Wavefront-optimized surface retreatments of refractive error following previous laser refractive surgery: a retrospective study

Broderick, Kevin; Sia, Rose K.; Ryan, Denise S.; Stutzman, Ray E.; Mines, Michael J.; Frazier, Travis; Torres, Mark F.; Bower, Kraig S.

doi:10.1186/s40662-016-0034-x

Cited by 12 publications

(7 citation statements)

References 17 publications

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“…2,3 The disadvantages of repeat PRK are represented by discomfort, slow visual recovery, and less predictability. In 3 recent reports of repeat PRK, 78% to 89.5% of eyes were 60.5 D SE, 1,9,10 whereas in the present series of retreatment by femtosecond LASIK, 60.5 D SE was reached in 100% of eyes.…”

Section: Discussioncontrasting

confidence: 52%

Femtosecond LASIK Retreatments After Primary Myopic Photorefractive Keratectomy

Leccisotti

Fields²,

Bartolo³

2022

Cornea

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The purpose of the study was to evaluate the results and complications of laser-assisted in situ keratomileusis (LASIK) using a femtosecond laser as a retreatment modality of myopia and myopic astigmatism after previous myopic photorefractive keratectomy (PRK).Methods: In this retrospective, consecutive, noncomparative case series study, 69 eyes of 41 patients receiving femtosecond LASIK after previous myopic PRK were evaluated. The mean age was 43.0 6 8.9 years. The preoperative mean SE was 21.82 6 1.01 diopter (D), range 20.62 to 26.25. The mean central epithelial thickness was 65 6 5 mm. A flap was created using a low-energy femtosecond laser (Ziemer LDV Z8), with a programmed thickness calculated by adding 40 mm to the epithelial thickness. Refractive ablation was performed using a Technolas Teneo 317 laser (Bausch and Lomb).Results: Twelve months after LASIK, the mean SE was 20.03 6 0.17 D, with all eyes #0.50 D of SE. The mean DE was 0.30 6 0.25, with 62 eyes (89.9%) #0.50 D and all eyes #1 D. The mean corrected distance visual acuity (CDVA) was 0.04 6 0.10 logMAR; no eye lost more than 1 line of CDVA. The mean uncorrected distance visual acuity was 0.07 6 0.13 logMAR, being 20/25 or better in all eyes. The safety index (postoperative CDVA/preoperative CDVA) was 1.05. The efficacy index (postoperative uncorrected distance visual acuity/ preoperative CDVA) was 0.98. No significant complications occurred.Conclusions: Myopic retreatments by femtosecond LASIK after primary PRK yielded excellent refractive results without relevant complications. The flap thickness must be tailored to the epithelial thickening after PRK.

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Section: Discussioncontrasting

confidence: 52%

Femtosecond LASIK Retreatments After Primary Myopic Photorefractive Keratectomy

Leccisotti

Fields²,

Bartolo³

2022

Cornea

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“…Jin et al evaluated outcomes of LASIK retreatment after wavefront-guided and standard LASIK treatments, Montague et al reported enhancement results using CustomVue wavefront-guided LASIK in 120 eyes of 102 patients, Kashani et al assessed wavefrontguided LASIK retreatment after initial wavefront-guided LASIK, and Broderick et al looked at wavefront-optimized PRK after prior PRK, LASIK, and LASEK; the outcomes from these studies were comparable. [24][25][26][27][28] There are a limited number of studies comparing PRK versus LASIK as retreatment modalities. Schallhorn et al performed a comparative study to evaluate the efficacy of wavefront-guided PRK versus a LASIK flap lift on patients who have had prior LASIK.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

<p>A Prospective Comparison of Wavefront-Guided LASIK versus Wavefront-Guided PRK After Previous Keratorefractive Surgery</p>

