Influence of the Difference Between Corneal and Refractive Astigmatism on LASIK Outcomes Using Solid-State Technology

Piñero, David P.; Ribera, David; Pérez-Cambrodí, Rafael J.; Ruiz-Fortes, Pedro; Blanes-Mompó, Francisco J.; Alzamora-Rodríguez, Antonio; Artola, Alberto

doi:10.1097/ico.0000000000000272

Cited by 6 publications

(8 citation statements)

References 26 publications

(31 reference statements)

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“…It should be pointed out that the initially obtained good results described above could be achieved without a nomogram and match the previously reported good safety and efficacy profiles reached with solid-state lasers of other research groups [ 17 , 18 , 24 , 25 , 26 , 27 , 28 ].…”

Section: Discussionsupporting

confidence: 87%

“…In addition, previously reported characteristics of solid-state laser sources, such as silent operation and the wet ablation process, suggesting a lower susceptibility to corneal hydration, could be reproduced [ 24 , 25 , 26 , 27 , 28 ]. The wet procedure potentially means less thermal stress and consequently less tensile stress in the irradiated tissue, which as an advantage resulting in a faster healing process [ 24 , 31 , 32 ].…”

Section: Discussionmentioning

confidence: 95%

“…Furthermore, based on the work of Hale and Querry on extinction coefficients of radiation over a large area of the electromagnetic spectrum, Dair and co-workers found less absorption of up to two orders of magnitude for solid-state lasers in Balanced Salt Solution (BSS) and 0.9% Sodium Chloride solution compared to an excimer system [ 19 , 20 ]. While for excimer lasers emitting at 193 nm, tissue hydration control was found to be crucial to achieve target ablation [ 21 , 22 , 23 ], solid-state ablation lasers emitting at longer wavelengths would offer the benefits of being less dependent on the hydration state of the cornea and the humidity of the surgical environment, as well as not using toxic gas and operating silently [ 24 , 25 , 26 , 27 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

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First Clinical Results of a New Generation of Ablative Solid-State Lasers

Pajic

Pajic-Eggspuehler²,

Cvejić

et al. 2023

JCM

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In the early 2000s, solid-state lasers emerged as an alternative technology to excimer systems in refractive surgery. Despite some technological limits at the time, good clinical results could be achieved with solid-state laser systems. This prospective case series reports clinical outcomes of five eyes treated with a newly developed solid-state laser system (AquariuZ) in three patients. Patients underwent preoperative examination, including corneal topo-and tomography, aberrometry, and confocal microscopy. All patients received a femtosecond LASIK with the Ziemer LDV Z8, a refractive treatment with the AquariuZ solid-state ablation laser, and were then followed up for a period of up to 12 months. The applied aspheric optimized profiles did not induce higher-order aberrations nor spherical aberration in any of these operated subjects. No eye lost BCVA lines throughout the duration of the follow-up. Six months after surgery, the safety index of patient 1 was 5, and for patients 2 and 3, it equaled 1. Confocal laser microscopy imaging findings were comparable to those seen typically for excimer lasers. The obtained results are encouraging and confirm that the new solid-state laser system is safe.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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First Clinical Results of a New Generation of Ablative Solid-State Lasers

Pajic

Pajic-Eggspuehler²,

Cvejić

et al. 2023

JCM

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“…It was reported that the efficacy of LASIK in eyes with a low ORA was twice as good as in eyes with a high ORA 5 . It was also shown that the ORA was strongly correlated with the PCA after LASIK surgery (r = 0.81) 6 . Thus, it is of clinical importance to investigate the PCA distribution in patients having corneal refractive surgery.…”

mentioning

confidence: 92%

A multicenter study of the distribution pattern of posterior corneal astigmatism in Chinese myopic patients having corneal refractive surgery

