Wavefront excimer laser refractive surgery for adults with refractive errors.
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ABSTRACT:
SUBMITTER: Li SM
PROVIDER: S-EPMC8094180 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:PurposeTo assess the performance of an open-view binocular handheld aberrometer (QuickSee) for diagnosing refractive errors in children.Methods123 school-age children (9.9 ± 3.3 years) with moderate refractive error underwent autorefraction (AR) with a standard desktop device and subjective refraction (SR), with or without cycloplegia to determine their eyeglass prescription. Measurements with QuickSee (QS) were taken in 62 of these patients without cycloplegia (NC), and in 61 under cycloplegia (C). Differences in refraction values (AR vs SR vs QS) as well as the visual acuity (VA) achieved by the patients with each method (QS vs SR) were used to evaluate the performance of the device in measuring refractive error.ResultsThe spherical equivalent refraction obtained by QS agreed within 0.5 D of the SR in 71% (NC) and 70% (C) of the cases. Agreement between the desktop autorefractor and SR for the same threshold was of 61% (NC) and 77% (C). VA resulting from QS refractions was equal to or better than that achieved by SR procedure in 77% (NC) and 74% (C) of the patients. Average improvement in VA with the QS refractions was of 8.6 and 13.4 optotypes for the NC and C groups respectively, while the SR procedure provided average improvements of 8.9 (NC) and 14.8 (C) optotypes.ConclusionsThe high level of agreement between QuickSee and subjective refraction together with the VA improvement achieved in both study groups using QuickSee refractions suggest that the device is a useful autorefraction tool for school-age children.
| S-EPMC7592806 | biostudies-literature
Project description:BackgroundA larger optical zone for photorefractive keratectomy may improve optical quality and stability. However, there is need for limiting ablation diameter in that a larger ablation diameter requires greater ablation depth, and minimizing ablation depth may reduce adverse effects on postoperative wound healing, haze and keratoectasia. In this study, we compared the changes in clinical outcomes and the degree of regression between a 6.0 mm optical zone and 6.5 mm optical zone following PRK.MethodsThe records of 95 eyes that had undergone PRK with a 6.0 OZ (n = 40) and a 6.5 OZ (n = 55) were retrospectively reviewed. We compared data including the spherical equivalent of manifest refraction (SE of MR), simulated K (Sim K), thinnest corneal thickness, change in thinnest corneal thickness (the initial value divided by corrected diopter [ΔTCT/CD]), Q value, corneal higher order aberrations (HOAs) and spherical aberration (SA) pre-operation, at 3 and 6 months postoperative and at the last follow-up visit (Mean; 20.71 ± 10.52, 17.47 ± 6.57 months in the 6.0 and 6.5 OZ group, respectively).ResultsThere were no significant differences in the SE of MR, Sim K and UDVA between the 6.0 OZ group and the 6.5 OZ group over 1 year of follow-up after PRK, and the 6.0 OZ group required less ΔTCT/CD than the 6.5 OZ group. The 6.5 OZ group showed better results in terms of post-operative HOAs of RMS, SA and Q value. When comparing that pattern of change in Sim K, there was no significant difference between the 6.0 OZ group and the 6.5 OZ group.ConclusionsThe clinical refractive outcomes and regression after PRK using Mel 90 excimer laser with a 6.0 OZ were comparable to those with a 6.5 OZ.
| S-EPMC7346386 | biostudies-literature
Project description:Laser refractive surgery for myopia increases the eye's higher-order wavefront aberrations (HOA's). However, little is known about the impact of such optical degradation on post-operative image quality (IQ) of these eyes. This study determined the relation between HOA's and IQ parameters (peak IQ, dioptric focus that maximized IQ and depth of focus) derived from psychophysical (logMAR acuity) and computational (logVSOTF) through-focus curves in 45 subjects (18 to 31 yrs) before and 1-month after refractive surgery and in 40 age-matched emmetropic controls. Computationally derived peak IQ and its best focus were negatively correlated with the RMS deviation of all HOA's (HORMS) (r≥-0.5; p<0.001 for all). Computational depth of focus was positively correlated with HORMS (r≥0.55; p<0.001 for all) and negatively correlated with peak IQ (r≥-0.8; p<0.001 for all). All IQ parameters related to logMAR acuity were poorly correlated with HORMS (r≤|0.16|; p>0.16 for all). Increase in HOA's after refractive surgery is therefore associated with a decline in peak IQ and a persistence of this sub-standard IQ over a larger dioptric range, vis-à-vis, before surgery and in age-matched controls. This optical deterioration however does not appear to significantly alter psychophysical IQ, suggesting minimal impact of refractive surgery on the subject's ability to resolve spatial details and their tolerance to blur.
