Wavefront excimer laser refractive surgery for adults with refractive errors

Li, Shiming; Kang, Meng-Tian; Wang, Ningli; Abariga, Samuel A

doi:10.1002/14651858.cd012687.pub2

Cited by 18 publications

(9 citation statements)

References 86 publications

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“… 2017 , Li et al . 2020 , Li et al . 2020 );and 1 review did not provide any information in this respect (Chen et al .…”

Section: Resultsmentioning

confidence: 99%

“… 2016 , Li et al . 2020 ) and one study considered the eyes for paired analysis (Shortt et al . 2013 ).…”

Section: Resultsmentioning

confidence: 99%

“…This comparison was made by one review at 12 months postsurgery (Li et al . 2020 ). The proportion of eyes with UCVA 20/20 or better showed low certainty of evidence favouring Wavefront PRK versus conventional PRK.…”

Section: Resultsmentioning

confidence: 99%

“…This comparison was made by one review at 12 months postsurgery (Li et al . 2020 ). The certainty of evidence was very low for all outcomes.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Laser‐based refractive surgery techniques to treat myopia in adults. An overview of systematic reviews and meta‐analyses

Soto-Peñaloza¹,

Alonso-Arroyo

Vidal-Infer

et al. 2022

Acta Ophthalmologica

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Systematic reviews (SRs) and meta-analyses (MAs) are of great importance for basing clinical decisions. However, misleading interpretations may result when informed decisions rest on biased review papers with methodological issues. To evaluate which treatment is optimal, an overview was made of SRs and MAs to establish the quality and certainty of meta-evidence published on the efficacy of laser-based refractive surgery techniques for treating myopia in adults. A search was made in five databases and was updated using Really Simple Syndication (RSS) feed appliances up to April 2021; SRs with or without MAs were included. Methodological quality was appraised using the AMSTAR-2 tool. The best available reviews were summarized using the GRADE approach. The corrected covered area (CCA) was used to determine the degree of over-representation of publications. The risk of bias of the primary studies was disclosed visually. Thirty-six studies published between 2003 and 2021 were included. Twenty SRs (56%) were conducted in China. The most studied comparisons were SMILE versus FS-LASIK (19%) and FS-LASIK versus MM-LASIK (11%). Of the 251 overlapping index publications, 165 were unique (CCA = 0.015%), representing a negligible risk of skewed reporting. The AMSTAR-2 tool showed most SRs to have critically low or low quality. Nine reviews presented moderate quality. The GRADE approach of the 41 a priori outcomes evidenced critically low and low certainty of evidence. Only the spherical equivalent refraction changes at 12 months between LASEK and PRK showed moderate certainty of evidence, favouring PRK (mean difference 0.06, 95%CI [À0.02 to 0.14], I 2 = 0%; p ≥ 0.05). Index trials among less biased reviews are prone to selection, performance and reporting bias. The appraised techniques exhibit comparable results in terms of efficacy. There is moderate certainty of evidence in favour of the use of PRK over LASEK in terms of the spherical equivalent refraction error changes at 1 year of follow-up. Most appraised SRs presented methodological flaws in critical domains, resulting in a low to critically low certainty of evidence after GRADE appraisal. Therefore, investigators need to study and compare the different laser-based refractive techniques to provide better evidence-based medicine. Further well-designed, high-quality clinical trials and SRs are needed to reappraise the current findings.

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“… 2017 , Li et al . 2020 , Li et al . 2020 );and 1 review did not provide any information in this respect (Chen et al .…”

Section: Resultsmentioning

confidence: 99%

“… 2016 , Li et al . 2020 ) and one study considered the eyes for paired analysis (Shortt et al . 2013 ).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…This comparison was made by one review at 12 months postsurgery (Li et al . 2020 ). The certainty of evidence was very low for all outcomes.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Laser‐based refractive surgery techniques to treat myopia in adults. An overview of systematic reviews and meta‐analyses

Soto-Peñaloza¹,

Alonso-Arroyo

Vidal-Infer

et al. 2022

Acta Ophthalmologica

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“…Transepithelial surface ablation for refractive treatment of myopia belongs to the state-of-the-art refractive management for myopia 1 , 2 . It holds the advantage of a lower impact on corneal biomechanical stability and hence fewer risks of dry eye when compared to laser in situ keratomileusis (LASIK) 3 , 4 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Diclofenac in Pain Reduction after Topography-Guided Transepithelial Surface Ablation

Jost

Pfaeffli

Kaufmann

et al. 2022

Klin Monbl Augenheilkd

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Purpose To report the efficacy of postoperative diclofenac eye drops for pain reduction in patients undergoing topography-guided transepithelial surface ablation. Methods Retrospective consecutive case series of patients undergoing topography-guided transepithelial surface ablation for refractive myopia treatment using a 1 KHz excimer laser. Patients were divided into three groups. Group 1 did not receive any diclofenac drops, group 2 received one diclofenac drop postoperatively (day 1), and group 3 received one drop of diclofenac postoperatively (day 1) and on the day after treatment (day 2). Postoperative pain was self-assessed by patients per eye daily for the first 4 consecutive days (days 1 to 4) after the treatment using the visual analogue scale (VAS). We compared VAS with respect to the use of additional oral or topical treatment as well as VAS with regards to the total amount of ablated tissue (< 50 µm, 50 – 100 µm, ≥ 100 µm) among the groups. Results We enrolled 163 eyes of 163 patients (55.0% female), with a mean age of 31.3 years (SD ± 6.6; range 21 – 68). We excluded 16 patients who applied other additional analgesics. Group 1 comprised 35 eyes (21%), group 2 had 21 eyes (13%), and group 3 consisted of 107 eyes (66%). Median pain score (VAS) was 5 (range 0, 10) in group 1, which was higher than in groups 2 (median 1, range 0 to 7) and 3 (median 1.5, range 0 to 7) on the day of surgery (p < 0.0001). Percentage of patients using an additional oral NSAID on days 1 and 2 was significantly higher in group 1 (69/83%) when compared to groups 2 (24/43%) or 3 (31/49%) (p < 0.001 day 1, p = 0.001 day 2). No correlation was found between pain sensation and maximum ablation depth (Spearman correlation p > 0.05). Conclusion The instillation of one drop of diclofenac after topography-guided transepithelial surface ablation reduced subjective pain sensation according to VAS and decreased the need for additional topical anesthetic drops or oral NSAID.

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For adults with refractive errors, how do wavefront ablation methods compare?

Burch¹,

Achiron²

2021

Cochrane Clinical Answers

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Wavefront excimer laser refractive surgery for adults with refractive errors

Cited by 18 publications

References 86 publications

Laser‐based refractive surgery techniques to treat myopia in adults. An overview of systematic reviews and meta‐analyses

Laser‐based refractive surgery techniques to treat myopia in adults. An overview of systematic reviews and meta‐analyses

Efficacy of Diclofenac in Pain Reduction after Topography-Guided Transepithelial Surface Ablation

For adults with refractive errors, how do wavefront ablation methods compare?

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