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Liu X, Ye Y, Ge Y, Qu J, Liedberg B, Zhang Q, Wang Y. Smart Contact Lenses for Healthcare Monitoring and Therapy. ACS NANO 2024; 18:6817-6844. [PMID: 38407063 DOI: 10.1021/acsnano.3c12072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
The eye contains a wealth of physiological information and offers a suitable environment for noninvasive monitoring of diseases via smart contact lens sensors. Although extensive research efforts recently have been undertaken to develop smart contact lens sensors, they are still in an early stage of being utilized as an intelligent wearable sensing platform for monitoring various biophysical/chemical conditions. In this review, we provide a general introduction to smart contact lenses that have been developed for disease monitoring and therapy. First, different disease biomarkers available from the ocular environment are summarized, including both physical and chemical biomarkers, followed by the commonly used materials, manufacturing processes, and characteristics of contact lenses. Smart contact lenses for eye-drug delivery with advancing technologies to achieve more efficient treatments are then introduced as well as the latest developments for disease diagnosis. Finally, sensor communication technologies and smart contact lenses for antimicrobial and other emerging bioapplications are also discussed as well as the challenges and prospects of the future development of smart contact lenses.
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Affiliation(s)
- Xiaohu Liu
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
| | - Ying Ye
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
| | - Yuancai Ge
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
| | - Jia Qu
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
| | - Bo Liedberg
- School of Materials Science and Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798, Singapore
| | - Qingwen Zhang
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
- Engineering Research Center of Clinical Functional Materials and Diagnosis & Treatment Devices of Zhejiang Province, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325001, China
| | - Yi Wang
- School of Ophthalmology and Optometry, Eye Hospital, School of Biomedical Engineering, Wenzhou Medical University, Wenzhou 325001, China
- Engineering Research Center of Clinical Functional Materials and Diagnosis & Treatment Devices of Zhejiang Province, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325001, China
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Saad A, Narr J, Frings A, Steinberg J, Katz T, Linke SJ. Surgical outcomes of laser in situ keratomileusis (LASIK) in patients with stable systemic disease. Int Ophthalmol 2024; 44:119. [PMID: 38418603 PMCID: PMC10902021 DOI: 10.1007/s10792-024-02956-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 12/04/2023] [Indexed: 03/01/2024]
Abstract
PURPOSE To evaluate the surgical outcome in terms of safety, efficacy, predictability, and retreatment rate of LASIK surgery in patients with controlled systemic diseases in comparison with healthy individuals. METHODS The retrospective study included data from 1936 eyes of 976 patients with stable systemic diseases who underwent LASIK surgery between January 2016 and June 2019. The safety, efficacy, predictability of the surgery, and retreatment rate were evaluated in comparison with a control group comprising 1951 patients. The study was approved by the local ethics committee and adhered to the principles of the Declaration of Helsinki. Statistical analysis was performed using R team and the level of statistical significance was set at p < 0.05. RESULTS All treatment groups demonstrated high safety and efficacy indices after LASIK surgery. Furthermore, the study arms demonstrated comparable predictability and retreatment rates to the control group in nearly all cases. Retreatment rates were significantly higher in the rheumatoid arthritis group (p = 0.03), while safety indices were significantly lower in the hay fever group compared to the control group (p = 0.004). No intra- or postoperative sight-threatening complications were documented. CONCLUSION Our findings suggest that selected patients with stable systemic conditions can safely undergo LASIK surgery and achieve comparable outcomes to healthy individuals. Further research is needed to better understand the treatment outcomes in this challenging patient population.
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Affiliation(s)
- Amr Saad
- Department of Ophthalmology, Heinrich-Heine University, Duesseldorf, Germany
| | - Jenny Narr
- Department of Ophthalmology, University Medical Center, Hamburg, Germany
| | - Andreas Frings
- Department of Ophthalmology, Heinrich-Heine University, Duesseldorf, Germany.
