Evaluating the Ectasia Risk Score System in Cancelled Laser In Situ Keratomileusis Candidates

Purpose: To evaluate the ectasia risk score system in cancelled laser in situ keratomileusis (LASIK) candidates at an academic hospital. Methods: LASIK candidates who had been cancelled by a surgeon considering the patient age, preoperative central corneal thickness, residual stromal bed thickness, or preoperative manifest refraction spherical equivalent were retrospectively reviewed, and their Randleman ectasia risk score system score was calculated. Results: The mean ectasia score of 194 eyes (97 patients) was 4.5 ± 2.67; 40 (20.6%), 46 (23.7%), and 108 (55.7%) eyes were classified as low-, moderate-, and high-risk eyes, respectively. The topography was abnormal in 69% of the patients. The mean manifest refraction spherical equivalent, central corneal thickness, and estimated residual stromal bed thickness were 4 (+0.50 to –15.50) diopters, 520 (439 to 608) μm, and 312.38 (61.5 to 424.12) μm, respectively. The main cause of cancellation in low- and moderate-risk patients (86 eyes) was the presence of unstable refractive error in the past year. Conclusion: Although promising, some other criteria, such as stable refraction, should be added to this scoring system to achieve greater practicality since a main cause of cancelling LASIK candidates in this study was the presence of unstable refraction.

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Validation of the Ectasia Risk Score System for Preoperative Laser In Situ Keratomileusis Screening

American Journal of Ophthalmology ◽

10.1016/j.ajo.2007.12.033 ◽

2008 ◽

Vol 145 (5) ◽

pp. 813-818.e2 ◽

Cited By ~ 126

Author(s):

J. Bradley Randleman ◽

William B. Trattler ◽

R. Doyle Stulting

Keyword(s):

Risk Score ◽

Laser In Situ Keratomileusis ◽

Score System ◽

Risk Score System

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Risk Assessment for Corneal Ectasia following Photorefractive Keratectomy

Journal of Ophthalmology ◽

10.1155/2017/2434830 ◽

2017 ◽

Vol 2017 ◽

pp. 1-10 ◽

Cited By ~ 3

Author(s):

Nir Sorkin ◽

Igor Kaiserman ◽

Yuval Domniz ◽

Tzahi Sela ◽

Gur Munzer ◽

...

Keyword(s):

Risk Factors ◽

High Risk ◽

Risk Score ◽

Significant Risk ◽

Laser In Situ Keratomileusis ◽

Photorefractive Keratectomy ◽

Score System ◽

Risk Scoring ◽

Risk Score System

Purpose.To analyze the risk factors associated with a series of ectasia cases following photorefractive keratectomy (PRK) and all published cases.Methods.In a retrospective study on post-PRK ectasia patients, 9 eyes of 7 patients were included, in addition to 20 eyes of 13 patients from the literature. Risk of post-PRK ectasia was calculated using the ectasia risk score system (ERSS) for laser in situ keratomileusis (LASIK) patients. The percent tissue altered (PTA) was also evaluated.Results.ERSS scoring of zero for age, RSB, and spherical equivalent was found in 66%, 86%, and 86% of the eyes, respectively. Pachymetry risk score was 2 in 60% of the eyes and 3 or 4 in 16% of the eyes. Topography risk score was 3 in 41% of the eyes and 4 in 21% of the eyes. Cumulative ectasia risk score was ≥4 (high risk) in 77% of the eyes and ≥3 (medium and high risk) in 86% of the eyes. Average PTA was 23.2 ± 7.0%. All eyes but one had a PTA < 40%.Conclusions.Preoperative corneal topographic abnormalities and thin corneas may be significant risk factors for developing ectasia following PRK. Post-LASIK ectasia risk scoring also has relevance in the risk for developing post-PRK ectasia.

