Journal of refractive surgery最新文献

{"title":"Comparison of Low Laser Energy Dose in KLEx: Short-term Clinical Results, Video Analysis, and Histologic Study of Lenticules.","authors":"Sang Yoon Hyun, Tae-Hwan Moon, Thomas Magnago, Samuel Arba-Mosquera, Gyeongsoo Lim, Moon Sun Jung","doi":"10.3928/1081597X-20260212-03","DOIUrl":"https://doi.org/10.3928/1081597X-20260212-03","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effects of reducing pulse energy and total energy dose during keratorefractive lenticule extraction (KLEx) using the ATOS femtosecond laser (SCHWIND eye-tech-solutions GmbH) on early surgical outcomes and corneal surface roughness.</p><p><strong>Methods: </strong>This study included 80 patients (160 eyes) who underwent KLEx for myopia correction at a single clinic. Eyes were divided into three groups according to energy settings: a conventional energy group (90 nJ, spot/track distance 3 × 3 μm, 1,000 mJ/cm²; C-group, 58 eyes), a low energy group (80 nJ, 4.5 × 3 μm, 593 mJ/cm²; L-group, 52 eyes), and a very low energy group (75 nJ, 6.5 × 2.9 μm, 398 mJ/cm²; VL-group, 50 eyes). Uncorrected distance visual acuity and mean spherical equivalent were evaluated at 1 day, 1 week, 1 month, and 3 months postoperatively. Intraoperative opaque bubble layer (OBL) and black areas were assessed using surgical video analysis. Surface roughness of selected lenticules was evaluated by scanning electron microscopy (SEM).</p><p><strong>Results: </strong>Uncorrected visual acuity (logarithm of the minimum angle of resolution [logMAR]) improved with lower energy levels at 1 day (C: 0.16, L: 0.05, VL: 0.00; <i>P</i> < .001), 1 week, and 1 month (<i>P</i> < .05), with the VL-group demonstrating the fastest early visual recovery. Mean spherical equivalent showed no significant differences among groups at 1 week, 1 month, or 3 months postoperatively. Black area incidence was similar between groups. However, OBL area increased with higher energy levels. SEM analysis showed the highest lenticule surface regularity score in the L-group (13.58), followed by the VL-group (10.00) and C-group (6.50).</p><p><strong>Conclusions: </strong>When performing KLEx surgery with the ATOS device, lowering the pulse energy and applying asymmetric spacing settings led to faster early visual recovery and reduced intraoperative OBL occurrence. The smoothest lenticule surface was observed in the L-group, whereas the VL-group showed a tendency toward increased surface roughness. These findings suggest the importance of balancing early visual recovery and surface smoothness when selecting low energy settings. Further evaluation of long-term surgical outcomes and corneal effects is warranted.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e335-e342"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Classification of a New IOL Into the Category of Partial Depth of Field: Enhanced IOLs According to the ESCRS Criteria.","authors":"Giacomo Savini, Alice Galzignato, Catarina P Coutinho, Arianna Grendele, Piero Barboni, Domenico Schiano-Lomoriello","doi":"10.3928/1081597X-20260214-03","DOIUrl":"https://doi.org/10.3928/1081597X-20260214-03","url":null,"abstract":"<p><strong>Purpose: </strong>To assess whether the Evolux (SIFI) intraocular lens (IOL) can be included in the category of partial-depth of field (DOFi) enhanced IOLs according to the functional classification of the European Society of Cataract and Refractive Surgeons.</p><p><strong>Methods: </strong>In this prospective study, a consecutive series of patients implanted with the Evolux in one eye was analyzed and compared to a control group with a monofocal IOL (AcrySof SA60WF; Alcon Laboratories, Inc). Preoperative examinations included optical biometry (IOLMaster 700; Carl Zeiss Meditec AG) and anterior segment imaging (MS-39; CSO). At 2 to 3 months postoperatively, monocular corrected distance visual acuity, distance-corrected intermediate visual acuity (DCIVA), distance-corrected near visual acuity (DCNVA), monocular DOFi in 0.2 logarithm of the minimum angle of resolution (logMAR), and the monocular defocus curve were measured in patients implanted with both IOLs.