Epithelial Remodeling After Femtosecond Laser-assisted High Myopic LASIK

Kanellopoulos, Anastasios John; Asimellis, George

doi:10.1097/ico.0000000000000087

Cited by 60 publications

(19 citation statements)

References 32 publications

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“…This difference may correlate with higher regression rates and/or may depict increased biomechanical instability in stand-alone LASIK. 31 We believe that this finding is a manifestation of the same aspect, which is the chief difference between the two groups – the application of preventive CXL in this group. As we have previously demonstrated, 32 CXL affects epithelial thickness, leading to reduced overall thickness.…”

Section: Discussionmentioning

confidence: 70%

Comparison of prophylactic higher fluence corneal cross-linking to control, in myopic LASIK, one year results

Kanellopoulos¹,

Asimellis²,

Karabatsas³

2014

OPTH

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PurposeTo compare 1-year results: safety, efficacy, refractive and keratometric stability, of femtosecond myopic laser-assisted in situ keratomileusis (LASIK) with and without concurrent prophylactic high-fluence cross-linking (CXL) (LASIK-CXL).MethodsWe studied a total of 155 consecutive eyes planned for LASIK myopic correction. Group A represented 73 eyes that were treated additionally with concurrent prophylactic high-fluence CXL; group B included 82 eyes subjected to the stand-alone LASIK procedure. The following parameters were evaluated preoperatively and up to 1-year postoperatively: manifest refractive spherical equivalent (MRSE), refractive astigmatism, visual acuity, corneal keratometry, and endothelial cell counts. We plotted keratometry measurements pre-operatively and its change in the early, interim and later post-operative time for the two groups, as a means of keratometric stability comparison.ResultsGroup A (LASIK-CXL) had an average postoperative MRSE of −0.23, −0.19, and −0.19 D for the 3-, 6-, and 12-month period, respectively, compared to −6.58±1.98 D preoperatively. Flat keratometry was 37.69, 37.66, and 37.67 D, compared to 43.94 D preoperatively, and steep keratometry was 38.35, 38.36, and 38.37 D, compared to 45.17 D preoperatively. The predictability of Manifest Refraction Spherical Equivalent (MRSE) correction showed a correlation coefficient of 0.979. Group B (stand-alone LASIK) had an average postoperative MRSE of −0.23, −0.20, and −0.27 D for the 3-, 6-, and 12-month period, respectively, compared with −5.14±2.34 D preoperatively. Flat keratometry was 37.65, 37.89, and 38.02 D, compared with 43.15 D preoperatively, and steep keratometry was 38.32, 38.57, and 38.66 D, compared with 44.07 D preoperatively. The predictability of MRSE correction showed a correlation coefficient of 0.970. The keratometric stability plots were stable for the LASIK CXL group and slightly regressing in the standard LASIK group, a novel stability evaluation metric that may escape routine acuity and refraction measurements.ConclusionApplication of prophylactic CXL concurrently with myopic LASIK surgery appears to contribute to improved refractive and keratometric stability compared to standard LASIK. The procedure appears safe and provides a new potential for LASIK correction.

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Section: Discussionmentioning

confidence: 70%

Comparison of prophylactic higher fluence corneal cross-linking to control, in myopic LASIK, one year results

Kanellopoulos¹,

Asimellis²,

Karabatsas³

2014

OPTH

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“…Therefore, it may be reasonable to assume that the epithelial thickness is stable 3 months after LASIK. It also should be pointed out that, besides focal corneal curvature, changes in corneal biomechanical properties, such as dry eye [ 22 ] and cross-linking [ 23 , 24 ], may result in corneal remodeling as well. Therefore, it is important to take multiple factors into consideration if they are mixed.…”

Section: Discussionmentioning

confidence: 99%

Corneal Epithelial Remodeling after LASIK Measured by Fourier-Domain Optical Coherence Tomography

