scholarly journals Features of Femtosecond Correction of High Myopia through Small Access

2019 ◽  
Vol 4 (4) ◽  
pp. 102-107
Author(s):  
O. V. Pisarevskaya ◽  
A. G. Shchuko ◽  
T. N. Iureva ◽  
E. M. Balgirova ◽  
T. N. Frolova ◽  
...  
Keyword(s):  
Visual Acuity ◽  
High Myopia ◽  
Operation Smile ◽  
Uncorrected Visual Acuity ◽  
Flap Thickness ◽  
Optical Zone ◽  
Optical Layer ◽  
High Degree ◽  
Cornea Thickness

Aim. To modify the calculated parameters of the lenticle extraction refractive surgery through a small access (SMILE), evaluate its safety and clinical efficacy in correcting high myopia.Materials and methods. 34 patients (68 eyes) underwent surgery by a modified SMILE technology under local anesthesia. In all cases, the patients had a high degree of myopia, in 37 % in combination with astigmatism.Uncorrected visual acuity before surgery averaged 0.05 ± 0.11, best corrected visual acuity of 0.94 ± 0.1, the pre-operative spherical refraction component was –7.23 ± 0.75, the cylindrical component was –0.48 ± 0.59.During the operation, to obtain the maximum possible refraction result using the proposed method, the standard operation parameters were changed: the corneal flap thickness was reduced to 100 μm, the neural optical layer by 5 μm, the diameter of the optical zone depended on the residual cornea thickness, which should exceed 280–290 μm. Corneal access was increased by 15–20 degrees.Results. The next day after surgery, monocular uncorrected visual acuity in distance in 73 % of patients was 0.8 or higher, and in 41 % of cases it was equal to or exceeded 1.0. The spherical equivalent on the first day after surgery had a slight hypermetropic shift, which was completely leveled by the year of follow-up. During the surgical intervention and in the postoperative period, no complications were noted.Conclusion. Using the proposed algorithm for calculating the refractive effect of the operation SMILE with a high degree of myopia allows obtaining a high refractive effect and avoiding possible complications.

scholarly journals Two Years’ Experience in Keratoconus Treatment using Collagen Cross-linking

2017 ◽  
Vol 6 (1) ◽  
pp. 11-13
Author(s):  
Dimitrii Dementiev ◽  
Maria Sysoeva ◽  
Anna Shipunova
Keyword(s):  
Visual Acuity ◽  
Cross Linking ◽  
Stage Of Disease ◽  
Central Cornea ◽  
Uncorrected Visual Acuity ◽  
Keratorefractive Surgery ◽  
Cornea Thickness ◽  
Central Cornea Thickness ◽  
Collagen Cross Linking

ABSTRACT Purpose To evaluate safety, efficacy, and stability of cross-linking (CLX) procedure as a method for keratoconus treatment in the I and II stage of disease. Materials and methods Twenty eyes of 15 patients (13 males, 2 females, average age 31 years) with keratoconus I stage (13 eyes) and II stage (2 eyes) (by Krumeich classi­fication) were treated by CLX procedure, using riboflavin Medio Cross for standard CLX); riboflavin Medio Cross TE for transepithelial CLX was used to treat keratectasia after previous keratorefractive surgery; in all the cases UV CBM X linker (Vega, CSO) was used. The study included evaluation of uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA) pre- and postoperative, pachymetry (central cornea thickness) (Visante OCT, Zeiss) pre- and postoperative, total astigmatism pre- and postoperative, using keratotopography (Atlas, Zeiss). Diagnosis and analysis have been performed at the International Center for Ophthalmology in Moscow, Russian ­Federation, since 2012 to 2014 years. Follow-up period was from 1 to 24 months. Results Average UCVA preoperative was 0.4 (Decimal), and average BCVA was 0.64. Average UCVA postoperative was 0.49; average BCVA was 0.66. Total astigmatism preoperative was 2.81 D; total astigmatism postoperative 2.80 D. Central cornea thickness (CCT) preoperative 454 mkm; CCT post­operative 447 mkm. Conclusion Cross-linking indicated safety, stability, and efficacy for treatment of I and II stage keratoconus at the end of follow-up period. Cross-linking is not effective in the treatment of II and III stage of disease. Further study is required. How to cite this article Dementiev D, Sysoeva M, Shipunova A. Two Years’ Experience in Keratoconus Treatment using Collagen Cross-linking. Int J Kerat Ect Cor Dis 2017;6(1):11-13.