</p><p><strong>Results: </strong>The Evolux group included 32 eyes (32 patients) and the monofocal group included 27 eyes (27 patients). The mean DCIVA was, respectively, 0.19 ± 0.11 and 0.30 ± 0.13 logMAR (<i>P</i> = .0009). The mean DCNVA was 0.39 ± 0.12 logMAR in the Evolux group and 0.53 ± 0.18 logMAR in the monofocal group (<i>P</i> = .0007). The mean DOFi in 0.2 logMAR provided by the Evolux was 1.42 ± 0.56 diopters (D); the corresponding value for the monofocal IOL was 1.04 ± 0.54 D (<i>P</i> = .0091). In eyes with the Evolux, the DOFi in 0.2 logMAR DCIVA was negatively correlated with photopic pupil size (<i>r</i> = -0.3748, <i>P</i> = .0346).</p><p><strong>Conclusions: </strong>The Evolux offers better visual acuity at an intermediate distance and can be classified as a partial-DOFi enhanced IOL.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e359-e366"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Intraocular Lens Power Calculation Formulas Using Total Keratometry in Eyes With Previous Radial Keratotomy.","authors":"Yuxing Zheng, Haowen Lin, Xiaohang Xie, Xiaozhang Qiu, Xuhua Tan, Jiaqing Zhang, Lixia Luo","doi":"10.3928/1081597X-20260112-07","DOIUrl":"https://doi.org/10.3928/1081597X-20260112-07","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the performance of intraocular lens (IOL) power calculation using standard keratometry (SK) and total keratometry (TK) in eyes after radial keratotomy (RK) surgery.</p><p><strong>Methods: </strong>A retrospective, consecutive case series study included 49 patients with cataract (65 eyes) after RK. All implanted IOLs were monofocal in-the-bag lenses. Formulas using SK included American Society of Cataract and Refractive Surgery (ASCRS) average, Barrett True K, double-K modified Holladay 1 formula (DK-Holladay), Emmetropia Verifying Optical formula 2.0 (EVO 2.0), Holladay 1, Holladay 2, PEARL-DGS, and LISA formula for patients with cataract and prior myopic refractive surgery (LISA-MRS). Formulas using TK included Barrett True K-TK, EVO 2.0-TK, Holladay 2-TK, and LISA-MRS-TK. Holladay formulas used both Wang-Koch (Holladay-WK) and Holladay axial length (Holladay-AL) adjustment. The mean prediction error (PE), mean absolute PE (MAE), median absolute error (MedAE), root mean square absolute error (RMSAE), and the percentage of eyes within ±0.25, ±0.50, ±0.75, and ±1.00 diopters (D) of PE were evaluated.</p><p><strong>Results: </strong>In formulas using SK, the LISA-MRS formula exhibited the lowest MAE (0.71 D), lowest MedAE (0.52 D), and highest percentage of eyes within ±0.50 D of PE (49.23%). In formulas using TK, the LISA-MRS-TK formula exhibited the lowest MAE (0.78 D), lowest MedAE (0.48 D), and highest percentage of eyes within ±0.50 D of PE (52.63%). Using TK instead of SK significantly reduced the PE of both the Holladay 2 and LISA-MRS formulas. When AL was 30 mm or greater, the Holladay 1-AL formula exhibited the lowest MAE (0.68 D), lowest MedAE (0.32 D), and the highest percentage of eyes within ±0.50 D of PE (59.09%).</p><p><strong>Conclusions: </strong>In post-RK eyes, the LISA-MRS formula displayed the highest prediction accuracy. TK could improve the prediction accuracy of the Holladay 2 and LISA-MRS formulas.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e318-e326"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flanged Polypropylene Scleral Fixation: A Comprehensive Analysis of Outcomes and Considerations.","authors":"Michael Ostrovsky, Mor Levi, Shalhevet Goldfeather Ben Zaken, Eilon Shcolnik, Nir Shoham-Hazon, Tamir Weinberg, Yuval Kozlov, Mor Schlesinger, Mor Bareket, Amit Meir, Arie Leonid Marcovich, Efraim Berco","doi":"10.3928/1081597X-20260214-01","DOIUrl":"https://doi.org/10.3928/1081597X-20260214-01","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate visual, refractive, and safety outcomes of secondary flanged polypropylene scleral intraocular lens (IOL) fixation in a large cohort. Additionally, this study aimed to compare preexisting IOL repositioning versus exchange, and horizontal versus vertical flange orientation.</p><p><strong>Methods: </strong>This was a retrospective, single-center cohort of consecutive eyes that underwent flanged polypropylene scleral IOL fixation between January 2021 and August 2024, with a minimum follow-up of 6 months. Preoperative and postoperative visual acuity, refraction, and complications were analyzed. Subgroup analyses compared IOL repositioning versus exchange and horizontal versus vertical flange fixation.