Efficacy of LASIK and LASEK methods in achieving the predicted result in excimer laser correction of myopia and myopic astigmatism

Excimer laser correction of refraction anomalies has entered ophthalmological practice as one of the most effective surgical techniques, which allows us to correct refractive errors by changing corneal curvature, including with myopia and myopic astigmatism. Usually, such correction is applied in young patients of working age that acquires special social significance and requires the use of the most accurate and safe technologies, which would guarantee the achievement of a rapid effect with the shortest period of rehabilitation. The results of surgical treatment of 60 patients (103 eyes) with myopia of various degrees and myopic astigmatism were analyzed. Among patients, there were 28 men (41 %) and 32 women (59 %) aged 18 to 47 (mean of 25.0 ± 2.5) years. They were divided into 2 groups. The first group consisted of 29 people (50 eyes) who underwent vision correction by laser-assisted in situ keratomileusis (LASIK). All patients underwent standard ophthalmological examinations (visometry, autorefractometry, biomicroscopy, direct ophthalmoscopy, tonometry, perimetry) and refractive diagnosis, which included corneal topography with pachymetry (Orbscan, Bausch + Lomb Inc., USA), aberrometry (Zywave, Bausch + Lomb Inc., USA), anterior segment optical coherence tomography (Visante OCT, Carl Zeiss Meditec, Germany) and optical biometry by optical biometer IOLMaster (Carl Zeiss Meditec, Germany). The refractive result achievement was assessed on day 1, as well as 1 month, 6 months and 1 year after surgery. All surgeries were performed on an excimer laser Allegretto WaveLight EX500 (Alcon, USA). One month after excimer laser correction by the LASIK method, the expected result of visual acuity was achieved in 46 eyes (80.7 %), and when using the laser epithelial keratomileusis (LASEK) technique — in 31 eyes (58.5 %) that indicates a longer rehabilitation period. Six months later, the predicted visual acuity without correction in the group where surgery was performed by LASEK was achieved in 46 eyes (86.8 %), while in the group operated by LASIK — in 50 eyes, 100 % (the difference is not reliable, p > 0.05). One year after excimer laser correction, uncorrected visual acuity, regardless of the degree of myopia, was 0.92 ± 0.04 U in the first group at maximum visual acuity with correction in these eyes before surgery 0.86 ± 0.05 U (the difference is not significant, p > 0.05) and 0.74 ± 0.10 U in the second group at the maximum indicators of corrected visual acuity before surgery of 0.92 ± 0.03 U (the difference is significant, p < 0.05). A slightly larger difference in the achieved results of maximum uncorrected visual acuity before surgery when performing excimer laser correction by the LASEK method is explained by the development of subepithelial fibroplasia in 3.77 % of cases, which affected the average end result.

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Changes in Higher Order Aberrations after Wavefront-Guided Prk for Correction of Low to Moderate Myopia and Myopic Astigmatism: Two-Year Follow-Up

European Journal of Ophthalmology ◽

10.1177/112067210701700405 ◽

2007 ◽

Vol 17 (4) ◽

pp. 507-514 ◽

Cited By ~ 14

Author(s):

D. Wygledowska-Promienska ◽

I. Zawojska

Keyword(s):

Visual Acuity ◽

Excimer Laser ◽

Spherical Aberration ◽

Higher Order ◽

Control Group ◽

Higher Order Aberrations ◽

Order Root ◽

Group 2 ◽

Myopic Astigmatism ◽

Group 1

Purpose To assess efficacy, safety, and changes in higher order aberrations after wavefront-guided photorefractive keratectomy (PRK) in comparison with conventional PRK for low to moderate myopia with myopic astigmatism using a WASCA Workstation with the MEL 70 G-Scan excimer laser. Methods A total of 126 myopic or myopic-astigmatic eyes of 112 patients were included in this retrospective study. Patients were divided into two groups: Group 1, the study group; and Group 2, the control group. Group 1 consisted of 78 eyes treated with wavefront-guided PRK. Group 2 consisted of 48 eyes treated with spherocylindrical conventional PRK. Results Two years postoperatively, in Group 1, 5% of eyes achieved an uncorrected visual acuity (UCVA) of 0.05; 69% achieved a UCVA of 0.00; 18% of eyes experienced enhanced visual acuity of −0.18 and 8% of −0.30. In Group 2, 8% of eyes achieved a UCVA of 0.1; 25% achieved a UCVA of 0.05; and 67% achieved a UCVA of 0.00 according to logMAR calculation method. Total higher-order root-mean square increased by a factor 1.18 for Group 1 and 1.6 for Group 2. There was a significant increase of coma by a factor 1.74 in Group 2 and spherical aberration by a factor 2.09 in Group 1 and 3.56 in Group 2. Conclusions The data support the safety and effectiveness of the wavefront-guided PRK using a WASCA Workstation for correction of low to moderate refractive errors. This method reduced the number of higher order aberrations induced by excimer laser surgery and improved uncorrected and spectacle-corrected visual acuity when compared to conventional PRK.

