Pachymetric Changes of the Cornea Amongst Patients Treated with LASIK

Abstract

Purpose:In this study, we have researched the possible parametrically changes before and after LASIK (laser-assisted in situ keratomileusis) and the influence of these changes in the cause of post LASIK ectasia.Materials and methods:In this study 204 eyes with different refractive anomalies were included. Candidates that underwent refractive surgery first have to undergo many ophthalmological examinations, firstly by evaluating their visual acuity, subjective and objective refraction with and without cycloplegia, slight lamp evaluation, computerized topography, pupillometry, retina examination and measurement of intraocular pressure. Pachymetric values were measured with Orbscan IIz (Bausch – Lomb). Refractive surgery was done with LASIK under local anesthesia.Results:In this study 102 patients were treated with LASIK who were with different refractive anomalies. According to the group age 44 or 43.1% were of the age 20 – 29, 46 or 45.1% were of the age 30 – 39, 11 or 10.8% were 40 – 49 years of age and 1 or 1% were above the age of 50 +. Pachymetric before surgery in right eye was approximately 565.4 µm (DS+- 39.4), from 507 µm up to 678 µm, but after surgery it was approximately 497.5 µm (DS+-61.7) from 346 µm up to 644 µm. Pachymetric on the left eye before surgery was approximately 564.8 µm (DS+-41.5) from 504 µm up to 696 µm but after surgery it was approximately 498.3 µm (DS+-62.2), from 329 µm up to 646 µm. Pachymetric in both eyes before surgery was approximately 549.1 µm (DS+=73.9), from 263 µm up to 687 µm. Pachymetric on both eyes after surgery was approximately 496.9 µm (DS+-60.1), from 337.5 µm up to 645 µm. With the “ Paired T – test “ we have reached a significant statistical change between the pachymetric values in both eyes before and after the surgery (P<0.0001).Conclusion:Corneal thickness is one of the main criteria in order to allow refractive surgeries, and as the main criteria it was evaluated at our patients treated with LASIK.

A Review of the Usage and Post-surgical Outcomes of Anesthesia for Laser In Situ Keratomileusis (LASIK) Procedure

“…During this procedure, the front of the eye, specifically the cornea, which is the dome-shaped clear tissue, is changed using a cutting laser to improve vision. Typically the anesthesia used in this procedure is in the form of eye drops that inhibit pain signals to the ocular nerve [9]. Thus patients are mostly awake during this procedure.…”

“…This procedure is used for myopia, hyperopia as well as astigmatism in order to correct refractive errors. Including regional as well as topical anesthesia in ocular surgeries has improved the quality of care for patients [9]. The choice of anesthetic should be based on factors that may influence safety, comfort, cooperation as well as the comorbidities of the patient.…”

“…Presumably, eye drops remain a preferred route of anesthesia administration due to their localized numbing effects on only the eye. Local anesthetics are generally safer and associated with fewer side effects than other types of anesthesia [9]. A patient under a local anesthetic remains conscious and does not require ventilatory support.…”

“…The duration of nerve blocking in a local anesthetic is also not long; as a result, the recovery time for patients who are administered local anesthetics is shorter. Thus, pain control via topical anesthesia has proven to be especially useful in short procedures such as LASIK [9]. However, it is important to note that topical anesthesia may not provide complete anesthesia due to insufficient blocking of the ocular nerves.…”

Results of presbyopia correction with multifocal profile application on the cornea by photorefractive keratectomy in hyperopic patients

“…В настоящее время в коррекции гиперметропии среди эксимерлазерных операций ведущее место занимают операции типа ЛАСИК (Laser assisted in situ keratomileusis), показавшие высокую эффективность, прогнозируемость, быстрое восстановление зрительных функций и минимальный дискомфорт для пациентов по сравнению с методом фоторефракционной кератэктомии (ФРК) [10,11,14]. Обратной стороной медали применения этой операции является более высокий риск развития кератэктазий, необходимость проводить вмешательство при достаточной толщине роговицы, длительное ограничение физических нагрузок, значимое нарушение биомеханических свойств роговицы [12,13].…”