Combined implantation of an add-on diffractive sulcus IOL and a monofocal capsular bag IOL was safe and effective in improving far and near visual acuity in cataract surgery. Preliminary visual acuity results were similar to those in eyes with a single 1-piece diffractive multifocal IOL.
Purpose:
To report refractive outcomes of hyperopic LASIK with automated centration on the visual axis compared with centration on the line of sight (LOS).
Methods:
The NIDEK Advanced Vision Excimer Laser platform (NAVEX) was used to treat 181 hyperopic eyes with centration on the LOS (LOS group) and 64 hyperopic eyes with centration on the visual axis (visual axis group). The coordinates of the visual axis were digitally transferred to the excimer laser system based on the positional relationship between the LOS and the coaxially sighted corneal light reflex. All eyes were treated with a 6.5-mm optical zone and 9.0-mm transition zone. Three-month postoperative outcomes were retrospectively analyzed.
Results:
The preoperative manifest refraction spherical equivalent (MRSE) was +2.57±1.26 diopters (D) (range: 0.13 to 5.63 D) in the visual axis group and +2.46±1.32 D (range: 0.38 to 5.63 D) in the LOS group. The postoperative MRSE was +0.29±0.70 D (range: −1.00 to 1.75 D) in the visual axis group and +0.19±0.57 D (range: −0.75 to 1.75 D) in the LOS group. Postoperatively, 81% (38/47) of eyes in the visual axis group and 64% (74/116) of eyes in the LOS group were ±0.50 D. In the visual axis group, 91% (44/52) of eyes and 92% (102/109) of eyes in the LOS group maintained best spectacle-corrected visual acuity within one line compared with preoperatively.
Conclusions:
Initial experience with hyperopic LASIK centered on the visual axis indicated safe and predictable outcomes. [
J Refract Surg
. 2009;25:S98–S103.]
PURPOSE: To assess refractive outcomes, changes in the total higher order root mean square (RMS) aberration, and changes in higher order wavefront aberrations after LASIK for myopia and myopic astigmatism with the NIDEK Advanced Vision Excimer Laser platform (NAVEX) using either an aspheric or topography-based or whole eye wavefront ablation algorithm.
METHODS: This was a retrospective study of 1459 eyes that underwent LASIK for myopia and myopic astigmatism. The mean preoperative spherical equivalent refraction was -4.68 diopters (D) (range: -0.50 to -9.63 D) with astigmatism up to -4.50 D. Treatments were classified into three categories depending on the type of ablation algorithm used - optimized aspheric transition zone (OATz) denoted eyes that underwent aspheric treatment zones; customized aspheric treatment zone (CATz) denoted eyes that underwent customized ablations based on corneal topography; and OPDCAT denoted eyes that underwent customized ablation based on the whole eye wavefront profile. Follow-up data are reported at 3 months (69%) and 12 months (17%) postoperatively.
RESULTS: Three months after LASIK, the predictability (±0.5 D from target refraction) was 80% for OATz, 91% for CATz, and 76% for OPDCAT. Of all eyes, 96% were within ±1.0 D of intended refraction 3 months postoperatively and 100% after 12 months (87% ±0.5 D). In the aspheric and custom groups, a notable improvement of uncorrected visual acuity was noted between 3 and 12 months after LASIK. No eye lost >1 line of best spectacle-corrected visual acuity. Mean higher order RMS increased in all groups.
CONCLUSIONS: The data support that the treatment of myopia and myopic astigmatism is safe and effective with NAVEX. Customized ablation based on corneal topography rather than on total wavefront error was more predictable. [J Refract Surg. 2006;22:754-763.]
The use of the fs-laser offers new possibilities in preparation of corneal flaps, possibly providing advantages over conventional microkeratomes. Furthermore, the fs-laser has the potential to create intrastromal refractive lenticules for complete refractive procedures (ILK).
The laser cuts of the IntraLase FS and Femto LDV femtosecond lasers were equally smooth and of excellent quality. The standard deviation of the flap thickness was small and equal in both systems.
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