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Fernández-Vigo JI, Almorín-Fernández-Vigo I, Burgos-Blasco B, De-Pablo-Gómez-de-Liaño L, Sánchez-Guillén I, Merino AM, Fernández-Vigo JÁ. Assessment of the biometric modifications of the eye in LASIK during suction. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023:S2173-5794(23)00106-8. [PMID: 37364677 DOI: 10.1016/j.oftale.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/05/2023] [Indexed: 06/28/2023]
Abstract
PURPOSE To study the biometric modifications of the eyeball during suction in Laser assisted in Situ Keratomileusis (LASIK). METHODS Observational and cross-sectional study. We studied 43 patients who underwent surgery for myopia and myopic astigmatism. Mean age was 38.3 ± 11.5 years, and 19 were female (44.2%). Conventional LASIK surgery with a manual microkeratome was performed. Before and during the suction maneuvre the following parameters were measured using an 11 Mhz biometric probe: aqueous depth (AQD), lens thickness (LT), vitreous cavity length (VCL) and axial length (AXL). Paired t-test was used to compare the biometric measurements before and during suction. RESULTS The mean spherical equivalent refractive error was -4.5 ± 2.3 diopters. During suction, the AQD did not change significantly (p = 0.231). However, AXL and VCL increased by 0.12 mm and 0.22 mm respectively (p = 0.039 and <0.01) and LT decreased by 0.20 mm (p < 0.01). AXL increased in 42% of the eyes and decreased in 16%, VCL increased in 70% of the eyes and decreased in 9%, and the LT was reduced in 67% of the eyes. CONCLUSIONS Suction maneuvres during LASIK surgery produce changes of little magnitude in the eye globe, mainly a decrease in LT and an increase in VCL and AXL. Therefore, these modifications are expected to produce minimal anatomic alterations.
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Affiliation(s)
- J I Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain; Department of Ophthalmology, Hospital Perpetuo Socorro, Badajoz, Spain; Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain.
| | | | - B Burgos-Blasco
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - L De-Pablo-Gómez-de-Liaño
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain; Department of Ophthalmology, Hospital 12 de Octubre, Madrid, Spain
| | - I Sánchez-Guillén
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain; Department of Ophthalmology, Hospital 12 de Octubre, Madrid, Spain
| | - A M Merino
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain; Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - J Á Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain; Centro Internacional de Oftalmología Avanzada, Badajoz, Spain; Department of Ophthalmology, Universidad de Extremadura, Badajoz, Spain
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Li XJ, Duan JL, Ma JX, Shang QL. Macular hole following phakic intraocular lens implantation: A case report. World J Clin Cases 2022; 10:7178-7183. [PMID: 36051152 PMCID: PMC9297414 DOI: 10.12998/wjcc.v10.i20.7178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/27/2022] [Accepted: 05/28/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Phakic intraocular lens (pIOL) implantation has been commonly prescribed and is considered as a safe and effective option for correcting high myopia. However, it is associated with multiple complications.
CASE SUMMARY This report describes a case of full-thickness macular hole (MH) in a patient with a history of bilateral pIOL implantation for the correction of myopia of –12.00 diopters in both eyes 7 mo ago. The MH closed after pars plana vitrectomy with internal limiting membrane removal and the best-corrected visual acuity improved to 20/40 in the left eye.
CONCLUSION In rare cases, MH can occur following pIOL. In this present case report, we analyzed the formation process of MH following the surgery and emphasized that it is important to inform highly myopic patients about the risk of MH occurrence while being aware of the symptoms of this complication.
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Affiliation(s)
- Xue-Jing Li
- Department of Ophthalmology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Jia-Liang Duan
- Department of Ophthalmology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Jing-Xue Ma
- Department of Ophthalmology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
| | - Qing-Li Shang
- Department of Ophthalmology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
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Ozsaygili C, Altunel O, Duru N. Evaluation of the change in retinal thickness after femtosecond laser-assisted laser in situ keratomileusis and photorefractive keratectomy. Curr Eye Res 2021; 47:18-24. [PMID: 34231433 DOI: 10.1080/02713683.2021.1951297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE OF THE STUDY To investigate the change in individual retinal layer thickness by spectral-domain optical coherence tomography (SD-OCT) in eyes underwent femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) and photorefractive keratectomy (PRK). METHODS In patients who underwent PRK and FS-LASIK, changes in the thickness of all retinal layers in the foveal, parafoveal, and perifoveal regions were evaluated by SD-OCT automated segmentation analysis at pre-operatively and different time points post-operatively. RESULTS Seventy-one eyes of 71 patients (38 patients in PRK, 33 patients in LASIK) were included. In the pre-operative period, mean spherical equivalent (SE), mean keratometry, axial length, and segmentation values of the retinal layers were similar (P> .05). In the PRK group, the pre-operative measurements of individual retinal layers did not show a statistically significant difference compared to the post-operative measurements on the 1st day, 1st week, and 1st month. In the FS-LASIK group, the mean inner nuclear layer (INL) thickness one day after the surgery was significantly higher than that before surgery in the foveal (21.22 ± 4.66 µm vs 19.03 ± 4.50 µm, P= .013) and parafoveal regions (41.98 ± 3.70 µm vs 40.56 ± 3.49 µm, P= .044). CONCLUSIONS The findings of our study suggest that the increase of INL thickness may be due to temporary structural and circulatory changes of the retina that may occur in the suction phase in the FS-LASIK procedure.
