Journal of refractive surgery最新文献

{"title":"Evaluating the Effectiveness and Corneal Aberrations After FS-LASIK and SMART (SPT-Guided TransPRK) Surgery for Myopia and Astigmatism: Retrospective Study.","authors":"Yanzhen Xue, Yonghong Guo, Jun Zhang","doi":"10.3928/1081597X-20241230-04","DOIUrl":"https://doi.org/10.3928/1081597X-20241230-04","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effects of SMART surgery (SCHWIND eye-tech-solutions GmbH) on corneal abnormalities and refractive errors compared to traditional femtosecond laser-assisted laser in situ keratomileusis (FSLASIK).</p><p><strong>Methods: </strong>A retrospective case series was conducted at Xi'an Gucheng Aier-Eye Hospital, analyzing data from 83 patients who underwent FS-LASIK and SMART procedures in 2021. Pentacam (Oculus Optikgeräte GmbH) measurements were taken before surgery and at 1, 3, and 6 months postoperatively to assess corneal higher order aberrations, spherical aberrations, and coma. Statistical analyses included an independent Student test between the two groups. Visual acuities were compared by the Mann-Whitney <i>U</i> test, paired <i>t</i>-tests, and repeated measures analysis of variance.</p><p><strong>Results: </strong>Comparison of visual acuity at 1 week and 1 month postoperatively showed significant differences between the FSLASIK and SMART groups. After 6 months, a higher percentage of patients in the SMART group achieved spherical equivalent within +1.00 diopter compared to the FS-LASIK group. Both groups showed a shift from negative to positive Q-values, indicating improved visual quality. Corneal spherical aberrations and horizontal coma were more prevalent at 6 months postoperatively in both groups compared to preoperatively.</p><p><strong>Conclusions: </strong>In the long term, SMART surgery demonstrates comparable results to FS-LASIK for myopia and astigmatism correction. Higher order aberrations were less common after SMART surgery compared to FS-LASIK. These findings suggest that SMART surgery may be a suitable option for patients seeking refractive surgery, considering its potential benefits for visual quality and corneal health. <b>[<i>J Refract Surg</i>. 2025;41(2):e164-e172.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 2","pages":"e164-e172"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408720","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":"Visual Performance and Patient Satisfaction of Bilaterally Implanted Extended Depth of Focus Intraocular Lens: Outcomes of a Multicenter Registry.","authors":"Frank Howes, Laureano A Rementeria-Capelo, Francisco Poyales, Armand Borovik, Ramin Khoramnia, Caridad Perez-Vives, Rudy M M A Nuijts","doi":"10.3928/1081597X-20241230-01","DOIUrl":"https://doi.org/10.3928/1081597X-20241230-01","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate visual performance, patient satisfaction, and spectacle independence in patients bilaterally implanted with AcrySof IQ Vivity intraocular lenses (IOLs) (Alcon Laboratories, Inc) during cataract or refractive lens exchange (RLE) surgery.</p><p><strong>Methods: </strong>This multicenter, ambispective, non-interventional registry study was conducted in Europe, Australia, and New Zealand. At the first follow-up visit, occurring between 3 and 6 months after IOL implantation, binocular uncorrected and corrected distance visual acuities at distance (UDVA/CDVA), intermediate (UIVA/DIVA 66 cm), and near (UNVA/DNVA 40 cm) were evaluated using the logarithm of the minimum angle of resolution (logMAR) chart. Patient satisfaction, spectacle independence, visual disturbances, and device deficiencies were also assessed.</p><p><strong>Results: </strong>The final analysis included 885 patients, with 790 (89.3%) and 82 (9.3%) patients who underwent cataract and RLE, respectively, where approximately 30% had one or more ocular comorbidity. Mean ± standard deviation logMAR (Snellen) UDVA, UIVA, and UNVA were 0.012 ± 0.102 (∼20/20), 0.088 ± 0.118 (∼20/25), and 0.256 ± 0.154 (∼20/40) for the cataract cohort and -0.005 ± 0.088 (∼20/20), 0.054 ± 0.141 (∼20/25), and 0.213 ± 0.151 (∼20/32) for the RLE cohort, respectively. The proportion of patients reporting spectacle independence at distance, intermediate, and near was 87.9%, 77.6%, and 46.1% for the cataract and 86.6%, 79.3%, and 59.8% for the RLE cohorts. The majority of patients among the cataract (92.1%) and RLE (85.4%) cohorts were satisfied with their postoperative sight, whereas 91.8% of the cataract and 84.1% of the RLE cohort reported no visual disturbances. No device deficiencies were reported.