1
|
Lee J, Son BK, Kim TG, Jin KH. Ten-year Results after Conventional Corneal Cross-linking in Korean Patients with Progressive Keratoconus. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.3341/jkos.2022.63.5.417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To evaluate the long-term effects of conventional corneal cross-linking in patients with progressive keratoconus.Methods: A total of 18 eyes of 9 patients diagnosed with keratoconus were analyzed retrospectively. One eye was diagnosed with progressive keratoconus and conventional corneal crosslinking was performed. The other eye was classified as non-progressive and remained untreated. All patients were assessed with best corrected visual acuity (BCVA), maximum keratometry (Kmax), mean keratometry (Kmean), corneal astigmatism, and corneal thickness. Clinical data were collected before the procedure and at 1, 3, 6 months and 1 to 10 years after the procedure.Results: The BCVA significantly improved from 0.63 ± 0.18 logarithm of the minimum angle of resolution (logMAR) to 0.46 ± 0.25 logMAR at 10 years after conventional corneal crosslinking (p = 0.027). The Kmax and Kmean decreased from 65.90 ± 9.43 D and 52.82 ± 5.16 D to 62.83 ± 8.16 D and 51.52 ± 5.18 D, respectively (p = 0.021, p = 0.028, respectively). Corneal astigmatism decreased from 6.97 ± 2.21 D to 5.53 ± 1.64 D (p = 0.008). The thinnest corneal thickness decreased from 435.11 ± 53.37 μm to 369.22 ± 64.00 μm 1 month after the procedure (p = 0.008), and gradually improved over time. At 10 years, the thinnest corneal thickness increased to 410.11 ± 61.32 μm (p = 0.097). In the untreated eyes, the mean keratometry significantly increased after 4 years of follow-up, but other factors did not change significantly. Although corneal opacity persisted for up to 10 years in 3 eyes of the treatment group, there was no significant difference of BCVA compared to the treated eyes without corneal opacity (p = 0.714).Conclusions: In patients with progressive keratoconus, conventional corneal crosslinking is a safe and effective procedure that suppresses long-term progression.
Collapse
|
2
|
Kim MJ, An JS, Moon JY, Kim HY, Choi JS, Pak KH, Chung SK. Short-term Comparison of Refractive Errors between Two Different Age Groups after LASEK for Moderate Myopia. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.11.1478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To investigate the safety of laser epithelial keratomileusis (LASEK) by drawing a comparison between two groups divided according to age (18-19 vs. 20-21 years old).Methods: The study was conducted as a retrospective analysis including 339 patients (678 eyes) who underwent LASEK between January 2017 and April 2020. Patients were divided by age group, group I (18-19 years old) and group II (20-21 years old). The objectives of the study included determination of visual acuity and refractive errors before and at 1, 3, and 6 months after the procedure.Results: The preoperative mean spherical equivalents (SEs) were -4.73 ± 0.88 diopters (D) in group I and -4.58 ± 0.87 D in group II (<i>p</i> = 0.34). At 1 month postoperatively, mean SEs were 0.32 ± 0.46 D in group I and 0.26 ± 0.59 D in group II (<i>p</i> = 0.18). At 3 months postoperatively, the mean SEs were 0.30 ± 0.47 D in group I and 0.28 ± 0.50 D in group II (<i>p</i> = 0.67). At 6 months postoperatively, the mean SEs were 0.15 ± 0.47 D in group I and 0.14 ± 0.50 D in group II (<i>p</i> = 0.89). There were no significant differences in postoperative best corrected visual acuity between group I and group II at 1, 3, or 6 months (<i>p</i> = 0.20, <i>p</i> = 0.13, and <i>p</i> = 0.11, respectively).Conclusions: There were no significant differences in postoperative mean SE or safety of LASEK between moderate myopia patients 18-19 years old and those 20-21 years old.
Collapse
|
3
|
Abdelwahab SM, Salem MH, Elfayoumi MA. Single-Step Transepithelial Photorefractive Keratectomy in Low to Moderate Myopia: A One-Year Follow-Up Study. Clin Ophthalmol 2021; 15:3305-3313. [PMID: 34408389 PMCID: PMC8363478 DOI: 10.2147/opth.s326048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 07/27/2021] [Indexed: 11/23/2022] Open
Abstract
Aim To evaluate predictability, safety, efficacy, and visual outcome of StreamLight. ™ (SL.), the newly released single-step transepithelial photorefractive keratectomy platform by Alcon WaveLight™ (WL). Methods In this prospective cohort study, photorefractive keratectomy (PRK) was conducted on 500 eyes of 250 patients seeking myopic refractive vision correction. The new single-step transepithelial PRK method was applied, using the SL. platform installed in the WL. Ex 500 excimer laser machine. Patients were followed up to monitor intensity and duration of postoperative pain, as well as speed of epithelial healing in the early post-operative period and visual acuity, postoperative refraction and development of postoperative haze for one year post-operatively. Results Average pain duration was 1.5 days, and the mean pain intensity score on a scale of 0–10 was 3.74 + 1.51. Mean postoperative spherical equivalence was 0.01 ± 0.38 D, and the final postoperative uncorrected distance visual acuity (UCDVA) was 20/20 in 98% of eyes included in this study. None of the eyes lost more than one Snellen chart line or developed visually significant postoperative haze during the follow-up period. Conclusion The new SL. platform for transepithelial PRK is a safe, accurate platform, offering an easier early post-operative recovery, with no compromise in final visual outcome. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/_lJS9rzTWDk
Collapse
|
4
|
Nam M, Kang DSY, Kim SW. Five-year Change in Corneal Endothelial Cell Density after Foldable Iris-fixed Lens Insertion. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.4.479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
5
|
Sudanaboina P, Murthy SI, Rathi VM. Excimer laser phototherapeutic keratectomy with mitomycin C application to treat haze after myopic photorefractive keratectomy. Indian J Ophthalmol 2020; 68:3030-3031. [PMID: 33229692 PMCID: PMC7856928 DOI: 10.4103/ijo.ijo_1845_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
| | | | - Varsha M Rathi
- Department of Cornea, L V Prasad Eye Institute, Hyderabad, Telangana, India
| |
Collapse
|
6
|
Correlation and regression analysis between residual gradation and uncorrected visual acuity one year after refractive surgery with LASIK, FS-LASIK, PRK, PRK Xtra techniques and the implantation of ICL® posterior chamber phakic lens in myopic correction. PLoS One 2020; 15:e0238399. [PMID: 32915816 PMCID: PMC7485817 DOI: 10.1371/journal.pone.0238399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 08/15/2020] [Indexed: 11/19/2022] Open
Abstract
Purpose To analyze the influence of the final spherical equivalent (SE) in LogMAR uncorrected distance visual acuity (UDVA) one year after refractive surgery. We analysed refractive results, their predictability and efficacy, and the safety results of the different methods as secondary outcomes. Setting Refractive Surgery Unit of the Institut Català de Retina (ICR) in Barcelona, Spain. Design Retrospective, analytical observational study. Methods Retrospective and observational study of 654 eyes of 327 patients who underwent refractive surgery to treat their myopia or myopic astigmatism using LASIK, FS-LASIK, PRK, PRK Xtra or ICL-type lens implantation surgery were included. Results The correlation between the SE in absolute value was statistically significant in all techniques utilized, reaching higher values in the FS-LASIK and LASIK techniques, 0.774 and 0.706 respectively, and lesser values in PRK (0.480) and PRK Xtra (0.482). A significant adjustment via a univariate linear regression model could be implemented in all techniques, albeit the R2 coefficient of determination values were higher than those for the FS-LASIK (0.599) and LASIK (0.494) techniques. Conclusions There is a positive correlation between post-surgical SE value and post-operative LogMAR UDVA. These regression models can be adjusted to predict the final UDVA according to the final SE. The techniques that are most influenced by the final SE in terms of their visual results are FS-LASIK and LASIK.
