Comparison between Wavefront-optimized and corneal Wavefront-guided Transepithelial photorefractive keratectomy in moderate to high astigmatism

Jun, Ikhyun; Kang, Dukjin; Arba-Mosquera, Samuel; Choi, Jin Young; Lee, Hyung Keun; Kim, Eung Kweon; Seo, Kyoung Yul; Kim, Tae Im

doi:10.1186/s12886-018-0827-x

Cited by 29 publications

(28 citation statements)

References 29 publications

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“…However, a long visual rehabilitation period and considerable postoperative pain deter many patients from opting for PRK [ 13 , 14 ]. Since a few years “no-touch” single-step tPRK procedures are available from various manufacturers and have proven to be effective and safe [ 15 – 17 ]. StreamLight™ is a novel, one-step tPRK procedure in which the epithelium is first removed by phototherapeutic keratectomy (PTK) immediately followed by PRK in a single procedure using the Wavelight EX500 excimer laser.…”

Section: Introductionmentioning

confidence: 99%

Early clinical outcomes and comparison between trans-PRK and PRK, regarding refractive outcome, wound healing, pain intensity and visual recovery time in a real‐world setup

Gaeckle

2021

BMC Ophthalmol

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Purpose To compare early clinical outcomes of single-step transepithelial photorefractive keratectomy (tPRK) and photorefractive keratectomy (PRK) regarding refractive outcome, visual acuity, wound healing, pain intensity and visual recovery time.d. Methods In this prospective clinical observational study 200 eyes of 100 consecutive patients with mild to moderate myopia with or without mild astigmatism were included. One hundred eyes each were either treated with StreamLight™ tPRK or PRK with the WaveLight® EX500 excimer laser. Visual acuity (Decimal) was assessed preoperatively and at day 4, 7 and 6 weeks postoperatively. Wound healing (hours between surgery and complete epithelial closure) was monitored at the slit lamp. At day 4, patients subjectively rated the maximum pain intensity within the last 4 days using a numerical pain rating scale (0–15). Results Visual recovery was significantly faster in the tPRK group. At days 4 and 7, the mean monocular UCDVA was significantly better in the tPRK group than in the PRK group (p < 0.001). Four days after surgery 72 % of eyes in the tPRK group but no eye in the PRK had a UCDVA of 0.7 or better. At six weeks postoperatively, a UCDVA of 1.0 or better was achieved in both groups. Complete epithelial wound closure was achieved significantly faster in the tPRK group (p < 0.0001) and maximum pain level within the first 4 days after surgery was significantly lower in the tPRK group (p < 0.0001). No patient had lost a line of BCDVA and no complications or adverse effects were observed. Conclusions According to our early clinical results, both treatments options appear to be safe and effective methods for the correction of low to moderate myopia with and without astigmatism. However, in our study, StreamLight™ tPRK offered faster visual recovery and epithelial healing and was associated with less pain compared to PRK. It can therefore be considered a good treatment option for patients who refuse or are not eligible for Femto-LASIK, but at the same time demand a faster and more comfortable recovery time than PRK can offer.

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Section: Introductionmentioning

confidence: 99%

Early clinical outcomes and comparison between trans-PRK and PRK, regarding refractive outcome, wound healing, pain intensity and visual recovery time in a real‐world setup

Gaeckle

2021

BMC Ophthalmol

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“…The introduction of wavefront-guided treatment and IR can ensure precise astigmatic correction, 22–24 with most eyes achieving a non-visually significant astigmatism at the final postoperative visit (0.34 ± 0.40 D). Four enhancement treatments were performed without IR, with low postoperative residual astigmatism (0.19 ± 0.24D), although the small number of eyes in this subgroup prevents any conclusive findings.…”

Section: Discussionmentioning

confidence: 99%

Three-Year Outcomes of Implantable Collamer Lens Followed by Excimer Laser Enhancement (“Bioptics”) in the Treatment of High Myopic Astigmatism

