scholarly journals Refractive Stability and Ocular Biometric Changes After Customized LASEK for Correction of Myopia; 8 Years Follow up

2020 ◽  
Author(s):  
Seyed Javad Hashemian ◽  
Acieh Es'haghi ◽  
Hossein Aghaei ◽  
Leila Ghiasian ◽  
Mohammad Ebrahim Jafari ◽  
...  

Abstract BACKGROUND: To assess long-term Visual and refractive stability and ocular biometric changes in low to moderate myopic subjects treated by customized LASEK. METHODS: Seventy eyes of 35 patients were treated by customized LASEK for correction of less than 6 diopter myopia in this cohort study. Uncorrected visual acuities (UCVA) and distance corrected visual acuities (DCVA), keratometry values and ocular biometric data by Lenstar LS900 including anterior chamber depth (ACD), aqueous depth, central corneal thickness(CCT),lens thickness(LT) and axial length(AL) were evaluated pre and 8 years postoperatively. RESULTS: Mean pre-operative spherical equivalent was -3.99 ±1.38 diopter (D) that improved to 0.01 ±0.27 D and -0.10 ±0.31 D, 6 months and 8 years postoperative respectively. Mean pachymetry, flat, steep and mean keratometry values increased significantly from 6 months to 8 years postoperative. Although, these changes had no significant effect on visual outcomes and subjective refraction. ACD decreased and LT increased significantly over 8 years follow-up in comparison with preoperative values. The change in AL was not significant at 8 years follow up.CONCLUSIONS: The long-term visual and refractive outcomes of customized LASEK in correction of low to moderate myopia were stable and predictable, although changes in ocular biometric parameters have occurred.

2021 ◽  
Vol 2 (2) ◽  
pp. 56-62
Author(s):  
Simin Hosseini ◽  
Amir Faramarzi ◽  
Siamak Moradian ◽  
Mehdi Yaseri

Background: The Lenstar LS 900 (Haag-Streit AG, Koeniz, Switzerland) is an optical biometer, and its measurements are highly repeatable and precise in cataractous eyes. This study investigated changes in biometric parameters, including axial length (AL), anterior chamber depth (ACD), lens thickness (LT), vitreous cavity depth (VD), and central corneal thickness (CCT) before and after three-port 23-Gauge pars plana vitrectomy with silicone oil tamponade. Methods: This was a prospective follow-up study. Patients who were scheduled for surgery underwent a detailed slit-lamp examination and objective cycloplegic refraction preoperatively. In eligible cases, the Lenstar LS 900 was used to measure biometric parameters. At the 1-month postoperative follow-up, we repeated the same assessments for the silicone oil (SO)-filled eyes. Data were analyzed to assess the significance of changes and to test the possible correlation of values between the two time points. Results: Twenty-three patients with a mean ± SD age of 60 ± 12 years completed the study. Postoperatively, we found a significant increase in AL and a decrease in ACD and CCT (all P < 0.05), with no significant changes in LT and VD. A significant correlation was found for ACD, CCT, and cylinder values between the two time points (all P < 0.05). Postoperatively, the spherical and cylindrical components of refraction demonstrated a hyperopic shift, but did not change statistically significantly. Conclusions: The Lenstar LS 900 underestimated the ACD and overestimated the AL in SO-filled eyes when comparing pre- and postoperative values, in phakic as well as pseudophakic eyes. In planning for cataract surgery in this group of patients, it is more reasonable to calculate IOL power based on the biometric data of the fellow eye, although this may not eliminate possible errors. Further studies with a larger sample size, longer follow-up, and robust study design are necessary to confirm our preliminary results.


2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Junjie Wang ◽  
Bernardo T. Lopes ◽  
Hechen Li ◽  
Riccardo Vinciguerra ◽  
Si Cao ◽  
...  

AbstractBackgroundCorneal refractive surgery has become reliable for correcting refractive errors, but it can induce unintended ocular changes that alter refractive outcomes. This study is to evaluate the unintended changes in ocular biometric parameters over a 6-month follow-up period after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE).Methods156 consecutive myopic patients scheduled for FS-LASIK and SMILE were included in this study. Central corneal thickness (CCT), mean curvature of the corneal posterior surface (Kpm), internal anterior chamber depth (IACD) and the length from corneal endothelium to retina (ER) were evaluated before and after surgery over a 6-month period.ResultsBoth the FS-LASIK and SMILE groups (closely matched at the pre-surgery stage) experienced flatter Kpm, shallower IACD and decreased ER 1 week post-surgery (P < 0.01), and these changes were larger in FS-LASIK than in SMILE group. During the 1 week to 6 months follow up period, Kpm, IACD and ER remained stable unlike CCT which increased significantly (P < 0.05), more in the FS-LASIK group.ConclusionsDuring the follow up, the posterior corneal surface became flatter and shifted posteriorly, the anterior chamber depth and the length from the corneal endothelium to retina decreased significantly compared with the pre-surgery stage. These unintended changes in ocular biometric parameters were greater in patients undergoing FS-LASIK than SMILE. The changes present clear challenges for IOL power calculations and should be considered to avoid affecting the outcome of cataract surgery.


