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 Salzmann nodular degeneration after photorefractive keratectomy for hyperopia

2015 ◽  
Vol 14 (2) ◽  
pp. 77-81
Author(s):  
Pawan Prasher
Keyword(s):  
Visual Acuity ◽  
Rare Complication ◽  
Visual Outcome ◽  
Early Postoperative Period ◽  
Photorefractive Keratectomy ◽  
Brown Pigment ◽  
Corneal Surface ◽  
Uncorrected Visual Acuity ◽  
Nodular Lesions ◽  
The Right

Purpose: To report a case of bilateral central Salzmann nodular degeneration (SND) after photorefractive keratectomy (PRK) for hyperopia.Methods: Case report.Results: A 47-year-old male presented with complaints of glare and difficulty with night driving. He had undergone PRK for hyperopia (+3.5+1.5x180 in the right eye and +4.5+1.0x180 in the left eye) in both eyes about 15 years back. The early postoperative period was uneventful; however, he started having these symptoms after two to three months. At presentation, uncorrected visual acuity was 20/100 and best corrected visual acuity was 20/30 with +3.5+1.0x180 in both eyes. Slit-lamp examination showed bilateral 1-1.5 mm diameter, bluish white nodular lesions involving the central corneas. There were also prominent paracentral brown pigment ring deposits consistent with pseudo-Fleischer rings in both eyes. Scheimpflug images showed dense hyper-reflective nodules that were associated with elevated anterior corneal surface and measured 290 μm in the right eye and 230 μm in the left eye, along with presence of significant astigmatism (K1- 45.1D, K2- 47.8D right eye and K1- 45.4D, K2- 49.2D left eye). Central pachymetry was 485 μm in the right eye and 464 μm in the left eye.Conclusions: SND is a rare complication of PRK for hyperopia that can lead to suboptimal visual outcome. PRK should be included in the list of etiologies leading to SND.

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 Conventional PRK versus single-step transPRK in corneal refractive surgery with excimer laser

2020 ◽  
Vol 94 (5) ◽  
Author(s):  
Giuseppe Miotto-Montesinos ◽  
Eduardo Rojas-Alvarez ◽  
Diego M. Torres-Piedra ◽  
Natali Torres-Palacios
Keyword(s):  
Excimer Laser ◽  
Refractive Surgery ◽  
Single Step ◽  
Corneal Refractive Surgery

scholarly journals Efficacy of LASIK and LASEK methods in achieving the predicted result in excimer laser correction of myopia and myopic astigmatism

2021 ◽  
Vol 8 (3) ◽  
pp. 19-23
Author(s):  
N.G. Zavgorodnia ◽  
Yu.Yu. Doroshenko ◽  
T.S. Zavgorodnia ◽  
I.O. Poplavska ◽  
K.O. Kostrovska ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Excimer Laser ◽  
Anterior Segment ◽  
Young Patients ◽  
Surgical Techniques ◽  
Social Significance ◽  
Uncorrected Visual Acuity ◽  
Working Age ◽  
The Difference ◽  
Myopic Astigmatism