</p><p><strong>Results: </strong>Among 138 eyes, mean visual acuity improved from 1.11 ± 0.63 to 0.40 ± 0.43 logarithm of the minimum angle of resolution (logMAR) (approximately 20/260 to 20/50 Snellen) at 12 months (<i>P</i> < .001). Final residual refraction averaged a myopic sphere of -1.56 ± 2.71 diopters (D) with a cylinder of 1.92 ± 1.71 D, yielding a mean postoperative spherical equivalent of -0.60 ± 2.35 D. Complications occurred in 10.1% of cases, and were predominantly flange-related (5.8%) and manageable. Residual spherical equivalent was significantly closer to emmetropia following IOL exchange compared with repositioning (-0.15 ± 1.50 vs -0.80 ± 2.26 D; <i>P</i> = .047), whereas visual acuity and complication rates were otherwise similar. Fixation orientation (horizontal vs vertical) had no significant effect on visual acuity, refraction, or complications (<i>P</i> > .050, for all).</p><p><strong>Conclusions: </strong>Flanged polypropylene scleral IOL fixation provides substantial visual improvement with low complication rates. Compared with repositioning, preexisting IOL exchange was associated with residual refraction closer to emmetropia, without increased risk. Flange orientation did not significantly impact clinical outcomes. Surgical decisions should therefore be guided by surgeon expertise and the clinical context.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e343-e353"},"PeriodicalIF":3.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Analysis of the Influence of Flap Margin Space on Corneal Nerve Regeneration After Femtosecond Laser-Assisted LASIK.","authors":"Chen Zhang, Zijie Fang, Emmanuel Eric Pazo, Fei Li, Shaozhen Zhao","doi":"10.3928/1081597X-20251217-01","DOIUrl":"https://doi.org/10.3928/1081597X-20251217-01","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effect of corneal flap margin space width after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) on corneal nerve regeneration using in vivo confocal microscopy (IVCM).</p><p><strong>Methods: </strong>This study assessed 46 consecutive patients who underwent FS-LASIK surgery. Routine examinations after myopic laser surgery were performed. IVCM was performed before and after surgery to observe the flap margin space and regeneration of the corneal subbasal nerve. The average of corneal flap margin space was calculated. Patients were divided into two groups: the wide-space group (> 20 µm) and the narrow-space group (⩽ 20 µm). Central and peripheral (average of 3-, 6-, and 9-o'clock positions) corneal sensitivity was tested by the Cochet-Bonnet esthesiometer and corneal subbasal nerve regeneration was quantitatively analyzed.</p><p><strong>Results: </strong>Postoperatively at days 1 to 90, the incision edge of the narrow-space group showed a high-density linear structure without obvious epithelial cells filling in the space, and the corneal nerve gradually grew from the outside of the flap through the incision edge to the inside of the flap. In the wide-space group, obvious epithelial cells filling in the space were observed from 1 day postoperatively, and the corneal nerve grew less from the outside of the flap through the incision edge to the inside of the flap. There was no significant intergroup difference in the central corneal nerve fiber length. However, the peripheral corneal nerve fiber length in the narrow-space group was significantly higher at both 30 and 90 days postoperatively. No statistically significant differences were observed between groups in central and peripheral corneal sensitivity. There was no significant difference in spherical equivalent between groups at each time point.</p><p><strong>Conclusions: </strong>Although the postoperative flap margin space significantly affects corneal nerve regeneration, it does not influence corneal sensitivity or the refractive outcome after FS-LASIK.