Comparison of efficacy, safety, and predictability of&amp;nbsp;laser in situ keratomileusis&amp;nbsp;using two laser suites

Meidani, Alexandra; Tzavara, Chara

doi:10.2147/opth.s110626

Cited by 10 publications

(5 citation statements)

References 28 publications

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“…Concerning the visual outcomes, both groups in our study achieved excellent refractive outcomes with no significant difference between them. This agrees with the results of Perez-Straziota et al [ 6 ], Meidani and Tzavara [ 28 ], Hassan et al [ 29 ], and Mahmoud et al [ 30 ]. On the other hand, our results were different from those reported by He et al [ 17 ], Ghoneim et al [ 31 ], and Roe and Manche [ 23 ], where WFG appeared to be superior to WFO ( P = 0.016).…”

Section: Discussionsupporting

confidence: 92%

Functional optical zone after wavefront-optimized versus wavefront-guided laser in situ keratomileusis

Elshawarby¹,

Saad²,

Helmy³

et al. 2021

Med Hypothesis Discov Innov Ophthalmol

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Background: Many studies have used functional optical zone (FOZ) as a measure to compare different refractive laser treatment modalities. However, to our knowledge, no study has compared wavefrontoptimized (WFO) and wavefront-guided (WFG) laser in situ keratomileusis (LASIK) using FOZ. We compared the FOZ after WFO versus WFG LASIK in patients with myopia and myopic astigmatism.Methods: In this prospective comparative study, we included 100 myopic eyes of 50 patients with or without astigmatism. They were divided into two groups according to the platform used: WFO or WFG femtosecond LASIK. Using Holladay’s equivalent keratometry reading (EKR) report of Pentacam HR, FOZ was defined as a zone centered on the pupil center with a standard deviation (SD) of 0.5 D, around the mean EKR. The differences in FOZ between the two platforms were analyzed at 3 months postoperatively. Visual acuity, refractive error, corneal asphericity (Q-value), and root mean square of higher-order aberrations (RMS for HOAs) were evaluated and compared.Results: The mean ± SD of patient age was 26.64 ± 5.67 years. The preoperative characteristics of the two groups were comparable (all P > 0.05). The intended optical zone (IOZ) was 6 mm in both groups. The mean laser ablation depth was significantly greater in the WFG group (18 ?m per D) than in the WFO group (16 ?m per D) (P = 0.035). At 3 months postoperatively, the mean ± SD of FOZ diameter was 4.32 ± 0.94 mm (71.99 ± 15.68% of intended optical zone) in the WFO group and 4.16 ± 1.13 mm (69.33 ± 18.78% of intended optical zone) in the WFG group, with no significant difference between the two groups (P = 0.622). The change in corneal asphericity was greater in the WFG group than in the WFO group (P = 0.034). Postoperative mean corrected and uncorrected distance visual acuity, manifest refraction, and RMS for HOAs showed no significant difference between the two groups (all P > 0.05).Conclusions: We found that WFG LASIK resulted in greater ablation depth and change in corneal asphericity than WFO LASIK at 3 months postoperatively. However, there was no significant difference in FOZ diameter, refractive error, and RMS for HOAs between the two groups. Further research is needed to confirm these findings.

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Section: Discussionsupporting

confidence: 92%

Functional optical zone after wavefront-optimized versus wavefront-guided laser in situ keratomileusis

Elshawarby¹,

Saad²,

Helmy³

et al. 2021

Med Hypothesis Discov Innov Ophthalmol

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“…Recently, the application of FS-LASIK can create a more precise, uniform corneal flap. [ 15 16 17 ] The elevation of the IOP (about 30 mmHg) is less than that demonstrated with the use of microkeratome; however, the amount of time the suction is applied is longer than that of microkeratome (25 s vs. 10 s, respectively). The IOP can drop to normal or 5 mmHg less than normal immediately after the suction is stopped.…”

Section: Discussionmentioning

confidence: 98%

Analysis of Macular and Retinal Nerve Fiber Layer Thickness in Children with Refractory Amblyopia after Femtosecond Laser-assisted Laser In situ Keratomileusis

