Pub Date : 2024-12-01DOI: 10.3928/1081597X-20241021-01
Markus Schranz, Marcus Lisy, Ioanna Dimakopoulou, Victor Danzinger, Daniel Schartmüller, Claudette Abela-Formanek
Purpose: To evaluate the refractive prediction error of common intraocular lens (IOL) power calculation formulas in patients who underwent intrascleral IOL fixation using the four-flanged technique.
Methods: This prospective, longitudinal, single-site, single-surgeon study's setting was the Department for Ophthalmology and Optometry, Medical University of Vienna, Austria. Patients who received IOL implantation via the four-flanged technique were followed up to 3 months after the operation. Refraction was measured using the Early Treatment of Diabetic Retinopathy Study visual acuity test at 4 m. Lens decentration, tilt, and aqueous anterior chamber depth were evaluated using anterior segment optical coherence tomography. The SRKT, Holladay 1, and Hoffer-Q formulas were used to assess prediction error (PE) and absolute error (AE). Correlations between axial length, keratometry, and white-to-white distance were subsequently evaluated.
Results: A total of 28 eyes of 28 patients were examined in this study. The application of all formulas resulted in a hyperopic PE (SRKT: 0.35 ± 0.86 diopters [D], Holladay 1: 0.36 ± 0.78 D and Hoffer-Q: 0.37 ± 0.73 D). There was no variation between the PE of different formulas discovered (P > .05). The AE was within 0.50 D in 54% to 61% and within 1.00 D in 79% of eyes, depending on the formula used. Furthermore, Cochrane's Q test detected no significant distinctions between formulas (P > .05). The PE of each formula demonstrated a significant correlation to the axial length of the eyes (P < .05). The correlation estimates ranged from -0.25 D/mm to -0.39 D/mm, subject to the applied formula.
Conclusions: This study demonstrates that the four-flanged technique for scleral IOL fixation yields reliable outcomes. PE was closest to zero using the Hoffer-Q formula, although there was no statistically significant difference compared to the other formulas. Axial length emerged as the most pertinent factor for PE. Short eyes resulted in a more hyperopic outcome, whereas longer eyes resulted in a more myopic outcome than intended. This myopic and hyperopic shift was due to the standardized surgical technique with an externalization of the haptics 2.5 mm behind the limbus resulting in a consistent aqueous anterior chamber depth across all eye lengths, coupled with a reduction or increase in the distance from the IOL to the macula, which is dependent on the length of the eye. [J Refract Surg. 2024;40(12):e985-e993.].
{"title":"Refractive Outcome, Lens Power Calculation, and Surgically Induced Astigmatism After Four-Flanged Intrascleral Intraocular Lens Fixation.","authors":"Markus Schranz, Marcus Lisy, Ioanna Dimakopoulou, Victor Danzinger, Daniel Schartmüller, Claudette Abela-Formanek","doi":"10.3928/1081597X-20241021-01","DOIUrl":"https://doi.org/10.3928/1081597X-20241021-01","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the refractive prediction error of common intraocular lens (IOL) power calculation formulas in patients who underwent intrascleral IOL fixation using the four-flanged technique.</p><p><strong>Methods: </strong>This prospective, longitudinal, single-site, single-surgeon study's setting was the Department for Ophthalmology and Optometry, Medical University of Vienna, Austria. Patients who received IOL implantation via the four-flanged technique were followed up to 3 months after the operation. Refraction was measured using the Early Treatment of Diabetic Retinopathy Study visual acuity test at 4 m. Lens decentration, tilt, and aqueous anterior chamber depth were evaluated using anterior segment optical coherence tomography. The SRKT, Holladay 1, and Hoffer-Q formulas were used to assess prediction error (PE) and absolute error (AE). Correlations between axial length, keratometry, and white-to-white distance were subsequently evaluated.