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Femtosecond Laser-Assisted In Situ Keratomileusis Treatment of Residual Refractive Error following Femtosecond Laser-Enabled Keratoplasty
摘要： Purpose. To evaluate the safety and effectiveness of femtosecond laser-assisted in situ keratomileusis (LASIK) in the treatment of residual myopia and astigmatism following femtosecond laser-enabled keratoplasty (FLEK). Design. Retrospective case review. Methods. Chart review of all patients with prior FLEK who subsequently underwent femto-LASIK surgery after full suture removal was performed at the Gavin Herbert Eye Institute at the University of California, Irvine. A total of 14 eyes in 13 patients met this criterion, and their comprehensive examinations performed at standard intervals were reviewed. Main outcome measures include uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) expressed as the logarithm of the minimum angle of resolution (logMAR), manifest refractive astigmatism, and spherical equivalent. Results. From the preoperative visit to the 3 month visit, all 14 eyes significantly improved in UDVA (logMAR, 0.93 ± 0.23 to 0.44 ± 0.32, P = 0.002) with no loss of CDVA (logMAR, 0.26 ± 0.19 to 0.18 ± 0.23, P = 0.50). All 14 eyes showed significant improvement in manifest refractive astigmatism (4.71 ± 1.77 to 2.18 ± 1.45 diopters (D), P = 0.003) and spherical equivalent (? 2.57 ± 2.45 to ? 0.48 ± 0.83 D, P = 0.0007). There were no flap or graft complications as a result of femto-LASIK. Conclusions. Our findings suggest that femto-LASIK on eyes with prior FLEK is safe and effective in improving visual acuity and reducing residual astigmatism.
关键词： femtosecond laser-enabled keratoplasty,LASIK,femtosecond laser-assisted in situ keratomileusis,residual myopia,astigmatism,FLEK
更新于2025-09-12 10:27:22
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Comparison of 9.0 and 9.2?mm Flap Diameter Options of Femtosecond Laser In-Situ Keratomileusis for Hypermetropia and Hypermetropic Astigmatism
摘要： Aim. To compare the postoperative one-year outcomes of asphericity (Q) and high order aberration (HOA) values of 9.0 and 9.2 mm diameter ?ap groups in hypermetropia and hypermetropic astigmatism subjects who underwent femtosecond laser in-situ keratomileusis (LASIK). Materials and Methods. The study included 68 eyes of 34 patients. A femtosecond laser platform (Allegrato Wave, Wavelight AG, Erlangen, Germany) was used for ?ap cutting. Corneal stroma was ablated using Wavelight EX500 with wavefront-optimized pro?le (WaveLight GmbH, Erlangen, Germany). 9.0 mm ?ap diameter was randomly chosen for one eye, and 9.2 mm ?ap diameter was chosen for the fellow eye. Two eyes of the patients who used two di?erent ?ap diameters were enrolled into two di?erent groups. Corneal stroma was ablated using Wavelight EX500 with wavefront-optimized pro?le (WaveLight GmbH, Erlangen, Germany). Postoperative one-year outcomes of Q and HOA values of 9.0 and 9.2 mm diameter ?ap groups were compared statistically. Results. The preoperative manifest refraction spherical equivalents of the 9.0 and 9.2 mm diameter ?ap groups were 1.86 ± 1.81 D and 1.69 ± 1.99 D (p ? 0.754). No intraoperative or postoperative complications were observed. At postoperative one-year, Q values were 0.98 ± 0.13 D and 0.91 ± 0.15 D (p ? 0.029). HOAs including horizontal and vertical coma, horizontal and vertical trefoil, spherical aberration, and second order vertical coma were not signi?cantly di?erent (p > 0.05 for all). Total HOA values were 1.62 ± 0.14 and 1.40 ± 0.16, in the 9.0 and 9.2 mm diameter ?ap groups, respectively (p < 0.001). Conclusion. Both the 9.0 and 9.2 mm diameter ?ap options in femtosecond LASIK are equally safe and e?ective. Many of the HOA values are similar in both options, and better results were provided in terms of total HOA and Q values with the 9.2 mm diameter ?ap option. This study was registered with trial registration number 118-011.
