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Spadea L, Di Genova L, Trovato Battagliola E, Paroli MP. Topography-Guided Transepithelial Photorefractive Keratectomy for the Treatment of Persistent and Visually-Significant Adenoviral Corneal Infiltrates. Ther Clin Risk Manag 2023; 19:341-349. [PMID: 37051278 PMCID: PMC10084871 DOI: 10.2147/tcrm.s407503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/02/2023] [Indexed: 04/14/2023] Open
Abstract
Purpose To evaluate visual and refractive outcomes of customized photorefractive keratectomy (PRK) in subjects with persistent subepithelial corneal opacities secondary to adenoviral epidemic keratoconjunctivitis (EKC). Patients and Methods Prospective study, which recruited patients with persistent and visually-significant post-EKC corneal opacities unresponsive to prolonged topical therapy (6 months or more). Outcome measures: uncorrected and best-corrected distance visual acuity, subjective refractive astigmatism, keratometric astigmatism, spherical equivalent, minimum corneal thickness, and corneal morphological irregularity index. Subjects were followed for 12 months post-treatment. Results Eighteen eyes of 18 patients aged between 32 and 75 years treated with topography-guided transepithelial PRK with iRes excimer laser (iVIS Technologies, Taranto, Italy) from June 2020 to July 2021. After 12 months, the mean UDVA improved from 1.0±0.00LogMAR pre-op to 0.15±0.154LogMAR, and the mean CDVA improved from 0.4±0.41LogMAR pre-op to 0.0±0.00LogMAR. With respect to UDVA, all treated eyes (100%) showed an improvement of 6 ETDRS lines or more and with respect to CDVA, 9 out of 18 eyes (50%) showed an improvement of 6 ETDRS lines or more. The mean ablation depth was 54.7±5.9μm. A statistically significant improvement was observed in all topographic indices. No infiltrate recurrence, post-treatment corneal haze, ocular hypertension or other side effects were observed throughout the follow-up period. Conclusion Topography-guided PRK could be considered an effective and safe treatment option to improve visual acuity in patients affected by persistent and visually-significant subepithelial corneal infiltrates caused by EKC.
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Affiliation(s)
- Leopoldo Spadea
- Eye Clinic, Policlinico Umberto I, “Sapienza” University of Rome, Rome, Italy
- Correspondence: Leopoldo Spadea, Head Eye Clinic, Policlinico Umberto I, “Sapienza” University of Rome, Via Benozzo Gozzoli 34, Rome, 00142, Italy, Tel +39 06 519 32 20, Fax +390688657818, Email
| | - Lucia Di Genova
- Eye Clinic, Policlinico Umberto I, “Sapienza” University of Rome, Rome, Italy
| | | | - Maria Pia Paroli
- Eye Clinic, Policlinico Umberto I, “Sapienza” University of Rome, Rome, Italy
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Giral JB, Bloch F, Sot M, Zevering Y, El Nar A, Vermion JC, Goetz C, Lhuillier L, Perone JM. Efficacy and safety of single-step transepithelial photorefractive keratectomy with the all-surface laser ablation SCHWIND platform without mitomycin-C for high myopia: A retrospective study of 69 eyes. PLoS One 2021; 16:e0259993. [PMID: 34874947 PMCID: PMC8651116 DOI: 10.1371/journal.pone.0259993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 10/30/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Studies suggest that transepithelial photorefractive keratectomy (TransPRK) with the all-surface laser ablation (ASLA)-SCHWIND platform is effective and safe for both low-moderate myopia and high myopia. In most studies, mitomycin-C is administered immediately after surgery to prevent corneal opacification (haze), which is a significant complication of photorefractive keratectomy in general. However, there is evidence that adjuvant mitomycin-C induces endothelial cytotoxicity. Moreover, a recent study showed that omitting adjuvant mitomycin-C did not increase haze in low-moderate myopia. The present case-series study examined the efficacy, safety, and haze rates of eyes with high myopia that underwent ASLA-SCHWIND TransPRK without adjuvant mitomycin-C. METHODS All consecutive eyes with high myopia (≤-6 D) that were treated in 2018-2020 with the SCHWIND Amaris 500E® TransPRK excimer laser without adjuvant mitomycin-C in a tertiary-care hospital (France) and were followed up for 6 months were identified. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and spherical equivalent (SE) were recorded before and after surgery. Postoperative haze was graded using the 4-grade Fantes scale. Efficacy rate (frequency of eyes with 6-month UCVA ≤0.1 logMAR), safety rate (frequency of eyes that lost <2 BSCVA lines), predictability (frequency of eyes with 6-month SE equal to target SE±0.5 D), efficacy index (mean UCVA at 6 months/preoperative BSCVA), and safety index (BSCVA at 6 months/preoperative BSCVA) were computed. RESULTS Sixty-nine eyes (38 patients) were included. Mean preoperative and 6-month SE were -7.44 and -0.05 D, respectively. Mean 6-month UCVA and BSCVA were 0.00 and -0.02 logMAR, respectively. Efficacy rate and index were 95.7% and 1.08, respectively. Safety rate and index were 95.7% and 1.13, respectively. Predictability was 85.5%. Grade 3-4 haze never arose. At 6 months, the haze rate was zero. CONCLUSIONS ASLA-SCHWIND TransPRK without mitomycin-C appears to be safe as well as effective and accurate for high myopia.
