Changes in fusional vergence amplitudes after laser refractive surgery for moderate myopia

Han, Jinu; Hong, Samin; Lee, Seungjae; Kim, Jin Kook; Han, Sueng‐Han

doi:10.1016/j.jcrs.2014.01.043

Cited by 11 publications

(14 citation statements)

References 6 publications

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“…Han et al. () studied changes in fusional vergence amplitude and near point of convergence in moderate myopic subjects as a result of corneal refractive surgery. They found a postoperative transient decrease in near vergence amplitude, with stabilization and a return to preoperative values achieved 3 months after surgery.…”

Section: Resultsmentioning

confidence: 99%

Binocular vision alterations after refractive and cataract surgery: a review

García-Montero

Diego

Garzón

et al. 2018

Acta Ophthalmologica

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To review binocular and accommodative disorders documented after corneal or intraocular refractive surgery, in normal healthy prepresbyopic patients. A bibliographic revision was performed; it included works published before 1st July 2017 where accommodation and/or binocularity was assessed following any type of refractive surgical procedure. The search in Pubmed yielded 1273 papers, 95 of which fulfilled the inclusion criteria. Few publications reporting binocular vision and/or accommodative changes after refractive surgery in normal subjects were found. The reduction in fusional vergence is the most frequently reported alteration. Anisometropia is an important risk factor for postoperative binocular vision-related complaints. Most diplopia-related visual complaints, irrespective of the surgical procedure, were in fact misdiagnosed preoperative disorders. The preoperative evaluation of patients seeking spectacle/contact lens independence should include a complete binocular and accommodation assessment where parameters such as the phoric posture, accommodative amplitude and facility, near point of convergence, fusional reserves and accommodative convergence/accommodation coefficient are measured. This would allow the identification of risk factors that could compromise the success of the refractive surgery and cause clinical symptoms.

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Section: Resultsmentioning

confidence: 99%

Binocular vision alterations after refractive and cataract surgery: a review

García-Montero

Diego

Garzón

et al. 2018

Acta Ophthalmologica

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“…Some patients who underwent corneal refractive surgery complained of visual fatigue symptoms such as blurred vision and short time of working distance in the early postoperative period, which affected the visual quality. Currently, studies have con rmed that the changes of binocular visual function and accommodation in the early postoperative period after LASIK, LASEK or PRK may be related to the early postoperative visual fatigue, due to the changes of refractive state, prism effect, wound healing, residual refractive error and other factors [4,[9][10][11]. As a new type of corneal refractive surgery that has emerged in recent years, and studies have found that the postoperative vision recovery time is longer than that of traditional LASIK because of different principles and operative techniques, and which may affect on binocular vision [6,7].…”

Section: (Fig 2)mentioning

confidence: 99%

“…In this study, we didn't nd any difference in BIFR or BOFR before and after SMILE surgery. However, Han et al, together with Rajavi et al observed that the break point and recovery point of BOFR decreased 1 week after refractive surgery, and returned to normal level 3 months after surgery [4,15]. Holland D and Kushner indicated persistent diplopia was observed in patients with high anisometropia preoperative.…”

Section: (Fig 2)mentioning

confidence: 99%

“…The relationship between ametropia and binocular vision can be critical to the successful, asymptomatic outcome of any refractive correction. Several studies have evaluated the effects of refractive surgery on fusional vergence amplitudes and ocular alignment; however, the results remain controversial [1][2][3][4]. Furthermore, all of these studies were limited to Laser in-situ keratomileusis (LASIK), the ap of cornea grinding with (laser epithelial keratectomy, LASEK) and refractile corneal surface cutting (photorefractive keratectomy, PRK), none of them was observed after the new novel corneal refractive surgery, small incision lenticule extraction(SMILE procedure.…”

Section: Introductionmentioning

confidence: 99%

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Near binocular visual function after SMILE surgery for myopia