Collapse
|
7
|
Oral l-Cysteine Supplementation Enhances the Long Term-Effect of Topical Basic Fibroblast Growth Factor (bFGF) in Reducing the Corneal Haze after Photorefractive Keratectomy in Myopic Patients. Pharmaceuticals (Basel) 2020; 13:ph13040067. [PMID: 32326563 PMCID: PMC7243117 DOI: 10.3390/ph13040067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/10/2020] [Accepted: 04/13/2020] [Indexed: 11/28/2022] Open
Abstract
We aimed at evaluating the long-term effects of l-cysteine oral supplementation to basic fibroblast growth factor (bFGF) eye-drops on corneal re-epithelization and transparency in myopic patients subjected to photorefractive keratectomy (PRK). Forty patients subjected to bilateral PRK for myopia were enrolled and randomly divided into two groups receiving an additional therapy together with the standard postoperative treatment consisting in local tobramycin 0.3%, dexamethasone 0.1%, diclofenac 0.1%, and 0.2% hyaluronate. Group 1 included 20 patients (11 males and 9 females; 34.09 ± 8 years of age) receiving only bFGF eye-drops (10 μg/10 μL) four times a day for 7 days starting from the day of surgery; Group 2 included 20 patients (12 males and 8 females; 37.35 ± 11.5 years of age) who were postoperatively administered with topical basic fibroblast growth factor (bFGF; 10 μg/10 μL) four times a day for 7 days plus oral l-cysteine supplementation (500 mg/capsule) once a day for 15 days, starting 7 days before PRK. Patients were followed-up for 12 months. Clinical ophthalmologic parameters were recorded for all the 80 examined eyes. The corneal transparency was evaluated in vivo by slit lamp and confocal microscopy. The data showed that: (a) the corneal haze occurred in a smaller percentage of the patients who were postoperatively administered with topical bFGF plus oral l-cysteine supplementation (Group 2) compared to patients who received only bFGF (Group 1); (b) at 6 months of follow-up, the stromal mean image brightness of the patients belonging to Group 2 was significantly lower than that of the Group 1 (p < 0.03), and, interestingly, the difference was even more evident at 12 month from the treatment (p < 0.001). Moreover, the final mean of the spherical equivalent refraction was −0.06 ± 0.2 D in Group 1 and −0.08 ± 0.3 D in Group 2, whereas the final uncorrected distance visual acuity (UDVA) was equal or superior to 20/25 in 100% of eyes in both Group 1 and 2. Post refractive patients can benefit from the administration of l-cysteine before the surgery and in association with bFGF in the early postoperative period, showing a faster corneal re-epithelization able to prevent corneal haze in the long-term recovery.
Collapse
|
8
|
Späth M, Klämpfl F, Stelzle F, Hohmann M, Lengenfelder B, Schmidt M. A quantitative evaluation of the use of medical lasers in German hospitals. JOURNAL OF BIOPHOTONICS 2020; 13:e201900238. [PMID: 31637849 PMCID: PMC7065607 DOI: 10.1002/jbio.201900238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/06/2019] [Accepted: 10/10/2019] [Indexed: 06/10/2023]
Abstract
The laser has become an integral part of modern medicine, procedures based on this technique have found their way into a multitude of medical disciplines. There is, however, no data available on the detailed quantitative development of laser use in the medical sector. This fact gave rise to the idea of the present study, which analyzed the raw data of the quality report of German hospitals with respect to this subject. Over the 9 years of report, a steady increase in the cumulative number of cases was evident, although not all body regions in which the medical laser is used followed this trend. The CO2 laser was found to be the most commonly applied laser, even though a large spectrum of different laser types is used. Based on the present study, the importance of the laser for medical purposes can be confirmed.
Collapse
Affiliation(s)
- Moritz Späth
- Institute of Photonic TechnologiesFriedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Erlangen Graduate School in Advanced Optical TechnologiesErlangenGermany
| | - Florian Klämpfl
- Institute of Photonic TechnologiesFriedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Erlangen Graduate School in Advanced Optical TechnologiesErlangenGermany
| | - Florian Stelzle
- Erlangen Graduate School in Advanced Optical TechnologiesErlangenGermany
- Department of Oral and Maxillofacial SurgeryUniversity Hospital ErlangenErlangenGermany
| | - Martin Hohmann
- Institute of Photonic TechnologiesFriedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Erlangen Graduate School in Advanced Optical TechnologiesErlangenGermany
| | - Benjamin Lengenfelder
- Institute of Photonic TechnologiesFriedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Erlangen Graduate School in Advanced Optical TechnologiesErlangenGermany
| | - Michael Schmidt
- Institute of Photonic TechnologiesFriedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
- Erlangen Graduate School in Advanced Optical TechnologiesErlangenGermany
| |
Collapse
|
9
|
Spadea L, Giovannetti F. Main Complications of Photorefractive Keratectomy and their Management. Clin Ophthalmol 2019; 13:2305-2315. [PMID: 31819355 PMCID: PMC6885542 DOI: 10.2147/opth.s233125] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 11/06/2019] [Indexed: 11/23/2022] Open
Abstract
Photorefractive keratectomy (PRK) was the first surface ablation procedure introduced for the treatment of refractive errors and has been proven to be effective and safe. In some cases, however, the patient may not be totally satisfied with the final result and retreatment may be necessary. We performed a literature review to describe the main conditions that may arise following PRK that may require retreatment and new promising techniques to allow customized and effective treatments for patients. There is currently no gold standard for retreatment of residual refractive error after PRK. The surgeon must take into account the patient's history and type of problem when choosing the most appropriate technique. LASIK and PRK are the main options. Haze can be treated with good results with phototherapeutic keratectomy and mytomicin C. High order aberrations and decentration may be addressed with topographically-guided excimer photoablation or with wavefront-guided PRK.
Collapse
Affiliation(s)
- Leopoldo Spadea
- Eye Clinic, Policlinico Umberto 1, Department of Sensory Organs, "La Sapienza" University of Rome, Rome, Italy
| | - Francesca Giovannetti
- Eye Clinic, Policlinico Umberto 1, Department of Sensory Organs, "La Sapienza" University of Rome, Rome, Italy
| |
Collapse
|
10
|
Carones F, Brancato R, Morico A, Venturi E, Gobbi PG. Compound Myopic Astigmatism Correction using a Mask In-the-Rail Excimer Laser Delivery System. Preliminary Results. Eur J Ophthalmol 2018; 6:221-33. [PMID: 8908425 DOI: 10.1177/112067219600600301] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The latest development in the erodible mask technology is an excimer laser containing the mask in the laser optical pathway. This paper reports the results of the first human series of consecutive treatments performed for the correction of compound myopic astigmatism. METHODS We have treated 83 eyes. Spherical equivalent attempted correction ranged between -1.75 and -11.75 D (mean -7.07+/- 2.45 D), astigmatic attempted correction ranged between -1.00 and -5.00 D (mean -2.42+/- 1.02 D). The sphere correction was made by diaphragm using a multi-zone software with three ablation zones: 100% of the total attempted correction for the central 5.0 mm zone, 70% for the second 6.0 mm zone, 30% for the outer 6.5 mm zone. Cylinder correction was made sequentially after myopic correction using the appropriate mask. RESULTS One month after treatment, mean refractive error was + 1.07 +/- 1.24 D (range + 4.50/-1.75 D) for spherical equivalent, and -0.49 +/- 0.57 D (range + 0.75/-2.00 D) for astigmatism. Forty-eight eyes (57.8%) had uncorrected visual acuity of 20/40 or better. At six months, mean refractive error was +0.42 +/- 0.97 D (range + 3.75/-1.00 D) for spherical equivalent, and -0.44 +/- 0.51 D (range +0.25/-3.00 D) for astigmatism. Vector analysis showed that 57 eyes (68.7%) had 5 or less degrees rotation. Seventy-two (86.7%) and 54 eyes (65.1%) had uncorrected visual acuity equal or better than 20/40 and 20/25 respectively. One eye (1.2%) showed a best corrected visual acuity loss of more than one line, but 8 eyes (9.6%) had a gain of more than one line. One-year results on a smaller series (33 eyes) overlap with the six-month results. CONCLUSIONS The mask in-the-rail excimer laser delivery system appears to be effective and predictable in the correction of compound myopic astigmatism. We observed no significant regression of the astigmatic correction over time. Longer follow-up on larger series is necessary to draw final conclusions.
Collapse
Affiliation(s)
- F Carones
- Department of Ophthalmology and Visual Sciences, Scientific Institute San Raffaele Hospital, University of Milano, Italy
| | | | | | | | | |
Collapse
|
11
|
Lohmann CP, Patmore A, O'Brart D, Reischl U, Winkler Mohrenfels C, Marshall J. Regression and wound Healing after Excimer Laser Prk: A Histopathological Study on Human Corneas. Eur J Ophthalmol 2018; 7:130-8. [PMID: 9243215 DOI: 10.1177/112067219700700202] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The results of excimer laser PRK are promising as more than 80% of eyes with up to -6.0 diopters of attempted correction have refractive results within 1.0 diopter of emmetropia. However, throughout the dioptric range some unexpected results have been observed with individual patients showing an aggressive wound healing response with excessive myopic regression and severe corneal haze. Unfortunately, only limited data are available about the cellular and extracellular responses in human corneas after PRK and this information is important to establish adequate postoperative pharmaceutical treatment. METHODS We made a histopathological and immunohistochemical study on 20 human corneal samples from patients with severe corneal haze and myopic regression. The indirect immunofluorescence method was used for demonstration of collagen types I, III, IV laminin, chondroitin sulphate, dermatan sulphate, and keratin. RESULTS All corneal specimens showed a hyperplastic epithelium. Histologically, most samples (16/20) showed mainly a loose lamination of extracellular material which could be identified as collagen type IV. The remaining four samples had newly synthesised collagen type III. CONCLUSIONS Our histopathological results indicate that corneal wound healing after excimer laser PRK varies among individuals. In some people epithelial basement proteins, such as collagen type IV, are the main wound healing products, whereas in others mainly collagen type III is found postoperatively, which does not effect the synthesis of collagen type IV. This suggests the need for individually-tailored postoperative pharmaceutical treatment regimens.