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Comparison of Intraocular Pressure before and after Laser In Situ Keratomileusis Refractive Surgery Measured with Perkins Tonometry, Noncontact Tonometry, and Transpalpebral Tonometry

Journal of Ophthalmology ◽

10.1155/2015/683895 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Isabel Cacho ◽

Juan Sanchez-Naves ◽

Laura Batres ◽

Jesús Pintor ◽

Gonzalo Carracedo

Keyword(s):

Intraocular Pressure ◽

Refractive Surgery ◽

Corneal Thickness ◽

Laser In Situ Keratomileusis ◽

Spherical Equivalent ◽

Transpalpebral Tonometry ◽

Spherical Equivalent Refraction ◽

Before And After ◽

Noncontact Tonometry

Purpose. To compare the intraocular pressure (IOP) before and after Laser In Situ Keratomileusis (LASIK), measured by Diaton, Perkins, and noncontact air pulse tonometers.Methods. Fifty-seven patients with a mean age of 34.88 were scheduled for myopia LASIK treatment. Spherical equivalent refraction (SER), corneal curvature (K), and central corneal thickness (CCT) and superior corneal thickness (SCT) were obtained before and after LASIK surgery. IOP values before and after surgery were measured using Diaton, Perkins, and noncontact air pulse tonometers.Results. The IOP values before and after LASIK surgery using Perkins tonometer and air tonometers were statistically significant (p<0.05). However, no significant differences were found (p>0.05) for IOP values measured with Diaton tonometer. CCT decreases significantly after surgery (p<0.05) but no statistical differences were found in SCT (p=0.08). Correlations between pre- and postsurgery were found for all tonometers used, withp=0.001andr=0.434for the air pulse tonometer,p=0.008andr=0.355for Perkins, andp<0.001andr=0.637for Diaton.Conclusion. Transpalpebral tonometry may be useful for measuring postsurgery IOP after myopic LASIK ablation because this technique is not influenced by the treatment.

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Twelve-Year Follow-Up of Laser In Situ Keratomileusis for Moderate to High Myopia

BioMed Research International ◽

10.1155/2017/9391436 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Tetsuya Ikeda ◽

Kimiya Shimizu ◽

Akihito Igarashi ◽

Sumie Kasahara ◽

Kazutaka Kamiya

Keyword(s):

High Myopia ◽

Central Corneal Thickness ◽

Pearson Correlation ◽

Corneal Thickness ◽

Laser In Situ Keratomileusis ◽

Manifest Refraction ◽

Observation Period

Purpose. To assess the long-term clinical outcomes of conventional laser in situ keratomileusis (LASIK) for moderate to high myopia.Methods. We retrospectively examined sixty-eight eyes of 37 consecutive patients who underwent conventional LASIK for the correction of myopia (−3.00 to −12.75 diopters (D)). At 3 months and 1, 4, 8, and 12 years postoperatively, we assessed the safety, efficacy, predictability, stability, mean keratometry, central corneal thickness, and adverse events.Results. The safety and efficacy indices were0.82±0.29and0.67±0.37, respectively, 12 years postoperatively. At 12 years, 53% and 75% of the eyes were within 0.5 and 1.0 D, respectively, of the targeted correction. Manifest refraction changes of −0.74±0.99 D occurred from 3 months to 12 years after LASIK (p<0.001). We found a significant correlation of refractive regression with the changes in keratometric readings from 3 months to 12 years postoperatively (Pearson correlation coefficient,r=-0.28,p=0.02), but not with the changes in central corneal thickness (r=-0.08,p=0.63). No vision-threatening complications occurred in any case.Conclusions. Conventional LASIK offered good safety outcomes during the 12-year observation period. However, the efficacy and the predictability gradually decreased with time owing to myopic regression in relation to corneal steepening.

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Higher-order aberrations following wavefront-guided photorefractive keratectomy and laser in situ keratomileusis

Medical Hypothesis, Discovery & Innovation in Optometry ◽

10.51329/mehdioptometry112 ◽

2021 ◽

Vol 1 (2) ◽

pp. 100-104

Author(s):

Esra Vural ◽

Deniz Kilic ◽

Ayse Cicek ◽

M. Rasit Sirem ◽

Necati Duru ◽

...