</p><p><strong>Results: </strong>A total of 28 eyes of 28 patients were examined in this study. The application of all formulas resulted in a hyperopic PE (SRKT: 0.35 ± 0.86 diopters [D], Holladay 1: 0.36 ± 0.78 D and Hoffer-Q: 0.37 ± 0.73 D). There was no variation between the PE of different formulas discovered (<i>P</i> > .05). The AE was within 0.50 D in 54% to 61% and within 1.00 D in 79% of eyes, depending on the formula used. Furthermore, Cochrane's Q test detected no significant distinctions between formulas (<i>P</i> > .05). The PE of each formula demonstrated a significant correlation to the axial length of the eyes (<i>P</i> < .05). The correlation estimates ranged from -0.25 D/mm to -0.39 D/mm, subject to the applied formula.</p><p><strong>Conclusions: </strong>This study demonstrates that the four-flanged technique for scleral IOL fixation yields reliable outcomes. PE was closest to zero using the Hoffer-Q formula, although there was no statistically significant difference compared to the other formulas. Axial length emerged as the most pertinent factor for PE. Short eyes resulted in a more hyperopic outcome, whereas longer eyes resulted in a more myopic outcome than intended. This myopic and hyperopic shift was due to the standardized surgical technique with an externalization of the haptics 2.5 mm behind the limbus resulting in a consistent aqueous anterior chamber depth across all eye lengths, coupled with a reduction or increase in the distance from the IOL to the macula, which is dependent on the length of the eye. <b>[<i>J Refract Surg</i>. 2024;40(12):e985-e993.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 12","pages":"e985-e993"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.3928/1081597X-20241030-03
Xinfang Cao, Jun Zhang, Jie Shao, Yonggang Zhang, Li Zheng
Purpose: To evaluate the performance of the InnovEyes Sightmap platform (Alcon Laboratories, Inc) in refractive surgery by comparing the visual acuity and higher order aberrations (HOAs) between ray-tracing-guided laser in situ keratomileusis (LASIK) and topography-guided LASIK.
Methods: This prospective study enrolled participants who underwent either ray-tracing-guided LASIK or topography-guided LASIK. Comprehensive ophthalmic evaluations were performed preoperatively, as well as at 1 day, 2 weeks, 1 month, and 3 months postoperatively. Patients in the ray-tracing-guided LASIK group underwent wavefront, tomography, and biometry assessment using the InnovEyes Sightmap diagnostic device. Assessments included visual acuity, manifest refraction, and whole-eye HOAs.
Results: A total of 42 eyes treated with ray-tracing-guided LASIK and 42 eyes treated with topography-guided LASIK were analyzed. Both strategies demonstrated comparable good refraction accuracy and refractive stability (P > .05). The ray-tracing-guided LASIK group exhibited significantly better postoperative uncorrected distance visual acuity (UDVA) compared to the topography-guided LASIK group (-0.12 ± 0.05 vs -0.07 ± 0.04 logarithm of the minimum angle of resolution, respectively; P < .05), with 48% of eyes achieving a UDVA of 20/12.5 or better. Ray-tracing-guided LASIK induced a small but statistically significant increase in HOAs and vertical coma aberration, along with a significant reduction in spherical aberration (P < .05). In contrast, topography-guided LASIK resulted in a significant increase in vertical coma (P < .05) without significant changes in overall HOAs or spherical aberration (P > .05). At 3 months postoperatively, spherical aberration was significantly different between the two groups (-0.021 ± 0.031 vs 0.054 ± 0.122 µm, respectively; P < .05).
Conclusions: The InnovEyes Sightmap platform's ray-tracing-guided LASIK demonstrated potential advantages in visual acuity outcomes compared to topography-guided LASIK. The observed negative shift in spherical aberration, characterized by a lower absolute value, may have contributed to the enhanced visual acuity results. [J Refract Surg. 2024;40(12):e994-e1002.].
