scholarly journals Myopic Laser-Assisted Subepithelial Keratectomy (LASEK) outcomes using three different excimer laser platforms: a retrospective observational study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Isabel Rodríguez-Pérez ◽  
Juan Gros-Otero ◽  
Miguel A. Teus ◽  
Rafael Cañones ◽  
Montserrat García-González
Keyword(s):  
Visual Acuity ◽  
Excimer Lasers ◽  
Distance Visual Acuity ◽  
Refractive Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity ◽  
Observational Cohort ◽  
Efficacy Index ◽  
Application Protocols ◽  
Retrospective Observational Cohort Study

Abstract Background To compare the visual and refractive outcomes after myopic LASEK using three different excimer lasers and standardized surgical and mitomycin C (MMC) application protocols. Methods In this retrospective, observational cohort study, we examined 122 eyes treated with Allegretto, 135 eyes treated with Esiris and 137 eyes treated with Technolas excimer lasers. All eyes were treated under the same surgical protocol, and a standardized MMC dosage was used. The three groups were refraction-matched, and both visual and refractive outcomes were evaluated at 1 and 7 days and 1 and 3 months after surgery. Results At 3 months postsurgery, Allegretto provided significantly better outcomes than Esiris and Technolas in terms of postoperative uncorrected distance visual acuity (UDVA) (1.11 ± 0.2 vs 1.01 ± 0.2 vs 0.98 ± 0.2) (P = 0.0001), corrected distance visual acuity (CDVA) (1.13 ± 0.2 vs 1.10 ± 0.1 vs 1.04 ± 0.2) (P = 0.0001), residual sphere (− 0.01 ± 0.2 vs + 0.29 ± 0.7 vs + 0.27 ± 0.6) (P = 0.0001), and efficacy index (0.99 ± 0.2 vs 0.90 ± 0.2 vs 0.91 ± 0.2) (P = 0.0004). Conclusions We found slightly better visual and refractive outcomes in the Allegretto group at 3 months post-op after LASEK with MMC to correct myopia.

Myopic lasik outcomes: comparison of three different femtosecond lasers and a mechanical microkeratome using the same excimer laser

2019 ◽  
Author(s):  
Juan Gros-Otero ◽  
Isabel Rodriguez-Perez ◽  
Miguel A. Teus ◽  
Andreas Katsanos ◽  
Dimitrios G. Mikropoulos ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Excimer Laser ◽  
Femtosecond Lasers ◽  
Safety Index ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity ◽  
Observational Cohort ◽  
Efficacy Index ◽  
Retrospective Observational Cohort Study

Abstract BACKGROUND To compare the influence of four different microkeratomes on myopic LASIK outcomes. METHODS Retrospective, observational cohort study. We compared 134 eyes treated with the IntraLase 60 kHz, 112 eyes treated with the Femto LDV Z6, 206 eyes treated with the FS200 and 98 eyes treated with the Hansatome zero compression microkeratome. All eyes were operated using the same surgical protocol with the same excimer laser (Wavelight Allegretto) and were allocated in refraction-matched groups. Uncorrected distance visual acuity, best corrected distance visual acuity and residual refraction were evaluated 1 and 7 days, 1 and 3 months postoperatively. RESULTS One day and one week postoperatively, uncorrected distance visual acuity was significantly lower in the FS200 group compared to others (P=0.0001). This difference disappeared at the 1- and 3-month postoperative visits. Significant differences were found among groups in terms of safety index (P=0.0001), residual sphere (P=0.0001) and residual cylinder (P=0.02) at the 3-months postoperative visit. No significant differences were found in corrected distance visual acuity or efficacy index. CONCLUSIONS According to our results, a slight delay in visual restoration after FS200 LASIK surgery might be expected. This delay was statistically significant at 1 day and 1 week postoperatively, but there were no differences from the 1-month visit onwards.

