scholarly journals Outcomes of Refractive Surgery Consultations at an Academic Center: Characteristics Associated with Proceeding (or Not Proceeding) with Surgery

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Irene C. Kuo ◽  
Benjamin Lee ◽  
Jiangxia Wang
Keyword(s):  
Refractive Surgery ◽  
Laser In Situ Keratomileusis ◽  
Spherical Equivalent ◽  
Implantable Collamer Lens ◽  
High Patient Satisfaction ◽  
Academic Center ◽  
Johns Hopkins University ◽  
Technological Limitations

Objective. Refractive surgery volume has not rebounded despite economic recovery and literature describing safety, efficacy, and high patient satisfaction. We sought to examine characteristics of consultation seekers and status after consultation. Methods. Charts of patients seeking refractive surgery at Johns Hopkins University from 2013 through 2016 were retrospectively reviewed for age, gender, refractive characteristics, and outcome: surgery (photorefractive keratectomy, laser in-situ keratomileusis, implantable collamer lens, or refractive lens exchange); no surgery—“lost candidate” (good candidates who were lost after consultation); noncandidates based on technological limitations or contraindications; or no surgery—possessing expectations that surgery would not meet. Associations between characteristics and status after consultation were examined. Results. Twenty percent (142/712) of all patients were “lost candidates”; 57% (408/712) completed surgery. More women (56% or 401/712) sought consultation, but a greater percentage (63% or 195/311) of men completed surgery than women did (53% or 213/401) p=0.02. Of consultation seekers, 60% were low myopes, 29% were high myopes (>6 diopters of myopic spherical equivalent), and 11% were hyperopes. Surgical patients’ mean age was 34.2 ± 10.2 (standard deviation) years; for each additional year of age, patients were less likely to have surgery p<0.001. Hyperopes were ≥3 times more likely than myopes to have expectations not met by surgery or to be noncandidates than to have surgery p<0.005. Conclusions. Most patients seeking refractive surgery had 6 diopters or less of myopia. About 20% of patients were lost after consultation; better counseling and follow-up of candidates may be warranted. Expectations and technology limit eligibility for many, especially hyperopes. Low surgery volume may affect training of future refractive surgeons.

scholarly journals Comparison of Intraocular Pressure before and after Laser In Situ Keratomileusis Refractive Surgery Measured with Perkins Tonometry, Noncontact Tonometry, and Transpalpebral Tonometry

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Isabel Cacho ◽  
Juan Sanchez-Naves ◽  
Laura Batres ◽  
Jesús Pintor ◽  
Gonzalo Carracedo
Keyword(s):  
Intraocular Pressure ◽  
Refractive Surgery ◽  
Corneal Thickness ◽  
Laser In Situ Keratomileusis ◽  
Spherical Equivalent ◽  
Transpalpebral Tonometry ◽  
Spherical Equivalent Refraction ◽  
Before And After ◽  
Noncontact Tonometry

Purpose. To compare the intraocular pressure (IOP) before and after Laser In Situ Keratomileusis (LASIK), measured by Diaton, Perkins, and noncontact air pulse tonometers.Methods. Fifty-seven patients with a mean age of 34.88 were scheduled for myopia LASIK treatment. Spherical equivalent refraction (SER), corneal curvature (K), and central corneal thickness (CCT) and superior corneal thickness (SCT) were obtained before and after LASIK surgery. IOP values before and after surgery were measured using Diaton, Perkins, and noncontact air pulse tonometers.Results. The IOP values before and after LASIK surgery using Perkins tonometer and air tonometers were statistically significant (p<0.05). However, no significant differences were found (p>0.05) for IOP values measured with Diaton tonometer. CCT decreases significantly after surgery (p<0.05) but no statistical differences were found in SCT (p=0.08). Correlations between pre- and postsurgery were found for all tonometers used, withp=0.001andr=0.434for the air pulse tonometer,p=0.008andr=0.355for Perkins, andp<0.001andr=0.637for Diaton.Conclusion. Transpalpebral tonometry may be useful for measuring postsurgery IOP after myopic LASIK ablation because this technique is not influenced by the treatment.

