Transepithelial photorefractive keratectomy on the same day of the initial consultation for the correction of myopia

2021 ◽  
pp. 112067212110334
Author(s):  
Olga Reitblat ◽  
Assaf Gershoni ◽  
Michael Mimouni ◽  
Eitan Livny ◽  
Yoav Nahum ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Clinical Outcomes ◽  
Photorefractive Keratectomy ◽  
Spherical Equivalent ◽  
Initial Visit ◽  
Safety Outcome ◽  
Uncorrected Visual Acuity ◽  
Safety Indices

Purpose: To examine the clinical outcomes, efficacy, safety, and predictability of transepithelial photorefractive keratectomy (Trans-PRK) operations performed on the day of the first screening visit in comparison with operations scheduled at a following appointment. Methods: Data of consecutive patients with myopia of various degrees, who underwent Trans-PRK, were retrospectively analyzed. Findings were compared between patients who underwent Trans-PRK on the same day of first consultation to patients that underwent surgery at subsequent visits, following initial consultation on a different day. Results: The study included 599 eyes treated on the initial visit day and 1936 eyes treated on a subsequent visit. Mean final spherical equivalent was close to emmetropia in both groups ( p = 0.183). Efficacy indices were 0.928 ± 0.192 in the initial-visit group and 0.945 ± 0.163 in the second-visit group ( p = 0.152). Safety indices were 0.954 ± 0.156 and 0.955 ± 0.151 ( p = 0.707), respectively. No differences between the groups were seen in uncorrected visual acuity (UDVA) of ⩾20/20, ⩾20/25, and ⩾20/32. Only the sub-analysis of patients reaching UDVA of 20/40 or better was slightly lower in the first-visit (95.5%) compared with the second-visit group (97.9%, p = 0.001). Results of attempted correction within ±0.50 D were: 63.3% and 69.0%, respectively ( p = 0.009). Complications profiles in the two groups were comparable. Conclusions: Trans-PRK completed on the day of the first screening appointment demonstrated a similar safety outcome compared with subsequent-visits procedures, and slightly lower, yet comparable, results regarding efficacy and predictability.

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 Treating intrasurgical complications of corneal refractive operation with customized ablation. A clinical case

2021 ◽  
Vol 14 (3) ◽  
pp. 102-105
Author(s):  
N. V. Khodzhabekyan ◽  
A. T. Khandzhyan ◽  
A. V. Ivanova ◽  
K. B. Letnikova ◽  
A. S. Sklyarova
Keyword(s):  
Visual Acuity ◽  
Excimer Laser ◽  
Refractive Surgery ◽  
Clinical Case ◽  
Photorefractive Keratectomy ◽  
Corneal Surface ◽  
Surface Errors ◽  
Spherical Component ◽  
Uncorrected Visual Acuity ◽  
Corneal Refractive Surgery

Purpose: to evaluate the prospects of customized Finalfit based ablation for optical rehabilitation of a patient with corneal surface errors caused by intrasurgical microtome-induced damage of a corneal flap during a LASIK excimer laser correction of vision.Material and methods. In Helmholtz Center, a patient with such damage was given a phototherapeutic keratectomy (PTK) combined with topographyguided photorefractive keratectomy.Results. In two months after the surgery, the patient’s uncorrected visual acuity rose from 0.15 to 1.0; the spherical component of refraction changed from -3.5 to +1.0 D, the cylindrical component of refraction fell from 1.75 to 0.25 D. Aberrometry demonstrated a decrease of RMS from 2.19 to 0.61 D, Total HOAs from 2.281 to 0.829; Tilt from 0.406 to 0.313; HOA from 1.152 to 0.247, Coma from 0.298 to 0.124, Trefoil from 1.088 to 0.094, SA from 0,127 to 0,021.Conclusion. The clinical case demonstrates the expediency and efficiency of corneal remodeling for the rehabilitation of induced errors of the corneal surface by excimer laser correction of vision based on PTK (Flex scan) + FinalFit after corneal refractive surgery.

scholarly journals Effects of V4c-ICL Implantation on Myopic Patients’ Vision-Related Daily Activities

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Taixiang Liu ◽  
Shaorong Linghu ◽  
Le Pan ◽  
Rong Shi
Keyword(s):  
Visual Acuity ◽  
Daily Activities ◽  
Central Hole ◽  
Spherical Equivalent ◽  
Implantable Collamer Lens ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
New Type ◽  
Best Corrected Visual Acuity ◽  
Better Than