- Augenheilkunde & Augenlaser Zentrum PD Dr. med. A. Frings, Nuremberg, Germany.
| | - Johannes Steinberg
- Department of Ophthalmology, University Medical Center, Hamburg, Germany
- Zentrum Sehstärke, Hamburg, Germany
| | - Toam Katz
- Department of Ophthalmology, University Medical Center, Hamburg, Germany
- Care-Vision, Hamburg, Germany
| | - Stephan Johannes Linke
- Department of Ophthalmology, University Medical Center, Hamburg, Germany
- Zentrum Sehstärke, Hamburg, Germany
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Wilson SE, de Oliveira RC. Pathophysiology and Treatment of Diffuse Lamellar Keratitis. J Refract Surg 2020; 36:124-130. [PMID: 32032434 DOI: 10.3928/1081597x-20200114-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 01/14/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE To review cytokine- and chemokine-mediated mechanisms of diffuse lamellar keratitis (DLK) after lamellar corneal surgical procedures. METHODS Review of the basic science and clinical literature. RESULTS DLK can occur early or late (months to decades) after all lamellar corneal surgeries, including laser in situ keratomileusis, small incision lenticule extraction, anterior lamellar keratoplasty, and Descemet's stripping automated endothelial keratoplasty. It is most commonly triggered by epithelial injury during or after lamellar surgery, which leads to the release of interleukin (IL)-1α, IL-1β, and tumor necrosis factor (TNF)-α from the epithelium and into the stroma. These chemokines directly attract inflammatory cells into the cornea from the limbal blood vessels and also bind to receptors on keratocytes and corneal fibroblasts where myriad chemokines are upregulated that also chemotactically attract monocytes, macrophages, granulocytes, lymphocytes, and other bone marrow-derived cells into the corneal stroma. Other factors that can trigger DLK include retained blood in the interface, endotoxins and other toxins, and excessive keratocyte necrosis caused by femtosecond lasers. Infiltrating cells show a preference to enter any lamellar interface in the cornea, regardless of the time since surgery, because of the ease of movement toward the chemotactic attractants relative to the surrounding stroma with intact collagen lamellae and stromal cells that serve as relative barriers impeding motility. The mainstay of treatment is topical corticosteroids, but severe cases may also be treated with flap lift irrigation and systemic corticosteroids. CONCLUSIONS DLK can occur early or late after any lamellar corneal surgical procedure and is most commonly triggered by epithelial-stromal-bone marrow-derived cellular interactions mediated by corneal cytokines and chemokines. [J Refract Surg. 2020;36(2):124-130.].
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Sharma B, Soni D, Saxena H, Stevenson LJ, Karkhur S, Takkar B, Vajpayee RB. Impact of corneal refractive surgery on the precorneal tear film. Indian J Ophthalmol 2020; 68:2804-2812. [PMID: 33229655 PMCID: PMC7856956 DOI: 10.4103/ijo.ijo_2296_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/28/2020] [Accepted: 06/24/2020] [Indexed: 11/13/2022] Open
Abstract
Corneal refractive surgeries are one of the commonly performed procedures for correction of refractive errors. Tear film abnormality is the most common postoperative complication of corneal refractive surgeries. Consequently, these procedures represent a clinically significant cause of dry eye disease. The mechanisms which lead to dry eye disease include corneal sensory nerve dysfunction, ocular surface desiccation, glandular apoptosis and ocular surface inflammation. Although transient tear film abnormalities occur in almost all patients following surgery, patients with pre-existing dry eye symptoms or dry eye disease are at significant risk of developing more severe or long-term ocular surface disease. As such, careful patient selection and preoperative evaluation is essential to ensuring successful surgical outcomes. This is particularly important with LASIK which has the strongest association with dry eye disease. Appropriate surface lubrication and anti-inflammatory therapy remains the cornerstone treatment. Timely and effective management is important to facilitate visual rehabilitation and reduce the risk of secondary complications. In this review we describe the causes, pathophysiology, risk factors, manifestations, and management of tear film dysfunction and dry eye disease following corneal refractive surgery.
