Journal of refractive surgery最新文献

{"title":"Evaluation of Visual Outcomes in Patients With Aberrated Corneas Implanted With the IC-8 Small-Aperture IOL.","authors":"Zhen Ling Teo, Nicole Ming Sie, Jodhbir S Mehta","doi":"10.3928/1081597X-20240826-02","DOIUrl":"10.3928/1081597X-20240826-02","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the visual outcomes in patients with cataract implanted with a small-aperture intraocular lens (IOL) in eyes with aberrated corneas.</p><p><strong>Methods: </strong>This prospective, non-interventional, single-center clinical study was conducted at Singapore National Eye Centre, Singapore. Twenty-one patients with aberrated corneas had IC-8 IOL (Bausch & Lomb, Inc) implantation. An aberrated cornea was defined as from natural causes: keratoconus (n = 1, 4.8%), high coma (n = 2, 9.5%), corneal scar (n = 1, 4.8%), or iatrogenic causes: keratorefractive procedure (n = 17, 86%). Uncorrected and corrected visual acuities were measured at distance (600 cm) (UDVA and CDVA), intermediate (66.7 cm) (UIVA and CIVA), and near (40 cm) (UNVA and CIVA). Defocus curve was tested monocularly and binocularly. Contrast sensitivity (CS) was measured under photopic and mesopic conditions with and without glare.</p><p><strong>Results: </strong>In IC-8 eyes, the mean ± standard deviation UDVA, UIVA, and UNVA was 0.24 ± 0.18, 0.19 ± 0.18, and 0.14 ± 0.14 logMAR, respectively. Mean CDVA, CIVA, and CNVA in IC-8 eyes was 0.12 ± 0.17, 0.16 ± 0.15, and 0.19 ± 0.13 logMAR, respectively. Binocular mean UDVA, UIVA, and UNVA was 0.07 ± 0.10, 0.07 ± 0.10, and 0.13 ± 0.12 logMAR, respectively. Defocus curve testing yielded a depth of focus of 1.50 D monocularly and 2.00 D binocularly at a 0.2 logMAR threshold. Photopic binocular CS with and without glare improved over monocular CS of IC-8 and fellow eyes under all spatial frequencies. Mesopic binocular CS with and without glare were similar among monocular IC-8 and fellow eyes across spatial frequencies. Most patients reported low levels of visual symptoms.</p><p><strong>Conclusions: </strong>The IC-8 IOL provides good monocular and binocular visual outcomes for patients with cataract who had aberrated corneas. <b>[<i>J Refract Surg</i>. 2024;40(10):e716-e723.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 10","pages":"e716-e723"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468350","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":"Clinical Performance of an Extended Range of Vision Intraocular Lens After LASIK.","authors":"Humberto Carreras, Josefina Reñones, María Del Rosario Carreras, Carlos Cantó, David P Piñero","doi":"10.3928/1081597X-20240903-01","DOIUrl":"10.3928/1081597X-20240903-01","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical and patient-reported outcomes (PROMs) of cataract surgery with implantation of a wavefront-shaping extended depth of focus (EDOF) intraocular lens (IOL) in eyes with previous laser in situ keratomileusis (LASIK) for myopia correction.</p><p><strong>Methods: </strong>This prospective observational study enrolled 50 eyes with previous LASIK from 25 patients (age: 46 to 70 years) who underwent cataract surgery with implantation of the AcrySof IQ Vivity IOL (Alcon Laboratories, Inc). Visual and refractive outcomes were evaluated during a 3-month follow-up. PROMs were evaluated with the Intraocular Lens Satisfaction (IOLSAT; Alcon Vision, LLC) (general satisfaction), Catquest-9SF (difficulty in doing vision-related activities), and Questionnaire for Visual Disturbances (QUVID; Alcon Vision, LLC) (photic phenomena) questionnaires.</p><p><strong>Results: </strong>Mean 3-month postoperative binocular uncorrected distance, intermediate, and near visual acuities were 0.02 ± 0.11, -0.02 ± 0.09, and 0.14 ± 0.13 logarithm of the minimum angle of resolution (logMAR), respectively. Mean binocular distance-corrected intermediate and near visual acuities were 0.05 ± 0.11 and 0.32 ± 0.14 logMAR, respectively. All eyes had a postoperative spherical equivalent within ±0.75 diopters (D). The mean defocus curve showed visual acuity values better than 0.20 logMAR for defocus levels from +0.50 to -1.50 D. Most patients (92.0%) confirmed that they had no vision-related difficulties limiting their normal daily life. Perception of starbursts, halos, glare, hazy vision, blurry vision, and double vision was referred by 24%, 24%, 28%, 28%, 8%, and 4% of patients, respectively. Most of symptoms were described as mild and not or a little bothersome.