Journal of refractive surgery最新文献

{"title":"Comparing the Postoperative Outcomes of Intrastromal Corneal Ring Segments in Three Different Topographic Patterns of Eccentric Keratoconus.","authors":"Mohamed Omar Yousif,Rania Serag Elkitkat,Ahmed Elmassry,Mohamed Nabil Hamza,Noha Abdelsadek Alaarag","doi":"10.3928/1081597x-20240716-02","DOIUrl":"https://doi.org/10.3928/1081597x-20240716-02","url":null,"abstract":"PURPOSETo compare the postoperative outcomes following implantation of KERATACx ring segments (Imperial Medical Technologies Europe GmbH) in patients having eccentric keratoconus with three different topographic patterns.METHODSThis retrospective cohort study was conducted at Maadi Eye Subspeciality Center, Cairo, Egypt. The study included patients with keratoconus who had implantation of KERATACx ring segments. Three groups were segregated based on topographic keratoconus patterns using the Sirius CSO Topographer (CSO Italia): type I ectasia where the cone coincides with the corneal flat axis, type II ectasia in which the cone coincides with neither the steep nor the flat axis and lies between the two axes, and type II ectasia for cones coinciding with the corneal steep axis. The visual and topographic outcomes were compared preoperatively and postoperatively for the three enrolled groups.RESULTSThis study enrolled 92 eyes of 92 patients and had a mean ± standard deviation follow-up of 16.9 ± 9.2 months. The patients' medical records revealed that night vision complaints and halos around the light were experienced the most by the type III ectasia group (31.25%). For the type III ectasia group, four topographic indices and one visual parameter did not show statistically significant differences between the preoperative and postoperative data (inferior-superior difference at 2- and 4-mm diameter, coma aberration, higher order aberrations, and uncorrected distance visual acuity), contrary to the type I and II ectasia groups, which showed significant improvements in all evaluated parameters.CONCLUSIONSThe type III morphological pattern of ectasia is the least likely to benefit from KERATACx ring segments implantation. [J Refract Surg. 2024;40(9):e625-e634.].","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"45 1","pages":"e625-e634"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225454","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: Astigmatism: Using Correct Analysis Methods and Terminology.","authors":"Jun Zhang, Jie Shao, Xinfang Cao, Yonggang Zhang, Li Zheng","doi":"10.3928/1081597X-20240805-01","DOIUrl":"10.3928/1081597X-20240805-01","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 9","pages":"e672-e674"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289710","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: Improving Second-Eye Vaulting in Deferred Bilateral Implantable Collamer Lens Surgery.","authors":"Andrea Russo, Ottavia Filini, Erik Mertens, Sheraz M Daya, Luigi Conti, Francesco Carones, Giulia Festa, Alessandro Boldini, Giacomo Savini","doi":"10.3928/1081597X-20240723-01","DOIUrl":"10.3928/1081597X-20240723-01","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 8","pages":"e579-e581"},"PeriodicalIF":2.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906845","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":"Nathan Courat, Frédéric Gobert, Thibault Naudin, Alexandre Ducloux, Camille Alleyrat, Nicolas Leveziel","doi":"10.3928/1081597X-20240611-04","DOIUrl":"https://doi.org/10.3928/1081597X-20240611-04","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the refractive predictability of the Carlevale sutureless scleral fixation intraocular lens (IOL) (Sole-ko IOL Division) power calculation.</p><p><strong>Methods: </strong>This retrospective, non-comparative, interventional case series included patients without a capsular support having undergone sutureless scleral fixation IOL implantation in two French hospitals between October 2019 and April 2022. IOL calculation was performed with the Barrett Universal II, Hoffer Q, Holladay 1, and SRK/T formulas with constant optimization to achieve a mean arithmetic prediction error equal to zero. The main outcomes were prediction error (PE) and its standard deviation (SD-PE), the median absolute error (MedAE), the mean absolute error (MAE), and the percentage of eyes with PE within ±0.50, ±1.00 and ±2.00 diopters (D) 6 months after surgery.