scholarly journals Corneal Higher-Order Aberrations after Microhook ab Interno Trabeculotomy and Goniotomy with the Kahook Dual Blade: Preliminary Early 3-Month Results

2021 ◽  
Vol 10 (18) ◽  
pp. 4115
Author(s):  
Hiromitsu Onoe ◽  
Kazuyuki Hirooka ◽  
Hideaki Okumichi ◽  
Yumiko Murakami ◽  
Yoshiaki Kiuchi

We examined postoperative corneal higher-order aberrations (HOAs) present after combined phacoemulsification with either microhook ab interno trabeculotomy (μLOT-Phaco) or goniotomy, using the Kahook Dual Blade (KDB-Phaco). Retrospective study: A total of 45 eyes underwent μLOT-Phaco and KDB-Phaco (LOT-Phaco) procedures, with 21 eyes that underwent cataract surgery alone used as controls. Visual acuity and corneal HOAs, coma-like aberrations, and spherical-like aberrations were analyzed before and at 1, 2, and 3 months after the surgeries. Risk factors that could potentially influence HOAs were evaluated. No significant postoperative changes were noted for corneal HOAs, coma-like aberrations, and spherical-like aberrations after cataract surgery alone. The mean corneal HOAs, coma-like aberrations, and spherical-like aberrations were 0.222 ± 0.115 μm, 0.203 ± 0.113 μm, and 0.084 ± 0.043 μm at baseline and 0.326 ± 0.195 μm (p < 0.001), 0.302 ± 0.289 μm (p = 0.03), and 0.150 ± 0.115 μm (p < 0.001) at 3 months after LOT-Phaco, respectively. Results of the analysis for risk factors suggested that a longer incision in Schlemm’s canal could influence corneal HOAs, coma-like aberrations, and spherical-like aberrations after LOT-Phaco. Although no significant postoperative changes were observed in corneal HOAs and coma-like or spherical-like aberrations after cataract surgery alone, a significant increase in corneal HOAs and coma-like or spherical-like aberrations remained after the LOT-Phaco procedure.

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Grzegorz Łabuz ◽  
Timur M. Yildirim ◽  
Gerd U. Auffarth ◽  
Hyeck-Soo Son ◽  
Ramin Khoramnia

Abstract Background Intraocular lens (IOL) calcification is a serious condition that can only be treated by removing the clouded lens. Since explantation bears the risk of complications, it is often deferred until the patient finds the symptoms intolerable. Usually, as the IOL opacifies, visual acuity is minimally affected early on. In this study, we assessed the impact of IOL opacification on optical quality. Methods We analyzed ten opacified explanted IOLs (Oculentis GmbH). Wavefront aberrations were obtained with a SHSOphthalmic device (Optocraft GmbH), which features a Hartmann-Shack sensor. The root mean square (RMS) of higher-order aberrations (HOAs) was compared. The effect of calcification on image quality was assessed through the Strehl ratio (SR). We detected light scattering with a C-Quant (Oculus GmbH) and expressed it as a straylight parameter. Results At 2 mm, 3 mm and 4 mm, the mean RMS (±standard deviation) was 0.033 μm (±0.026 μm), 0.044 μm (±0.027), and 0.087 μm (±0.049), respectively. The mean SR value was 0.81 ± 0.15 at 3 mm, with four IOLs showing a nearly diffraction-limited performance, but in two explants, opacification precluded reliable measurements. Increased straylight was found in all opacified IOLs with a mean value of 150.2 ± 56.3 deg2/sr at 3 mm. Conclusions We demonstrated that IOL opacification induces HOAs. However, the RMS remained low, which resulted only in a slight reduction of the SR-derived optical quality. On the other hand, we found a severe straylight elevation in the opacified lenses, which may result in dysphotopsia, such as glare, and subjective complaints, despite good visual acuity.


2019 ◽  
Author(s):  
Lin Fu ◽  
Yau Kei Chan ◽  
Junhua Li ◽  
Li Nie ◽  
Na Li ◽  
...  

Abstract Background: To investigate the long term surgical outcomes of cataract surgery in severe and end glaucoma patients with preoperative intraocular pressure less than 21mmHg, and to detect the associated factors. Methods: A retrospective study of severe and end stage glaucoma patients who underwent cataract surgery or combined with goniosynechialysis from March 2015 to April 2018. Main outcome measures were visual acuity, intraocular pressure, number of glaucoma medications and complications. Results: Twenty patients (24 eyes) were included. The mean age was 64.6 ± 11.0 years and the mean followed up duration was 21.4 ± 7.3 months. The final visual acuity was significantly improved from 0.93±0.72 to 0.70±0.74, within 14 (58.3%) eyes improved, 5 (20.8%) eyes kept unchanged, and 5 (20.8%) eyes reduced. Linear regression analysis indicated that higher mean deviation, higher visual field index and lower glaucoma stage associated with greater final visual acuity improvement (r = -0.545, r = -0.501, r = 0.521 respectively). Moreover, the final number of medications were reduced from 1.1 ± 0.9 to 0.2 ± 0.5 (p < 0.01). The mean intraocular pressure was not significantly reduced with the final IOP of 13.2 ± 3.9 (6.8-25.9) mmHg (p = 0.97). While the eyes with intraocular pressure above 15 mmHg was reduced to 7 (29.2%) eyes compared to 11 (45.8%) eyes at baseline. Moreover, the number of eyes without the use of medications was increased from 6 (25%) preoperatively to 20 (83.3%) eyes postoperatively. Conclusions: Final visual acuity was significantly improved in the severe and end stage glaucoma patients and the number of eyes came off medications increased by 58.3% after cataract surgery. Preoperatively, the glaucoma stage, mean deviation and visual field index are important parameters to predict the visual acuity changes after cataract surgery.


