Profiles of Intraocular Pressure in Human Donor Eyes during Femtosecond Laser Procedures—A Comparative Study

Strohmaier, Clemens; Runge, Christian; Seyeddain, Orang; Emesz, Martin; Nischler, C.; Dexl, Alois K.; Grabner, Günther; Reitsamer, Herbert A.

doi:10.1167/iovs.12-11155

Cited by 31 publications

(25 citation statements)

References 34 publications

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“…Several in-vivo and in-vitro studies showed that IOP value would dramatically increase during femtosecond laser assisted corneal refractive surgeries as the response to attachment and suction. [15]–[16] In this study we did not detect a significant increase in IOP after lenticule creation, implying that the IOP rise might be temporary. And the SMILE procedure is safe.…”

Section: Discussioncontrasting

confidence: 51%

Changes in Corneal Deformation Parameters after Lenticule Creation and Extraction during Small Incision Lenticule Extraction (SMILE) Procedure

et al. 2014

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PurposeTo investigate the effects of lenticule creation and subsequent corneal lenticule extraction on corneal deformation parameters during small incision lenticule extraction (SMILE) procedure.Materials and MethodsIn this prospective study, 18 eyes of 10 patients (27.90±7.11 years, −5.64±2.45 diopters) scheduled for SMILE procedure were enrolled. Changes in the corneal deformation parameters, including deformation amplitude (DA), applanation time(AT1 and AT2), applanation length(AL1 and AL2), corneal velocity(CV1 and CV2), peak distance(P.Dist.), radius and intraocular pressure values were measured preoperatively, immediately after lenticule creation and subsequent to corneal lenticule extraction in all eyes with the Corvis Scheimpflug Technology (Corvis ST, OCULUS, Wetzlar, Germany). Repeated measures analysis of variance (ANOVA) with bonferroni-adjusted post hoc comparisons was performed to investigate changes following each step of the procedure.ResultsAll surgical procedures were uneventful. A significant difference was detected among the three time points (pre-operation, post-lenticule creation and post lenticule extraction) for AT1 (P<0.001), AT2 (P = 0.001), DA(P<0.001), and IOP(P = 0.002). Bonferroni-adjusted post hoc comparisons indicated that there was no significant change in AT1, AT2, DA, or IOP after lenticule creation (post hoc P>0.05), but there was a significant change in these parameters following subsequent corneal lenticule extraction (post hoc P<0.01), when compared to values obtained pre-operatively. The scheimpflug camera of the Corvis ST demonstrated the intralamellar small gas bubbles formed from the vaporisation of tissue after lenticule creation and a gray zone was observed between the cap and the residual stromal bed after lenticule extraction.ConclusionsThere is a significant change in corneal deformation parameters following SMILE procedure. The changes may be caused predominantly by stromal lenticule extraction, while lenticule creation with femtosecond laser may not have an obvious effect on corneal deformation properties.

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Section: Discussioncontrasting

confidence: 51%

Changes in Corneal Deformation Parameters after Lenticule Creation and Extraction during Small Incision Lenticule Extraction (SMILE) Procedure

et al. 2014

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“…[1][2][3][4] As in other laser-assisted treatments, fixation of the eye during surgery is a necessary step, and different fixation devices are available. 1,[5][6][7] In some approaches, the corneal curvature is changed, leading to variable decreases in the volume of the anterior chamber. As a side effect and a consequence of volume changes, the intraocular pressure (IOP) increases.…”

mentioning

confidence: 99%

“…IOP values may even exceed the ocular perfusion pressure, which causes impairment of ocular blood flow. 5,7 Patients report this phenomenon during laser surgery as a vision blackout.…”

mentioning

confidence: 99%

Intraocular Pressure Course During the Femtosecond Laser-Assisted Cataract Surgery in Porcine Cadaver Eyes

Sperl

Strohmaier

Kraker

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Femtosecond laser-assisted cataract surgery (FLACS) is an increasingly common procedure. Most laser systems require corneal applanation and thereby increase intraocular pressure (IOP). The purpose of the present study was to evaluate the IOP changes that occur during the FLACS procedure performed using the Catalys femtosecond laser system. METHODS. IOP was measured by direct cannulation of the vitreous body of porcine cadaver eyes (N ¼ 20). By inserting a second cannula connected to a water column, all the eyes were set to a baseline IOP of 20 mm Hg. The eyes were lifted by custom-made stands to achieve the appropriate height and position under the Catalys system. The standard FLACS procedure was performed using varying fragmentation times to assess the influence of tissue fragmentation times on IOP peaks. RESULTS.We identified significant IOP elevations from baseline IOP levels during all steps of the FLACS procedure (baseline: 20.28 6 1.32 mm Hg; vacuum: 34.48 6 4.21 mm Hg; capture: 47.90 6 13.02 mm Hg; lock: 48.41 6 9.04 mm Hg; analysis: 47.15 6 5.97 mm Hg; capsulotomy: 45.74 6 6.52 mm Hg; fragmentation: 48.41 6 6.80 mm Hg; end: 17.81 6 1.61 mm Hg; all P < 0.001). Furthermore, the tissue fragmentation time had a significant effect on the peak IOP values detected (R ¼ 0.62, P ¼ 0.04, n ¼ 9).CONCLUSIONS. The present study reveals significant IOP increases during FLACS procedures carried out using the Catalys system.

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“…Besides, in GTS keratoplasty the high intraocular pressure caused by applanation in femtosecond laser-assisted keratoplasty is avoided. 30 In summary, the cost-benefit ratio may be better in the GTS group than in the femtosecond laser group, because femtosecond laser-assisted keratoplasty requires expensive disposable glass interfaces and operation time is usually longer.…”

Section: Femtosecond Laser-assisted Keratoplasty Versus Gts Keratoplastymentioning

confidence: 99%

Comparison of Long-Term Outcomes of Femtosecond Laser-Assisted Keratoplasty with Conventional Keratoplasty

Daniel

Böhringer

Maier³

et al. 2016

Cornea

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Profiles of Intraocular Pressure in Human Donor Eyes during Femtosecond Laser Procedures—A Comparative Study

Abstract: Based on previous findings of visual field defects after LASIK, and as a consequence of the present study, it seems feasible to design patient interfaces in a more physiologic manner to prevent high IOPs during refractive procedures.

Cited by 31 publications

References 34 publications

Changes in Corneal Deformation Parameters after Lenticule Creation and Extraction during Small Incision Lenticule Extraction (SMILE) Procedure

Changes in Corneal Deformation Parameters after Lenticule Creation and Extraction during Small Incision Lenticule Extraction (SMILE) Procedure

Intraocular Pressure Course During the Femtosecond Laser-Assisted Cataract Surgery in Porcine Cadaver Eyes

Comparison of Long-Term Outcomes of Femtosecond Laser-Assisted Keratoplasty with Conventional Keratoplasty

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