Introduction: In the field of ophthalmology, laser technology is used in many basic and clinical disciplines and specialities. It has played an important role in promoting the development of ophthalmology. Aim: This article is designed to review the evolution of laser technology in refractive surgeries in ophthalmology, mainly focusing on the characteristics of the excimer laser applied in corneal refractive surgery. Methods: This article was performed based on a literature review and Internet search through scientific databases such as PubMed, Scopus, Web of Science and Google Scholar. Result: The literature on excimer laser technology addresses the technical and physical aspects of excimer lasers including types, characteristics and commercially available lasers on the market. Conclusion: The conclusion on this forum aims to help understand the benefits of excimer laser use in ophthalmology, with focus on correction of refractive errors.

Introduction: Keratoconus (KCN) is known to affect all ethnicities but its incidence exhibits geographical variability plausibly due to subclinical forms of the disease, differences in diagnostic methods and criteria, or differences in genetic variations in populations. Aim: To examine the prevalence of keratoconus among the refractive surgery population of Vojvodina, who underwent refractive surgery screening at Eye Clinic Svjetlost Novi Sad, Serbia from September 2018 to September 2019. This is a single-center study. Methods: Retrospective analysis of 876 patients who presented for refractive surgery evaluation. Corneal tomographers represent the gold standard in the detection and classification of corneal ectatic diseases and screening is an essential part of the preoperative diagnostics before any refractive surgery. The corneal tomographer used in this study was a Scheimpflug imaging device (Pentacam AXL, Oculus Optikgeräte GmbH, Wetzlar, Germany). The device was realigned before each measurement. Results: Out of a total number of patients, 619 (70,7%) were candidates for corneal refractive surgery procedure, and 257 patients (29.3%) were not. Out of 257 patients that were not candidates for the procedure 157 (61,0%) patients had thin corneas, high myopia/hypermetropia or had some retinal disease; 75 patients (29,1) were keratoconus suspect and 25 patients (9,7%) had keratoconus. KCN patients had a mean age of 29.5 ± 7.7 years, 18 patients (72.0%) were male and 7 patients were female (28%). Conclusion: The most cited annual incidence of KCN is 2 approximately 1 per 2,000. Recent data from the biggest Netherland study revealed many different epidemiological results which deprive keratoconus of the community of rare diseases. The incidence of keratoconus in Vojvodina refractive surgery population presented in our Clinic was 2.9%.

Background: The creation of corneal flap is considered to be the most critical part of laser in situ keratomileusis (LASIK) surgery. Currently, flaps can be created with mechanical micorkeratomes or femtosecond lasers. Objective: To analyze and compare flap characteristics created with two different methods for flap creation in Laser in situ keratomileusis (LASIK). Methods: This was a retrospective study. The thickness and morphology of the flap were compared between the two mechanical microkeratomes (group I – Moria M2, group II – Moria SBK One Use Plus) and femtosecond laser (group III – Ziemer Femto LDV). Central flap thickness was measured intraoperatively, while the flap profile was measured with anterior optical coherence tomography at two axes (90° and 180°) and 5 measuring points on the first day, the first week, and one month after the surgery. Results: Central flap thickness was 110.91±15.79 micrometers (µm) (80-164 µm) in group I, 98.08±13.33 µm (65-136 µm) in group II and 103.52±13.89 µm (66-138 µm) in group III. Anterior optical coherence tomography revealed a meniscus-shaped flap in all three groups at both axes (90° and 180°). The least variability in flap thickness was observed in group III (±6 µm). Conclusion: All three methods of flap creation provide good shape and thickness reproducibility. Ziemer Femto LDV femtosecond laser had the least variable flap thickness in a single flap. Mechanical microkeratomes had slightly lower performance.

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Background: Septo-optic dysplasia (SOD) or de Morsiers’s syndrome is a rare congenital disorder characterized by optic nerve hypoplasia, hypothalamic-pituitary axis hypoplasia, and midline abnormalities of the brain, agenesis of septum pellucidum and corpus callosum. Initially, it was described in 1941 by Reeves and further discussed by the French-Swiss neurologist de Morsier in 1956. The phenotype of SOD is highly heterogeneous, and the existence of at least two features is considered sufficient for diagnosis. Objective: The aim is to emphasize the importance of including SOD in the differential diagnosis of young patients, presenting with strabismus, especially if very low vision is documented in one or both eyes. Case report: In this case, a 13-year-old male presented to our institution with a complaint of deviating left eye outwards in the last few years. During the examination, left eye exotropia, as well as low visual acuity (light perception) of the left eye were documented. The findings of the right eye were normal and visual acuity was 1.0. Magnetic resonance imaging, optical coherence tomography, and fundus photography revealed optic nerve, brain midline, and retinal abnormalities. The patient was diagnosed as having SOD with optic nerve hypoplasia, septum pellucidum agenesis, and hypothalamic-pituitary axis hypoplasia. Conclusion: Although SOD is not curable, many aspects of this syndrome can be improved through a multidisciplinary approach consisting of hormonal replacement, corrective ophthalmological surgery, as well as neuropsychological treatment, and support if necessary.