2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Ying Yu ◽  
Wenwen Zhang ◽  
Xinliang Cheng ◽  
Jianru Cai ◽  
Hui Chen

Purpose. To evaluate decentration following femtosecond laser small incision lenticule extraction (SMILE) and sub-Bowman keratomileusis (SBK) and its impact on higher-order aberrations (HOAs). Methods. Prospective, nonrandom, and comparison study. There were 96 eyes of 52 patients who received SMILE and 96 eyes of 49 patients who received SBK in this study. Decentration was calculated 6 months after surgery with Pentacam. HOAs and visual acuity after the surgery were examined for patients in both groups before and 6 months after surgery. Results. The mean decentration displacement in SMILE group was significantly less than SBK group (P=0.020). 89 eyes were decentered within 0.50 mm after SMILE and SBK. The association between vertical decentration and the induced spherical aberration was insignificant in SMILE group (P=0.035). There was an association between decentration and safety index, efficacy index, vertical coma, spherical aberration, and HOAs in root mean square (RMS, μm) after SBK (all P<0.05). No difference was found in uncorrected and corrected distance visual acuity, safety index, efficacy index, and wavefront aberrations between the two subgroups at any delimited value after SMILE (all P>0.05). Decentration exceeding 0.37 mm affected vertical coma and RMSh of SBK eyes (P=0.002, 0.005). Conclusion. SMILE surgery achieved more accurate centration than SBK surgery. Vertical decentration is associated with the induced spherical aberration in SMILE.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khaled M Al-Boraie ◽  
Tamer M. El Mekkawy ◽  
Mohammad G Metwally ◽  
Ashraf H Soliman

Abstract Aim of the Work To compare visual acuity, refractive and topographic outcome between small incision lenticule extraction (SMILE) and wavefront-guided femtosecond laser-assisted in situ keratomileusis (WFG FS-LASIK) in patients with myopic astigmatism. Patients and methods This prospective, non-randomized, comparative clinical study included 60 eyes of 30 patients with simple or compound myopic astigmatism presenting for refractive error correction. Femtosecond assisted LASIK group included 30 eyes and SMILE group included 30 eyes. The following tests were done for all patients preoperatively and at 3 months postoperatively: full ophthalmological examination, manifest refraction, UDVA, CDVA, corneal topography using combined schimflug and placcido disc imaging namely Pentacam. (Oculus Inc.) and wavefront analysis using ATLAS 9000 (Carl Zeiss Meditec) Main Outcome Measures: Uncorrected distance visual acuity (UDVA), corrected disctance visual acuity (CDVA), manifest refraction, Efficacy, safety, predictability, corneal higher order aberrations. Results At 3 months, the mean manifest refractive spherical equivalent (MRSE) in SMILE group was -0.33 ± 0.34 D and the mean MRSE in FS- LASIK group was 0.23 ± 0.35 D and there was a statistically significant difference between both groups (P &lt; 0.05). mean postoperative cylinder was -0.56 ± 0.28 D in SMILE group and -0.53 ± 0.38D in FS-LASIK with statistically significant difference ( P = 0.254 ) 93% and 93% of eyes in the SMILE and FS-LASIK groups were within ± 0.5 D; 96.67% and 100% of eyes in the SMILE and FS-LASIK groups, respectively, were within ± 1 D. There were 86.66% of treated eyes in the SMILE group, and 93.33% treated eyes in the FS-LASIK group that had 20/25 or better UDVA. Regarding safety, the CDVA in the SMILE group, 20 eyes (66.67%) showed no change, 8 eyes (27%) gained 1 line, 2 eyes (7%) lost 1 line, and no eyes lost more than 1 line. whereas in the FS-LASIK group, 27 eyes (90%) exhibited no change, 2 eyes (6.66%) gained 1 line, 1 eye (3.33%) lost 1 line, and no eyes lost more than 1 line and There was no statistically significant difference between both groups (P = 0. 554 ). Regarding corneal asphericity, both procedures increased Q-value with no statistically significant difference between both groups (P = 0. 052). Regarding corneal higher order aberrations, both procedures significantly increased total corneal aberrations but there was no statistically significant difference in the change in RMS of total corneal higher order aberration (P = 0.434) .but SMILE increased RMS of coma aberration significantly more than FS-LASIK (P = 0. 029). Conclusion both SMILE and FS-LASIK procedures have shown excellent efficacy, safety, and predictability for the correction of myopia and myopic astigmatism. SMILE was closer to emmetropia regarding sphere and spherical equivalent, However, astigmatic undercorrection was noted after both surgeries with increased astigmatism. Both procedures increased the total corneal higher order aberrations with no statistically significant difference between both groups. A higher vertical coma was found in SMILE than WFG FS-LASIK.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Miraftab ◽  
Hassan Hashemi ◽  
Mohammadreza Aghamirsalim ◽  
Shiva Fayyaz ◽  
Soheila Asgari

