Refractive regression after laser <i>in situ</i> keratomileusis

Yan, Ming; Chang, Jinn-Ming; Chan, Tak‐Mao

doi:10.1111/ceo.13315

Cited by 29 publications

(18 citation statements)

References 97 publications

(235 reference statements)

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“… i. Regression Refractive regression, defined as >0.25D shift in refractive error, is observed in nearly 30% hyperopes and 5.5%–27.7% myopes. [ 84 ] Risk factors include high refractive error, low RSBT, old age, chronic DED, m-LASIK, and small OZ. [ 84 85 ] Compensatory epithelial hyperplasia, decreased flap thickness, an anterior shift of cornea, stromal remodeling, and lenticular nuclear sclerosis are hypothesized to result in refractive regression.…”

Section: Postoperative Complicationsmentioning

confidence: 99%

“…[ 84 85 ] Compensatory epithelial hyperplasia, decreased flap thickness, an anterior shift of cornea, stromal remodeling, and lenticular nuclear sclerosis are hypothesized to result in refractive regression. [ 84 85 ]…”

Section: Postoperative Complicationsmentioning

confidence: 99%

“…Surgical treatment options include LASIK enhancement, PRK, and laser-assisted sub-epithelial keratomileusis (LASEK). [ 84 ] Careful RSBT calculation is essential in these cases to avoid corneal ectasia.…”

Section: Postoperative Complicationsmentioning

confidence: 99%

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Complications of laser-assisted in situ keratomileusis

Sahay

Bafna

Reddy

et al. 2021

Indian J Ophthalmol

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Laser-assisted in situ keratomileusis (LASIK) is one of the most commonly performed kerato-refractive surgery globally. Since its introduction in 1990, there has been a constant evolution in its technology to improve the visual outcome. The safety, efficacy, and predictability of LASIK are well known, but complications with this procedure, although rare, are not unknown. Literature review suggests that intraoperative complications include suction loss, free cap, flap tear, buttonhole flap, decentered ablation, central island, interface debris, femtosecond laser-related complications, and others. The postoperative complications include flap striae, flap dislocation, residual refractive error, diffuse lamellar keratitis, microbial keratitis, epithelial ingrowth, refractive regression, corneal ectasia, and others. This review aims to provide a comprehensive knowledge of risk factors, clinical features, and management protocol of all the reported complications of LASIK. This knowledge will help in prevention as well as early identification and timely intervention with the appropriate strategy for achieving optimal visual outcome even in the face of complications.

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Section: Postoperative Complicationsmentioning

confidence: 99%

Section: Postoperative Complicationsmentioning

confidence: 99%

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Complications of laser-assisted in situ keratomileusis

Sahay

Bafna

Reddy

et al. 2021

Indian J Ophthalmol

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“…The most common complication of any refractive procedure is residual refraction. Overcorrection, undercorrection, induced or residual astigmatism are all included; however, refractive regression is characterised as the gradual, partial, or complete loss of initial correction, limiting the predictability, efficiency, and long-term stability of this refractive procedure [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

SmartSurfACE transepithelial photorefractive keratectomy with mitomycin C enhancement after small incision lenticule extraction