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Affiliation(s)
- Cemal Ozsaygili
- Kayserı City Training and Research Hospital, Kocasinan, Turkey
| | - Orhan Altunel
- Kayserı City Training and Research Hospital, Kocasinan, Turkey.,Kutahya Evliya Celebi Training and Research Hospital, Kutahya, Turkey
| | - Necati Duru
- Kayserı City Training and Research Hospital, Kocasinan, Turkey
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Liu J, Tonk RS, Huang AM, Han E, Karp CL, Zeng M, Zou H, Zheng Y, Luo W, Sha X, Liu Z. Transient effect of suction on the retinal neurovasculature in myopic patients after small-incision lenticule extraction. J Cataract Refract Surg 2021; 46:250-259. [PMID: 32126039 DOI: 10.1016/j.jcrs.2019.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To characterize retinal neurovasculature changes after small-incision lenticule extraction (SMILE) in myopic patients. SETTING Ophthalmic Center, the Second Affiliated Hospital of Guangzhou Medical University, China. DESIGN Prospective interventional study. METHODS The corrected distance visual acuity/uncorrected distance visual acuity, corrected intraocular pressure (CIOP), and corneal tomography were evaluated at baseline (PRE), postoperative day (POD) 1, and POD 7. Ganglion cell-inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) thicknesses were measured. The vessel area densities (VADs, %), vessel skeleton densities (VSDs, %), vessel diameter index (VDI), and fractal dimensions (Dbox) of the superficial vascular plexus (SVP) and deep vascular plexus (DVP) were measured in a circular area (ϕ 2.5 mm) centered on the fovea. RESULTS A total of 38 myopic patients were recruited. The GCIPL thickness was increased after SMILE at POD 1 and POD 7 (P < .01) but no significant changes in the pRNFL thickness. The VAD, VSD, and Dbox of the SVP were decreased at POD 1 (P < .01), but not at POD 7. The VDI in small vessels of the SVP and DVP was decreased at POD 1 (P < .05) and increased at POD 7 (P < .05). Changes in CIOP were positively correlated with changes in the GCIPL thickness. Changes in CIOP were negatively correlated with changes in the VAD of small vessels and the Dbox of total vessels in the DVP. Changes in CIOP were negatively correlated with the VSD and VDI of small vessels in the DVP and changes in the VDI of big vessels in the SVP. CONCLUSIONS The transient fluctuations in the retinal neurovasculature after SMILE may represent a characteristic homeostasis pattern in patients after refractive surgery.
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Affiliation(s)
- Jiayan Liu
- Ophthalmic Center, the Second Affiliated Hospital of Guangzhou Medical University (Liu, Zeng, Zou, Zheng, Luo, Sha, Liu), Department of Ophthalmology, the Sixth Affiliated Hospital of Guangzhou Medical University (Liu), Qingyuan, China; and Bascom Palmer Eye Institute, University of Miami Miller School of Medicine (Tonk, Huang, Han, Karp), Miami, Florida, USA
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Abstract
PURPOSE To study the etiology, clinical features, management options, and visual prognosis in various types of atypical macular holes (MHs). METHODS A review of the literature was performed, which focused on the etiopathogenesis of atypical or secondary MHs, their differentiating clinical features, management strategies, and varied clinical outcomes. Idiopathic or age-related, myopic, and traumatic MHs were excluded. RESULTS Atypical or secondary MHs arise out of concurrent ocular pathologies (dystrophy, degeneration, or infections) and laser/surgery. The contributing factors may be similar to those responsible for idiopathic or typical MHs, i.e., tangential or anteroposterior vitreofoveal traction or cystoid degeneration. The management is either observation or treatment of the underlying cause. The prognosis depends on the background pathology, duration of disease, and baseline visual acuity governed by the size of MH and morphologic health of underlying RPE and photoreceptors. The closer the morphology of atypical MH is to that of an idiopathic MH, the better the surgical outcome is. CONCLUSION With the advancements in retinal imaging, atypical MHs are now more frequently recognized. With increasing understanding of the underlying disease processes, and improvement in investigations and surgical treatment, management of atypical MHs may improve in the future.
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Macular Hole: From Diagnosis to Therapy. J Ophthalmol 2020; 2020:1473763. [PMID: 32280514 PMCID: PMC7125507 DOI: 10.1155/2020/1473763] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 02/17/2020] [Indexed: 11/23/2022] Open
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Kumar A, Padhy SK, Dhiman R, Kumar P, Parekh T, Varshney T. Macular hole following phakic intraocular lens implantation and its management. Indian J Ophthalmol 2019; 67:1758-1760. [PMID: 31546556 PMCID: PMC6786197 DOI: 10.4103/ijo.ijo_126_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A 28-year-old male presented to retina clinic with complains of blurring and distortion in right eye for past 1 week. There was history of implantation of phakic intraocular lens (pIOL) bilaterally 4 months back. Ophthalmic examination revealed a full-thickness macular hole in the right eye. Pars plana vitrectomy with inverted internal limiting membrane flap was planned. Post-operatively, patient had a good gain in vision (20/40) with closure of the hole. Macular hole is an unusual complication of pIOL. A detailed pre-operative fundus screening is indispensable. Early presentation and timely intervention can optimize the visual outcome.