{"title":"Study of the InnovEyes Sightmap Platform in Comparing Ray-Tracing-Guided LASIK and Topography-Guided LASIK.","authors":"Xinfang Cao, Jun Zhang, Jie Shao, Yonggang Zhang, Li Zheng","doi":"10.3928/1081597X-20241030-03","DOIUrl":"https://doi.org/10.3928/1081597X-20241030-03","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the performance of the InnovEyes Sightmap platform (Alcon Laboratories, Inc) in refractive surgery by comparing the visual acuity and higher order aberrations (HOAs) between ray-tracing-guided laser in situ keratomileusis (LASIK) and topography-guided LASIK.</p><p><strong>Methods: </strong>This prospective study enrolled participants who underwent either ray-tracing-guided LASIK or topography-guided LASIK. Comprehensive ophthalmic evaluations were performed preoperatively, as well as at 1 day, 2 weeks, 1 month, and 3 months postoperatively. Patients in the ray-tracing-guided LASIK group underwent wavefront, tomography, and biometry assessment using the InnovEyes Sightmap diagnostic device. Assessments included visual acuity, manifest refraction, and whole-eye HOAs.</p><p><strong>Results: </strong>A total of 42 eyes treated with ray-tracing-guided LASIK and 42 eyes treated with topography-guided LASIK were analyzed. Both strategies demonstrated comparable good refraction accuracy and refractive stability (<i>P</i> > .05). The ray-tracing-guided LASIK group exhibited significantly better postoperative uncorrected distance visual acuity (UDVA) compared to the topography-guided LASIK group (-0.12 ± 0.05 vs -0.07 ± 0.04 logarithm of the minimum angle of resolution, respectively; <i>P</i> < .05), with 48% of eyes achieving a UDVA of 20/12.5 or better. Ray-tracing-guided LASIK induced a small but statistically significant increase in HOAs and vertical coma aberration, along with a significant reduction in spherical aberration (<i>P</i> < .05). In contrast, topography-guided LASIK resulted in a significant increase in vertical coma (<i>P</i> < .05) without significant changes in overall HOAs or spherical aberration (<i>P</i> > .05). At 3 months postoperatively, spherical aberration was significantly different between the two groups (-0.021 ± 0.031 vs 0.054 ± 0.122 µm, respectively; <i>P</i> < .05).</p><p><strong>Conclusions: </strong>The InnovEyes Sightmap platform's ray-tracing-guided LASIK demonstrated potential advantages in visual acuity outcomes compared to topography-guided LASIK. The observed negative shift in spherical aberration, characterized by a lower absolute value, may have contributed to the enhanced visual acuity results. <b>[<i>J Refract Surg</i>. 2024;40(12):e994-e1002.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 12","pages":"e994-e1002"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.3928/1081597X-20241002-01
Manja Krämer, Anastasios Charonis, Samuel Arba-Mosquera
Purpose: To present a new approach to customized treatments that inherently saves tissue by design, especially for pathological corneas.
Methods: From the elevation of the anterior cornea and the refractive error of the eye, the target cornea can be calculated and the difference between actual and target cornea corresponds to the tissue to be removed. In this approach, it is further possible to preset the ablation depth at one (Model 1) or two (Models 2 and 3) particular locations. In all three models, the target cornea floats in z-direction, until the depth is reached at one of these defined locations. In Model 2, the depth at the second location is reached by modulating the asphericity, whereas in Model 3, asphericity is maintained but average curvature is modulated to achieve the desired depth at the second location. After floating in z-direction, and modulation, locations with a negative ablation value are set to zero (primary clipping). Additionally, locations exceeding a preset maximum ablation depth are set to a predefined depth (secondary clipping).
Results: Simulated cases based on patient diagnosis were used to better explain and illustrate the technique.
Conclusions: With this approach, free-form ablation zones are generated, providing for a tissue-saving correction of refractive error and partial correction of higher order aberrations, the overall corneal shape will be recentered, and the corneal curvature gradient is reduced. [J Refract Surg. 2024;40(12):e1003-e1014.].
