Journal of refractive surgery最新文献

{"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}

{"title":"A New Small-Aperture Device Implanted on Top of the Intraocular Lens: Safety, Feasibility, and First Clinical Results.","authors":"Tim Schultz,H Burkhard Dick","doi":"10.3928/1081597x-20240723-03","DOIUrl":"https://doi.org/10.3928/1081597x-20240723-03","url":null,"abstract":"PURPOSETo investigate the feasibility and safety of a new small-aperture device, which is implanted on top of the intraocular lens.METHODSRegular cataract surgery was performed in both eyes in 7 patients. In the non-dominant eye, a small-aperture device (VisionXtender; Morcher) was additionally implanted into the capsular bag at the end of the surgery. The mask had an inner diameter of 1.4 mm. Feasibility and safety were investigated 3 months and 2 years after surgery.RESULTSIn all cases, the device was successfully positioned in the capsular bag without any intraoperative complications. No inflammation was observed at the 3-month follow-up visit. All patients achieved binocular uncorrected distance visual acuity of 0 logarithm of the minimum angle of resolution (log-MAR) or better. Additionally, distance-corrected intermediate visual acuity of 0.1 logMAR or better was measured in the non-dominant eye. Two years postoperatively, Nd:YAG capsulotomy was performed in three patients in both eyes.CONCLUSIONSThis clinical feasibility trial demonstrates that the use of the new small-aperture device is both easy and safe. No intraoperative or postoperative complications were reported. All patients attained satisfactory distance, intermediate, and near visual acuity. The device shows significant potential when used in combination with different intraocular lenses (eg, toric). In the future, different opening shapes seem to be possible. [J Refract Surg. 2024;40(9):e662-e666.].","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"282 1","pages":"e662-e666"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225439","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":"Reply: The Impact of Corneal Higher Order Aberrations on the Discrepancy Between Manifest Refractive Astigmatism and Topography-Measured Anterior Corneal Astigmatism in Healthy Candidates.","authors":"Kepa Balparda,Mariana Escobar-Giraldo,Luisa Fernanda Trujillo-Cabrera,Yeliana M Valencia Gómez,María Alejandra Nicholls-Molina,Tatiana Herrera-Chalarca","doi":"10.3928/1081597x-20240801-01","DOIUrl":"https://doi.org/10.3928/1081597x-20240801-01","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"184 1","pages":"e678-e679"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225442","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 Objective and Subjective Visual Outcomes Between Pentafocal and Trifocal Diffractive Intraocular Lenses.","authors":"Carlo Bellucci,Paolo Mora,Salvatore Antonio Tedesco,Stefano Gandolfi,Roberto Bellucci","doi":"10.3928/1081597x-20240715-04","DOIUrl":"https://doi.org/10.3928/1081597x-20240715-04","url":null,"abstract":"PURPOSETo compare the clinical and aberrometric outcomes obtained with a new diffractive pentafocal intraocular lens (IOL) and a diffractive trifocal IOL.METHODSPatients bilaterally implanted with the pentafocal Intensity SeeLens IOL (Hanita Lenses) (n = 30) and the trifocal FineVision POD F IOL (PhysIOL) (n = 30) during cataract surgery were studied after 1 month for refraction, visual acuity, defocus curve, contrast sensitivity, Hartmann-Shack aberration, and double-pass aberration. The Quality of Vision (QoV) questionnaire was used to evaluate visual comfort.RESULTSDistance and near visual acuities were similar with the two IOLs, but distance-corrected intermediate visual acuity was better with the Intensity IOLs (0.03 ± 0.04 vs 0.11 ± 0.04 logMAR in the FineVision eyes, P < .01). The difference between objective and subjective refraction was more myopic for the Intensity IOL (-1.15 vs -0.29 diopters [D]). The defocus curve was flatter with the Intensity IOL. Contrast sensitivity was similar in both IOLs. Hartmann-Shack aberration and double-pass aberration were similar, but the modulation transfer function cut-off value was worse with the Intensity IOL: 11.6 ± 2.7 vs 15.3 ± 4.9 (P < .01). QoV scores were better with the Intensity IOL, in particular for glare, halos, and starburst.CONCLUSIONSIn this comparative series, the pentafocal Intensity IOL provided better intermediate vision and better