</p><p><strong>Conclusions: </strong>In this real-world study, patients bilaterally implanted with AcrySof IQ Vivity IOLs demonstrated good visual performance and the majority reported spectacle independence for distance to intermediate, high visual satisfaction, and low levels of visual disturbances across both cohorts, despite approximately 30% who reported 1 or greater ocular comorbidity. <b>[<i>J Refract Surg</i>. 2025;41(2):e131-e143.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 2","pages":"e131-e143"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408225","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 Outcomes After Scleral Fixation of the Carlevale Intraocular Lens.","authors":"Agnieszka Dyrda, Ignasi Jürgens","doi":"10.3928/1081597X-20250103-03","DOIUrl":"https://doi.org/10.3928/1081597X-20250103-03","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 2","pages":"e186"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407730","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":"Analysis of Crystalline Lens Tilt and Decentration Using a Fully Automated Swept-Source Optical Coherence Tomography Biometer.","authors":"Robert Montés-Micó, Maria Nilsson, Rune Brautaset, Abinaya Priya Venkataraman, Alberto Domínguez-Vicent","doi":"10.3928/1081597X-20241230-03","DOIUrl":"https://doi.org/10.3928/1081597X-20241230-03","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the repeatability of a fully automated swept-source optical coherence tomography (SS-OCT) biometer to measure healthy crystalline lens decentration and tilt and their correlation with other biometric parameters.</p><p><strong>Methods: </strong>In this prospective study, 135 eyes of 135 patients were included. Ocular biometric parameters including crystalline decentration and tilt were measured three times with the Eyestar 900 SS-OCT (Haag-Streit AG). The repeatability was analyzed with the within-subject standard deviation (S_w), coefficient of variability, and coefficient of repeatability. Other biometric parameters such as keratometry (K1 flat and K2 steep), anterior chamber depth (ACD), lens thickness (LT), and axial length (AL) were also analyzed to explore possible relationships.</p><p><strong>Results: </strong>For K1, K2, ACD, LT, and AL, S_w values were 0.07 diopters (D), 0.14 D, 0.01 mm, 0.02 mm, and 0.01 mm, respectively. For X and Y decentration and tilt, S_w values were 0.01, 0.02, and 0.39 mm, respectively. The correlation coefficient (<i>r</i>) between the crystalline lens tilt was low (<i>r</i> < -0.300) for all ocular biometric parameters, and was only associated with the AL (<i>P</i> < .001, <i>r</i> = -0.295). The <i>r</i> value between the decentration along the X and Y direction and the ocular biometric parameters was in all cases lower than 0.300. There was only a correlation between the decentration (Y direction) and K2 and ACD parameters (<i>P</i> < .001, <i>P</i> = .007, respectively). The linear regression parameters resulted in a slope value lower than -0.15 between any direction of the decentration and the other ocular biometric parameters.</p><p><strong>Conclusions: </strong>The Eyestar 900 provides repeatable measurements for crystalline lens decentration and tilt. AL was the only biometric parameter correlated with the crystalline lens tilt, and keratometry, ACD, and LT were correlated with the crystalline lens decentration along the Y direction. <b>[<i>J Refract Surg</i>. 2025;41(2):e155-e163.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 2","pages":"e155-e163"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408763","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, Randomized, Contralateral Eye Comparison of the Lenticule Decentration Following SMILE: Coaxially Sighted Corneal Light Reflex Versus Tear Film Mark Centration.","authors":"Taiwei Chen, Na Yu, Shumin Yuan, Yiming Ye, Xiangtao Hou, Jing Zhuang, Keming Yu","doi":"10.3928/1081597X-20241230-02","DOIUrl":"https://doi.org/10.3928/1081597X-20241230-02","url":null,"abstract":"<p><strong>Purpose: </strong>To examine lenticule decentration and visual quality following small incision lenticule extraction (SMILE) using either the coaxially sighted corneal light reflex (CSCLR) or the tear film mark (TFM) centration method.</p><p><strong>Methods: </strong>A total of 186 eyes from 93 patients were enrolled in this prospective, randomized, contralateral eye comparison study. Each patient had one eye randomly assigned to the CSCLR group (n = 93) and the contralateral eye to the TFM group (n = 93). Visual outcomes, optical zone decentration, contrast sensitivity, corneal higher order aberrations (HOAs), and the relationships between the magnitude of decentration and induced corneal HOAs were evaluated at 3 months postoperatively.