Collapse
Affiliation(s)
- C P Lohmann
- University Eye Clinic, University of Regensburg, Germany
| | | | | | | | | | | |
Collapse
|
12
|
Liu YL, Tseng CC, Lin CP. Visual performance after excimer laser photorefractive keratectomy for high myopia. Taiwan J Ophthalmol 2017; 7:82-88. [PMID: 29018762 PMCID: PMC5602153 DOI: 10.4103/tjo.tjo_6_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PURPOSE: To evaluate the efficacy, safety, predictability, and visual performance of excimer laser photorefractive keratectomy (PRK) for myopia greater than −8 diopters (D). METHODS: Fifty-four patients (104 eyes) with myopia from −8D to −13D and cylinder up to −4D received surface ablation technique with the Allegretto wave version 1009-1 excimer laser to correct their refractive error. The patients were examined on days 1, 3, 7, and 14 and 1, 3, 6, and 12 months postoperatively. Visual acuity, manifest refraction, corneal haze, topography, intraocular pressure, contrast sensitivity, and wavefront aberration were evaluated. RESULTS: Twelve months postoperatively, 95% of eyes were within 1D of the intended correction. In addition, 94% of eyes had attained uncorrected distance visual acuity of 20/25 or better, and 98% of eyes had improved or remained their corrected distance visual acuity. All eyes exhibited barely detectable corneal haze which peaked during the 1st month with a gradual reduction in the 3rd month. Ninety-five percent of patients had no or only mild degree of night glare. CONCLUSIONS: Excimer laser PRK is an effective and predictive treatment for high myopia greater than −8D with or without astigmatism up to −4D. The incidence of complication is low. All patients who are candidates for laser in situ keratomileusis can be candidates for surface ablation, especially those with preoperative thinner cornea or higher risk of corneal flap complications.
Collapse
Affiliation(s)
- Yu-Ling Liu
- Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan
| | - Chien-Chi Tseng
- Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan
| | - Chang-Ping Lin
- Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan
| |
Collapse
|
13
|
Kim HW, Na KS, Kim MS. Comparison of 10-year Clinical Results between Laser in situKeratomileusis and Surface Ablation for Moderate to High Myopia. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2016. [DOI: 10.3341/jkos.2016.57.3.380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Hyo Won Kim
- Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyung Sun Na
- Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Man Soo Kim
- Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
14
|
Kim S, Park YW, Lee E, Park SW, Park S, Noh H, Kim JW, Seong JK, Seo K. Effect of onion extract on corneal haze suppression after air assisted lamellar keratectomy. J Vet Med Sci 2015; 78:419-25. [PMID: 26607134 PMCID: PMC4829509 DOI: 10.1292/jvms.15-0455] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study evaluated the effect of onion extract on corneal haze suppression
after applying the air assisted lamellar keratectomy. The air assisted lamellar
keratectomy was performed on 24 canine eyes. They were treated with an artificial tear
(group C), prednisolone acetate (group P), onion extract (group O) and TGF-β1 (group T)
three times per day from 7 to 28 days after the surgery. Corneal haze occurred on the all
eyes and was observed beginning 7 days after the surgery. The haze was significantly
decreased in groups P and O from day 14 compared with the group C using the clinical
(group P; P=0.021, group O; P=0.037) and objective
evaluation method (group P; P=0.021, group O; P=0.039).
In contrast, it was significantly increased in group T from day 14 compared with group C
based on the clinical (P=0.002) and objective evaluation method
(P<0.001). Subsequently, these eyes were enucleated after
euthanasia, and immunohistochemistry with α-SMA antibodies was done. The total green
intensity for α-SMA was significantly more expressed in group T and significantly less
expressed in groups P and O than in group C. Onion extract could have potential as a
therapeutic in preventing corneal haze development by suppressing the differentiation of
fibroblasts into myofibroblasts.
Collapse
Affiliation(s)
- Soohyun Kim
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Son GS, Kim JW, Lim TH, Choi KY, Cho BJ. Comparison of Clinical Outcomes in Implantable Collamer Lens Implantation between AQUA ICL® and Conventional ICL. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.9.1316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
16
|
Kang DW, Eom YS, Rhim JW, Kang SY, Kim HM, Song JS. Sudden Loss of Endothelial Cell Density 7 Years after Receiving an Implantable Contact Lens: A Case Report. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.5.784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Dong Wan Kang
- Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Young Sub Eom
- Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jay Won Rhim
- Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Su Yeon Kang
- Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hyo Myung Kim
- Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jong Suk Song
- Department of Ophthalmology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| |
Collapse
|
17
|
|
18
|
Gibson CR, Mader TH, Schallhorn SC, Pesudovs K, Lipsky W, Raid E, Jennings RT, Fogarty JA, Garriott RA, Garriott OK, Johnston SL. Visual stability of laser vision correction in an astronaut on a Soyuz mission to the International Space Station. J Cataract Refract Surg 2012; 38:1486-91. [PMID: 22814056 DOI: 10.1016/j.jcrs.2012.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Revised: 01/20/2012] [Accepted: 01/21/2012] [Indexed: 10/28/2022]
Abstract
UNLABELLED This report documents the effects of photorefractive keratectomy (PRK) in an astronaut during a 12-day Russian Soyuz mission to the International Space Station in 2008. Changing environmental conditions of launch, microgravity exposure, and reentry create an extremely dynamic ocular environment. Although many normal eyes have repeatedly been subject to such stresses, the effect on an eye with a relatively thin cornea as a result of PRK has not been reported. This report suggests that PRK is a safe, effective, and well-tolerated procedure in astronauts during space flight. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
Collapse
|
19
|
Gimbel HV, Kaye GB, Ferensowicz M. Results of Photorefractive Keratectomy in High Myopia and Hyperopia. Semin Ophthalmol 2009. [DOI: 10.3109/08820539609063817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
20
|
McDonald M, Wyse T. Photorefractive Keratectomy Complications and Their Management. Semin Ophthalmol 2009. [DOI: 10.3109/08820539609063820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
21
|
Slade SG, Doane JF. Excimer Laser in Situ Keratomileusis. Semin Ophthalmol 2009. [DOI: 10.3109/08820539609063819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
22
|
Kim SE, Hong SM, Lee HK. Long-term Change in Corneal Endothelium After Iris-fixed Phakic Intraocular Lens Insertion. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2009. [DOI: 10.3341/jkos.2009.50.5.677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Sung Eun Kim
- The Institute of Vision Research, Department of Ophthalmology, College of Medicine, Yonsei University, Seoul, Korea
| | - Sa Min Hong
- The Institute of Vision Research, Department of Ophthalmology, College of Medicine, Yonsei University, Seoul, Korea
| | - Hyung Keun Lee
- The Institute of Vision Research, Department of Ophthalmology, College of Medicine, Yonsei University, Seoul, Korea
| |
Collapse
|
23
|
Kramarevsky N, Hardten DR. Excimer Laser Photorefractive Keratectomy. Ophthalmology 2009. [DOI: 10.1016/b978-0-323-04332-8.00018-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
24
|
[A prospective intraindividual comparison between laser in situ keratomileusis and laser subepithelial keratectomy for myopia. 1-year follow-up results]. Ophthalmologe 2008; 105:921-6. [PMID: 18431582 DOI: 10.1007/s00347-008-1726-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND The aim of this study was to intraindividually compare the outcome of laser in situ keratomileusis (LASIK) and laser subepithelial keratectomy (LASEK) in patients with similar refraction in both eyes when treated with two different procedures. PATIENTS AND METHODS In this prospective nonrandomized study, 30 myopic patients with and without astigmatism were treated by Lasik in one eye and LasEk in the fellow eye. All eyes were treated using the MEL 70-G Excimer laser (Carl Zeiss Meditec, Germany). Uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA) as well as photopic contrast sensitivity (Pelli-Robson charts) and scotopic contrast sensitivity (Nyktometer, Rodenstock, Germany) were evaluated. The patients were also asked about their preferences regarding the procedures. RESULTS The preoperative spherical equivalent (SE) was -4.54+/-1.64 D and the mean BSCVA was 0.94 in Lasik eyes. The SE was -3.9+/-1.57 D and the BSCVA was 0.89 in LASEK eyes. The mean 1-year post-operative SE was -0.33+/-0.48 D in the Lasik eyes and -0.19+/-0.26 D in the LASEK eyes. Efficacy and safety were similar in the two groups, but Lasik eyes had a greater standard deviation at 1 year. Pelli-Robson contrast sensitivity was 10.75+/-3.05 in the Lasik eyes compared with 11.4+/-3.21 in the fellow LASEK eyes. Seventeen patients named Lasik and 12 patients named LASEK as their procedure of choice. CONCLUSION Both procedures enable similarly good results. LASEK showed a tendency to a smaller standard deviation in final refraction and better contrast sensitivity.
