Comparison of femtosecond and excimer laser platforms available for corneal refractive surgery

Chen, Lisa Y.; Manche, Edward E.

doi:10.1097/icu.0000000000000268

Cited by 22 publications

(9 citation statements)

References 77 publications

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“…Patients with low to moderate myopia and suitable cornea may be good candidates for laser approach, either excimer one (LASIK, PRK, etc.) or Femtosecond-based one (SMILE) [9]. Those patients with relatively low refractive error and some corneal irregularity, such as those with mild keratoconus may undergo combined surgery with topography-guided PRK and Corneal Collagen Crosslinking (CXL); technique known as Athen's Protocol [10, 11].…”

Section: Discussionmentioning

confidence: 99%

Contralateral Posterior Chamber Phakic Intraocular Lens Implantation as Rehabilitation of Refractive Lens Exchange with a Monofocal Intraocular Lens in a Young, Nonpresbyopic, Bilateral Highly-Myopic Patient

Balparda¹,

Vanegas-Ramírez

Segura-Muñoz

et al. 2019

Case Reports in Ophthalmological Medicine

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Background Refractive errors are widespread in the human population; nowadays, numerous surgical options allow for efficient and safe correction them. One of the main elements to ensure success in this kind of intervention will depend on the careful patient and surgical approach selection. Excimer laser corneal surgery is considered by most for low to moderate ametropias. Another option, which has been suggested may be safer, is to cut a small corneal lenticule with femtosecond laser, and then extracting it through a small incision. Nevertheless, in some specific cases, such as patients with high refractive error or those with some corneal abnormality, laser corneal ablations are considered unsafe from either a biomechanical or refractive standpoint. In this kind of particular cases, Phakic Intraocular Lens (P-IOL) implantation constitutes attractive, highly predictable and safe option. Objective The authors want to show the case of a young high-myopic woman, already pseudophakic in one eye, where the P-IOL implantation in the fellow eye yielded excellent short-term visual results, and high patient's satisfaction, is presented. Materials The authors present the case of a 32-years-old, highly myopic female patient underwent a Refractive Lens Exchange (RLE) with a monofocal Intraocular Lens (IOL) implantation in her left eye elsewhere, and developed severe visual issues, especially regarding near-work. Symptoms resolved through the implantation of a posterior chamber P-IOL in the contralateral eye. Results The postoperative course was unremarkable, inflammation was mild, and visual recovery was quick. There was no need to perform any procedure on her left eye or to use any reading glasses, as unilateral effective near vision through her right eye was enough for all her daily tasks. Conclusions RLE in young pre-presbyopic highly myopic patients may not be an advisable alternative in most cases, because of the high risks of retinal complications observed. In addition, eliminating accommodation will cause significant limitations, and multifocal IOLs currently available are far from the quality of vision that a young human crystalline lens yields. On the other hand, implantation of a P-IOL is a good option if eye conditions are optimal, as it preserves natural accommodation. In this case an EyeCryl Phakic Toric® IOL showed excellent short-term refractive predictability and safety.

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Section: Discussionmentioning

confidence: 99%

Contralateral Posterior Chamber Phakic Intraocular Lens Implantation as Rehabilitation of Refractive Lens Exchange with a Monofocal Intraocular Lens in a Young, Nonpresbyopic, Bilateral Highly-Myopic Patient

Balparda¹,

Vanegas-Ramírez

Segura-Muñoz

et al. 2019

Case Reports in Ophthalmological Medicine

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“…Given that MMC can disrupt cellular DNA, there are concerns regarding its ophthalmic safety. It is important to minimize damage to the corneal epithelium because corneal endothelial cells do not regenerate and the endothelial layer of the cornea functions to maintain tissue hydration and therefore clarity, of the cornea [16] . There has been inconsistency in the literature regarding the question of whether MMC reduces endothelial cell numbers in the cornea [17][18][19] .…”

Section: Based On Visualizationmentioning

confidence: 99%

New Bubble Mitomycin C Application Technique for Haze Prevention following Customized Photorefractive Keratectomy

