scholarly journals Scheimpflug Topography Oriented Adequate Repositioning of a Misaligned Free Flap after Laser in situ Keratomileusis

2021 ◽  
pp. 889-893
Author(s):  
Ha Eun Sim ◽  
Min Ji Kang ◽  
Jee Hye Lee ◽  
Seung Hwa Baik ◽  
Sun Young Kim ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Free Flap ◽  
Laser In Situ Keratomileusis ◽  
Clockwise Rotation ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
The Right ◽  
Original Configuration ◽  
Irregular Astigmatism

This report describes a case of Scheimpflug topography oriented adequate repositioning of a misaligned thick free flap after laser in situ keratomileusis (LASIK). A 24-year-old patient consulted for irregular astigmatism and disoriented free right eye flap. The patient previously underwent binocular LASIK at a private clinic. During the right eye surgery, the flap was repositioned after laser ablation due to the free flap. The free flap was not repositioned to its original configuration due to insufficient preoperative corneal marking. On examination, the uncorrected visual acuity was 0.4, and refractive power was +2.00 Dsph with −4.25 Dcyl axis 66 in the right eye. Scheimpflug topography revealed irregular right eye astigmatism. The sagittal curvature of topography showed a 40° counterclockwise misalignment of the steep axis of the cornea. The free flap was repositioned by 40° clockwise rotation. After this, the refractive corneal power improved to −1.00 Dsph with −1.00 Dcyl Axis 19 in the right eye. The uncorrected and best-corrected visual acuity improved to 20/30 and 20/25 (x − 0.25Dsph −1.25 Dcyl A20), respectively. This is the first report on free flap repositioning using Scheimpflug topography. As proper flap positioning was compromised because of the free LASIK flap with no preoperative corneal marking, the flap was effectively repositioned using Scheimpflug topography.

scholarly journals Long-Term Outcomes of Radial Keratotomy, Laser In Situ Keratomileusis, and Astigmatic Keratotomy Performed Consecutively over a Period of 21 Years

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Priyanka Chhadva ◽  
Florence Cabot ◽  
Anat Galor ◽  
Sonia H. Yoo
Keyword(s):  
Visual Acuity ◽  
Laser In Situ Keratomileusis ◽  
Radial Keratotomy ◽  
Manifest Refraction ◽  
Uncorrected Visual Acuity ◽  
Initial Improvement ◽  
Astigmatic Keratotomy ◽  
The Right

Purpose. To describe a case of 3 refractive procedures performed in one eye over 2 decades.Methods. Case report.Results. A 41-year-old patient presented for refractive surgery evaluation. His ocular history includes bilateral radial keratotomy performed 21 years ago for moderate myopia: spherical equivalence of −4.25 D bilaterally. Postoperative uncorrected visual acuity (UCVA) was 20/30; however, over time he developed a hyperopic shift and UCVA decreased to 20/40 in the right eye. Thus, laser-assisted in situ keratomileusis (LASIK) was performed at an outside institution 6.5 years later, and the patient had initial improvement of UCVA to 20/25. Due to a change in refractive error, the patient underwent uneventful astigmatic keratotomy 13 years after LASIK in the right eye, and 1.5 years after surgery best-corrected visual acuity was 20/25 with manifest refraction of −1.00+5.50×134°.  Conclusion. We report the outcomes and natural refractive progression in a patient who underwent three corneal refractive procedures over two decades. This case underlines the difficulties of long-term management of post-RK hyperopia and astigmatism.

Use of new-generation hybrid contact lenses for managing challenging corneas

2020 ◽  
pp. 112067212094275
Author(s):  
Ibrahim Inan Harbiyeli ◽  
Elif Erdem ◽  
Puren Isik ◽  
Meltem Yagmur ◽  
Reha Ersoz
Keyword(s):  
Visual Acuity ◽  
Medical Records ◽  
Contact Lenses ◽  
Corrected Visual Acuity ◽  
Manifest Refraction ◽  
Uncorrected Visual Acuity ◽  
The Mean ◽  
New Generation ◽  
Generation Hybrid ◽  
Irregular Astigmatism

Introduction: To evaluate the safety and efficacy of new-generation hybrid contact lenses (HCL) among patients with irregular astigmatism. Methods: Medical records of 25 patients fit with new-generation HCL (Eyebrid® and AirFlex®) were retrospectively reviewed. The data collected included etiology of irregular astigmatism, uncorrected visual acuity, manifest refraction, spectacle-corrected visual acuity (S-CDVA), steep / flat keratometric values, corneal astigmatism, records of rigid / soft CL fitted before HCL, all parameters of the trial lenses, and the final prescribed HCL parameters and HCL-CDVA. Results: The study included 34 eyes from 25 patients (nine females and 16 males) with an average age of 29 ± 13 (ranging from 8–56) years. In total, 25 eyes with keratoconus, four with post - keratoplasty astigmatism, three with irregular astigmatism due to corneal trauma and two with residual astigmatism after radial keratotomy were fit with HCL. The mean S-CDVA (logMAR) improved significantly from 0.76 ± 0.41 to 0.14 ± 0.15 with HCL ( p < 0.01). The most common indication for HCL was inability to fit with rigid gas permeable (RGP) lenses (22 eyes). The average number of lenses to successful fit was 1.4 (mode, 1; median, 1) and ideal fit was achieved with the first trial lens in 25 eyes (73%). Seven patients (nine eyes, 36%) discontinued lens use within the first 6 months because of discomfort (six eyes, 24%), ocular allergy (two eyes, 8%) and tearing of contact lens (one eye, 4%). Discussion: New-generation HCL may be a suitable option for fitting challenging corneas with irregular astigmatism that cannot be rehabilitated efficiently with rigid lenses.