Implantable collamer lens for the correction of post-keratoplasty myopia and astigmatism

2020 ◽  
Vol 1 (2) ◽  
pp. 113-116
Author(s):  
Nasser A Alsabaani ◽  
◽  
Salem Almalki ◽  
Keyword(s):  
Visual Acuity ◽  
Contact Lenses ◽  
Posterior Chamber ◽  
Implantable Collamer Lens ◽  
Distance Visual Acuity ◽  
Refractive Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Single Center Study ◽  
Corrected Distance Visual Acuity ◽  
Corneal Refractive Surgery

AIM: To evaluate the safety, refractive outcomes and vision after phakic posterior chamber implantable collamer lens (ICL) after keratoplasty (KP). METHODS: This retrospective single center study evaluated 32 (35 eyes) patients who received an ICL for myopia and/or astigmatism after keratoplasty. Patients underwent ICL surgery if they were unable to wear glasses or contact lenses and excimer laser surgery was contraindicated. Data were collected on uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refraction and complications. Data were analyzed for the preoperative and last postoperative visits (16.7±13mo) (P<0.05). RESULTS: Preoperatively, spherical equivalent (SE) ranged from -4.00 to -20.00 D and cylinder from -2.00 to -9.00 D. The mean SE decreased statistically significantly from -11.41±3.62 D preoperatively to -1.95±1.78 D postoperatively (P<0.0001). Mean UDVA increased statistically significantly from 20/400 preoperatively to 20/25 postoperatively (P<0.0001). There was a mean improvement in postoperative CDVA of 1.5 lines compared to preoperatively, 37% of eyes had an increase of 2 or more lines. One eye (2.8%) lost ≥1 line of CDVA. There were no intraoperative or postoperative complications. CONCLUSION: Posterior chamber phakic intraocular lens implantation is a safe and effective treatment for post-keratoplasty myopia and astigmatism in patients unable to wear spectacles or contact lenses and where corneal refractive surgery is contraindicated.

Small incision lenticule extraction for the correction of high myopia

2019 ◽  
Vol 30 (5) ◽  
pp. 917-927
Author(s):  
Suphi Taneri ◽  
Saskia Kießler ◽  
Anika Rost ◽  
Tim Schultz ◽  
H Burkhard Dick
Keyword(s):  
Visual Acuity ◽  
High Myopia ◽  
Case Series ◽  
Small Incision Lenticule Extraction ◽  
Distance Visual Acuity ◽  
Small Incision ◽  
Refractive Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity ◽  
Lenticule Extraction

Purpose: Excimer laser-based refractive procedures can have less predictable results when used for correcting high myopia than when used for moderate myopia. Small incision lenticule extraction might overcome this weakness. However, small incision lenticule extraction is only Food and Drug Administration approved for use in myopic eyes up to −8 D with astigmatism of −3 D or less. We report outcomes of small incision lenticule extraction in highly and moderately myopic eyes and compare these to modern laser-assisted in situ keratomileusis. Methods: Retrospective, observational consecutive case series. Inclusion criteria: attempted myopic spherical correction ⩾−8 or−3 to −7.75 D with astigmatism ⩽−3 D, and corrected distance visual acuity of 1.0 (decimal scale) or better. Results: A total of 62 highly myopic and 407 moderately myopic eyes were included. At 3 months postoperatively, the highly myopic eyes had a mean spherical equivalent refraction of −0.28 ± 0.41 D (range: −1.13 to +0.75 D). Mean uncorrected distance visual acuity was 1.0. Mean efficacy index was 0.84. Mean safety index was 1.03. Uncorrected distance visual acuity same or better than corrected distance visual acuity: 61%. Astigmatism was ⩽0.5 D in 90% and ⩽1 D in 100%. The results in the moderately myopic eyes were comparable. Conclusion: We found equally good visual and refractive outcomes after small incision lenticule extraction for the correction of high and of moderate myopia combined with an astigmatic correction of up to 3 D, respectively.

scholarly journals Comparison of 6.0 mm versus 6.5 mm Optical Zone on Visual Outcomes after LASIK

2021 ◽  
Vol 10 (17) ◽  
pp. 3776
Author(s):  
Majid Moshirfar ◽  
Rachel Huynh ◽  
Nour Bundogji ◽  
Alyson N. Tukan ◽  
Thomas M. Sant ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Laser System ◽  
Spherical Equivalent ◽  
Distance Visual Acuity ◽  
Visual Outcomes ◽  
Refractive Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity ◽  
Optical Zone ◽  
The Difference

Previous studies have demonstrated safety and efficacy using 6.0 and 6.5 mm optical zones in the WaveLight EX500 Excimer Laser System but have not evaluated if differing optical zone sizes influence refractive outcomes. This study examines visual outcomes between two study populations undergoing LASIK with either a 6.0 mm (1332 patients) or 6.5 mm (1332 patients) optical zone. Outcomes were further stratified by severity of myopia (low, moderate, and high) and astigmatism (low and high). Patients were matched by age and preoperative manifest sphere and cylinder. Postoperative measurements were then compared. The 6.5 mm group demonstrated better postoperative manifest refractive spherical equivalent (MRSE), manifest sphere, and absolute value of the difference in actual and target spherical equivalent refraction (|∆ SEQ|), within the total population, moderate myopia, and low astigmatism groups, but this did not lead to improved postoperative uncorrected distance visual acuity (UDVA) or best corrected distance visual acuity (CDVA). Though astigmatic correction and postoperative angle of error were similar between optical zone sizes, they were significantly worse with high myopia. Overall, this study demonstrates differences in visual outcomes between the 6.0 and 6.5 mm optical zone sizes that may warrant consideration; however, essentially, the results are comparable between them.

