Journal of refractive and corneal surgery最新文献

{"title":"Endothelial change after excimer laser photorefractive keratectomy.","authors":"I Toda, K Tsubota, S Itoh","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79348,"journal":{"name":"Journal of refractive and corneal surgery","volume":"10 3","pages":"379"},"PeriodicalIF":0.0,"publicationDate":"1994-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18530977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal epithelial dots following excimer laser photorefractive keratectomy.","authors":"M Busin,&nbsp;D Meller","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Map-dot-fingerprint epithelial changes of the cornea have been reported to occur as a consequence of trauma or surgical procedures, such as radial keratotomy.</p><p><strong>Methods: </strong>We describe a case of dot-like changes in the corneal epithelium following excimer laser photorefractive keratectomy for the correction of myopia. Because the lesions were located centrally, possibly reducing visual acuity, the epithelium was removed mechanically.</p><p><strong>Results: </strong>Dot-like changes recurred in the same areas 4 weeks after epithelial debridement. Best spectacle-corrected visual acuity improved from 20/200 to 20/100 and remained stable thereafter.</p><p><strong>Conclusions: </strong>Photorefractive keratectomy can lead to abnormal regeneration of epithelium basement membrane, possibly resulting in dot-like changes of corneal epithelium.</p>","PeriodicalId":79348,"journal":{"name":"Journal of refractive and corneal surgery","volume":"10 3","pages":"357-9"},"PeriodicalIF":0.0,"publicationDate":"1994-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18530974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial implications of excimer laser phototherapeutic keratectomy.","authors":"M Moretti","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79348,"journal":{"name":"Journal of refractive and corneal surgery","volume":"10 3","pages":"316-7"},"PeriodicalIF":0.0,"publicationDate":"1994-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18528287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractive surgery goes mainstream: establishing radial keratotomy services at a suburban community hospital.","authors":"R J Epstein","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79348,"journal":{"name":"Journal of refractive and corneal surgery","volume":"10 3","pages":"378"},"PeriodicalIF":0.0,"publicationDate":"1994-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18529215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical behavior of the cornea and its response to radial keratotomy.","authors":"G. Simón, Q. Ren","doi":"10.3928/1081-597X-19940501-08","DOIUrl":"https://doi.org/10.3928/1081-597X-19940501-08","url":null,"abstract":"BACKGROUND\u0000Radial keratotomy reduces myopia by flattening the central cornea, but the mechanism remains a matter of controversy. In this article, we studied the biomechanical behavior of the cornea and its response to radial keratotomy.\u0000\u0000\u0000METHODS\u0000A human cadaver eye model without corneal epithelium was used in this study. We studied the effects which varying intraocular pressure (IOP) and corneal hydration would have on the keratometric power of unoperated eyes and eyes following radial keratotomy. For nonoperated eyes, first, normal corneal hydration was maintained while the IOP was varied. Second, the IOP was maintained at a constant level of 20 mm Hg while the corneal hydration was changed. The effects of separately varying the IOP and corneal hydration of postoperative eyes following an eight-incision radial keratotomy were studied in a similar fashion.\u0000\u0000\u0000RESULTS\u0000In the nonoperated eye, a very high IOP was associated with a general reduction of corneal astigmatism without significantly affecting the overall keratometric spherical equivalent refraction. A steepening change of less than 0.50 diopters (D) was obtained in all eyes when dehydrating the cornea from 700 +/- 50 microns (centrally) and 830 +/- 70 microns (peripherally), to 495 +/- 25 microns (centrally) and 655 +/- 45 microns (peripherally). Following radial keratotomy, changes in IOP within the physiological range were found to have minimal influence (< 0.50 D) on the radial keratotomy keratometric power. However, after hydrating the cornea with balanced salt solution for 30 minutes, we obtained a mean flattening of 10.00 D. When dehydrating these corneas with topical hyperosmotic solution over a period of 3.5 hours, the flattening reversed to near preoperative values. The change in keratometric power resulting from radial keratotomy was significantly modulated by varying the hydration state of the deepithelialized cornea: the greater the hydration, the flatter the central cornea; therefore, the unpredictable surgical outcomes and diurnal fluctuations observed after radial keratotomy may be affected by applying topical hyperosmotic agents.