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Affiliation(s)
- Atul Kumar
- Retina Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Srikanta K Padhy
- Retina Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rebika Dhiman
- Retina Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Prashant Kumar
- Retina Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Twinkle Parekh
- Retina Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Toshit Varshney
- Retina Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Fakhrutdinova AF, Siplivy VI, Fedoruk NA, Bolshunov AV, Gamidov AA. [Retinal changes after laser interventions on anterior segment of the eyeball]. Vestn Oftalmol 2019; 135:122-129. [PMID: 31215543 DOI: 10.17116/oftalma2019135021122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Laser surgery of the cornea, iris, angle of the anterior chamber and other parts of anterior segment of the eye sees wide application in clinical practice. The adverse effects it can cause in the anterior segment are well known and understood. At the same time, changes the treatment method can cause in the posterior segment of the eye - primarily, in macular area of the cornea, which is of great importance, have not been studied sufficiently. Purpose of the review - to consolidate previously published data on changes in the retina after laser intervention on the anterior segment of the eye.
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Affiliation(s)
- A F Fakhrutdinova
- Moscow Municipal Polyclinic #219, 47 Jana Rainisa Blvd., Moscow, Russian Federation, 125373
| | - V I Siplivy
- I.M. Sechenov First Moscow State Medical University, Department of Ophthalmology, 8-2 Trubetskaya St., Moscow, Russian Federation, 119991
| | - N A Fedoruk
- Research Institute of Eye Diseases, 11, A, Rossolimo St., Moscow, Russian Federation, 119021
| | - A V Bolshunov
- Research Institute of Eye Diseases, 11, A, Rossolimo St., Moscow, Russian Federation, 119021
| | - A A Gamidov
- Research Institute of Eye Diseases, 11, A, Rossolimo St., Moscow, Russian Federation, 119021
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Cheng W, Liu L, Yu S, Jing Y, Zuo T, Cui T, Zhang H, Ma J, Wei P, Hao W, Lap-Ki Ng A, Pak-Man Cheng G, Chi-Pang Woo V, Chiu K, Wang Y. Real-Time Intraocular Pressure Measurements in the Vitreous Chamber of Rabbit Eyes During Small Incision Lenticule Extraction (SMILE). Curr Eye Res 2018; 43:1260-1266. [PMID: 29874938 DOI: 10.1080/02713683.2018.1485949] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE To investigate real-time intraocular pressure (IOP) during small incision lenticule extraction (SMILE) in rabbit eyes for myopia correction. METHODS During SMILE, real-time IOP was measured in the vitreous cavity of rabbit eyes with an optic fiber pressure sensor (OFPS). Two groups (n = 6 for each) underwent surgery, one group for a -2.00 diopter (D) refractive spherical correction and the other for a -6.00 D correction. RESULTS During surgery, the IOP increased once the glass contact attached to the cornea (Pre-suction), and peaked 83.94 mmHg (SD ± 23.87 mmHg) for the -2.00 D group and 89.17 mmHg (SD ± 22.66 mmHg) for the -6.00 D group, both average values were less than 110 mmHg when suction was initiated to fix the glass contact onto the cornea (Suction on). It then fell to 74.81 mmHg (SD ± 20.64 mmHg) and 76.94 mmHg (SD ± 27.43 mmHg), respectively, and remained stable during lenticule creation (Cutting). After suction stopped (Suction off), IOP fell steeply. During lenticule separation/extraction, the change in IOP was 32.26 mmHg (SD ± 2.91 mmHg). Notably, the average duration of elevated IOP during the surgery was 166.05 s (no longer than 3 min). CONCLUSIONS The IOP fluctuations in the vitreous cavity using an OFPS in a rabbit model during SMILE showed that real-time IOP significantly was increased during Pre-suction, Suction on, Cutting, Suction off, and lenticule separation/extraction compared to baseline IOP, although, peaked at Suction on. Neither the degree of myopic correction nor central corneal thickness significantly affected these changes in IOP.
