LONG-TERM FOLLOWUP OF EXCIMER LASER PHOTOTHERAPEUTIC KERATECTOMY (PTK)

We report long-term alterations of anterior corneal stroma after excimer laser surface ablation for a high astigmatism. The patient claimed progressive visual loss in his right eye (RE) during the last 3 years after bilateral laser-assisted subepithelial keratectomy (LASEK) surgery. His examination comprised visual acuity (UDVA and CDVA), slit-lamp examination, corneal topography and tomography, AS-OCT, and confocal microscopy. The UDVA was 0.1 in his RE and 1.0 in the left eye. The CDVA in the RE was 0.8. The slit-lamp examination showed a stromal lesion in the inferior paracentral corneal zone, with multiple vertical tissue bridges and severe thinning. Corneal topography and tomography showed central flattening with inferior steepening and severe alteration in elevation maps. AS-OCT showed void areas in the anterior stroma with thinning of the underlying tissue, and confocal images were not specific. In this case, progressive corneal steepening and thinning that manifest topographically as inferior ectasia occurred in correspondence to the singular stromal alterations after LASEK.

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Experimental Simplification of the Excimer Laser-Assisted Nonocclusive Anastomosis (ELANA) Technique

Operative Neurosurgery ◽

10.1227/01.neu.0000382959.43931.ea ◽

2010 ◽

Vol 67 (3) ◽

pp. ons-ons ◽

Cited By ~ 3

Author(s):

Tristan P.C. van Doormaal ◽

Albert van der Zwan ◽

Bon H. Verweij ◽

Matthijs Biesbroek ◽

Luca Regli ◽

...

Keyword(s):

Excimer Laser ◽

Potential Benefit ◽

Burst Pressure ◽

Application Time ◽

Term Survival ◽

New Techniques ◽

Recipient Artery ◽

Saphenous Veins ◽

Survival Studies

Abstract BACKGROUND: The excimer laser-assisted nonocclusive anastomosis (ELANA) technique facilitates the construction of an end-to-side anastomosis between a donor vessel and a recipient artery without the need to temporarily occlude the recipient artery. OBJECTIVE: To test whether the surgically difficult ELANA technique can be simplified. METHODS: In 42 rabbits, with the aorta as the recipient artery and human saphenous veins as donor grafts, we made 30 conventional ELANAs with 8 microsutures, 90 ELANAs with 4 microsutures (ELANA-4s), 40 ELANAs with 2 microsutures (ELANA-2s), and 90 sutureless ELANAs (SELANAs). SELANA involved a new ring design with 2 pins. ELANA-4, ELANA-2, and SELANA were each combined with 3 different sealants (Bioglue , Tachoseal, and Tisseel ) and compared regarding application time, complications, and burst pressure. RESULTS: The conventional ELANA was constructed in a mean of 14.8 ± 2.6 minutes. All experimental anastomoses were constructed significantly faster; the ELANA-4 in a mean of 10.9 ± 1.3 minutes, the ELANA-2 in a mean of 5.4 ± 1.7 minutes, and the SELANA in a mean of 2.5 ± 1.8 minutes. All ELANA and ELANA-4 anastomoses were sufficiently strong with a burst pressure > 200 mm Hg, except for 1 insufficiently sealed ELANA-4 anastomosis. ELANA-2 was sufficiently strong only with Bioglue, showing a burst pressure < 280 mm Hg. SELANA was sufficiently strong with Bioglue or TachoSil, showing a burst pressure < 260 mm Hg. CONCLUSION: The ELANA technique can be simplified by reducing or even abandoning microsutures. Of the experimental anastomoses tested, we consider the SELANA technique combined with TachoSil of most potential benefit. Long-term survival studies will be performed in animals before we consider using any of these new techniques in patients.

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One-Year Visual and Refractive Outcomes following LASIK for Myopia and Myopic Astigmatism with MEL 90 versus Schwind Amaris 750S Excimer Laser: A Comparative Study

Journal of Ophthalmology ◽

10.1155/2021/9929181 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Sheetal Brar ◽

Dishitha P. Rathod ◽

C. R. Roopashree ◽

Sri Ganesh

Keyword(s):

Comparative Study ◽

Clinical Outcomes ◽

Excimer Laser ◽

Infectious Keratitis ◽

Safety And Efficacy ◽

Refractive Outcomes ◽

The Mean ◽

One Year ◽

Myopic Astigmatism

Purpose. To compare clinical outcomes following LASIK for myopia performed with MEL 90 vs. Schwind Amaris 750S excimer laser. Methods. Data were collected retrospectively for patients who underwent Femto-LASIK, using the MEL 90 and Schwind Amaris 750S excimer laser for correction of myopia and myopic astigmatism within the range of −1.00 to −10.00 D SE from January 2013 till June 2018. Outcomes were analysed at 12 months for safety, efficacy, enhancement rate, and long-term complications. Results. A total of 328 eyes of 328 patients were analysed. One hundred and sixty-three eyes were treated with Schwind Amaris and the remaining 165 eyes with the MEL 90 laser. Twelve months postoperatively, the mean UDVA, CDVA, residual SE, and cylinder in the Amaris group were −0.10 ± 0.09 logMAR, −0.14 ± 0.06 logMAR, −0.21 ± 0.22 D, −0.13 ± 0.18 D versus −0.05 ± 0.07 logMAR, −0.09 ± 0.08 logMAR, −0.23 ± 0.23 D, and −0.14 ± 0.21 D for the MEL 90 group ( p values >0.05). For the Amaris group, safety and efficacy indices were 1.12 and 1.02, whereas for the MEL 90 group, these indices were 1.08 and 1.00, respectively. No eye in either group had any postop flap-related complications, infectious keratitis, diffuse lamellar keratitis, or keratectasia. Two eyes in the Amaris and 4 eyes in MEL 90 group required enhancement for the progression of myopia. Conclusion. At 12 months, both Schwind Amaris 750S and MEL 90 lasers demonstrated comparable clinical outcomes for myopic LASIK in a single surgeon setting.

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