Femtosecond LASIK Retreatments After Primary Myopic Photorefractive Keratectomy

Leccisotti, Antonio; Fields, Stefania V.; Bartolo, Giuseppe De

doi:10.1097/ico.0000000000003074

Cited by 6 publications

(4 citation statements)

References 16 publications

(25 reference statements)

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“…Microkeratome LASIK is rarely performed because of the reduced accuracy of the thickness of the flap in eyes in which stromal thickness is already affected by previous surgery [9]. Femtosecond LASIK is an ideal method of correction after PRK because it allows thinner and more precise flaps [10]; it can be, however, be characterized by postoperative dry eye and is therefore less indicated in eyes with a compromised tear film. In our case, the presence of altered Schirmer and breakup time was the reason why RCLE was chosen.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Refractive Corneal Lenticule Extraction on Previous Photorefractive Keratectomy, with Optical Coherence Tomography Study

Leccisotti

Fields²,

Bartolo³

2022

Case Rep Ophthalmol

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We report the first case of refractive corneal lenticule extraction with the femtosecond laser application CLEAR as retreatment technique after previous laser vision correction. A 42-year-old woman, operated by bilateral photorefractive keratectomy (PRK) 19 years previously, with moderate dry eye, came for post-PRK regression and underwent correction of a residual myopia of −3 −0.5 × 159° D in the left eye by CLEAR. Surgery was uneventful, with a regular laser pattern and a normal dissection of the lenticule. At day 1, uncorrected visual acuity was 20/25; at 3 months, it was 20/20, with a refraction of +0.25 × 115° D. The cornea and interface were regular and transparent; no dry eye symptoms occurred. At 3 months, on optical coherence tomography, the treatment was well centered, the surgical interface was centrally regular, whereas the anterior profile of the stromal surface was slightly corrugated, compensated by a smooth epithelial surface. The present case demonstrates that myopia after PRK can be achieved by CLEAR; an irregular stromal surface may occur, not affecting the visual result in virtue of epithelial remodeling.

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Section: Discussionmentioning

confidence: 99%

“…It is uncertain whether nomogram adjustments are required in previously operated corneas. In a series of femtosecond LASIK over PRK, the standard nomogram was predictable [10], and in the previous report of RCLE over PRK, no nomogram changes were suggested [6].…”

Section: Discussionmentioning

confidence: 99%

Refractive Corneal Lenticule Extraction on Previous Photorefractive Keratectomy, with Optical Coherence Tomography Study

Leccisotti

Fields²,

Bartolo³

2022

Case Rep Ophthalmol

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“…Our technique for femtosecond LASIK has been described in detail [5]. Briefly, full manifest spherical and cylindrical corrections were set.…”

Section: Methodsmentioning

confidence: 99%

Creation of the Corneal Flap for Laser In Situ Keratomileusis with a 3-Dimension Femtosecond Laser Cut: Clinical and Optical Coherence Tomography Features

Leccisotti,

Fields,

De Bartolo

et al. 2024

Preprint

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Laser in situ keratomileusis (LASIK) is the gold standard in the surgical correction of refractive errors on the cornea. It entails the creation of a superficial hinged corneal flap by a femtosecond laser, ablation of the underlying stromal bed by an excimer laser, and reposition of the flap. The corneal flap can be build in a 2-dimension (2D) fashion with tapered edges, or in a 3-dimension (3D) fashion, with angled sidecut. The latter reduces the risk of flap dislocation and infiltration of epithelial cells. This retrospective study compares with optical coherence tomography 3D and 2D flaps, and respective intra- and early post-operative complications. Four hundred consecutive eyes were included, 200 for each group. In the 3D group, the mean edge angle was 92°. The procedure was in average 5.2 seconds slower in the 3D group (p=0). Non visually significant flap folds were found in 13 eyes of the 2D group and in 7 eyes of the 3D group (p= 0.17). An intracorneal opaque bubble layer induced by laser photodisruption was more commonly observed in the 3D group (9 eyes vs. 2; p=0.03). In conclusion, the creation of a LASIK flap by a 3D-femtosecond laser cut was safe and effective.

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“…Our technique for femtosecond LASIK has been described in detail [9]. In brief, full manifest spherical and cylindrical corrections were set.…”

Section: Methodsmentioning

confidence: 99%

Creation of a Corneal Flap for Laser In Situ Keratomileusis Using a Three-Dimensional Femtosecond Laser Cut: Clinical and Optical Coherence Tomography Features

Leccisotti,

Fields,

De Bartolo

et al. 2024

Optics

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Laser in situ keratomileusis (LASIK) is the most frequently used technique for the surgical correction of refractive errors on the cornea. It entails the creation of a superficial hinged corneal flap using a femtosecond laser, ablation of the underlying stromal bed using an excimer laser, and repositioning of the flap. A corneal flap with an angled side cut reduces the risk of flap dislocation and infiltration of epithelial cells and confers unique biomechanical properties to the cornea. A new laser software creating three-dimensional (3D) flaps using a custom angle side cut was retrospectively evaluated, comparing optical coherence tomography 3D (with intended 90° side cut) and 2D flaps (with tapered side cuts) as well as respective intra- and early postoperative complications. Four hundred consecutive eyes were included, two hundred for each group. In the 3D group, the mean edge angle was 92°, and the procedure was on average 5.2 s slower (p = 0). Non-visually significant flap folds were found in thirteen eyes of the 2D group and in seven eyes of the 3D group (p = 0.17). In conclusion, the creation of a LASIK flap using a 3D femtosecond laser cut, although slightly slower, was safe and effective. The side cut angle was predictable and accurate.

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Femtosecond LASIK Retreatments After Primary Myopic Photorefractive Keratectomy

Cited by 6 publications

References 16 publications

Refractive Corneal Lenticule Extraction on Previous Photorefractive Keratectomy, with Optical Coherence Tomography Study

Refractive Corneal Lenticule Extraction on Previous Photorefractive Keratectomy, with Optical Coherence Tomography Study

Creation of the Corneal Flap for Laser In Situ Keratomileusis with a 3-Dimension Femtosecond Laser Cut: Clinical and Optical Coherence Tomography Features

Creation of a Corneal Flap for Laser In Situ Keratomileusis Using a Three-Dimensional Femtosecond Laser Cut: Clinical and Optical Coherence Tomography Features

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