{"title":"Clipped Topography-Guided Treatments: A Different Approach to Custom Corrections.","authors":"Manja Krämer, Anastasios Charonis, Samuel Arba-Mosquera","doi":"10.3928/1081597X-20241002-01","DOIUrl":"https://doi.org/10.3928/1081597X-20241002-01","url":null,"abstract":"<p><strong>Purpose: </strong>To present a new approach to customized treatments that inherently saves tissue by design, especially for pathological corneas.</p><p><strong>Methods: </strong>From the elevation of the anterior cornea and the refractive error of the eye, the target cornea can be calculated and the difference between actual and target cornea corresponds to the tissue to be removed. In this approach, it is further possible to preset the ablation depth at one (Model 1) or two (Models 2 and 3) particular locations. In all three models, the target cornea floats in z-direction, until the depth is reached at one of these defined locations. In Model 2, the depth at the second location is reached by modulating the asphericity, whereas in Model 3, asphericity is maintained but average curvature is modulated to achieve the desired depth at the second location. After floating in z-direction, and modulation, locations with a negative ablation value are set to zero (primary clipping). Additionally, locations exceeding a preset maximum ablation depth are set to a predefined depth (secondary clipping).</p><p><strong>Results: </strong>Simulated cases based on patient diagnosis were used to better explain and illustrate the technique.</p><p><strong>Conclusions: </strong>With this approach, free-form ablation zones are generated, providing for a tissue-saving correction of refractive error and partial correction of higher order aberrations, the overall corneal shape will be recentered, and the corneal curvature gradient is reduced. <b>[<i>J Refract Surg</i>. 2024;40(12):e1003-e1014.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 12","pages":"e1003-e1014"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To assess real-time intraoperative pachymetry changes occurring during corneal cross-linking (CXL) using microscope-integrated optical coherence tomography (Mi-OCT) and compare accuracy of various modalities of pachymetry assessment.
Methods: This was a cross-sectional observational comparative study including 45 consecutive patients with progressive keratoconus planned for CXL. Mi-OCT (RESCAN 700) was used to measure central corneal thickness (CCT) during four stages of CXL: before epithelial debridement, after debridement, after riboflavin instillation, and after ultraviolet irradiation. Scheimpflug imaging, anterior segment OCT (AS-OCT), and ultrasound pachymetry were used to assess CCT preoperatively. All data were entered into Excel software (Microsoft Corporation) and analyzed.
Results: The CCT significantly decreased after each step of CXL as measured on Mi-OCT (P < .0001). Mi-OCT overestimated the CCT significantly by 1.12 times on average (range: 1.02 to 1.43) compared to ultrasound pachymetry (P = .0004). CCT measured using Scheimpflug imaging and anterior segment OCT was statistically comparable to ultrasound pachymetry.
Conclusions: Mi-OCT provides a real-time assessment of CCT during CXL. However, because it overestimates the pachymetry, ultrasound pachymetry remains the gold standard for decision-making during CXL. [J Refract Surg. 2024;40(12):e934-e940.].
{"title":"Microscope-Integrated OCT-Assisted Real-time Monitoring of Central Corneal Thickness During Corneal Cross-linking.","authors":"Nandyala Sushma, Shivam Sharma, Aafreen Bari, Tushar Agarwal, Tanuj Dada, Namrata Sharma","doi":"10.3928/1081597X-20241021-02","DOIUrl":"https://doi.org/10.3928/1081597X-20241021-02","url":null,"abstract":"<p><strong>Purpose: </strong>To assess real-time intraoperative pachymetry changes occurring during corneal cross-linking (CXL) using microscope-integrated optical coherence tomography (Mi-OCT) and compare accuracy of various modalities of pachymetry assessment.</p><p><strong>Methods: </strong>This was a cross-sectional observational comparative study including 45 consecutive patients with progressive keratoconus planned for CXL. Mi-OCT (RESCAN 700) was used to measure central corneal thickness (CCT) during four stages of CXL: before epithelial debridement, after debridement, after riboflavin instillation, and after ultraviolet irradiation. Scheimpflug imaging, anterior segment OCT (AS-OCT), and ultrasound pachymetry were used to assess CCT preoperatively. All data were entered into Excel software (Microsoft Corporation) and analyzed.</p><p><strong>Results: </strong>The CCT significantly decreased after each step of CXL as measured on Mi-OCT (<i>P</i> < .0001). Mi-OCT overestimated the CCT significantly by 1.12 times on average (range: 1.02 to 1.43) compared to ultrasound pachymetry (<i>P</i> = .0004). CCT measured using Scheimpflug imaging and anterior segment OCT was statistically comparable to ultrasound pachymetry.</p><p><strong>Conclusions: </strong>Mi-OCT provides a real-time assessment of CCT during CXL. However, because it overestimates the pachymetry, ultrasound pachymetry remains the gold standard for decision-making during CXL. <b>[<i>J Refract Surg</i>. 2024;40(12):e934-e940.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 12","pages":"e934-e940"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.3928/1081597X-20241009-02
Lorenzo de Angelis, Vito Romano, Giuseppe Ruben Barbera, Mario Galasso, Jorge L Aliò, Fabrizio Giansanti, Francesco Barca
Purpose: To compare the aberrometric profile of the Artisan Aphakia lens (Opthec BV) and transscleral plug FIL-SSF lens (Soleko) and to assess the impact of tilt and decentration on their optical performance.