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Affiliation(s)
- Wenbo Cheng
- a Clinical College of Ophthalmology , Tianjin Medical University , Tianjin , China
| | - Lingjia Liu
- b Medical College of Nankai University , Tianjin , China
| | - Shasha Yu
- a Clinical College of Ophthalmology , Tianjin Medical University , Tianjin , China.,c Department of Ophthalmology, LKS Faculty of Medicine , The University of Hong Kong , Hong Kong SAR , China
| | - Yin Jing
- d Tianjin Eye Hospital & Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science , Clinical College of Ophthalmology , Tianjin , China
| | - Tong Zuo
- d Tianjin Eye Hospital & Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science , Clinical College of Ophthalmology , Tianjin , China
| | - Tong Cui
- a Clinical College of Ophthalmology , Tianjin Medical University , Tianjin , China
| | - Hui Zhang
- d Tianjin Eye Hospital & Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science , Clinical College of Ophthalmology , Tianjin , China
| | - Jiaonan Ma
- a Clinical College of Ophthalmology , Tianjin Medical University , Tianjin , China
| | - Pinghui Wei
- d Tianjin Eye Hospital & Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science , Clinical College of Ophthalmology , Tianjin , China
| | - Weiting Hao
- a Clinical College of Ophthalmology , Tianjin Medical University , Tianjin , China
| | - Alex Lap-Ki Ng
- c Department of Ophthalmology, LKS Faculty of Medicine , The University of Hong Kong , Hong Kong SAR , China
| | | | | | - Kin Chiu
- c Department of Ophthalmology, LKS Faculty of Medicine , The University of Hong Kong , Hong Kong SAR , China.,f State Key Laboratory of Brain and Cognitive Sciences , The University of Hong Kong , Hong Kong SAR , China
| | - Yan Wang
- a Clinical College of Ophthalmology , Tianjin Medical University , Tianjin , China.,b Medical College of Nankai University , Tianjin , China.,d Tianjin Eye Hospital & Eye Institute, Tianjin Key Lab of Ophthalmology and Visual Science , Clinical College of Ophthalmology , Tianjin , China
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Rodríguez A, Infante R, Rodríguez FJ, Valencia M. Spontaneous Separation in Idiopathic Vitreomacular Traction Syndrome Associated with Contralateral Full-Thickness Macular Hole. Eur J Ophthalmol 2018; 16:733-40. [PMID: 17061226 DOI: 10.1177/112067210601600512] [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: 11/15/2022]
Abstract
Purpose Vitreomacular traction syndrome (VMTS) and full-thickness macular hole are two different well-known entities that on follow-up may be subjected to clinical modifications. Precisely, a spontaneous separation of idiopathic VMTS occurred in three eyes of three patients relieving in addition traction of the posterior hyaloid that had led also to a focal macular pigment epithelium detachment (RPE). An association to a full-thickness macular hole was observed in the contralateral eye of one of the patients. Methods This is a retrospective study of three patients evaluated with fluorescein angiography and documented with optical coherence tomography using the Stratus (OCT) model 3000, with scans analysis and protocols analysis, measuring the size and shape of vitreomacular adhesions, macular thickness changes before and after the spontaneous separation of the fractional posterior hyaloid adhesion. In addition, the vitreous was evaluated with contact lens slit lamp biomicroscopy and ultrasound. The associated contralateral macular hole in one of the patients was surgically treated. Results Two of the three eyes with spontaneous separation of the VMTS recovered 20/25 central visual acuity; the other eye maintained the initial 20/50 visual acuity. The treated macular hole recovered 20/100 corrected visual acuity. Conclusions Spontaneous separation of posterior hyaloid is a possible outcome during follow-up of idiopathic VMTS that can be well evaluated and documented with OCT while macular fluorescein angiography may be silent in cases like these presently reported. Central vision recovery can be excellent following the spontaneous separation, which releases anterior-posterior traction including on the retinal pigment epithelium and decreases macular thickness as measured with OCT. Therefore, regarding management, the indication for vitrectomy should be delayed awaiting the spontaneous release of vitreomacular traction in 4 to 6 months. The association between idiopathic VMTS in one eye and full-thickness macular hole in the opposite eye of one patient is an important pathophysiologic consideration.
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Affiliation(s)
- A Rodríguez
- Servicio Retina y Vítreo, Fundacion Oftalmologica Nacional, Facultad de Medicina, Universidad del Rosario, Bogotá, Colombia.
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Incidence of Posterior Vitreous Detachment After Femtosecond LASIK Compared With Microkeratome LASIK. Cornea 2017; 36:1036-1039. [DOI: 10.1097/ico.0000000000001277] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hooshmand J, Vote BJ. Femtosecond laser-assisted cataract surgery, technology, outcome, future directions and modern applications. Asia Pac J Ophthalmol (Phila) 2017; 6:393-400. [PMID: 28780777 DOI: 10.22608/apo.2017159] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 07/26/2017] [Indexed: 11/08/2022] Open
Abstract
Since its introduction in 2009 femtosecond laser-assisted cataract surgery (FLACS) has promised to revolutionize cataract surgery. Despite its promise, the assessment of FLACS's perceived benefits has proven to be far more complicated than initially might have been thought. Most studies to date have not provided validation of FLACS technology as a clinically significant advancement on our current techniques. We review FLACS technology and outcomes including detailed analysis of safety, efficacy, cost effectiveness and future prospects using data from the literature and our own published clinical experience.
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Affiliation(s)
| | - Brendan J Vote
- Tasmanian Eye Institute, South Launceston, Tasmania, Australia
- University of Tasmania, Hobart, Tasmania, Australia
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Yumusak E, Ornek K, Ozkal F. Bilateral Simultaneous Rhegmatogenous Retinal Detachment following Laser in situ Keratomileusis. Case Rep Ophthalmol 2016; 7:341-5. [PMID: 27462264 PMCID: PMC4943299 DOI: 10.1159/000446602] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 05/03/2016] [Indexed: 12/02/2022] Open
Abstract
A 21-year-old woman developed simultaneous rhegmatogenous retinal detachment after laser in situ keratomileusis (LASIK) in both eyes. She underwent pars plana vitrectomy surgery combined with endolaser photocoagulation and silicone oil tamponade in the right eye. A week later, pneumatic retinopexy was done in the left eye. As the retinal tear did not seal, 360° scleral buckling surgery was performed and retina was attached. Bilateral simultaneous rhegmatogenous retinal detachment after LASIK for correction of myopia can be a serious complication. Patients should be informed about the possibility of this complication.