Abstract Background The refractive surgeries induce corneal higher order aberrations (C-HOAs). In this study, change of C-HOAs after small-incision lenticule extraction (SMILE) compared to femtosecond assisted laser in situ keratomileusis (femto-LASIK), and to photorefractive keratectomy with mitomycin-C (PRK) under photopic and mesopic conditions. Methods In this prospective study, age, gender, and apical corneal thickness (ACT) matched cases with moderate myopia [spherical equivalent (SE) 3.00 to 6.00D) to high myopia (SE > 6.00D)] were enrolled. In addition to visual acuity and refraction, total C-HOA, coma, spherical aberration (SA), and trefoil in the 3- and 6-mm zones were measured before and 3 and 6 months after surgery. Results Overall, 372 moderate myopia cases (124 eyes of 124 individuals in each surgical group) and 171 high myopia cases (57 eyes of 57 individuals in each surgical group) were enrolled. At baseline, the differences in age, gender, ACT, uncorrected and corrected visual acuity, and SE were not statistically significant between subgroups of surgical methods within each myopia group (all P > 0.05). At 12 months, in the moderate myopia group, there was less increase in 6-mm zone total C-HOA, coma, and SA with SMILE compared to the other groups (all P < 0.05). In the high myopia group, there was greater increase in photopic total C-HOA and trefoil and less increase in mesopic SA with SMILE (all P < 0.05). Conclusions In correction of moderate myopia, SMILE has better results in mesopic condition. In high myopia correction, femto-LASIK and PRK have better results in photopic and SMILE in mesopic condition.


2007 ◽  
Vol 17 (4) ◽  
pp. 507-514 ◽  
Author(s):  
D. Wygledowska-Promienska ◽  
I. Zawojska

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.


2014 ◽  
Vol 91 (10) ◽  
pp. 1244-1250 ◽  
Author(s):  
Hongfei Ye ◽  
Keke Zhang ◽  
Jin Yang ◽  
Yi Lu

2019 ◽  
Vol 35 (2) ◽  
pp. 102-108 ◽  
Author(s):  
Paul H. Ernest ◽  
Marko Popovic ◽  
Matthew B. Schlenker ◽  
Lindsay Klumpp ◽  
Iqbal Ike K. Ahmed

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Li-Quan Zhao ◽  
Jin-Wei Cheng

Aims. To examine possible benefits of intravitreal anti-vascular endothelial growth factor (VEGF) agent treatment immediately after cataract surgery for patients with diabetic retinopathy (DR). Methods. A comprehensive literature search was performed using the Cochrane collaboration methodology to identify randomized controlled trials (RCTs) and comparative studies of cataract surgery with or without anti-VEGF agent treatment for any diabetic retinopathy. Meta-analyses were performed for clinical outcome parameters including changes in macular thickness (MT), best-corrected visual acuity (BCVA), incidence of diabetic retinopathy and maculopathy progression, laser treatment rate, and other complications. Results. Nine RCTs and 3 nonrandomized comparative studies were identified and used for comparing cataract surgery with intravitreal bevacizumab (IVB) or intravitreal ranibizumab (IVR) treatment (338 eyes, intervention group) to cataract surgery alone (329 eyes, control group). Analysis of all data showed that the mean BCVA at 1 week postoperatively had no statistically significant difference in the two groups, but at 1, 3, and 6 months postoperatively, the mean BCVA was statistically significantly better in the anti-VEGF treatment group than that in cataract surgery alone group. Analysis of all data showed that the mean MT was statistically significantly less in the anti-VEGF treatment group at 1 week and 1, 3, and 6 months postoperatively (P=0.05, P=0.006, P=0.0001, and P=0.0001, respectively); but postoperative clinical outcomes were differentiated from the type of anti-VEGF agents, IVB or IVR, and the existing macular edema preoperatively. Intravitreal anti-VEGF agent treatment statistically significantly reduced the incidence of diabetic retinopathy progression and maculopathy progression compared to the control group (P=0.0003, P<0.00001, respectively). Conclusion. IVB or IVR treatment immediately after cataract surgery may represent a safe and effective strategy to prevent postoperative macular thickening or reduce macular edema and result in greater mean improvements in visual acuity for diabetic patients.


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