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 3","pages":"e208-e217"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Total Laser Fluence on Early and Mid-term Visual and Optical Quality Outcomes After Lenticule Extraction With the SCHWIND ATOS: A Single-Center Study.","authors":"Ivan Gabrić, Samuel Arba-Mosquera, Karla Bodakoš, Maja Bohač","doi":"10.3928/1081597X-20260112-01","DOIUrl":"https://doi.org/10.3928/1081597X-20260112-01","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of total laser fluence on early and mid-term visual outcomes after keratorefractive lenticule extraction performed with a femtosecond laser. The setting was a single-surgeon, single-center refractive surgery clinic. The design was a retrospective comparative cohort analysis of prospectively collected data.</p><p><strong>Methods: </strong>This retrospective comparative case series included 112 eyes of 112 patients. Eyes were stratified into four quartiles (Q1 to Q4, n = 28 each) based on total fluence (range: 290 to 767 mJ/cm²). Outcomes included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest spherical equivalent, and higher order aberrations (HOAs) measured by corneal and ocular wavefront at 4 and 6 mm. Assessments were performed at postoperative day 1 (POD1) and month 6 (POM6). Statistical analyses used Kruskal-Wallis and Mann-Whitney <i>U</i> tests with Holm step-down correction.</p><p><strong>Results: </strong>At POD1, lower fluence groups showed faster UDVA recovery (Q1: -0.11 ± 0.07 vs Q4: -0.01 ± 0.10 logMAR), but these differences were not significant after Holm correction. By POM6, UDVA was excellent across all quartiles. CDVA line gains were significantly more frequent in Q1 and Q2 (79% and 54% gained ⩾ one line) compared with Q3 and Q4 (7% each, Holm-adjusted <i>P</i> < .005). Predictability remained high, with 82% to 93% of eyes within ±0.50 diopters at 6 months. HOA induction was slightly greater with higher fluence at POD1 but converged by POM6, except spherical aberration at 6 mm, which differed significantly (<i>P</i> = .006).</p><p><strong>Conclusions: </strong>Lower total fluence was associated with non-significant trends toward faster recovery and greater mid-term CDVA gains, whereas refractive accuracy and safety were not compromised. Fluence optimization may enhance early visual quality without sacrificing predictability.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 3","pages":"e218-e226"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct Neodymium:YAG Laser Over the Occluded Phakic Implantable Collamer Lens Port to Manage Pupillary Block.","authors":"Xiang Ren, Jiaying Zhang, Nanji Lu, Yunxia Gao, Xiangyu Fu, Yijia Chen, Ling Huang, Yongzhi Huang, Ming Zhang, Lin Wang, Hongbo Yin","doi":"10.3928/1081597X-20260112-16","DOIUrl":"https://doi.org/10.3928/1081597X-20260112-16","url":null,"abstract":"<p><strong>Purpose: </strong>To present the first case of a pupillary block that was successfully managed with neodymium:YAG (Nd:YAG) laser to eliminate the obstruction of the central port in patients with Implantable Collamer Lens (ICL) implantation.</p><p><strong>Methods: </strong>Case report and literature review.</p><p><strong>Results: </strong>A V4c ICL (STAAR Surgical) was implanted in a 25-year-old woman, and the intraocular pressure was 47 mm Hg 2 months later. Anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) indicated that this patient underwent pupillary block, and a membranous structure was found in the ICL hole. Nd:YAG laser was uneventfully applied to the membranous structure to eliminate the pupillary block.</p><p><strong>Conclusions: </strong>This is the first case of direct Nd:YAG over the occluded phakic IOL port to manage pupillary occlusion, which broadens the experience of ophthalmologists. Nd:YAG laser treatment is one of the effective options for pupillary block in patients with ICL implantation.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 3","pages":"e280-e284"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Visual Acuity Improvement in Patients With Amblyopia Following Laser Vision Correction Surgery.","authors":"Asaf Friehmann, Malachy Nemet, Nir Sorkin, Eyal Cohen, Tzahi Sela, Gur Munzer, Marcony R Santhiago, Igor Kaiserman, Michael Mimouni","doi":"10.3928/1081597X-20260112-14","DOIUrl":"https://doi.org/10.3928/1081597X-20260112-14","url":null,"abstract":"<p><strong>Purpose: </strong>To identify factors predicting a two-line (0.2 logarithm of the minimum angle of resolution [logMAR]) improvement in corrected distance visual acuity (CDVA) following laser vision correction surgery in patients with amblyopia.