Correction of Refractive Errors after Corneal Transplantation

Guccione, Laura; Mosca, L.; Scartozzi, Luca; Crincoli, Emanuele; Fasciani, Romina; Caporossi, Tomaso; Rizzo, Stanislao

doi:10.5772/intechopen.101830

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…Similarly, Guccione et al demonstrated the effectiveness of correcting visual defects via the Femto-LASIK procedure among 31 patients. These researchers noted a correction of the preoperative astigmatic topographic cylinder of 56% and of the preoperative refractive error of over 42%, as well as an approximate 20% improvement in BCVA and UCVA values [ 41 ]. Chuprov et al also confirmed the safety and effectiveness of the Femto-LASIK procedure during the correction of astigmatism while operating on cataracts among a group of patients for whom the implantation of toric intraocular lenses or peripheral femtolaser corneal incision were used.…”

Section: Discussionmentioning

confidence: 99%

Prospective Safety Evaluation of the Femtosecond Laser-Assisted Keratomileusis Procedure in Correcting Residual Ametropia in Patients After Deep Anterior Lamellar Keratoplasty

Janiszewska-Bil

Czarnota-Nowakowska²,

Krysik

et al. 2023

Med Sci Monit

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Background This prospective study, from a single center in Poland, aimed to evaluate the correction of residual ametropia, or refractive errors, after corneal grafting using femtosecond laser-assisted in situ keratomileusis (Femto-LASIK) in 60 patients (96 eyes) who had previously undergone deep anterior lamellar keratoplasty (DALK) compared with that achieved in 60 patients (108 eyes) who underwent vision correction using Femto-LASIK alone. Material/Methods The study group included 60 patients (96 eyes) whose residual ametropia was corrected using the Femto-LASIK procedure after having previously undergone DALK. The comparison group consisted of 60 patients (108 eyes) who underwent vision correction with the Femto-LASIK procedure without previously having undergone DALK. Uncorrected vision acuity, best-corrected vision acuity, and intraocular pressure were measured for both groups before the procedures and at 3, 6, 12, and 24 months after the procedures. Corneal endothelial cell density was evaluated by non-contact specular microscopy before the procedures and at 6, 12, and 24 months after the procedures. Results In the study group, within the 24-month observation period, no transplant rejection, transplant decompensation, or corneal ectasia were noted. Statistical analysis did not show any significant differences between the best-corrected vision acuity values in the study group in the preoperative and postoperative periods ( P >0.05). In contrast, uncorrected vision acuity values were significantly higher in patients during the postoperative period than the preoperative period ( P >0.05). Conclusions The effects of vision correction with the Femto-LASIK procedure after DALK demonstrate the safety and effectiveness of the procedure for patients.

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Section: Discussionmentioning

confidence: 99%

Prospective Safety Evaluation of the Femtosecond Laser-Assisted Keratomileusis Procedure in Correcting Residual Ametropia in Patients After Deep Anterior Lamellar Keratoplasty

Janiszewska-Bil

Czarnota-Nowakowska²,

Krysik

et al. 2023

Med Sci Monit

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“…Furthermore, additional intervention is required in cases of contact lens failure brought on by corneal irregularity, lens intolerance, dry eye, and issues with manual dexterity [ 9 ]. This includes incisional keratotomy, wedge resection, laser refractive surgeries, intracorneal segments, and intraocular lens (IOL) implantation [ 2 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Postoperative Astigmatism after Keratoplasty: A Systematic Review Meta-Analysis Based on PRISMA