</p><p><strong>Results: </strong>Thirty eyes of 30 patients were included in the study. The mean age was 66.6 years, the mean axial length was 24.31 mm, and the mean keratometry was 43.07 D. SDPE ranged from 0.73 to 0.87 D depending on the formula. MedAE ranged from 0.38 to 0.61 D, and MAE from 0.52 to 0.68 D. Between 46.7% and 56.7% of eyes were within ±0.50 D, 76.7% and 90.0% were within ±1.00 D, and 96.7% were within ±2.00 D of target equivalent. No statistically significant difference was observed between the four formulas for any outcomes.</p><p><strong>Conclusions: </strong>This study confirmed that the design of the Carlevale sutureless scleral fixation IOL provides satisfactory refractive results. <b>[<i>J Refract Surg</i>. 2024;40(8):e527-e532.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 8","pages":"e527-e532"},"PeriodicalIF":2.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906843","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":"Impact and Correction of an Anterior Phakic Intraocular Lens on Swept-Source Optical Coherence Tomography Biometry.","authors":"Bruno Barbosa Ribeiro, Sílvia Monteiro, João Heitor Marques, Ana Carolina Abreu, Maria do Céu Pinto","doi":"10.3928/1081597X-20240716-01","DOIUrl":"https://doi.org/10.3928/1081597X-20240716-01","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of anterior chamber phakic intraocular lens (pIOL) on swept-source optical coherence tomography (SS-OCT) biometric measurements and IOL power calculation.</p><p><strong>Methods: </strong>This retrospective analysis of 67 eyes of 49 patients with previous anterior chamber pIOL implantation analyzed the accuracy of automatic segmentation of the anterior surface of the crystalline lens and its impact on anterior chamber depth (ACD, measured from epithelium to lens), lens thickness measurements, and IOL power calculation. The sample was divided into two groups: correct detection of the anterior surface of the crystalline lens and inaccurate detection. Segmentation of eyes from the inaccurate detection group was manually corrected and ACD and lens thickness were calculated using ImageJ software. IOL power was calculated using 7 formulas for both measurements.</p><p><strong>Results: </strong>The anterior surface of the crystalline lens was mis-identified in 13 (19.4%) eyes. ACD was underestimated (Δ -0.85 ± 0.33 mm, <i>P</i> < .001) and lens thickness was overestimated (Δ +0.81 ± 0.25 mm, <i>P</i> < .001). Manual correction changed the target spherical equivalent only in the Haigis formula (<i>P</i> = .009). After correction for segmentation bias, the Pearl DGS, Cooke K6, and EVO 2.0 formulas showed the lowest prediction error, with the Pearl DGS showing greatest accuracy within ±1.00 diopters of prediction error range (81.0%).</p><p><strong>Conclusions: </strong>SS-OCT biometry misidentifies the anterior surface of the crystalline lens in a significant proportion, resulting in significant IOL power calculation error in the Haigis formula. Manual proofing of segmentation is mandatory in every patient with anterior chamber pIOL implantation. After correct segmentation, the Pearl DGS, Cooke K6, and EVO seem to be the best formulas. <b>[<i>J Refract Surg</i>. 2024;40(8):e562-e568.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 8","pages":"e562-e568"},"PeriodicalIF":2.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906840","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":"LASIK Versus PRK Based on Increased Risk of Corneal Haze: Assessing Current Decision-Making Capabilities of Six Artificial Intelligence Models in Refractive Surgery.","authors":"Majid Moshirfar, Kayvon A Moin, Soroush Omidvarnia, Spencer D Moulton, Preston B Willey, Isabella M Stoakes, Phillip C Hoopes","doi":"10.3928/1081597X-20240611-05","DOIUrl":"https://doi.org/10.3928/1081597X-20240611-05","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the current decision-making capabilities of 6 different artificial intelligence (AI) models by assessing their refractive surgery recommendations (laser in-situ keratomileusis [LASIK] or photorefractive keratectomy [PRK]) for a theoretical patient with a history of keloid formation.