Both laser platforms provided predictable and effective treatment of mixed astigmatism in the patient populations treated, with over 90% of eyes achieving UDVA of 20/25 or better 6 months after surgery.
SurgeryIt has been almost 10 years since the first wavefront-guided laser refractive surgery procedure was approved in the US. beneficial effect is to be realized. 5 The study conducted to obtain the US Food and Drug Administration (FDA) label for wavefront-optimized AbstractThe purpose of this article is to compare refractive outcomes based on all wavefront-guided procedures versus a decision tree designed to assist with the selection of wavefront-guided or wavefront-optimized procedures. The setting was the The Laser Center, Greensboro. Twenty subjects were treated with a VISX CustomVue™ wavefront-guided refractive procedure in one eye and a WaveLight Allegretto procedure (wavefront-guided or optimized) in the contralateral eye. A decision tree was used to decide whether a wavefront-guided or wavefront-optimized procedure would be performed with the WaveLight system. The CustomVue eye was chosen at random. Visual acuity and refractive error were recorded pre-operatively and post-operatively. Subjective post-operative data included patient reported eye preference and post-operative glare and halos. The results were that one subject was lost to follow-up, leaving 19 subjects for analysis at three months. Of those subjects with data, 12 received wavefront-optimized treatment while seven subjects received a wavefront-guided treatment with the WaveLight laser. There were no significant differences in uncorrected visual acuity between the VISX and Wavelight groups at the one-day or six-month visits. At three months, 56 % of patients indicated no preference, with the remaining 44 % indicating a preference for the WaveLight-treated eye (p<0.05). The patient reported outcomes showed a similar incidence of post-operative glare and halos reported between the two treatments. Results with the Allegretto Wave Eye-Q laser, using a decision tree to determine whether a wavefront-optimized or a wavefront-guided treatment would be performed, were equivalent to those achieved with the VISX Star S4 wavefront-guided procedure.
Importance: This study highlights the value of current therapeutic devices in the authors practice for the management of meibomian gland dysfunction (MGD) and eyelid margin disease (ELD). Background:To evaluate the effects of current therapeutic devices on clinical measures of dry eye related to MGD and ELD in patients unresponsive to previous therapies. Design:A retrospective chart review of patients treated at one site.Participants: One thousand three hundred eighty-six eyes of 711 treated patients who were documented treatment failures with previous pharmaceuticals and/or devices were included in the patient population.Methods: Treatments for MGD included: lid exfoliation, low level light therapy in combination or alone with intense pulsed light therapy (LLLT or LLLT/IPL), thermal pulsation, blink assisted thermal energy, and radiofrequency thermal energy all performed at one center. Main Outcome Measures:Results included changes in the graded MGD score (grading scale 0 -4), tear breakup time (TBUT), Ocular Surface Disease Index (OSDI) questionnaire score and lissamine green staining (LGS).Results: Significant improvements in the MGD scores, TBUT, OSDI questionnaire scores and LGS were seen. There were no ocular or facial adverse events or side effects related to any of the treatments. Conclusion:The application of an algorithm for the treatment of MGD and ELD is beneficial in the majority of patients who had failed to improve with alternative pharmaceutical and device interventions.
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