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Senile eye cataract: medical and social aspects and the risk to public health

Vestnik of Russian military medical Academy ◽

10.17816/brmma25991 ◽

2020 ◽

Vol 22 (1) ◽

pp. 191-195

Author(s):

G Ch Javadova ◽

I E Ioshin ◽

S T Guliyeva

Keyword(s):

Growth Rate ◽

Visual Acuity ◽

Intraoperative Complications ◽

Treatment Options ◽

Medical Science ◽

Surgical Techniques ◽

Surgical Removal ◽

Industrialized Countries ◽

Severity Of Injury ◽

Working Age

A review of literature data on issues related to the prevalence of cataract among the population and the possibilities of its treatment is provided. In 2010, there were more than 10,8 million people worldwide who completely lost their vision due to cataracts, and partially lost more than 35,1 million people. Currently, the growth rate of senile cataract is two times faster than the growth rate of the total population, and in industrialized countries - five times. The problem of the wide spread and severity of injury in cataracts, along with the medical one, also has a medical and social character, which is why worldwide attention is paid to the study of etiopathogenesis and treatment options for cataracts among people of working age. To date, cataract treatment involves only surgical removal of a clouded lens with implantation of an intraocular lens. More than 20 million such operations are carried out annually in the world. With the development of medical science and technological progress, new, more advanced surgical techniques are being developed, such as ultrasound and femtolaser phacoemulsification, which allow performing operations in the early stages of the disease and achieving better results in terms of visual acuity, avoiding the development of induced astigmatism, and reducing the likelihood of complications, including macular edema. However, despite the improvement of surgical techniques for cataract phacoemulsification, cases of postoperative complications are not uncommon. Thus, despite the study of the etiopathogenesis of cataracts and the development of advanced modern methods for its surgical treatment, the risk of complications remains. At the same time, the problem of preventing the development of macular postoperative edema is one of the main reasons for the decrease in visual acuity in operated patients. To reduce intraoperative complications, it is necessary to take into account risk factors, their combination, as well as improve the methods of their drug prophylaxis and treatment.

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Case Report of Myopia Correction by ReLEx SMILE in a Patient with Superficial Corneal Opacity

Ophthalmology in Russia ◽

10.18008/1816-5095-2020-2-295-299 ◽

2020 ◽

Vol 17 (2) ◽

pp. 295-299

Author(s):

N. V. Maychuk ◽

I. A. Mushkova ◽

A. M. Mayorova ◽

A. A. Shpak

Keyword(s):

