Journal of refractive surgery最新文献

{"title":"Astigmatism Correction Through Excimer Laser Ablation Profiles: A Descriptive Review and Guide.","authors":"Shwetabh Verma, Samuel Arba-Mosquera","doi":"10.3928/1081597X-20250617-01","DOIUrl":"https://doi.org/10.3928/1081597X-20250617-01","url":null,"abstract":"<p><strong>Purpose: </strong>To review the reported outcomes for correction of astigmatism using excimer laser-based corneal refractive surgery techniques and to present distinctly the intricacies of the different ablation profiles.</p><p><strong>Methods: </strong>Keywords such as \"refractive correction,\" \"excimer lasers,\" \"ablation profiles,\" and \"astigmatism\" were used for literature research. Inclusion criteria were strict relevance and adequacy to the clinical questions under research, and availability of the abstract in the English language.</p><p><strong>Results: </strong>Bitoric, cross-cylinder, and custom wavefront-optimized (aberration-neutral) or wavefront-guided treatments are used in modern laser systems to correct astigmatism. From scientific literature reviewed in this article, laser ablation to correct astigmatism was found to produce satisfactory visual outcomes in terms of safety, efficacy, and predictability. Custom ablation respecting postoperative corneal curvature gradient, correcting true corneal astigmatism after eliminating the higher order aberrations, and accurately compensating for possible cyclotorsion will result in patient satisfaction.</p><p><strong>Conclusions: </strong>Integrating subjective and objective assessment of astigmatism effectively to optimize treatment outcomes is complex, particularly across a wide range of refractive errors. Properly determining how much astigmatism should be incorporated into the treatment is critical. Ignoring ocular residual astigmatism and sculpting the cornea based only on manifest refraction has the penalty that the entire ocular residual astigmatism remains as postoperative surgical residual astigmatism, also resulting in induction of spherical aberrations. Centration, optical zone sizes, cyclotorsion compensation, and use of appropriate treatment algorithms are of prime importance in obtaining favorable outcomes in correction of astigmatism.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 8","pages":"e855-e879"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799460","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 the Efficacy of Restoring Reading Performance After Refractive Lens Exchange With a Trifocal Intraocular Lens.","authors":"Tadas Naujokaitis, Gerd U Auffarth, Isabella D Baur, Oliver Hassel, Nikola Henningsen, Emanuel Reitemeyer, Lizaveta Chychko, Grzegorz Łabuz, Ramin Khoramnia","doi":"10.3928/1081597X-20250611-02","DOIUrl":"https://doi.org/10.3928/1081597X-20250611-02","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy of refractive lens exchange (RLE) with a trifocal intraocular lens (IOL) implantation by assessing reading performance and visual acuity at near and intermediate distances.</p><p><strong>Methods: </strong>This was a prospective interventional case series of 27 patients (54 eyes) at a university hospital who underwent a femtosecond laser-assisted RLE with Clareon PanOptix IOL (Alcon Laboratories, Inc) implantation. Visual acuity was tested before surgery and 6 months postoperatively and reading performance was evaluated using the Salzburg Reading Desk (SRD Vision) at near and intermediate distances. With a software-based simulator, the perception of halo and glare were quantified.</p><p><strong>Results: </strong>The uncorrected and distance-corrected near (40 cm) and intermediate (60 cm) visual acuities improved, with the mean (± standard deviation) postoperative binocular uncorrected visual acuity of 0.03 ± 0.08 logarithm of the minimum angle of resolution (logMAR) at 40 cm and -0.08 ± 0.06 logMAR at 60 cm. The surgery also improved uncorrected reading acuities, with the postoperative binocular uncorrected reading acuity of 0.05 ± 0.08 logMAR at 40 cm and 0.09 ± 0.10 logMAR at 60 cm. The postoperative uncorrected reading acuity matched the preoperative reading acuity with spectacle correction for near (0.04 ± 0.10 logMAR, <i>P</i> = .495). The near vision efficacy index was 0.75 ± 0.12 for conventionally measured visual acuity and 0.99 ± 0.35 for reading acuity. A total of 77.8% of patients reported halo and 14.8% reported glare, although none complained of bothersome photic phenomena.