</p><p><strong>Conclusions: </strong>The wavefront-shaping EDOF IOL evaluated provides efficacious distance, intermediate, and near visual restoration in eyes with previous LASIK, with minimal photic phenomena associated. <b>[<i>J Refract Surg</i>. 2024;40(10):e742-e753.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 10","pages":"e742-e753"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468322","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":"Comparison of the Accuracy Between the Z CALC2 Calculator and Barrett Toric Calculator in Toric IOL Calculation.","authors":"Lan Wang, Jiaqi Meng, Yanwen Fang, Wenwen He, Chen Zhao, Yi Lu, Xiangjia Zhu","doi":"10.3928/1081597X-20240731-01","DOIUrl":"https://doi.org/10.3928/1081597X-20240731-01","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the accuracy of the Z CALC2 calculator and Barrett toric calculator in toric intraocular lens (IOL) calculation.</p><p><strong>Methods: </strong>Eighty-five eyes of 85 patients who underwent uneventful cataract surgery with toric IOL implantation were included. The accuracy was compared between the Z CALC2 calculator and Barrett toric calculator under two calculation modes: using simulated keratometry (SimK) from the IOLMaster 700 (Carl Zeiss Meditec AG) for posterior corneal astigmatism (PCA) prediction and employing total corneal astigmatism (total corneal refractive power [TCRP] or measured PCA) obtained from the Pentacam (Oculus Optikgeräte GmbH). The centroid of prediction errors, percentage of eyes with prediction errors within ±0.50 diopter (D), mean prediction error, and mean absolute prediction error were calculated. Subgroup analysis was conducted based on the orientation and magnitude of anterior corneal astigmatism and axial length.</p><p><strong>Results: </strong>When using SimK, the two calculators with predicted PCA showed comparable accuracy. When employing total corneal astigmatism, the Barrett toric calculator with measured PCA showed a lower centroid error (0.15 vs 0.38 D), a higher percentage of eyes with prediction errors within ±0.50 D (47.1% vs 32.9%, <i>P</i> = .018), and a lower mean prediction error (0.57 vs 0.71 D, <i>P</i> = .033) compared to the Z CALC2 calculator with TCRP in the 4-mm zone. In subgroup analysis, when employing total corneal astigmatism, the Barrett toric calculator with measured PCA exhibited superior accuracy, especially in the with-the-rule and anterior corneal astigmatism of 2.00 D or less subgroups.</p><p><strong>Conclusions: </strong>When using SimK, the Z CALC2 calculator and Barrett toric calculator yield comparable accuracy. The Barrett toric calculator with measured PCA may be more recommended when employing total corneal astigmatism. <b>[<i>J Refract Surg</i>. 2024;40(10):e681-e691.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 10","pages":"e681-e691"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468324","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":"Photorefractive Keratectomy: Technical Evolution, Refractive Outcomes, Corneal Wound Healing Response, and Complications.","authors":"André A M Torricelli, Veronica B Giglio, Renato Garcia, Marcony R Santhiago, Samir J Bechara, Steven E Wilson, Mario Luiz R Monteiro","doi":"10.3928/1081597X-20240826-05","DOIUrl":"https://doi.org/10.3928/1081597X-20240826-05","url":null,"abstract":"<p><p>Photorefractive keratectomy (PRK) was the first excimer laser procedure developed to treat refractive errors. The safety and efficacy of PRK established it as one of the most performed corneal refractive procedures worldwide. With the introduction of laser in situ keratomileusis (LASIK), and more recently keratorefractive lenticule extraction (KLEx) procedures, many corneal surgeons favor these newer corneal procedures as the first choice due to faster visual rehabilitation and less discomfort during the early postoperative period. Importantly, however, PRK remains a viable alternative for most corneal refractive candidates and there are many situations in which PRK remains the refractive procedure of choice. This review addresses the technical evolution of PRK-mechanical epithelial debridement versus alcohol-assisted epithelial removal versus excimer laser-assisted epithelial debridement (transepithelial) PRK-and reports the PRK refractive outcomes compared to other keratorefractive laser procedures. The corneal wound response associated with each PRK technique and the indications, limitations, and complications of PRK are reviewed to aid refractive surgeons to best position PRK in their overall practice. <b>[<i>J Refract Surg</i>. 