Visual Acuity ◽

Case Report ◽

Anterior Segment ◽

Corneal Opacity ◽

Optical Center ◽

Interface Zone ◽

Uncorrected Visual Acuity ◽

Corneal Opacities ◽

Different Depths ◽

The Right

Introduction. Reduced corneal transparency leads to dissipation of energy of the femtosecond laser (FSL), which may complicate the formation of the intrastromal incision and limits the use of FSL in eyes with corneal opacities and scars. The purpose of this work is to demonstrate the possibility of successful ReLEx SMILE in a patient with superficial corneal opacity located in the paracentral zone. Case report. Patient R., 29 years old, complained of decreased vision in both eyes since childhood. Visual acuity OD = 0.1 sph –2.75D = 1.0; OS = 0.1 sph –3.50 D cyl –0.75D ax 165° = 1.0. Biomicroscopy of the right eye visualized a superficial semi-transparent corneal opacity of 5 x 3 mm located at 5.30–6 hours at a distance of 1.3 mm from the optical center. According to the anterior segment optical coherence tomography (AS-OCT) the depth of the opacity was 73–78 microns and was limited by the Bowman’s membrane. ReLEx SMILE for myopia correction was performed on both eyes with 6.7 mm lenticule diameter at a depth of 120 µm, which covered the opacity area by 1.1 mm. The surgery was standard and uncomplicated. Seven days postoperatively the patient did not complain. Uncorrected visual acuity (UCVA) was 1.0 for both eyes (and binocularly it was 1.2). According to the AS-OCT data, a hyperreflective line of the interface zone was visualized on the right eye at the depth of 141–147 µm; the opacified superficial corneal layers were detected in the lower paracental zone over the interface line. In one month after the surgery the visual acuity did not change: UCVA = 1.0 in both eyes (binocularly 1.2). Conclusion. ReLEx SMILE technology can be considered as one of the options for myopia correction in patients with superficial corneal opacity located in the paracental zone. More observations are required to evaluate the effectiveness of this technology on corneas with paracentral opacities different in sizes and located at different depths.

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Factors influencing occlusion therapy in refractive amblyopia

The Journal of Medical Research ◽

10.31254/jmr.2019.5105 ◽

2019 ◽

Vol 5 (1) ◽

pp. 15-21

Author(s):

Niharika K Shetty ◽

◽

Indireddy Prathyusha ◽

Keyword(s):

Visual Acuity ◽

Refractive Error ◽

Vision Loss ◽

Anterior Segment ◽

Influential Factor ◽

Adaptation Period ◽

Health Care Centre ◽

Factors Affecting ◽

Occlusion Therapy ◽

Myopic Astigmatism

Introduction: Amblyopia is an of important cause of preventable blindness and early detection with timely rehabilitation can prevent blindness in childhood age. It also carries a higher risk of vision loss in fellow eye. The most common method of treatment to recover the monocular function involves patching the good eye in an effort to reinforce the amblyopic eye to improve. In our study we evaluated the factors affecting occlusion therapy in amblyopia patients in terms of age, gender, amount of refractive error and the time period of occlusion as the influential factor in rehabilitation of amblyopia. Methods: In this observational study, all patients between 3 years to 25 years who attended the ophthalmic OPD at Sri Siddhartha Medical College, a tertiary health care centre for ocular evaluation and diagnosed with amblyopia were included in the study. The patients were evaluated for Visual acuity on Snellens visual acuity chart and then subjected to Refractive error evaluation on Unique RK 800 Autorefractometer. Anterior segment was evaluated on Slit lamp and Fundus examination was done on Direct and indirect ophthalmoscope. Post refraction and Post treatment visual acuity was evaluated for the patients on Snellens visual acuity chart. Results: Total of 42 patients were studied out of which 16 were males and 26 were females. All patients were between 3- 35 years of age, with maximum patients 20 (47. 6%) in the age group of 6 to 15 years. 21 patients (50%) were having a baseline visual acuity in the range of 3 meter finger counting to 6/36. The commonest refractive error was astigmatism 23(54.8%) amongst whom compound myopic astigmatism was commonest in 9 patients (21.4%). In our study the post correction visual acuity improvement was 6/24 to 6/6 which was found in maximum patients 31 (73.8%), which further improved in the post occlusion visual acuity in 35 patients (83.3%) from 6/24 to 6/6. Conclusion: In this study we found myopic astigmatism as the commonest refractive error in anisometropic amblyopias. Though we found a female preponderance, the gender association was not found significant in the visual recovery or the treatment response. A good improvement following occlusion treatment as well as refractive adaptation period

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Treating intrasurgical complications of corneal refractive operation with customized ablation. A clinical case

Russian Ophthalmological Journal ◽

10.21516/2072-0076-2021-14-3-102-105 ◽

2021 ◽

Vol 14 (3) ◽

pp. 102-105

Author(s):

N. V. Khodzhabekyan ◽

A. T. Khandzhyan ◽

A. V. Ivanova ◽

K. B. Letnikova ◽

A. S. Sklyarova

Keyword(s):

