scholarly journals Correction of Myopia and Myopic Astigmatism by Femtosecond Laser in Situ Keratomileusis

2019 ◽  
Vol 75 (2) ◽  
pp. 65-71
Author(s):  
Tereza Řeháková ◽  
Věra Veliká ◽  
Naďa Jirásková
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
High Myopia ◽  
Laser In Situ Keratomileusis ◽  
Patient’S Satisfaction ◽  
The Mean ◽  
One Year ◽  
Myopic Astigmatism

Aim: We analysed one-year refractive results and the incidence of complications in patients with correction of low-to-high myopia or myopic astigmatism by femtosecond laser in situ keratomileusis (FS-LASIK) using femtosecond laser LenSx® (Alcon, Fort Worth, Texas, USA) a excimer laser Excimer Amaris 500 (Schwind eye-tech-solutions GmbH and Co KG, Kleinostheim, Germany). Methods: To the retrospective study were included 171 eyes of 87 patients (38 men, 49 women) who underwent correction of myopia and myopic astigmatism by FS-LASIK in the outpatient Department of Ophthalmology, University Hospital in Hradec Králové between 2013-2017. We assessed uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA), subjective refraction, central corneal thickness (CCT) in the thinnest point, patient’s satisfaction and the incidence of complications in the one-year follow-up period. Results: At the time of laser procedure the mean patient‘s age was 29,26 ± 6,47 years (range 18 to 46 years). In 21 eyes was corrected myopia (range -6,5 to -2,5 D sph) and in 150 eyes myopic astigmatism (range -8,75 to -0,25 D sph and -3,0 to -0,25 D cyl). The mean preoperative UCVA 0,06 ± 0,08 (range 0,02 to 0,8) got better to 1,12 ± 0,17 (range 0,8 to 1,5) at the end of follow-up period. There wasn’t statistically significant change in BCVA between preoperative and postoperative values. Preoperative mean value of subjective refraction was -4,14 ± 1,43 D sph (range -8,5 to -1 D sph) and -0,57 ± 0,58 D cyl (range -3 to 0 D cyl) and after 12 months -0,02 ± 0,16 D sph (range -0,1 to 0,75 D sph) and -0,01 ± 0,1 D cyl (range -0,5 to 0,5 D cyl). The initial mean CCT was 554,76 ± 30,07 μm (range 485 to 660 μm), after 6 months 494,06 ± 34,99 μm (range 421 to 594 μm) and after 12 months 492,92 ± 34,55 μm (range 411 to 592 μm). We observed peroperative complications in 3 eyes. The suction loss of femtosecond laser occurred during flap creation due to sudden eye movement. Postoperatively in one case we enrolled flap pucker first postoperative day. In other case flap dislocation occurred after abdonimal surgery under general anesthesia which was performed 3 months after refractive procedure and we had to indicate flap reposition. The mean grade of patient’s satisfaction was at the end of follow-up period 1,04. The most often complaints were the sensation of dry eye (10 patients) and blurry vision during computer working, inadequate lighting and fatique (6 pacients). Conclusions: According to our experience correction of low-to-high myopia or myopic astigmatism by using FS-LASIK is an effective, relatively safe and predictable method. The basic assumption of good postoperative results and patient’s satisfaction is thorough and comprehensive preoperative examination with respect to indication criteria.

scholarly journals Three-year outcomes of small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for myopia and myopic astigmatism

2018 ◽  
Vol 103 (4) ◽  
pp. 565-568 ◽  
Author(s):  
Tian Han ◽  
Ye Xu ◽  
Xiao Han ◽  
Li Zeng ◽  
Jianmin Shang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Laser In Situ Keratomileusis ◽  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Lenticule Extraction ◽  
Myopic Astigmatism

AimsTo compare long-term clinical outcomes following small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for myopia and myopic astigmatism correction.MethodsIn this retrospective study, we enrolled a total of 101 patients (101 eyes) who underwent SMILE or FS-LASIK 3 years prior. Measured parameters included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction and corneal wavefront aberrations.ResultsNo significant differences in patient characteristics were found between the two groups. At the 3-year follow-up, UDVA was better than or equal to 20/20 in 90% and 85% (p=0.540) of the eyes; the efficacy indexes were 1.05±0.19 and 1.01±0.21 in the SMILE and FS-LASIK groups, respectively (p=0.352). Safety indexes were 1.19±0.17 and 1.15±0.20 in the SMILE and FS-LASIK groups, respectively (p=0.307). Eighty per cent and 65% of eyes were within ±0.50 D of the attempted spherical equivalent correction after SMILE and FS-LASIK, respectively (p=0.164). Vector analysis revealed no significant differences in astigmatic correction between the two groups (p>0.05). Surgically induced spherical aberration was higher in the FS-LASIK group than in the SMILE group (p<0.001).ConclusionLong-term follow-up analysis suggested that both SMILE and FS-LASIK were safe and equally effective for myopic and astigmatic correction.