2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Tetsuya Ikeda ◽  
Kimiya Shimizu ◽  
Akihito Igarashi ◽  
Sumie Kasahara ◽  
Kazutaka Kamiya

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.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Xi Feng ◽  
Yong Wang ◽  
Jianheng Liang ◽  
Yali Xu ◽  
Julio Ortega-Usobiaga ◽  
...  

Objective. This study aimed to analyze the distribution of lens thickness (LT) and its associations in age-related cataract patients based on swept-source optical coherence tomography (SS-OCT). Methods. This cross-sectional study included 59,726 Chinese age-related cataract patients. Only right-eye data were included in the study. Repeated measures of ocular parameters were performed using an IOL Master 700 device. The distributions of ocular biometric data including anterior chamber depth (ACD), LT, axial length (AL), central corneal thickness (CCT), white-to-white (WTW), and mean keratometry (MK) and their associations with age were assessed. The anterior segment (AS) was measured as the sum of CCT, ACD, and LT, while the vitreous chamber depth (VCD) was calculated as the difference between AL and AS. The values of LT : AL, AS : AL, and VCD : AL in different AL groups and their changes are the main outcome measures used to observe the proportion of the anterior and posterior segments of the eye. Results. Biometric data were available for 59,726 individuals. The mean age was 68.81 years (range = 40–100); 40.62% were male and 59.38% were female. Mean anterior chamber depth (ACD) was 3.02 ± 0.44 mm, mean LT was 4.51 ± 0.44 mm, mean axial length (AL) was 23.89 ± 1.92 mm, mean central corneal thickness (CCT) was 0.53 ± 0.03 mm, mean white-to-white (WTW) was 11.64 ± 0.44 mm, and mean keratometry (MK) was 44.27 ± 1.65 diopter. Female patients had shorter AL, shallower ACD, smaller CCT and WTW, decreased LT, and steeper corneas ( p  < 0.005). ACD revealed the strongest negative correlation ( p  ≤ 0.001, r = –0.682) with LT. Age ( p  ≤ 0.001, r = 0.348) showed a moderate positive correlation, whereas MK ( p  < 0.05, r = 0.011), CCT ( p  ≤ 0.001, r = 0.041) had a weak positive correlation and WTW ( p  ≤ 0.001, r = –0.034) had a weak negative correlation with LT. A nonlinear correlation was found between LT and AL. LT increased with age in both males and females. LT changed variably in eyes with AL less than 27 mm, LT decreased as AL increased, then LT gradually increased as AL increased in extremely long and extra-long eyes ( p  ≤ 0.001). LT : AL and AS : AL decreased as AL increased, VCD : AL gradually increased as AL increased in highly myopic eyes, and VCD : AL increased by about 0.01 for every 1 mm increase in AL. Conclusions. Among Chinese age-related cataract patients, we found LT to have the strongest relation with ACD. The lens was thicker in elderly patients and women. The correlation between LT and AL is not a simple negative correlation; with the increase of age, LT decreases first and then increases. The proportion of VCD is constantly rising with the elongation of AL.


2021 ◽  
Author(s):  
Zhengxuan Li ◽  
Lu Sun ◽  
Hongxin Song

Abstract Purpose: The primary aim of this study was to analyze the distribution of ocular parameters of children aged from eight to eighteen-year-old with low to moderate myopia as well as offer useful information for the design and clinical fitting of ortho-k lens in China.Methods: In this retrospective study, we collected data of 300 subjects (600 eyes) age between eight to eighteen-year-old from the myopic control outpatient clinic at Beijing Tongren Hospital, Beijing, China. The spherical equivalent (SE), axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), corneal endothelial cell density (CECD),corneal diameter (CD), simulated K (Sim K) were collected from all the subjects and analyzed. Results: The mean of SE for all subjects was -3.12 ± 1.21D, the median was -3.16D. The mean of AL for all subjects was 24.72 ± 0.83 mm, the median was 24.72 mm. The mean of CCT for all subjects was 537.8 ± 29.82 μm, the median was 538.17 μm. The mean of CECD for all subjects was 3340.3 ± 352.6 cells/mm2, the median was 3357.77 cells/mm2. The mean of ACD for all subjects was 3.71 ± 0.21 mm, the median was 3.69 mm. The mean of CD for all subjects was 12.15 ± 1.67 mm, the median was 12.05 mm. The mean of flat K was 42.80 ± 1.29, the median was 42.81. The mean of steep K was 43.76 ± 1.37, the median was 43.76.Conclusions: This study provided the distribution of ocular parameters to offer useful information for diagnosis of many eye conditions. Meanwhile, the distribution of ocular parameters of children aged from eight to eighteen-year-old with low to moderate myopia is beneficial to make the application of overnight orthokeratology lens more appropriate and effective.


