder within ±0.50 and ±1.00 D was seen in 93% and 99.4% eyes, respectively. The refractive outcomes were stable throughout the follow-up of 9 months. The proportion of patients satisfied with their vision rose from 27.7% preoperatively to 98.1% postoperatively. Conclusions: LASIK performed using a new aspheric ablation profile of the Technolas Teneo 317 (Model 2) excimer laser is safe and effective for correcting myopia and myopic astigmatism, yielding excellent visual and refractive outcomes that were stable over 9 months. [J Refract Surg. 2024;40(8):e544–e553.] [ABSTRACT FROM AUTHOR]
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- 2024
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50. Corrigendum: The impact of patient-reported visual disturbance on dynamic visual acuity in myopic patients after corneal refractive surgery.
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LASIK ,PHOTOREFRACTIVE keratectomy ,VISUAL acuity ,SMALL-incision lenticule extraction ,CORNEA - Abstract
This corrigendum corrects errors in a previously published article on the impact of patient-reported visual disturbance on dynamic visual acuity in myopic patients after corneal refractive surgery. The corrections have been made to ensure accuracy. The article discusses a study on postoperative dynamic visual acuity in patients who underwent different types of corneal refractive surgery. The study found that patients who had undergone FS-LASIK and did not have difficulty judging distance had better dynamic visual acuity compared to those with abnormal symptoms. However, there were no significant differences in dynamic visual acuity between patients with and without visual distance in the PRK or SMILE subgroups. The article acknowledges limitations of the study, such as the nonrandomized design and short follow-up period. [Extracted from the article]
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- 2024
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