Collapse
|
25
|
Choi WS, Choi BJ, Her J. Two-year Endothalial Changes after Iris Fixed Phakic Intraocular Lens Implantation in Korean. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2008. [DOI: 10.3341/jkos.2008.49.2.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Woo Seok Choi
- Department of Ophthalmology, Pusan Paik Hospital, College of Medicine, Inje University, Pusan, Korea
| | | | - Jun Her
- Department of Ophthalmology, Pusan Paik Hospital, College of Medicine, Inje University, Pusan, Korea
| |
Collapse
|
26
|
Choi WS, Lee HY, Seo SG, Her J. Clinical Outcomes of Implantable Contact Lens and Iris-Fixed Intraocular Lens for Correction of Myopia. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2008. [DOI: 10.3341/jkos.2008.49.9.1406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Woo Seok Choi
- Department of Ophthalmology, Pusan Paik Hospital, Inje University College of Medicine, Pusan, Korea
| | - Ho Young Lee
- Department of Ophthalmology, Pusan Paik Hospital, Inje University College of Medicine, Pusan, Korea
| | - Sung Guan Seo
- Department of Ophthalmology, Pusan Paik Hospital, Inje University College of Medicine, Pusan, Korea
| | - Jun Her
- Department of Ophthalmology, Pusan Paik Hospital, Inje University College of Medicine, Pusan, Korea
| |
Collapse
|
27
|
Kim HG, Cho CW, Cho JK, Park YG, Yoon KC. Long-term Outcomes and Side Effects after Implantation of Phakic Posterior Chamber Intraocular Lenses. Chonnam Med J 2008. [DOI: 10.4068/cmj.2008.44.2.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Hwang-Gyun Kim
- Department of Ophthalmology, Chonnam National University and Hospital, Gwangju, Korea
| | | | - Jae-Kap Cho
- Department of Ophthalmology, Seonam University and Hospital, Korea
| | - Yeoung-Geol Park
- Department of Ophthalmology, Chonnam National University and Hospital, Gwangju, Korea
| | - Kyung-Chul Yoon
- Department of Ophthalmology, Chonnam National University and Hospital, Gwangju, Korea
| |
Collapse
|
28
|
Spadea L, D'Alessandri L, Necozione S, Balestrazzi E. Three different techniques for photorefractive keratectomy for mixed astigmatism. Ophthalmic Surg Lasers Imaging Retina 2007; 38:307-13. [PMID: 17674921 DOI: 10.3928/15428877-20070701-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To compare three different PRK techniques for the correction of mixed astigmatism. PATIENTS AND METHODS Sixty eyes of 40 patients affected by mixed astigmatism underwent PRK using an excimer laser with three different techniques: (A) combined myopic spherical and hyperopic cylindrical treatment (mean attempted correction in defocus equivalent [DE], 2 +/- 0.4 D), (B) combined cross-cylinder and spherical equivalent treatment (mean attempted correction in DE, 2.72 +/- 0.6 D), and (C) customized ablation with topography-supported customized ablation (TOSCA) method (mean attempted correction in DE, 2.67 +/- 0.9 D). RESULTS Twelve months postoperatively, the mean DE in group A was 0.45 +/- 0.6 D and an UCVA of 20/40 or better was achieved in 80% of eyes; the mean DE in group B was 0.55 +/- 0.4 D and an UCVA of 20/40 or better was achieved in 70%; and the mean DE in group C was 0.38 +/- 0.1 D and an UCVA of 20/40 or better was achieved in 90%. No patient lost more than 2 lines of spectacle-corrected visual acuity and there were no complications observed during the follow-up. No statistically significant difference among the three groups was evidenced. CONCLUSIONS PRK for the correction of mixed astigmatism can be considered a useful technique in terms of efficacy, safety, and predictability with all three tested techniques.
Collapse
Affiliation(s)
- Leopoldo Spadea
- Department of Ophthalmology, University of L'Aquila, L'Aquila, Italy
| | | | | | | |
Collapse
|
29
|
Gloaguen Y, Cochener B. [GBR foldable anterior phakic intraocular lens with angular supports: a 3-year experience]. J Fr Ophtalmol 2006; 29:542-51. [PMID: 16885829 DOI: 10.1016/s0181-5512(06)73808-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the efficiency, predictability, and safety of the GBR foldable anterior chamber implant with angular supports to correct high myopia after 3 years of follow-up. MATERIAL and methods: A GBR anterior chamber lens with angular supports was implanted in 44 eyes between November 2001 and February 2004. These eyes were highly myopic (preoperative mean of -10.65 +/- 2.62 diopters (D) (range, -6.25 to -16.50 D). Visual acuity, refraction, biomicroscopy, and quality of vision were estimated with a follow-up of 3 years. The potential complications required endothelial density, mobility of the pupil, intraocular pressure, and gonioscopy measurements. RESULTS No severe intra- or postoperative complications required an ablation of the lens. Increased intraocular pressure in three cases and decentration in one were the most serious side effects reported. Eighteen eyes (40.9%) presented pupil ovalization; 68.2% of the eyes reached the attempted correction +/-0.50 D. Implants seemed stable in their position and refractive results. Functional signs included night glare for eight patients (18.2%) and glare in the sun for 11 (25%). There was no significant decrease in cellular endothelial density mean during follow-up. CONCLUSION The GBR implant (Ioltech) is the pioneer of foldable anterior chamber implants, a concept in full expansion. Long-term satisfaction of the operated patients is encouraging. However, the medium-term anatomical modifications noted require monitoring and a search for the responsible mechanism.
Collapse
Affiliation(s)
- Y Gloaguen
- Service d'Ophtalmologie, CHU Morvan, Brest
| | | |
Collapse
|
30
|
Kim TH, Kim SJ, Ryu YH, Chung SY, Seo JS, Kim YJ, Choi BW, Lee SH, Cho SH. Differential CT features of infectious pneumonia versus bronchioloalveolar carcinoma (BAC) mimicking pneumonia. Eur Radiol 2006; 16:1763-8. [PMID: 16418864 DOI: 10.1007/s00330-005-0101-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2005] [Revised: 11/14/2005] [Accepted: 11/25/2005] [Indexed: 12/17/2022]
Abstract
The purpose of this study was to evaluate retrospectively the differential CT features of bronchioloalveolar carcinoma (BAC) mimicking pneumonia and infectious pneumonia at the lung periphery. CT images were reviewed in 47 patients with focal areas of parenchymal opacification at the lung periphery. We evaluated the presence of ground-glass attenuation, marginal conspicuity of the lesion, CT angiogram sign, air-bronchogram sign, a bubble-like low-attenuation area within the lesion, presence of pleural thickening and retraction associated with the lesion, presence of pleural effusion and extra-pleural fatty hypertrophy, presence of bronchial wall thickening proximal to the lesion, and air-trapping in the normal lung near the lesion. BAC (n=18) depicted the presence of a bubble-like low-attenuation area within the lesion, whereas infectious pneumonia (n=29) represented the pleural thickening associated with the lesion and bronchial wall thickening proximal to the lesion (P<0.05). The other CT findings showed no significant differences (P>0.05). The focal areas of the parenchymal opacification on the CT images may suggest infectious pneumonia rather than BAC when they show bronchial wall thickening proximal to the lesion and pleural thickening associated with the lesion, whereas BAC is characterized as the presence of a bubble-like low attenuation area within the tumor.
Collapse
Affiliation(s)
- Tae Hoon Kim
- Department of Radiology, Yonsei University College of Medicine, Seoul 120-749, South Korea.
| | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Lee JE, Choi HY, Oum BS, Lee JS. A Comparative Study for Mesopic Contrast Sensitivity Between Photorefractive Keratectomy and Laser In Situ Keratomileusis. Ophthalmic Surg Lasers Imaging Retina 2006; 37:298-303. [PMID: 16898390 DOI: 10.3928/15428877-20060701-06] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To compare the effect on visual performance of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) with mesopic contrast sensitivity. PATIENTS AND METHODS Postoperative visual performance for 40 eyes undergoing PRK and 40 eyes undergoing LASIK was compared with mesopic contrast sensitivity at 1, 3, and 6 months postoperatively. Eyes were divided into two groups (< -6.0 D and > -6.25 D). Mesopic contrast sensitivity was performed with the patient's best-corrected visual acuity of 20/20 or better under photopic conditions. RESULTS A significant decrease in mesopic contrast sensitivity from preoperative baseline was obtained at all spatial frequencies for the PRK and LASIK groups (P < .05). There was no statistically significant difference at 1 or 3 months postoperatively in both groups (P > .05). At 6 months postoperatively, LASIK significantly decreased mesopic contrast sensitivity more than PRK in myopia with a refractive error of less than -6.0 D, especially at the middle and high spatial frequencies of 6, 9, and 12 cycles per degree (P < .05). However, no statistically significant differences in mesopic contrast sensitivity between PRK and LASIK were found in myopia with a refractive error of greater than -6.25 D (P > .05). CONCLUSIONS In broad-beam excimer laser refractive surgery, PRK seemed to have a more significant effect on mesopic contrast sensitivity than LASIK for myopia with a refractive error of less than -6.0 D at 6 months postoperatively.