Kijonka,

Nowińska,

Wylęgała

et al. 2024

JCM

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Background: The number of corneal transplants is rising, with the aim to treat a spectrum of diseases ranging from dystrophies to corneal opacities caused by trauma or chemical burns. Refractive outcomes after this procedure are often impossible to predict and associated with high levels of astigmatism. However, there are many techniques that affect the reduction of astigmatism and improve the quality of life of patients. Objectives: The aim was to compare the improvement in postoperative visual acuity (logMAR) and amount of corneal astigmatism (Diopters) after corneal keratoplasty in patients who additionally underwent a surgical procedure, which affects the reduction in postoperative astigmatism, and to determine the most effective method. Search Methods and Selection Criteria: A thorough search was carried out across online electronic databases including PubMed, Embrase, Ovid MEDLINE, Scopus, and Web of Science, using combinations containing the following phrases: postoperative astigmatism, post-keratoplasty astigmatism, anterior lamellar keratoplasty (ALK), deep anterior lamellar keratoplasty (DALK), posterior lamellar keratoplasty, endothelial keratoplasty (EK), penetrating keratoplasty (PK), corneal transplant, keratoplasty, refractive surgery, kerato-refractive surgery, laser in situ keratomileusis (LASIK), and femtosecond LASIK. This was to determine all English-language publications that discuss refractive operations for postoperative or post-keratoplasty astigmatism. These bibliographies were searched for English-language publications published between 2010 and 2023. We proceeded to review each detected record’s reference list. Data Extraction: Study characteristics such as study design, sample size, participant information, operations performed, and clinical outcomes were all extracted. Data Statistical Analyses: The Comprehensive Meta-Analysis software (version 3.3.070, 2014) was used to perform the analysis. The threshold of 0.05 for p-values was considered statistically significant. All effect sizes are reported as standardized differences (Std diff) in means with a 95% confidence interval (CI) and visualized graphically as forest plots. Publication bias is presented as a funnel plot of standard error by Std diff in means. Four methods were used to evaluate the heterogeneity among the studies: Q-value, I2, chi-square (χ2), and tau-squared. Main Results: We included 21 studies that randomized 1539 eyes that underwent corneal transplantation surgery either by PKP, DALK, or DSEAK techniques. The results showed the most significant improvement in the visual acuity and significant decrease in the corneal astigmatism after laser surgery procedures, like femtosecond-assisted keratotomy after DALK and PKP and LASIK after DSEAK.

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“…Two phases can be distinguished after a corneal transplant: the "plastic phase", usually during the first 6 to 8 months after surgery, when the sutures are still in place and astigmatism can be managed by the modulation of their tension due to the transplant scar plasticity, and the "static phase" in which all sutures have been taken out, the graft scar has solidified, and the corneal architecture is no longer capable of considerable change [11].…”

Section: Introductionmentioning

confidence: 99%

Managing Post-Keratoplasty Astigmatism: High-Tech vs. Low-Tech Imaging Techniques for Guiding Suture Manipulation

Borgia

Romano

et al. 2023

JCM

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Astigmatism is a visually significant condition that can develop after keratoplasty. The management of post-keratoplasty astigmatism can be performed both when transplant sutures are in place and when they have been removed. Fundamental for astigmatism management is its identification and characterization in terms of type, amount, and direction. Commonly, post-keratoplasty astigmatism is evaluated through corneal tomography or topo-aberrometry; however, many other techniques can be used in case these instruments are not readily available. Here, we describe several low-tech and high-tech techniques used for post-keratoplasty astigmatism detection in order to quickly understand if it contributes to low vision quality and to determine its characteristics. The management of post-keratoplasty astigmatism through suture manipulation is also described.

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Correction of Refractive Errors after Corneal Transplantation

Cited by 4 publications

References 22 publications

Prospective Safety Evaluation of the Femtosecond Laser-Assisted Keratomileusis Procedure in Correcting Residual Ametropia in Patients After Deep Anterior Lamellar Keratoplasty

Prospective Safety Evaluation of the Femtosecond Laser-Assisted Keratomileusis Procedure in Correcting Residual Ametropia in Patients After Deep Anterior Lamellar Keratoplasty

Postoperative Astigmatism after Keratoplasty: A Systematic Review Meta-Analysis Based on PRISMA

Managing Post-Keratoplasty Astigmatism: High-Tech vs. Low-Tech Imaging Techniques for Guiding Suture Manipulation

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