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Differences in Simulated Refractive Outcomes of Photorefractive Keratectomy (PRK) and Laser In-Situ Keratomileusis (LASIK) for Myopia in Same-Eye Virtual Trials
摘要： The use of computational mechanics for assessing the structural and optical consequences of corneal refractive procedures is increasing. In practice, surgeons who elect to perform PRK rather than LASIK must often reduce the programmed refractive treatment magnitude to avoid overcorrection of myopia. Building on a recent clinical validation study of finite element analysis (FEA)-based predictions of LASIK outcomes, this study compares predicted responses in the validated LASIK cases to theoretical PRK treatments for the same refractive error. Simulations in 20 eyes demonstrated that PRK resulted in a mean overcorrection of 0.17 ± 0.10 D relative to LASIK and that the magnitude of overcorrection increased as a function of attempted correction. This difference in correction closely matched (within 0.06 ± 0.03 D) observed differences in PRK and LASIK from a historical nomogram incorporating thousands of cases. The surgically induced corneal strain was higher in LASIK than PRK and resulted in more forward displacement of the central stroma and, consequently, less relative flattening in LASIK. This FE model provides structural confirmation of a mechanism of action for the difference in refractive outcomes of these two keratorefractive techniques, and the results were in agreement with empirical clinical data.
关键词： laser in situ keratomileusis (LASIK),refractive surgery,cornea,photorefractive keratectomy (PRK),finite element analysis
更新于2025-09-16 10:30:52
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Outcomes of Flap Lift Laser In Situ Keratomileusis Enhancements in a Large Patient Population
摘要： Purpose: To compare the incidence of corneal epithelial ingrowth (EIG) and the visual outcomes of enhancement with laser in situ keratomileusis (LASIK) by ?ap lift when a bandage soft contact lens (CL) was ?tted after the procedure and when it was not. Methods: This is a multicenter, retrospective, interventional case series in which all patients who underwent LASIK enhancement from January 2005 to January 2015 were included consecutively. Patients were grouped depending on whether a bandage CL was ?tted after re-treatment by ?ap lift (group 1) or not (group 2). Results: A total of 16,702 eyes from 12,485 patients were included. There were statistically signi?cant differences between the groups regarding corrected distance visual acuity (better in group 1) and safety index (better in group 2) although these were not clinically relevant. The incidence of EIG was 0.58% in group 1 and 0.55% in group 2 although, again, the difference was not statistically different. Conclusions: We found no relevant differences in LASIK enhancement between patients who received a bandage CL and those who did not regarding the incidence of EIG and visual outcomes.
关键词： LASIK re-treatment,corneal epithelial ingrowth,bandage contact lens,laser in situ keratomileusis,LASIK
更新于2025-09-12 10:27:22
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Partial Scleral Rupture Presenting 4 Years After Laser in Situ Keratomileusis
摘要： To report a case of partial scleral rupture after laser in situ keratomileusis (LASIK) surgery. This is a retrospective case report describing a late complication of LASIK surgery. A 32-year-old white woman with a history of LASIK surgery performed with a mechanical microkeratome 4 years previously presented for evaluation of partial bilateral scleral ruptures. An arcuate ?ltering bleb along the contour of the cornea was found on the right eye with associated hypotony and corneal astigmatism. There were no signs or symptoms of prior in?ammation, and rheumatologic workup was negative. Imaging revealed scleral microbreaks in the absence of adjacent thinning. The pattern and location of thinning without ?ndings consistent with in?ammatory disease suggest that the partial bilateral scleral rupture was because of mechanical damage at the time of LASIK, possibly compounded by the hormonal changes of pregnancy.
关键词： scleral rupture,complications,complication,hypotony,scleral microbreaks,laser in situ keratomileusis (LASIK)
更新于2025-09-12 10:27:22