Journal of refractive surgery最新文献

{"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":"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":"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":"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":"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":"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":"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}

{"title":"Pharmacological Accommodative Changes of Haptic Position and Its Impact on Vault After ICL Implantation.","authors":"Meipan Shi, Ruoyan Wei, Xingtao Zhou, Shengtao Liu","doi":"10.3928/1081597X-20241126-02","DOIUrl":"10.3928/1081597X-20241126-02","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate dynamic changes in ciliary parameters and Implantable Collamer Lens V4C (ICL) (STAAR Surgical) haptic position using mydriatic and miotic agents and their effects on the central and peripheral vault.</p><p><strong>Methods: </strong>This study involved 80 eyes from 40 consecutive patients (mean age: 28.05 years; range: 19 to 42 years) examined 3 months after ICL implantation. Patients were randomly assigned to either a mydriasis group or a miosis group. Ultrasound biomicroscopy was used to measure the following parameters at baseline and after pharmacological induction with tropicamide or pilocarpine: ciliary process length (CPL), iris ciliary angle (ICA), final tip point of the ICL haptic (ftICL haptic), central vault (c-vault), mid-peripheral vault (m-vault), and peripheral vault (p-vault).</p><p><strong>Results: </strong>In the mydriatic group, the proportion of eyes with all ICL haptics in the ciliary sulcus increased from 70.0% to 77.5% after tropicamide administration, whereas in the miotic group, this proportion decreased from 67.5% to 57.5% after pilocarpine administration. The CPL and ftICL haptic increased significantly in the mydriatic group (all <i>P</i> < .01) but decreased in the miotic group (all <i>P</i> < 0.01). Conversely, the ICA decreased significantly in the mydriatic group and increased in the miotic group (all <i>P</i> < .01). The correlation analysis showed no significant relationship between changes in c-vault, m-vault, and p-vault with alterations in CPL, ICA, and ftICL haptic in both groups.</p><p><strong>Conclusions: </strong>Haptic position contributes to the movement of the ICL optical zone during accommodation, but changes in haptic position were not significantly correlated with changes in the vault. <b>[<i>J Refract Surg</i>. 2025;41(1):e22-e28.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 1","pages":"e22-e28"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950615","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":"Clarification of Femtosecond Laser Terminology: Energy, Fluence, Dose.","authors":"Holger Lubatschowski, Jodhbir S Mehta","doi":"10.3928/1081597X-20241120-02","DOIUrl":"https://doi.org/10.3928/1081597X-20241120-02","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 1","pages":"e2-e4"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950593","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 Stromal Lenticule Rotation for High Astigmatism Correction.","authors":"Pavel Stodulka, Eva Randárová, Martin Slovák, Martin Šramka","doi":"10.3928/1081597X-20241030-02","DOIUrl":"https://doi.org/10.3928/1081597X-20241030-02","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical outcome of laser-assisted surgical correction of high hyperopic or mixed astigmatism using small incision intrastromal lenticule rotation (SMILERO) alone or combined with photorefractive keratectomy (PRK).</p><p><strong>Methods: </strong>This retrospective case series enrolled 25 eyes with high astigmatism that underwent SMILERO surgery. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), manifest refraction, central corneal thickness, and corneal higher order aberrations were analyzed before surgery and after 3, 6, and 12 months of follow-up. The postoperative residual refractive errors were fine-tuned using PRK.</p><p><strong>Results: </strong>The median absolute preoperative cylinder of 4.50 diopters (D) decreased to 1.25 D at 3 months postoperatively. The lenticule rotation improved UDVA (0.80 vs 0.45 logMAR) due to a noticeable myopic shift. Regarding UNVA, 14 of 24 eyes were capable of reading Jaeger number 1 chart postoperatively in comparison to one eye preoperatively. The lenticule rotation led to successful correction of both astigmatic and spherical components in 13 of 25 eyes. The residual refractive errors in 12 of 25 eyes were fine-tuned postoperatively by PRK. The SMILERO and PRK combination led to a satisfactory refractive outcome with median absolute cylinder of 0.75 D, median spherical equivalent of -0.25 D, and median UDVA of 20/40 Snellen equivalent at 12 months postoperatively.</p><p><strong>Conclusions: </strong>This study demonstrates that SMILERO is capable of correcting both corneal and refractive astigmatism with mid-term corneal stability. The residual refractive errors were further minimized with subsequent PRK fine-tuning. <b>[<i>J Refract Surg</i>. 2025;41(1):e5-e13.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 1","pages":"e5-e13"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950603","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}