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Affiliation(s)
- Bhavana Sharma
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Deepak Soni
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Harsha Saxena
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Louis J Stevenson
- Cornea Unit, Royal Victorian Eye and Ear Hospital, East Melbourne, Melbourne, Victoria, Australia
| | - Samendra Karkhur
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Brijesh Takkar
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Rasik B Vajpayee
- Cornea Unit, Royal Victorian Eye and Ear Hospital, East Melbourne, Melbourne, Victoria, Australia
- Cornea Unit, Vision Eye Institute, Melbourne, Victoria, Australia
- Cornea and Cataract Surgery Unit, University of Melbourne, Melbourne, Victoria, Australia
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Tsatsos M, Athanasiadis I, MacGregor C, Aristeidou A, Moschos MM, Ziakas N. Combined photorefractive keratectomy and cross-linking. Pushing the limits. Taiwan J Ophthalmol 2019; 9:206-209. [PMID: 31572660 PMCID: PMC6759553 DOI: 10.4103/tjo.tjo_7_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 06/25/2019] [Indexed: 11/18/2022] Open
Abstract
Correction of refractive error through laser-assisted means has soared in popularity in recent years, allowing it to become an increasingly routine surgical procedure. Technique refinement and adjustments resulted in laser-assisted refractive surgery to be combined with treatments such as collagen cross linking (CXL). This has broadened safety parameters and widened the treatment boundaries. Laser correction combined with CXL has been advocated in the treatment of high refractive errors as a safe option for full refractive correction while increasing corneal biomechanical stability. We present a complicated case where a young female patient with a preoperative best-corrected visual acuity (BCVA) of 20/20 in each eye was fully corrected by excimer laser followed by CXL. Factors potentially leading to inflammation, such as ocular surface disease, in addition to laser treatment and CXL, resulted in persistent epithelial defect followed by corneal melt and subsequent thinning. After the treatment, the patient relies on rigid gas-permeable contact lenses, achieving a BCVA of 20/25 and 20/23 in the right eye and left eye, respectively.
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Affiliation(s)
- Michael Tsatsos
- Department of Ophthalmology, Aristotle University of Thessaloniki, Greece.,Modern Ophthalmic Practice, Thessaloniki, Greece
| | - Ioannis Athanasiadis
- Department of Ophthalmology, Aristotle University of Thessaloniki, Greece.,Modern Ophthalmic Practice, Thessaloniki, Greece
| | | | | | | | - Nikolaos Ziakas
- Department of Ophthalmology, Aristotle University of Thessaloniki, Greece
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Lu CW, Liu XF, Zhou DD, Kong YJ, Qi XF, Liu TT, Qu T, Pan XT, Liu C, Hao JL. Bilateral diffuse lamellar keratitis triggered by permanent eyeliner tattoo treatment: A case report. Exp Ther Med 2017; 14:283-285. [PMID: 28672926 PMCID: PMC5488537 DOI: 10.3892/etm.2017.4506] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 03/03/2017] [Indexed: 11/20/2022] Open
Abstract
Diffuse lamellar keratitis (DLK) is a sterile inflammation of the cornea, which may occur after laser-assisted in situ keratomileusis (LASIK) surgery. Little is known about the association of DLK with permanent eyeliner tattoo. The present case report describes the case of a 37-year-old Chinese woman who developed severe foreign body sensation in both eyes 1 week after receiving bilateral permanent eyeliner tattoo treatment. The patient had received bilateral LASIK surgery 10 years previously. Slit-lamp biomicroscopy revealed diffused granular infiltrates precipitated around the edge of the corneal flaps in both eyes. After topical treatment, DLK persisted. Therefore, the patient underwent surgery to remove the corneal epithelium around the DLK lesion. There was no recurrence of the disease during the 3-month observation period. To our knowledge, this is the first case report describing a case of late-onset of DLK that was triggered by permanent eyeliner tattoo. Doctors should be aware of the diagnosis and treatment of this complication associated with the application of permanent eyeliner tattoo as the popularity of this cosmetic procedure increases.
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Affiliation(s)
- Cheng-Wei Lu
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Xiu-Fen Liu
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Dan-Dan Zhou
- Department of Radiology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Yu-Jiao Kong
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Xiao-Feng Qi
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Tao-Tao Liu
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Ting Qu
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Xiao-Tao Pan
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Cong Liu
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Ji-Long Hao
- Department of Ophthalmology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
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Current options and emerging therapies for anterior ocular inflammatory disease. Curr Opin Allergy Clin Immunol 2014; 14:485-9. [DOI: 10.1097/aci.0000000000000097] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
PURPOSE OF REVIEW The purpose of this article is to provide an overview and update on recent literature regarding ocular surface disease and corneal refractive surgery. RECENT FINDINGS Studies involving ocular surface disease and/or keratorefractive (corneal) surgery published found on the Medline database were included in the report. Studies focused on mechanisms of refractive surgery induced dry eye disease, surgical options, including modification of technique, to prevent dry eye, and postoperative dry eye prevention and management by way of both established and novel therapies. SUMMARY By understanding the mechanisms of postoperative dry eye as well as patient risk factors for dry eye, patient satisfaction and surgical outcomes can be maximized. Patients identified as having an increased risk for postoperative dry eye may benefit from surgical techniques such as small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in-situ keratomileusis (LASIK). Employing well known therapies such as preserved and nonpreserved artificial tears, nutritional supplements, topical cyclosporins, punctal plugs and autologus serum as well as novel therapies such as insulin-like growth factor 1, neuropeptides and acupuncture could provide improve outcomes and, if started early, could allow more patients to be candidates for corneal refractive surgery.