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Affiliation(s)
- Jean Baptiste Giral
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Florian Bloch
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Maxime Sot
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Yinka Zevering
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Arpine El Nar
- Clinical Research Support Unit, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Jean Charles Vermion
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Christophe Goetz
- Clinical Research Support Unit, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Louis Lhuillier
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Jean-Marc Perone
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
- * E-mail:
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Lin M, Zhou H, Hu Z, Huang J, Lu F, Hu L. Comparison of small incision lenticule extraction and transepithelial photorefractive keratectomy in terms of visual quality in myopia patients. Acta Ophthalmol 2021; 99:e1289-e1296. [PMID: 33982437 DOI: 10.1111/aos.14823] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 01/24/2021] [Accepted: 02/08/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To comprehensively compare visual quality between small incision lenticule extraction (SMILE) and transepithelial photorefractive keratectomy (tPRK). METHODS Sixty-four eyes in the SMILE group and 42 eyes in the tPRK group were enrolled in this study. In both groups, visual acuity, manifest refraction, higher-order aberrations (HOAs), contrast sensitivity (CS) at four spatial frequencies (3, 6, 12, 18 c/d) under three conditions (photopic, low glare, high glare), the cut-off value of the modulation transfer function (MTFcut-off), the objective scatter index (OSI) and the Strehl ratio (SR) were measured preoperatively and 1, 3 and 6 months postoperatively. RESULTS At 6 months postoperatively, the SMILE and tPRK groups showed similar safety, efficacy and predictability. Additionally, MTFcut-off, SR and OSI exhibited comparable results. In contrast, the photopic area under the logarithm of the CS function (AULCSF) showed better outcomes in the tPRK group than in the SMILE group (SMILE versus tPRK: 1.21 ± 0.10 versus 1.25 ± 0.09, p = 0.014). Furthermore, the induced coma aberrations were larger in the SMILE group (SMILE versus tPRK: 0.10 ± 0.16 versus 0.06 ± 0.12, 95% CI [0.08, 0.31], p < 0.0001). CONCLUSIONS Both SMILE and tPRK obtained comparable visual quality at 6 months postoperatively, accompanied by better photopic CS and smaller induced coma aberrations with tPRK. Paying more attention to alignment or developing a centration technique would be beneficial for visual quality when performing SMILE.