Zhao

Zhou

Zhang

et al. 2017

Chinese Medical Journal

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Background:Localized macular edema and retinal nerve fiber layer (RNFL) thinning have been reported shortly after laser in situ keratomileusis (LASIK) in adults. However, it is still unclear how LASIK affects the retina of children. This study aimed to investigate the macular retina and RNFL thickness in children with refractive amblyopia who underwent femtosecond laser-assisted LASIK (FS-LASIK).Methods:In this study, we included 56 eyes of 32 patients with refractive amblyopia who underwent FS-LASIK in our hospital from January 2012 to December 2016. Foveal (foveal center retinal, parafoveal retinal, and perifoveal), macular inner retinal (superior and inferior), and peripapillary RNFL thicknesses (superior, inferior, temporal, and nasal) were measured using Fourier-domain optical coherence tomography before surgery and 1 day, 3 days, and 1 week after surgery. We divided these patients into three groups based on their refractive error: High myopic group with 22 eyes (equivalent sphere, >6.00 D), mild myopic group with 19 eyes (equivalent sphere, 0–6.00 D), and hyperopic group with 15 eyes (equivalent sphere, >+0.50 D). We compared the macular retina and RNFL thickness before and after LASIK. A paired simple t-test was used for data analysis.Results:One week after surgery, the visual acuity for all 56 eyes of the 32 patients reached their preoperative best-corrected vision. Visual acuity improved two lines or better for 31% of the patients. The residual refractive errors in 89% of the patients were within ±0.5 D. In the high myopic group, the foveal center retinal and parafoveal retinal thicknesses were thicker 1 day and 3 days after surgery than before surgery (t = 2.689, P = 0.012; t = 2.383, P = 0.018, respectively); no significant difference was found 1 week after surgery (P > 0.05). The foveal center retinal and parafoveal retinal thicknesses were greater 1 day after surgery than they were before surgery (P = 0.000 and P = 0.005, respectively) in the mild myopic and hyperopic groups. No significant difference was found 3 days or 1 week after surgery (P > 0.05). In all three groups, no significant difference was found in the macular inner retinal or peripapillary RNFL thickness 1 day, 3 days, or 1 week after surgery (P > 0.05).Conclusions:The foveal center retinal edema after FS-LASIK is mild and reversible in children, that mostly occurred in the high myopic group with no effect on the visual acuity, and is always relieved within 1 week.

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“…While the WL EX500 is approved for use with a 6.0 or 6.5 mm optical zone, the initial clinical trials showing appropriate safety and efficacy only used a 6.5 mm optical zone in the 200 Hz WaveLight Allegretto Wave Excimer Laser. Recent studies have shown that the WL EX500 achieves excellent visual outcomes, even for patients with high myopia [23], and is safe, effective, and predictable for the correction of refractive error [24]. However, these investigations failed to examine the effects of different optical zones on safety, efficacy, predictability, and stability.…”

Section: Discussionmentioning

confidence: 99%

Comparison of 6.0 mm versus 6.5 mm Optical Zone on Visual Outcomes after LASIK

Moshirfar

Huynh

Bundogji

et al. 2021

JCM

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Previous studies have demonstrated safety and efficacy using 6.0 and 6.5 mm optical zones in the WaveLight EX500 Excimer Laser System but have not evaluated if differing optical zone sizes influence refractive outcomes. This study examines visual outcomes between two study populations undergoing LASIK with either a 6.0 mm (1332 patients) or 6.5 mm (1332 patients) optical zone. Outcomes were further stratified by severity of myopia (low, moderate, and high) and astigmatism (low and high). Patients were matched by age and preoperative manifest sphere and cylinder. Postoperative measurements were then compared. The 6.5 mm group demonstrated better postoperative manifest refractive spherical equivalent (MRSE), manifest sphere, and absolute value of the difference in actual and target spherical equivalent refraction (|∆ SEQ|), within the total population, moderate myopia, and low astigmatism groups, but this did not lead to improved postoperative uncorrected distance visual acuity (UDVA) or best corrected distance visual acuity (CDVA). Though astigmatic correction and postoperative angle of error were similar between optical zone sizes, they were significantly worse with high myopia. Overall, this study demonstrates differences in visual outcomes between the 6.0 and 6.5 mm optical zone sizes that may warrant consideration; however, essentially, the results are comparable between them.

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Comparison of efficacy, safety, and predictability of laser in situ keratomileusis using two laser suites

Cited by 10 publications

References 28 publications

Functional optical zone after wavefront-optimized versus wavefront-guided laser in situ keratomileusis

Functional optical zone after wavefront-optimized versus wavefront-guided laser in situ keratomileusis

Analysis of Macular and Retinal Nerve Fiber Layer Thickness in Children with Refractory Amblyopia after Femtosecond Laser-assisted Laser In situ Keratomileusis

Comparison of 6.0 mm versus 6.5 mm Optical Zone on Visual Outcomes after LASIK

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