Advances in Refractive Surgery

Pillar, Angelique; Krueger, Ronald R.

doi:10.1097/apo.0000000000000200

Cited by 5 publications

(5 citation statements)

References 74 publications

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“…In current clinical practice, several surgical options are available to myopic patients seeking refractive surgery. Laser-based refractive surgeries including LASIK, ASA procedures, and SMILE are currently the most popular 45. It is important for both clinicians and patients to understand the risks associated with the different procedures offered.…”

Section: Discussionmentioning

confidence: 99%

<p>Corneal Ectasia Risk And Percentage Tissue Altered In Myopic Patients Presenting For Refractive Surgery</p>

Ong¹,

Farook²,

Tan³

et al. 2019

OPTH

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PurposeA percentage tissue altered (PTA) score of ≥40% has been advocated as an independent indicator of post-operative ectasia risk following laser in-situ keratomileusis (LASIK). This study was performed to test the hypothesis that refractive procedures, such as laser-assisted sub-epithelial keratectomy (LASEK) or small incision lenticule extraction (SMILE), may alter the range of PTA, within which refractive corneal surgery can be safely performed.SettingRefractive department, tertiary ophthalmic hospital.DesignRetrospective observational study.MethodsReview of case notes was performed for patients who presented for refractive surgeries, other than LASIK. To determine the risk of corneal ectasia for each patient prior to refractive surgery, we estimated what each patient’s PTA would have been if they had undergone LASIK. The Randleman Ectasia Risk Score System (ERSS) was also calculated.Results114 eyes (66 patients) were included. 94 eyes underwent SMILE. 20 eyes underwent LASEK. A significant proportion of eyes had PTA ≥40% – SMILE eyes: up to 31.9%, LASEK eyes: up to 60.0% (at presumed LASIK flap of 120 μm). The maximum calculated PTA was up to 47.9% in the SMILE group and up to 51.5% in the LASEK group. Using ERSS, 12.8–16% of SMILE eyes and 15.0–80.0% of LASEK eyes would have been considered to have moderate-to-high ectasia risk. No post-surgical ectasia was observed at 3 years.ConclusionSMILE and LASEK alter the range of PTA, within which corneal refractive surgery may be performed with a lower risk of developing post-operative corneal ectasia; a safe PTA threshold needs to be determined for these procedures before recommendations for clinical practice can be made.

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Section: Discussionmentioning

confidence: 99%

<p>Corneal Ectasia Risk And Percentage Tissue Altered In Myopic Patients Presenting For Refractive Surgery</p>

Ong¹,

Farook²,

Tan³

et al. 2019

OPTH

View full text Add to dashboard Cite

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“…Despite a large number of surgical options, still, the refractive procedure most commonly performed worldwide is Laserassisted in situ keratomileusis (LASIK). (Pillar et al, 2016) Apart from the conventional LASIK surgery, various types of LASIK procedures have been developed that include wavefront guided (WFG), wavefront optimized (WFO) and topography guided (TG). (Krueger et al, 2008) All these procedures were additionally aimed at correcting or reducing the higher order aberrations, so as to reduce the chances of glare and halos post-operatively.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Percent Tissue altered in Topography Guided and Wavefront Optimized Laser-assisted in situ Keratomileusis using Zeiss MEL 80 Excimer Laser

Singh

Shilpy²,

Purohit

et al. 2021

Nep J Oph

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Introduction: Laser-assisted in situ Keratomileusis (LASIK) is the most commonly performed refractive surgical procedure. The amount of tissue ablated in LASIK affects the safety and long-term outcome. The objective of this study was to compare the percent tissue altered (PTA) in topography guided (TG) and wavefront optimized (WFO) LASIK using Zeiss MEL 80 excimer laser. Materials and methods: This retrospective observational study was conducted at a tertiary eye center. Patients with moderate myopia who underwent LASIK between June 2016 and January 2019 were divided into two groups (Group I: TG LASIK, 69 eyes; Group II: WFO LASIK, 70 eyes). The groups were compared for preoperative parameters [spherical equivalent (SE), keratometry and pachymetry], intraoperative parameters [ablation depth (AD), PTA and residual stromal bed thickness (RSBT)] and postoperative parameters (vision, SE). Results: Among preoperative parameters, SE and keratometry were similar while thinnest pachymetry was significantly less in group I. Among the intraoperative parameters, PTA (P < 0.01) and AD (P < 0.01) were significantly less in group I while RSBT (P = 0.54) was not significantly different. Postoperatively at 6 months, 92.75% (64) eyes in group I and 90% (63) eyes in group II had visual acuity of 6/6 or better (P = 0.57). 98.55% (68) and 97.14% (68) eyes in group I and group II respectively had SE refraction within ± 0.5 dioptres. Conclusion: TG LASIK induces less tissue alteration for given refractive error with similar visual outcome as compared to WFO LASIK which makes TG apparently safer and is the preferred technique for borderline thin corneas.

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“…Laser-Assisted In Situ Keratomileusis (LASIK) has drastically emerged as a modality for the correcting refractive errors and is currently the most frequently performed refractive surgery. 1,2 The surgical outcomes of LASIK are safe and predictable. The purpose of this study is to assess functional outcome and patient satisfaction after LASIK.…”

Section: Introductionmentioning

confidence: 99%

Functional outcome and patient satisfaction following LASIK surgery

Patel¹,

Patel²,

Shah³

et al. 2020

IJCEO

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Aims:The purpose of the study was to evaluate the functional gain, visual outcome and patient satisfaction after LASIK. Materials and Methods: The study included 150 patients (85 males and 65 females) that underwent LASIK procedure for correction of refractive error and were followed up on first week, first and third month postoperatively. Visual acuity, Schirmer's test and contrast sensitivity were evaluated on each follow up. The patients were asked to fill a questionnaire consisting of 14 questions scored as 0, 1 and 2 for an unsatisfied, satisfied and very satisfied patient respectively prior to surgery and on the last visit. The patients were divided into three groups on the basis of the score obtained as: (<10) for unsatisfied, (11-20) for satisfied and (21-28) for a very satisfied patient. Results: In this study, the UCVA in 98.6% of our patients was ≥20/30 postoperatively. The mean Schirmer's I value was 13.99 ± 1.530 in the right eye and 14.01 ± 1.544 in the left eye, while Schirmer's II values were 13.44 ± 2.128 and 13.51 ± 2.351 in the right and left eye respectively at the end of 3 months. Contrast sensitivity improved to a mean of 1.79 ± 0.15 at three months. Night driving complications reduced from a mean score of 1.59 ± 0.29 to 0.58 ± 0.05 postoperatively. Conclusions: High level of patient satisfaction can be attained with LASIK procedure. Night vision problems and dry eye are imperative causes of dissatisfaction.

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Advances in Refractive Surgery

Abstract: Laser-assisted in situ keratomileusis and photorefractive keratectomy continue to dominate the keratorefractive literature, as they remain the most frequently performed refractive surgeries.

Cited by 5 publications

References 74 publications

<p>Corneal Ectasia Risk And Percentage Tissue Altered In Myopic Patients Presenting For Refractive Surgery</p>

<p>Corneal Ectasia Risk And Percentage Tissue Altered In Myopic Patients Presenting For Refractive Surgery</p>

Comparison of Percent Tissue altered in Topography Guided and Wavefront Optimized Laser-assisted in situ Keratomileusis using Zeiss MEL 80 Excimer Laser

Functional outcome and patient satisfaction following LASIK surgery

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