Clinically significant laser in situ keratomileusis flap striae

Wallerstein, Avi; Gauvin, Mathieu; Adiguzel, Eser; Singh, Harmanjit; Gupta, Vasudha; Harissi‐Dagher, Mona; Cohen, Mark E.

doi:10.1016/j.jcrs.2017.09.023

Cited by 27 publications

(28 citation statements)

References 21 publications

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“…The safety index of 1.05 was comparable to lesser myopia studies ( Table 3), suggesting that LVC in VHM has equivalent safety to that of high myopia [16,25,29,36]. As reported elsewhere [6], the high-rate of microstriae (11.9%) can likely be attributed to the very deep ablations (mean 150 μm), although only two eyes with microstriae were deemed to be visually significant requiring intervention. This VHM spectacle-wearing group may be more tolerant of the aberrations caused by striae, as they may have been accustomed to visual phenomena with spectacle correction [37,38].…”

Section: Complicationssupporting

confidence: 73%

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Refractive, visual, and subjective quality of vision outcomes for very high myopia LASIK from − 10.00 to − 13.50 diopters

Kam

Gauvin

Adiguzel³

et al. 2020

BMC Ophthalmol

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Background: To evaluate laser-assisted in situ keratomileusis (LASIK) outcomes, subjective quality of vision (QoV) and patient satisfaction in eyes with very high myopia (VHM) above − 10.00 diopters (D). Methods: Consecutive myopic and myopic-astigmatism eyes with spherical equivalent (SEQ) ranging between − 10.00 to − 13.50 D underwent LASIK with the WaveLight® Allegretto Wave® Eye-Q 400 Hz excimer laser. Treatment accuracy, efficacy, safety, stability, cylinder vectors, and higher-order aberrations were evaluated, together with subjective QoV and night vision disturbances (NVDs). Results: 114 eyes had a preoperative SEQ of − 11.02 ± 0.81 D, with a median follow-up of 24 months. A total of 72, 84, and 94% of eyes were within ± 0.50, ± 0.75 and ± 1.00 D of intended SEQ (R 2 = 0.71). The efficacy index was 0.93 ± 0.20, with 51 and 81% of eyes achieving 20/20 and 20/25. The astigmatism correction index was 0.95 ± 0.33. The safety index was 1.05 ± 0.12. The average myopic regression was − 0.51 ± 0.38 D. Preoperative QoV scores improved significantly postoperatively (7.5 ± 0.8 vs. 9.1 ± 0.7; P < 0.001), with less NVDs (P < 0.001). Total, spherical and coma root mean square (RMS) postoperative ocular higher-order aberrations were 1.07 ± 0.34, 0.67 ± 0.25, and 0.70 ± 0.40 μm. Conclusions: Very high myopia LASIK between − 10.00 to − 13.50 D is safe and results in good visual outcomes, with high patient satisfaction and a significant improvement in patient-reported QoV after surgery. Appropriately selected patients within this very high myopia group can be included as LASIK candidates.

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Section: Complicationssupporting

confidence: 73%

“…Additional surgical technique details were published elsewhere [3][4][5]. A standardized postoperative regimen of antibiotics and steroids was used [6].…”

Section: Surgical Techniquementioning

confidence: 99%

Refractive, visual, and subjective quality of vision outcomes for very high myopia LASIK from − 10.00 to − 13.50 diopters

Kam

Gauvin

Adiguzel³

et al. 2020

BMC Ophthalmol

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“…All surgeons followed the same previously described standardized technique, 11 using the same equipment and identical nomogram, treating the refractive astigmatism axis in the first group of consecutive eyes and then treating the ACA axis in the following group of consecutive eyes using the WaveLight EX500 excimer laser with the Contoura software. The relative volume of eyes per surgeon remained constant during the study.…”

Section: Lasik Surgical Techniquementioning

confidence: 99%

“…The target was emmetropia in all eyes. A standardized postoperative regimen 11 of antibiotics and steroids was used.…”

Section: Lasik Surgical Techniquementioning

confidence: 99%

Primary Topography-Guided LASIK: Treating Manifest Refractive Astigmatism Versus Topography-Measured Anterior Corneal Astigmatism

Wallerstein¹,

Gauvin²,

Qi³

et al. 2019

J Refract Surg

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“…Six experienced surgeons followed the same previously described standardized techniques. 9 The IntraLase femtosecond laser iFS (Abbott Medical Optics, Inc., Santa Clara, CA) or Z16 or Z18 Hansatome Microkeratome (Bausch & Lomb, Rochester, NY) in combination with an 8.5-or 9.5-mm suction ring were used to create the corneal flaps. The WaveLight EX500 excimer laser with T-CAT software was used for excimer ablation.…”

Section: Lasik Surgical Techniquementioning

confidence: 99%

Primary Topography-Guided LASIK: Refractive, Visual, and Subjective Quality of Vision Outcomes for Astigmatism ⩾2.00 Diopters

Wallerstein¹,

Caron-Cantin²,

Gauvin³

et al. 2019

J Refract Surg

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T opography-guided excimer ablation uses highresolution corneal topographic height maps to generate a customized ablation profile consisting of anterior corneal higher order aberrations (HOAs) and an accurate measure of the anterior corneal astigmatism (ACA). Topography-guided custom ablation treatment (T-CAT, now called Contoura) (Alcon Laboratories, Inc., Fort Worth, TX; Contoura in the United States) has been approved by the U.S. Food and Drug Administration (FDA) for primary laser in situ keratomileusis (LASIK) in myopic and myopic astigmatism eyes, with resulting good efficacy and safety. 1 However, this trial and its subsequent publication excluded eyes with naturally occurring irregular astigmatism. Healthy corneas with skewed radial axes, non-orthogonal cylinder, and asymmetric bowties were excluded to standardize the preoperative cohort, maximize outcomes, and avoid refractive surprises. 1,2 T-CAT refractive predictability can be a concern with increasing corneal irregularities and elevated anterior corneal HOAs. 3 Eyes with greater cylinder magnitude, particularly those with irregular astigmatism, have more anterior corneal HOAs. 4,5 They also have a greater discrepancy between subjective refractive astigmatism and topography-measured ACA, 6

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Clinically significant laser in situ keratomileusis flap striae

Cited by 27 publications

References 21 publications

Refractive, visual, and subjective quality of vision outcomes for very high myopia LASIK from − 10.00 to − 13.50 diopters

Refractive, visual, and subjective quality of vision outcomes for very high myopia LASIK from − 10.00 to − 13.50 diopters

Primary Topography-Guided LASIK: Treating Manifest Refractive Astigmatism Versus Topography-Measured Anterior Corneal Astigmatism

Primary Topography-Guided LASIK: Refractive, Visual, and Subjective Quality of Vision Outcomes for Astigmatism ⩾2.00 Diopters

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