Tang

Huang

2015

Journal of Ophthalmology

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Purpose. To quantify corneal epithelial thickness changes after myopic LASIK by OCT. Methods. Epithelial thickness before and after myopic LASIK were measured by a Fourier-domain OCT system. Average central (within 1 mm diameter) and paracentral epithelial thickness (5~6 mm diameter) before and after LASIK were compared. Correlation between central epithelial thickness change and laser spherical equivalent setting was evaluated. An epithelial smoothing constant was estimated based on a mathematical model published previously. Results. Nineteen eyes from 11 subjects were included in the study. Eyes had myopic LASIK ranging from −1.69 D to −6.75 D spherical equivalent. The average central epithelial thickness was 52.6 ± 4.1 μm before LASIK and 56.2 ± 4.3 μm 3 months after LASIK (p = 0.002). The average paracentral epithelial thickness was 51.6 ± 6.6 μm before LASIK and 54.8 ± 4.3 μm 3 months after LASIK (p = 0.007). The change in average central epithelial thickness was correlated with laser spherical equivalent (R 2 = 0.40, p = 0.028). The epithelial smoothing constant was estimated to be 0.46 mm. Conclusions. Corneal epithelial thickens centrally and paracentrally after myopic LASIK. The extent of epithelial remodeling correlated with the amount of LASIK correction and could be predicted by a mathematical model.

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“…Epithelial remodeling after keratorefractive treatment has been recognized for a considerable time [ 37 , 38 ]. Although there is no study to date that directly compares epithelial remodeling following FS-LASIK with conventional MK-LASIK, the plausible explanations for epithelial remodeling, such as the rate of stromal curvature change [ 39 ] and the change in biomechanical stability especially in large corrections [ 40 ] should have a much smaller impact compared to MK-LASIK.…”

Section: Reviewmentioning

confidence: 99%

The evolution of corneal and refractive surgery with the femtosecond laser

Aristeidou¹,

Taniguchi

Tsatsos³

et al. 2015

Eye and Vis

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The use of femtosecond lasers has created an evolution in modern corneal and refractive surgery. With accuracy, safety, and repeatability, eye surgeons can utilize the femtosecond laser in almost all anterior refractive procedures; laser in situ keratomileusis (LASIK), small incision lenticule extraction (SMILE), penetrating keratoplasty (PKP), insertion of intracorneal ring segments, anterior and posterior lamellar keratoplasty (Deep anterior lamellar keratoplasty (DALK) and Descemet's stripping endothelial keratoplasty (DSEK)), insertion of corneal inlays and cataract surgery. As the technology matures, it will push surgical limits and open new avenues for ophthalmic intervention in areas not yet explored. As we witness the transition from femto-LASIK to femto-cataract surgery it becomes obvious that this innovation is here to stay. This article presents some of the most relevant advances of femtosecond lasers to modern corneal and refractive surgery.

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Epithelial Remodeling After Femtosecond Laser-assisted High Myopic LASIK

Cited by 60 publications

References 32 publications

Comparison of prophylactic higher fluence corneal cross-linking to control, in myopic LASIK, one year results

Comparison of prophylactic higher fluence corneal cross-linking to control, in myopic LASIK, one year results

Corneal Epithelial Remodeling after LASIK Measured by Fourier-Domain Optical Coherence Tomography

The evolution of corneal and refractive surgery with the femtosecond laser

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Epithelial Remodeling After Femtosecond Laser-assisted High Myopic LASIK

Cited by 60 publications

References 32 publications

Comparison of prophylactic higher fluence corneal cross-linking to control, in myopic LASIK,&nbsp;one year results

Comparison of prophylactic higher fluence corneal cross-linking to control, in myopic LASIK,&nbsp;one year results

Corneal Epithelial Remodeling after LASIK Measured by Fourier-Domain Optical Coherence Tomography

The evolution of corneal and refractive surgery with the femtosecond laser

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Comparison of prophylactic higher fluence corneal cross-linking to control, in myopic LASIK, one year results

Comparison of prophylactic higher fluence corneal cross-linking to control, in myopic LASIK, one year results