Methods: This retrospective observational study was conducted at Azienda Ospedaliera Universitaria Careggi, Florence, Italy, with a consecutive cohort of aphakic eyes undergoing secondary lens implantation with an Artisan or FIL-SSF lens. Wavefront analysis was performed using a pyramidal wavefront-based aberrometer (Osiris-T; CSO). Tilt and decentration were calculated using anterior segment optical coherence tomography (MS-39; CSO).
Results: The study included 47 eyes from 45 patients: 24 eyes in the FIL-SSF group and 23 eyes in the Artisan group. Decentration was 0.39 ± 0.14 mm in the FIL-SSF group and 0.51 ± 0.16 mm in the Artisan group (P = .02). The mean tilt value was 6.6 ± 2.35 degrees in the FIL-SSF group and 5.9 ± 1.86 degrees in the Artisan group (P = .13). Internal higher order aberrations (HOAs) were 0.23 ± 0.07 μm in the FIL-SSF group and 0.29 ± 0.13 μm in the Artisan group (P = .02). The point spread function (PSF) Strehl ratio was 0.12 ± 0.05 in the FIL-SSF group and 0.10 ± 0.04 (P = .11) in the Artisan group. The PSF Strehl ratio without lower order aberration (PSFw2) was 0.28 ± 0.12 in the FIL-SSF group and 0.23 ± 0.09 in the Artisan group (P = .01).
Conclusions: The Artisan and FIL-SSF lenses provide comparable optical performance in terms of the PSF Strehl ratio. However, the Artisan lens appears to be more susceptible to decentration, which may result in increased higher order aberrations and a consequently lower PSFw2 Strehl ratio. [J Refract Surg. 2024;40(12):e926-e933.].
{"title":"Clinical Comparison of Decentration and Tilt Effects in Iris-Claw and Trans-scleral Plug Lenses: Wavefront Analysis With a Pyramidal Sensor Aberrometer.","authors":"Lorenzo de Angelis, Vito Romano, Giuseppe Ruben Barbera, Mario Galasso, Jorge L Aliò, Fabrizio Giansanti, Francesco Barca","doi":"10.3928/1081597X-20241009-02","DOIUrl":"10.3928/1081597X-20241009-02","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the aberrometric profile of the Artisan Aphakia lens (Opthec BV) and transscleral plug FIL-SSF lens (Soleko) and to assess the impact of tilt and decentration on their optical performance.</p><p><strong>Methods: </strong>This retrospective observational study was conducted at Azienda Ospedaliera Universitaria Careggi, Florence, Italy, with a consecutive cohort of aphakic eyes undergoing secondary lens implantation with an Artisan or FIL-SSF lens. Wavefront analysis was performed using a pyramidal wavefront-based aberrometer (Osiris-T; CSO). Tilt and decentration were calculated using anterior segment optical coherence tomography (MS-39; CSO).</p><p><strong>Results: </strong>The study included 47 eyes from 45 patients: 24 eyes in the FIL-SSF group and 23 eyes in the Artisan group. Decentration was 0.39 ± 0.14 mm in the FIL-SSF group and 0.51 ± 0.16 mm in the Artisan group (<i>P</i> = .02). The mean tilt value was 6.6 ± 2.35 degrees in the FIL-SSF group and 5.9 ± 1.86 degrees in the Artisan group (<i>P</i> = .13). Internal higher order aberrations (HOAs) were 0.23 ± 0.07 μm in the FIL-SSF group and 0.29 ± 0.13 μm in the Artisan group (<i>P</i> = .02). The point spread function (PSF) Strehl ratio was 0.12 ± 0.05 in the FIL-SSF group and 0.10 ± 0.04 (<i>P</i> = .11) in the Artisan group. The PSF Strehl ratio without lower order aberration (PSFw2) was 0.28 ± 0.12 in the FIL-SSF group and 0.23 ± 0.09 in the Artisan group (<i>P</i> = .01).</p><p><strong>Conclusions: </strong>The Artisan and FIL-SSF lenses provide comparable optical performance in terms of the PSF Strehl ratio. However, the Artisan lens appears to be more susceptible to decentration, which may result in increased higher order aberrations and a consequently lower PSFw2 Strehl ratio. <b>[<i>J Refract Surg</i>. 2024;40(12):e926-e933.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 12","pages":"e926-e933"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.3928/1081597X-20241016-01
Yara Bteich, Jad F Assaf, Jeremiah E Gendy, Shady T Awwad
Purpose: To present the outcomes and detail the surgical procedure employed in the initial 102 eyes treated with keratorefractive lenticule extraction (KLEx) using the FEMTO LDV Z8 platform (Ziemer Ophthalmic Systems).