scholarly journals Explantation and Rotation of Intracorneal Ring Segments with the Support of Femtosecond Laser: An Asymmetrical Version

2013 ◽  
Vol 2 (1) ◽  
pp. 40-42
Author(s):  
E Levinger ◽  
S Levinger ◽  
A Hirsh
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Lower Segment ◽  
Medical Optics ◽  
Corrected Visual Acuity ◽  
Body Sensation ◽  
Uncorrected Visual Acuity ◽  
The Right ◽  
Visual Results

ABSTRACT Purpose To report a 25-year-old man who presented with advance keratoconus in the right eye with uncorrected visual acuity (UCVA) of 0.2 and best spectacle-corrected visual acuity (BSCVA) of 0.33 with +0.50 −9.25 × 45°. Materials and methods Clinical examination and corneal topography revealed grade III keratoconus in the right eye. Intracorneal ring segments (INTACS SK; Addition Technology, Des Plaines, IL) were implanted without surgical complications at 400 µm, with the 450 µm segments implanted superiorly and inferiorly using the femtosecond laser (Intralase®, Advanced Medical Optics, Inc, Abbott Park, IL). Results For 3 months postoperatively, BSCVA remained at 0.5 with plano −4.50 × 25°. The patient was complaining of foreign body sensation in the upper part of the eye and glare asking the surgeon to remove the two segments. The superior segment was removed and the lower segment was rotated 30° counter clockwise. Three months later, UCVA was 0.67 and remained stable for 24 months of follow-up. Conclusion This report shows that implanting the thicker segment inferiorly provides better visual results. How to cite this article Levinger E, Levinger S, Hirsh A. Explantation and Rotation of Intracorneal Ring Segments with the Support of Femtosecond Laser: An Asymmetrical Version. Int J Kerat Ect Cor Dis 2013;2(1):40-42.

scholarly journals Comparison of efficacy and visual quality after CWFG-FS-LASIK, AF-FS-LASIK and SMILE for correcting myopia with asymmetry mid-to-high astigmatism

2020 ◽  
Author(s):  
Zhongxiu Zhao ◽  
Miaomiao Zhu ◽  
Qian Jian ◽  
Xialu Liu ◽  
Pingting Ma ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Visual Quality ◽  
Laser In Situ Keratomileusis ◽  
Modulation Transfer ◽  
Guided Mode ◽  
Surgical Methods ◽  
Uncorrected Visual Acuity

Abstract Background The individualized ablation is not only able to correct corneal low-order aberrations but also improve the corneal high-order aberrations in corneal asymmetry patients. In this study, we compared the effect of patients with mid-to-high astigmatism asymmetric corneas (1-4D) after three different surgical methods: Selective coma guidance femtosecond Laser in-situ keratomileusis (CWFG-FS-LASIK),Aberration-Free femtosecond Laser in-situ keratomileusis (AF-FS-LASIK) and Small incision lenticule (SMILE).Methods One hundred and fourteen eyes from 58 patients were enrolled in the retrospective study. We measured and compared the best corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), residual astigmatism, total coma, vertical coma (Z3-1), horizontal coma (Z31), Modulation Transfer Function (MTF) and Point Spread Function (PSF) at preoperation and postoperation after three months.Results Visual acuity of patients in three groups was increased after surgeries, but the improvements of visual acuity and residual astigmatism among them were no significant differences. However, the improvements of 4mm and 6mm total coma, Z3-1 and Z31 in CWFG-FS-LASIK were superior than in AF-FS-LASIK and SMILE. Consistent with this, the improvements of MTF and PSF (3mm and 5mm) in CWFG-FS-LASIK were better than in AF-FS-LASIK and SMILE.Conclusions In surgeries for treating patients with mid-to-high astigmatism in asymmetric corneas, the selective coma-guided mode was able to decrease the coma of original cornea, improve visual acuity and optimize the visual quality of patients.

scholarly journals Macular Hole after Laser In Situ Keratomileusis in a 26-Year-Old Patient

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Guzel Bikbova ◽  
Toshiyuki Oshitari ◽  
Madoka Sakurai ◽  
Takayuki Baba ◽  
Shuichi Yamamoto
Keyword(s):  
Visual Acuity ◽  
Informed Consent ◽  
Macular Hole ◽  
Final Visual Acuity ◽  
Laser In Situ Keratomileusis ◽  
Irregular Surface ◽  
Vitreoretinal Interface ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