</p><p><strong>Conclusions: </strong>The RLE surgery effectively restored good uncorrected near and intermediate vision in terms of visual acuity and reading performance. At high luminance and contrast levels, the postoperative uncorrected reading ability matched the preoperative spectacle-corrected performance for near.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 8","pages":"e786-e796"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799459","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":"Predicting Visual Acuity in Pseudophakic Eyes With Pupil-Dependent Extended Depth of Focus Intraocular Lenses.","authors":"Fidel Vega, María S Millán","doi":"10.3928/1081597X-20250611-01","DOIUrl":"https://doi.org/10.3928/1081597X-20250611-01","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the impact of the pupil size on the prediction of the clinical monocular visual acuity (VA) with a representative pupil-dependent extended depth of focus intraocular lens (EDOF IOL).</p><p><strong>Methods: </strong>An optical bench with a model eye was used to obtain with 2-, 3-, and 4.5-mm pupils (at the IOL plane) the through-focus area under the modulation transfer function (TF-MTFa) of the refractive EDOF AcrySof IQ Vivity (Alcon Laboratories, Inc). The TF-MTFa curve with a 3-mm pupil was correlated with the clinical VA defocus curve (<i>R</i>² = 0.95) of a large sample of pseudophakic patients (n = 107). This group also was split into three cohorts according to pupil size: small (< 3 mm; n = 6), medium (3 to 4 mm; n = 52), and large (> 4 mm; n = 49). Each pupil group showed a differentiated clinical VA defocus curve that was highly correlated with the 2- (<i>R</i>² = 0.97), 3- (<i>R</i>² = 0.97), and 4.5-mm (<i>R</i>² = 0.96) TF-MTFa, respectively. The clinical VA versus MTFa curves were fitted using the formula proposed by the American National Standards Institute to derive for each pupil a new set of fitting coefficients to transform MTFa into expected VA accordingly.</p><p><strong>Results: </strong>Four new predictive functions of the clinical VA were obtained for the pupil-dependent refractive EDOF IOL: one for the whole sample of patients, which averages out pupillary differences between patients, and three functions that incorporate the influence of the pupil size.</p><p><strong>Conclusions: </strong>Better prediction of the clinical VA of pseudophakic patients implanted with pupil-dependent refractive EDOF IOLs is achieved with fitting functions that take into account the pupil size.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 8","pages":"e831-e838"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799466","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":"Rotationally Asymmetric Refractive Low Addition Multifocal IOL Implantation in Patients With Previous Corneal Laser Myopic Refractive Surgery.","authors":"Katerina Nouzovská, Mario Canto-Cerdan, Ana Belen Plaza-Puche, Alexander Gonzales, Jorge L Alió, Jorge L Alió Del Barrio","doi":"10.3928/1081597X-20250606-01","DOIUrl":"10.3928/1081597X-20250606-01","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the visual and refractive outcomes, retinal optical image quality, and patient satisfaction following implantation of a rotationally asymmetric refractive low addition multifocal intraocular lens (IOL) (Lentis Mplus; Te-leon) during cataract surgery in patients with prior myopic corneal laser refractive correction.</p><p><strong>Methods: </strong>This observational, retrospective study included 35 eyes (26 patients) with previous laser corneal myopic refractive surgery that were implanted with the LENTIS Mplus (LS-313 MF15) multifocal IOL during cataract surgery. Refractive and visual outcomes were analyzed at 1, 3, and 6 months of follow-up. At the last visit (range: 7 to 130 months), monocular defocus curve and monocular contrast sensitivity were examined. Total ocular aberrometry was obtained with a pyramidal wavefront sensor (Osiris; CSO) at a 4-mm pupil diameter. Patient satisfaction was evaluated with the Quality of Vision (QoV) questionnaire and Near Activity Visual Questionnaire (NAVQ-10).</p><p><strong>Results: </strong>A statistically significant improvement was observed in uncorrected and corrected distance visual acuity postoperatively (0.09 ± 0.12 and 0.03 ± 0.12 logarithm of the minimum angle of resolution [logMAR], respectively). Postoperative uncorrected near visual acuity remained nearly unchanged at good levels of 0.38 ± 0.23 logMAR and corrected near visual acuity was 0.09 ± 0.10 logMAR. The monocular defocus curve demonstrated high levels of visual acuity achieved at far and intermediate distances along with acceptable levels at near vision. The QoV questionnaire showed lower scores for frequency (29.12 ± 19.55), severity (29.26 ± 17.40), and bothersomeness (25.87 ± 17.42).