</p><p><strong>Results: </strong>The magnitudes of total decentration (CSCLR: 0.23 ± 0.13; TFM: 0.22 ± 0.13; <i>P</i> = .996), as well as horizontal and vertical decentration, were comparable between the two methods. However, in the angle kappa greater than 200 µm subgroup, a statistically significant smaller horizontal decentered displacement was observed in the CSCLR group (0.01 ± 0.16) compared to the TFM group (0.07 ± 0.18) (<i>P</i> = .024). The induced HOAs and contrast sensitivity were comparable between the two methods (all <i>P</i> > .05). Additionally, significant correlations were identified between total decentered displacement and induced HOAs, including RMS HOAs, RMS coma, vertical coma, and RMS spherical aberration, in both groups.</p><p><strong>Conclusions: </strong>Both the CSCLR and TFM methods can yield accurate treatment centration and satisfactory visual quality. However, the CSCLR method may contribute to less horizontal decentration in patients with a large preoperative pupil offset. <b>[<i>J Refract Surg</i>. 2025;41(2):e144-e154.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 2","pages":"e144-e154"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408692","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":"Determining the Relationship Between Regional Epithelial Thickness, Corneal Toricity, and Corneal Power in Normal Corneas.","authors":"Barbara A L Dutra, Bassel Hammoud, Justin S Schumacher, Bianca N Susanna, Lara Asroui, Imane Tarib, Lycia P Sampaio, Giuliano Scarcelli, Cynthia J Roberts, J Bradley Randleman","doi":"10.3928/1081597X-20250103-01","DOIUrl":"https://doi.org/10.3928/1081597X-20250103-01","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the relationship between regional epithelial thickness and corneal toricity and estimate the epithelium's impact on corneal power in normal corneas.</p><p><strong>Methods: </strong>This was a retrospective case-control study evaluating 200 eyes from 200 patients categorized into one of three groups based on corneal toricity obtained with Scheimpflug imaging: (1) 80 non-toric (NT) eyes (< 0.50 diopters [D] in any meridian), (2) 80 with-the-rule (WTR) eyes (⩾ +1.50 D @90 ± 22.5°), and (3) 40 against-the-rule (ATR) eyes (⩾ +1.50 D @180 ± 22.5°). Epithelial thickness maps (9 mm) were generated using anterior segment optical coherence tomography (ASOCT) imaging (Avanti RTVue XR; Optovue, Inc). Mathematical modeling was used to evaluate the epithelium's impact on corneal power.</p><p><strong>Results: </strong>There were no differences in mean curvature between groups (range: 43.2 to 43.7 µm). Average epithelial thickness profile within the central 9-mm zone varied by approximately 2 µm or less laterally but was thinner superiorly than inferiorly in all three groups (52.45 to 53.36 vs 56.01 to 56.48 µm) with no significant differences between groups. There were no differences in any measured epithelial metric at any location nor any deviation in overall epithelial thickness pattern between groups. There were minimal average variations (< 4 µm) across the cornea between central and peripheral values in any meridian. The modeled impact on corneal optics was a net reduction in curvature by approximately 0.30 D with less than 0.10 D of possible variation resulting from differences in regional thickness.</p><p><strong>Conclusions: </strong>Regional epithelial thickness was unrelated to underlying corneal toricity and had minimal impact on corneal power in normal eyes. There was no evidence that normal epithelium significantly masks underlying normal stromal toricity, nor does the epithelium significantly contribute to corneal power under normal conditions. <b>[<i>J Refract Surg</i>. 2025;41(2):e91-e101.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 2","pages":"e91-e101"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408767","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 Asymmetric Corneal Curvature on Optical Zone Decentration and Refractive Outcomes in SMILE for Myopic Astigmatism.","authors":"Xinyi Fu, Xiaoyan Zhao, Guohong Gao, Zhilong Yu, Feng Wang, Shuxin Li","doi":"10.3928/1081597X-20241219-02","DOIUrl":"https://doi.org/10.3928/1081597X-20241219-02","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effect of asymmetric corneal curvature on refractive outcomes and optical zone decentration at a 2-year follow-up after small incision lenticule extraction (SMILE) for myopic astigmatism.</p><p><strong>Methods: </strong>In this prospective study, 96 patients (169 eyes) with myopia and astigmatism (low astigmatism group [cylinder < -2.00 diopters (D)], 91 eyes; high astigmatism group [cylinder ⩾ -2.00 D], 78 eyes) were treated using SMILE. Two-year postoperative refractive outcomes and optical zone decentration were analyzed and compared between the groups.