The new type implantable Collamer lens with a central hole (V4c-ICL) is widely used to treat myopia. However, halos occur in some patients after surgery. The aim is to evaluate the effect of V4c-ICL implantation on vision-related daily activities. This retrospective study included 42 patients. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), intraocular pressure (IOP), endothelial cell density (ECD), and vault were recorded and vision-related daily activities were evaluated at 3 months after operation. The average spherical equivalent was-0.12±0.33 D at 3 months after operation. UCVA equal to or better than preoperative BCVA occurred in 98% of eyes. The average BCVA at 3 months after operation was-0.03±0.07LogMAR, which was significantly better than preoperative BCVA (0.08±0.10LogMAR) (P=0.029). Apart from one patient (2.4%) who had difficulty reading computer screens, all patients had satisfactory or very satisfactory results. During the early postoperation, halos occurred in 23 patients (54.8%). However there were no significant differences in the scores of visual functions between patients with and without halos (P>0.05). Patients were very satisfied with their vision-related daily activities at 3 months after operation. The central hole of V4c-ICL does not affect patients’ vision-related daily activities.

scholarly journals Effect of Photorefractive Keratectomy and Laser in situ Keratomileusis in High Myopia on logMAR Visual Acuity and Contrast Sensitivity

2003 ◽  
Vol 46 (1) ◽  
pp. 15-18 ◽  
Author(s):  
Hana Langrová ◽  
Matthias Derse ◽  
Dagmar Hejcmanová ◽  
Alena Feuermannová ◽  
Pavel Rozsíval ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
High Myopia ◽  
Laser In Situ Keratomileusis ◽  
Photorefractive Keratectomy ◽  
Spherical Equivalent ◽  
Spatial Frequencies ◽  
Quality Of Vision

Purpose: To compare effect of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) on contrast sensitivity (CS) and best corrected visual acuity (BCVA) in high myopia. Methods: 38 myopes (PRK) and 31 patients (LASIK) were examined before and 1, 3, 6, and 12 months postoperatively. Mean preoperative spherical equivalent was -8.0 ± 1.7D (PRK) and -9.2 ± 2.1D (LASIK). CS was tested on a computerized system of the Contrast Sensitivity 8010 Type at 6 spatial frequencies (0.74 and 29.55 c/deg), BCVA was measured on logMAR charts. Results: At 12 months postoperatively, mean spherical equivalent was -0.6 ± 1.0D (PRK) and -1.0 ± 0.8D (LASIK). Postoperative values of CS were significantly higher in the PRK group, except for spatial frequencies of 3.69 and 7.39 c/deg up to 3 months postoperatively. The initial significant decrease of BCVA lasted up to 6 months after PRK. In the LASIK group BCVA was not significantly different from its preoperative level at the 3-months follow-up. Conclusions: The significant improvement of CS after PRK suggest that PRK can improve quality of vision in eyes with high myopia. Although recovery of BCVA after LASIK was faster than after PRK, there may be a persistent decrease in CS.

scholarly journals The evaluation of a web-based tool for measuring the uncorrected visual acuity and refractive error in keratoconus eyes: A method comparison study

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256087
Author(s):  
Marc B. Muijzer ◽  
Janneau L. J. Claessens ◽  
Francesco Cassano ◽  
Daniel A. Godefrooij ◽  
Yves F. D. M. Prevoo ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Refractive Error ◽  
Mean Difference ◽  
Index Test ◽  
Spherical Equivalent ◽  
Reference Test ◽  
Web Based ◽  
Manifest Refraction ◽  
Uncorrected Visual Acuity ◽  
The Web

Purpose To evaluate the outcome of a web-based digital assessment of visual acuity and refractive error, compared to a conventional supervised assessment, in keratoconus patients with complex refractive errors. Material and methods Keratoconus patients, aged 18 to 40, with a refractive error between -6 and +4 diopters were considered eligible. An uncorrected visual acuity and an assessment of refractive error was taken web-based (index test) and by manifest refraction (reference test) by an optometrist. Corrected visual acuity was assessed with the prescription derived from both the web-based tool and the manifest refraction. Non-inferiority was defined as the 95% limits-of-agreement (95%LoA) of the differences in spherical equivalent between the index and reference test not exceeding +/- 0.5 diopters. Agreement was assessed by a Bland-Altman analyses. Results A total of 100 eyes of 50 patients were examined. The overall mean difference of the uncorrected visual acuity measured -0.01 LogMAR (95%LoA:-0.63–0.60). The variability of the differences decreased in the better uncorrected visual acuity subgroup (95%LoA:-0.25–0.55). The overall mean difference in spherical equivalent between the index and reference test exceeded the non-inferiority margin: -0.58D (95%LoA:-4.49–3.33, P = 0.008). The mean differences for myopic and hyperopic subjects were 0.09 diopters (P = 0.675) and -2.06 diopters (P<0.001), respectively. The corrected visual acuities attained with the web-based derived prescription underachieved significantly (0.22±0.32 logMAR vs. -0.01±0.13 LogMAR, P <0.001). Conclusions Regarding visual acuity, the web-based tool shows promising results for remotely assessing visual acuity in keratoconus patients, particularly for subjects within a better visual acuity range. This could provide physicians with a quantifiable outcome to enhance teleconsultations, especially relevant when access to health care is limited. Regarding the assessment of the refractive error, the web-based tool was found to be inferior to the manifest refraction in keratoconus patients. This study underlines the importance of validating digital tools and could serve to increase overall safety of the web-based assessments by better identification of outlier cases.