关键词： hypermetropic astigmatism,asphericity,femtosecond laser,LASIK,high order aberration,hypermetropia,flap diameter
更新于2025-09-11 14:15:04
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The Association between Ocular Dominance and Refractive Errors in Chinese Myopic Subjects
摘要： Background: To determine the association between ocular dominance and myopic anisometropia in Chinese myopic subjects. This relevance would facilitate to identify the ocular dominance in bilateral cataract patients. Design: Retrospectively case study. Participants: 1503 Chinese myopic subjects, mean age 27 years, who were candidates for corneal myopic refractive surgery were reviewed between 2011 and 2012. Methods: The ocular dominance was determined by the hole-in-the-card test. The associations between ocular the sphere, cylinder, spherical and astigmatic laterality and refractive characters, including dominance anisometropia, were analyzed. Main outcome measures: Ocular dominance, manifest refraction, cycloplegic refraction. Results: 992 (66%) subjects were right-eye dominant while 511 (34%) subjects were left-eye dominant. The dominant eyes had lower spherical equivalents (SE) and cylinders than the non-dominant eyes (-5.36 D vs. -5.48 D and -0.70 D vs. -0.76 D, respectively, P<0.001). The ocular dominance was significantly associated with the lower myopic eye in subjects with SE anisometropia >0.5 D (P<0.05). There was also significant association between the dominant eyes and the lower astigmatic eyes in the subjects with astigmatic anisometropia > 0.25 D (P<0.05). In unilateral astigmatic subjects, non-astigmatic eyes were noted to be the dominant eyes in 111 (57.51%) subjects and astigmatic eyes represented dominance in 82 (42.49%) subjects. The difference was not statistically significant (P=0.249). The ocular dominance was not associated with the sex. Conclusion: In Chinese myopic subjects, the dominant eye usually had lower myopic SE and lower astigmatism compared with the non-dominant eye, especially in subjects with high amount of anisometropia.
关键词： Astigmatism,Ocular dominance,Cataract,Myopia
更新于2025-09-10 09:29:36
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Effect of astigmatism on refraction in children with high hyperopia
摘要： The aim of this study was to evaluate primitively whether the extent and component of astigmatism influences regression in degree of spherical (DS) and the best corrected visual acuity (BCVA) of children with hyperopia of +5.00 diopters (D) or greater. Children were screened from the outpatient refraction database in the Wenling No. 1 People's Hospital in Zhejiang province and in Eye & ENT Hospital of Fudan University between June 2005 and December 2015. Eligible eyes were divided into three groups according to the extent of astigmatism: group of astigmatism ≤ ?2 D of cylinder, group without astigmatism or with astigmatism ≥ ?0.5 D of cylinder, and the group with astigmatism ≥ ?0.75 D and ≤ ?1.75 D of cylinder. For the component of astigmatism, eyes with astigmatism as ≤ ?0.75 D of cylinder were divided into 3 groups: with the rule (WTR), against the rule (ATR) and the group with the oblique. Differences in the changes of BCVA and refractive error (RE) during follow-up terms were compared within and among groups. Differences in the mean DS or BCVA were not statistically signi?cant between groups according to the extent of the astigmatism at the last visit (p = 0.2396 and p = 0.2131, respectively). As for the component of astigmatism, the group with oblique astigmatism had more severe hyperopia than the group of WTR (p < 0.0001) and mean BCVA in the group of ATR were better than that of the other two groups (p < 0.0001) at the first visit. However, the among-group changes were not significant at the end of the observation (p > 0.1). The regression of DS and improvement of the BCVA in children with hyperopia of +5.00D or greater may be irrespective of the component and the extent of astigmatism.
关键词： high hyperopia,refraction,Astigmatism,child
更新于2025-09-10 09:29:36
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Comparison of visual performance of toric versus non-toric intraocular lenses with same material
摘要： We compared the visual performance of toric intraocular lenses (IOLs) and non-toric IOLs made of the same material. The subjects included patients implanted with either Acrysof IQ? toric IOLs (SN6AT3-9) or Acrysof IQ? IOLs (SN60WF) bilaterally. The toric group included 103 patients who were implanted with Acrysof IQ toric IOLs bilaterally. The non-toric group was a corneal astigmatism-matched control group and included 103 patients who were implanted with Acrysof IQ IOLs bilaterally. Results: The uncorrected distance visual acuity was significantly better in the toric group, whereas the uncorrected 50 cm visual acuity was better in the non-toric group. There was no significant difference in contrast sensitivity (with and without glare) between both the groups. The rate of spectacle dependency for distance vision was significantly lower in the toric group. There were no significant differences between the two groups in all items of the postoperative quality-of-vision questionnaire (25-item Visual Function Questionnaire). Conclusion: The toric IOLs used in this study reduced spectacle dependency more than the non-toric IOLs and did not compromise the subjective visual function, but the uncorrected 50 cm vision was worse in toric IOL implanted eyes.