2020 ◽  
pp. 112067212091453
Author(s):  
Ali Keleş ◽  
Emine Şen ◽  
Ufuk Elgin

Purpose: The aims of this study were to compare the biometric parameters and axial lengths of eyes with phacomorphic glaucoma and mature cataract and to identify differences that might predispose to development of phacomorphic glaucoma. Methods: Three hundred forty-two patients were enrolled in this retrospective study. The eyes were divided into four groups—Group (G)1: phacomorphic glaucoma ( n = 29), G2: mature cataract ( n = 313), G3: contralateral phacomorphic glaucoma ( n = 29), and G4: contralateral mature cataract ( n = 313). Central corneal thickness and anterior chamber depth were assessed by optical low-coherence reflectometry (Lenstar LS 900®; Haag-Streit AG, Switzerland), while axial length was determined by A-scan ultrasound biometry. Results: The mean central corneal thickness of G1 was significantly higher than in other groups ( p < 0.001) and the mean anterior chamber depth of G1 was the lowest among the groups ( p < 0.001). Also, G2 had lower mean anterior chamber depth than G4 ( p < 0.001) and G3 had lower mean anterior chamber depth than G4 ( p = 0.007). Anterior chamber depth less than 3.27 mm had the higher odds ratio for distinguishing G3 versus G4 (odds ratio = 10.79, p < 0.001). Furthermore, patients aged ⩾68.9 years had the higher odds ratio for distinguishing G1 versus G2 (odds ratio = 2.82, p = 0.019). There was no significant difference in the presence of pseudoexfoliation material between G1 and G2 ( p = 0.057). There were no significant differences in axial length values among the four groups ( p = 0.097). Conclusion: Advanced age and shallow anterior chamber depth were found to be risk factors for developing phacomorphic glaucoma, but the presence of pseudoexfoliation material was not found to play a role as a risk factor in phacomorphic glaucoma development.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hae Min Park ◽  
Jiin Choi ◽  
Won June Lee ◽  
Ki Bang Uhm

Abstract Background Central corneal thickness (CCT) and its association with intraocular pressure, which is a pivotal parameter in glaucoma management, has previously been reported. In this study, we intended to investigate the long-term change of CCT in terms of rate in eyes with primary angle-closure (PAC). Additionally, we aimed to analyze events that could affect CCT. Methods In this retrospective study, 26 patients with PAC who had a follow-up period of more than 5 years were analyzed. The rate of CCT changes from baseline was evaluated from the serial CCT measurements over the average follow-up period. The pattern of CCT change rate according to modes of treatment and history of angle-closure attack was analyzed using the repeated linear mixed model analysis. Results A total of 52 eyes were enrolled. The CCT reduction rate of the entire study population was − 0.72 ± 0.22 μm/yr (P = 0.001) with statistical significance. The CCT thinning rate of the laser peripheral iridotomy (PI) group was − 0.53 ± 0.25 μm/yr (P = 0.034) and that of the surgical trabeculectomy group was − 1.32 ± 0.43 μm/yr (P = 0.002), and it was not statistically significant (P = 0.112). The rate of CCT thinning in patients with a history of acute angle-closure attack was − 0.81 ± 0.31 μm/yr (P = 0.009) and that in patients without an attack was − 0.63 ± 0.30 μm/yr (P = 0.001), and it was not statistically significant (P = 0.680). Baseline CCT appeared to be the only significant factor affecting the rate of CCT changes (P < 0.001). Conclusions We found a significant reduction in CCT over a long observation period in PAC eyes. We also found that the rates of CCT reduction were not affected by different treatment modalities or acute angle-closure attacks. The analysis of long-term CCT changes in conjunction with baseline CCT would also be helpful in the clinical evaluation of the PAC patients.


Optics ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 55-62
Author(s):  
Federico Alonso-Aliste ◽  
Jonatan Amián-Cordero ◽  
Rahul Rachwani-Anil ◽  
Concepción De-Hita-Cantalejo ◽  
Davide Borroni ◽  
...  