Keyword(s):

Higher Order ◽

Laser In Situ Keratomileusis ◽

Photorefractive Keratectomy ◽

City Hospital ◽

Higher Order Aberrations ◽

Significant Difference ◽

Manifest Refraction ◽

Group A ◽

The Mean

Background: We aimed to evaluate higher-order aberrations (HOAs) following wavefront-guided photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) in patients with myopia and myopic astigmatism. Methods: This retrospective observational case-control study included patients who underwent wavefront-guided PRK (40 eyes of 20 patients) or LASIK (40 eyes of 20 patients) between August 2018 and November 2018 at the refractive surgery unit of Kayseri City Hospital Eye Clinic, Turkey. The corrected distance visual acuity (CDVA), manifest refraction, corneal topography, and HOAs were evaluated preoperatively and 3 months postoperatively in all patients. Results: The mean age ± standard deviation (SD) was 27.13 ± 5.54 years and 29.10 ± 4.38 years in the PRK and LASIK groups, respectively (P = 0.06). Both groups had a mean CDVA of 1.00. The mean ± SD of spherical and spherical equivalent values was -2.09 ± 1.56 diopter (D) and -3.03 ± 1.72 D in the PRK group and -2.23 ± 1.69 D and -3.35 ± 1.71 D in the LASIK group, respectively (P = 0.58). When the preoperative and postoperative HOAs and root mean square (RMS) values (for a 6-mm pupil diameter) were compared in the PRK group, a significant difference was found in vertical coma and total RMS values (P = 0.003 and P ˂ 0.001, respectively); in the LASIK group, there was a significant difference in preoperative and postoperative vertical coma and total RMS values (P = 0.0.001 and P ˂ 0.001, respectively). There was no significant difference in preoperative and postoperative vertical coma values between the two groups (P = 0.735 and P = 0.583, respectively). Conclusions: In terms of HOAs, total RMS values decreased significantly and vertical coma values increased significantly at 3 months postoperatively in both PRK and LASIK groups. However, there were no differences between the two groups.

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Visual differences in topography-guided versus wavefront-optimized LASIK in the treatment of myopia: a Meta-analysis

International Journal of Ophthalmology ◽

10.18240/ijo.2021.10.19 ◽

2021 ◽

Vol 14 (10) ◽

pp. 1602-1609

Author(s):

Peng-Cheng Hu ◽

◽

Xian-Hui Wu ◽

Yan-Qing Li ◽

Ke-Wei Li ◽

...

Keyword(s):

Visual Acuity ◽

Web Of Science ◽

Spherical Aberration ◽

Meta Analysis ◽

Laser In Situ Keratomileusis ◽

Wavefront Aberration ◽

Spherical Equivalent ◽

Uncorrected Distance Visual Acuity ◽

Manifest Refraction

AIM: To investigate the potential differences between topography-guided (TG) and wavefront-optimized (WFO) laser in situ keratomileusis (LASIK) for the treatment of myopia. METHODS: A systematic literature search was performed to determine relevant trials comparing LASIK with TG and WFO from the time of library construction to August 2020, and The PubMed, Cochrane, Web of Science, EMBASE and Chinese databases (i.e. CNKI, CBM, WAN FANG and VIP) were accessed. The data on visual acuity, refractive status and wavefront aberration were retrieved and evaluated from three to six months after surgery. STATA (version 14.0) software was used for statistical analysis. A cumulative Meta-analysis was simultaneously performed. RESULTS: Eleven studies with a total of 1425 eyes were incorporated. No statistically significant differences were evident between TG and WFO ablation in the proportion of eyes achieving an uncorrected distance visual acuity (UCVA) of 20/20 or better (P=0.377), gaining one line or more (P=0.05), postoperative cylinder (P=0.40), vertical coma (P=0.593) and horizontal coma (P=0.957). After TG ablation, the proportion of the patients’ eyes of which postoperative refraction is within ±0.5 diopter of the target refraction was significantly higher than that undergoes WFO (P=0.003). As opposed to the WFO group, manifest refraction spherical equivalent (MRSE; P=0.000) was lower, and UCVA (P=0.005) was better in the TG group. The higher-order aberrations (HOAs; P=0.000), spherical aberration (P=0.000) and coma (P=0.000) were significantly lower in TG group. The cumulative Meta-analysis illustrated that the proportion of eyes achieving UCVA of 20/20 or better, postoperative refraction within ±0.5 diopter, and MRSE has steady between the two groups. CONCLUSION: Both TG-LASIK and WFO-LASIK are safe, effective, and predictable for correcting myopia. TG-LASIK may produce fewer aberration and is more precise than WFO-LASIK.