Gab-Alla

2021

Eye and Vis

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Background To evaluate predictability, stability, efficacy, and safety of transepithelial photorefractive keratectomy (TPRK) using smart pulse technology (SPT) (SmartSurface procedure) of Schwind Amaris with mitomycin C for correction of post small incision lenticule extraction (SMILE) myopic residual refractive errors. Method This study is a prospective, non-comparative case series conducted at a private eye centre in Ismailia, Egypt, on eyes with post-SMILE myopic residual refractive errors because of undercorrection or suction loss (suction loss occurred after the posterior lenticular cut and the creation of side-cuts; redocking was attempted, and the treatment was completed in the same session with the same parameters) with myopia or myopic astigmatism. The patients were followed up post-SMILE for six months before the SmartSurface procedure, and then they were followed up for one year after that. TPRK were performed using Amaris excimer laser at 500 kHz. The main outcomes included refractive predictability, stability, efficacy, safety and any reported complications. Results This study included 68 eyes of 40 patients out of 1920 total eyes (3.5%) with post-SMILE technique myopic residual refractive errors. The average duration between the SMILE surgery and TPRK was 6.7 ± 0.4 months (range 6 to 8 months). The mean refractive spherical equivalent (SE) was within ± 0.50 D of plano correction in 100% of the eyes at 12 months post-TPRK. Astigmatism of < 0.50 D was achieved in 100% of the eyes. The mean of the residual SE error showed statistically significant improvement from preoperative − 1.42 ± 0.52 D to 0.23 ± 0.10 D (P < 0.0001). Uncorrected distance visual acuity (UDVA) (measured by Snellen's chart and averaged in logMAR units) was improved significantly to 0.1 ± 0.07 (P < 0.0001). UDVA was 0.2 logMAR or better in 100% of the eyes, 0.1 logMAR or better in 91.2% of the eyes, and 0.0 logMAR in 20.6% of the eyes. Corrected distance visual acuity (CDVA) remained unchanged in 79.4% of eyes. 14.7% of eyes gained one line of CDVA (Snellen). 5.9% of eyes gained two lines of CDVA (Snellen). Conclusion Transepithelial photorefractive keratectomy using smart pulse technology with mitomycin C enhancement after SMILE is a safe, predictable, stable, and effective technique.

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“…Post-laser in situ keratomileusis myopic regression can be defined as gradual, incomplete, or complete loss of primary correction that limits the efficiency, predictability, and longterm stability of laser in situ keratomileusis (LASIK) [1].…”

Section: Introductionmentioning

confidence: 99%

Is the axial length a risk factor for post-LASIK myopic regression?

Gab-Alla

2020

Graefes Arch Clin Exp Ophthalmol

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Purpose To assess the relationship between the axial length and post-LASIK regression in myopic patients. Methods This is a retrospective case series study conducted at a private eye centre, Ismailia, Egypt. The clinical records of the patients, who experienced LASIK to correct myopia from January 2016 to January 2018, were analysed for myopic regression. The patients were operated on, examined, and followed-up 1 year by one surgeon (AAG). Results This study included 1219 patients (2316 eyes) with myopia. Mean ± SD of pre-operative spherical equivalent (SE) was − 4.3 ± 2.1D, range (− 0.50 to − 10.0D). Mean ± SD age of the patients was 26.4 ± 6.8 years, range (21 to 50 years). Male to female ratio was 30.5 to 69.5%. The cumulative incidence rate of myopic regression according to the medical records of the patients was 25.12% (582 eyes out of total 2316 eyes) along the 2 years of this study (12.6% per year). Of the total patients, 14.94% had pre-operative high myopia, 35.84% had pre-operative moderate myopia, and 49.2% had pre-operative low myopia. Of the patients with myopic regression, 52.6% had pre-operative high myopia, 34% had pre-operative moderate myopia, and 13.4% had pre-operative low myopia. The mean ± SD of the axial length of the patients with myopic regression was 26.6 ± 0.44 mm, range (26.0 to 27.86 mm), while the mean ± SD of the axial length of other patients with stable refraction was 24.38 ± 0.73 mm, range (22.9 to 25.9 mm) (t test statistic = 69.3; P value < 0.001). Conclusions Pre-operative high axial length increases the risk of myopic regression after LASIK.

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Refractive regression after laser in situ keratomileusis

Cited by 29 publications

References 97 publications

Complications of laser-assisted in situ keratomileusis

Complications of laser-assisted in situ keratomileusis

SmartSurfACE transepithelial photorefractive keratectomy with mitomycin C enhancement after small incision lenticule extraction

Is the axial length a risk factor for post-LASIK myopic regression?

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