Methods: This was a retrospective analysis of 102 eyes of 53 patients treated with KLEx at the American University of Beirut Medical Center. Visual, refractive, topographic, and aberrometric parameters were evaluated 1 week and 1, 3, 6, and 12 months postoperatively.
Results: Mean preoperative spherical equivalent refraction (SEQ) was -4.11 ± 1.82 diopters (D) (range: -10.00 to -1.625 D) and mean preoperative cylinder was -0.75 ± 0.65 D (range: -3.00 to 0.00 D). Postoperatively, the mean SEQ was 0.06 ± 0.54 D (range: -2.88 to +1.00 D) at 1 week and -0.04 ± 0.26 D at 12 months and was within ±0.50 D in 95.6% and ±1.00 D in 100% of eyes. A total of 96.7% of eyes had an uncorrected distance visual acuity (UDVA) of 20/20 at 12 months postoperatively. Fifty percent gained one or more lines of corrected distance visual acuity (CDVA), 5 eyes (5.4%) lost one line, and none lost two or more lines. No suction losses were encountered and all extracted lenticules were intact without tears.
Conclusions: The application of KLEx using the FEMTO LDV Z8 platform yields safe and effective outcomes, aligning comparably with established modes of lenticule extraction and femtosecond laser-assisted laser in situ keratomileusis procedures previously employed and accepted within the field of refractive surgery. [J Refract Surg. 2024;40(11):e898-e905.].
{"title":"Keratorefractive Lenticule Extraction Using the Ziemer FEMTO LDV Z8 Platform (CLEAR): One-Year Results.","authors":"Yara Bteich, Jad F Assaf, Jeremiah E Gendy, Shady T Awwad","doi":"10.3928/1081597X-20241016-01","DOIUrl":"https://doi.org/10.3928/1081597X-20241016-01","url":null,"abstract":"<p><strong>Purpose: </strong>To present the outcomes and detail the surgical procedure employed in the initial 102 eyes treated with keratorefractive lenticule extraction (KLEx) using the FEMTO LDV Z8 platform (Ziemer Ophthalmic Systems).</p><p><strong>Methods: </strong>This was a retrospective analysis of 102 eyes of 53 patients treated with KLEx at the American University of Beirut Medical Center. Visual, refractive, topographic, and aberrometric parameters were evaluated 1 week and 1, 3, 6, and 12 months postoperatively.</p><p><strong>Results: </strong>Mean preoperative spherical equivalent refraction (SEQ) was -4.11 ± 1.82 diopters (D) (range: -10.00 to -1.625 D) and mean preoperative cylinder was -0.75 ± 0.65 D (range: -3.00 to 0.00 D). Postoperatively, the mean SEQ was 0.06 ± 0.54 D (range: -2.88 to +1.00 D) at 1 week and -0.04 ± 0.26 D at 12 months and was within ±0.50 D in 95.6% and ±1.00 D in 100% of eyes. A total of 96.7% of eyes had an uncorrected distance visual acuity (UDVA) of 20/20 at 12 months postoperatively. Fifty percent gained one or more lines of corrected distance visual acuity (CDVA), 5 eyes (5.4%) lost one line, and none lost two or more lines. No suction losses were encountered and all extracted lenticules were intact without tears.</p><p><strong>Conclusions: </strong>The application of KLEx using the FEMTO LDV Z8 platform yields safe and effective outcomes, aligning comparably with established modes of lenticule extraction and femtosecond laser-assisted laser in situ keratomileusis procedures previously employed and accepted within the field of refractive surgery. <b>[<i>J Refract Surg</i>. 2024;40(11):e898-e905.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 11","pages":"e898-e905"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.3928/1081597X-20240903-03
Alireza Peyman, Mohsen Pourazizi
{"title":"Biostatistics and Ophthalmology: The Case of Two Eyes, What Is Correct and What Is Customary.","authors":"Alireza Peyman, Mohsen Pourazizi","doi":"10.3928/1081597X-20240903-03","DOIUrl":"https://doi.org/10.3928/1081597X-20240903-03","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 11","pages":"e908"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.3928/1081597X-20240913-04
George O Waring
{"title":"Reply: Biostatistics and Ophthalmology: The Case of Two Eyes, What Is Correct and What Is Customary.","authors":"George O Waring","doi":"10.3928/1081597X-20240913-04","DOIUrl":"https://doi.org/10.3928/1081597X-20240913-04","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 11","pages":"e908-e909"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.3928/1081597X-20240923-02
