Excimer laser treatment of corneal surface pathology: a laboratory and clinical study.

Gartry, David; Muir, M Kerr; Marshall, John

doi:10.1136/bjo.75.5.258

Cited by 114 publications

(37 citation statements)

References 23 publications

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“…Corneal surface irregularity, epithelial instability, and superficial opacification may all benefit from the procedure. [1][2][3][4][5][6][7][8] Band keratopathy is a relatively common superficial corneal degeneration in which deposition of extracellular granular material throughout the epithelial basement membrane, Bowman's layer, and anterior stroma may result in any combination of these problems. Histological analysis shows that cases may be due to deposition of calcific, noncalcific, or mixed-type materials.…”

Section: Introductionmentioning

confidence: 99%

Management of band keratopathy with excimer phototherapeutic keratectomy: visual, refractive, and symptomatic outcome

Stewart

Morrell

2003

Eye

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Section: Introductionmentioning

confidence: 99%

Management of band keratopathy with excimer phototherapeutic keratectomy: visual, refractive, and symptomatic outcome

Stewart

Morrell

2003

Eye

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“…Roberts and other authors have noted an increased flattening and hyperopic shifts in studies on PTK and myopic PRK and LASIK. [13][14][15][16][17] This effect can be attributed to a severing and retraction of the collagen lamellae. Corneal topography reveals this thickening and steepening of the midperiphery with the "red ring," which is associated with positive spherical aberration.…”

mentioning

confidence: 99%

Separate effects of the microkeratome incision and laser ablation on the eye’s wave aberration

Porter¹,

MacRae

Yoon

et al. 2003

American Journal of Ophthalmology

134

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• PURPOSE: To study the optical changes induced by the microkeratome cut, the subsequent laser ablation, and the biomechanical healing response of the cornea in normal laser in situ keratomileusis (LASIK) eyes.• DESIGN: Prospective randomized clinical trial.• METHODS: A Hansatome microkeratome was used to cut a corneal flap in one eye (study eye) of 17 normal myopic patients and a subsequent laser ablation was performed 2 months after this initial microkeratome incision. Control eyes received conventional LASIK treatments at the latter time point. The wave aberration of both the study and contralateral control eyes were measured over a 6-mm pupil with a Shack-Hartmann wavefront sensor for all preoperative, postflap cut, and postablation visits.• RESULTS: The eye's higher order aberrations had a small, but significant increase (P ‫؍‬ .03) of approximately 30% 2 months after cutting a flap. No systematic changes were observed in nearly all Zernike coefficients from their preoperative levels at 2 months postflap cut. A significant difference between the study and control eyes was observed for one trefoil mode, Z 3 3 (P ‫؍‬ .04).• CONCLUSIONS: There was a wide variation in the response of individual Zernike modes across patients after cutting a flap. The majority of spherical aberration induced by the LASIK procedure seems to be due to the laser ablation and not the microkeratome cut. In addition, the total and higher order root mean square of wavefront errors were nearly identical for both the study and control eyes 3-months after the laser ablation, indicating that a procedure in which the incision and the ablation are separated in time to better control aberrations does not compromise the outcome of a conventional LASIK treatment. ( have been encouraging, further refinements of wavefront-guided laser in situ keratomileusis (LASIK) procedures are needed to obtain an aberration-free ablative correction. 1-4 It has been well established that conventional photorefractive keratectomy (PRK) and LASIK procedures induce higher order aberrations, including increased amounts of spherical aberration, despite their accurate correction of spherocylindrical errors. [5][6][7][8][9][10] To date, little evidence has been presented to determine the origins of these induced higher order aberrations. Consequently, not much is known about the importance or relative contribution of the two separate effects of creating a microkeratome flap and performing a subsequent laser ablation on the overall optical quality of an eye receiving a LASIK treatment. Developing a firm understanding of the aberrations induced by these two processes is crucial for achieving an optimal, customized correction of the eye's higher order aberrations with laser refractive surgery.Studies have been conducted to investigate structural changes in corneal shape due to the laser ablation in refractive surgery procedures. Howland and coworkers 11 found that changes made in the midperipheral and peripheral cornea could create biomechanical changes in the central corn...

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“…By shrinking the collagen, the shape ofthe cornea and its refractive power is changed. The cornea is comprised of approximately 78% water; therefore, several researchers have used the optical properties of water to model the cornea [40][41][42][43][44][45] The lens provides a template or mold for the desired shape and curvature of the cornea. Once the Biomask material has solidified, the contact lens is removed.…”

Section: Refractive Keratoplastymentioning

confidence: 99%

Laser Ophthalmology

Barrett¹,

Wright²,

Welch³

2002

Medical Applications of Lasers

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Lasers have been employed in ophthalmology since their inception over four decades ago. In this chapter we will investigate many of these exciting applications. The chapter begins with a brief review of the characteristics of the human eye including eye anatomy and movements, visual refractive errors, and fixation capability. We will then briefly review laser interaction with eye tissue followed by a detailed look at therapeutic and diagnostic applications of lasers in ophthalmology. The chapter concludes with new laser technologies now on the horizon. CHARACTERISTICS OF THE HUMAN EYEIn this section we will investigate the anatomy and characteristics of the human eye pertinent to laser applications. We will begin with a review of the gross anatomy of the eye followed by a detailed look at both the cornea and the retina. We will then discuss eye movements and fixation capability followed by characteristics of the aging eye. Gross Anatomical StructureEyes are the complex sense organs of the visual system. The adult eye is somewhat like a fluid filled globe approximating a spherical shape measuring 24 mm long by 22 mm across [1], as shown in Figure 1

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Excimer laser treatment of corneal surface pathology: a laboratory and clinical study.

Abstract: The argon fluoride excimer laser emits radiation in the far ultraviolet part of the electromagnetic spectrum (193 nm

Cited by 114 publications

References 23 publications

Management of band keratopathy with excimer phototherapeutic keratectomy: visual, refractive, and symptomatic outcome

Management of band keratopathy with excimer phototherapeutic keratectomy: visual, refractive, and symptomatic outcome

Separate effects of the microkeratome incision and laser ablation on the eye’s wave aberration

Laser Ophthalmology

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