</p><p><strong>Results: </strong>Both groups achieved good visual and refractive outcomes. The mean postoperative cylinder in the low astigmatism group was significantly lower than that in the high astigmatism group (<i>P</i> < .05). The mean decentration in the low astigmatism group was lower than that in the high astigmatism group (<i>P</i> < .05). In the low astigmatism group, a weak positive correlation was observed between target induced astigmatism (TIA) and the arithmetic mean of angle of error (|AE|), difference vector (DV), and the arithmetic mean of magnitude of error (|ME|). Additionally, a weak positive correlation was observed between decentration and both the arithmetic mean of corneal front surface curvature asymmetry indices (|Sif|) and TIA. Within the high astigmatism group, TIA exhibited a weak positive correlation with |AE|, DV, and |ME|. Similarly, decentration demonstrated a weak positive correlation with |Sif|, TIA, DV, and |ME| (all <i>P</i> < .05).</p><p><strong>Conclusions: </strong>SMILE surgery achieves good long-term refractive outcomes for correcting myopic astigmatism. However, there are still limitations to the accuracy of high astigmatism correction. Asymmetric corneal surface curvature may affect the astigmatism correction and optical zone decentration. <b>[<i>J Refract Surg</i>. 2025;41(2):e173-e185.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 2","pages":"e173-e185"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408769","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":"Leeuwenhoek.","authors":"Daniel Gonzalez-Coves","doi":"10.3928/1081597X-20241120-01","DOIUrl":"https://doi.org/10.3928/1081597X-20241120-01","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 1","pages":"e1"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950607","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":"2024 Reviewers.","authors":"","doi":"10.3928/1081597X-20241217-01","DOIUrl":"https://doi.org/10.3928/1081597X-20241217-01","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 1","pages":"e88-e89"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950582","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 Clinical Outcomes and Patient Satisfaction Following SMILE Performed With the VisuMax 800 in One Eye and VisuMax 500 in the Contralateral Eye.","authors":"Sri Ganesh, Sheetal Brar, Deepak T Swamy","doi":"10.3928/1081597X-20241113-02","DOIUrl":"https://doi.org/10.3928/1081597X-20241113-02","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the clinical outcomes, surgical workflow, and patient satisfaction following small incision lenticule extraction (SMILE) performed with the VisuMax 800 in one eye and the VisuMax 500 in the contralateral eye (both Carl Zeiss Meditec).</p><p><strong>Methods: </strong>This was a prospective, single-site clinical study of patients undergoing SMILE for myopia and myopic astigmatism between February 2022 and August 2023. Each patient underwent bilateral treatment using the VisuMax 800 (VM800 group) in one eye and the VisuMax 500 (VM500 group) in the contralateral eye. Intraoperative docking time, suction time, laser time, and surgical time were noted. Patient satisfaction and laser preference was evaluated immediately after treatment. Visual and refractive outcomes, contrast sensitivity, and quality of vision were assessed at the 3-month postoperative visit.</p><p><strong>Results: </strong>A total of 30 patients undergoing bilateral SMILE were included. The mean docking time and surgical time were significantly lower in the VM800 group (46.53 ± 11 sec and 4.52 ± 2.33 min, respectively) compared to the VM500 group (68.25 ± 15 sec and 6.22 ± 2.04 min, respectively) (<i>P</i> < .001). No significant differences were observed at the 1-day or 3-month visit for uncorrected distance visual acuity, corrected distance visual acuity, spherical equivalent, higher order aberrations, Objective Scatter Index, modulation transfer function, and contrast sensitivity. Patient scores regarding subjective symptoms were comparable. However, overall satisfaction with the surgical experience was rated significantly better in the VM800 group, with 80% of patients preferring the VM800 eye. No complications occurred for eyes in either group.</p><p><strong>Conclusions: </strong>No significant differences were observed in clinical outcomes between the two laser systems. However, the surgical workflow and patient-reported intraoperative experience favored the VisuMax 800. <b>[<i>J Refract Surg</i>. 2025;41(1):e14-e21.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 1","pages":"e14-e21"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950600","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}