Collapse
Affiliation(s)
- Ji-Eun Lee
- Department of Ophthalmology, College of Medicine, Pusan National University, Korea
| | | | | | | |
Collapse
|
32
|
Spadea L, Di Gregorio A. Enhancement outcomes after photorefractive keratectomy and laser in situ keratomileusis using topographically guided excimer laser photoablation. J Cataract Refract Surg 2005; 31:2306-12. [PMID: 16473222 DOI: 10.1016/j.jcrs.2005.08.055] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2005] [Accepted: 05/27/2005] [Indexed: 11/21/2022]
Abstract
PURPOSE To evaluate the efficacy and safety of topographically guided excimer laser photoablation to retreat unsuccessful myopic and hyperopic photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK). SETTING Eye Clinic, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy. METHODS At least 3 months after primary PRK (Group A) or primary LASIK (Group B), 48 eyes of 42 patients were submitted to PRK or LASIK enhancements. The eyes were treated with an excimer laser linked to a computerized videokeratography unit with a topographically supported customized ablation workstation. RESULTS The mean follow-up was 27.8 months +/- 8.2 (SD). In Group A, the uncorrected visual acuity (UCVA) changed from 0.5 +/- 0.7 logarithm of the minimum angle of resolution (logMAR) (range 20/600 to 20/200) to 0.1 +/- 0.7 logMAR (range 20/60 to 20/20); the mean best spectacle-corrected visual acuity (BSCVA) changed from 0.1 +/- 0.7 logMAR (range 20/50 to 20/20) to 0 +/- 0.7 logMAR (range 20/50 to 20/20) after the enhancement. In Group B, the UCVA changed from 0.7 +/- 0.8 logMAR (range 20/600 to 20/40) to 0.1 +/- 0.7 logMAR (range 20/40 to 20/20); the mean BSCVA improved from 0.2 +/- 0.8 logMAR (range 20/30 to 20/20) to 0 +/- 1.3 logMAR (range 20/25 to 20/20) after surgery. CONCLUSIONS The enhancements using topographically guided excimer laser photoablation with a topographically supported customized ablation method resulted in satisfactory and stable visual outcome with good safety and efficacy after unsuccessful PRK and LASIK.
Collapse
Affiliation(s)
- Leopoldo Spadea
- Eye Clinic, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.
| | | |
Collapse
|
33
|
Abstract
This study evaluated the visual quality after wavefront-guided laser in situ keratomileusis (LASIK) for treating myopia. Thirty-two eyes with moderate myopia (-5.78 - -2.17D) and 25 eyes with high myopia (-7.78 - -6.17D) were prospectively reviewed. The contrast sensitivity (CS), glare and the total higher order aberrations (HOA) were measured before and 1 week, 1 month and 2 months after LASIK. The pupil diameter was measured at day- and night-time illumination. The CS and glare at all spatial frequencies were not reduced after wavefront-guided LASIK (p<0.05) and the difference between the moderate and high myopia group was not significant. No significant correlation was found between the amounts of myopia and the postoperative CS (p>0.05). The area under the log contrast sensitivity function (AULCSF) showed no correlation with the total HOA (r2=-0.071, p=0.612, between the daytime AULCSF and the total HOA with a 4 mm entrance pupil, r2=-0.176, p=0.260, between the nighttime AULCSF and the total HOA with a 6 mm entrance pupil). There was no decrease in CS and glare after wavefront-guided LASIK for myopia. In conclusion, wavefront-guided LASIK based on the individual ablation patterns is a good option for refractive surgery to improve the visual quality in both moderate and high myopia cases.
Collapse
Affiliation(s)
- Hyojin Kim
- Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Choun-Ki Joo
- Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
34
|
Pineda-Fernández A, Jaramillo J, Vargas J, Jaramillo M, Jaramillo J, Galíndez A. Phakic posterior chamber intraocular lens for high myopia. J Cataract Refract Surg 2004; 30:2277-83. [PMID: 15519075 DOI: 10.1016/j.jcrs.2004.03.035] [Citation(s) in RCA: 108] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2004] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the efficacy, predictability, stability, and safety of the surgical correction of high myopia using a phakic posterior chamber intraocular lens (PPC IOL). SETTING Centro Oftalmológico de Valencia-CEOVAL, Valencia, Venezuela. METHODS A retrospective study was performed to analyze 18 eyes of 12 patients who had implantation of a modified PPC IOL, the implantable contact lens (ICL), for the treatment of high myopia. The target postoperative spherical equivalent (SE) refraction was emmetropia. RESULTS The mean follow-up was 26.6 months +/- 11.3 (SD) (range 12 to 36 months). The mean preoperative SE was -15.27 +/- 3.47 diopters (D) (range -10.0 to -21.25 D) and the mean postoperative SE, -0.62 +/- 0.81 D (range -2.75 to +0.75 D). Eleven eyes (61.1%) had an SE within +/-1.00 D of emmetropia. The best spectacle-corrected visual acuity was maintained or improved in all except 1 eye, which lost more than 2 lines of Snellen visual acuity. Two eyes (11.1%) developed pupillary block the first day after surgery. Four eyes (22.2%) had moderate pigmentary dispersion. Two eyes (11.1%) had lens opacification, 1 with mild peripheral anterior capsule opacification and the other eye with central anterior subcapsular opacification. One eye (5.5%) had a significant decrease in anterior chamber depth after surgery. CONCLUSIONS Implantation of an ICL was effective for the correction of high myopia. Predictability must be improved and the long-term safety of the ICL determined. The main concerns over potential cataract formation, pigmentary dispersion, and angle-closure glaucoma remain.
Collapse
|
35
|
Miller A, Solomon R, Bloom A, Palmer C, Perry HD, Donnenfeld ED. Prevention of Recurrent Reis-B??cklers Dystrophy Following Excimer Laser Phototherapeutic Keratectomy With Topical Mitomycin C. Cornea 2004; 23:732-5. [PMID: 15448504 DOI: 10.1097/01.ico.0000127476.37175.6d] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To report a case of excimer laser phototherapeutic keratectomy (PTK) for Reis-Bücklers dystrophy with a single intraoperative application of adjunctive topical 0.02% mitomycin C (MMC). METHODS Interventional case report and review of the literature. RESULTS A 73-year-old woman with visually significant Reis-Bücklers dystrophy underwent PTK of her right eye with 0.02% adjunctive MMC for visual rehabilitation. Before treatment, best corrected visual acuity (BCVA) was 20/400. The left eye had previously undergone PTK on 2 occasions without MMC, and the dystrophy had recurred following each treatment. One year after the procedure, her MMC-treated cornea remains clear with no recurrence of Reis-Bücklers dystrophy. CONCLUSIONS The use of topical MMC in conjunction with PTK may be a safe and effective treatment of Reis-Bücklers dystrophy and may be helpful in preventing recurrence of the disease.
Collapse
Affiliation(s)
- Andrew Miller
- Manhattan Eye Ear and Throat Hospital, New York, NY, USA
| | | | | | | | | | | |
Collapse
|
36
|
Hashemi H, Taheri SMR, Fotouhi A, Kheiltash A. Evaluation of the prophylactic use of mitomycin-C to inhibit haze formation after photorefractive keratectomy in high myopia: a prospective clinical study. BMC Ophthalmol 2004; 4:12. [PMID: 15363107 PMCID: PMC520812 DOI: 10.1186/1471-2415-4-12] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2004] [Accepted: 09/14/2004] [Indexed: 11/25/2022] Open
Abstract
Background To study the effect of prophylactic application of mitomycin-C on haze formation in photorefractive keratectomy (PRK) for high myopia. Methods Fifty-four eyes of 28 myopic patients were enrolled in this prospective study. All eyes were operated by PRK followed by 0.02% mitomycin-C application for two minutes and washed with 20 ml normal saline afterwards. All eyes were examined thoroughly on the first 7 days and one month after surgery; 48 eyes (88.9%) at 3 and 6 months postoperatively. Hanna grading (in the scale of 0 to 4+) was used for assessment of corneal haze. Results The mean spherical equivalent refraction (SE) was -7.08 diopters (D) ± 1.11 (SD) preoperatively. Six months after surgery, 37 eyes (77.1%) achieved an uncorrected visual acuity (UCVA) of 20/20 or better, all eyes had a UCVA of 20/40 or better and 45 (93.7%) eyes had an SE within ± 1.00D. One month postoperatively, 2 eyes (3.7%) had grade 0.5+ of haze, while at 3 and 6 months after surgery no visited eye had haze at all. All eyes had a best corrected visual acuity (BCVA) of 20/40 or better and there were no lost lines in BCVA by 6 months after surgery. In spatial frequencies of 6 and 12 cycles per degree contrast sensitivity had decreased immediately after PRK and it had increased 1.5 lines by the 6th postoperative month compared to the preoperative data. Conclusions The results show the efficacy of mitomycin-C in preventing corneal haze after treatment of high myopia with PRK. This method- PRK + mitomycin-C – can be considered an alternative treatment for myopic patients whose corneal thicknesses are inadequate for laser in situ keratomileusis (LASIK). However, the results should be confirmed in longer follow-ups.