defocus curve than the FineVision IOL, with comparable distance and near vision. The optical disturbances as reported by the patients were higher with the FineVision IOL. Additional studies will better define the aberration profile obtained with the pentafocal IOL. [J Refract Surg. 2024;40(9):e604-e613.].","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"10 1","pages":"e604-e613"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225446","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 Objective Analysis of Corneal Haze Following Customized Transepithelial PRK Without Mitomycin C Combined With Accelerated Corneal Cross-Linking Versus Corneal Cross-Linking Alone.","authors":"Shady T Awwad,Yara Bteich,Jad F Assaf,Andre Ghosn,Farhad Hafezi,Emilio Torres-Netto,Lily M Chacra,Karim Kozhaya","doi":"10.3928/1081597x-20240715-03","DOIUrl":"https://doi.org/10.3928/1081597x-20240715-03","url":null,"abstract":"PURPOSETo compare haze and refractive outcomes in patients undergoing combined accelerated corneal cross-linking (A-CXL) and selective wavefront-guided transepithelial photorefractive keratectomy (WG-transPRK) without mitomycin C (MMC) versus those undergoing A-CXL.METHODSThis prospective study analyzed 95 eyes (86 patients) with progressive keratoconus from October 2018 to October 2022. The first group underwent CXL combined with corneal or ocular WG-transPRK (CXL+PRK, n = 52), targeting higher order aberrations (HOAs). The second underwent CXL only (n = 43), both following the same accelerated CXL protocol without MMC on the SCHWIND Amaris laser platform (SCHWIND eye-tech-solutions). Baseline and postoperative evaluations (1, 3, 6, and 12 months) included uncorrected (UDVA) and corrected (CDVA) distance visual acuity, manifest refraction, tomography, corneal HOAs, and optical coherence tomography (OCT) scans. A patented machine learning algorithm objectively detected and quantified stromal haze on OCT scans in grayscale units.RESULTSIn both groups, anterior corneal haze reflectivity and subepithelial haze peaked at 3 months postoperatively, then progressively decreased at 6 and 12 months. Haze did not differ between groups at any time point. By 12 months, CDVA increased by 2.5 lines in the CXL+PRK group (P < .001) and by 0.7 lines in the CXL group (P = .10), and maximum keratometry decreased from 51.70 ± 5.10 to 47.90 ± 7.90 diopters (D) (CXL+PRK group) (P < .001) and from 51.20 ± 5.10 to 50.30 ± 4.60 D (CXL group) (P = .004). Corneal HOAs decreased in both groups but more in the CXL+PRK group.CONCLUSIONSCombining CXL with WG-transPRK without MMC does not result in increased haze when compared to A-CXL alone. This combined approach achieves greater improvements in visual, topographic, and aberrometric parameters. [J Refract Surg. 2024;40(9):e583-e594.].","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"1 1","pages":"e583-e594"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142198904","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":"Influence of Capsular Tension Rings on the IOL-Capsule Complex in Patients With Long Axial Length: A Clinical Observation Based on SS-OCT.","authors":"Pingjun Chang,Yiwen Hu,Xueer Wu,Shuyi Qian,Yuanyuan Li,Yiyi Wang,Fuman Yang,Yune Zhao","doi":"10.3928/1081597x-20240723-02","DOIUrl":"https://doi.org/10.3928/1081597x-20240723-02","url":null,"abstract":"PURPOSETo evaluate the influence of a capsular tension ring (CTR) on the intraocular lens (IOL)-capsule complex after cataract surgery in patients with long axial length.METHODSThis was a prospective study. Patients underwent phacoemulsification and IOL implantation, with or without CTR implantation. Swept-source optical coherence tomography was performed at 1 day, 1 week, 1 month, and 3 months postoperatively to determine the postoperative aqueous depth (PAD), capsular bend index (CBI), and IOL tilt and decentration. Spherical equivalent values were obtained through subjective refraction and autorefraction. Root mean square was adopted to evaluate the indices listed above.RESULTSForty-three patients (56 eyes) were included in the study. Generalized estimating equation analysis of PAD showed a statistical difference between groups (P = .031). The RMS of the change in PAD was smaller in the CTR group than in the non-CTR group during the 3 months after surgery (P = .015). CBI in the CTR group increased more from 1 to 3 months after surgery than that in the non-CTR group (P = .025). The RMS of the change in vertical decentration was smaller in the CTR group than in the non-CTR group during the 3-month follow-up (P = .009).CONCLUSIONSCTR implantation can stabilize the axial position of the IOL within the capsular bag after cataract surgery in patients with long axial length without affecting the refractive stability. The formation of capsular bend may be slightly delayed in the early stage after CTR implantation, but it accelerates from 1 to 3 months after surgery. [J Refract Surg. 2024;40(9):e654-e661.].","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"48 1","pages":"e654-e661"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142198877","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":"12-Month Visual and Refractive Outcomes of Topography-guided Femtosecond Laser-Assisted LASIK for Myopia and Myopic Astigmatism.","authors":"Solin Saleh,Liam J Epp,Elaine My Tien Tran,Edward E Manche","doi":"10.3928/1081597x-20240717-01","DOIUrl":"https://doi.org/10.3928/1081597x-20240717-01","url":null,"abstract":"PURPOSETo report 12-month visual and refractive outcomes following topography-guided femtosecond laser-assisted laser in situ keratomileusis (LASIK) for myopia and compound myopic astigmatism correction.METHODSThis prospective, single-center observational study was conducted in an outpatient clinical practice at the Stanford University Byers Eye Institute in Palo Alto, California. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity, 5% and 25% contrast sensitivity CDVA, and manifest refraction following topography-guided femtosecond laser-assisted LASIK were assessed. Refractive measurements were used to perform a vector analysis.RESULTSSixty eyes of 30 patients (mean age: 32.8 ± 7.0 years; range: 23 to 52 years) undergoing topography-guided LASIK for the correction of myopia and compound myopic astigmatism were analyzed. Mean postoperative UDVA was -0.09 ± 0.10 logarithm of the minimum angle of resolution (logMAR) at 12 months. Mean preoperative CDVA was -0.09 ± 0.09 and -0.13 ± 0.08 logMAR at postoperative 12 months. At 12 months, 26.9% of eyes had gained one or more lines of postoperative UDVA compared to baseline CDVA. Mean pre-operative 5% contrast sensitivity CDVA was 0.68 ± 0.07 and 0.64 ± 0.12 logMAR at 12 months (P = .014) following LASIK.CONCLUSIONSTopography-guided LASIK for myopia and myopic astigmatism correction provided excellent visual and refractive outcomes that were predictable, precise, and stable up to 12 months postoperatively. [J Refract Surg. 2024;40(9):e595-e603.].","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"1 1","pages":"e595-e603"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225444","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":"Low Contrast Acuity Outcomes After SMILE and LASIK.","authors":"Rose K Sia,Isabel Eaddy,Hind Beydoun,Jennifer B Eaddy,Alexis Hogan,Zachary P Skurski","doi":"10.3928/1081597x-20240723-04","DOIUrl":"https://doi.org/10.3928/1081597x-20240723-04","url":null,"abstract":"PURPOSETo compare early visual quality of small incision lenticule extraction (SMILE) versus laser in situ keratomileusis (LASIK) in terms of low contrast acuity.METHODSA secondary analysis was performed using a harmonized dataset derived from two completed prospective cohort studies on active-duty military service members undergoing either SMILE (n = 37), wavefront-guided (WFG) LASIK (n = 51), or wavefront-optimized (WFO) LASIK (n = 56). Night vision and photopic and mesopic low contrast visual acuity (LCVA) up to 3 months postoperatively were compared between groups.RESULTSCompared to SMILE-treated eyes, WFG LASIK-treated eyes had significantly better night vision and photopic LCVA at 1 month postoperatively (beta = -0.039, P = .016; beta = -0.043, P = .007, respectively). WFO LASIK-treated eyes had significantly better photopic LCVA at 1 month postoperatively (beta = -0.039, P = .012) but had worse mesopic LCVA at 3 months postoperatively (beta = 0.033, P = .015) versus SMILE-treated eyes.CONCLUSIONSSMILE and LASIK, on either a WFG or WFO laser platform, yielded excellent outcomes, but LCVA seemed to recover quicker following LASIK compared to SMILE. [J Refract Surg. 2024;40(9):e667-e671.].","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"30 1","pages":"e667-e671"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225440","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}