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Affiliation(s)
- Meng Lin
- Wenzhou Medical University Eye Hospital Wenzhou China
| | | | - Zhongli Hu
- Zhuji People's Hospital of Zhejiang Province Zhuji China
| | - Jinhai Huang
- Wenzhou Medical University Eye Hospital Wenzhou China
| | - Fan Lu
- Wenzhou Medical University Wenzhou China
| | - Liang Hu
- Wenzhou Medical University Eye Hospital Wenzhou China
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Hashemian MN, Faegh A, Latifi G, Abdi P. Clinical outcomes of transepithelial PRK using SCHWIND AMARIS laser platform with actual versus default epithelial thickness values. J Cataract Refract Surg 2021. [PMID: 34486580 DOI: 10.1097/j.jcrs.0000000000000803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 08/22/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE to investigate the clinical outcomes of transepithelial photorefractive keratectomy (tPRK) with actual epithelial thickness versus default software values. METHODS eighty-three patients with refractive spherical error of -1.50 to -7.00 diopters (D), and refractive astigmatism up to 4.00 D were consecutively enrolled and divided into two groups: group 1 undergone tPRK with actual central and peripheral epithelial thickness input in right eyes, group 2 undergone tPRK with actual central and 10 μm higher peripheral epithelial thickness in right eyes, left eyes underwent tPRK with default protocol in both groups. Outcome measures were induced refractive error, achieved optical zone (OZ), and wasted stromal tissue. SETTING Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, IranDesign: prospective controlled study. RESULTS Mean ± SD of induced spherical equivalent (SE) was +0.15 ± 0.39 D and +0.01 ± 0.35 D in right and left eyes of group 1 (p=0.01), and +0.04 ± 0.22 D and +0.03 ± 0.23 D in right and left eyes of group 2 (p=0.75), respectively. There was no statistically significant difference between wasted tissue between right and left eyes in group 1 and group 2 (p=0.77 and p=0.49, respectively). OZ contraction was significantly higher in right compared to left eyes in group 1 (p=0.05), but not in group 2 (p=0.95). CONCLUSION In tPRK, refractive outcomes, wasted tissue, and OZ contraction depend little on pre-existing corneal epithelial thickness in corneas with normal range epithelial thickness. However, OZ contraction may be a concern in lower amount of ablations.
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Lu NJ, Koppen C, Awwad S, Aslanides MI, Aslanides IM, Chen SH. Effect of intraoperative mitomycin-C application on epithelial regeneration after transepithelial photorefractive keratectomy. J Cataract Refract Surg 2021; 47:227-32. [PMID: 32947389 DOI: 10.1097/j.jcrs.0000000000000427] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/16/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the effect of mitomycin-C (MMC) intraoperative application on postoperative corneal epithelial remodeling, haze incidence, and refractive correction in transepithelial photorefractive keratectomy (transPRK). SETTING Eye Hospital of Wenzhou Medical University, Wenzhou, China. DESIGN Prospective randomized controlled study. METHODS Eyes that completed all follow-ups were included. Epithelial thickness (ET) map measurement was conducted preoperatively and at 1 week, and at 1 month, 3 months, and 6 months postoperatively, generating ET in central, paracentral, and midperipheral zones. The difference between postoperative and preoperative ET (ΔET) was computed for each zone. During follow-up, haze incidence and visual acuity were assessed and compared between groups. RESULTS A total of 100 eyes completed all follow-up, including 40 eyes treated with MMC in MMC group and 60 eyes in control group without MMC treatment. For ΔET, between-group difference was found in midperipheral (P = .011) zone at 1 week postoperatively and in central (P = .036) and paracentral zones (P = .039) at 1 month postoperatively. Haze incidence was lower in MMC group at 1 week and 1 month postoperatively (P = .035 and .018, respectively). Safety index (postoperative uncorrected distance visual acuity/preoperative corrected distance visual acuity [CDVA]) and efficacy index (postoperative CDVA/preoperative CDVA) were higher in MMC group (P = .012 and P = .036, respectively) at 1 month postoperatively. No difference was found after 3 months postoperatively. CONCLUSIONS With a temporary impact on corneal epithelial regeneration and refractive correction, intraoperative MMC application in transPRK decreased the haze incidence but had no effect on epithelial remodeling.