scholarly journals Prospective Randomized Multicenter Comparison of the Clinical Outcomes of V4c and V5 Implantable Collamer Lenses: A Contralateral Eye Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Takashi Kojima ◽  
Yoshihiro Kitazawa ◽  
Tomoaki Nakamura ◽  
Masahide Takahashi ◽  
Kazutaka Kamiya ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Refractive Surgery ◽  
Night Vision ◽  
Visual Performance ◽  
Distance Visual Acuity ◽  
Refractive Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity ◽  
The Mean ◽  
Contralateral Eye

Purpose. To compare the visual and refractive outcomes and night vision performance questionnaire results between V4c and V5 implantable Collamer lenses in a prospective, randomized, multicenter study.Settings. Four refractive surgery centers.Design. Prospective randomized multicenter single-masked comparative study.Methods. Twenty-three patients were enrolled in this study. A conventional V4c model (EVO Visian ICL) was implanted in one eye, and a V5 model (EVO+ Visian ICL), which has a larger optic diameter than the V4c model, was implanted in the contralateral eye. The uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were evaluated before and 6 months after surgery. At 6 months after surgery, a questionnaire on night vision disturbances was administered. The efficacy, safety, and predictability of the two implanted ICL models were compared.Results. There were no significant differences in the postoperative UDVA and CDVA between the two ICL models. The mean efficacy indexes for the V4c and V5 lenses were 1.16 ± 0.22 and 1.03 ± 0.23, respectively. The mean safety indexes of the V4c and V5 lenses were 1.21 ± 0.20 and 1.19 ± 0.20, respectively. The night vision performance questionnaire revealed that 7 patients (37%) noticed a difference in visual performance between the eyes, and all of them reported that they could see better at night with the V5-implanted eye compared with the V4c-implanted eye.Conclusion. The V4c and V5 ICL models achieved similar visual and refractive outcomes, whereas the V5 model showed a possible advantage in reducing night vision disturbances.

scholarly journals Toric phakic IOLs in keratoconus—evaluation of preoperative parameters on the outcome of phakic anterior chamber lens implantation in patients with keratoconus

2021 ◽  
Author(s):  
Isaak R. Fischinger ◽  
Jascha Wendelstein ◽  
Kristin Tetz ◽  
Matthias Bolz ◽  
Manfred R. Tetz
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Intraocular Lenses ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Significant Difference ◽  
Corrected Distance Visual Acuity ◽  
Lens Implantation ◽  
Efficacy Index ◽  
The Mean

Abstract Purpose To evaluate the influence of the type of the keratectasia and preoperative keratometry readings on the efficacy of implantation of iris-fixated phakic anterior chamber intraocular lenses (pIOL) in patients with keratoconus. Methods In this retrospective study, iris-fixated pIOLs (Artisan/Artiflex (Ophtec®), Verisyse/Veriflex (AMO®)) were implanted in 38 eyes of 22 patients with stable keratoconus. Thirty-six eyes underwent corneal crosslinking (CXL) prior to the lens implantation. The refractive outcome was evaluated 6 weeks postoperatively and the influence of preoperative refraction and topo- and tomographical factors were analyzed. Results The mean postoperative uncorrected distance visual acuity (UDVApost) was 0.25 ± 0.15 logMAR and was not statistically different from the mean preoperative corrected distance visual acuity (CDVApre), which was 0.24 ± 0.13 logMAR. Twenty-seven eyes (71%) reached UDVApost/CDVApre ≥ 1 (efficacy index), whereas patients with PMD-like ectasia (n = 14) showed significantly (p = 0.003) higher efficacy index (100%) than patients diagnosed with keratoconus (n = 24) (54%). Higher eccentricity of the maximum posterior elevation showed a significant beneficial influence on the efficacy index (p = 0.021). Furthermore, a higher Amsler-Krumeich stage and preoperative MAE were correlated with a worse UDVApost. The mean absolute spherical equivalent was significantly decreased from 5.71 ± 4.96 D to 1.25 ± 1.20 D (p < 0.001). No significant difference was found in endothelial cell count. Conclusion The results indicate that the implantation of phakic iris-fixated anterior chamber IOLs is a reasonable refractive option for patients with keratoconus. Keratoconus patients with a pellucidal marginal degeneration (PMD)-like appearance ectasia seem to benefit most from such procedures.