Laureano A Rementería-Capelo, Inés Contreras, Juan Gros-Otero, Laura Mariñas, Javier Ruiz-Alcocer
Purpose: To assess the visual quality, patient satisfaction, and photic phenomena 3 and 12 months after the implantation of two similar diffractive intraocular lenses (IOLs) manufactured with different materials.
Methods: This retrospective observational study included patients with the AcrySof PanOptix IOL or the Clareon Pan-Optix IOL (both Alcon Laboratories, Inc). Three and 12 months after the surgery, binocular contrast sensitivity under photopic conditions was measured. The presence of dysphotopsias and difficulties when driving in dim light conditions was also reported. Patient satisfaction was assessed through the Catquest 9-SF questionnaire and patients also reported the need for additional spectacles at different distances. Twelve months after the surgery, the presence of posterior capsule opacification and glistening was reported.
Results: The study included 59 patients. Contrast sensitivity was stable in both groups 12 months after the surgery, the proportion of patients that always perceived halos decreased approximately 15%, and difficulties when driving at night were minimized. Both groups showed high and similar rates of satisfaction with their vision and achieved spectacle independence rates greater than 85% at the two visits. The presence of posterior capsule opacification was similar for both groups, whereas 64% and 90% of the eyes were free of glistening in the AcrySof and Clareon groups, respectively.
Conclusions: Both diffractive IOLs offer consistent visual outcomes and high rates of patient satisfaction during the initial 12 months after surgery. The results also suggest that the novel material may better preserve the transparency of the IOL in the long term. [J Refract Surg. 2024;40(11):e877-e883.].
{"title":"Visual Quality, Patient Satisfaction, and Photic Phenomena With a Diffractive Intraocular Lens and Its New Evolved Materials Version.","authors":"Laureano A Rementería-Capelo, Inés Contreras, Juan Gros-Otero, Laura Mariñas, Javier Ruiz-Alcocer","doi":"10.3928/1081597X-20240923-02","DOIUrl":"https://doi.org/10.3928/1081597X-20240923-02","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the visual quality, patient satisfaction, and photic phenomena 3 and 12 months after the implantation of two similar diffractive intraocular lenses (IOLs) manufactured with different materials.</p><p><strong>Methods: </strong>This retrospective observational study included patients with the AcrySof PanOptix IOL or the Clareon Pan-Optix IOL (both Alcon Laboratories, Inc). Three and 12 months after the surgery, binocular contrast sensitivity under photopic conditions was measured. The presence of dysphotopsias and difficulties when driving in dim light conditions was also reported. Patient satisfaction was assessed through the Catquest 9-SF questionnaire and patients also reported the need for additional spectacles at different distances. Twelve months after the surgery, the presence of posterior capsule opacification and glistening was reported.</p><p><strong>Results: </strong>The study included 59 patients. Contrast sensitivity was stable in both groups 12 months after the surgery, the proportion of patients that always perceived halos decreased approximately 15%, and difficulties when driving at night were minimized. Both groups showed high and similar rates of satisfaction with their vision and achieved spectacle independence rates greater than 85% at the two visits. The presence of posterior capsule opacification was similar for both groups, whereas 64% and 90% of the eyes were free of glistening in the AcrySof and Clareon groups, respectively.</p><p><strong>Conclusions: </strong>Both diffractive IOLs offer consistent visual outcomes and high rates of patient satisfaction during the initial 12 months after surgery. The results also suggest that the novel material may better preserve the transparency of the IOL in the long term. <b>[<i>J Refract Surg</i>. 2024;40(11):e877-e883.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 11","pages":"e877-e883"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.3928/1081597X-20240913-01
Ozgun Melike Gedar Totuk, Mehmet Akif Ozdamar, Meltem Guzin Altınel
Purpose: To evaluate the effect of eyelid laxity on the structure of the cornea.