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Update on contraindications for laser-assisted in situ keratomileusis and photorefractive keratectomy. Curr Opin Ophthalmol 2014; 25:251-7. [DOI: 10.1097/icu.0000000000000055] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Neuhaus-Richard I, Frings A, Görsch IC, Druchkiv V, Katz T, Linke SJ, Richard G. Do outside temperature and sunlight duration influence the outcome of laser refractive surgery? Results from the Hamburg Weather Study. Clin Ophthalmol 2014; 8:1129-37. [PMID: 24966665 PMCID: PMC4063864 DOI: 10.2147/opth.s57717] [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] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To examine the impact of temperature and sunlight duration on refractive and visual outcome of laser-assisted in situ keratomileusis (LASIK) in myopic eyes. SETTING University Medical Center Hamburg-Eppendorf, Germany, and Care Vision Refractive Centers, Germany. DESIGN Retrospective, cross-sectional data analysis. METHODS This study comprised 1,052 eyes of 1,052 consecutive myopic patients (419 males, 633 females; mean age at surgery 35.0±9.0 years) with a mean preoperative refractive spherical equivalent (SE) of -3.88±1.85 diopters (D). Two subgroups were defined, comprising patients undergoing surgery during either meteorological winter or summer. Manifest refraction, uncorrected, and corrected distant visual acuity (UDVA and CDVA) were assessed pre- and postoperatively. We applied robust regression analysis with efficiency index (EI), safety index (SI), and postoperative SE (in D) as dependent variables. RESULTS At the 1-month (33.0±5.0 days) follow-up, the mean postoperative SE was -0.18±0.44 D. Bivariate comparisons showed that statistically significant better EI was related to days with lower temperature. We obtained a significant difference for SI which suggested that low temperature had a positive influence on SI. No change by more than one line on LogMAR scale was obtained. CONCLUSION Although being statistically significant, there was no clinically relevant difference in the outcome of LASIK, which demonstrates its highly standardized quality. Prospective, longitudinal studies are warranted to address meteorotropic reactions through evaluating defined meteorological parameters.
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Affiliation(s)
- Ines Neuhaus-Richard
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Germany
| | - Andreas Frings
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Germany
| | | | - Vasyl Druchkiv
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Germany
| | - Toam Katz
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Germany ; Care Vision Refractive Centers, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stephan Johannes Linke
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Germany ; Care Vision Refractive Centers, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gisbert Richard
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Germany
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Variation in the effectiveness of refractive surgery during the year: results from the Hamburg Weather Study. J Cataract Refract Surg 2014; 40:1139-46. [PMID: 24957434 DOI: 10.1016/j.jcrs.2013.11.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 10/31/2013] [Accepted: 11/11/2013] [Indexed: 11/23/2022]
Abstract
PURPOSE To examine the impact of seasonality on the refractive and visual outcomes of laser in situ keratomileusis (LASIK) in myopic eyes. SETTING Department of Ophthalmology and Care Vision Refractive Centers, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. DESIGN Retrospective cross-sectional data analysis. METHODS Two subgroups were defined. The first comprised patients having surgery during meteorological winter and the second, patients having surgery during meteorological summer. The manifest refraction and uncorrected and corrected visual acuities were assessed preoperatively and postoperatively. Robust regression analysis was applied with the efficacy index, safety index, and postoperative SE as dependent variables. RESULTS This study comprised 1052 eyes of 1052 consecutive myopic patients (419 men, 633 women; mean age at surgery 35.0 years ± 9.0 [SD]) with a mean preoperative refractive spherical equivalent (SE) of -3.88 ± 1.85 diopters (D). At the 1-month follow-up (mean 33.0 ± 5.0 days), the mean postoperative SE was -0.18 ± 0.44 D. The efficacy index was 0.023 higher in eyes with refractive surgery during summer than in eyes treated during winter (P=.032), indicating less efficacy during winter. The differences in the safety index and postoperative SE between summer and winter were not statistically significant. No eye had a change of more than 1 line on the logMAR scale (corrected distance visual acuity). CONCLUSIONS Although the difference in the efficacy index was statistically significant, the difference in the outcomes of LASIK was not clinically relevant, which shows the procedure's highly standardized reliability. Prospective longitudinal studies are warranted to address meteorotropic reactions by evaluating defined meteorological parameters. FINANCIAL DISCLOSURE(S) No author has a financial or proprietary interest in any material or method mentioned.