2024;40(10):e754-e767.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 10","pages":"e754-e767"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468351","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":"Comparison Between Monofocal and Aspheric Monofocal Intraocular Lens With Higher Order Aspheric Optic in Pediatric Patients: Early Outcomes.","authors":"Luca Buzzonetti, Sergio Petroni, Matteo Federici, Paola Valente, Carlo De Sanctis, Giancarlo Iarossi","doi":"10.3928/1081597X-20240826-03","DOIUrl":"https://doi.org/10.3928/1081597X-20240826-03","url":null,"abstract":"<p><strong>Purpose: </strong>To retrospectively compare the visual acuity outcomes for far, intermediate, and near vision of an aspheric monofocal intraocular lens (IOL) with higher order aspheric optic with a monofocal IOL in pediatric patients.</p><p><strong>Methods: </strong>Thirty-eight eyes of 38 patients (mean age: 9.0 ± 2.3 years) affected by monolateral infantile cataract were evaluated 6 months after surgery performed with simultaneous IOL implantation. The Tecnis Eyhance ICB00 aspheric monofocal IOL (Johnson & Johnson Vision) was implanted in 17 eyes (Tecnis Eyhance group, mean age: 8.9 ± 2.5 years) and the Tecnis PCB00 monofocal IOL (Johnson & Johnson Vision) was implanted in 21 eyes (control group, mean age: 9.1 ± 2.2 years). Corrected visual acuity expressed in logarithm of the minimum angle of resolution (logMAR) was assessed for distance (CDVA) and, expressed in Jaeger standard, for intermediate (DCIVA) and near vision (CNVA). DCIVA was measured with distance correction and without addition. The Mann-Whitney test for two independent samples was performed, and a <i>P</i> value less than .05 was considered statistically significant.</p><p><strong>Results: </strong>Six months postoperatively, mean CDVA was 0.20 ± 0.2 logMAR and mean DCIVA and CNVA were 5 ± 1 and 2 ± 1 Jaeger, respectively, in the Tecnis Eyhance group. In the control group, mean CDVA was 0.21 ± 0.2 logMAR and mean DCIVA and CNVA were 8 ± 1 and 3 ± 1 Jaeger, respectively. Only DCIVA showed a significant statistical difference between groups (<i>P</i> < .0001).</p><p><strong>Conclusions: </strong>In pediatric patients, the aspheric monofocal IOL with higher order aspheric optic seems to provide better intermediate distance visual acuity than a monofocal one, whereas no significant difference was observed for CDVA and CNVA. <b>[<i>J Refract Surg</i>. 2024;40(10):e724-e727.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 10","pages":"e724-e727"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468323","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":"Corneal Epithelial Remodeling Following Cylinder Correction With SMILE or FS-LASIK: A Contralateral Comparative Study.","authors":"Pei Chen, Xiangtao Hou, Na Yu, Yiming Ye, Han Wei, Jing Zhuang, Keming Yu","doi":"10.3928/1081597X-20240826-04","DOIUrl":"https://doi.org/10.3928/1081597X-20240826-04","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the corneal epithelial remodeling in eyes with high astigmatism that had small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK).</p><p><strong>Methods: </strong>Seventy-four patients with myopic astigmatism of greater than -2.00 diopters (D) and little binocular difference in spherical equivalent were included in this contralateral comparative study. All patients received SMILE in one eye and FS-LASIK in the other eye randomly. The corneal epithelial remodeling pattern was mapped using the latest RTVue spectral-domain optical coherence tomographer (Optovue) by region.</p><p><strong>Results: </strong>Satisfactory refractive correction was achieved in all enrolled eyes with either SMILE or FS-LASIK. The corneal epithelium gradually thickened following surgical cylinder correction, distributing mainly along the flat medium. The corneal epithelium proliferation is milder centrally but more pronounced in the mid-peripheral area after SMILE, compared with FS-LASIK. The flat-steep difference in corneal epithelial thickness (CET) is evident in the mid-peripheral and peripheral areas, which is more obvious in SMILE. Residual cylinder was positively correlated with CET in eyes that had FS-LASIK, but not SMILE. More importantly, these epithelial changes were positively correlated with the ablation depth and higher order aberrations following surgical refractive correction.