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Affiliation(s)
- Erhan Yumusak
- Department of Ophthalmology, School of Medicine, Kirikkale University, Kirikkale, Turkey
| | - Kemal Ornek
- Department of Ophthalmology, School of Medicine, Kirikkale University, Kirikkale, Turkey
| | - Fatma Ozkal
- Department of Ophthalmology, School of Medicine, Kirikkale University, Kirikkale, Turkey
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Ibarz M, Hernández-Verdejo JL, Bolívar G, Tañá P, Rodríguez-Prats JL, Teus MA. Porcine Model to Evaluate Real-Time Intraocular Pressure During Femtosecond Laser Cataract Surgery. Curr Eye Res 2015; 41:507-12. [PMID: 26016665 DOI: 10.3109/02713683.2015.1023459] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE To investigate the changes in intraocular pressure (IOP) in porcine eyes during femtosecond laser-assisted cataract surgery using a liquid-optic interface system. MATERIALS AND METHODS Femtosecond laser cataract surgery with the Catalys™ was performed on freshly enucleated porcine eyes in Oftalvist Moncloa, Madrid, Spain. Capsulorhexis and lens fragmentation were completed in all the eyes without complications. IOP was measured with a reusable blood pressure transducer connected by direct cannulation to the anterior chamber, recording data before suction (basal), at the beginning of the suction phase, every five seconds during femtosecond procedure and after the removal of the suction ring from the eye. RESULTS Nine porcine eyes were used in this study. Basal IOP before suction was 5.67 ± 2.39 mmHg, rising to 20.33 ± 4.18 mmHg at the beginning of the suction phase (p < 0.001). During femtosecond procedure, pressure reached a value of 19.74 ± 4.31 mmHg, remaining stable during the entire process. The IOP recorded prior to removal of the suction ring was 21.00 ± 6.93 mmHg, returning to basal values in all the eyes after the suction ring was removed, with no statistical differences between basal and post-suction IOPs. Total femtosecond procedure time was 125.9 ± 15.9 s. CONCLUSIONS Real-time IOP can be measured during surgery using a transducer connected to the anterior chamber. The results showed a significant increase in IOP during the procedure due to the pressure exerted by the suction ring but not by the effect of the femtosecond laser.
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Affiliation(s)
- Marta Ibarz
- a Hospital Moncloa, Oftalvist Madrid , Madrid , Spain
| | | | - Gema Bolívar
- c Hospital Príncipe de Asturias , Alcalá de Henares, Madrid , Spain
| | - Pedro Tañá
- d Clínica Vistahermosa, Oftalvist Alicante , Alicante , Spain , and
| | | | - Miguel A Teus
- e Hospital Príncipe de Asturias, Universidad de Alcalá de Henares , Madrid , Spain
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Inner segment ellipsoid band and cone outer segment tips changes preceding macular hole development in a young patient. Case Rep Ophthalmol Med 2014; 2014:132565. [PMID: 25548697 PMCID: PMC4273506 DOI: 10.1155/2014/132565] [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: 06/24/2014] [Revised: 11/20/2014] [Accepted: 11/20/2014] [Indexed: 11/23/2022] Open
Abstract
Purpose. Pathophysiology of macular hole (MH) is not yet well defined but the advances of spectral domain optical coherence tomography (SD-OCT) give us access to further detailed imaging. We report a case with macular inner segment ellipsoid (ISe) band loss and cone outer segment tips (COST) line changes seen in SD-OCT preceding MH appearance in a young patient. Methods. 21-year-old woman presented with a partial central scotoma, metamorphopsia, and a 20/25 vision in her right eye. Past medical history was positive for laser assisted in situ keratomileusis (LASIK) surgery 7 months ago with no complications. Macular SD-OCT showed ISe band loss and COST line elevation. She was followed a month later with visual acuity deteriorating to 20/200 and a full thickness MH. Results. The patient underwent a pars plana vitrectomy with internal limiting membrane peeling. Her visual acuity 2 months later was 20/20. Conclusion. SD-OCT can identify preliminary changes, yet to be described, preceding MH formation. Our patient demonstrated ISe band loss and COST abnormalities on SD-OCT a month prior to MH development. SD-OCT should be considered in young patients with subtle visual symptoms and mild changes in visual acuity that are not readily explained by ophthalmological exam.