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Sánchez-González JM, Alonso-Aliste F, Borroni D, Amián-Cordero J, De-Hita-Cantalejo C, Capote-Puente R, Bautista-Llamas MJ, Sánchez-González MC, Rodríguez-Calvo-de-Mora M, Rocha-de-Lossada C. Plasma Rich in Growth Factors (PRGF) in Transepithelial Photorefractive Keratectomy (TPRK). J Clin Med 2021; 10:jcm10091939. [PMID: 33946455 PMCID: PMC8124326 DOI: 10.3390/jcm10091939] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 01/13/2023] Open
Abstract
To evaluate the usage of plasma rich in growth factor (PRGF) in transepithelial photorefractive keratectomy (TPRK) in low and moderate myopia, patients who underwent myopic and astigmatism TPRK with PRGF were involved in this retrospective, observational study. Subjects underwent a surgical procedure between February 2019 and June 2019. A three-month follow-up was recorded. Pain score was assessed with a visual analogue scale (0–10) and re-epithelialization time recorded. A total of 48 eyes from 24 patients were recruited. Mean uncorrected distance visual acuity (UDVA) was 20/20.31 (0.00 ± 0.02 LogMAR). A total of 98% of eyes did not change corrected distance visual acuity (CDVA) lines. Two percent of eyes lost one line of CDVA. Preoperative spherical equivalent was −2.67 ± 1.37 D and after three months changed to −0.21 ± 0.34 D, and 2% of eyes changed 0.50 D or more between one and three months. Pain score was 3.29 ± 0.61 (3 to 6) score points at day one and 0.08 ± 0.27 score points at day seven. Finally, re-epithelialization time was 2.50 ± 1.20 days. PRGF addition to conventional refractive treatment such as TPRK seems to alleviate immediate postoperative pain and positively contribute to corneal re-epithelization time.
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Affiliation(s)
- José-María Sánchez-González
- Department of Physics of Condensed Matter, Optics Area, University of Seville, 41012 Seville, Spain; (C.D.-H.-C.); (R.C.-P.); (M.-J.B.-L.); (M.C.S.-G.)
- Department of Ophthalmology, Tecnolaser Clinic Vision, 41018 Seville, Spain; (F.A.-A.); (J.A.-C.)
- Correspondence:
| | - Federico Alonso-Aliste
- Department of Ophthalmology, Tecnolaser Clinic Vision, 41018 Seville, Spain; (F.A.-A.); (J.A.-C.)
| | - Davide Borroni
- The Veneto Eye Bank Foundation, 30174 Venice, Italy;
- Department of Doctoral Studies, Riga Stradins University, LV-1007 Riga, Latvia
| | - Jonatan Amián-Cordero
- Department of Ophthalmology, Tecnolaser Clinic Vision, 41018 Seville, Spain; (F.A.-A.); (J.A.-C.)
| | - Concepción De-Hita-Cantalejo
- Department of Physics of Condensed Matter, Optics Area, University of Seville, 41012 Seville, Spain; (C.D.-H.-C.); (R.C.-P.); (M.-J.B.-L.); (M.C.S.-G.)
| | - Raúl Capote-Puente
- Department of Physics of Condensed Matter, Optics Area, University of Seville, 41012 Seville, Spain; (C.D.-H.-C.); (R.C.-P.); (M.-J.B.-L.); (M.C.S.-G.)
| | - María-José Bautista-Llamas
- Department of Physics of Condensed Matter, Optics Area, University of Seville, 41012 Seville, Spain; (C.D.-H.-C.); (R.C.-P.); (M.-J.B.-L.); (M.C.S.-G.)
| | - María Carmen Sánchez-González
- Department of Physics of Condensed Matter, Optics Area, University of Seville, 41012 Seville, Spain; (C.D.-H.-C.); (R.C.-P.); (M.-J.B.-L.); (M.C.S.-G.)
| | | | - Carlos Rocha-de-Lossada
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120 Almería, Spain;
- Department of Ophthalmology, University Hospital Virgen de las Nieves, 18014 Granada, Spain
- Department of Ophthalmology, Ceuta Medical Center, 51001 Ceuta, Spain
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Sanchez-Avila RM, Uribe-Badillo EE, Sanz JFV, Muruzabal F, Jurado N, Alfonso-Bartolozzi B, Alfonso JF, Baamonde B, Anitua E, Merayo-Lloves J. Plasma rich in growth factors versus Mitomycin C in photorefractive keratectomy. Medicine (Baltimore) 2021; 100:e24139. [PMID: 33546027 PMCID: PMC7837908 DOI: 10.1097/md.0000000000024139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 12/08/2020] [Indexed: 01/28/2023] Open
Abstract
To evaluate the efficacy and safety of plasma rich in growth factors (PRGF) in photorefractive keratectomy (PRK) versus Mitomycin C (MMC).This is a comparative, longitudinal and retrospective case-control study (MMC vs PRGF), in patients with a spherical correction from -0.25 to -8.00 D and cylinder correction from -0.25 to -3.00. The uncorrected distance visual acuity (UDVA), refractive efficacy and safety indices, and changes in endothelial cell density were evaluated. The predictability was assessed with the postoperative manifest spherical equivalent.Forty-four patients (72 eyes) were treated with MMC and twenty-five patients (45 eyes) with PRGF. The final UDVA (LogMar) in MMC was 0.029 ± 0.065 and in PRGF it was 0.028 ± 0.048 (p = 0.383). The efficacy index for MMC was 0.98 ± 0.10 and 1.10 ± 0.46 for patients treated with PRGF (p = 0.062). The safety index for MMC was 1.03 ± 0.11 and 1.12 ± 0.46 (p = 0.158) for PRGF group. The change percentage of endothelial cell density was 0.9 ± 11.6 for MMC and 4.3 ± 13.1 for PRGF (p = 0.593). The predictability for MMC was 92.1% and for the PRGF was 91.9% (p = 0.976). Hyperemia, eye pain and superficial keratitis were observed in 11.1% of the MMC group; no adverse events were observed with the PRGF.The use of PRGF in PRK surgery is as effective as MMC. The PRGF shows a better safety profile than MMC for its intraoperative use in PRK.