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Acute Keratoconus-Like Hydrops after Laser In Situ Keratomileusis

Journal of Ophthalmology ◽

10.1155/2009/363482 ◽

2009 ◽

Vol 2009 ◽

pp. 1-3 ◽

Cited By ~ 3

Author(s):

Carsten H. Meyer ◽

Stefan Mennel ◽

Jörg C. Schmidt

Keyword(s):

Corneal Thickness ◽

Laser In Situ Keratomileusis ◽

Slit Lamp ◽

Hand Motion ◽

Optical Zone ◽

Progressive Myopia ◽

Bed Thickness ◽

Minimal Residual ◽

Acute Keratoconus

Purpose.To demonstrate keratoconus-like hydrops after laser in situ keratomileusis (LASIK) by optical coherence tomography (OCT).Patient and Methods.A 21-year-old man received uneventful bilateral LASIK. On slit lamp examination or corneal topography there were no signs of fruste keratoconus. The preoperative corneal thickness was 587-m OD and the calculated ablation for two treatments was 114-m. Uneventful LASIK with an optical zone of 7 mm and an ablation of 89-m OD, and an ablation of 73-m OS was performed. Three years postoperatively, he complained about progressive myopia and impaired vision OD. His VA was hand motion OD and 20/20 OS.Results.OCT and light microscopy revealed an anterior corneal steepening and acute keratoconus-like excessive edematous swelling.Conclusion.The cornea is mechanically weakened after LASIK by the lamellar cut and tissue subtraction. Although the advocated minimal residual stromal bed thickness is 250-m, it may not be adequate to prevent progressive keratoconus-like hydrops in the selected cases.

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Photorefractive Keratectomy for Residual Myopia after Myopic Laser In Situ Keratomileusis

Journal of Ophthalmology ◽

10.1155/2017/8725172 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Kamal A. M. Solaiman ◽

Sameh M. Fouda ◽

Ashraf Bor’i ◽

Haitham Y. Al-Nashar

Keyword(s):

Corneal Thickness ◽

Laser In Situ Keratomileusis ◽

Photorefractive Keratectomy ◽

Safety Index ◽

Corneal Resistance Factor ◽

Corrected Visual Acuity ◽

High Predictability ◽

Efficacy Index ◽

The Mean

Purpose. To evaluate the safety, efficacy, and predictability of photorefractive keratectomy (PRK) on the corneal flap for correction of residual myopia following myopic laser in situ keratomileusis (LASIK).Patients and Methods. A retrospective study on eyes retreated by PRK on the corneal flap for residual myopia after LASIK. All eyes had no enough stroma after LASIK sufficient for LASIK enhancement. Data included spherical equivalent (SE), uncorrected and best corrected visual acuity (UCVA and BCVA), central pachymetry, corneal higher order aberrations (HOAs), corneal hysteresis (CH), corneal resistance factor (CRF), and corneal haze.Results. The study included 64 eyes. Before PRK, the mean central pachymetry was400.21±7.8 μm, the mean SE was −1.74±0.51 D, and the mean UCVA and BCVA were0.35±0.18and0.91±0.07, respectively. 12 months postoperatively, the mean central corneal thickness was382.41±2.61 μm, the mean SE was −0.18±0.32 D (P<0.01), and the mean UCVA and BCVA were0.78±0.14(P=0.01) and0.92±0.13(P>0.5), respectively. The safety index was 1.01 and the efficacy index was 0.86. No significant change was observed in corneal HOAs.Conclusions. Residual myopia less than 3 D after LASIK could be safely and effectively treated by PRK and mitomycin C with a high predictability. This prevents postoperative ectasia and avoids the flap related complications but has no significant effect on HOAs.

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