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Fibrin glue to manage flap necrosis secondary to late-onset infectious keratitis after laser in?situ karatomileusis
摘要： A 52-year-old man developed flap necrosis secondary to late-onset infectious keratitis after laser in situ keratomileusis. Management involved a flap lift and irrigation of the interface with fortified antibiotics. The flap was then replaced, and fibrin glue was placed at the flap edges and over the necrotic area to seal it completely. Two months after surgery, the corrected distance visual acuity was 20/20 and a slitlamp examination showed no signs of infection. Localized flap necrosis can be adequately managed with fibrin glue, including in cases of herpes simplex virus keratitis.
关键词： fibrin glue,infectious keratitis,flap necrosis,herpes simplex virus,laser in situ keratomileusis
更新于2025-09-12 10:27:22
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Long-term assessment of visual and refractive outcomes of laser in situ keratomileusis for hyperopia using the AMARIS? 750S Excimer laser
摘要： Purpose. — To evaluate the long-term efficacy and safety of hyperopic laser in situ keratomileusis (LASIK) using the AMARIS? 750S (Schwind, Eye-tech-solutions, GmbH) excimer laser. Methods. — The medical records of one hundred eleven eyes of 62 patients who underwent LASIK for hyperopia using the AMARIS? 750S excimer laser were reviewed retrospectively. Patients were divided into three groups based on preoperative spherical equivalent (SE) refraction: low hyperopia (less than +2.50 diopters [D]), moderate hyperopia (+2.75D to +4.00D), and high hyperopia (over +4.00D). Uncorrected and best corrected visual acuity (BCVA), long-term stability of refraction, and complications were evaluated. Results. — Of the entire sample, the mean preoperative SE was +3.64D ± 1.22D. The mean age was 37.4 ± 11.2 years (20—59). The mean follow-up for all eyes was 51 months. At the last visit, the mean SE was +0.85D ± 0.34D in the low hyperopia group, +1.09D ± 0.43D in the moderate hyperopia group, and +1.63D ± 0.47D in the high hyperopia group (+1.15D ± 0.49D overall). Preoperative uncorrected visual acuity (UCVA) was 0.52 ± 0.34 logMAR and increased to 0.18 ± 0.15 logMAR at 4 years follow-up (P < 0.01). There was no statistically significant difference between preoperative and postoperative BCVA. The UCVA was 0.30 logMAR or better in 100% of eyes in the low hyperopia group, 93.7% in the moderate hyperopia group, and 69.9% in the high hyperopia group (%89.2 overall). Conclusions. — LASIK is safe and effective for correcting hyperopia in the short term; however, the efficacy of the procedure is limited in the patients with high hyperopia and longer follow-up.
关键词： Hyperopic laser in situ keratomileusis,Excimer laser,LASIK,Laser in situ keratomileusis,Hyperopia
更新于2025-09-11 14:15:04
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Clinical outcomes of small incision lenticule extraction versus femtosecond laser-assisted LASIK for myopia: a Meta-analysis
摘要： ● AIM: To evaluate the possible differences in visual quality between small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK) for myopia. ● METHODS: A Meta-analysis was performed. Patients were from previously reported comparative studies treated with SMILE versus FS-LASIK. The PubMed, EMBASE, Cochrane, Web of Science and Chinese databases (i.e. WANFANG and CNKI) were searched in Nov. of 2016 using RevMan 5.1 version software. The differences in visual acuity, aberration and biomechanical effects within six months postoperatively were showed. Twenty-seven studies including 4223 eyes were included. ● RESULTS: No significant differences were observed between SMILE and FS-LASIK in terms of the proportion of eyes that lost one or more lines of corrected distance visual acuity after surgery (P=0.14), the proportion of eyes achieving an uncorrected distance visual acuity of 20/20 or better (P=0.43), the final refractive spherical equivalent (P=0.89), the refractive spherical equivalent within ±1.00 diopter of the target values (P=0.80), vertical coma (P=0.45) and horizontal coma (P=0.06). Compared with the FS-LASIK group, total higher-order aberration (P<0.001) and spherical aberration (P<0.001) were higher and the decrease in corneal hysteresis (P=0.0005) and corneal resistance factor (P=0.02) were lower in the SMILE group. ● CONCLUSION: SMILE and FS-LASIK are comparable in efficacy, safety and predictability for correcting myopia.
关键词： Meta-analysis,small incision lenticule extraction,myopia,femtosecond laser in situ keratomileusis
更新于2025-09-11 14:15:04
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Stability of corneal topography and aberrometry after hyperopic laser in situ keratomileusis with a 500-Hz excimer laser platform: A 3-year follow-up study
摘要： The aim of this study is to analyze the long-term stability of the corneal topography, the functional optical zone, and the refractive stability throughout 3 years following laser in situ keratomileusis surgery for hyperopia using a 500-Hz excimer laser system. This retrospective consecutive observational case series study comprised 66 eyes that underwent laser in situ keratomileusis to correct hyperopia with a postoperative follow-up of 3 years. Laser in situ keratomileusis procedures were performed using the SCHWIND Amaris 500-Hz excimer laser. Main outcomes measured were stability of the functional optical zone at corneal topography and corneal aberrometry. Statistically significant differences were found in simulated keratometry (K2 (steep meridian) and Km (mean keratometry)) between 3 and 36 months postoperatively (p ? 0.01); these differences disappeared at 12 and 36 months (p ? 0.18). No statistically significant changes were observed in the horizontal and vertical diameter of the functional optical zone throughout the whole follow-up (p ? 0.07). A statistically significant difference was found in the spherical aberration between 3 and 36 months (p = 0.02); this difference disappeared when compared between 12 and 36 months (p = 0.72). Statistically significant correlations were detected between the vertical functional optical zone and coma root mean square (r = –0.510, p < 0.01) and between the vertical functional optical zone and spherical aberration (r = 0.441, p = 0.02) 36 months after surgery. Following 3 years of hyperopic laser in situ keratomileusis with a 500-Hz Amaris excimer laser, keratometry, functional optical zone, and corneal aberrations remain stable from 1 year after surgery. Topographical regression is not observed in hyperopic laser in situ keratomileusis with this excimer laser technology from 1 year after surgery.
关键词： corneal topography,refractive surgery,hyperopic laser in situ keratomileusis,hyperopia,Functional optical zone,corneal aberrations,hyperopic regression
更新于2025-09-11 14:15:04