Visual Acuity ◽

Excimer Laser ◽

Refractive Surgery ◽

Clinical Case ◽

Photorefractive Keratectomy ◽

Corneal Surface ◽

Surface Errors ◽

Spherical Component ◽

Uncorrected Visual Acuity ◽

Corneal Refractive Surgery

Purpose: to evaluate the prospects of customized Finalfit based ablation for optical rehabilitation of a patient with corneal surface errors caused by intrasurgical microtome-induced damage of a corneal flap during a LASIK excimer laser correction of vision.Material and methods. In Helmholtz Center, a patient with such damage was given a phototherapeutic keratectomy (PTK) combined with topographyguided photorefractive keratectomy.Results. In two months after the surgery, the patient’s uncorrected visual acuity rose from 0.15 to 1.0; the spherical component of refraction changed from -3.5 to +1.0 D, the cylindrical component of refraction fell from 1.75 to 0.25 D. Aberrometry demonstrated a decrease of RMS from 2.19 to 0.61 D, Total HOAs from 2.281 to 0.829; Tilt from 0.406 to 0.313; HOA from 1.152 to 0.247, Coma from 0.298 to 0.124, Trefoil from 1.088 to 0.094, SA from 0,127 to 0,021.Conclusion. The clinical case demonstrates the expediency and efficiency of corneal remodeling for the rehabilitation of induced errors of the corneal surface by excimer laser correction of vision based on PTK (Flex scan) + FinalFit after corneal refractive surgery.

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Outcomes of Wavefront-Optimized Laser-Assisted In-Situ Keratomileusis and Photorefractive Keratectomy for correction of Myopia and Myopic Astigmatism over One Year Follow-Up

The Open Ophthalmology Journal ◽

10.2174/1874364101812010256 ◽

2018 ◽

Vol 12 (1) ◽

pp. 256-263 ◽

Cited By ~ 1

Author(s):

Mohammad M. Shehadeh ◽

Mohammad T. Akkawi ◽

Ammar A. Aghbar ◽

Muna T. Musmar ◽

Malak N Khabbas ◽

...

Keyword(s):

Visual Acuity ◽

Excimer Laser ◽

Photorefractive Keratectomy ◽

Distance Visual Acuity ◽

Visual Outcomes ◽

Corrected Distance Visual Acuity ◽

One Year ◽

Myopic Astigmatism

Background: Laser corneal refractive surgery suits, technology and nomograms are improving with time. This may improve the refractive and visual outcomes of the patients. Objectives: To evaluate the safety, efficacy, stability, and predictability of wavefront-optimized photorefractive keratectomy and Laser-assisted in-situ keratomileusis in patients with myopia and myopic astigmatism over 1-year using WaveLight® EX500 Excimer Laser machine. Methods: In this prospective cohort study, refractive and visual outcomes in 596 eyes (365 patients), either having myopia or myopic astigmatism were assessed. Patients were divided into Two groups: 1) Patients who underwent PRK (53 eyes have myopia and 217 eyes have myopic astigmatism), 2) Patients who underwent LASIK (53 eyes have myopia and 273 eyes have myopic astigmatism). Results: At 12 months postoperatively 94.3% of the myopic patients reached their preoperative best corrected distance visual acuity at the final one year follow up visit post PRK and LASIK. In patients with myopic astigmatism who underwent LASIK and PRK, 95.2%, and 96.3% of the patients reached their preoperative best corrected distance visual acuity at the final one year follow up visit post LASIK and PRK, respectively. The efficacy and safety indices were 1.00 or more for all groups with no eye lost any line of best corrected distance visual acuity. Conclusion: Our study results confirm the excellent efficacy, safety, good predictability and stability of myopia / myopic astigmatism correction by either wavefront- optimized LASIK or PRK over 1-year follow-up without significant differences between them using the WaveLight® EX500 excimer laser system.

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Unilateral Post-LASIK Ectasia in a Topographical Normal Eye with a Slight Asymmetry in the Contralateral Eye

International Journal of Keratoconus and Ectatic Corneal Diseases ◽

10.5005/jp-journals-10025-1078 ◽

2014 ◽

Vol 3 (1) ◽

pp. 47-51

Author(s):

Marouen Berguiga ◽

Alain Saad

Keyword(s):