scholarly journals Bandage Therapeutic-Optical Keratoplasty in Keratoconus Patients after Intrastromal Corneal Segments Implantation

2019 ◽  
Vol 16 (3) ◽  
pp. 283-288
Author(s):  
G. A. Osipyan ◽  
V. M. Sheludchenko ◽  
N. Y. Youssef ◽  
Kh. Khraystin
Keyword(s):  
Visual Acuity ◽  
Past History ◽  
Functional Results ◽  
Intrastromal Corneal Ring ◽  
Uncorrected Visual Acuity ◽  
Long Term Follow Up ◽  
History Of ◽  
Optical Zone

Purpose — to evaluate the functional results of bandage therapeutic-optical keratoplasty (BTOK) in keratoconus eyes after implantation of intrastromal corneal ring segments (CRS). Material and methods. The study included 18 patients with stage II and III keratoconus (as per Amsler-Krumeich classification) who had underwent implantation of CRS with unsatisfactory long-term outcomes. The patients were divided into two groups. The first group consisted of 7 patients (7 eyes) of 27 ± 3 years old with had past history of CRS implantation followed by the absence of predicted improvement of visual acuity during the observation period of up to 18 months. The second group included 11 patients (11 eyes) who had visual acuity improvements after CRS implantation, but had regression in the long-term follow-up of 2 to 5 years. The surgical algorithm consisted of two steps: first, all 18 patients had the intrastromal ring segments removed; second, 3 months later they underwent BTOK. Outcomes. After the removal of CRS, patients of both groups showed improvements in central corneal refraction, their visual acuity decreased to 0.07 ± 0.02 and 0.09 ± 0.04, respectively. The 36 months follow-up after BTOK revealed significant improvements in visual acuity — up to 0.48 ± 0.04 and 0.54 ± 0.11, respectively — in all patients in both group due to marked flattening of the cornea in the optical zone. Conclusion. Bandage therapeutic-optical keratoplasty allows treatment of patients with complicated or who had unsatisfactory results after implantation of intrastromal ring segments. The surgery leads to stabilization of keratectasia in keratoconus patients and significantly increases uncorrected visual acuity.

scholarly journals A New Sutureless Illuminated Macular Buckle Designed for Myopic Macular Hole Retinal Detachment

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Ahmed M. Bedda ◽  
Ahmed M. Abdel Hadi ◽  
Mohamed Lolah ◽  
Muhammad S. Abd Al Shafy
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Macular Hole ◽  
High Myopia ◽  
Terminal Part ◽  
Macular Hole Retinal Detachment ◽  
Myopic Macular Hole ◽  
The Mean ◽  
Visual Results

Purpose. To report the anatomic and visual results of a new sutureless illuminated macular buckle designed for patients with macular hole retinal detachment related to high myopia (MMHRD). Design. Prospective nonrandomized comparative interventional trial. Methods. Twenty myopic eyes of 20 patients (mean age, 51.4 years; range, 35–65 years) presenting with MMHRD with a posterior staphyloma, in whom the new buckle was used, were evaluated. The buckle used was assembled from a 5 mm wide sponge and a 7 mm wide silicone tire; it was fixed utilizing the sterile topical adhesive Histoacryl Blue (B Braun, TS1050044FP) which polymerizes in seconds upon being exposed to water-containing substances. The primary outcomes measured included aided visual acuity (BCVA) and optical coherence tomography (OCT) findings. The mean follow-up period was 6 months. Results. Postoperatively, the MH closure was identified by OCT in 8 (40%) eyes. The mean BCVA increased from 0.11 to 0.21 (p<0.005). The axial length of the eyes included decreased from 30.5 mm preoperatively to 29.8 mm (p=0.002) postoperatively. Conclusion. Preparation of the new sutureless macular buckle is simple and easy. Illumination of the terminal part of the buckle ensures proper placement. Histoacryl Blue is effective in fixing the buckle in its place for at least 6 months with no reported intra- or postoperative complications.

scholarly journals Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana

2021 ◽  
Vol 18 (3) ◽  
pp. 143-149
Author(s):  
Samuel Kyei ◽  
Ebenezer Zaabaar ◽  
Frank Assiamah ◽  
Michael Agyemang Kwarteng ◽  
Kofi Asiedu
Keyword(s):  
Visual Acuity ◽  
Postoperative Complications ◽  
Cataract Surgery ◽  
Medical Records ◽  
Cross Sectional Study ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Small Incision ◽  
Uncorrected Visual Acuity

