In adult patients with RAE, treatment of the refractive error using hyperopic LASIK was safe and effective and corrected the esodeviation. Further studies in younger patients will help determine the age at which this intervention may be indicated.
Excimer laser ablation appears to be an effective option for the treatment of glaucoma that may be easier to perform than other procedures for many surgeons.
RESUMEN
Methods:In a prospective study, following the protocol, 16 eyes with refractory glaucoma were included and operated. Intraocular pressure ≤21mmHg with or without additional medication was considered successful. The follow-up was one year. Averages, percentages and their 95% confidence bands were calculated. Analysis of variance for repeated measures was used to compare averages. Results: The average preoperative intraocular pressure was 32.81 mmHg, SD ± 10.94 mmHg in a range of 14 to 50 mmHg. The average post-surgical intraocular pressure at one year was 12.43 mmHg, SD ± 2.85 mmHg in a range of 7 to 19 mmHg. The difference between the pre-and post-surgery average intraocular pressure was 20.38 mmHg. The number of successes was 14 eyes (87.5%, confidence interval (CI) 95% 61.6% -98.6%). The number of failures was two eyes (12.5%, CI 95% 1.43% -38.4%).
Conclusions:The results show that the microdevice is successful for the treatment of refractory glaucoma.
BACKGROUND: A new technique, therapeutic alloplastic laser in situ keratomileusis to correct high myopia, is introduced.
METHODS: Therapeutic alloplastic laser in situ keratomileusis consists of neutral homoplastic epikeratoplasty combined with superficial keratectomy performed with an excimer laser and/or a microkeratome. Indications for the technique are: myopia over 20 diopters (D), eyes with corneal scarring after photorefractive keratectomy (PRK), complications following keratomileusis, radial keratotomy complications with undercorrection, and keratoconus suspect myopic eyes.
RESULTS: In all five eyes we achieved precise corneal lathing with the microkeratome or the excimer laser, and obtained a clear allograft. In all eyes, we maintained or improved the patient's spectacle-corrected visual acuity related to baseline values. We did not induce astigmatism, and corneal thickness was almost unchanged.
CONCLUSIONS: Advantages of therapeutic alloplastic laser in situ keratomileusis are that it provides a Bowman's layer for the cornea following keratectomy, it is possible to lathe ablation diameters larger than 5 mm, it prevents the appearance of corneal haze, and reduces the need for corticosteroid treatment. [J Refract Surg 1998;14:64-69]
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