Methods: This was a retrospective study performed in one institution. Patients with and without upper and lower eyelid laxity, which were determined using the snap-back test (SBT) and the upper eyelid distraction test (LDT), were evaluated for corneal structural changes with Scheimpflug imaging corneal tomography for the keratometric readings, and cor-neal spectral domain optical coherence tomography for the epithelial thickness (ET) measurements. The ET values were obtained using the statistics report for the superior quadrant (SET), the inferior quadrant (IET) within the 2- to 7-mm region, and central thickness (CET) within the 2-mm region. The minimum corneal thickness values within the central 5-mm region (MinCT) were also included in the study. Keratometric readings (in diopters), horizontal white-to-white (HWTW) measurements, pachymetry, and ET measurements were assessed along with the presence or absence of eyelid laxity.
Results: A total of 170 eyes from 85 patients were evaluated (50.6% with eyelid laxity, and 49.4% without eyelid laxity). There was no significant difference between the mean keratometric readings, HWTW, and the mean IET and CET values (P > .05); however, the difference was significant for the MinCT and SET (P < .05). A statistically significant negative correlation was found between the SET values and age, LDT, and SBT measurements (P < .05).
Conclusions: A strong association was found between decreased SET and MinCT values and eyelid laxity. The possible reason for these decreases may be inflammation, which plays a role in the pathophysiology of eyelid laxity. [J Refract Surg. 2024;40(11):e783-e791.].
{"title":"The Effect of Eyelid Laxity on Corneal Mapping and Corneal Topography.","authors":"Ozgun Melike Gedar Totuk, Mehmet Akif Ozdamar, Meltem Guzin Altınel","doi":"10.3928/1081597X-20240913-01","DOIUrl":"https://doi.org/10.3928/1081597X-20240913-01","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of eyelid laxity on the structure of the cornea.</p><p><strong>Methods: </strong>This was a retrospective study performed in one institution. Patients with and without upper and lower eyelid laxity, which were determined using the snap-back test (SBT) and the upper eyelid distraction test (LDT), were evaluated for corneal structural changes with Scheimpflug imaging corneal tomography for the keratometric readings, and cor-neal spectral domain optical coherence tomography for the epithelial thickness (ET) measurements. The ET values were obtained using the statistics report for the superior quadrant (SET), the inferior quadrant (IET) within the 2- to 7-mm region, and central thickness (CET) within the 2-mm region. The minimum corneal thickness values within the central 5-mm region (MinCT) were also included in the study. Keratometric readings (in diopters), horizontal white-to-white (HWTW) measurements, pachymetry, and ET measurements were assessed along with the presence or absence of eyelid laxity.</p><p><strong>Results: </strong>A total of 170 eyes from 85 patients were evaluated (50.6% with eyelid laxity, and 49.4% without eyelid laxity). There was no significant difference between the mean keratometric readings, HWTW, and the mean IET and CET values (<i>P</i> > .05); however, the difference was significant for the MinCT and SET (<i>P</i> < .05). A statistically significant negative correlation was found between the SET values and age, LDT, and SBT measurements (<i>P</i> < .05).</p><p><strong>Conclusions: </strong>A strong association was found between decreased SET and MinCT values and eyelid laxity. The possible reason for these decreases may be inflammation, which plays a role in the pathophysiology of eyelid laxity. <b>[<i>J Refract Surg</i>. 2024;40(11):e783-e791.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 11","pages":"e783-e791"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}