Excimer laser correction of refraction anomalies has entered ophthalmological practice as one of the most effective surgical techniques, which allows us to correct refractive errors by changing corneal curvature, including with myopia and myopic astigmatism. Usually, such correction is applied in young patients of working age that acquires special social significance and requires the use of the most accurate and safe technologies, which would guarantee the achievement of a rapid effect with the shortest period of rehabilitation. The results of surgical treatment of 60 patients (103 eyes) with myopia of various degrees and myopic astigmatism were analyzed. Among patients, there were 28 men (41 %) and 32 women (59 %) aged 18 to 47 (mean of 25.0 ± 2.5) years. They were divided into 2 groups. The first group consisted of 29 people (50 eyes) who underwent vision correction by laser-assisted in situ keratomileusis (LASIK). All patients underwent standard ophthalmological examinations (visometry, autorefractometry, biomicroscopy, direct ophthalmoscopy, tonometry, perimetry) and refractive diagnosis, which included corneal topography with pachymetry (Orbscan, Bausch + Lomb Inc., USA), aberrometry (Zywave, Bausch + Lomb Inc., USA), anterior segment optical coherence tomography (Visante OCT, Carl Zeiss Meditec, Germany) and optical biometry by optical biometer IOLMaster (Carl Zeiss Meditec, Germany). The refractive result achievement was assessed on day 1, as well as 1 month, 6 months and 1 year after surgery. All surgeries were performed on an excimer laser Allegretto WaveLight EX500 (Alcon, USA). One month after excimer laser correction by the LASIK method, the expected result of visual acuity was achieved in 46 eyes (80.7 %), and when using the laser epithelial keratomileusis (LASEK) technique — in 31 eyes (58.5 %) that indicates a longer rehabilitation period. Six months later, the predicted visual acuity without correction in the group where surgery was performed by LASEK was achieved in 46 eyes (86.8 %), while in the group operated by LASIK — in 50 eyes, 100 % (the difference is not reliable, p > 0.05). One year after excimer laser correction, uncorrected visual acuity, regardless of the degree of myopia, was 0.92 ± 0.04 U in the first group at maximum visual acuity with correction in these eyes before surgery 0.86 ± 0.05 U (the difference is not significant, p > 0.05) and 0.74 ± 0.10 U in the second group at the maximum indicators of corrected visual acuity before surgery of 0.92 ± 0.03 U (the difference is significant, p < 0.05). A slightly larger difference in the achieved results of maximum uncorrected visual acuity before surgery when performing excimer laser correction by the LASEK method is explained by the development of subepithelial fibroplasia in 3.77 % of cases, which affected the average end result.

scholarly journals Outcomes of Wavefront-Optimized Laser-Assisted In-Situ Keratomileusis and Photorefractive Keratectomy for correction of Myopia and Myopic Astigmatism over One Year Follow-Up

2018 ◽  
Vol 12 (1) ◽  
pp. 256-263 ◽  
Author(s):  
Mohammad M. Shehadeh ◽  
Mohammad T. Akkawi ◽  
Ammar A. Aghbar ◽  
Muna T. Musmar ◽  
Malak N Khabbas ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Excimer Laser ◽  
Photorefractive Keratectomy ◽  
Distance Visual Acuity ◽  
Visual Outcomes ◽  
Corrected Distance Visual Acuity ◽  
One Year ◽  
Myopic Astigmatism

Background: Laser corneal refractive surgery suits, technology and nomograms are improving with time. This may improve the refractive and visual outcomes of the patients. Objectives: To evaluate the safety, efficacy, stability, and predictability of wavefront-optimized photorefractive keratectomy and Laser-assisted in-situ keratomileusis in patients with myopia and myopic astigmatism over 1-year using WaveLight® EX500 Excimer Laser machine. Methods: In this prospective cohort study, refractive and visual outcomes in 596 eyes (365 patients), either having myopia or myopic astigmatism were assessed. Patients were divided into Two groups: 1) Patients who underwent PRK (53 eyes have myopia and 217 eyes have myopic astigmatism), 2) Patients who underwent LASIK (53 eyes have myopia and 273 eyes have myopic astigmatism). Results: At 12 months postoperatively 94.3% of the myopic patients reached their preoperative best corrected distance visual acuity at the final one year follow up visit post PRK and LASIK. In patients with myopic astigmatism who underwent LASIK and PRK, 95.2%, and 96.3% of the patients reached their preoperative best corrected distance visual acuity at the final one year follow up visit post LASIK and PRK, respectively. The efficacy and safety indices were 1.00 or more for all groups with no eye lost any line of best corrected distance visual acuity. Conclusion: Our study results confirm the excellent efficacy, safety, good predictability and stability of myopia / myopic astigmatism correction by either wavefront- optimized LASIK or PRK over 1-year follow-up without significant differences between them using the WaveLight® EX500 excimer laser system.

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