Karaarslan¹

2020

pharmaceutical-sciences

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Present investigation deals with a pilot study in which a new technique for applying mitomycin C directly onto the ablated corneal surface in the form of an injector-administered bubble. Here, a technique was introduced and the observations made with this technique in this pilot study involving 125 patients who received wave front bilateral photorefractive keratectomy. Mitomycin C was administered using the common minisponge application technique in one eye and mitomycin C was administered using the new bubble technique in the other eye. Photorefractive keratectomy presentation was compared between the minisponge-treated and bubble-treated eyes. Visual parameters such as visual acuity, spherical refractive error and cylindrical refractive error were similar in eyes across the two treatments before and after wave front photorefractive keratectomy. None of the minisponge-treated or bubble-treated eyes developed clinically evident photorefractive keratectomy haze. Compared to the minisponge-treated eyes, bubbletreated eyes showed faster healing (3 d vs. 5 d for contact lens bandage removal) and faster visual recovery (≤5 d vs. 7-10 d). In conclusion, the new bubble technique for applying mitomycin C after wave front photorefractive keratectomy provided a safe, effective and time-saving alternative to the standard mini sponge mitomycin C application technique.

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“…e use of FS in ophthalmology began in the early part of the 21 st century and marked a new era in corneal refractive surgery. It has been shown to create laser in situ keratomileusis (LASIK) flaps as well as or even better than mechanical microkeratomes (MMKs) [2][3][4]. FS-assisted LASIK (FS-LASIK) promises more predictable flaps and fewer flap complications, less ocular aberrations, better uncorrected visual acuity (UCVA), less variation in intraocular pressure, and less dry eye.…”

Section: Introductionmentioning

confidence: 99%

Effect of Myopic Femtosecond Laser-Assisted LASIK on Anterior Chamber Inflammation (Flare Values) and Corneal Endothelium: A Prospective before and after Study

Özbilen

Altınkurt

Ceylan

et al. 2021

Journal of Ophthalmology

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Purpose. This study aimed to investigate whether femtosecond laser-assisted LASIK (FS-LASIK) surgery causes inflammation in the anterior chamber and to analyze its effect on endothelial cells. Methods. This prospective, longitudinal study included left eyes of 30 patients (19 females) who had undergone FS-LASIK surgery due to myopia and myopic astigmatism. Endothelial cell density (ECD) and morphological measurements were performed using a specular microscopy, and laser flare photometry was used to measure the anterior chamber flare values on the day of surgery. iFS™ Advanced FS and VISX STAR S4-IR Wavescan Excimer Laser platforms were used. Flare measurements were repeated on the postoperative 1st day and 7th day and the 1st and 3rd months. The endothelial measurements were repeated in the 3rd month. Results. Preoperatively, the mean flare was 5.59 ± 1.24 photons/ms; it was 6.49 ± 2.42 on the postoperative 1st day, 5.87 ± 2.27 on the 7th day, 5.68 ± 1.66 on the 1st month, and 5.35 ± 1.24 on the 3rd month. A significant difference was observed only between the preoperative and postoperative 1st day flare values ( p = 0.047 ). The decrease in the ECD was clinically insignificant but statistically significant, with an average of 97.0 ± 209.9 cell count/mm2 (3.3%, p = 0.017 ). However, there was no significant change in the coefficient of variation ( p = 0.448 ) and hexagonality ( p = 0.096 ). No significant correlation was found between the increase in the flare value on the postoperative 1st day and variables. A significant correlation was found between the decrease in ECD and the preoperative ECD (r = 0.356, p = 0.027 ). Conclusion. FS-LASIK caused minimal inflammation in the anterior chamber on only the 1st postoperative day; additionally, a minimal decrease of cell count with no morphological changes were noted in the endothelial cells on postoperative 3rd month. This trial is registered with NCT04899258.

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Comparison of femtosecond and excimer laser platforms available for corneal refractive surgery

Cited by 22 publications

References 77 publications

Contralateral Posterior Chamber Phakic Intraocular Lens Implantation as Rehabilitation of Refractive Lens Exchange with a Monofocal Intraocular Lens in a Young, Nonpresbyopic, Bilateral Highly-Myopic Patient

Contralateral Posterior Chamber Phakic Intraocular Lens Implantation as Rehabilitation of Refractive Lens Exchange with a Monofocal Intraocular Lens in a Young, Nonpresbyopic, Bilateral Highly-Myopic Patient

New Bubble Mitomycin C Application Technique for Haze Prevention following Customized Photorefractive Keratectomy

Effect of Myopic Femtosecond Laser-Assisted LASIK on Anterior Chamber Inflammation (Flare Values) and Corneal Endothelium: A Prospective before and after Study

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