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Affiliation(s)
- Ronald M. Sanchez-Avila
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo
- Biotechnology Institute (BTI), Vitoria, Spain
| | - Edmar E. Uribe-Badillo
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo
- Universidad de San Martin de Porres, Lima, Peru
| | | | - Francisco Muruzabal
- Biotechnology Institute (BTI), Vitoria, Spain
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
| | - Nancy Jurado
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo
| | - Belén Alfonso-Bartolozzi
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo
| | - Jose F. Alfonso
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo
| | - Begoña Baamonde
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo
| | - Eduardo Anitua
- Biotechnology Institute (BTI), Vitoria, Spain
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
| | - Jesus Merayo-Lloves
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo
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Wang J, Cao W, Tao L. Effect of Transepithelial Photorefractive Keratectomy without Mitomycin C in the Treatment of Femtosecond Laser In Situ Keratomileusis Corneal Flap Complications. J Ophthalmol 2021; 2021:8847922. [PMID: 33520302 DOI: 10.1155/2021/8847922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/28/2020] [Accepted: 12/31/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose To assess the efficacy and safety of transepithelial photorefractive keratectomy (TPRK) without mitomycin C as treatment for femtosecond laser in situ keratomileusis (FS-LASIK) corneal flap complications. Methods Eight patients with corneal flap complications that occurred after FS-LASIK (five with eccentric flaps, two with buttonhole flaps, and one with a thick flap) were included in the study. Patients were treated with TPRK without mitomycin C between two weeks and twelve months after surgery. The postoperative manifest refraction, uncorrected distance visual acuity, and haze formation were assessed during six months of follow-up. Results The mean manifest refractive spherical and cylinder refraction was 0.16 ± 0.26 and -0.44 ± 0.33 diopters, respectively, at six months postoperatively. The uncorrected distance visual acuity was above 20/25 in all patients after six months of follow-up. No haze formation was detected. Conclusions TPRK without mitomycin C appears to be a safe and effective treatment for FS-LASIK corneal flap complications.
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Montorio D, Cennamo G, Menna F, Donna P, Napolitano P, Breve MA, Fiore U, Cennamo G, Rosa N. Evaluation of corneal structures in myopic eyes more than twenty-two years after photorefractive keratectomy. J Biophotonics 2020; 13:e202000138. [PMID: 32668101 DOI: 10.1002/jbio.202000138] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/05/2020] [Accepted: 07/12/2020] [Indexed: 06/11/2023]
Abstract
The aim of this study is to evaluate corneal epithelial thickness (CET), corneal densitometry (CD) in 84 myopic eyes (57 patients) more than 22 years after photorefractive keratectomy, using anterior segment-optical coherence tomography (AS-OCT) and Scheimpflug imaging system. The CET was significantly higher in all operated eyes than in unoperated eyes in central sector. A statistically significant increase in CD in corneal anterior layer of central sector was shown in groups of operated eyes with greater ablation depth respect to unoperated eyes. While there was no significant difference in CD between the operated eyes groups with lower ablation depth and unoperated eyes. A significant trend toward higher values in anterior CD with deeper ablations in central sector was found. These noninvasive imaging techniques allow to better understand the corneal remodeling process after photoablation and to monitor the patients over time.