| S-EPMC4747534 | biostudies-literature
Project description:This study assesses the agreement between intraocular pressure (IOP) measurements taken with the Goldmann applanation tonometer (GAT) and a new experimental applanation tonometer with a convexly shaped apex (CT) after laser myopic refractive surgery. Two different CT radii (CT1 and CT2) were designed with a finite element analyser, and a prospective double masked study on 102 eyes from 102 patients was carried out. A Bland-Altman plot and intra-class correlation coefficient (ICC) were calculated to assess the agreement between GAT measurements and the measurements of both CT1 and CT2 before and after myopic laser assisted in situ keratomileusis (LASIK; n = 73) and photorefractive keratectomy (PRK; n = 29). We evaluated a subset of two subgroups (n = 36 each) for intra and inter-observer (IA/IE) error. From the whole cohort, the best IOP agreement was observed between GATpre and CT1post surgery: 16.09 ± 2.92 vs 16.42 ± 2.87 (p < 0.001); ICC = 0.675 (95% CI: 0.554-0.768). In the analysis of LASIK vs PRK, GATpre and CT1post showed the highest agreement, although LASIK measurements were more accurate than PRK, as the ICC = 0.718 (95% CI: 0.594-0.812) and ICC = 0.578 (95% CI: 0.182-0.795) respectively. Excellent agreement was observed for IA/IE, and there was an ICC > 0.8 (95% CI) in all cases. CT1 proved more accurate in the LASIK subgroup. In conclusion, our new version of GAT could be used with post-surgery LASIK patients as a more accurate measurement device compared to the current reference tonometer.
| S-EPMC7184562 | biostudies-literature
Project description:There are an increasing number of people who have had refractive surgery now developing cataract. To compare the accuracy of different intraocular lens (IOL) power calculation formulas after laser refractive surgery (photorefractive keratectomy or laser in situ keratomileusis), a comprehensive literature search of PubMed and EMBASE was conducted to identify comparative cohort studies and case series comparing different formulas: Haigis-L, Shammas-PL, SRK/T, Holladay 1 and Hoffer Q. Seven cohort studies and three observational studies including 260 eyes were identified. There were significant differences when Hoffer Q formula compared with SRK/T, Holladay 1. Holladay 1 formula produced less prediction error than SRK/T formula in double-K method. Hoffer Q formula performed best among SRK/T and Holladay 1 formulas in total and single-K method. In eyes with previous data, it is recommended to choose double-K formula except SRK/T formula. In eyes with no previous data, Haigis-L formula is recommended if available, if the fourth formula is unavailable, single-k Hoffer Q is a good choice.
| S-EPMC7021678 | biostudies-literature
Project description:The statistical characteristics of biometry and refractive error in a large sample of cataractous Cuban patients are presented, comparing between sexes and age groups. All patients were studied at the Cuban Institute of Ophthalmology "Ramón Pando Ferrer," La Habana. The sample consists of 28252 eyes of 25068 patients, subjected to cataract surgery during the time period between 2006 and 2019. Their biometry was obtained using IOL Master devices; also, visual acuity, refraction, and corneal power were registered. After surgery, the visual acuity and refraction were measured. The refractive prediction error was determined. For patients with both eyes registered, anisometropia was also calculated. Age and sex were used to segment the data. The preoperative biometric parameters show highly significant differences between sexes, with male eyes being longer and with a deeper anterior chamber but with a thinner lens. Also, keratometry shows highly significant differences, with female eyes being steeper than male. Before surgery, both sexes have myopic eyes as average, with males being more myopic than females (p < 0.001). After surgery, the average spherical equivalent is -0.36 D and female eyes are more myopic than males (p < 0.001). Visual acuity with and without distance correction has a significant increase after surgery. These results are of importance not only for Cuba but also for other countries with a large Cuban population and/or similar ethnic composition, such as the USA (particularly the south of Florida), Spain, and many countries in Latin America.