Background: The growing middle-class population of Ghana has seen more people being employed in visually demanding occupations  and hence there is an increased desire for quality post-cataract surgical visual outcomes. This study aimed at comparing the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification (PHACO) among Ghanaians. Methods: This was a retrospective cross-sectional study in which records of patients who underwent MSCIS or phacoemulsification by the same surgeon were reviewed. Results: Medical records of 248 eyes were reviewed, out of which 132 underwent PHACO and 116 had MSICS. A significant number of the  PHACO group had good (6/6–6/18) uncorrected visual acuity (UCVA) compared to the MSICS group at 1–2 weeks follow-up (p = 0.003) and 4–6 weeks follow-up (p = 0.002). MSICS resulted in a higher total astigmatic change compared to PHACO (p < 0.001). The PHACO grouphad a higher number of postoperative complications compared with the MSICS group (p <0.001). Postoperative borderline and poor  uncorrected visual acuity were associated with age, total astigmatic change, and postoperative complications. Conclusion: The postoperative UCVA outcomes at 4–6 weeks’ follow-up indicates that PHACO resulted in noticeably less spectacle dependency when compared to MSICS.

scholarly journals Corneal Cross-linking in Patients Younger than 18 Years: Long-term Follow-up in Three Israeli Medical Centers

2014 ◽  
Vol 3 (2) ◽  
pp. 84-87
Author(s):  
David Zadok ◽  
Isaac Avni ◽  
Erez Bakshi ◽  
Irina S Barequet ◽  
Isaac Aizenman ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Pediatric Population ◽  
Cross Linking ◽  
Safe Procedure ◽  
Medical Centers ◽  
Manifest Refraction ◽  
Uncorrected Visual Acuity ◽  
Long Term Follow Up

ABSTRACT Purpose To report refractive, topographic and safety outcomes of corneal cross-linking (CXL) in patients younger than 18 years of age with progressive keratoconus. Materials and methods In this retrospective study, we enrolled 31 eyes of 21 children aged 11 to 17 years that underwent corneal riboflavin-ultraviolet A induced CXL due to progressive keratoconus at three different ophthalmology departments in Israel. They were followed for 3 to 48 months (average 23 ± 13.6 months). Evaluated parameters were uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), manifest refraction, pachymetry, slit- lamp examination and corneal topography at baseline and at 1,3,6,12,24 and 48 months. Results We found a nonsignificant improvement in UCVA and BSCVA with a small reduction of manifest cylinder and no significant change in spherical equivalent or K-values. Following CXL, stability of UCVA and BSCVA at the last follow-up examination was found in 71 and 77% of treated eyes, respectively. No permanent adverse events have been recorded throughout the study period. Conclusion In our series, CXL was a safe procedure in the pediatric population. Stabilization of progressive keratoconus was achieved in visual acuity, refractive and topography parameters with no improvement in corneal indices in contrary to adult CXL treatment. How to cite this article Bakshi E, Barequet IS, Aizenman I, Levinger S, Avni I, Zadok D. Corneal Corss-linking in Patients Younger than 18 Years: Long-term Follow-up in Three Israeli Medical Centers. Int J Kerat Ect Cor Dis 2014;3(2):84-87.

Topographically Guided Two-Step LASIK and Standard LASIK in the Correction of Refractive Errors after Penetrating Keratoplasty

2009 ◽  
Vol 19 (4) ◽  
pp. 535-543 ◽  
Author(s):  
Leopoldo Spadea ◽  
Massimo Saviano ◽  
Angela Di Gregorio ◽  
Domenico Di Lodovico ◽  
Fabio De Sanctis
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Laser In Situ Keratomileusis ◽  
Refractive Errors ◽  
Manifest Refraction ◽  
Uncorrected Visual Acuity ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Purpose To evaluate in a long-term period the effectiveness and safety of topographically guided two-step laser in situ keratomileusis (LASIK) and standard LASIK technique in the correction of refractive errors after successful penetrating keratoplasty (PKP) for keratoconus. Methods At least 2 years after PKP and 6 months after removal of all sutures, 15 eyes of 15 patients (Group 1; mean manifest refraction spherical equivalent (MRSE) −7.23 D ± 3.42 SD) were submitted to standard LASIK and 15 eyes of 15 patients (Group 2; mean MRSE −4.37 D ± 1.97 SD) to a topographically guided two-step LASIK procedure (first the flap and at least 2 weeks later the laser ablation). In all cases, a superior hinged corneal flap (160 μm/9.5 mm) was created. Results After a follow-up of 36 months, in Group 1 the mean uncorrected visual acuity (UCVA) was 0.51 logarithm of the minimum angle of resolution (logMAR) ± 0.41 SD and the mean best-corrected visual acuity (BCVA) was 0.03 logMAR ± 0.05 SD, with a mean MRSE of −1.57 D ± 2.65 SD. In Group 2, the mean UCVA was 0.28 logMAR ± 0.24 SD and the mean BCVA was 0.01 logMAR ± 0.03 SD, with a mean MRSE of −0.07 D ± 1.00 SD. In both groups, no complications were observed. Conclusions After a long follow-up period, both topographically guided two-step LASIK and standard LASIK could be considered effective and safe tools in the correction of refractive errors after successful PKP for keratoconus.