The purpose of this study is to describe the 26-year-old patient with developed macular hole after bilateral laser in situ keratomileusis (LASIK). A macular hole with sharp margins and irregular surface of surrounding retina appeared in the left eye of the female 26-year-old patient two months after LASIK for correction of myopia (followup of 6 months). Although the best corrected visual acuity (BCVA) after LASIK was 1.0, after the macular hole has developed BCVA became 0.5. After surgery, the final visual acuity recovered to 0.7. Macular hole may develop after LASIK for myopia correction due to unknown changes of vitreoretinal interface. Complete informed consent must be obtained from patients with high myopic eyes before LASIK.

scholarly journals Redo surgery using IntraLase femtosecond laser for treating a decentered laser in situ keratomileusis flap

2017 ◽  
Vol 46 (2) ◽  
pp. 901-907
Author(s):  
Yulin Lei ◽  
Jie Hou ◽  
Xiuyun Zheng
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Intraoperative Complications ◽  
Anterior Segment ◽  
Laser In Situ Keratomileusis ◽  
Redo Surgery ◽  
Laser Technique ◽  
Uncorrected Visual Acuity

Objective Decentered flaps are rarely reported after femtosecond laser-assisted in situ keratomileusis flap procedures. We present a patient with a decentered flap after preparation of a corneal flap using the Femto LDV technique. Methods The 22-year-old man required a redo operation because of a decentered corneal flap. It was performed the same day at the patient's insistence and with his consent. The new corneal flap for the redo surgery was prepared using the femtosecond laser technique and IntraLase. Results Uncorrected visual acuity for each eye was 1.2 during the 12-month follow-up. The results of the Femtosecond laser technique showed good predictability and repeatability regarding the preparation of corneal flaps, but it still may cause some intraoperative complications. Conclusion Once redo surgery is needed, the size and depth of the initially prepared flap should be determined using anterior segment optical coherence tomography to pre-set the parameters for preparation of the redo flap.

scholarly journals Calzone-Like Traumatic Flap Dislocation Four Years after Laser in situ Keratomileusis

2019 ◽  
Vol 10 (2) ◽  
pp. 281-286
Author(s):  
Isaak Fischinger ◽  
Jascha Wendelstein ◽  
Matthias Bolz ◽  
Manfred Tetz
Keyword(s):  
Visual Acuity ◽  
Epithelial Cells ◽  
Laser In Situ Keratomileusis ◽  
New Approach ◽  
Epithelial Ingrowth ◽  
Mechanical Removal ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

A 46-year-old patient presented with a flip-folded partially dislocated flap after trauma caused by a sheet of paper, four years after a reportedly uneventful laser in situ keratomileusis procedure using microkeratome. Flap re-lift, mechanical debridement, and flap stretching were performed in a first interventional approach. Due to epithelial ingrowth two month after the first intervention, a flap re-lift and mechanical removal of epithelial cells from the stroma bed and flap were performed. In addition, triamcinolone was applied subconjunctivally. Thereafter, best corrected visual acuity of 20/20 was regained and no more epithelial ingrowth was observed. Only few cases of flap dislocation with epithelial ingrowth have been described in the literature following trauma, though none of a permanently inward folded flap. The use of subconjunctival triamcinolone is a new approach to prevent recurrent epithelial ingrowth.

Why does an ophthalmologist wear glasses?

2021 ◽  
pp. 121-123
Author(s):  
L.S. Voskanyan ◽  
◽  
I.V. Zverova ◽  
M.E. Mirgorodskaya ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Online Survey ◽  
Surgical Interventions ◽  
Work Related ◽  
Corrected Visual Acuity ◽  
Quality Of Vision ◽  
Uncorrected Visual Acuity ◽  
Subsequent Choice ◽  
Personal Use ◽  
Visual Organ

The aim of the study was to identify the reasons for the personal use of vision correction tools by ophthalmologists and the importance of vision for the specialty. Materials and methods. An anonymous online survey was conducted, which was attended by 122 respondents, including 111 ophthalmologists. Results. The visual acuity of two eyes without correction among the respondents was 1.0 and higher in 51 people. The maximum corrected visual acuity with two eyes was: 1.0 and higher in 79 respondents; less than 1.0 to 0.7 inclusive in 12 (those who refrained from answering the question had uncorrected visual acuity of 1.0 and higher). More than half of the respondents (56) suffer from myopia. Among the respondents, 53 use point correction. Of the spectacle lenses, ophthalmologists prefer plastic ones more. 36 respondents use contact correction. Surgical interventions on the organ of vision were performed in 12 patients. All respondents noted that they do not have cataracts, glaucoma, diseases of the optic nerve and color perception disorders. The choice of specialty did not depend on the existing diseases of the visual organ in 101 doctors, 9 people noted the connection between the previous pathologies of the visual organ with the subsequent choice of profession. Conclusions. According to the results of the study, it is possible to note the high maximum corrected visual acuity of ophthalmologists. Despite this, some respondents experience inconveniences at work related to visual impairments. For themselves, ophthalmologists often choose eyeglass correction instead of contact. And of the spectacle lenses, they prefer plastic ones more. The reasons for the use of glasses or contact correction among doctors of this specialty are increased requirements for the quality of vision. Key words: ophthalmologist, myopia, vision, glasses.

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