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Shoeibi N, Jabbarpoor Bonyadi MH, Abrishami M, Ansari-Astaneh MR. Bilateral macular hole following myopic photorefractive keratectomy. KOREAN JOURNAL OF OPHTHALMOLOGY 2014; 28:268-71. [PMID: 24882962 PMCID: PMC4038734 DOI: 10.3341/kjo.2014.28.3.268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 03/27/2014] [Indexed: 11/23/2022] Open
Abstract
A 42-year-old man was admitted to our clinic complaining of visual distortion in his left eye two months after bilateral myopic photorefractive keratectomy (PRK). Macular optical coherence tomography (OCT) showed a stage II macular hole in the left eye. Simultaneous OCT in the right eye showed vitreous traction and distortion of the outer retina. One month later, the patient underwent vitrectomy for the left eye, and the macular hole was closed. Two months after that, the patient complained of visual distortion in the right eye, and OCT revealed increased traction and accentuated outer retinal distortion indicating a stage IB macular hole. Traction attenuated later without any intervention. The short interval between PRK and hole formation, bilateral involvement, and the moderate refractive error in this case highlight the possible role of PRK in aggravating vitreoretinal interface abnormalities. We recommend the addition of PRK to the list of procedures that may be associated with the formation of a macular hole.
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Affiliation(s)
- Nasser Shoeibi
- Retina Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Hossein Jabbarpoor Bonyadi
- Department of Ophthalmology, Gonabad University of Medical Sciences, Gonabad, Iran. ; Center of Excellence for Biodiversity, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Majid Abrishami
- Retina Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Kang HM, Lee CS, Park HJ, Lee KH, Byeon SH, Koh HJ, Lee SC. Characteristics of rhegmatogenous retinal detachment after refractive surgery: comparison with myopic eyes with retinal detachment. Am J Ophthalmol 2014; 157:666-72.e1-2. [PMID: 24321470 DOI: 10.1016/j.ajo.2013.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 12/01/2013] [Accepted: 12/02/2013] [Indexed: 12/30/2022]
Abstract
PURPOSE To evaluate the characteristics of rhegmatogenous retinal detachment (RD) in patients with previous laser in situ keratomileusis (LASIK) and compare them to RD in patients with previous laser assisted subepithelial keratomileusis (LASEK) and myopic patients with no previous refractive surgery. DESIGN Retrospective, comparative case series. METHODS In 106 eyes of 106 patients with RD, patients with previous refractive surgery included 21 eyes after LASIK and 13 eyes after LASEK; 72 myopic patients with refractive errors of -3.0 diopters or less were grouped as the R (-) group. Characteristics of RD included distribution of RD and associated retinal breaks, location and number of retinal breaks, presence of lattice degeneration, and axial lengths. RESULTS The mean interval between refractive surgery and the onset of rhegmatogenous RD was 63.7 ± 43.5 months, occurring across a broad spectrum of time intervals. There were no significant differences among the LASIK group, the LASEK group, and the R (-) group in axial length (26.8 mm vs 26.4 mm vs 26.9 mm, respectively); in mean number of retinal holes/tears, (2.1/1.5, 0.9/1.4, 1.5/1.6, respectively); or in the presence of lattice degeneration (52.4% vs 46.2% vs 43.1%, respectively). Distribution of RD and associated retinal breaks were also not significantly different; retinal holes and tears were more prevalent in the temporal quadrants, and inferotemporal quadrants were the most commonly detached areas in both the LASEK and LASIK groups and in the R (-) group. CONCLUSIONS Myopia is a well-known risk factor for rhegmatogenous RD and may contribute more to the development of RD in myopic patients after refractive surgery, rather than refractive surgery itself.
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Jun JH, Kim YC, Kim KS. Macular hole after phakic intraocular lens implantation: two cases with divergent manifestations. Semin Ophthalmol 2013; 29:213-7. [PMID: 24171834 DOI: 10.3109/08820538.2013.835839] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract We describe two cases of a macular hole (MH) which had divergent manifestations and clinical courses following implantation of an Implantable Collamer Lens (ICL) in two high myopic patients. The onset of symptoms and shape of the holes, which were observed by optical coherence tomography and fundoscopy, and prognosis of the visual acuity after the surgery of each patient, were quite different. In the first patient, the symptom was an acute onset. Fundoscopy showed a cuneiform-shaped hole with internal limiting membrane defect around the hole. The prognosis after the surgery was very poor, and the best corrected visual acuity was 0.08 after complete anatomical closure. In another patient, the MH showed insidious progression with disease-free interval from ICL implantation to MH onset. After the surgery, the best corrected visual acuity was recovered to 1.0.
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Affiliation(s)
- Jong Hwa Jun
- Department of Ophthalmology, School of Medicine, Dongsan Medical Center, Keimyung University , Daegu , Korea
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Majji AB, Chhablani JK, Bagga B. Vitreo-retinal interface changes on optical coherence tomography in the fellow eyes of patients with macular hole. Int J Ophthalmol 2013; 6:526-30. [PMID: 23991391 DOI: 10.3980/j.issn.2222-3959.2013.04.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2012] [Accepted: 06/06/2013] [Indexed: 11/02/2022] Open
Abstract
AIM To study the vitreo-retinal interface and macular changes on optical coherence tomography (OCT) in the fellow eyes of patients with macular hole. METHODS Patients with idiopathic macular hole in one or both eyes presented to our institute between January 2003 and December 2009 were evaluated retrospectively. Demographic details, best-corrected visual acuity and vitreo-retinal interface, and macular changes of the fellow eye on OCT were studied. RESULTS Seventy patients underwent OCT of both eyes during the study period. The average age group was 61.96 years and 35 (50%) were females. Among the fellow eyes, normal foveal contour was noted in 36 (51.4%) eyes and 34 (48.6%) eyes were observed to have vitreo-retinal interface changes. Of them, 13 (18.6%) eyes had some stage of full thickness macular hole and 21 (30.0%) eyes had interface changes. There was no statistical correlation between involved eye lesions (P=0.64) or visual acuity (P=0.55) as predictors of development of either fellow eye lesions or poor visual acuity. CONCLUSION There is a significant chance of having vitreo-retinal interface findings in the fellow eyes of patients presenting with macular hole. OCT should be considered in both eyes of patients with macular hole to detect early changes in the fellow eyes, which may require an early intervention.