</p><p><strong>Conclusions: </strong>This study demonstrated efficacy and safety of a rotationally asymmetric refractive low addition multifocal IOL implanted in eyes with prior myopic corneal ablation. It provided good levels of patient satisfaction and spectacle independence.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 8","pages":"e760-e767"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799467","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":"Beyond the Glance.","authors":"Rafaela Ava Kastowsky","doi":"10.3928/1081597X-20250627-01","DOIUrl":"10.3928/1081597X-20250627-01","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 8","pages":"e747"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799461","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":"A Blended Approach to Spectacle Independence After Cataract Surgery Using a Novel Extended Depth of Focus Intraocular Lens.","authors":"Margarita Safir, Justine Ong, Oriel Spierer, Michael Mimouni, Tanya Trinh","doi":"10.3928/1081597X-20250606-02","DOIUrl":"https://doi.org/10.3928/1081597X-20250606-02","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effectiveness of a blended approach to spectacle independence after cataract surgery using a novel extended depth of focus (EDOF) lens.</p><p><strong>Methods: </strong>This retrospective comparative study took place at Mosman Eye Centre, Australia. This was a single-site, single-surgeon study evaluating patients who underwent consecutive bilateral cataract surgery with implantation of a novel EDOF lens using a symmetrical (both eyes +1.50 diopter [D] add) or blended (dominant eye +1.50 D, non-dominant +3.00 D) approach. Endpoints included uncorrected (UDVA) and corrected (CDVA) distance visual acuity and intermediate (45 and 60 cm) and near (30 cm) visual acuity at 1 month. Additional endpoints included postoperative refraction, spectacle independence, overall satisfaction with vision, and adverse events.</p><p><strong>Results: </strong>Overall, 148 eyes of 74 patients were included, 41 patients in the symmetrical group and 33 in the blended group. The mean age was 72.28 ± 8.18 years (range: 50 to 89 years) with 33.78% being men. Both near and distance visual acuity improved significantly for both refractive approaches (<i>P</i> < .001). All eyes (148/148) were within 0.18 D of emmetropia postoperatively. Comparing the two approaches, postoperative distance, intermediate, and near UDVA was significantly better for the blended approach: -0.09 ± 0.05 versus -0.03 ± 0.07 at 6 m (<i>P</i> = .03), 7.97 ± 2.98 N versus 9.12 ± 2.63N at 30 cm (<i>P</i> = .014), .47 ± 2.21 N versus 8.68 ± 2.17 N at 45 cm (<i>P</i> = .001) and 8.32 ± 2.48 N versus 9.12 ± 2.00 N at 60 cm (<i>P</i> = .03). Postoperative adverse events were comparable between the groups and similar to previous reports.</p><p><strong>Conclusions: </strong>Blended EDOF IOL implantation using +1.50 and +3.00 D addition resulted in excellent distance, intermediate, and near vision, with a high rate of spectacle independence and low rate of reported visual disturbances. Future randomized comparative trials with a larger sample size, longer follow-up, and additional objective assessments of postoperative visual quality, such as contrast sensitivity, are needed to further validate these findings.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 8","pages":"e768-e775"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799413","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":"Postoperative Adjustment of Implanted Corneal Allogeneic Intrastromal Ring Segments (CAIRS) to Improve Visual and Topographic Outcomes.","authors":"Soosan Jacob, Amar Agarwal, Shady T Awwad, Hyeck Soo Son, Gerd U Auffarth, Riya Abraham, Smita Narasimhan","doi":"10.3928/1081597X-20250515-05","DOIUrl":"https://doi.org/10.3928/1081597X-20250515-05","url":null,"abstract":"<p><strong>Purpose: </strong>To report adjustment of different corneal allogeneic intrastromal ring segments (CAIRS) parameters in a group of patients with suboptimal visual and topographic results.</p><p><strong>Methods: </strong>Thirteen eyes of 13 patients with suboptimal first-stage outcomes in the form of a decrease or lack of improvement in uncorrected (UDVA) or corrected (CDVA) distance visual acuity or complaining of decreased visual quality together with worsening of topographic map were included in this retrospective interventional case series. Adjustment was performed for arc length, width, thickness, placement, or optical zone.