</p><p><strong>Methods: </strong>Consecutive patients with amblyopia undergoing primary laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) between 2013 and 2024 were included. Inclusion criteria were age older than 18 years, stable refraction for 12 months or more, myopia of -12.00 diopters (D) or less, hyperopia of +6.00 D or less, and cylinder of 6.00 D or less. Amblyopia was classified as mild (CDVA better than 20/40) or moderate (CDVA worse than or equal to 20/40 and better than 20/80). Patients were grouped by CDVA improvement (⩾ 2 lines vs < 2 lines). Binary logistic regression identified predictors of CDVA improvement, including variables with <i>P</i> < .15 in univariate analysis.</p><p><strong>Results: </strong>Of 1,894 amblyopic eyes reviewed, 1,007 eyes met inclusion criteria. Two-line CDVA improvement was observed in 22.8% (n = 230). Predictors of improvement included younger age (odds ratio [OR]: 0.96 per year, <i>P</i> < .001), male gender (OR: 1.38, <i>P</i> = .04), and worse preoperative CDVA (OR: 1.67 per 0.1 logMAR unit, <i>P</i> < .001). Higher preoperative cylinder values were inversely associated with improvement (OR: 0.88 per diopter, <i>P</i> = .03). Patients in the improvement group were younger (27.3 ± 8.4 vs 30.9 ± 10.5 years, <i>P</i> < .001) and more likely to have moderate amblyopia (28.7% vs 21.5%, <i>P</i> = .03).</p><p><strong>Conclusion: </strong>Younger age, male gender, worse preoperative CDVA, and lower cylinder values are significant predictors of a two-line improvement in CDVA in patients with amblyopia undergoing LASIK or PRK. These findings can guide preoperative counseling and help set realistic expectations for this subset of patients.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 3","pages":"e273-e279"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Keratorefractive Lenticule Extraction: Addressing Centration, Epithelial Remodeling, and Nomogram Refinement.","authors":"Yujie Zhang, Lidetian Hu, Xiang Ma","doi":"10.3928/1081597X-20260112-13","DOIUrl":"https://doi.org/10.3928/1081597X-20260112-13","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 3","pages":"e285"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Optical Zone Decentration After Corneal Refractive Laser Treatment Using ImageJ Software.","authors":"David Donate, Rozenn Thaëron","doi":"10.3928/1081597X-20260112-02","DOIUrl":"https://doi.org/10.3928/1081597X-20260112-02","url":null,"abstract":"<p><strong>Purpose: </strong>To assess a new method for measuring optical zone decentration after corneal laser surgery using postoperative topography with ImageJ software (National Institutes of Health).</p><p><strong>Methods: </strong>Postoperative topographies from 40 eyes that underwent keratorefractive lenticule extraction (KLEx) surgery were analyzed twice in a randomized manner by three different operators to assess the repeatability and reproducibility of the new centration method for the treatment zone. For each topography, the ablation zone was identified, and the distance between the vertex (the visual axis defined on the topography) and the center of the optical zone was measured using ImageJ software.</p><p><strong>Results: </strong>The analysis demonstrated good repeatability. The inter-operator reliability of decentration measurements ranged from moderate to good (0.689 to 0.901), with no significant bias (< 0.02 mm) and concordance limits remaining within acceptable ranges for this measurement method (-0.15 to 0.21 mm). The results indicate good reproducibility of the method, with no significant inter-operator bias, high intraclass correlation coefficient values (0.811), and agreement limits within acceptable ranges (-0.12 to -0.27), supporting its overall reliability and a good agreement. The mean total decentration was 0.18 ± 0.08 mm (0.05 to 0.41).</p><p><strong>Conclusions: </strong>This study demonstrates the repeatability and reproducibility of a new centration assessment method in corneal refractive surgery, paving the way for the development of artificial intelligence-driven automated solutions.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 3","pages":"e227-e234"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}