Zhu²,

Xiong³

et al. 2020

Sci Rep

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Including posterior corneal astigmatism (PCA) into consideration may increase the accuracy of astigmatism correction after corneal refractive surgery. In the present study we aim to investigate the distribution pattern of PCA in a large number of myopic patients from multiple ophthalmic centers. There were 7829 eyes retrospectively included in the study. Pentacam data of the eyes were retrieved from the machine and only results with image quality labelled with ‘OK’ were included. Distribution of PCA was slightly positively skewed (Skewness = 0.419, Kurtosis = 0.435, KS P < 0.0001). Mean PCA was 0.34 ± 0.14 D (range: 0.00 D-0.99 D). PCA was ≥ 0.25 D in 74.91% of the eyes and was ≥ 0.50 D in 11.61% of the eyes. In 97.55% of the eyes the steep meridian of PCA was vertical (SMV). PCA magnitude was significantly higher in eyes with SMV PCA (P < 0.0001) or high manifest astigmatism (MA, P < 0.0001). There was a significant correlation between anterior corneal astigmatism (ACA) magnitude and PCA magnitude in all of the eyes (r = 0.704, P < 0.0001). There was also a trend of decreasing frequency and magnitude of SMV PCA with aging (both P < 0.0001). In conclusion, PCA is present in myopic patients having corneal refractive surgery and PCA magnitude is increased with higher MA or ACA. Consideration of the impact of PCA on laser astigmatism correction may be necessary.

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“…In the meantime, solid-state laser technology has become a more reliable source for treating organic tissue materials, and the possibility of performing corneal ablation with high efficacy and safety as compared to using an excimer laser is challenging, and has been investigated in experimental studies with good results [ 1 , 2 , 3 , 4 , 5 ]. Since the beginning, corneal refractive surgery with a solid-state laser has been a safe and effective procedure [ 2 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. Now, growing interest has been noted with the recent presentation of the new platform [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

One-Year Results of Photorefractive Keratectomy for Myopia and Compound Myopic Astigmatism with 210 nm Wavelength All Solid-State Laser for Refractive Surgery

Roszkowska

Tumminello

Licitra

et al. 2023

JCM

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Background: To examine the 12-month clinical and refractive outcomes of PRK performed with a UV all-solid-state laser. Methods: The study included healthy patients with myopia and/or compound myopic astigmatism enrolled for refractive surgery and treated with PRK using a 210 nm wavelength, 2 kHz repetition rate, UV all-solid-state laser (LaserSoft, Katana Technologies GmbH, Kleinmachnow, Germany). All subjects were examined at baseline and after 1, 3, 6, and 12 months after the treatment with a slit lamp, refraction, visual acuity assessment (logMAR chart), tonometry, ophthalmoscopy, and corneal tomography with a Scheimpflug camera. The outcome measures considered were uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, central corneal thickness, and transparency. The efficacy, safety, predictability, and stability were determined. Results: The study included 34 eyes of 19 patients. The mean UDVA changed from 1.20 ± 0.43 to −0.05 ± 0.10 logMAR at 12 months, and the mean CDVA changed from −0.03 ± 0.06 to −0.06 ± 0.09 logMAR, respectively. The mean spherical equivalent (SE) changed from −4.90 ± 2.12 D to −0.01 ± 0.40 D and was within ±0.50 D of the intended correction in 91% of eyes and within ±1.00 D in 97% of eyes at 12 months. No eyes lost lines of visual acuity, and 64% of eyes gained one or more lines. Conclusions: PRK with the 210 nm wavelength, 2 kHz repetition rate, all-solid-state laser LaserSoft system proved to have good visual, refractive, and clinical outcomes after the follow-up at 12 months. The emerging gas-free, solid-state technology might be considered a valid alternative for the gas operating lasers for corneal refractive surgery.

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Influence of the Difference Between Corneal and Refractive Astigmatism on LASIK Outcomes Using Solid-State Technology

Abstract: The magnitude of ORA does not seem to be a predictive factor of efficacy and safety of myopic LASIK using a solid-state laser platform. The higher relevance of PCA after surgery in some cases may explain the presence of unexpected astigmatic residual refractive errors.

Cited by 6 publications

References 26 publications

First Clinical Results of a New Generation of Ablative Solid-State Lasers

First Clinical Results of a New Generation of Ablative Solid-State Lasers

A multicenter study of the distribution pattern of posterior corneal astigmatism in Chinese myopic patients having corneal refractive surgery

One-Year Results of Photorefractive Keratectomy for Myopia and Compound Myopic Astigmatism with 210 nm Wavelength All Solid-State Laser for Refractive Surgery

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