Jabbour

Bower

2021

OPTH

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Purpose Describe three-year outcomes of spherical implantable Collamer lens (ICL) followed by excimer laser enhancement (bioptics) in eyes with high myopic astigmatism. Patients and Methods Retrospective case series of thirty-four cases that underwent bioptics enhancement at the Johns Hopkins Wilmer Eye Institute. All eyes had a preoperative sphere of −6.00 D or more with a cylinder of at least 2.00 D. Uncorrected and corrected distance visual acuity (UDVA and CDVA), manifest spherical equivalent refraction (MSE), ICL vault measurements and central corneal thickness (CCT) were collected. Endothelial cell counts (ECC), root mean square (RMS) of higher order aberrations (HOAs), adverse events and subsequent surgeries were also assessed. Results All patients had a minimum follow-up of 3 years. Preoperative UDVA was 2.29 ± 0.46 logMAR and improved to 0.03 ± 0.23 logMAR at 3 years (p<0.05). MSE was −12.30 ± 4.05 preoperatively and changed to −0.21 ± 0.46 at 3 years (p<0.05). The efficacy and safety indices were 1.28 ± 0.32 and 1.47 ± 0.27 at 3 years post-enhancement. HOA did not significantly change throughout the follow-up (p<0.05). Endothelial cell loss at 12 months was calculated at 5.7%. Two eyes required ICL exchange due to vault-related issues. Conclusion Bioptics offered excellent long-term safe, predictable, and efficient outcomes for high myopic astigmatism and can be considered an option if toric ICL is not available. Results confirm that wavefront-guided photoablation remains an excellent option to manage residual refractive error after phakic IOL.

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“…The SCHWIND excimer laser (SCHWIND eye-tech-solutions, Kleinostheim, Germany) is a laser platform that uses a six-dimensional tracking system to compensate for eye movements to ablate corneal tissue during corneal refractive surgery [8]. Recently, SmartSurf ACE (Smart Pulse Technology, SCHWIND eye-techsolutions) touch-free transepithelial PRK (T-PRK) has become a common surgical option, with a one-step treatment system, rapid visual recovery, and functional binocular uncorrected distance visual acuity (UDVA) provided immediately after surgery [9][10][11][12][13]. However, the speci c stromal ablation designed pro les were not mentioned [14,15].…”

Section: Introductionmentioning

confidence: 99%

Comparative Evaluation of the Visual and Refractive Outcomes Following SMILE, FS-LASIK, and T-PRK Surgery: A Retrospective, Non-Blinded Clinical Study

Piao

2021

Preprint

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Background: To comparatively evaluate of the visual and refractive outcomes after small-incision lenticule extraction (SMILE), femtosecond laser-assisted in situ keratomileusis (FS-LASIK), and transepithelial photorefractive keratectomy (T-PRK) surgery.Methods: This was a retrospective, case-series, non-blinded clinical study. Consecutive eligible patients underwent SMILE, FS-LASIK, and T-PRK at the Department of Ophthalmology of Peking Union Medical Hospital, a tertiary referral center. All myopic patients were treated with corneal refractive surgery (SMILE, FS-LASIK, and T-PRK) using the VisuMax (Carl Zeiss Meditec AG, Jena, Germany) 500-kHz femtosecond laser system and the Amaris 750S excimer laser platform (SCHWIND eye-tech solutions, Kleinostheim, Germany). Visual and topographic astigmatism changes at 6 months were the main outcome measure. Secondary outcomes were the efficacy index at 1, 3, and 6 months postoperatively.Results: We recruited 75 consecutive patients (mean age, 27.88 ± 5.76 years; 68% women; all Asian) with no significant differences between groups in terms of preoperative demographic data, except in preoperative spherical equivalent (SE) (-5.54 ± 1.86 D, -5.64 ± 1.66 D, and -3.78 ± 1.30 D, respectively; P<0.001), astigmatism (1.24 ± 1.62 D, 1.16 ± 0.75 D, and 0.72 ± 0.42 D, respectively; P=0.008), and residual bed thickness (313.08 ± 32.18 μm, 427.59 ± 30.69 μm, and 427.09 ± 41.07 μm, respectively; P<0.001). A superior efficacy index was shown in SMILE and FS-LASIK compared to T-PRK 1 month after surgery.Conclusions: The results from this retrospective, non-blind, case-series clinical study suggest that all of the corneal refractive surgery options are safe and effective. However, while SMILE and FS-LASIK procedures have equal visual outcomes, they have superior efficacy index values in the early postsurgical period.

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Comparison between Wavefront-optimized and corneal Wavefront-guided Transepithelial photorefractive keratectomy in moderate to high astigmatism

Cited by 29 publications

References 29 publications

Early clinical outcomes and comparison between trans-PRK and PRK, regarding refractive outcome, wound healing, pain intensity and visual recovery time in a real‐world setup

Early clinical outcomes and comparison between trans-PRK and PRK, regarding refractive outcome, wound healing, pain intensity and visual recovery time in a real‐world setup

Three-Year Outcomes of Implantable Collamer Lens Followed by Excimer Laser Enhancement (“Bioptics”) in the Treatment of High Myopic Astigmatism

Comparative Evaluation of the Visual and Refractive Outcomes Following SMILE, FS-LASIK, and T-PRK Surgery: A Retrospective, Non-Blinded Clinical Study

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