scholarly journals Clinical Outcomes of Small Incision Lenticule Extraction with Accelerated Cross-Linking (ReLEx SMILE Xtra) in Patients with Thin Corneas and Borderline Topography

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Sri Ganesh ◽  
Sheetal Brar
Keyword(s):  
Visual Acuity ◽  
Clinical Outcomes ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Small Incision Lenticule Extraction ◽  
Uncorrected Visual Acuity ◽  
Distant Visual Acuity ◽  
Lenticule Extraction ◽  
The Mean

Purpose. To study the safety and clinical outcomes of ReLEx SMILE with accelerated cross-linking in individuals with thinner corneas, borderline topography, and higher refractive errors.Methods. Eligible patients first underwent SMILE procedure for correction of myopic refractive error. Following the removal of lenticule, 0.25% riboflavin in saline was injected into the interface and allowed to diffuse for 60 seconds. Finally, eye was exposed to UV-A radiation of 45 mW/cm2for 75 seconds through the cap. Total energy delivered was 3.4 J/cm2.Results. 40 eyes of 20 patients with mean age of 26.75 ± 5.99 years were treated. Mean follow-up was 12 months ± 28.12 days. Mean spherical equivalent (SE) was −5.02 ± 2.06 D preoperatively and −0.24 ± 0.18 D postoperatively. The mean central corneal thickness (CCT) and keratometry changed from 501 ± 25.90 µm to 415 ± 42.26 µm and 45.40 ± 1.40 D to 41.2 ± 2.75 D, respectively. Mean uncorrected visual acuity (UCVA) was 20/25 or better in all eyes. No eyes lost lines of corrected distant visual acuity (CDVA). There were no complications like haze, keratitis, ectasia, or regression.Conclusion. Based on the initial clinical outcome it appears that SMILE Xtra may be a safe and feasible modality to prevent corneal ectasia in susceptible individuals.

scholarly journals Visual outcomes of Visian ICL implantation for high myopia in patients with shallow anterior chamber depth

2019 ◽  
Author(s):  
Lingling Niu ◽  
Huamao Miao ◽  
Tian Han ◽  
Lan Ding ◽  
Xiaoying Wang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Observational Study ◽  
Anterior Chamber ◽  
High Myopia ◽  
Anterior Chamber Depth ◽  
Distance Visual Acuity ◽  
Visual Outcomes ◽  
Icl V4c ◽  
Shallow Anterior Chamber

Abstract Background: High myopia with shallow anterior chamber depth (ACD less than 2.8 mm) is not rare. This observational study aims to evaluate visual outcomes after implantation of the Visian Implantable Collamer Lens with a central hole (ICL V4c) in these patients. Methods: A prospective cohort of consecutive 51 eyes of 31 patients (20 to 42 years old) was followed for at least 12 months (average 15.35 ± 4.90 months, rangers from 12 to 25 months). The preoperative ACD was 2.74 ± 0.04 mm (2.65 to 2.79 mm). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), manifest refraction, vault, and endothelial cell density (ECD) were measured during the follow-ups after surgery. Results: All surgeries were performed safely and no complication was observed during the follow-up. At the last follow-up, the safety index (postoperative CDVA / preoperative CDVA) was 1.33 ± 0.60 and the efficacy index (postoperative UDVA / preoperative CDVA) was 1.14 ± 0.54. After the surgery, no eye had decreased CDVA and 59% (30 eyes) of the eyes gained at least one line. Forty-seven eyes (92%) were within ± 1.0 D and 35 eyes (69%) were within ± 0.5 D of the attempted refraction. The mean postoperative vault was 380.00 ± 152.84 µm (90 to 700µm). The ECD was reduced by 8.38 ± 0.06% as compared to the preoperative value (p < 0.001). No significant change was observed in IOP (p = 0.061) at the last follow-up. Ultrasound Biomicroscopy (UBM) showed none of the eyes had trabecular-iris angle closed. Conclusions: In this prospective observational study, ICL V4c implantation in patients with high myopia and shallow ACD achieved satisfying and stable visual outcomes. Its long-term safety and stability require further investigation. Trial Registration: This trial was retrospectively registered on 05/08/2018 under the number (ChiCTR1800017594)

scholarly journals Functional optical zone and visual quality after SMILE and FS-LASIK treatment for high myopia