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Affiliation(s)
- Daniela Montorio
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Gilda Cennamo
- Eye Clinic, Public Health Department, University of Naples Federico II, Naples, Italy
| | - Feliciana Menna
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Piero Donna
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Pasquale Napolitano
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Maria Angelica Breve
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Ugo Fiore
- Department of Management and Quantitative Studies, Parthenope University, Naples, Italy
| | - Giovanni Cennamo
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Nicola Rosa
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
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Adib-Moghaddam S, Haydar AA, Razi-Khosroshahi M, Soleyman-Jahi S, Tefagh G, Grentzelos MA, Arba-Mosquera S, Kymionis GD. Predictors of Visual Acuity Improvement and Supernormal Vision After Refined Single-Step Transepithelial Photorefractive Keratectomy. J Refract Surg 2019; 35:771-780. [PMID: 31830293 DOI: 10.3928/1081597x-20191025-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/25/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate predicting factors of visual acuity improvement and achieving uncorrected (UDVA) or corrected (CDVA) distance visual acuity supernormal vision (⩾ 15/10; Snellen 20/13) 1 year after refined transepithelial photorefractive keratectomy (TransPRK). METHODS In this retrospective case series, a total of 155 eyes with myopia (mean ± standard deviation = -3.53 ± 1.81 diopters) with and without astigmatism (range = 0.25 to 4.50 diopters) were recruited and observed for 1 year. Patients underwent refined single-step TransPRK using the SCHWIND AMARIS 500 laser (SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany). The main predicting factors of postoperative supernormal vision and visual acuity improvements were sought by statistical modeling. RESULTS Logistic models showed mesopic contrast sensitivity, high laser fluence, and coma higher-order aberration (HOA) as predicting factors for both UDVA and CDVA super-normal vision. Myopia, astigmatism, dynamic cyclotorsion correction, optical zone, and transitional zone showed associations only in simple models and were not retained in multivariable models. According to the linear regression models, CDVA, mesopic contrast sensitivity, coma HOA, and keratometry were common predictors of both postoperative UDVA and CDVA improvement compared to preoperative UDVA. Astigmatism, optical and transitional zones, and high laser fluence were common predictors only in simple regression models. CONCLUSIONS Through statistical modeling, preoperative CDVA, mesopic contrast sensitivity, coma HOA, and simulated keratometry were found to be the main factors that predicted improvement of both postoperative CDVA and UDVA compared to preoperative CDVA. Furthermore, mesopic contrast sensitivity, coma HOA, and high laser fluence were the common predictors of achieving both CDVA and UDVA supernormal vision 1 year after refined single-step TransPRK. [J Refract Surg. 2019;35(12):771-780.].
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Chen TC, Ho WT, Lai CH, Chang SW. Mitomycin C modulates intracellular matrix metalloproteinase-9 expression and affects corneal fibroblast migration. Eur J Pharmacol 2019; 865:172752. [PMID: 31647907 DOI: 10.1016/j.ejphar.2019.172752] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/11/2019] [Accepted: 10/18/2019] [Indexed: 01/28/2023]
Abstract
Mitomycin C (MMC) is often used to prevent postoperative corneal haze and subconjunctival fibrosis in ocular surgery. It also affects the motility and viability of the residual ocular cells, including corneal stromal cells. Extracellular matrix metalloproteinase-9 (MMP-9) contributes to the promotion of cell movement in macrophage and cancer cells, but the intracellular role of MMP-9 remained unclear. Herein, we illustrated the novel role of intracellular MMP-9 in MMC-suppressed cell migration using isolated human corneal fibroblasts (HCFs). In HCFs, MMC enhanced intracellular MMP-9 at transcriptional and protein levels. Using co-immunoprecipitation analysis, we confirmed that MMC enhanced the association between intracellular MMP-9 and inactive FAK/paxillin (PXN) complexes, i.e. PXN without phospho-tyrosine 118 (pY118) and FAK without phospho-tyrosine 397 (pY397). To verify the role of intracellular MMP-9 in migration, its gene was directly isolated from HCFs and highly expressed in HCFs by a lentivirus-based pseudovirus system with encephalomyocarditis virus (EMCV)-driven enhanced green fluorescent protein (GFP) as the MMP-9-IG-versus IG-expressing cells. Compared with the IG-expressing cells, higher intracellular MMP-9 expression in the MMP-9-IG-expressing HCFs proliferated and migrated more slowly. Phosphorylation of FAK at Y397 and PXN at both Y31 and Y118 were significantly less in the MMP-9-IG-expressing HCFs. These suggested that MMC-upregulated intracellular MMP-9 clutched inactive FAK/PXN complexes at focal adhesion sites to form a new "inactive" trimer, prohibited FAK/PXN complexes phosphorylation and retarded corneal fibroblast migration.