</p><p><strong>Methods: </strong>Claude-2 (Anthropic, 2023), GPT-4 (OpenAI, 2023), GPT-3.5 (OpenAI, 2022), Gemini 1.0 (Google DeepMind, 2023), Microsoft Copilot (Microsoft AI, 2023), and Google-PaLM (Google AI, 2022) underwent three systematic queries to determine the most appropriate surgical plan (LASIK or PRK) for a theoretical patient with an increasing manifest refraction of -3.50, -5.00, and -7.00 diopters (D) in both eyes, an uncomplicated ocular examination, and history of keloid formation. They were then tasked with providing published scientific references to support their responses. The AI models' recommendations were compared to those of a group of 6 experienced ophthalmologists, serving as a benchmark.</p><p><strong>Results: </strong>The group of ophthalmologists unanimously recommended LASIK (6/6 ophthalmologists), in contrast to the unanimous initial recommendation for PRK from the AI models (6/6 models). Of the 42 references provided by the AI models, 55% were fictitious and 45% were authentic. Only 1 of the 6 models altered its initial recommendation to LASIK when presented with the same patient with a history of keloid formation but with increasing severity of myopia (-3.50 to 5.00 to 7.00 D).</p><p><strong>Discussion: </strong>It is evident that current AI models lack the critical-thinking abilities required to accurately analyze and assess apparent risk factors in clinical scenarios, such as the risk of corneal haze after PRK at higher levels of myopia, particularly in cases with a history of keloid formation. <b>[<i>J Refract Surg</i>. 2024;40(8):e533-e538.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 8","pages":"e533-e538"},"PeriodicalIF":2.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906842","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":"The KERATO Biomechanics Study 1: A Comparative Evaluation Using Brillouin Microscopy and Dynamic Scheimpflug Imaging.","authors":"Riccardo Vinciguerra, Sara Palladino, Robert Herber, Mario R Romano, Paolo Vinciguerra","doi":"10.3928/1081597X-20240701-02","DOIUrl":"https://doi.org/10.3928/1081597X-20240701-02","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the corneal biomechanical properties in normal individuals and patients with keratoconus using the Brillouin optical scanning system (Intelon Optics) (BOSS) and compare them with ultra-high-speed Scheimpflug imaging (Corvis ST; Oculus Optikgeräte GmbH).</p><p><strong>Methods: </strong>Sixty eyes from 60 patients (30 normal and 30 keratoconus) were included in this prospective, single-center, comparative, non-interventional study. Corneal biomechanics were evaluated using the Corvis ST and the BOSS. With the BOSS, each corneal image was acquired three times, measuring 10 locations within an 8-mm diameter. Parameters extracted included mean, maximum, and minimum Brillouin shift. These 10 points were also grouped into superior, central, and inferior regions. BOSS repeatability was assessed using the coefficient of repeatability and coefficient of variation. Furthermore, normal individuals and patients with keratoconus were compared using the Corvis ST and BOSS.</p><p><strong>Results: </strong>The BOSS exhibited good repeatability, with coefficient of repeatability ranging from 0.098 to 0.138 GHz for single points in normal individuals and 0.096 to 0.149 GHz for patients with keratoconus. Statistical analysis revealed significant differences between normal individuals and patients with keratoconus, indicating softer corneas in keratoconus, observed with both the Corvis ST and BOSS. Specifically, the BOSS showed significant differences in mean, inferior, and superior mean, maximum, and minimum Brillouin frequency shift (all <i>P</i> < .05), whereas the Corvis ST displayed highly significant differences in stiffness parameter at first applanation, stress strain index, deformation amplitude ratio, and inverse integrated radius (all <i>P</i> < .001).</p><p><strong>Conclusions: </strong>Corneal biomechanical measurements proved highly repeatable and effectively demonstrated significant differences between normal individuals and patients with keratoconus using both the BOSS and the Corvis ST. <b>[<i>J Refract Surg</i>. 2024;40(8):e569-e578.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 8","pages":"e569-e578"},"PeriodicalIF":2.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906848","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 Surgery Patient Characteristics Associated With Satisfaction Scores.","authors":"Elaine M Tran, Edward E Manche","doi":"10.3928/1081597X-20240611-02","DOIUrl":"https://doi.org/10.3928/1081597X-20240611-02","url":null,"abstract":"<p><strong>Purpose: </strong>To determine factors influencing patient satisfaction scores in recipients of refractive surgery.