Collapse
Affiliation(s)
- Hassan Hashemi
- Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Noor Vision Correction Center, Tehran, Iran
| | | | - Akbar Fotouhi
- Epidemiology and Biostatistics Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|
37
|
Kim JK, Kim SS, Lee HK, Lee IS, Seong GJ, Kim EK, Han SH. Laser in situ keratomileusis versus laser-assisted subepithelial keratectomy for the correction of high myopia. J Cataract Refract Surg 2004; 30:1405-11. [PMID: 15210215 DOI: 10.1016/j.jcrs.2003.12.053] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2003] [Indexed: 11/19/2022]
Abstract
PURPOSE To compare the visual and refractive outcomes of laser in situ keratomileusis (LASIK) and laser-assisted subepithelial keratectomy (LASEK) in the treatment of high myopia. SETTING Institute of Vision Research, Department of Ophthalmology, College of Medicine, Yonsei University, and Balgeunsesang Ophthalmology Clinic, Seoul, South Korea. METHODS Four hundred seventy eyes of 240 patients with manifest refraction spherical components greater than -6.00 diopters (D) were assigned to 2 groups: 324 eyes (167 patients) were treated with LASIK and 146 eyes (73 patients), with LASEK. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), remaining refractive error, corneal haze, and complications were followed in both groups for 12 months. RESULTS At 12 months, the mean spherical equivalent (SE) was within +/-0.50 D of emmetropia in 205 eyes (63.3%) in the LASIK group and 81 eyes (55.5%) in the LASEK group and within +/-1.00 D in 261 eyes (80.6%) and 104 eyes (71.2%), respectively. The UCVA was 20/25 or better in 269 LASIK eyes (83.0%) and 111 LASEK eyes (76.0%). There was more than a 1-line loss of BSCVA in 4 LASIK eyes (1.2%) and 21 LASEK eyes (14.3%). The between-group differences in SE, magnitude of cylinder, UCVA, and haze were statistically significant (P<.05). CONCLUSIONS Both LASIK and LASEK were safe and effectively treated eyes with high myopia. Laser in situ keratomileusis provided superior results in visual predictability and corneal opacity.
Collapse
Affiliation(s)
- Jin Kook Kim
- Balgensesang Ophthalmology Clinic, Institute of Vision Research, Department of Ophthalmology, College of Medicine, Yonsei University, Seoul, South Korea
| | | | | | | | | | | | | |
Collapse
|
38
|
Paysse EA, Hamill MB, Hussein MAW, Koch DD. Photorefractive keratectomy for pediatric anisometropia: safety and impact on refractive error, visual acuity, and stereopsis. Am J Ophthalmol 2004; 138:70-8. [PMID: 15234284 DOI: 10.1016/j.ajo.2004.01.044] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2004] [Indexed: 10/26/2022]
Abstract
PURPOSE To establish the safety and possible efficacy of excimer laser photorefractive keratectomy (PRK) for treatment of pediatric anisometropia. DESIGN Interventional case series METHODS This is a prospective, noncomparative interventional case series at an individual university practice of photorefractive keratectomy in 11 children aged 2 and 11 years with anisometropic amblyopia who were unable or unwilling to use contact lens, glasses, and occlusion therapy to treat the amblyopia. The eye with the higher refractive error was treated with PRK using a standard adult nomogram. The refractive treatment goal was to decrease the anisometropia to 3 diopters or less. Main outcome measures were cycloplegic refraction, refractive correction, degree of corneal haze, uncorrected and best spectacle-corrected visual acuity, and stereopsis over 12 months. RESULTS All patients tolerated the procedure well. The mean refractive target reduction was -10.10 +/- 1.39 diopters for myopia and +4.75 +/- 0.50 diopters for hyperopia. The mean achieved refractive error reduction at 12 months for myopia was -10.56 +/- 3.00 diopters and for hyperopia was +4.08 +/- 0.8 diopters. Corneal haze at 12 months was minimal. Uncorrected visual acuity improved by 2 or more lines in 6 (75%) of the eight children able to perform psychophysical acuity tests. Best spectacle-corrected visual acuity improved by 2 lines in 3 (38%) of patients. Stereopsis improved in 3 (33%) of nine patients. CONCLUSIONS Pediatric PRK can be safely performed for anisometropia. The refractive error response in children appears to be similar to that of adults with comparable refractive errors. Visual acuity and stereopsis improved despite several children being outside the standard age of visual plasticity. Photorefractive keratectomy may play a role in the management of anisometropia in selected pediatric patients.
Collapse
Affiliation(s)
- Evelyn A Paysse
- Cullen Eye Institute, Baylor College of Medicine, Department of Ophthalmology, Texas Children's Hospital, 6621 Fannin Street, CC 640.00, Houston, Texas 77030, USA.
| | | | | | | |
Collapse
|
39
|
Hashemi H, Fotouhi A, Foudazi H, Sadeghi N, Payvar S. Prospective, Randomized, Paired Comparison of Laser Epithelial Keratomileusis and Photorefractive Keratectomy for Myopia Less Than -6.50 Diopters. J Refract Surg 2004; 20:217-22. [PMID: 15188897 DOI: 10.3928/1081-597x-20040501-04] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE We compared predictability, efficacy, safety, and patient satisfaction following laser epithelial keratomileusis (LASEK) and photorefractive keratectomy (PRK) for low to moderate myopia with either the Nidek EC-5000 excimer laser or the Technolas 217C excimer laser. METHODS Forty-two patients with spherical equivalent refraction in the range -1.00 to -6.50 D were enrolled in this prospective study, each randomized for choice and sequence of LASEK and PRK on each of their eyes. Patients were examined daily for 7 days, and at 1 and 3 months. Patient satisfaction and quality of vision were assessed using a subjective questionnaire. RESULTS Mean baseline refraction was -3.57 +/- 1.25 D in LASEK eyes and -3.44 +/- 1.13 D in PRK eyes. Follow-up rates were 100% up to 1 month and 76% at 3 months. At 3 months, 32 (100%) of LASEK eyes and 31 (97%) of PRK eyes had uncorrected visual acuity > or = 20/40, 25 (79%) of LASEK eyes and 26 (82%) of PRK eyes had uncorrected visual acuity > or = 20/20, mean refraction was 0.08 +/- 0.53 D in LASEK eyes and 0.12 +/- 0.50 D in PRK eyes, 26 (81%) of LASEK eyes and 23 (72%) of PRK eyes had a refraction within +/- 0.50 D and 29 (91%) of LASEK eyes and 30 (94%) of PRK eyes had refraction within +/- 1.00 D. Epithelial healing time and pain in LASEK and PRK eyes were not statistically different, and patients were equally satisfied. CONCLUSION LASEK had similar predictability, efficacy, safety, and patient satisfaction to PRK in the treatment of low to moderate myopia.
Collapse
Affiliation(s)
- Hassan Hashemi
- Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | | | | | | | | |
Collapse
|
40
|
Ferrara G, Cennamo G, Marotta G, Loffredo E. New Formula to Calculate Corneal Power After Refractive Surgery. J Refract Surg 2004; 20:465-71. [PMID: 15523958 DOI: 10.3928/1081-597x-20040901-09] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the validity of intraocular lens (IOL) power calculations utilizing a theoretical variable refractive index correlated to axial length after myopic photorefractive keratectomy (PRK) in a clinical simulation and in patients who underwent cataract surgery after PRK for myopia. METHODS Our study included 374 eyes of 300 patients who had PRK for myopia (-2.00 to -12.00 D, mean -4.83 +/- 2.57 D), divided into three groups: Group I had 44 eyes with small ablation zones of 5 to 5.5 mm; Group II had 49 eyes with large ablation zones of 6 to 7 mm; Group III was the control group of 281 eyes (201 patients; 87 males and 114 females) with small and large ablation zones. PRK was performed using the Aesculap-Meditec MEL 60/94 and MEL 70 lasers, and the corneal power was acquired by corneal topography (EyeSys 2000) and a Nidek KM-800 keratometer. RESULTS There was a higher correlation between corneal power and both the change in refraction and axial length when calculated using keratometric measurements. IOL power calculated using keratometric postoperative PRK power was underestimated. The difference between the mean calculated and actual IOL power for emmetropia was 4.30 +/- 2.34 D. A theoretical variable refractive index (obtained from eyes treated with large PRK ablation zones) that correlated with axial length provided the correct keratometric postoperative PRK power: difference between mean calculated and mean actual IOL power was 0.42 +/- 1.23 D. CONCLUSIONS We propose a theoretical variable refractive index that is correlated to axial length. Utilizing this keratometric correct power, we calculated IOL power similar to that for emmetropia.