Visual Acuity ◽

Refractive Surgery ◽

Anterior Segment ◽

Manifest Refraction ◽

Uncorrected Visual Acuity ◽

History Of ◽

Orbscan Ii ◽

Contralateral Eye ◽

The Right ◽

Radial Axis

ABSTRACT Purpose To report a case of post-LASIK unilateral corneal ectasia. Setting Department of anterior segment and Refractive surgery, Rothschild Foundation, Paris. Case report A 33-year-old woman was referred with a history of unilateral post-LASIK ectasia in her left eye, 18 months post operatively. Her best-corrected visual acuity was 20/20 with a manifest refraction of +1.75 (–4.75 × 90). Orbscan ii® revealed an inferior steepening associated with irregular astigmatism. The preoperative Placido topographies revealed a slight skewed radial axis in the right eye associated with an inferior-superior keratometry difference of 1.6 Diopters at 3 mm. in the left eye that developed ectasia, regular symmetric astigmatism was present. Uncorrected visual acuity improved to 20/25 2 weeks after keraRing® segment insertion. How to cite this article Berguiga M, saad a, Gatinel D. Unilateral Post-LASIK Ectasia in a Topographical Normal Eye with a slight asymmetry in the Contralateral Eye. int J kerat Ect Cor Dis 2014;3(1):47-51.

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Outcomes of LASIK for Myopia or Myopic Astigmatism Correction with the FS200 Femtosecond Laser and EX500 Excimer Laser Platform

The Open Ophthalmology Journal ◽

10.2174/1874364101812010063 ◽

2018 ◽

Vol 12 (1) ◽

pp. 63-71 ◽

Cited By ~ 5

Author(s):

Muanploy Niparugs ◽

Napaporn Tananuvat ◽

Winai Chaidaroon ◽

Chulaluck Tangmonkongvoragul ◽

Somsanguan Ausayakhun

Keyword(s):

Visual Acuity ◽

Femtosecond Laser ◽

Excimer Laser ◽

Clinical Results ◽

Laser In Situ Keratomileusis ◽

Distance Visual Acuity ◽

Astigmatism Correction ◽

Full Correction ◽

One Year ◽

Myopic Astigmatism

Purpose: To evaluate the efficacy, predictability, stability and safety of laser in situ keratomileusis (LASIK) using the FS200 femtosecond laser and EX500 excimer laser platform. Methods: The outcomes of 254 eyes of 129 consecutive patients with myopia or myopic astigmatism who underwent full correction femtosecond laser-assisted LASIK at CMU LASIK Center were assessed. Pre-operative and post-operative parameters including manifest refraction, Uncorrected Distance Visual Acuity (UDVA), Best Corrected Distance Visual Acuity (BDVA), corneal topography and tomography were analyzed. The results between low to moderate myopia and high myopia were compared up to 12 months. Results: Mean pre-operative Spherical Equivalent (SE) was -5.15±2.41 Diopters (D) (range -0.50 to -11.50 D) and -0.13±0.28 D, -0.13±0.27 D, -0.13±0.28 D and -0.14±0.30 D at 1, 3, 6, and 12 months, post-operatively. At 12 months, the propor¬tion of eyes achieving UDVA ≥ 20/20 was 90.0% and ≥20/40 was 98.8%. The proportion of eyes achieving post-operative mean SE ±0.5 D, and ±1 D was 91.3%, and 98.5%. No eyes lost more than two lines of BDVA. The low to moderate myopic group had a statistically significant better UDVA at one (p=0.017) and three months (p=0.014) but no difference at six (p=0.061) and 12 months (p=0.091). The mean post-operative SE was better in low to moderate myopic group at every follow-up visit (p=0.001, 0.007, <0.001 and <0.001). Conclusion: One-year clinical results of LASIK with the FS200 femtosecond laser and EX500 excimer laser showed high efficacy, predictability, stability and safety.

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Three-year Clinical Outcomes of Aspheric Micro-monovision LASIK for Correction of Presbyopia and Myopic Astigmatism

10.21203/rs.2.15661/v2 ◽

2020 ◽

Author(s):

Fang Liu ◽

Ting Zhang ◽

Quan Liu

Keyword(s):