The purpose of our study was to evaluate the safety, effectiveness, predictability, and stability of myopic and astigmatic laser-assisted in situ keratomileusis (LASIK) with simultaneous prophylactic corneal cross-linking (CXL) in thin corneas. In total, 100 eyes from 50 patients who were subjected to myopic and astigmatism femtosecond LASIK with simultaneous prophylactic CXL were included. The design of the study was retrospective, longitudinal, and observational. All patients had a 48-month follow-up. The MEL 80 excimer laser was utilized with the Aberration Smart Ablation platform. CXL treatment was applied when the predicted stromal thickness was less than 330 µm. Patients’ mean age was 30.22 ± 5.97 years. Previous mean spherical equivalent was −5.50 ± 1.65 (−9.50 to −1.13) diopters (D). Postoperative mean spherical equivalent was −0.24 ± 0.29 (−0.85 to +0.50) D. Visual acuity (VA) of 20/20 or better was observed in 87% of the eyes and no eyes experienced VA loss. Spherical equivalent within ±0.50 D was observed in 93% of eyes, and 4% of eyes varied by 0.50 D or more between 3 and 48 months. Prophylactic corneal cross-linking with simultaneous femtosecond laser-assisted in situ keratomileusis in thin corneas proved to be effective, safe, and predictable. The results remained stable after 48 months of follow-up.


2020 ◽  
Author(s):  
Anita Csorba ◽  
Huba Kiss ◽  
Kinga Kránitz ◽  
Zoltán Zsolt Nagy

Abstract Background: Our aim was to evaluate the long-term effects of conventional epithelium-off corneal cross-linking performed on patients with progressive keratoconus. Methods: A retrospective analysis was performed on 34 eyes of 34 patients with progressive keratoconus underwent conventional cross-linking using Pentacam HR Scheimpflug camera. Visual acuity, spherical equivalent, keratometry, pachymetry and corneal topographic indices were analysed preoperatively and at 1, 3, and 6 years after the surgery. Results: Statistically significant decrease was detected at 1 year in spherical equivalent (p = 0.022), with no significant changes afterward (p =0.616). Uncorrected and best corrected distance visual acuity improved significantly in the first postoperative year (p =0.017 and p= 0.003, respectively), and remained stable with no significant changes at further visits (p = 0.203 and p = 0.336, respectively). Significant decrease of central corneal thickness and thinnest corneal thickness was observed at 1 year (both p <0.001), with additional thinning of thinnest corneal pachymetry up to 3 years (p = 0.01). Maximum keratometry and mean keratometry showed significant, continuous improvement between all consecutive visits over the whole follow-up period (all p-values <0.05). Significant improvement was found in the following 5 topographic indices at 1 year: ISV (p = 0.001), IVA (p = 0.028), KI (p = 0.002), CKI (p <0.001 and Rmin (p <0.001), with further improvement up to 3 years in ISV (p = 0.007), in CKI (p = 0.019) and in Rmin (p = 0.015). Rmin showed more improvement up to the end of follow-up (p <0.001).Conclusions: Conventional epithelium-off corneal cross-linking is effective in halting the progression of keratoconus and in regularization of the anterior corneal surface over a long-term follow-up period up to 6 years.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Ammar M Khan ◽  
Derek M. Waldner ◽  
Micah Luong ◽  
Emi Sanders ◽  
Andrew C. S. Crichton ◽  
...  

Abstract Background Accumulating evidence suggests that refractive stabilization occurs rapidly following small incision cataract surgery. Nonetheless, many guidelines still suggest waiting four to 6 weeks before prescribing corrective lenses. This study was undertaken to supplement the existing literature regarding refractive stabilization, and evaluate multiple contributing factors that could dissuade clinicians from confidently correcting refractive error in the early post-operative course following routine cataract surgeries. Methods Adult patients undergoing phacoemulsification cataract surgery with uncomplicated surgeries and post-surgical courses at the Calgary Ophthalmology Centre (Calgary, Alberta, Canada) were included in this prospective observational case series. Exclusion criteria included known corneal dystrophies, infectious keratitis, complicated surgery or toric/multifocal IOLs. Data was collected at weekly intervals for a total of 6 weeks. Collected data included autorefraction, visual acuity, corneal pachymetry, and effective lens position. Results One hundred six eyes of 104 patients were included in this study. Post-operative sphere, cylinder and spherical equivalent were not significantly different at any post-operative week compared with week six, and 80–86% of patients were within 0.5D of last follow-up spherical equivalent at any week. The secondary outcomes of central corneal thickness, effective lens position and visual acuity did, however, exhibit significant differences between early post-operative weeks and last follow-up values. Conclusions These data suggest that refractive error can be effectively measured and corrected as early as one-week post-operatively in the majority of patients, though other measures of post-operative stability including central corneal thickness, effective lens position and visual acuity can require up to 4 weeks to stabilize. Thus a conservative and pragmatic approach may be to wait until 4 weeks post-operatively prior to obtaining refractive correction following uncomplicated phacoemulsification cataract surgery.


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