</p><p><strong>Conclusions: </strong>The postoperative CET map varied between SMILE and FS-LASIK. In eyes with high astigmatism, SMILE surgery is followed by milder and more stable corneal epithelial thickening. Moreover, the corneal epithelium is sensitive to stromal ablation and corneal remodeling is crucial to the postoperative visual quality. This study rigorously distinguished the CET difference between SMILE and FS-LASIK in astigmatic eyes and shed light on subsequent research. <b>[<i>J Refract Surg</i>. 2024;40(10);e728-e741.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 10","pages":"e728-e741"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468325","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":"Prospective Evaluation of Clinical and Patient-Reported Outcomes Following Contralateral Implantation of an Extended Depth of Focus (EDOF) and Hybrid EDOF-Multifocal IOL.","authors":"George O Waring, Arthur B van den Berg, Roberta M van den Berg, Karolinne M Rocha","doi":"10.3928/1081597X-20240805-02","DOIUrl":"https://doi.org/10.3928/1081597X-20240805-02","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate clinical outcomes following contralateral implantation of a diffractive extended depth of focus (EDOF) and a hybrid EDOF-multifocal intraocular lens (IOL) with a violet filter in a U.S.-based population.</p><p><strong>Methods: </strong>In this prospective, non-comparative study, 60 eyes of 30 patients aged 40 years and older underwent bilateral cataract surgery and implantation of a DXR00V IOL (Tecnis Symfony OptiBlue) in the dominant eye and a DFR00V (Tecnis Synergy) IOL in the non-dominant eye. Outcome measures included uncorrected (UDVA) and corrected (CDVA) distance visual acuity, distance-corrected intermediate (DCIVA, 66 cm), near and very near visual acuity (DCNVA, 40 and 33 cm), and patient-reported outcomes.</p><p><strong>Results: </strong>At 6 months postoperatively, binocular mean UDVA and CDVA were -0.10 ± 0.07 and -0.11 ± 0.05 logarithm of the minimum angle of resolution (logMAR), respectively. The mean DCIVA was 0.26 ± 0.08 logMAR in the DXR00V eyes and 0.23 ± 0.06 logMAR in the DFR00V eyes. The mean DCNVA at 40 and 33 cm were 0.28 ± 0.12 and 0.30 ± 0.15 logMAR, respectively, in the DXR00V eyes and 0.07 ± 0.08 and 0.07 ± 0.10 logMAR, respectively, in the DFR00V eyes. The mean binocular DCIVA and DCNVA at 33 and 40 cm were 0.18 ± 0.05, 0.06 ± 0.08, and 0.06 ± 0.07 logMAR, respectively. The percentages of patients achieving spectacle independence at far, intermediate, and near distances were 100%, 100%, and 81%, respectively.</p><p><strong>Conclusions: </strong>Contralateral implantation of the diffractive EDOF and a hybrid EDOF-multifocal IOL yielded excellent binocular visual acuity at all distances, as well as high patient satisfaction and functional performance on visual tasks. <b>[<i>J Refract Surg</i>. 2024;40(10):e699-e705.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 10","pages":"e699-e705"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468352","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":"AI Will Never Reach Human Beauty.","authors":"Clara Forner Martinez","doi":"10.3928/24761222-20240820-01","DOIUrl":"https://doi.org/10.3928/24761222-20240820-01","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 10","pages":"680"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468321","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":"Evaluation of Corneal Biomechanics Using Brillouin Microscopy in Chinese Adults With Myopia.","authors":"Jian Cao, Yanze Yu, Yong Ma, Yongle Bao, Lingling Niu, Xiaoying Wang, Xingtao Zhou, Jing Zhao","doi":"10.3928/1081597X-20240826-06","DOIUrl":"10.3928/1081597X-20240826-06","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the corneal biomechanical metrics of Chinese adults with myopia and identify relevant factors of Brillouin microscopy.