Visual Acuity ◽

Spherical Equivalent ◽

Distance Visual Acuity ◽

Uncorrected Distance Visual Acuity ◽

High Satisfaction ◽

Manifest Refraction ◽

Corrected Distance Visual Acuity ◽

Uncorrected Visual Acuity ◽

Registration Number ◽

Myopic Astigmatism

Abstract Background: To investigate the long-term safety and efficacy of aspheric micro-monovision LASIK for the correction of presbyopia and myopic astigmatism. Methods: In total, 114 eyes of 57 patients with a mean age of 48 ± 4.05 years (range: 43 to 62 years) who were undergoing aspheric micro-monovision LASIK treatment were enrolled. Visual acuity, manifest refraction, amplitude of accommodation, contrast sensitivity, entire eye aberrations and patients’ subjective ratings were evaluated from 1 day to 3 years postoperatively. Results: None of the eyes showed a spherical equivalent change of over 0.75 D between 3 months and 3 years, while 95% of the eyes were within ±0.50 D of the target correction of the spherical equivalent. The percentage of patients showing monocular uncorrected distance visual acuity ≥20/20 was 95%, and all eyes achieved a visual acuity of 20/25 or better. The percentage of patients showing binocular uncorrected near visual acuity ≥J2 was 93%, and all patients achieved a visual acuity of J4 or better. Ninety-one percent of the patients had an uncorrected visual acuity of 20/20 in both eyes and J2 or better binocular visual acuity. Six of 108 eyes (6%) lost 1 line, and no eyes lost 2 lines of corrected distance visual acuity. The overall satisfaction score for surgery was 93 ± 6. Conclusions: Aspheric micro-monovision LASIK using the Carl Zeiss Meditec MEL 80 Platform was an efficacious option for older myopic patients with presbyopia. Three-year postoperative outcomes in the Chinese population indicated improvements in uncorrected binocular vision at far and near distances with high satisfaction. Trial registration: The registration number is ChiCTR-IPC-15005842, and the date of registration is January 16, 2015.

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Comparative Analysis of the Wave Front Aberrations and Ophthalmoergonomic Parameters after Excimer Laser and Orthokeratological Correction of Myopia in Patients over 35 Years

Ophthalmology in Russia ◽

10.18008/1816-5095-2020-4-719-724 ◽

2020 ◽

Vol 17 (4) ◽

pp. 719-724

Author(s):

E. P. Tarutta ◽

N. V. Khodzhabekyan ◽

A. T. Khandzhyan ◽

M. D. Sengaeva ◽

S. D. Harutunyan ◽

...

Keyword(s):

Visual Acuity ◽

Comparative Analysis ◽

Excimer Laser ◽

Laser Surgery ◽

Wavefront Aberrations ◽

Accommodative Response ◽

The Difference ◽

Group 2 ◽

Special Studies ◽

Group 1

Purpose. Comparative analysis of the wavefront aberrations and ophthalmoergonomic parameters after excimer laser and orthokeratological correction of myopia in patients aged over 35 years.Patients and methods. The study included 21 patients: 12 (24 eyes) after excimer laser correction of myopia (group 1) and 9 (18 eyes) after orthokeratology (group 2). The average age of patients after excimer laser surgery was 38.5 years, after orthokeratological correction 46.1 years. Special studies included ophthalmoergonomical tests: far and near distance visual acuity, capacity of the visual analyzer, visual productivity, reading velocity, mesopic vision, relative accommodation reserves, objective accommodative response, pseudo-accommodation volume. Wavefront aberrations were conducted on the OPD-scan 3.Results. The spherical equivalent of residual refraction was –0.625 ± 0.08D in the excimer group, and –1.58 ± 0.24D in orthokeratological group. Despite the difference in refraction, values of distance binocular and monocular visual acuity were the same in both groups: in group 1 monocular visual acuity was 0.74 ± 0.03, binocular 0.85 ± 0.03; in group 2 — 0.71 ± 0.06 and 0.89 ± 0.05 respectively. The parameters of both monocular and binocular accommodative response measured on Grand Seiko were 50 % higher in the excimer group compared to those in the orthokeratological group. Relative accommodation reserves appeared to be two times more in the excimer group. The volume of pseudo-accommodation was 2.375 ± 0.12D in group 1, which appeared to be 20 % more than in the group 2 (p = 0.0414). The level of wavefront aberrations was significantly higher in orthokeratological group with the exception of vertical aberrations and, especially horizontal coma, which were significantly higher after excimer laser surgery. Generally, the dynamics of aberrations in both groups correlates with changes of the corneal topography.Conclusion. Excimer laser surgery with hypocorrection is more recommended for patients aged 35–40, and orthokeratological correction for patients over 45 years old.

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