The Effect of Astigmatism Axis on Visual Acuity

2016 ◽  
Vol 27 (3) ◽  
pp. 308-311 ◽  
Author(s):  
Michael Mimouni ◽  
Achia Nemet ◽  
Russell Pokroy ◽  
Tzahi Sela ◽  
Gur Munzer ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Refractive Surgery ◽  
Laser In Situ Keratomileusis ◽  
Stepwise Multiple Regression ◽  
Spherical Equivalent ◽  
Tel Aviv ◽  
Uncorrected Distance Visual Acuity ◽  
Laser Refractive Surgery ◽  
Better Than

Purpose To evaluate the effect of astigmatism axis on uncorrected distance visual acuity (UDVA) in emmetropic eyes that underwent laser refractive surgery. Methods This retrospective study included patients who underwent laser in situ keratomileusis or photorefractive keratectomy between January 2000 and December 2015 at the Care-Vision Laser Centers, Tel Aviv, Israel. Eyes with a 3-month postoperative spherical equivalent between -0.5 D and 0.5 D were included in this study. Eyes with ocular comorbidities and planned ametropia were excluded. Study eyes were divided into 3 groups according to the steep astigmatic axis: with the rule (WTR) (60-120), oblique (31-59 or 121-149), and against the rule (ATR) (0-30 or 150-180). The UDVA of these 3 groups was compared. The oblique group was divided into oblique ATR and oblique WTR, which were compared with each other. Results A total of 17,416 consecutive eyes of 8,708 patients were studied. The WTR eyes (n = 10,651) had significantly better UDVA (logMAR 0.01 ± 0.08) than the oblique (n = 3,141, logMAR 0.02 ± 0.09) and ATR eyes (n = 3,624, logMAR 0.02 ± 0.10) (p<0.001). The oblique WTR group had significantly better UDVA than the oblique ATR group (p<0.001). The UDVA of the oblique and ATR groups was similar. Stepwise multiple regression analysis showed that the group accounted for 15% of the UDVA variance (p = 0.04). Conclusions The astigmatic axis has a small but significant effect on UDVA in emmetropic eyes; WTR was better than oblique and ATR astigmatism. Therefore, when correcting astigmatism, it may be preferable to err towards WTR astigmatism.

scholarly journals Comparison of Accommodation and Accommodative Micro-Fluctuation After Implantable Collamer Lens and LASIK Surgery for Myopia

2021 ◽  
Author(s):  
Li Li ◽  
Bo Zhang ◽  
Zheng Wang
Keyword(s):  
Frequency Component ◽  
Ciliary Muscle ◽  
Laser In Situ Keratomileusis ◽  
High Frequency Component ◽  
Implantable Collamer Lens ◽  
Positive Correlation ◽  
Structural Evaluation ◽  
Icl V4c

Abstract Background: To longitudinally analyze and compare the accommodative micro-fluctuation (MFs) and accommodative function between myopic patients after implantable collamer lens (ICL) implantation and laser in situ keratomileusis (LASIK).Methods: Patients with good corrected visual acuity (20/20 or better) that underwent ICL (V4c) and LASIK for myopic-correction (ranging from -3.50 to -8.50 D) were recruited. Refraction, amplitude of accommodation (AMP), accommodative lags, high-order aberrations (HOAs), and MFs were recorded before surgery and 1 and 3 months after surgery. The ACOMEREF automatic refractor was used to measure the high-frequency component (HFC) of the MFs, which suggested tension of the ciliary muscle.Results: The study comprised 120 eyes. At 3 months after surgery, the manifest refractive spherical equivalent of the ICL and LASIK groups were -0.11 and -0.09 D, respectively (p = 0.46). HFC values were significantly higher at 1 month (p = 0.03) and 3 months postoperatively (p = 0.03) in the ICL group compared to that in the LASIK group. The ocular HOAs of the ICL group was 1.08 ± 0.43 μm, which was lower than the LASIK group 1.45 ± 0.54 μm (p = 0.01). No significant differences in AMP and accommodative lags between groups were noted at 3 months postoperatively. There was a positive correlation between HFC and vault of the ICL lens (r2 = 0.14, p = 0.005). There were no correlations between HFC and HOAs and postoperative MRSE in the two groups (all p﹥0.05).Conclusions: The HFC increased significantly after ICL implantation compared to laser in situ keratomileusis for myopic correction, which indicated increased tension of the ciliary muscle, and had a positive correlation on the vault of the ICL lens; However, studies with longer follow-up time and more structural evaluation are needed.