</p><p><strong>Results: </strong>Post-implantation (Intervention-1) mean improvement in UDVA and CDVA compared to preoperatively was 1.5 ± 3 (range: 6 to 3) and 0.2 ± 1.5 (range: 2.5 to 3) lines of vision, respectively. Three lines of UDVA and 0.5 to 3 lines of CDVA were lost in 2 and 5 patients, respectively. Post-adjustment (Intervention-2) mean improvement in UDVA and CDVA compared to preoperatively was 3.6 ± 3 (range: 10 to 0) and 1.15 ± 1.6 (range: 5.5 to 0) lines, respectively. No patient lost any lines of UDVA or CDVA after adjustment. All patients who lost lines after Intervention-1 regained it after adjustment. The Friedman chi-squared test showed a global difference across the three time points for UDVA, CDVA, spherical equivalent (SE), refractive astigmatism (RA), keratometry (steep [Ksteep], flat [Kflat], and mean [Kmean]) (chi-square = 11.7 to 16.8, <i>P</i> ≤ .003). Bonferroni-corrected Wilcoxon tests showed significant improvements for UDVA, SE, RA, Ksteep, Kflat, Kmean, and maximum keratometry (Kmax) between different time points. Before Intervention-1 to after Intervention-2 contrast yielded smaller <i>P</i> values than before Intervention-1 to after Intervention-1 for all parameters, thus showing larger improvements. Kmax showed a statistically significant difference but was not considered important because Kmax after CAIRS implantation is often outside the visual axis.</p><p><strong>Conclusions: </strong>Adjustments are possible to try and improve-suboptimal results after CAIRS implantation.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 8","pages":"e814-e821"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799465","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":"Correlation and Agreement of Anterior Chamber Biometric Parameters and Sulcusto-Sulcus Diameter in Chinese Patients With High Myopia and Varying Axial Lengths.","authors":"Yuyan Huang, Huiling Xu, Xiaoling Yang, Hehe Huang, Zhina Zhi, Si Chen","doi":"10.3928/1081597X-20250612-01","DOIUrl":"10.3928/1081597X-20250612-01","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the relationship between anterior chamber biometric parameters (angle-to-angle diameter [ATA] and anterior chamber width [ACW]) and the sulcus-to-sulcus diameter (STS) in myopic patients with varying axial length (AL).</p><p><strong>Methods: </strong>A 50-MHz ultrasound biomicroscopy (UBM) device measured STS at the 0° and 90° meridians in the right eyes of 77 Chinese patients with high myopia and an anterior chamber depth greater than 2.80 mm. Swept-source optical coherence tomography device (CASIA2; Tomey) measured ATA and ACW at the 0°, 45°, 90°, and 135° meridians, whereas corneal topography measured the horizontal white-to-white diameter (WTW-0°).</p><p><strong>Results: </strong>Vertical STS, ATA, and ACW measurements were significantly longer than their horizontal counterparts (<i>P</i> < .001). Differences in STS and ACW between vertical and horizontal meridians were comparable (<i>P</i> = .503), whereas ATA differences was more pronounced than that of STS (<i>P</i> = .032). Both STS-0° and STS-90° were significantly greater than WTW-0°, ATA, and ACW at their respective meridians (<i>P</i> ⩽ .016), except for STS-0° versus ACW-0° (<i>P</i> = .127). Correlations between STS-0°/STS-90° and WTW-0° were weaker than those with ACW or ATA. STS-0° exhibited the strongest correlation with ACW-0°, whereas STS-90° correlated best with ACW-45°. For patients with AL shorter than 28.5 mm, no significant differences existed between STS-0° and WTW-0°/ATA-0°/ACW-0°. In contrast, for those with AL greater than 28.5 mm, only ACW-0° was comparable to STS-0°. At the vertical meridian, only ACW had no significant differences compared to STS for patients with different ranges of AL.</p><p><strong>Conclusions: </strong>In Chinese patients who are potential candidates for Implantable Collamer Lens implantation, ACW shows better concordance with STS than ATA and WTW-0°. The reliability of WTW-0° for estimating STS decreases with increased AL, making ACW more suitable for STS estimation in patients with AL greater than 28.5 mm, especially at non-horizontal meridians.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 8","pages":"e805-e813"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799462","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 Biomechanical Alterations in Eyes After Radial Keratotomy Compared With Keratoconus.","authors":"Yuri Iwamoto, Shizuka Koh, Ryota Inoue, Renato Ambrósio, Naoyuki Maeda, Kohji Nishida","doi":"10.3928/1081597X-20250922-01","DOIUrl":"10.3928/1081597X-20250922-01","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the corneal biomechanical characteristics of eyes after radial keratotomy (RK) versus eyes with keratoconus.