| S-EPMC8099509 | biostudies-literature
Project description:Purpose:To evaluate the effect of laser refractive surgery on sensory eye dominance of anisometropia. Methods:A total of 156 subjects with nonanisometropic myopia and 70 subjects with anisometropic myopia were enrolled in the first part of the study. The dichoptic motion coherence threshold technique was applied to collect the normal dataset and distribution of sensory eye dominance. The second part of the study included 40 subjects with nonanisometropic myopia and 40 subjects with anisometropic myopia who received the femtosecond laser-assisted in situ keratomileusis (Fs-LASIK). A comprehensive ophthalmologic evaluation was performed with particular attention to sensory eye dominance preoperatively and one-week and one-month postoperatively. The ocular dominance index (ODI) was applied to evaluate the subject's overall degree of sensory ocular dominance. Visual acuity, sighting eye dominance, and stereo acuity were also accessed. Results:In experiment one, the mean ODI in the nonanisometropic group and the anisometropic group was 1.48?±?0.63 and 1.95?±?1.07, respectively. The ODI values of the anisometropic group were significantly higher than those of the nonanisometropic group (Mann-Whitney U test, P < 0.001). The demographics information and the distribution of ODI values in both groups are summarized in tables and figures. In experiment two, all LASIK procedures were uneventful and no postoperative complications were observed during the postoperative follow-up. Preoperatively, the ODI values of the anisometropic LASIK group were significantly higher than those of the nonanisometropic LASIK group, which was consistent with the results of part 1. However, one week after operation, the mean ODI values of the anisometropic LASIK group had significantly decreased from 1.89?±?1.09 to 1.39?±?0.44. And, the mean ODI values slightly increased to 1.65?±?0.61 one-month postoperatively. In the nonanisometropic LASIK group, there were no statistically significant differences of ODI changes among preoperative, post-one-week and post-one-month visits. The demographics information and the changes of ODI of both LASIK groups are summarized in tables and figures. Conclusion:Stronger sensory eye dominance is seen in the subjects with anisometropic myopia compared to subjects with nonanisometropic myopia. The strong sensory dominance of anisometropia becomes more balanced at one week of postoperation but returns to the preoperative level after one month. Laser refractive surgery had a short-term modulation of sensory eye dominance.
| S-EPMC7152944 | biostudies-literature
Project description:Cataract surgery combined with excimer laser trabeculotomy (phaco-ELT) can reduce intraocular pressure (IOP). The aim of this study was to evaluate the effect of phaco-ELT on IOP in patients as a function of preoperative IOP.Patients with open-angle glacuoma or ocular hypertension who received phaco-ELT between 01/2008 and 10/2009 were included. Patients were assigned based on preoperative IOP either to the study group (?21 mmHg) or control group (>21 mmHg) in this IRB-approved, prospective, consecutive case series. Visual Acuity, IOP, and number of anti-glaucoma drugs (AGD) were recorded at baseline and 12 months after phaco-ELT. Any postoperative complications were also recorded.64 eyes of 64 patients (76.5 ± 9.4 years) were included. Baseline IOP was 19.8 ± 5.3 mmHg (AGD 2.4 ± 1.1) for all eyes, 16.5 ± 2.9 mmHg (AGD 2.5 ± 1.0) for the study group, and 25.8 ± 2.9 mmHg (AGD 2.2 ± 1.4) for the control group. Across the two groups, IOP was reduced by 4.5 ± 5.9 mmHg (-23.0%, p < 0.001) and AGD by 0.9 ± 1.5 (-38.9%, p < 0.001). For the study group IOP was reduced by 1.9 ± 4.4 mmHg (-11. 5 %, p = 0.012) and AGD by 1.1 ± 1.4 (-42.9%, p < 0.001), and for the control group by 9.5 ± 5.4 mmHg (-36.6%, p < 0.001) and AGD by 0.7 ± 1.6 (-29.5%, p = 0.085). There were no serious postoperative complications such as endophthalmitis, significant hyphema, or a severe fibrinous reaction of the anterior chamber.IOP remained significantly reduced from baseline 12 months after phaco-ELT regardless of preoperative IOP levels, with no major complications. The IOP reduction remained constant over the entire follow-up. Hence, phaco-ELT can be considered in glaucoma and ocular hypertensive patients whenever cataract surgery is performed, in order to further reduce IOP or to reduce the requirement for IOP-reducing medications.
| S-EPMC3724507 | biostudies-literature
Project description: Not available
| S-EPMC9585644 | biostudies-literature
Project description:Laser wakefield acceleration (LWFA) continues to grow and awaken interest worldwide, especially as in various applications it approaches performance comparable to classical accelerators. However, numerous challenges still exist until this can be a reality. The complex non-linear nature of the process of interaction between the laser and the induced plasma remains an obstacle to the widespread LWFA use as stable and reliable particle sources. It is commonly accepted that the best wavefront is a perfect Gaussian distribution. However, experimentally, this is not correct and more complicated ones can potentially give better results. in this work, the effects of tuning the laser wavefront via the controlled introduction of aberrations are explored for an LWFA accelerator using the shock injection configuration. Our experiments show the clear unique correlation between the generated beam transverse characteristics and the different input wavefronts. The electron beams stability, acceleration and injection are also significantly different. We found that in our case, the best beams were generated with a specific complex wavefront. A greater understanding of electron generation as function of the laser input is achieved thanks to this method and hopes towards a higher level of control on the electrons beams by LWFA is foreseen.
| S-EPMC10611724 | biostudies-literature