Myopic laser in situ keratomileusis retreatment: Incidence and associations

Pokroy, Russell; Mimouni, Michael; Sela, Tzahi; Munzer, Gur; Kaiserman, Igor

doi:10.1016/j.jcrs.2016.07.032

Cited by 51 publications

(28 citation statements)

References 7 publications

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“…Previous reports [2,5,36] indicated that older-aged patients are more likely to develop regression or require retreatment, as was found in the multivariate analysis in our study. One explanation is that surgeons are careful to undercorrect with myopic presbyopia with patients who are around 40 years of age, while they tend to overcorrect for young patients [41].…”

Section: Agesupporting

confidence: 87%

“…Rao et al [35] reported greater undercorrection in eyes with preoperative keratometry readings of \ 43.5D than those with preoperative readings of [ 44.5D. However, Russell et al [36] found that higher K power (mean K) significantly increased the odds for regression and retreatment, because steep corneas were less stable, and therefore, they regressed more and might be corneal ectasia.…”

Section: Pre-k Maxmentioning

confidence: 99%

“…Although Fig. 1 shows a relatively stable mean SE (D), the cumulative probability (%) of myopic regression was different, which might be definition and the follow-up time after the surgery [1,7,18,36,38,39]. In our study, the cumulative probability of myopic regression at 12 months varies from 45 to 89% in the surgeries of LASEK, FS-LASIK, and MM-LASIK, which was similar to Lin et al [18], that myopic regression was defined as residual myopia of -0.50D or less and a 0.50D or more shift toward myopia during 12 months.…”

Section: Agementioning

confidence: 99%

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Predictors affecting myopic regression in − 6.0D to − 10.0D myopia after laser-assisted subepithelial keratomileusis and laser in situ keratomileusis flap creation with femtosecond laser-assisted or mechanical microkeratome-assisted

Zhou

Gu²,

Li³

et al. 2019

Int Ophthalmol

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Purpose To investigate the predictive factors of postoperative myopic regression among subjects who have undergone laser-assisted subepithelial keratomileusis (LASEK), laser-assisted in situ keratomileusis (LASIK) flap created with a mechanical microkeratome (MM), and LASIK flap created with a femtosecond laser (FS). All recruited patients had a manifest spherical equivalence (SE) from − 6.0D to − 10.0D myopia. Methods This retrospective, observational case series study analyzed outcomes of refraction at 1 day, 1 week, and 1, 3, 6, and 12 months postoperatively. Predictors affecting myopic regression and other covariates were estimated with the Cox proportional hazards model for the three types of surgeries. Results The study enrolled 496 eyes in the LASEK group, 1054 eyes in the FS-LASIK group, and 910 eyes in the MM-LASIK group. At 12 months, from − 6.0D to − 10.0D myopia showed that the survival rates (no myopic regression) were 52.19%, 59.12%, and 58.79% in the MM-LASIK, FS-LASIK, and LASEK groups, respectively. Risk factors for myopic regression included thicker postoperative central corneal thickness (P ≦ 0.01), older age (P ≦ 0.01), aspherical ablation (P = 0.02), and larger transitional zone (TZ) (P = 0.03). Steeper corneal curvature (Kmax) (P = 0.01), thicker preoperative central corneal thickness (P < 0.01), smaller preoperative myopia (P < 0.01), longer duration of myopia (P = 0.02), with contact lens (P < 0.01), and larger optical zone (OZ) (P = 0.02) were protective factors. Among the three groups, the MM-LASIK had the highest risk of postoperative myopic regression (P < 0.01). Conclusions The MM-LASIK group experienced the highest myopic regression, followed by the FS-LASIK and LASEK groups. Older age, aspheric ablation used, thicker postoperative central corneal thickness, and enlarging TZ contribute to myopic regression; steeper preoperative corneal curvature (Kmax), longer duration of myopia, with contact lens, thicker preoperative central corneal thickness, lower manifest refraction SE, and enlarging OZ prevent postoperative myopic regression in myopia from − 6.0D to − 10.0D.

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Section: Agesupporting

confidence: 87%

Section: Pre-k Maxmentioning

confidence: 99%

Section: Agementioning

confidence: 99%

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Predictors affecting myopic regression in − 6.0D to − 10.0D myopia after laser-assisted subepithelial keratomileusis and laser in situ keratomileusis flap creation with femtosecond laser-assisted or mechanical microkeratome-assisted

Zhou

Gu²,

Li³

et al. 2019

Int Ophthalmol

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“…Despite the immense advances in RS over the last few decades and the stringent criteria for safety, efficacy, costeffectiveness, and predictability of the refractive outcome [5,6] that have been introduced, a small but not negligible percentage of RS outcomes require corrective retreatment [7][8][9]. Although the incidence of RS failures in certain clinics has declined (2-year annual retreatment rates) from 4.52% for primary surgeries done in 2005 to 0.18% for surgeries performed in 2012 [18] and, generally, is extremely low there is still room for improvement.…”

Section: Discussionmentioning

confidence: 99%

“…The methods for the individualized correction of refractive errors and the techniques that are presently available fulfill stringent criteria for safety, efficacy, cost-effectiveness, and predictability of the refractive outcome [5,6]. However, a small but not negligible percentage of RS outcomes require corrective retreatment [7][8][9]. Despite the small incidence of RS failures, it is extremely important that they are minimized.…”

Section: Introductionmentioning

confidence: 99%

Using neural networks to predict the outcome of refractive surgery for myopia

Balidis¹,

Παπαδοπούλου

Malandris

et al. 2019

4open

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Introduction: Refractive Surgery (RS), has advanced immensely in the last decades, utilizing methods and techniques that fulfill stringent criteria for safety, efficacy, cost-effectiveness, and predictability of the refractive outcome. Still, a non-negligible percentage of RS require corrective retreatment. In addition, surgeons should be able to advise their patients, beforehand, as to the probability that corrective RS will be necessary. The present article addresses these issues with regard to myopia and explores the use of Neural Networks as a solution to the problem of the prediction of the RS outcome. Methods: We used a computerized query to select patients who underwent RS with any of the available surgical techniques (PRK, LASEK, Epi-LASIK, LASIK) between January 2010 and July 2017 and we investigated 13 factors which are related to RS. The data were normalized by forcing the weights used in the forward and backward propagations to be binary; each integer was represented by a 12-bit serial code, so that following this preprocessing stage, the vector of the data values of all 13 parameters was encoded in a binary vector of 1 × (13 × 12) = 1 × 156 size. Following the preprocessing stage, eight independent Learning Vector Quantization (LVQ) networks were created in random way using the function Ivqnet of Matlab, each one of them responding to one query with (0 retreat class) or (1 correct class). The results of the eight LVQs were then averaged to permit a best estimate of the network’s performance while a voting procedure by the neural nets was used to arrive at the outcome Results: Our algorithm was able to predict in a statistically significant way (as evidenced by Cohen’s Kappa test result of 0.7595) the need for retreatment after initial RS with good sensitivity (0.8756) and specificity (0.9286). Conclusion: The results permit us to be optimistic about the future of using neural networks for the prediction of the outcome and, eventually, the planning of RS.

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