Comparing a new hydroexpression technique with conventional forceps method for SMILE lenticule removal

2017 ◽  
Vol 102 (8) ◽  
pp. 1122-1126 ◽  
Author(s):  
Alex L K Ng ◽  
George P M Cheng ◽  
Victor C P Woo ◽  
Vishal Jhanji ◽  
Tommy C Y Chan
Keyword(s):  
Visual Acuity ◽  
Safety Index ◽  
Distance Visual Acuity ◽  
Early Results ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity ◽  
Spherical Equivalent Refraction ◽  
Lenticule Extraction ◽  
Efficacy Index ◽  
Retrospective Comparative Study

BackgroundWe described a modified ‘hydroexpression’ technique for the lenticule removal during small-incision lenticule extraction (SMILE) surgery and compared the results with conventional forceps method.MethodsThis was a retrospective, comparative study of 50 patients who underwent SMILE surgery by the same surgeon. We compared the 1-week and 3-months postoperative results after SMILE using the hydroexpression technique with the conventional forceps technique. Main outcome measures included uncorrected distance visual acuity, corrected distance visual acuity, refractive accuracy, safety index and efficacy index.ResultsThe baseline characteristics were comparable between both groups. At postoperative 1 week, the safety index in forceps and hydroexpression group was 0.93±0.11 and 0.97±0.10, respectively (P=0.246). At 3 months, they were 1.00±0.06 and 0.99±0.09 (P=0.850). For efficacy indices, at 1 week they were 0.84±0.17 and 0.91±0.17 (P=0.158). At 3 months, they were 0.92±0.13 and 0.94±0.19 (P=0.624). All eyes aimed for a plano target. 96% in forceps group and 90% in hydroexpression group were within ±0.50 dioptre (D) in spherical equivalent refraction (SEQ) correction at postoperative 3 months (P=0.567). The mean errors of SEQ correction were −0.10±0.21 D in forceps group and −0.08±0.30 D in hydroexpression group (P=0.705).ConclusionHydroexpression was simple and safe and had early results comparable to the conventional forceps technique. This technique was particularly useful for cases with more adhesions between lenticule and anterior cap, thin lenticule cases and for the inexperienced SMILE surgeons.

Outcomes of refractive error correction in pseudophakic patients using a sulcus piggyback intraocular lens

2020 ◽  
pp. 112067212090356
Author(s):  
Eliya Levinger ◽  
Michael Mimouni ◽  
Yaron Finkelman ◽  
Yossi Yatziv ◽  
Jonathan Shahar ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intraocular Lens ◽  
Refractive Error ◽  
Spherical Equivalent ◽  
Distance Visual Acuity ◽  
Refractive Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity

Purpose: The purpose of this study was to assess the results of a sulcus intraocular lens (Sulcoflex) for pseudophakic refractive errors following phacoemulsification cataract surgery. Methods: This retrospective clinical observational cohort study included consecutive eyes in which a Sulcoflex was implanted. Uncorrected distance visual acuity and corrected distance visual acuity as well as refractive outcomes were assessed. The minimum follow-up time required for inclusion was 3 months. Results: In total, 15 eyes ( n = 15) were evaluated. The mean follow-up was 14 months (range: 3–18 months). The Sulcoflex aspheric (653L) was implanted in 13 eyes and the Sulcoflex toric (653T) in two eyes. The preoperative mean logMAR (Snellen) uncorrected distance visual acuity and corrected distance visual acuity were 0.88 (20/150) and 0.27 (20/40), respectively. The postoperative mean logMAR (Snellen) corrected distance visual acuity was 0.15 (20/30). The preoperative mean spherical equivalent was −0.22 ± 5.95 D and the postoperative mean spherical equivalent was −1.59 ± 1.45 D. There was a significant and strong correlation ( r = 0.64, p < 0.001) between the attempted and the achieved spherical equivalent. Conclusion: The Sulcoflex is a safe and viable option for patients with residual refractive error following cataract surgery.

scholarly journals Clinical Outcomes of Sequential Intrastromal Corneal Ring Segments and an Extended Range of Vision Intraocular Lens Implantation in Patients with Keratoconus and Cataract

