Predictive factors for efficacy and safety in refractive surgery for myopia

Abstract

PurposeTo evaluate the predictive factors for safety and efficacy in laser refractive surgery for myopiaSettingA singular refractive surgery center, at a University-affiliated tertiary medical center.DesignRetrospective cohort studyMethodsStudy population—A total 8,775 eyes having laser refractive laser procedures for myopia (in4,623 patients).Observation procedures–Using a prospective database of refractive procedures performed over the span of 13 years, variables such as gender, age, type of surgery, date of surgery, pre-operative corneal thickness and Spherical Equivalent (SEQ) were evaluated.Main outcome measures—Proportion of patients with Safety index higher than 0.85 and Efficacy index higher than 0.80.Results91.9% and 86.0% of all evaluated eyes were above the safety and efficacy cut-off levels, respectively. Younger age was significantly correlated with safety and efficacy indices above the cut-off levels (p<0.001). Male gender was significantly correlated with efficacy above the cut-off level (p<0.001). Myopic eyes with lower SEQ were associated with both safety (p = 0.002) and efficacy (p<0.001) indices above the cut-offs. The surgical procedure was found to significantly affect the outcome only using univariate analysis: Safety was higher in Photorefractive Keratectomy (PRK), while Efficacy was higher in Laser Assisted In Situ Keratomileusis (LASIK) (p<0.001, respectively) but no difference was found using multivariate analysis. Safety index above the cut-off level increased over the years (p<0.001).ConclusionsEfficacy in refractive surgery for myopia is correlated with younger age, male gender and low myopia. Safety is correlated with younger age, low myopia and increases over the years. Multivariate analysis found no differences between PRK and LASIK regarding safety and efficacy.

Three-Year Outcomes of Implantable Collamer Lens Followed by Excimer Laser Enhancement (“Bioptics”) in the Treatment of High Myopic Astigmatism

“…The mean residual refractive target after ICL implantation (−0.51 ± 1.12 D) falls within a range that guarantees precise correction with an excimer-based approach. 18 , 19 In a retrospective comparative study between TICL implantation and bioptics for high myopic astigmatism, Alfonso et al 20 demonstrated that bioptics were more likely to achieve MSE within 0.50 D (94% vs 81%) at 12-month postoperatively. Postoperative UDVA was also twice as likely to meet or exceed preoperative CDVA (57.8% vs 32.1%).…”

Comparison of single-step transepithelial photorefractive keratectomy and conventional photorefractive keratectomy in low to high myopic eyes

“…Myopia was grouped as mild (MRSE is between 0 and −3.00 D), moderate (MRSE is between −3.01 D and −6.00 D), and high (MRSE is -6.01 D and above). [ 12 ] A total of 115 eyes of 59 patients were included among which 67 eyes underwent t-PRK and 48 eyes underwent PRK.…”

Intercellular Trafficking of Gold Nanostars in Uveal Melanoma Cells for Plasmonic Photothermal Therapy

“…Currently, the most commonly used local treatments for this tumor are brachytherapy (iodine-125, ruthenium-106, or palladium-103, or cobalt-60) and teletherapy (proton beam, helium ion, or stereotactic radiosurgery using a cyber knife, gamma knife, or linear accelerator); the alternative to radiation is eye enucleation [24,25]. In this context, uveal melanoma cells offer an excellent biological environment to study due to the ubiquitous use of NIR CW and pulse lasers in multiple types of eye surgery [26][27][28].…”