关键词： astigmatism,cataract surgery,visual function,cataract
更新于2025-09-10 09:29:36
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Trial-based cost-effectiveness analysis of toric versus monofocal intraocular lenses in cataract patients with bilateral corneal astigmatism in the Netherlands
摘要： To evaluate the cost-effectiveness of toric versus monofocal intraocular lens (IOL) implantation in cataract patients with bilateral corneal astigmatism. Setting: Two ophthalmology clinics in the Netherlands. Design: Prospective cost-effectiveness analysis. Methods: Resource-use data were collected over a 6-month postoperative period. Consecutive patients with bilateral age-related cataract and 1.25 diopters or more of corneal astigmatism were included in the economic evaluation. Patients were randomized to phacoemulsification with bilateral toric or monofocal IOL implantation. All relevant resources were included in the cost analysis. The base-case analysis was performed from a societal perspective based on quality-adjusted life years (QALYs). The main outcome was the incremental cost-effectiveness ratio. Results: The analysis comprised 77 consecutive patients (33 toric IOL; 44 monofocal IOL). Societal costs were higher in the toric IOL group (V3203 [$3864]) than in the monofocal IOL group (V2796 [US$3373]). QALYs were slightly lower in the toric IOL group (0.30 versus 0.31; P Z .75). Toric IOLs were therefore inferior to monofocal IOLs from a cost-effectiveness perspective. The cost-effectiveness probability ranged from 1% to 15%, assuming a ceiling ratio for the incremental cost-effectiveness ratio of V2500 to V20 000 per QALY. Conclusions: From a societal perspective, bilateral toric IOL implantation in cataract patients with corneal astigmatism was not cost-effective compared with monofocal IOL implantation. Copayment by patients should therefore be considered.
关键词： monofocal intraocular lens,corneal astigmatism,cost-effectiveness,toric intraocular lens,cataract
更新于2025-09-10 09:29:36
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Intrastromal crosslinking in post-LASIK ectasia
摘要： We describe a case of early post-LASIK ectasia detected in the first 6 months after surgery. The patient was treated by means of intrastromal corneal crosslinking under the flap, without de-epithelialization, which resulted in a positive outcome. At the time of writing, 2 years after the procedure, the patient remained free of progression.
关键词： Keratomileusis, laser in situ,Adult,Case reports,Corneal wavefront aberrations,Corneal stroma,Astigmatism,Postoperative complications,Cross-linking reagent,Refractive surgical procedures,Humans,Female
更新于2025-09-09 09:28:46
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Long-term Changes in Refractive Error after Spectacle Use
摘要： Purpose: To evaluate the long-term changes in spherical equivalent (SE) refractive error and astigmatism in patients after spectacle use. Methods: A total of 103 patients with refractive error without strabismus and amblyopia who received at least 3 years of follow-up after using spectacles were included in this study. Patients were divided into groups according to the age at which spectacles were used (<4 years, ≥4 to <7 years, ≥7 years), the initial degree of SE refractive error (<-0.50 diopter [D], -0.50 to +0.75 D, >+0.75 D), and the initial degree of astigmatism (<1.00 D, 1.00 to 3.00 D, ≥ 3.00 D). Changes in the SE refractive error and astigmatism were compared between these groups using mixed linear models. Results: Patients were followed up for a mean of 9.1 ± 1.6 years. An overall negative shift in SE refractive error and an increasing tendency in astigmatism during follow-up were noted regardless of the age at which spectacles were used (p < 0.001). The myopic group showed the largest negative shift in SE and the largest increase in astigmatism (p < 0.001, p = 0.02 respectively). The low and moderate astigmatism groups were more likely to have significant increases in astigmatism (p < 0.001). Conclusions: Patients with refractive error showed a negative shift in SE and an increasing tendency in astigmatism regardless of the age at which spectacles were used. Changes in SE and astigmatism may be influenced by the initial degree of SE, and the initial degree of astigmatism may influence changes in astigmatism.