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Affiliation(s)
- Tsan-Chi Chen
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Wei-Ting Ho
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Hsueh Lai
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Shu-Wen Chang
- Department of Ophthalmology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
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Adib-Moghaddam S, Soleyman-Jahi S, Tofighi S, Tefagh G, Arba-Mosquera S, Kontadakis G, Kymionis GD. Factors Associated With Ocular Cyclotorsion Detected by High-Speed Dual-Detection Eye Tracker During Single-Step Transepithelial Photorefractive Keratectomy. J Refract Surg 2018; 34:736-744. [PMID: 30428093 DOI: 10.3928/1081597x-20181001-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/24/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine demographic, surgical, and preoperative visual factors affecting the level of static and dynamic cyclotorsion (SC and DC) in eyes undergoing single-step transepithelial photorefractive keratectomy (TransPRK). METHODS In this cross-sectional study, 386 patients with different types of refractive errors scheduled for single-step TransPRK were enrolled. A comprehensive profile of personal, optic, and visual characteristics of patients as surgical parameters were collected. Statistical modeling was used to explore correlates of SC and DC before and during the refractive procedure, respectively. RESULTS There was no difference in various indices of SC and DC between right and left eyes. Lower age (beta = -0.20), uncorrected (beta = -0.99) and corrected (beta = -0.72) visual acuities, and keratometry (beta = -0.09) were significantly associated with higher ranges of DC during the laser ablation procedure. Worse mesopic contrast sensitivity (beta = 0.24) and higher (beta = 0.002, left eyes) or lower (beta = -0.002, right eyes) kappa locus also showed significant associations with a higher range of DC. In cases of SC before the procedure, amount (beta = 0.46) and axis (beta = -0.003) of the astigmatism demonstrated notable associations. CONCLUSIONS Through comprehensive modeling, age, visual axis indices, visual acuity, and contrast sensitivity were found to be the main factors significantly associated with dynamic ocular globe cyclotorsions during single-step TransPRK. This could help identify eyes at higher risk of cyclotorsion and its potential complications in refractive surgery. [J Refract Surg. 2018;34(11):736-744.].
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Adib-Moghaddam S, Soleyman-Jahi S, Sanjari Moghaddam A, Hoorshad N, Tefagh G, Haydar AA, Razi-Khoshroshahi M, Arba Mosquera S. Efficacy and safety of transepithelial photorefractive keratectomy. J Cataract Refract Surg 2018; 44:1267-79. [PMID: 30172569 DOI: 10.1016/j.jcrs.2018.07.021] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 07/03/2018] [Accepted: 07/11/2018] [Indexed: 11/21/2022]
Abstract
Transepithelial photorefractive keratectomy (PRK) was introduced to prevent complications from conventional PRK and femtosecond laser-assisted laser in situ keratomileusis (LASIK). In the 2-step platform, phototherapeutic keratectomy is followed by PRK. It did not show notable safety or efficacy superiorities over conventional PRK. In the conventional single-step transepithelial PRK, ablation of epithelium and stroma occurs in a single continuous session by an Amaris laser. It showed better comparative safety results. Reverse single-step transepithelial PRK and the platform using smart-pulse technology were recent improvements in the single-step Amaris laser. They provide a smoother postablative stromal bed counter. In the refined single-step platform, a modified nomogram is used for determination of ablation parameters, along with modifications in postablative measures. It yielded better comparative results in hyperopia. Controlled trials comparing reverse, smart-pulse technology-equipped, or refined platforms of single-step transepithelial PRK with other modern laser-assisted methods could provide more robust evidence on the topic. Some key elements with significant roles in post-transepithelial PRK outcomes are discussed.
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