Chen

Wang

2020

Preprint

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KEYWORDSNear heterophoria; Near point convergence; Small incision lenticule extraction (SMILE); Visual fatigue 2 Abstract Purpose: To analyze the changes of near binocular vision function after small incision lenticule extraction and association with asthenopia. Methods: This was a retrospective study Twenty-five myopic patients who underwent small incision lenticular extraction (SMILE) surgery from Tianjin Eye Hospital were included in this study The values of parameters of near binocular vision function were measured at preoperative, 1 week, 1 month and 3 months postoperatively including near heterophoria, near point convergence (NPC), horizontal base-in fusional reserves (BIFR) and base-out fusional reserves (BOFR). The patients were grouped by the preoperative symptoms scores. The comparisons among different follow-up periods were conducted by the repeated measures analysis of variance. The Pearson correlation coefficient (r) was used to evaluate the linear fit of the relationship between variables. Multiple linear regressions were used to analyze the relationship between asthenopia and parameters of binocular and accommodative function. Results: The NPC significantly increased at 1 week and 1 month after SMILE and then get back to the level of preoperatively in 3 months postoperatively. Near heterophoria significantly decreased at 1 week after SMILE and then remained stable in 3 months postoperatively. In the regression analysis, there was no significant association between the values of the fatigue questionnaire at different stages after SMILE operation and the parameters of near binocular visual function (P>0.05). However, there was significant positive correlation among each visit with the preoperative visual fatigue questionnaire P<0.05).There was no significant difference in the parameters of binocular visual function between the normal group and the fatigue group. For the visual fatigue group, there was positive correlation between the score of visual fatigue questionnaire 1 week after SMILE surgery and the difference in near horizontal phoria between 1w postoperative and that preoperative (r=0.523, P=0.046), and significant negative correlation with the recovery point of BOFR at 1 week (r=-0.581, P=0.023). Conclusion: SMILE surgery wouldn't influence the binocular vision in the short term. Since there was no significant association between binocular vision function and visual fatigue, factors of asthenopia in the early period of SMILE surgery should be further studied. Background Declarations Ethics approval and consent to participateThis study was approved by the Ethics Committee of Tianjin Eye Hospital and adhered to the tenets of the Declaration of Helsinki. Written informed consent to use any clinical data for analysis and publication was obtained from all patients prior to surgery.

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“…Hashemi (2013) highlights hot the near poing of convergence and the near point of accommodation may increase significantly after photorefractive keratectomy (PRK) [2]. In 2014 Han reported an increase in the fusional vergence at near following refractive surgery [3]. Chung (2014) underlines the risk of a change in the ocular alignment, particulary in cases with a large-angle heterophoria/ heterotropia [4].…”

Section: Introductionmentioning

confidence: 99%

Study of the Orthoptic Assessment in Refractive Eye Surgery

Sabetti¹,

Ciancaglini²,

Guetti³

et al. 2020

OJOph

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Purpose: The aim of our study was to assess the variations in fusion and stereopsis before and after refractive surgery. Methods: We conducted a retrospective study. 140 patients (78 M, 62 F) were selected, aged 20 -59 years (mean age 36 ± 10 DS). All patients received a comprehensive ophtalmological and orthoptic examination. Surgery was performed using a MEL-80 excimer laser (Carl Zeiss Meditec, Jena, Germany). Results. Fusional convergence amplitudes after refractive eye surgery range from at near 18 -20 PD in 42 (30%) patients; 25 -30 PD in 56 (40%) patients; 35 -40 PD in 42 (30%) patients, at far 20 -25 PD in 84 (60%) patients; 30 -40 PD in 56 (40%) patients, fusional divergence at near after refractive eye surgery range from at near 6 -8 PD in 108 (75.7%) patients; 10 -12 PD in 52 (37.1%), at far 6 -8 PD in 126 (90%) patients; 10 -12 PD in 14 (10%) patients. None of the patients developed any ocular deviations. NCP, on average, decreases from 9.4 ± 1.5 cm to 9.1 ± 0.9 cm after. None of these patients with a normal NCP before surgery developed an abnormal NCP after refractive surgery. Eighteen patients (12.8%) had a stereopsis higher than 60 s of arch before surgical intervention. Of these, in 2 cases (2.8%) stereopsis increased from 200 to 40 s of arch after surgery. In the rest of patients stereopsis remained unchanged. Conclusion: The increase in fusion at near appears to be considerably interesting, whereas there is no worsening of stereopsis. A careful pre-surgery orthoptic evaluation is extremely revelant for a safe refractive surgery, this reducing the risk of complications associated with fusion and stereopsis.

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Changes in fusional vergence amplitudes after laser refractive surgery for moderate myopia

Abstract: No author has a financial or proprietary interest in any material or method mentioned.

Cited by 11 publications

References 6 publications

Binocular vision alterations after refractive and cataract surgery: a review

Binocular vision alterations after refractive and cataract surgery: a review

Near binocular visual function after SMILE surgery for myopia

Study of the Orthoptic Assessment in Refractive Eye Surgery

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