scholarly journals Three-year Clinical Outcomes of Aspheric Micro-monovision LASIK for Correction of Presbyopia and Myopic Astigmatism

2020 ◽  
Author(s):  
Fang Liu ◽  
Ting Zhang ◽  
Quan Liu
Keyword(s):  
Visual Acuity ◽  
Spherical Equivalent ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
High Satisfaction ◽  
Manifest Refraction ◽  
Corrected Distance Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Registration Number ◽  
Myopic Astigmatism

Abstract Background: To investigate the long-term safety and efficacy of aspheric micro-monovision LASIK for the correction of presbyopia and myopic astigmatism. Methods: In total, 114 eyes of 57 patients with a mean age of 48 ± 4.05 years (range: 43 to 62 years) who were undergoing aspheric micro-monovision LASIK treatment were enrolled. Visual acuity, manifest refraction, amplitude of accommodation, contrast sensitivity, entire eye aberrations and patients’ subjective ratings were evaluated from 1 day to 3 years postoperatively. Results: None of the eyes showed a spherical equivalent change of over 0.75 D between 3 months and 3 years, while 95% of the eyes were within ±0.50 D of the target correction of the spherical equivalent. The percentage of patients showing monocular uncorrected distance visual acuity ≥20/20 was 95%, and all eyes achieved a visual acuity of 20/25 or better. The percentage of patients showing binocular uncorrected near visual acuity ≥J2 was 93%, and all patients achieved a visual acuity of J4 or better. Ninety-one percent of the patients had an uncorrected visual acuity of 20/20 in both eyes and J2 or better binocular visual acuity. Six of 108 eyes (6%) lost 1 line, and no eyes lost 2 lines of corrected distance visual acuity. The overall satisfaction score for surgery was 93 ± 6. Conclusions: Aspheric micro-monovision LASIK using the Carl Zeiss Meditec MEL 80 Platform was an efficacious option for older myopic patients with presbyopia. Three-year postoperative outcomes in the Chinese population indicated improvements in uncorrected binocular vision at far and near distances with high satisfaction. Trial registration: The registration number is ChiCTR-IPC-15005842, and the date of registration is January 16, 2015.

scholarly journals The evaluation of a web‐based tool for measuring the uncorrected visual acuity and refractive error in keratoconus eyes: a prospective open‐label method comparison study

2021 ◽  
Author(s):  
Marc B Muijzer ◽  
Janneau L J Claessens ◽  
Francesco Cassano ◽  
Daniel A Godefrooij ◽  
Yves F D M Prevoo ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Refractive Error ◽  
Intraclass Correlation ◽  
Mean Difference ◽  
Spherical Equivalent ◽  
Reference Test ◽  
Web Based ◽  
Manifest Refraction ◽  
Uncorrected Visual Acuity ◽  
The Web