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
C. Lisa ◽  
R. Zaldivar ◽  
A. Fernández-Vega Cueto ◽  
R. M. Sanchez-Avila ◽  
D. Madrid-Costa ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Lens ◽  
Iol Implantation ◽  
Distance Visual Acuity ◽  
Refractive Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Intrastromal Corneal Ring ◽  
Corrected Distance Visual Acuity ◽  
Extended Range ◽  
The Mean

Purpose. To evaluate efficacy, safety, and predictability of sequential Ferrara-type intrastromal corneal ring segments (ICRS) and an extended range of vision intraocular lens (IOL) implantation in patients with keratoconus and cataract. Methods. This study comprised patients with keratoconus and cataract that had ICRS implantation followed 6 months later by extended range of vision IOL implantation. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and residual refractive errors, analysed using vector analysis, were recorded preoperatively, 6 months after ICRS implantation, and 6 months after IOL implantation, respectively. Results. The study enrolled 17 eyes (11 patients). The mean UDVA (logMAR scale) was 1.15 ± 0.67 preoperatively, 0.88 ± 0.69 six months after ICRS implantation (P=0.005), and 0.27 ± 0.18 six months after IOL implantation (P<0.0001). The CDVA changed from 0.26 ± 0.15 (logMAR) before surgery to 0.17 ± 0.08 six months after Ferrara-type ICRS implantation (P=0.002) and to 0.07 ± 0.06 six months after IOL implantation (P<0.0001). The spherical equivalent and the refractive cylinder declined steeply after IOL implantation (P<0.001). The magnitude of depth of focus was 2.60 ± 1.02 D. There were no statistically significant differences in visual acuity for a defocus range from +0.50 D to −0.50 D (P>0.1). Conclusion. Sequential Ferrara-type ICRS and an extended range of vision IOL implantation provided good visual and refractive outcomes, being an effective, safe, and predictable procedure for the treatment of selected cases of patients with keratoconus and cataract. In addition, this approach provides an increase of tolerance to defocus.

Outcomes of a 320-degree intrastromal corneal ring segment implantation for keratoconus: Results of a 6-month follow-up

2018 ◽  
Vol 30 (1) ◽  
pp. 139-146 ◽  
Author(s):  
Guilherme Andrade do Nascimento Rocha ◽  
Paulo Ferrara de Almeida Cunha ◽  
Leonardo Torquetti Costa ◽  
Luciene Barbosa de Sousa
Keyword(s):  
Visual Acuity ◽  
Spherical Equivalent ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Intrastromal Corneal Ring ◽  
Corrected Distance Visual Acuity ◽  
Ring Segment ◽  
The Mean ◽  
Corneal Tomography

Importance: This study shows that a newer long-arc length intrastromal corneal ring segment is efficient and safe for keratoconus treatment. Background: To evaluate visual, tomographic results and complications of a 320-degree intrastromal corneal ring segment implantation with the femtosecond laser for keratoconus treatment. Design: A prospective, nonrandomized, and interventional study. Participants: A total of 34 eyes of 31 patients diagnosed with keratoconus were enrolled. Methods: Patients were divided into two groups based on the strategy used for 320-degree intrastromal corneal ring segment thickness selection. In one group, this selection was based on spherical equivalent (SE group) and in the other on the mean asphericity (Q group). The uncorrected and corrected distance visual acuities, spherical equivalent, K1, K2, Km, Kmax, and mean asphericity ( Q) on corneal tomography were evaluated preoperatively and at 3 and 6 months postoperatively. For astigmatism improvement, we analyzed the corneal tomographic vectorial astigmatism change preoperatively and at 6 months postoperatively. The mean follow-up period was 6.63 ± 0.96 months. Results: The mean uncorrected distance visual acuity and corrected distance visual acuity improved with a significant spherical equivalent improvement ( p < 0.05), with no differences between the 320-degree intrastromal corneal ring segment groups. All corneal tomographic parameters improved significantly ( p < 0.05) between the preoperative and postoperative intervals, with a significant better performance when we used spherical equivalent for the 320-degree intrastromal corneal ring segment thickness selection. Finally, the mean vectorial corneal tomographic astigmatism significantly improved after 6 months, again with no differences between groups. Conclusion: This study suggests that implanting a 320-degree intrastromal corneal ring segment is a safe and effective procedure for treating patients with keratoconus. It also suggests that for thickness selection spherical equivalent is the better strategy.

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