PURPOSE: To observe the epithelial remodeling over a 9-mm diameter cornea induced by topography-guided femtosecond laser–assisted in situ keratomileusis (FS-LASIK) for myopia correction using spectral-domain optical coherence tomography (SD-OCT). METHODS: Forty-three eyes of 22 patients who underwent topography-guided FS-LASIK for myopic correction were included. The “Pachymetrywide” scan pattern was used to generate the epithelial thickness map using SD-OCT preoperatively and 1, 3, and 6 months postoperatively. Epithelial thickness was compared and analyzed by section and zone. RESULTS: Compared to the preoperative values, the change in the average epithelial thickness in the central, paracentral, and mid-peripheral zones was 2.09, 4.53, and −0.87 µm at 1 month; 3.00, 4.61, and −0.97 µm at 3 months; and 3.28, 4.55, and −0.81 µm at 6 months postoperatively, respectively. From 1 to 3 months postoperatively, the central epithelial thickness changed significantly ( P = .021), whereas the epithelial thickness in the paracentral ( P = .973) and mid-peripheral ( P = .996) zones stabilized. No significant epithelial thickness change was observed in the zones between 3 and 6 months postoperatively (all P > .05). The epithelial thickness in the paracentral inferotemporal section increased by 12.7% at 6 months after surgery. The central epithelial hyperplasia showed no correlation with the change in postoperative manifest refraction spherical equivalent ( P = .313). CONCLUSIONS: After topography-guided FS-LASIK, the 9-mm diameter epithelial thickness showed a longitudinal and regional non-uniform redistribution. Central epithelial remodeling stabilized more slowly. The greatest increase in epithelial thickness was observed in the paracentral inferotemporal section. This epithelial remodeling did not cause refractive regression. [ J Refract Surg . 2019;35(2):88–95.]
Purpose: To observe the crystalline lens rise (CLR) in horizontal and vertical orientations using anterior segment optical coherence tomography (AS-OCT). Methods: Non-invasive swept-source AS-OCT was used to measure the lens thickness, CLR, and angle-to-angle distance (ATA) in both the horizontal and vertical orientations. Anterior chamber depth (ACD) and horizontal white-to-white corneal diameter were obtained using the Pentacam HR (Oculus Optikgeräte GmbH). Axial length was obtained using the IOLMaster 700 (Carl Zeiss Meditec AG). The paired t test was used to analyze the difference in CLR between the two orientations. Pearson correlation analysis was performed to investigate the correlations between CLR and other ocular variables. Results: This prospective observational study comprised 99 eyes (99 patients) that underwent Visian Implantable Collamer Lens (STAAR Surgical) implantation for myopic correction. The mean CLR was 64.29 ± 168.04 and 208.09 ± 173.12 µm in the horizontal and vertical orientations, respectively. The vertical CLR (VCLR) was significantly greater than the horizontal CLR (HCLR) ( P < .05). Both the HCLR and VCLR were positively correlated with lens thickness and negatively correlated with ACD (all P < .05). The difference in CLR (VCLR-HCLR) was positively correlated with the axial length and the difference in ATA between the two orientations ( P < .05). Conclusions: VCLR was greater than HCLR in most patients with myopia, especially in the longer eyes. This nonuniform distribution in CLR implied different placements of the iridocorneal angles in the horizontal and vertical orientations and should be considered for the selection of ICL size and placement position. [ J Refract Surg . 2023;39(5):354–359.]
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