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 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 Long-term Outcomes of Femtosecond Laser-assisted Laser in situ Keratomileusis for Anisometropic Amblyopia in Children with Hyperopia

2018 ◽  
Vol 15 (2S) ◽  
pp. 46-51
Author(s):  
I. L. Kulikova ◽  
N. V. Chapurin
Keyword(s):  
Refractive Surgery ◽  
Functional Results ◽  
Laser In Situ Keratomileusis ◽  
Spherical Equivalent ◽  
Long Term Outcomes ◽  
Fellow Eye ◽  
Anisometropic Amblyopia ◽  
General Period

Objective: analysis of remote clinical functional results of femtolaser-assisted laser in situ keratomileusis (FS-LASIK) in children with hyperopia and anisometropic amblyopia.Patients and methods: 30 children aged 5–13 (7.9 ± 2.3) years were in the study. FS-LASIK refined technology surgery was rendered to all children under general anesthesia at amblyopic eye, previously they had no success of conservative treatment. Mean spherical equivalent of refraction (SE) of amblyopic eye was +5,08 ± 1.64 D in conditions of cycloplegia. Mean SE anisometropia was 3,42 ± 1.92 D, difference in refraction between eyes was statistically significant (pmu = p < 0,001) in all patients. There was 43.3% of severe amblyopia, 56.7% cases of moderate amblyopia. General period of control was 5 years.Results: In 5 years after FS-LASIK SE of operated eye was +1.02 ± 0.28 D, predictability of refractive effect within ±0.5 D was 47%, ±1.0 D was 77% of cases. All patients gained 1–5 lines, UDVA was 0,5 and higher in 61% of cases. There were 6.7% of cases with moderate amblyopia, mild –80%, and amblyopia absence –13.3 % of cases. SE anisometropia decreased 2,37 ± 1.17 and was 0,18 ± 1.05 D, difference between operated and fellow eye was minor, but statistically significant (pmu = p < 0,05). Trend to myopisation of fellow eye was revealed.Conclusion: remote clinical functional results of FS-LASIK in correction of hyperopic anisometropia in children show safety and efficacy of interference. Refractive surgery in children should be considered not as an independent method of treatment, but in complex with conservative methods of amblyopia treatment. 

A quality of life assessment of military recruits after refractive surgery

2020 ◽  
Vol 1 (1) ◽  
pp. 42-46
Author(s):  
Jian-He Xiao ◽  
◽  
Shi-Yang Li ◽  
Xing Xing ◽  
Ai-Hong Zhao ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Refractive Error ◽  
High Myopia ◽  
Refractive Surgery ◽  
Laser In Situ Keratomileusis ◽  
Significant Difference ◽  
Lenticule Extraction ◽  
Postoperative Interval

AIM: To evaluate the quality of life of recruits after refractive surgery. METHODS: Population-based, cross-sectional study. Using the Quality of Life Impact of Refractive Correction (QIRC) questionnaire, the quality of life in 615 recruits underwent refractive surgery was evaluated. The overall score and each question score of QIRC were compared between subgroups of different strength of preoperative refractive error, postoperative interval, type of surgical procedure and postoperative recovery. RESULTS: The mean overall QIRC score of recruits underwent refractive surgery was 49.15±7.89. Significant difference was found for strength of preoperative refractive error (F=4.16, P<0.05), with the low myopia group (50.67±7.59) had significantly better scores than those with high myopia (47.57±7.52, F=4.16, P<0.05). Recruits after a postoperative interval no more than 6mo (49.18±7.86) scored equally to those of more than 6mo (49.18±8.03). Recruits underwent surface ablation surgery scored lowest (46.68±6.09), but showed no significant difference when compared with all underwent refractive surgery (t=1.99, P>0.05). Scores of recruits underwent mechanical microkeratome laser in situ keratomileusis (MK-LASIK), Sub-Bowman’s keratomileusis (SBK), femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK), femtosecond lenticule extraction (ReLEx flex) or small-incision lenticule extraction (ReLEx SMILE) procedure showed no significant difference too. Recruits had adverse complaints postoperatively (45.85±6.66) scored lower when compared with all underwent refractive surgery (t=5.28, P<0.01). CONCLUSION: The quality of life of recruits after refractive surgery was good except those with postoperative complications. Preoperative low myopia recruits had better quality of life than medium and high myopia ones.