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

2018 ◽  
Vol 12 (1) ◽  
pp. 256-263 ◽  
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.

scholarly journals Five year refractive outcome of LASIK for myopia and myopic astigmatism in Vietnam

2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Thanh Ngoc Dan Pham
Keyword(s):  
Refractive Surgery ◽  
Laser In Situ Keratomileusis ◽  
Ho Chi Minh City ◽  
Refractive Outcome ◽  
Vietnamese Population ◽  
The Mean ◽  
Myopic Astigmatism

Purpose: To assess the long-term refractive outcome of laser in situ keratomileusis (LASIK) for myopia and myopic astigmatismDesign:  An observational, single center, multisurgeon case seriesMethods: This study was a follow up study of 128 patients contacted to return for repeat investigation post refractive surgery. It included 245 eyes of 128 patients who underwent LASIK for myopia or myopic astigmatism at the Ho Chi Minh City Eye Hospital, Vietnam in 2008. Surgical parameters as well as patient data at presentation, three months and five years after surgery were analyzed. The main outcome was spherical equivalent (SE) within ± 0.5D at 5 years. Results: At the fifth year follow up, 80% of eyes were within ± 0.5D and 98% of eyes were within ± 1.0D of emmetropia. No eyes underwent laser enhancement prior to the last visit although the retreatment criteria was met in 45 eyes (18.4%). The mean SE decreased from 0.16 ± 0.33 at 3 months to -0.07 ± 0.50 at 5 years for the whole cohort. Patients with severe myopia were most susceptible to myopic regression and had a less predictable refractive outcome. The overall UCVA of 20/20 or better and of 20/40 or better were obtained in 68.2% and 95.1% of eyes. Fourteen eyes (5.7%) improved 1 line of BCVA. Forty two eyes (17.1%) lost 2 lines of BCVA which were unrelated to laser complications.Conclusion: Although there was myopic regression over time, LASIK provided excellent  5 year refractive outcome for myopia and myopic astigmatism.  Almost 20% of patients meet criteria for retreatment but do not seek a retreatment in this Vietnamese population.

scholarly journals Clinical Outcomes of Single-Step Transepithelial Photorefractive Keratectomy and Off-Flap Epipolis-Laser in Situ Keratomileusis in Moderate to High Myopia: 12-Month Follow-Up

2021 ◽  
Author(s):  
Yunjie Zhang ◽  
Tiankun Li ◽  
Zhangliang Li ◽  
Mali Dai ◽  
Qinmei Wang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
High Myopia ◽  
Single Step ◽  
Self Control ◽  
Laser In Situ Keratomileusis ◽  
Photorefractive Keratectomy ◽  
Group 3

Abstract Background To compare the quantitative and qualitative optical outcomes of single-step transepithelial photorefractive keratectomy (TPRK) and off-flap epipolis-laser in situ keratomileusis (Epi-LASIK) in moderate to high myopia. Methods In this prospective self-control study, we included patients with moderate to high myopia who were randomized to undergo TPRK in one eye and Epi-LASIK in the other eye. Twelve-month follow-up results for visual acuity, refraction, ocular high-order aberrations, contrast sensitivity, postoperative pain, epithelial healing, and haze grade were assessed. Results A total of 64 eyes (32 patients) were enrolled in the study. More eyes completed re-epithelialization in the TPRK group than in the Off-flap Epi-LASIK group 3–4 days postoperatively, while all eyes completed re-epithelialization by seven days. More eyes achieved a visual acuity (both UDVA and CDVA) of better than 20/20 in the TPRK group than in the Off-flap Epi-LASIK group. The ± 0.50 D predictability for correction of the spherical equivalent (SE) was higher in the eyes of the TPRK group (91%) than in those of the off-flap Epi-LASIK group (80%) 12 months after surgery. No significant differences in ocular aberrations, including coma, spherical, and trefoil, were found between the two groups at 12 months. There were also no significant differences in visual acuity, contrast sensitivity, pain, and haze grading between the two groups. Conclusions Both TPRK and off-flap Epi-LASIK are safe, effective, and predictable treatments for moderate to high myopia with comparable surgical outcomes. Trial registration: This study was retrospectively registered on ClinicalTrial.gov (NCT05060094, 17/09/2021).