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Affiliation(s)
- Ajit Babu Majji
- Smt. Kanuri Santhamma Retina Vitreous Centre, L.V. Prasad Eye Institute, Kallam Anji Reddy Campus, L.V. Prasad Marg, Banjara Hills, Hyderabad 500034, India
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Vetter JM, Faust M, Gericke A, Pfeiffer N, Weingärtner WE, Sekundo W. Intraocular pressure measurements during flap preparation using 2 femtosecond lasers and 1 microkeratome in human donor eyes. J Cataract Refract Surg 2013; 38:2011-8. [PMID: 23079315 DOI: 10.1016/j.jcrs.2012.05.042] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 05/05/2012] [Accepted: 05/08/2012] [Indexed: 01/28/2023]
Abstract
PURPOSE To evaluate and compare intraocular pressures (IOPs) during flap preparations performed using 2 femtosecond lasers and a mechanical microkeratome in human donor globes. SETTING University Medical Center Mainz, Mainz, and Euroeyes Clinic Stuttgart, Stuttgart, Germany. DESIGN Experimental study. METHODS A cannula was inserted through the optic nerve in human globes. The IOP was obtained continuously during flap preparation using the 60 kHz Intralase femtosecond laser, the 200 kHz Visumax femtosecond laser, or the Amadeus II microkeratome. For each experiment, a normal lamellar flap preparation (regular procedure) and a worst-case procedure (femtosecond laser interface was pressed against globe until docking maneuver was aborted) were performed. RESULTS During the regular procedure, the mean maximum IOP measured was 181.3 mm Hg (range 159.1 to 194.8 mm Hg) with the 60 kHz femtosecond laser, 77.6 mm Hg (range 58.1 to 100.3 mm Hg) with the 200 kHz femtosecond laser, and 198.1 mm Hg (range 162.8 to 299.6 mm Hg) with the microkeratome. During the worst-case procedure, the maximum measured IOP was 319.7 mm Hg (range 299.1 to 341.2 mm Hg) with the 60 kHz laser and 120.4 mm Hg (range 118.1 to 134.7 mm Hg) with the 200 kHz laser. CONCLUSION Maximum IOPs during corneal flap preparations in human enucleated eyes were lower during performance of a regular procedure and a worst-case procedure with the 200 kHz femtosecond laser than with the 60 kHz femtosecond laser and the mechanical microkeratome. FINANCIAL DISCLOSURE Dr. Sekundo is a member of the Scientific Advisory Board of Carl Zeiss Meditec AG, Jena, Germany. No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Jan M Vetter
- Departments of Ophthalmology, Medical Centre of the Johannes Gutenberg University, Mainz, Germany.
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Kerr NM, Abell RG, Vote BJ, Toh T'Y. Intraocular pressure during femtosecond laser pretreatment of cataract. J Cataract Refract Surg 2013; 39:339-42. [PMID: 23312148 DOI: 10.1016/j.jcrs.2012.12.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 11/08/2012] [Accepted: 12/03/2012] [Indexed: 02/02/2023]
Abstract
PURPOSE To analyze the course of intraocular pressure (IOP) during femtosecond laser pretreatment to cataract surgery. SETTING Launceston Eye Institute, Tasmania, Australia. DESIGN Interventional prospective study. METHODS Femtosecond laser pretreatment was performed using the Catalys Precision Laser System with Liquid Optics Interface. The IOP was measured using a rebound tonometer (iCare PRO) during different stages of surgery and analyzed by number of docking attempts, vacuum time, treatment time, and central corneal thickness (CCT). RESULTS The mean baseline IOP in the 25 eyes was 17.5 mm Hg ± 2.4 (SD). During vacuum application, the mean IOP rise was 11.4 ± 3.3 mm Hg. Peak IOPs were recorded immediately after laser capsulotomy and lens fragmentation (mean 36.0 ± 4.4 mm Hg; mean increase from baseline 18.5 ± 4.7 mm Hg) and remained above baseline 2 minutes after the procedure (26.6 ± 4.0 mm Hg) (P<.001). Multiple regression analysis found no association between IOP rise and number of docking attempts, vacuum time, treatment time, or CCT. CONCLUSION Femtosecond laser pretreatment was associated with a mean peak increase in IOP of 18.5 mm Hg from baseline and appeared to be safe and well tolerated.
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Affiliation(s)
- Nathan M Kerr
- Launceston Eye Institute, Launceston, Tasmania, Australia.