</p><p><strong>Methods: </strong>In this cross-sectional study, corneal biomechanics in Chinese adults with myopia were quantified and analyzed using Brillouin microscopy and the Corvis ST (CST) (Oculus Optikgeräte GmbH) and analyzed. Univariate linear regression was used with potential factors including age, sex, spherical equivalent (SE), intraocular pressure (IOP), central corneal thickness (CCT), and mean keratometry (Kmean).</p><p><strong>Results: </strong>The study included 87 eyes of 87 participants (mean age: 24.47 ± 6.27 years). Central, Mean, maximum (Max), minimum (Min), standard deviation, and Max-Min Brillouin modulus (BM) values obtained from Brillouin microscopy exhibited values of 2.826 ± 0.039, 2.827 ± 0.027, 2.864 ± 0.034, 2.790 ± 0.038, 0.108 ± 0.042, and 0.074 ± 0.041 GPa, respectively. No significant correlations were found between BM parameters and age, sex, SE, IOP, or CCT. However, the Mean (β = -0.251, <i>P</i> = .019), Min (β = -0.315, <i>P</i> = .003), and Max-Min (β = 0.229, <i>P</i> = .033) BM values were significantly associated with Kmean. The Central, Mean, Min, and Max BM values negatively correlated with the Tomographic Biomechanical Index measured by CST (Spearman's <i>r</i> = -0.24, -0.35, -0.29, and -0.23, respectively, all <i>P</i> < .05).</p><p><strong>Conclusions: </strong>Brillouin microscopy accurately reflects corneal biomechanical parameters in Chinese adults with myopia, independent of IOP and CCT, with a good correlation with CST. Concurrent evaluation of the corneal curvature is imperative when employing Brillouin microscopy in clinical practice. <b>[<i>J Refract Surg</i>. 2024;40(10):e768-e776.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 10","pages":"e768-e776"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468349","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":"Refractive Coupling Effects in Keratorefractive Lenticule Extraction Procedures: A Machine Learning-Assisted Approach.","authors":"Soodabeh Darzi, Samuel Arba-Mosquera, Kishore Raj Pradhan, Anika Förster, H Burkhard Dick, Suphi Taneri","doi":"10.3928/1081597X-20240826-01","DOIUrl":"https://doi.org/10.3928/1081597X-20240826-01","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of refractive couplings in myopia and myopic astigmatism with two different keratorefractive lenticule extraction (KLEx) systems.</p><p><strong>Methods: </strong>This was a retrospective evaluation of refractive outcomes with two different lasers studying 2,841 eyes undergoing small incision lenticule extraction (SMILE) (VisuMax 500; Carl Zeiss Meditec) and 2,528 eyes undergoing SmartSight (ATOS; SCHWIND eye-tech-solutions GmbH). Coupling effects (derived from the ratio between partial slopes) were determined for sphere and cylinder and for spherical equivalent, cardinal, and oblique astigmatism separately.</p><p><strong>Results: </strong>Statistically significant coupling effects were observed for both the VisuMax and ATOS systems, as indicated by <i>P</i> values less than .05. For the VisuMax, a coupling effect of 8% of cylinder into sphere and a 2% coupling of sphere into cylinder was found. For the ATOS, the coupling effect of sphere into cylinder was 1%. A 3% coupling effect of oblique astigmatism into cardinal astigmatism in the VisuMax, and conversely, a 0.1% coupling effect of defocus into oblique astigmatism in the ATOS were found. In cases with no astigmatism plan, sphere had a 2% effect on induced astigmatism in the VisuMax and 0.6% in the ATOS. In high astigmatism plans, sphere had a significant 16% impact on cylinder in the VisuMax. Additionally, the effect of defocus on cardinal astigmatism was 6% in the VisuMax and 0.8% on oblique astigmatism in the ATOS.</p><p><strong>Conclusions: </strong>Despite the <i>P</i> values less than .05 indicating statistical significance, the observed coupling effects were consistently low, with magnitudes below 10%, even for astigmatism exceeding 2.50 diopters. These couplings may be partly attributed to cross-effects of torsional eye movements. Coupling values for KLEx were markedly lower than those reported for non-aspheric excimer laser ablations. The results suggest that surgical results may be refined further by optimizing nomograms to mitigate coupling effects. <b>[<i>J Refract Surg</i>. 2024;40(10):e706-e715.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 10","pages":"e706-e715"},"PeriodicalIF":2.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468353","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}