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

2018 ◽  
Vol 12 (1) ◽  
pp. 63-71 ◽  
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.

scholarly journals Effect of Transepithelial Photorefractive Keratectomy without Mitomycin C in the Treatment of Femtosecond Laser In Situ Keratomileusis Corneal Flap Complications

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jing Wang ◽  
Weiqian Cao ◽  
Liming Tao
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Mitomycin C ◽  
Laser In Situ Keratomileusis ◽  
Photorefractive Keratectomy ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Haze Formation

Purpose. To assess the efficacy and safety of transepithelial photorefractive keratectomy (TPRK) without mitomycin C as treatment for femtosecond laser in situ keratomileusis (FS-LASIK) corneal flap complications. Methods. Eight patients with corneal flap complications that occurred after FS-LASIK (five with eccentric flaps, two with buttonhole flaps, and one with a thick flap) were included in the study. Patients were treated with TPRK without mitomycin C between two weeks and twelve months after surgery. The postoperative manifest refraction, uncorrected distance visual acuity, and haze formation were assessed during six months of follow-up. Results. The mean manifest refractive spherical and cylinder refraction was 0.16 ± 0.26 and −0.44 ± 0.33 diopters, respectively, at six months postoperatively. The uncorrected distance visual acuity was above 20/25 in all patients after six months of follow-up. No haze formation was detected. Conclusions. TPRK without mitomycin C appears to be a safe and effective treatment for FS-LASIK corneal flap complications.

scholarly journals Optical and visual quality comparison of implantable collamer lens and femtosecond laser assisted laser in situ keratomileusis for high myopia correction

2021 ◽  
Vol 14 (5) ◽  
pp. 737-743
Author(s):  
Zheng Jiang ◽  
◽  
Dong-Qiang Luo ◽  
Jiao Chen ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Clinical Outcomes ◽  
High Myopia ◽  
Cutoff Frequency ◽  
Laser In Situ Keratomileusis ◽  
Spherical Equivalent ◽  
Implantable Collamer Lens ◽  
Significant Difference

AIM: To compare clinical outcomes and refractive stability of implantable collamer lens (ICL) implantation and femtosecond laser assisted laser in situ keratomileusis (FS-LASIK) for high myopia correction. METHODS: The Optical Quality Analysis System (OQAS) was used to evaluate clinical outcomes objectively after operation for high myopia correction. We compared the two procedures in terms of 1-year changes in uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), safety index, efficacy index, spherical equivalent, modulation transfer function (MTF) cutoff frequency, strehl ratio (SR) and objective scatter index (OSI). RESULTS: At 1y postoperatively, the safety indices were 1.33±0.27 in ICL group, and 1.17±0.24 in FS-LASIK group. 39.58% in the ICL group and 27.59% in the FS-LASIK group gained CDVA in 2 lines or better than that in preoperative CDVA. The efficacy indices were 1.28±0.22 in ICL group, and 1.13±0.26 in FS-LASIK group. The changes of spherical equivalent from 1wk to 1y postoperatively was -0.12±0.37 D in ICL group, and -0.79±0.58 D in FS-LASIK group (P&#x003C;0.05). Spherical equivalent within ±0.50 D was achieved in 97.92% in ICL group and 68.97% in FS-LASIK group. MTF cutoff frequency were higher with ICL as compared to FS-LASIK (P&#x003C;0.05) at each postoperative follow-up stage; for postoperative 1mo later, SR was statistically significant difference between two groups (P&#x003C;0.05); with no statistically significant difference in OSI between two groups (P&#x003E;0.05) in postoperative 3mo later. CONCLUSION: ICL implantation and FS-LASIK procedures both provide good safety and predictability in high myopia correction. ICL implantation provides better clinical outcomes and refractive stability than FS-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 Correction of Myopic Astigmatism with Topography-Guided Laser In Situ Keratomileusis (TOPOLINK)

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 477
Author(s):  
Pei-Lun Wu ◽  
Chia-Yi Lee ◽  
Han-Chih Cheng ◽  
Hung-Yu Lin ◽  
Li-Ju Lai ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Laser In Situ Keratomileusis ◽  
Primary Group ◽  
Chi Square ◽  
Chi Square Test ◽  
One Year ◽  
Myopic Astigmatism

We aim to assess the feasibility of topography-guided laser in situ keratomileusis (TOPOLINK) for correcting pre-existing and surgical-induced astigmatism. A retrospective, single center cohort study was conducted. Patients with pre-existing irregular myopic astigmatism were recruited into the primary group and those with irregular myopic astigmatism following laser in situ keratomileusis (LASIK) were recruited into the enhancement group. The changes in uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), maximum astigmatism, spherical equivalent (SE) and patient satisfaction were recorded. The Chi-square test, Mann–Whitney U test and Generalized Linear Mixed Model were utilized for the analysis in the current study. A total of 18 eyes were studied in the primary group and 14 eyes were examined in the enhancement group. One year postoperatively, the UCVA, BCVA, maximum astigmatism and SE improved significantly in both the primary and the enhancement groups (all p < 0.05). The UCVA (p = 0.046) and SE (p = 0.003) were worse in the primary group preoperatively but became similar in both groups postoperatively, while the BCVA and maximum astigmatism remained identical between groups throughout the study period (all p < 0.05). In addition, the rate of high and moderate satisfaction reached 90.0% in the primary and the enhancement groups, without significant differences (p = 0.871). In conclusion, the TOPOLINK showed high predictability and will contribute to similar outcomes between primary and postoperative irregular myopic astigmatism concerning visual acuity, refractive status and subject satisfaction.

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