Refractive surgery in the late adulthood and adolescent age groups

Hecht, Idan; Achiron, Asaf; Haim, Liron Naftali Ben; Sorin, Vera; Kaiserman, Igor

doi:10.1007/s00417-019-04396-x

Cited by 8 publications

(7 citation statements)

References 12 publications

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“…The adolescents show relatively more favorable outcomes with slightly better safety and efficacy indices and lower retreatment rates, than adults. 20 From previous studies, superior results…”

Section: Discussionmentioning

confidence: 93%

“…There have been a few trials that compared results between adolescents and adults using different laser machines and nomograms. 19,20 Compared to the Streamlight, two-step TransPRK using EX500 required no additional cost to perform the procedure. To prevent under-correction from the PTK mode, the surgeon should add PRK laser to over-correct between −0.25 and −0.50 diopters to subtract that myopic shift.…”

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confidence: 99%

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Two-Step Transepithelial Photorefractive Keratectomy with WaveLight EX500 Platform for Adolescents and Adults with Low to Moderate Myopia: A 12-Month Comparative Evaluation

Tangmonkongvoragul¹,

Supalaset²,

Tananuvat³

et al. 2021

OPTH

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Purpose: To compare the visual and refractive results obtained after two-step TransPRK using an EX500 excimer laser for low to moderate myopic correction in adolescents and adults. Patients and Methods: Retrospectively, 91 eyes of 52 patients were categorized into four groups based on age and level of myopia. The demographics, data of efficacy, safety, predictability, stability, and post-operative complications were evaluated at 1, 3, 6, and 12 months post-operatively. Results: At 1-month, adolescents with low myopia achieved the highest mean efficacy index (P =0.034). The efficacy indices continuously increased during the 1-year follow-up in all groups, except in adolescents with moderate myopia. The highest safety and efficacy indices were recorded in adolescents with low myopia at 1-year. Post-operative spherical equivalent within ±0.50 D at 1 year was 48.75% of all treated eyes; however, the final mean refractive spherical equivalent (MRSE) was under-corrected in all groups. By month 3, the percentage of eyes that had grade 0.5 haze was most prevalent in adolescents with moderate myopia (P <0.001). Conclusion: two-step TransPRK using an EX500 proved to be an effective, predictable, stable and safe procedure for the correction of low to moderate myopia with or without astigmatism at 1 year. Adolescents with low myopia achieved the best-post-operative UDVA, efficacy and safety indices. Adolescents tolerated night visual problems and dry eye symptoms better than adults.

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Section: Discussionmentioning

confidence: 93%

mentioning

confidence: 99%

Two-Step Transepithelial Photorefractive Keratectomy with WaveLight EX500 Platform for Adolescents and Adults with Low to Moderate Myopia: A 12-Month Comparative Evaluation

Tangmonkongvoragul¹,

Supalaset²,

Tananuvat³

et al. 2021

OPTH

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“…1 Moreover, limited but available long term data of myopic LASIK in pediatric population (⩽16 years) can't be extrapolated as well to the late adolescent population considered here (⩾17 and <20 years), as the risk for intraoperative complications (such as decentrations and subsequently aberrated corneas due to lack of fixation) and myopia progression (higher as lower the age at the time of surgery) is different. [2][3][4][5] This points out the relevance of studying closely and reporting properly the long term outcomes of these late adolescent patients candidates for refractive surgery that, although they are not the usual reality of any refractive center, any refractive surgeon face these type of patients with relative frequency. Hecht et al 5 reported the short term outcomes (mean follow-up of 7.1 months) of 607 myopic adolescents (mean age of 16.9 years), demonstrating equivalent refractive and visual outcomes compared with young adults (20-40 years), observing even significant better values of postoperative UDVA in the adolescent population.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5] This points out the relevance of studying closely and reporting properly the long term outcomes of these late adolescent patients candidates for refractive surgery that, although they are not the usual reality of any refractive center, any refractive surgeon face these type of patients with relative frequency. Hecht et al 5 reported the short term outcomes (mean follow-up of 7.1 months) of 607 myopic adolescents (mean age of 16.9 years), demonstrating equivalent refractive and visual outcomes compared with young adults (20-40 years), observing even significant better values of postoperative UDVA in the adolescent population. However, this study mixed myopic PRK and LASIK cases (95% vs 5%, respectively), and did not report long term data, including patients with a minimum follow-up time of only 1 month for LASIK.…”

Section: Discussionmentioning

confidence: 99%

“…1 On the other hand, LASIK is also rarely performed at a pediatric age due to resistant unilateral anisometropic amblyopia, 2 or at late adolescence (17-20 years old) due to professional reasons (such as government security forces applicants) despite the absence of refractive stability. However, while evidence about short and long term LASIK outcomes in the adult population is widely available, 1 little evidence is available regarding the outcomes in the pediatric population (mainly at short term, with anecdotic data at long term), [2][3][4][5] and none has been reported specifically in the late adolescence population.…”

Section: Introductionmentioning

confidence: 99%

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Laser-assisted in situ keratomileusis long term outcomes in late adolescence

Barrio

Cantó-Cerdán

et al. 2020

European Journal of Ophthalmology

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Purpose: Evaluate the long term outcomes of myopic-LASIK in a late adolescent population (age ⩾17 and <20 at the time of surgery). Methods: Monocentric retrospective case series study. Eyes with at least 3 years of follow-up time were included. Primary outcome measures were long term efficacy, safety and stability of the refractive error. Secondary outcome measure was the evaluation of the relation between the postoperative spherical aberration and the long term stability of the refractive error. Results: Forty-seven eyes of 25 patients were included. Mean follow-up was 9.23 ± 3.16 years. Mean age at the time of surgery was 18.74 ± 0.44 years. With time, postoperative UDVA showed a mild but significant deterioration of 1–2 Snellen lines ( p = 0.012), in connection with a mild but significant myopization of the SE (mean increase of −0.43 D; p < 0.001), sphere (mean increase of −0.29 D; p = 0.004) and cylinder (mean increase of −0.16 D; p = 0.013). CDVA remained stable over time ( p > 0.05). Efficacy index decreased from 1.01 to 0.87 in the long term (77% UDVA ⩾ 20/32). Safety remained at 1.06. 66% and 74% of eyes presented a SE within ±0.50 D and ±1.00 D respectively. SE changed over 0.50D in 33% of eyes. No correlation could be detected between the SE and the postoperative spherical aberration. No cases of corneal ectasia were detected. Conclusions: Myopic-LASIK in late adolescence is safe and effective, but a mild myopic progression occurs. Despite presence of refractive stability is preferable, if necessary, myopic LASIK provides relatively good outcomes in the long term in this young population.

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