关键词： Spherical equivalent,Spectacle use,Refractive error,Astigmatism
更新于2025-09-09 09:28:46
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The role of sideport incision in astigmatism change after cataract surgery
摘要： Purpose: To study the changes in corneal astigmatism after cataract surgery when the sideport incision is performed at a predetermined location away from the tunnel incision. Setting: General Hospital of Piraeus “Tzaneio”, Attiki, Greece. Materials and methods: A total of 333 eyes with corneal astigmatism #1.5 diopters (D) underwent cataract surgery. A three-step superotemporal clear corneal incision for the right eye and a superonasal clear corneal incision for the left eye (3.0 mm) was made, while the sideport incision was located at ,90°, 90°–110°, and .110°. Keratometric data were measured with corneal topography EyeSys Vista 2000 pre- and postoperatively at the 1st and 6th month. Surgically induced astigmatism was calculated by vector analysis. We noted all cases in which a change .0.5 D in corneal astigmatic power occurred, as well as a change .20° in axis torque, despite axis direction. Results: After multiple logistic regression analysis was conducted, cases with .110° distance between the tunnel and sideport incision had 2.22 times (P=0.021) greater likelihood for having changed .0.5 D in astigmatic power at the 1st month and 3.45 times (P=0.031) at the 6th month postoperatively, as compared with cases with a 90°–110° distance between the tunnel and sideport incision. As for the change in the astigmatic axis, cases with ,90° distance had a 4.18 times greater likelihood for having a change .20° (P,0.001) (preoperative to 1st month) as compared with cases having 90°–110° of distance. Conclusion: For surgeons that operate only from the superior position, we propose that in order to produce an incision that is as “astigmatically neutral” as possible, they should perform the sideport incision at a 90°–110° distance.
关键词： tunnel incision,sideport incision,astigmatism,cataract surgery
更新于2025-09-04 15:30:14
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Comparison between Toric and Non-Toric Intraocular Lenses in Patients with Corneal Astigmatism: A One-Year Multicenter Study
摘要： Objective: To compare the clinical results obtained with a toric intraocular lens (IOL) and non-toric IOL in eyes with corneal astigmatism. Methods: This multicenter retrospective study included eyes with corneal astigmatism ranging from 0.75 diopter (D) to 3.00 D that were implanted with a toric IOL and a non-toric IOL. Non-toric IOLs were implanted before toric IOLs were approved, and the eyes were divided into three groups (T3, T4, or T5) depending on the preoperative degree of corneal astigmatism. Residual refractive cylinder, uncorrected distance visual acuity (UDVA), and contrast sensitivity were compared more than 1 year after implantation. Results: The toric group included 149 eyes (mean patient age, 73.7 ± 7.9 years standard deviation, SD) and the non-toric group included 121 eyes (mean patient age, 76.2 ± 5.9 years). One year postoperatively, the respective residual refractive cylinder values and ± SD of the toric/non-toric groups were -0.61 ± 0.43/-1.45 ± 0.98 D (all eyes), -0.58 ± 0.42/-1.14 ± 0.70 D (T3), -0.59 ± 0.42/-1.63 ± 0.99 D (T4), and -0.67 ± 0.47/-2.18 ± 1.27 D (T5). The respective logarithm of the minimum angle of resolution UDVA values was 0.00 ± 0.12/0.16 ± 0.20 (all eyes), 0.00 ± 0.11/0.13 ± 0.18 (T3), 0.00 ± 0.13/0.25 ± 0.23 (T4), and 0.00 ± 0.11/0.17 ± 0.16 (T5). The toric group had better cylinder and UDVA outcome values; the difference between the groups reached significance (p<0.0001). In the toric group, the IOL rotation after implantation was 4.3 ± 4.0 degrees. Conclusion: Toric IOLs reduced the residual refractive cylinder in cases with corneal astigmatism between 0.75 and 3.00 D, and this effect was similar among different toric models. Toric IOLs are useful to improve the UDVA after cataract surgery.
关键词： Uncorrected visual acuity,Cataract surgery,Contrast sensitivity,Toric intraocular lens,Corneal astigmatism
更新于2025-09-04 15:30:14