Collapse
Affiliation(s)
- Giuseppe Ferrara
- University of Naples Federico II, Eye Department, Naples, Italy.
| | | | | | | |
Collapse
|
41
|
Cennamo G, Rosa N, Breve MA, di Grazia M. Technical Improvements in Photorefractive Keratectomy for Correction of High Myopia. J Refract Surg 2003; 19:438-42. [PMID: 12899475 DOI: 10.3928/1081-597x-20030701-10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the effects of hardware and software improvements in photorefractive keratectomy (PRK) for the treatment of highly myopic eyes. METHODS A retrospective study was carried out in 554 patients (582 eyes) with myopia between -7.00 and -17.00 D (mean -11.20 +/- 3.60 D) who had undergone PRK using the Aesculap Meditec laser. Group 1 with a 5-mm-diameter single ablation zone; Group 2 with a 5-mm-diameter single zone surrounded by a 2-mm tapered transitional zone; Group 3 and Group 4, same as Group 2 but with the laser upgraded with a smoke aspiration control system (Group 3), and with a computer-controlled fluence (Group 4). RESULTS In Group 1 at 2 years after PRK (50 eyes), 10 eyes (20%) were within +/-1.00 D of attempted correction and 13 eyes (26%) were within +/-2.00 D. In Group 2 at 2 years (118 eyes), 42 eyes (36%) were within +/-1.00 D of attempted correction and 65 eyes (55%) were within +/-2.00 D. In Group 3 at 2 years (43 eyes), 18 eyes (42%) were within +/-1.00 D of attempted correction and 28 eyes (65%) were within +/-2.00 D. In Group 4 at 2 years (47 eyes), 25 eyes (53%) were within +/-1.00 D of attempted correction and 29 eyes (62%) were within +/-2.00 D. CONCLUSIONS Software and hardware improvements facilitated PRK correction of high myopia with reasonable predictability, especially if a tapered transition zone was used. At 12 and 24-month follow-up, only the use of a tapered transition zone was associated with a statistically significant improvement in predictability.
Collapse
|
42
|
Ginis HS, Katsanevaki VJ, Pallikaris IG. Influence of Ablation Parameters on Refractive Changes After Phototherapeutic Keratectomy. J Refract Surg 2003; 19:443-8. [PMID: 12899476 DOI: 10.3928/1081-597x-20030701-11] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE The aim of the current study was to control the hypothetical effects of decreased laser energy delivered to the peripheral cornea during phototherapeutic keratectomy (PTK) and provide quantitative calculation of induced low and high order aberrations. METHODS We employed a model eye to simulate the refractive effect of homogeneous laser corneal irradiation, as in PTK, for different laser fluences (range 125 to 225 mJ/cm2) and treatment depths up to 200 microm. RESULTS The hyperopic shift induced by the relatively lower energy delivered at the peripheral ablation zone during PTK was proportional to the treatment depth and inversely proportional to the energy fluence. The hyperopic shift calculated using the above ablation parameters was lower compared to previously reported clinical results. Higher order wavefront aberration (total root mean square) changes were of minimal significance for treatment depths up to 200 microm. CONCLUSIONS After PTK, a hyperopic shift cannot be attributed to the energy delivery method alone. Modification of laser energy delivery algorithms may only minimize PTK-induced hyperopia.
Collapse
Affiliation(s)
- Harilaos S Ginis
- University of Crete, School of Medicine, Vardinoyannion Eye Institute, Heraklion, Crete, Greece.
| | | | | |
Collapse
|
43
|
Stojanovic A, Ringvold A, Nitter T. Ascorbate Prophylaxis for Corneal Haze After Photorefractive Keratectomy. J Refract Surg 2003; 19:338-43. [PMID: 12777030 DOI: 10.3928/1081-597x-20030501-11] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate whether prophylactic systemic ascorbic acid influences the average level of haze and the incidence of late onset corneal haze after photorefractive keratectomy (PRK). METHODS Two consecutive groups of eyes treated with PRK for myopia with or without astigmatism were retrospectively compared. The patients had been treated similarly, with the exception that systemic ascorbate had been supplied orally in one of the groups. Haze intensity was quantified on a scale from 0 (clear cornea) to 4 (anterior chamber not visible). The diagnostic criterion for late onset corneal haze was a haze grade 2 or higher, occurring 4 to 12 months after surgery. RESULTS One week, 1, 3, 6, and 12 months after surgery, the group without ascorbate (314 eyes) showed haze of average levels 0.61, 0.51, 0.50, 0.32, 0.10, respectively, and the group with ascorbate (201 eyes) showed haze of average levels 0.38, 0.18, 0.16, 0.09, 0.06, respectively. Comparison of the respective values showed a statistically significant difference between the two groups (P<.01) at 1 week, 1, 3, and 6 months. Late onset corneal haze was observed in 11 eyes in the group without ascorbate, and none was observed in the group with ascorbate (P<.02). CONCLUSION This retrospective nonrandomized clinical study suggests that oral ascorbic acid supplementation may have a prophylactic effect against haze development after PRK. However, routine prophylactic use of ascorbate can be recommended only after a randomized, prospective clinical trial substantiates its efficacy.
Collapse
Affiliation(s)
- Aleksandar Stojanovic
- Eye Department, University Hospital of North Norway, University of Tromsø, SynsLaser Clinic, Tromsø, Trondheim, Norway.
| | | | | |
Collapse
|
44
|
Katsanevaki VJ, Ginis HS, Naoumidi II, Pallikaris IG. The PALM Technique: histological findings of masked phototherapeutic keratectomy on rabbit corneas. BMC Ophthalmol 2003; 3:4. [PMID: 12597779 PMCID: PMC151685 DOI: 10.1186/1471-2415-3-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2002] [Accepted: 02/19/2003] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To compare the corneal healing response between conventional and phototherapeutic keratectomy through a masking agent, in rabbit corneas. METHODS 24 adult rabbits underwent phototherapeutic keratectomy. Animals were divided in two groups: 12 received photoablation through a masking agent (PALM gel) and the remaining 12 received conventional phototherapeutic keratectomy of equal depth and served as control. Light and transmission electron microscopy was performed in specimens of both groups obtained: immediately after, four hours, one week, one, three and six months after treatment. RESULTS Reepitheliazation was complete within five days in all eyes. Light and transmission electron microscopy did not reveal any differences of the healing process in the experimental eyes compared to the controls. CONCLUSION Photoablation through the PALM technique did not result any evident alterations of the reepithelisation and stromal healing process.
Collapse
Affiliation(s)
- Vikentia J Katsanevaki
- University of Crete, Medical School, Vardinoyannion Eye Institute of Crete, Heraklion, Crete, Greece
- University Hospital of Crete, Department of Ophthalmology, Heraklion Greece
| | - Harilaos S Ginis
- University of Crete, Medical School, Vardinoyannion Eye Institute of Crete, Heraklion, Crete, Greece
| | - Irini I Naoumidi
- University of Crete, Medical School, Vardinoyannion Eye Institute of Crete, Heraklion, Crete, Greece
| | - Ioannis G Pallikaris
- University of Crete, Medical School, Vardinoyannion Eye Institute of Crete, Heraklion, Crete, Greece
- University Hospital of Crete, Department of Ophthalmology, Heraklion Greece
| |
Collapse
|
45
|
Sanders DR, Vukich JA, Doney K, Gaston M. U.S. Food and Drug Administration clinical trial of the Implantable Contact Lens for moderate to high myopia. Ophthalmology 2003; 110:255-66. [PMID: 12578765 DOI: 10.1016/s0161-6420(02)01771-2] [Citation(s) in RCA: 212] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To assess the safety and efficacy of the Implantable Contact Lens (ICL) to treat moderate to high myopia. DESIGN Prospective nonrandomized clinical trial. PARTICIPANTS Five hundred twenty-three eyes of 291 patients with between 3 and 20.0 diopters (D) of myopia participating in the U. S. Food and Drug Administration clinical trial of the ICL for myopia. INTERVENTION Implantation of the ICL. MAIN OUTCOME MEASURES Uncorrected visual acuity (UCVA), refraction, best spectacle-corrected visual acuity (BSCVA), adverse events, operative and postoperative complications, lens opacity analysis (Lens Opacity Classification System III), subjective satisfaction, and symptoms. RESULTS Twelve months postoperatively, 60.1% of patients had a visual acuity of 20/20 or better, and 92.5% had an uncorrected visual acuity of 20/40 or better. Patients averaged a 10.31-line improvement in UCVA, 61.6% of patients were within 0.5 D, and 84.7% were within 1.0 D of predicted refraction. Only one case (0.2%) lost > 2 lines of BSCVA. Gains of 2 or more lines of BSCVA occurred in 55 cases (11.8%) at 6 months and 41 cases (9.6%) at 1 year after ICL surgery. Early and largely asymptomatic, presumably surgically induced anterior subcapsular (AS) opacities were seen in 11 cases (2.1%); an additional early AS opacity (0.2%) was seen because of inadvertent anterior chamber irrigation of preservative-containing solution at surgery. Two (0.4%) late (> or = 1 year postoperatively) AS opacities were observed. Two (0.4%) ICL removals with cataract extraction and intraocular lens implantation have been performed. Patient satisfaction (very/extremely satisfied) was reported by 92.4% of subjects on the subjective questionnaire; only four patients (1.0%) reported dissatisfaction. Slightly more patients reported an improvement at 1 year over baseline values for the following subjective symptoms: quality of vision, glare, double vision, and night driving difficulties. Only a 3% difference between pre-ICL and post-ICL surgery was reported for haloes. CONCLUSIONS The results support the safety, efficacy, and predictability of ICL implantation to treat moderate to high myopia.