AbstractPurposeTo evaluate the outcome of a web‐based digital assessment of visual acuity and refractive error, compared to a manifest refraction assessment, in keratoconus patients with complex refractive errors.Material and methodsKeratoconus patients, aged 18 to 40, with a refractive error between ‐6 and +4 diopters were eligible. Each participant subsequently underwent an uncorrected visual acuity and a refractive assessment. Refractive error was assessed with the web‐based tool (index test), an autorefractor, and a manifest refraction (reference test) by an optometrist. Corrected visual acuity was assessed with the web‐based and manifest refractive prescription. Non‐inferiority was defined as the 95% limits‐of‐agreement (95%LoA) of the differences in spherical equivalent between the index and reference test not exceeding +/‐ 0.5 diopters. Agreement was assessed by an intraclass correlation coefficient and Bland‐Altman analyses.ResultsA total of 100 eyes of 50 patients were examined. The overall mean difference of the uncorrected visual acuity measured ‐0.01 LogMAR (95%LoA:‐0.63–0.60). The variability decreased in the high uncorrected visual acuity subgroup (mean difference: 0.15 LogMAR, 95%LoA:‐0.25–0.55). The intraclass correlation coefficient of the three refractive assessments was 0.32. The overall mean difference in spherical equivalent between the index and reference test measured ‐0.58 diopters (95%LoA:‐4.49 – 3.33, P=0.008). The mean differences for myopic and hyperopic subjects were 0.09 diopters (P=0.675) and ‐2.06 diopters (P<0.001), respectively.ConclusionsOur results show promising results in the ability of the web‐based tool to remotely assess visual acuity in keratoconus patients. The agreement is better in higher visual acuity ranges and could provide physicians with an objective measurement to enhance teleconsultations, especially relevant when access to health care is limited. The assessment of the refractive error using the web‐based tool was found to be inferior to the manifest refraction and deserves further training of the tools algorithm.

scholarly journals Near Visual Acuity Following Hyperopic Photorefractive Keratectomy in a Presbyopic Age Group

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Michael Moore ◽  
Antonio Leccisotti ◽  
Claire Grills ◽  
Tara C. B. Moore
Keyword(s):  
Visual Acuity ◽  
Photorefractive Keratectomy ◽  
Control Group ◽  
Age Group ◽  
Near Vision ◽  
Corrected Visual Acuity ◽  
Uncorrected Visual Acuity ◽  
Near Visual Acuity ◽  
The Mean ◽  
Better Than

Purpose. To assess near visual acuity in a presbyopic age group following hyperopic photorefractive keratectomy (PRK). Setting. Private practice in Siena, Italy. Methods. In this retrospective single-surgeon comparative study, PRK with mitomycin C was performed to correct hyperopia using Bausch & Lomb 217z laser for 120 eyes of 60 patients in the presbyopic age group (mean spherical equivalent SE +2.38 D ± 0.71 D and mean age ). 120 eyes of 60 age-matched controls (mean age ) had their unaided near vision measured. Results. At 12 months mean SE was −0.10 D ± 0.27 D in the PRK group. Mean best corrected visual acuity (BSCVA) was log MAR; 2 eyes lost ≥0.1 log MAR. Mean uncorrected visual acuity was log MAR. Mean distance corrected near visual acuity (DCNVA) in the PRK group was . This was statistically better () than the mean unaided near visual acuity in the control group . Conclusion. PRK was found to be safe, predictable, and an effective way of correcting hyperopia in this age group. It was also found to give better than expected near vision.

scholarly journals Plasma Rich in Growth Factors (PRGF) in Transepithelial Photorefractive Keratectomy (TPRK)

2021 ◽  
Vol 10 (9) ◽  
pp. 1939
Author(s):  
José-María Sánchez-González ◽  
Federico Alonso-Aliste ◽  
Davide Borroni ◽  
Jonatan Amián-Cordero ◽  
Concepción De-Hita-Cantalejo ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Growth Factors ◽  
Pain Score ◽  
Analogue Scale ◽  
Photorefractive Keratectomy ◽  
Spherical Equivalent ◽  
Distance Visual Acuity ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity

To evaluate the usage of plasma rich in growth factor (PRGF) in transepithelial photorefractive keratectomy (TPRK) in low and moderate myopia, patients who underwent myopic and astigmatism TPRK with PRGF were involved in this retrospective, observational study. Subjects underwent a surgical procedure between February 2019 and June 2019. A three-month follow-up was recorded. Pain score was assessed with a visual analogue scale (0–10) and re-epithelialization time recorded. A total of 48 eyes from 24 patients were recruited. Mean uncorrected distance visual acuity (UDVA) was 20/20.31 (0.00 ± 0.02 LogMAR). A total of 98% of eyes did not change corrected distance visual acuity (CDVA) lines. Two percent of eyes lost one line of CDVA. Preoperative spherical equivalent was −2.67 ± 1.37 D and after three months changed to −0.21 ± 0.34 D, and 2% of eyes changed 0.50 D or more between one and three months. Pain score was 3.29 ± 0.61 (3 to 6) score points at day one and 0.08 ± 0.27 score points at day seven. Finally, re-epithelialization time was 2.50 ± 1.20 days. PRGF addition to conventional refractive treatment such as TPRK seems to alleviate immediate postoperative pain and positively contribute to corneal re-epithelization time.

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