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Schultz T, Conrad-Hengerer I, Hengerer FH, Dick BH. Intraocular pressure variation during femtosecond laser–assisted cataract surgery using a fluid-filled interface. J Cataract Refract Surg 2013; 39:22-27. [DOI: 10.1016/j.jcrs.2012.10.038] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2012] [Revised: 10/05/2012] [Accepted: 10/11/2012] [Indexed: 02/03/2023]
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García-Fernández M, Castro-Navarro J, Bajo-Fuente A. Vitreoretinal surgery for bilateral macular holes after laser-assisted in situ keratomileusis for the correction of myopia: a case report. J Med Case Rep 2012; 6:381. [PMID: 23140584 PMCID: PMC3514132 DOI: 10.1186/1752-1947-6-381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2012] [Accepted: 10/16/2012] [Indexed: 11/16/2022] Open
Abstract
Introduction Laser-assisted in situ keratomileusis surgery may induce postoperative changes in the vitreomacular interface due to the mechanical stretch of the vitreous produced by the suction ring and the shock waves generated by the excimer laser and, subsequently, may provoke macular hole formation. Case presentation A 53-year-old Spanish woman who had undergone a laser-assisted in situ keratomileusis for the correction of myopia in her right and left eye (10 years ago) was referred to our department with a complaint of decreased visual acuity in both eyes. A fundoscopy and optical coherence tomography examination revealed a bilateral full-thickness macular hole. A 23-gauge sutureless pars plana vitrectomy was performed in both eyes, and 1 month after surgery her visual acuity improved and the hole closed. Conclusion The development of a bilateral full-thickness macular hole after laser-assisted in situ keratomileusis has been reported once. This case study enhances our understanding of the vitreoretinal pathology induced by laser-assisted in situ keratomileusis, showing the importance of a rigorous follow-up, because complications may occur even a decade later. In this case study we must also consider the contribution of the underlying myopia to the development of the bilateral macular holes.
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Affiliation(s)
- Miriam García-Fernández
- Department of Opthalmology, Central University Hospital of Asturias, C/Dionisio Ridruejo, nº5, 11ºD, CP: 33007, Oviedo, Spain.
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RELEASE AND VELOCITY OF MICRONIZED DEXAMETHASONE IMPLANTS WITH AN INTRAVITREAL DRUG DELIVERY SYSTEM. Retina 2012; 32:2133-40. [DOI: 10.1097/iae.0b013e31825699e5] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Abstract
There has been the unsubstantiated clinical impression that laser refractive surgery accelerates cataract development along with solid experimental data about the cataractogenic effects of excimer laser treatment. We present the first documented case of significant cataract formation in a young myope after repeat excimer laser ablation necessitating phacoemulsification with a posterior chamber implant. Proposed explanations include focusing of the ablation wave on the posterior capsule (acoustic wave lens epithelial damage), photooxidative stress of the lens (ultraviolet and inflammatory oxidative stress), and corticosteroid-induced cataract (lens toxicity).
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Affiliation(s)
- Ahmad M Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
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Gavrilov JC, Gaujoux T, Sellam M, Laroche L, Borderie V. Occurrence of posterior vitreous detachment after femtosecond laser in situ keratomileusis: Ultrasound evaluation. J Cataract Refract Surg 2011; 37:1300-4. [DOI: 10.1016/j.jcrs.2011.01.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 01/01/2011] [Accepted: 01/04/2011] [Indexed: 10/18/2022]
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Vetter JM, Holzer MP, Teping C, Weingärtner WE, Gericke A, Stoffelns B, Pfeiffer N, Sekundo W. Intraocular Pressure During Corneal Flap Preparation: Comparison Among Four Femtosecond Lasers in Porcine Eyes. J Refract Surg 2011; 27:427-33. [DOI: 10.3928/1081597x-20101210-01] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Accepted: 10/19/2010] [Indexed: 11/20/2022]
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Abstract
PURPOSE OF REVIEW To describe recent evidence from the literature regarding central toxic keratopathy syndrome (CTK). RECENT FINDINGS CTK describes a rare, self-limited, noninflammatory postsurgical condition that presents with central corneal opacity and a significant hyperopic shift. Although its cause remains uncertain, CTK bears a striking clinical resemblance to other more serious conditions and is, therefore, often misdiagnosed and mismanaged. Despite its noninflammatory nature, the overlapping clinical features CTK shares with other inflammatory and infectious processes have led some to treat CTK with steroids. Recent studies discourage the use of steroids in CTK and recommend allowing the condition to resolve on its own. SUMMARY Although CTK resembles other inflammatory conditions that are responsive to steroids, current studies suggest that steroid administration is contraindicated in CTK and can exacerbate preexisting refractive alterations in patients with the condition.
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Mirshahi A, Baatz H. Posterior Segment Complications of Laser in situ Keratomileusis (LASIK). Surv Ophthalmol 2009; 54:433-40. [DOI: 10.1016/j.survophthal.2009.04.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Khaled M, . MAEM, . SK, . HI. Structural Changes in Rabbit Iris Following Excimer Laser Treatment. JOURNAL OF MEDICAL SCIENCES 2007. [DOI: 10.3923/jms.2007.732.739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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