</p><p><strong>Methods: </strong>In this prospective survey-based study, patients who had refractive surgery at an outpatient refractive clinic completed a survey of selected questions from the Press Ganey survey and the National Eye Institute Visual Function Questionnaire-25. Correlation between patient-specific variables and survey questions were assessed using Student's <i>t-</i>tests.</p><p><strong>Results: </strong>Fifty-three patients were recruited over a 3-year period. Most were male (55%) and middle aged (mean age: 34 years). Eleven percent underwent photorefractive keratectomy surgery and the rest had laser in situ keratomileusis, with no complications. Twenty-four percent of surveyed patients reported mild to moderate eye pain postoperatively, with the rest reporting no pain. All patients reported a full score for overall satisfaction.</p><p><strong>Conclusions: </strong>This study found persistent high patient satisfaction score across a variation of characteristics, suggesting that optimal scores are mainstay after refractive surgery procedures with excellent visual outcomes, independent of patient clinical and sociodemographic characteristics. <b>[<i>J Refract Surg</i>. 2024;40(8):e539-e543.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 8","pages":"e539-e543"},"PeriodicalIF":2.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906844","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":"The Eye Sick and Healthy.","authors":"Arturo Lopez Aguilar","doi":"10.3928/1081597X-20240711-01","DOIUrl":"https://doi.org/10.3928/1081597X-20240711-01","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 8","pages":"507"},"PeriodicalIF":2.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906847","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":"Correction of High Astigmatism by Autologous Astigmatic Lenticule Reshaping and Rotation.","authors":"Jianmin Shang, Xiaoying Wang, Haipeng Xu, Jia Huang, Xingtao Zhou","doi":"10.3928/1081597X-20240701-01","DOIUrl":"https://doi.org/10.3928/1081597X-20240701-01","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the use of autologous astigmatic lenticule reshaping and rotation surgery to correct high astigmatism in conjunction with excimer laser technology to correct residual refractive error.</p><p><strong>Methods: </strong>Six patients with high astigmatism (8 eyes, all with astigmatism from -5.50 to -11.00 diopters [D]) seeking refractive error correction were enrolled. The following methods were used to correct refractive errors that could not be corrected by a single conventional surgery: (1) cutting of a customized lens using FLEx technology, (2) lifting of the corneal flap and reshaping the autologous astigmatic lenticule in situ using an excimer laser, and (3) rotation of the autologous astigmatic lenticule by 90°. Uncorrected distance visual acuity, subjective refraction, corneal topography, and anterior segment optical coherence tomography were performed preoperatively and postoperatively.</p><p><strong>Results: </strong>The efficacy and safety indices at 6 months postoperatively were 0.93 ± 0.18 and 1.06 ± 0.11, respectively, the spherical equivalent remained stable and close to emmetropia (-0.13 ± 0.70 D) from 1 to 6 months postoperatively, postoperative astigmatism was generally mildly undercorrected (-1.22 ± 0.43 D), and the difference in corneal curvatures at 2 mm from the apex of the cornea was significantly reduced compared to preoperatively (<i>P</i> < .05); however, the corresponding values at 1 and 3 mm showed no difference.</p><p><strong>Conclusions: </strong>Correction of high astigmatism with autologous astigmatic lenticule reshaping and rotation surgery is tissue-sparing, predictable, and significantly improves postoperative visual acuity and quality. This method is feasible and safe, with predictability requiring further study. This novel surgical approach has potential for patients with high astigmatism that cannot be corrected by conventional refractive surgery. <b>[<i>J Refract Surg</i>. 2024;40(8):e554-e561.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"40 8","pages":"e554-e561"},"PeriodicalIF":2.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906839","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}