Lee

Chen

Tran

et al. 2020

OPTH

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Purpose: To compare the results of retreatment with wavefront-guided LASIK versus wavefront-guided PRK for residual refractive error following previous myopic keratorefractive surgery. Methods: In this prospective study, 32 eyes of 28 patients after prior myopic keratorefractive surgery underwent retreatment with flap-lift wavefront-guided LASIK (n = 12) or wavefront-guided PRK (n = 20) for residual refractive error. Safety, efficacy, predictability, and wavefront outcomes were evaluated. Results: At last follow-up, both LASIK and PRK retreatment resulted in similar improvement in visual acuity with respective mean ± standard deviation (SD) uncorrected distance visual acuity of −0.07 ± 0.11 logMAR and −0.06 ± 0.13 logMAR (p = 0.87). In the study, 16.7% of LASIK and 33.3% of PRK eyes gained one or more lines of best-corrected distance visual acuity (CDVA), while 16.7% and 9.5% of eyes lost one or more lines of CDVA with LASIK and PRK, respectively. One hundred % of LASIK eyes and 89.5% of PRK eyes were within ± 0.50 diopters of emmetropia. Wavefront analysis demonstrated similar reductions in total RMS error higher-order aberrations (p = 0.84) with no difference in coma, trefoil, or spherical aberration between eyes undergoing LASIK or PRK retreatment. Conclusion: Wavefront-guided LASIK and wavefront-guided PRK following previous keratorefractive surgery demonstrate similar safety, efficacy, and predictability with comparable wavefront outcomes.

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“…Similar symptoms might be caused by accidental flap ablation. [3,9,10] In the current study, a Weck-Cel sponge was used to shield the flap from the laser during ablation and was associated with a better efficacy index and index of success when compared with the no-guarding group. The NOAR was calculated using pre-operative and post-operative corneal topographies and a considerably high percentage of patients (32.4%) had a 200% or greater nasal over-ablation in the no-protection group, compared to the flap protection group (4.4%), P = 0.02.…”

Section: Discussionmentioning

confidence: 88%

Flap protection during laser-assisted in situ keratomileusis improves refractive outcomes in high myopic astigmatism

Duvdevan¹,

Dominitz²,

Sela³

et al. 2019

cleverjournal

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Purpose: Subtle irregularities in the corneal flap may affect laser-assisted in situ keratomileusis (LASIK) outcomes. The aim of this study was to evaluate flap protection during ablation in myopic astigmatic patients. Methods: Medical files and corneal topographies of consecutive patients with myopic astigmatism (>2.5 D) that underwent LASIK were retrospectively reviewed. The visual and refractive outcomes with and without flap protection during the procedure were compared. We calculated and compared safety index, efficacy index, index of success (Alpins vector analysis) and ratio between nasal and temporal ablation. Results: We included 57 subjects that fulfilled inclusion criteria. Patients in the flap guarding group were similar to patients in the no-guarding group, in terms of pre-operative parameters and similar treatment zones were used in both groups. Post-operatively, the flap guarding group had a better efficacy index (1.08 ± 0.17 vs. 0.96 ± 0.24, P = 0.04) and index of success (0.16 ± 0.07 vs. 0.23 ± 0.17, P = 0.04). The proportion of subjects with more than double nasal over-ablation ratio (>200%) was significantly lower in the guarding group compared to the no-guarding group (04.2% [1/23] vs. 32.3% [11/34], P = 0.02). No significant differences were found between groups in terms of post-operative safety index, uncorrected visual acuity, best-corrected visual acuity, sphere, cylinder and keratometry. Conclusion: Guarding the flap during high myopic astigmatic LASIK was associated with better visual and refractive outcomes.

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Wavefront-optimized surface retreatments of refractive error following previous laser refractive surgery: a retrospective study

Cited by 12 publications

References 17 publications

Femtosecond LASIK Retreatments After Primary Myopic Photorefractive Keratectomy

Femtosecond LASIK Retreatments After Primary Myopic Photorefractive Keratectomy

<p>A Prospective Comparison of Wavefront-Guided LASIK versus Wavefront-Guided PRK After Previous Keratorefractive Surgery</p>

Flap protection during laser-assisted in situ keratomileusis improves refractive outcomes in high myopic astigmatism

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