</p><p><strong>Methods: </strong>In this retrospective case-control study, 15 eyes of 8 post-RK patients, 20 eyes of 20 age-matched patients with keratoconus, and 20 eyes of 20 normal control participants were assessed. Using an air pulse device with dynamic Scheimpflug imaging, corneal biomechanical parameters, including time, velocity, deformation amplitude, and deflection amplitude/length/area, were measured during deformation. Parameters for comprehensive biomechanical screening and ectasia detection were also recorded. In total, 27 corneal biomechanical parameters among the post-RK, keratoconus, and control groups were compared.</p><p><strong>Results: </strong>There were statistically significant differences in 21 parameters between the post-RK and keratoconus groups and 18 parameters between the post-RK and control groups (<i>P</i> < .05, all). Seventeen of the 21 parameters, including deflection amplitude/length/area, were significantly greater in the post-RK group than in both the keratoconus and control groups (<i>P</i> < .05). Eight parameters in both the post-RK and keratoconus groups were significantly different from those in the control group (<i>P</i> < .05, all). Although less corneal stiffness was observed in the post-RK and keratoconus groups than in the control group, radius-related parameters, the ratio between the deformation amplitude at the apex and at 2 mm, and the difference in corneal thickness from the center to the periphery differed between the post-RK and keratoconus groups.</p><p><strong>Conclusions: </strong>Dynamic Scheimpflug imaging quantitatively demonstrated that the mechanism of decreased corneal biomechanical characteristics in post-RK eyes differs from that in eyes with keratoconus, which generally causes localized corneal thinning and protrusion around the corneal apex.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 8","pages":"e822-e830"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130786","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":"Occurrence of Invisible Eye Movement in KLEx and Its Effect on Visual Quality and Refractive Outcomes.","authors":"Bo Mei, Yu Li, Dan Su, Shuangfeng Liang, Yue-Hua Zhou, Chun-Yang Zhou","doi":"10.3928/1081597X-20250515-03","DOIUrl":"https://doi.org/10.3928/1081597X-20250515-03","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effect of invisible eye movements on visual quality and refractive outcomes during intraoperative laser scanning with keratorefractive lenticule extraction (KLEx).</p><p><strong>Methods: </strong>Eye movement direction and maximum distance were measured using ImageJ software (National Institutes of Health) in 487 patients (958 eyes). Comparisons were made among left eyes with movement of 0.1 mm or less, movement of less than 0.1 mm, and movement of 0 mm regarding refraction, astigmatism vector analysis, uncorrected distance visual acuity (UDVA), Strehl ratio (SR), modulation transfer function (MTF) cut-off, and higher order aberrations (HOAs).</p><p><strong>Results: </strong>Among 958 eyes, 105 eyes experienced invisible movement (10.96%). Specifically, 23 right eyes (4.80%) and 82 left eyes (17.12%) showed a mean movement of 0.07 mm. There was a significant difference in incidence of invisible movement between the different eyes (<i>P</i> < .001), but not in movement distances (<i>P</i> = .63). Movements were primarily directed between 45° and 135°. At 3 months postoperatively, no significant differences were found in refraction, astigmatism vector analysis, UDVA, SR, MTF cut-off, total HOAs, coma aberration, and spherical aberration (<i>P</i> ⩾ .05). Trefoil aberration was higher in the 0.1 mm or greater group compared to the other groups (<i>P</i> = .03). However, the difference between the less than 0.1 mm group and 0 mm group was not statistically significant (<i>P</i> = .48).</p><p><strong>Conclusions: </strong>Invisible movement is common in KLEx surgery. It is typically observed upward (45° to 135°), and with a higher incidence in the left eye than the right eye. Although invisible movement does not affect postoperative refractive outcomes, a movement distance of 0.1 mm or greater may increase corneal trefoil aberration. <b>[<i>J Refract Surg</i>. 2025;41(7):e674-e681.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 7","pages":"e674-e681"},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584178","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}