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Bielory L. A 37-year-old man referred for assistance with persistent asthma, atopic dermatitis, and chronic conjunctivitis. Ann Allergy Asthma Immunol 2014; 112:290-5. [PMID: 24679732 DOI: 10.1016/j.anai.2013.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 11/21/2013] [Accepted: 12/13/2013] [Indexed: 10/25/2022]
Affiliation(s)
- Leonard Bielory
- Robert Wood Johnson University Hospital, Rutgers University, Robert Wood Johnson Medical School and the School of Environmental and Biological Sciences Center for Environmental Prediction, New Brunswick, New Jersey.
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AlKharashi M, Bower KS, Stark WJ, Daoud YJ. Refractive surgery in systemic and autoimmune disease. Middle East Afr J Ophthalmol 2014; 21:18-24. [PMID: 24669141 PMCID: PMC3959036 DOI: 10.4103/0974-9233.124082] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Patients with underlying systemic disease represent challenging treatment dilemma to the refractive surgeon. The refractive error in this patient population is accompanied by a systemic disease that may have an ocular or even a corneal component. The literature is rather sparse about the use of laser refractive surgery (LRS) and such procedure is not approved by the United States Food and Drug Administration (FDA) in this patient population. Patients with collagen vascular disease, diabetes mellitus (DM), allergic and atopic disease, or human immunodeficiency virus (HIV) are never ideal for LRS. Patients with uncontrolled systemic disease or ocular involvement of the disease should not undergo LRS. However, a patient with well-controlled and mild disease, no ocular involvement, and not on multidrug regimen may be a suitable candidate if they meet stringent criteria. There is a need for a large, multicenter, controlled trial to address the safety and efficacy of LRS in patients with systemic disease before such technology can be widely adopted by the refractive surgery community.
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Affiliation(s)
- Majed AlKharashi
- The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA
| | - Kraig S Bower
- The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA
| | - Walter J Stark
- The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA
| | - Yassine J Daoud
- The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA
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Neuhaus-Richard I, Frings A, Ament F, Görsch IC, Druchkiv V, Katz T, Linke SJ, Richard G. Do air pressure and wind speed influence the outcome of myopic laser refractive surgery? Results from the Hamburg Weather Study. Int Ophthalmol 2014; 34:1249-58. [PMID: 24562594 DOI: 10.1007/s10792-014-9923-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 02/11/2014] [Indexed: 11/30/2022]
Abstract
Laser in situ keratomileusis (LASIK) is one of the dominant procedures for the surgical correction of refractive errors. Meteorotropic reaction has been described regarding the field of ophthalmology. This study was thus initiated to assess the impact of air pressure and wind speed on the refractive and visual outcome of LASIK in myopic eyes. Our study comprised 1,052 eyes of 1,052 consecutive myopic patients (419 males, 633 females; mean age at surgery 35.0 ± 9.0 years) with mean preoperative refractive spherical equivalent (SE) of -3.88 ± 1.85 diopters (D). Two subgroups were defined, which had undergone surgery either during meteorological winter or summer. Manifest refraction, uncorrected and corrected visual acuity were assessed pre- and post-operatively. We applied robust regression analysis with efficiency index (EI), safety index, and postoperative SE (D) as dependent variables. At the 1-month (33.0 ± 5.0 days) follow-up, the mean postoperative SE was -0.18 ± 0.44 D. Bivariate comparisons showed that statistically significant better EI was related to days with low to moderate air-pressure. This was confirmed by robust regression analysis. Moderate to high wind speed was related to more appropriate postoperative SE. No change by more than one line on logMar scale was obtained. Although being statistically significant, there is no clinically relevant difference in outcome of LASIK, which demonstrates its highly standardized quality. Prospective, longitudinal studies are warranted to address meteorotropic reactions through evaluating individual risk profiles.
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Affiliation(s)
- Ines Neuhaus-Richard
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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Tong L, Zhao Y, Lee R. Corneal refractive surgery-related dry eye: risk factors and management. EXPERT REVIEW OF OPHTHALMOLOGY 2014. [DOI: 10.1586/17469899.2013.851602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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