Laser-Assisted in Situ Keratomileusis with Optimized, Fast-Repetition, and Cyclotorsion Control Excimer Laser to Treat Hyperopic Astigmatism with High Cylinder

2017 ◽  
Vol 27 (6) ◽  
pp. 686-693 ◽  
Author(s):  
Jorge L. Alió del Barrio ◽  
Mauro Tiveron ◽  
Ana B. Plaza-Puche ◽  
María A. Amesty ◽  
Laura Casanova ◽  
...  

Purpose To evaluate the visual outcomes after femtosecond laser-assisted laser in situ keratomileusis (LASIK) surgery to correct primary compound hyperopic astigmatism with high cylinder using a fast repetition rate excimer laser platform with optimized aspheric profiles and cyclotorsion control. Methods Eyes with primary simple or compound hyperopic astigmatism and a cylinder power ≥3.00 D had uneventful femtosecond laser-assisted LASIK with a fast repetition rate excimer laser ablation, aspheric profiles, and cyclotorsion control. Visual, refractive, and aberrometric results were evaluated at the 3- and 6-month follow-up. The astigmatic outcome was evaluated using the Alpins method and ASSORT software. Results This study enrolled 80 eyes at 3 months and 50 eyes at 6 months. The significant reduction in refractive sphere and cylinder 3 and 6 months postoperatively (p<0.01) was associated with an improved uncorrected distance visual acuity (p<0.01). A total of 23.75% required retreatment 3 months after surgery. Efficacy and safety indices at 6 months were 0.90 and 1.00, respectively. At 6 months, 80% of eyes had an SE within ±0.50 D and 96% within ±1.00 D. No significant differences were detected between the third and the sixth postoperative months in refractive parameters. A significant increase in the spherical aberration was detected, but not in coma. The correction index was 0.94 at 3 months. Conclusions Laser in situ keratomileusis for primary compound hyperopic astigmatism with high cylinder (>3.00 D) using the latest excimer platforms with cyclotorsion control, fast repetition rate, and optimized aspheric profiles is safe, moderately effective, and predictable.

2019 ◽  
Vol 30 (3) ◽  
pp. 446-454 ◽  
Author(s):  
Alfredo Vega-Estrada ◽  
Jorge L Alio

Objective: Report the outcomes of laser in situ keratomileusis (LASIK) for high myopia correction after long-term follow-up. Methods: Retrospective, consecutive, clinical study including 70 eyes that underwent LASIK using a 500 Hertz (Hz) repetition rate excimer laser and femtosecond technology for flap creation. Visual, refractive, corneal aberrations, and correlation among the variables were evaluated during 3 years. In addition, 34 eyes were followed during 5 years. Results: Significant improvement of 17 logMAR lines was observed in uncorrected vision at 5 years (p < 0.01). This was consistent with spherical equivalent reduction that came from mean preoperative –7.79 diopters (D) to 5 years postoperative –0.24 D (p < 0.01). Significant induction of primary spherical aberration and coma aberration was also found (p < 0.01) at 3 months with levels of 0.61 µm and 0.47 µm, respectively, with no further changes at 5 years (p > 0.05). Pearson correlation showed that the amount of high-order aberrations at 3 months postoperativeley was significantly correlated with the changes in the keratometry throughout the 5 years (delta K) (R2 0.242 p = 0.05). Finally, preoperative corneal asphericity showed an inverse correlation with the delta K (R2 –308 p = 0.01). Conclusions: Results from this study suggests that LASIK for high myopia correction using 500 Hz repetition rate excimer laser provides stable visual, refractive and aberrometric results after 5 years of follow-up. A more prolate cornea and the amount of higher-order aberrations induced after LASIK are factors that negatively impact in the long-term stability of the procedure.


2019 ◽  
Vol 30 (6) ◽  
pp. 1238-1245
Author(s):  
Ana B Plaza-Puche ◽  
Verónica Vargas ◽  
Pilar Yébana ◽  
Samuel Arba ◽  
Jorge L Alio

Purpose: The aim of this study is to analyze the long-term stability of the corneal topography, the functional optical zone, and the refractive stability throughout 3 years following laser in situ keratomileusis surgery for hyperopia using a 500-Hz excimer laser system. Methods: This retrospective consecutive observational case series study comprised 66 eyes that underwent laser in situ keratomileusis to correct hyperopia with a postoperative follow-up of 3 years. Laser in situ keratomileusis procedures were performed using the SCHWIND Amaris 500-Hz excimer laser. Main outcomes measured were stability of the functional optical zone at corneal topography and corneal aberrometry. Results: Statistically significant differences were found in simulated keratometry (K2 (steep meridian) and Km (mean keratometry)) between 3 and 36 months postoperatively ( p ⩽ 0.01); these differences disappeared at 12 and 36 months ( p ⩾ 0.18). No statistically significant changes were observed in the horizontal and vertical diameter of the functional optical zone throughout the whole follow-up ( p ⩾ 0.07). A statistically significant difference was found in the spherical aberration between 3 and 36 months ( p = 0.02); this difference disappeared when compared between 12 and 36 months ( p = 0.72). Statistically significant correlations were detected between the vertical functional optical zone and coma root mean square ( r = –0.510, p < 0.01) and between the vertical functional optical zone and spherical aberration ( r = 0.441, p = 0.02) 36 months after surgery. Conclusion: Following 3 years of hyperopic laser in situ keratomileusis with a 500-Hz Amaris excimer laser, keratometry, functional optical zone, and corneal aberrations remain stable from 1 year after surgery. Topographical regression is not observed in hyperopic laser in situ keratomileusis with this excimer laser technology from 1 year after surgery.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Jing Wang ◽  
Weiqian Cao ◽  
Liming Tao

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.


Cornea ◽  
2008 ◽  
Vol 27 (2) ◽  
pp. 174-179 ◽  
Author(s):  
Luca Buzzonetti ◽  
Gianni Petrocelli ◽  
Paola Valente ◽  
Ciro Tamburrelli ◽  
Luigi Mosca ◽  
...  

2014 ◽  
Vol 5 (3) ◽  
pp. 423-428 ◽  
Author(s):  
Iraklis Vastardis ◽  
Zisis Gatzioufas ◽  
Brigitte Eggspühler Pajic ◽  
Jörg Müller ◽  
Bojan Pajic

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.


2018 ◽  
Vol 103 (4) ◽  
pp. 565-568 ◽  
Author(s):  
Tian Han ◽  
Ye Xu ◽  
Xiao Han ◽  
Li Zeng ◽  
Jianmin Shang ◽  
...  

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.


Sign in / Sign up

Export Citation Format

Share Document