scholarly journals Posterior-Chamber Phakic Intraocular Lens Implantation in Patients over 40 Years of Age

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Pedro Tañá-Rivero ◽  
Francisco Pastor-Pascual ◽  
Marceliano Crespo ◽  
José L. Rodríguez-Prats ◽  
José J. Muñoz-Tomás ◽  
...  
Keyword(s):  
Crystalline Lens ◽  
Posterior Chamber ◽  
Spherical Equivalent ◽  
Efficacy And Safety ◽  
Phakic Intraocular Lens ◽  
Implantable Collamer Lens ◽  
Lens Implantation ◽  
Over 40 Years ◽  
Myopic Astigmatism

Purpose. To assess the efficacy, safety, and predictability of the Visian Implantable Collamer Lens (ICL) model having a central port in patients over 40 years of age. Methods. This study included 33 eyes from 21 patients who underwent V4c ICL implantation for the correction of myopia and myopic astigmatism. We assessed uncorrected (UDVA) and corrected (CDVA) distance visual acuity, refraction, intraocular pressure (IOP), endothelial cell density (ECD), vault, and adverse events occurring over a 1-year period. Results. Mean age of the patients at the time of implantation was 43.52 ± 4.49 years (range: 40 to 56 years). Efficacy and safety indexes were 1 and 1.09, respectively. Surgical outcomes for CDVA were as follows: no eye lost any lines, 19 eyes (57.58%) showed no CDVA changes, 7 eyes (21.21%) gained 1 line, 4 eyes (12.12%) gained 2 lines, and 3 eyes (9.09%) gained ≥3 lines. Mean postoperative spherical equivalent (SE) was −0.09 ± 0.47 D. A total of 29 eyes (87.8%) were within ±0.50 D and 31 eyes (93.9%) were within ±1.00 D of the desired SE. At 1-year, mean IOP was 15.27 ± 3.03 mmHg (range: 9 to 20 mmHg, p=0.12 pre vs. post) and mean ECD was 2516 ± 234 cells/mm2 (p=0.29 pre vs. post). Mean postoperative vault was 320 ± 136 μm, with 201–300 μm being the most prevalent vault range for 9 eyes (31.03%). None of the eyes showed a vault >701 μm. There were neither intraoperative nor postoperative complications; in fact, all ICL implantation procedures were uneventful. Conclusions. Our study’s findings support the use of this lens in patients over 40 years of age. A long follow-up period is advisable to monitor ICL position relative to the crystalline lens.

scholarly journals The Incidence of Central Serous Chorioretinopathy after Photorefractive Keratectomy and Laser In Situ Keratomileusis

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Majid Moshirfar ◽  
Maylon Hsu ◽  
Julia Schulman ◽  
Joseph Armenia ◽  
Shameema Sikder ◽  
...  
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Refractive Surgery ◽  
Chart Review ◽  
Previous History ◽  
Laser In Situ Keratomileusis ◽  
Photorefractive Keratectomy ◽  
Causal Association ◽  
History Of ◽  
Low Incidence

Purpose. To assess the incidence of central serous chorioretinopathy (CSCR) following laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK).Methods. A chart review was performed to identify all patients with CSCR and a previous history of LASIK or PRK.Results. Over the 6-year study period, 1 of 4,876 eyes which had LASIK or PRK at the Moran Eye Center was diagnosed with CSCR. One other patient was referred from an outside center, developed CSCR symptoms one month after PRK. Both patients were managed conservatively with a final visual acuity of 20/20 or better. All other patients presented 4 or more years after refractive surgery.Conclusions. We report the first 2 CSCR cases developing within one month after PRK. The low incidence argues against a causal association. Topical corticosteroids or anxiety may elevate cortisol levels presenting therapeutic challenges for the management of CSCR after PRK or LASIK.

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