Measurement of the Intraocular Pressure Elevation During Laser-Assisted In Situ Keratomileusis Flap Creation Using a Femtosecond Laser Platform

Lauzirika, Gorka; García-González, Montserrat; Bolívar, Gema; Hernández-Verdejo, José Luis; Sánchez, Víctor Sánchez; Gros-Otero, Juan; Teus, Miguel A.

doi:10.1167/tvst.10.3.9

Cited by 3 publications

(1 citation statement)

References 26 publications

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“…Corneal cross-linking (CXL) immediately after LASIK and the use of femtosecond lasers producing the lowest suction increase in IOP, such as VisuMax (Carl Zeiss Meditec AG, Jena, Germany) [85][86][87], can be utilized as added measures to prevent the development of ectasia or other intraoperative and postoperative complications [88,89]. If VisuMax is unavailable, other options to be considered are the Wavelight FS200 (Alcon Laboratories Inc., Fort Worth, TX, USA), LenSx (Alcon LenSx Inc., Aliso Viejo, CA, USA), or Victus (Bausch & Lomb Incorporated, Rochester, NY, USA).…”

Section: Refractive Surgery Considerations and Consultationmentioning

confidence: 99%

Controversy and Consideration of Refractive Surgery in Patients with Heritable Disorders of Connective Tissue

Moshirfar

Barke

Huynh

et al. 2021

JCM

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Heritable Disorders of Connective Tissue (HDCTs) are syndromes that disrupt connective tissue integrity. They include Osteogenesis Imperfecta (OI), Ehlers Danlos Syndrome (EDS), Marfan Syndrome (MFS), Loeys-Dietz Syndrome (LDS), Epidermolysis Bullosa (EB), Stickler Syndrome (STL), Wagner Syndrome, and Pseudoxanthoma Elasticum (PXE). Because many patients with HDCTs have ocular symptoms, commonly myopia, they will often present to the clinic seeking refractive surgery. Currently, corrective measures are limited, as the FDA contraindicates laser-assisted in-situ keratomileusis (LASIK) in EDS and discourages the procedure in OI and MFS due to a theoretically increased risk of post-LASIK ectasia, poor wound healing, poor refractive predictability, underlying keratoconus, and globe rupture. While these disorders present with a wide range of ocular manifestations that are associated with an increased risk of post-LASIK complications (e.g., thinned corneas, ocular fragility, keratoconus, glaucoma, ectopia lentis, retinal detachment, angioid streaks, and ocular surface disease), their occurrence and severity are highly variable among patients. Therefore, an HDCT diagnosis should not warrant an immediate disqualification for refractive surgery. Patients with minimal ocular manifestations can consider LASIK. In contrast, those with preoperative signs of corneal thinning and ocular fragility may find the combination of collagen cross-linking (CXL) with either photorefractive keratotomy (PRK), small incision lenticule extraction (SMILE) or a phakic intraocular lens (pIOL) implant to be more suitable options. However, evidence of refractive surgery performed on patients with HDCTs is limited, and surgeons must fully inform patients of the unknown risks and complications before proceeding. This paper serves as a guideline for future studies to evaluate refractive surgery outcomes in patients with HDCTs.

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