Laser in situ keratomileusis with a mechanical microkeratome had a higher risk for myopic regression than LASIK with a femtosecond laser through 12 months postoperatively.
Soft contact lens wear can induce corneal warpage mimicking keratoconus. Had the standard treatment for keratoconus been implemented before resolution of the warpage, it could have proven injurious to the patient, because the treatment itself could have provided an impetus for the protrusion to remain or perhaps even progress. Our case gives clinicians reason to pause when dealing with contact lens wearers presenting with corneal curvature irregularities such as keratoconus or ectasia, because of the possibility of lens-induced warpage.
The aim of this study is to describe factors that influence the measured intraocular pressure (IOP) change and to develop a predictive model after myopic laser in situ keratomileusis (LASIK) with a femtosecond (FS) laser or a microkeratome (MK). We retrospectively reviewed preoperative, intraoperative, and 12-month postoperative medical records in 2485 eyes of 1309 patients who underwent LASIK with an FS laser or an MK for myopia and myopic astigmatism. Data were extracted, such as preoperative age, sex, IOP, manifest spherical equivalent (MSE), central corneal keratometry (CCK), central corneal thickness (CCT), and intended flap thickness and postoperative IOP (postIOP) at 1, 6 and 12 months. Linear mixed model (LMM) and multivariate linear regression (MLR) method were used for data analysis. In both models, the preoperative CCT and ablation depth had significant effects on predicting IOP changes in the FS and MK groups. The intended flap thickness was a significant predictor only in the FS laser group (P < .0001 in both models). In the FS group, LMM and MLR could respectively explain 47.00% and 18.91% of the variation of postoperative IOP underestimation (R2 = 0.47 and R2 = 0.1891). In the MK group, LMM and MLR could explain 37.79% and 19.13% of the variation of IOP underestimation (R2 = 0.3779 and 0.1913 respectively). The best-fit model for prediction of IOP changes was the LMM in LASIK with an FS laser.
Background/Purpose:To evaluate the efficacy of autologous serum eye drops for patients with recalcitrant laser-assisted in situ keratomileusis (LASIK)-induced neurotrophic epitheliopathy (LINE) unresponsive to conventional treatment, and to determine the possible predisposing risk factors of these patients.Methods:We enrolled 10 consecutive patients (20 eyes) undergoing femtosecond-assisted myopic LASIK surgery presenting with recalcitrant LINE for > 1 year. Another 340 patients (713 eyes) receiving femtosecond-assisted myopic LASIK without recalcitrant LINE were set as controls. Possible risk factors associated with recalcitrant LINE were investigated. Twenty percent autologous serum treatment was prescribed to 20 eyes. The efficacy of autologous serum was assessed with ocular surface conditions, tear function, and the change of best-corrected visual acuity.Results:Age older than 30 years [odds ratio (OR) = 7.74; 95% confidence interval (CI), 1.74–34.50], flap thickness < 110 μm (OR = 3.47; 95% CI, 1.22–9.73), and a flap diameter < 8.5 mm (OR = 5.38; 95% CI, 1.95–14.85) pose higher risks in femtosecond laser-assisted myopic LASIK. All eyes (100%) achieved remission after autologous serum treatment. The visual acuity before treatment was 0.49 ± 0.41 in LogMAR, and the visual acuity after treatment was 0.14 ± 0.22 in LogMAR. Time to achieve remission was 8.26 ± 11.87 weeks. Mean relapse-free survival after discontinuing autologous serum was 47 weeks.Conclusion:Risk factors of recalcitrant LINE in femtosecond laser-assisted myopic LASIK were identified as older age, a thinner flap (<110 μm), and a small flap diameter (<8.5 mm). Autologous serum eye drops can effectively improve corneal surface conditions and postoperative visual acuity.
INTRACOR procedure produces a gain of near vision for presbyopia patients but also introduces a high lost of contrast sensitivity plus worsen of vision quality. Pre-surgical patient selection and advise should be given with specific regards to night driving and glare conditions.
Purpose: To investigate biomechanical properties of the cornea as measured using a Reichert ocular response analyzer (ORA) in a Taiwanese population. Methods: Basic demographic data were recorded for 1875 Taiwanese subjects. Corneal hysteresis (CH), corneal resistance factor (CRF), central corneal thickness (CCT), Goldmann-equivalent intraocular pressure (IOPg), and corneal-compensated intraocular pressure (IOPcc) were measured with an ORA. Descriptive statistics and multiple regression analyses were used to assess and compare relevant factors of the CRF and CH. Results: In total, 1817 eyes were included in this study. The mean patient age was 21.4 ± 17.01 years. The mean (±SD) CH and CRF values were 10.6 ± 1.81 and 10.6 ± 1.99 mmHg, respectively. The mean CCT was 560.4 ± 38.53 μm. CH was correlated with IOPcc, CRF, and CCT. In the multiple linear-regression model, CH was associated with and affected by IOPcc, CRF, and CCT. In another multiple linear-regression model, CRF was associated with and affected by IOPcc, CH, and CCT. Conclusions: Measuring biomechanical properties by Reichert ORA, we found that CH and CRF values of a Taiwanese population were similar to those other Asian populations and other races. Our findings provided fundamental data of CH and CRF in a Taiwanese (ethic Chinese) and also Asian population.
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