Collapse
|
46
|
Thompson RW, Choi DM, Price FW. Clear lens replacement surgery. Int Ophthalmol Clin 2002; 42:131-52. [PMID: 12409928 DOI: 10.1097/00004397-200210000-00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
47
|
Fan-Paul NI, Li J, Miller JS, Florakis GJ. Night vision disturbances after corneal refractive surgery. Surv Ophthalmol 2002; 47:533-46. [PMID: 12504738 DOI: 10.1016/s0039-6257(02)00350-8] [Citation(s) in RCA: 140] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A certain percentage of patients complain of "glare" at night after undergoing a refractive surgical procedure. When patients speak of glare they are, technically, describing a decrease in quality of vision secondary to glare disability, decreased contrast sensitivity, and image degradations, or more succinctly, "night vision disturbances." The definitions, differences, and methods of measurement of such vision disturbances after refractive surgery are described in our article. In most cases of corneal refractive surgery, there is a significant increase in vision disturbances immediately following the procedure. The majority of patients improve between 6 months to 1 year post-surgery. The relation between pupil size and the optical clear zone are most important in minimizing these disturbances in RK. In PRK and LASIK, pupil size and the ablation diameter size and location are the major factors involved. Treatment options for disabling glare are also discussed. With the exponential increase of patients having refractive surgery, the increase of patients complaining of scotopic or mesopic vision disturbances may become a major public health issue in the near future. Currently, however, there are no gold-standard clinical tests available to measure glare disability, contrast sensitivity, or image degradations. Standardization is essential for objective measurement and follow-up to further our understanding of the effects of these surgeries on the optical system and thus, hopefully, allow for modification of our techniques to decrease or eliminate post-refractive vision disturbances.
Collapse
Affiliation(s)
- Nancy I Fan-Paul
- Edward S. Harkness Eye Institute, Columbia Presbyterian Medical Center, 635 West 165th Street, New York, NY 10032, USA
| | | | | | | |
Collapse
|
48
|
Chan JWW, Edwards MH, Woo GC, Woo VCP. Contrast sensitivity after laser in situ keratomileusis. one-year follow-up. J Cataract Refract Surg 2002; 28:1774-9. [PMID: 12388027 DOI: 10.1016/s0886-3350(02)01499-2] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE To determine whether contrast sensitivity measurement, a more sensitive test of visual function than visual acuity, better characterizes visual outcomes after laser in situ keratomileusis (LASIK). SETTING Hong Kong Laser Eye Centre, Hong Kong, China. METHODS Contrast sensitivity was monitored in 41 LASIK patients for 1 year. Seven spatial frequencies (0.3, 0.8, 1.5, 3.4, 6.9, 10.3, and 20.5 cpd) were tested with 15 sequences per spatial frequency, and a staircase technique was used for target presentation. RESULTS There was a general depression in the contrast sensitivity function after LASIK; 1.5 cpd and 3.4 cpd were the most affected frequencies. Recovery took at least 6 months. The reduction in contrast sensitivity was greater for higher amounts of myopia. CONCLUSION The post-LASIK nonpermanent depression in contrast sensitivity was probably due to optical factors.
Collapse
Affiliation(s)
- Jay W W Chan
- Centre for Myopia Research, Department of Optometry and Radiography, The Hong Kong Polytechnic University , Hong Kong, China
| | | | | | | |
Collapse
|
49
|
Gokmen F, Jester JV, Petroll WM, McCulley JP, Cavanagh HD. In vivo confocal microscopy through-focusing to measure corneal flap thickness after laser in situ keratomileusis. J Cataract Refract Surg 2002; 28:962-70. [PMID: 12036637 DOI: 10.1016/s0886-3350(02)01275-0] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To measure flap thickness in laser in situ keratomileusis (LASIK) patients using in vivo confocal microscopy through-focusing (CMTF) and compare measured versus intended flap thickness achieved by 2 microkeratomes, the Automated Corneal Shaper(R) (ACS) (Chiron Bausch & Lomb) and the Hansatome (Bausch & Lomb). SETTING Department of Ophthalmology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA. METHODS Twenty-seven eyes of 27 patients were examined by in vivo CMTF 3 to 12 months after LASIK was performed with the ACS (12 patients) or Hansatome (15 patients) microkeratome. The central cornea was scanned, and the epithelium, flap, stroma, and total corneal thickness were measured. Normalized flap thickness (NFT) was also calculated to account for changes in epithelial thickness that may have occurred postoperatively. RESULTS The mean posterior stromal thickness was 341.1 microm +/- 53.9 (SD) (range 233 to 431 microm) in the ACS group and 320.3 +/- 42.3 microm (range 258 to 382 microm) in the Hansatome group. The mean nonnormalized flap thickness was 132.7 +/- 12.5 microm (range 11 to 151 microm) in the ACS group and 167.4 +/- 21.4 microm (range 141 to 209 microm) in the Hansatome group. The NFT was 129.6 +/- 9.5 microm and 158.4 +/- 22.1 microm, respectively. Both microkeratomes cut significantly less than intended (P <.05); however, the ACS cut a thinner-than-intended thickness in all cases, and the Hansatome cut thicker than intended in 13% of cases. The Hansatome also showed significantly greater variability in flap thickness than the ACS (P <.05). CONCLUSIONS A significant difference in precision was noted between the 2 microkeratomes. The findings emphasize the importance of performing thickness measurements and the usefulness of in vivo CMTF in making these determinations to ensure the safety and effectiveness of LASIK.
Collapse
Affiliation(s)
- Fusun Gokmen
- Department of Ophthalmology, University of Texas Southwestern Medical Center at Dallas, USA
| | | | | | | | | |
Collapse
|
50
|
Chen S, Hu FR. Correlation between refractive and measured corneal power changes after myopic excimer laser photorefractive surgery. J Cataract Refract Surg 2002; 28:603-10. [PMID: 11955899 DOI: 10.1016/s0886-3350(01)01323-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE To determine the correlation between the refractive and measured corneal power changes after myopic photorefractive surgery. SETTING Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan. METHODS Eighty-six eyes that had myopic photorefractive surgery were analyzed. The data included preoperative and 1-year postoperative subjective refraction, standard automated keratometry, and computerized videokeratography. Statistical analysis was performed to determine the relationship between the changes in subjective refraction in the corneal plane (Delta SEQco) and in 4 corneal power measurements including the power measured by automated keratometry (Delta Auto K), topographic-simulated keratometric power (Delta Sim K), the power of the first photokeratoscopic ring on videokeratography (Delta Central K), and the average videokeratographic power on the pupil margin (Delta Pupil K). RESULTS The measured corneal power always underestimated the Delta SEQco, with Delta SEQco > Delta Central K > Delta Sim K > Delta Pupil K > Delta Auto K. All the changes in measured corneal power could predict the Delta SEQco with more than 90.00% (90.19% to 92.31%) reliability at 1 year as calculated by the regression formulas (P <.001). The underestimation of measured corneal power changes was correlated with the amount of myopic correction, especially the Auto K (all P <.001). CONCLUSIONS Direct corneal power measurements using automatic keratometry underestimated the actual corneal flattening after photorefractive surgery, which could be adjusted by a linear regression formula. Measuring the power of the first photokeratoscopic ring on videokeratography might provide a better estimation of actual corneal flattening after photorefractive surgery.
Collapse
Affiliation(s)
- Shuan Chen
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | | |
Collapse
|