2019 ◽  
Author(s):  
Xuan Ding ◽  
Dan Fu ◽  
Meiyan Li ◽  
Lin Wang ◽  
Xingtao Zhou ◽  
...  
Keyword(s):  
High Myopia ◽  
Spherical Aberration ◽  
Wavefront Aberrations ◽  
Post Surgery ◽  
Spherical Equivalent Refraction ◽  
Ring Diameter ◽  
Optical Zone ◽  
Lenticule Extraction

Abstract Background We compared the functional optical zone (FOZ) and wavefront aberrations achieved after small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) in high-myopia patients.METHODS Thirty four and fourty high myopic (spherical equivalent refraction ≤ -6D) patients were respectively enrolled in FS-LASIK group and SMILE group, only right eye of each patient was analyzed. The planned FOZ (PFOZ), ablation depth/lenticule thickness and other data were acquired from medical records. The achieved FOZs (AFOZ) were assessed using a Pentacam at 1 month, 3 month, 6 month post-surgery. We defined the AFOZ diameter as the mean ring diameter corresponding to average total corneal refractive power (TCRP) in the central 4-mm zone plus 0.5D. The wavefront aberrations were obtained with WASCA system pre-operatively and 6-month-postoperatively.RESULTS The PFOZs in the SMILE and FS-LASIK groups were 6.57±0.22 mm vs 6.54±0.15 mm (P =0.350). In both groups, the AFOZ at every follow-up point was smaller than the PFOZ (P < 0.001). The AFOZ correlated negatively with the wavefront higher order aberrations (HOA), spherical aberration in both groups. HOA, spherical aberration (P<0.001), but not coma (P=0.477) and trefoil (P=0.812), differed significantly between the groups.CONCLUSIONS In high-myopia patients, the AFOZ was smaller than the PFOZ, irrespective of whether SMILE or FS-LASIK. In SMILE group, the AFOZ was larger and more consistent with the PFOZ, probably resulting in with less wavefront aberrations.

scholarly journals Simultaneous Topography-guided Surface Ablation with Collagen Cross-linking for Keratoconus

2016 ◽  
Vol 5 (2) ◽  
pp. 71-76
Author(s):  
Igor Kaiserman ◽  
Lily Karmona ◽  
Tzahi Sela ◽  
Oz Franco ◽  
Avi Shoshani ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contact Lenses ◽  
Cross Linking ◽  
Visual Rehabilitation ◽  
Surface Ablation ◽  
Uncorrected Visual Acuity ◽  
Promising Treatment ◽  
Functional Vision ◽  
Collagen Cross Linking

ABSTRACT Purpose In this article, we present the results of eight eyes of patients who underwent combined same-day partial topography-guided surface ablation followed by accelerated collagen cross-linking (CXL) procedure at Care-Vision Laser Centers to achieve stabilization of corneal ectasia and enhance visual rehabilitation in keratoconus. Materials and methods A retrospective nonrandomized review of 8 eyes of 6 patients who underwent the Athens Protocol for progressive keratoconus. Each patient underwent topography-guided ablation followed by CXL procedure. Follow-up Follow-up was done on day 1, day 7, and then at 1, 3, 6, and 12 months. Results There was a rapid and significant improvement in uncorrected visual acuity and best-corrected visual acuity in 100% eyes, a reduction of keratometric values, and symmetry between vertical hemimeridians. Topographic evaluation showed a marked improvement in irregularity. There were no signs of keratoconic progression noted in any of the eyes on last follow-up. No adverse events were reported in any patient. Conclusion Simultaneous surface ablation + CXL seems to be a promising treatment capable of offering patients functional vision and halting progression of the disorder. Precis Simultaneous topography-guided custom ablation treatment and photorefractive keratectomy with CXL offers keratoconic patients intolerant to contact lenses both stabilization of the cornea and improved functional vision with spectacles correction. How to cite this article Karmona L, Sela T, Franco O, Shoshani A, Munzer G, Kaiserman I. Simultaneous Topography-guided Surface Ablation with Collagen Cross-linking for Keratoconus. Int J Kerat Ect Cor Dis 2016;5(2):71-76.

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