\u0000\u0000\u0000CONCLUSIONS\u0000We hypothesize that the corneal stroma is an inelastic, anisotropic, layered collagen structure that distributes tensile stress unequally throughout its thickness as a function of the amount of hydration. IOP, within physiological levels, did not have a significant effect on corneal flattening.","PeriodicalId":79348,"journal":{"name":"Journal of refractive and corneal surgery","volume":"64 1","pages":"343-51; discussion 351-6"},"PeriodicalIF":0.0,"publicationDate":"1994-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70145514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endothelial change after excimer laser photorefractive keratectomy.","authors":"I. Toda, K. Tsubota, S. Itoh","doi":"10.3928/1081-597X-19940501-15","DOIUrl":"https://doi.org/10.3928/1081-597X-19940501-15","url":null,"abstract":"","PeriodicalId":79348,"journal":{"name":"Journal of refractive and corneal surgery","volume":"10 3 1","pages":"379"},"PeriodicalIF":0.0,"publicationDate":"1994-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70145623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal ectasia as a complication of repeated keratotomy surgery.","authors":"K L Wellish,&nbsp;B J Glasgow,&nbsp;F Beltran,&nbsp;R K Maloney","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Staged keratotomy surgery, or \"enhancement surgery,\" may allow a more predictable outcome, but also subjects the patient to additional surgical risks.</p><p><strong>Methods: </strong>A 39-year-old man underwent astigmatic keratotomy for myopic astigmatism, followed by 12 enhancement procedures for residual astigmatism.</p><p><strong>Results: </strong>These procedures effectively resulted in a double hexagonal keratotomy. The patient's best spectacle-corrected acuity deteriorated to counting fingers. Clinically, a conically-shaped protrusion of the central cornea, Munson's sign, diffuse subepithelial scarring, and central corneal thinning were noted. Penetrating keratoplasty was performed. Histopathologic examination showed central thinning, epithelial edema, disruption of Bowman's layer, marked stromal scarring, and focal areas of endothelial attenuation--findings consistent with keratoconus.</p><p><strong>Conclusion: </strong>This case illustrates that multiple keratotomy procedures may result in corneal ectasia in apparently normal eyes and suggests that hexagonal keratotomy may be more likely to cause iatrogenic keratoconus.</p>","PeriodicalId":79348,"journal":{"name":"Journal of refractive and corneal surgery","volume":"10 3","pages":"360-4"},"PeriodicalIF":0.0,"publicationDate":"1994-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18530972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractive stability after cataract extraction using a 6.5-millimeter scleral pocket incision with horizontal or radial sutures.","authors":"T. Werblin","doi":"10.3928/1081-597X-19940501-07","DOIUrl":"https://doi.org/10.3928/1081-597X-19940501-07","url":null,"abstract":"BACKGROUND\u0000Radial suturing of 6.5-millimeter scleral tunnel incisions following cataract surgery can create significant with-the-rule astigmatism in the immediate postoperative period. Because of the significant visual distortion and slow visual recovery seen with radial suturing, this study was undertaken to compare two other suturing techniques which induce lesser amounts of with-the-rule astigmatism in the immediate postoperative period.\u0000\u0000\u0000METHODS\u0000The refractive behavior of eyes closed with loose radial sutures and with horizontal sutures was compared to the behavior of eyes closed with the more traditional \"tight\" radial sutures following phacoemulsification surgery.\u0000\u0000\u0000RESULTS\u0000Eyes sutured with loosely tied radial sutures demonstrated minimal with-the-rule cylinder immediately following surgery (1.25 D) and showed a more rapid stabilization of astigmatism than did the eyes tied with tight radial sutures, 2 months versus up to 6 months. However, the eyes tied with horizontal sutures, which showed no induced with-the-rule astigmatism at the time of surgery, showed even more rapid stabilization between 5 days and 1 month from the time of surgery.\u0000\u0000\u0000CONCLUSION\u0000To get the most rapid visual rehabilitation following cataract surgery, a wound closure which generates no induced with-the-rule cylinder such as horizontal sutures would be required.","PeriodicalId":79348,"journal":{"name":"Journal of refractive and corneal surgery","volume":"10 3 1","pages":"339-42"},"PeriodicalIF":0.0,"publicationDate":"1994-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70145469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of night vision disturbances.","authors":"G J Florakis,&nbsp;D A Jewelewicz,&nbsp;H E Michelsen,&nbsp;S L Trokel","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Evaluation of night vision disturbances has relied on subjective responses. We designed a test to more objectively measure night vision disturbances.</p><p><strong>Methods: </strong>The test consisted of projecting a small circle onto a visual acuity screen. The patient is asked to draw exactly what he sees on an Amsler grid. We evaluated 118 eyes in photopic and scotopic conditions and under different conditions of refractive correction.</p><p><strong>Results: </strong>Image degradation increased in scotopic conditions for myopes (p = .0001), hyperopes (p = .005), and emmetropes (p = .01). Myopic refractive error correlated with size of glare response (p = .001). Astigmatism correlated with decentration of glare response (p = .0001). Decentration increased in scotopic compared to photopic conditions (p = .002).</p><p><strong>Conclusion: </strong>Our test offers a simple, convenient way to evaluate night vision disturbances and may offer a means of assessing night vision disturbances in patients considering refractive surgery.</p>","PeriodicalId":79348,"journal":{"name":"Journal of refractive and corneal surgery","volume":"10 3","pages":"333-8"},"PeriodicalIF":0.0,"publicationDate":"1994-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18528291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal epithelial dots following excimer laser photorefractive keratectomy.","authors":"M. Busin, D. Meller","doi":"10.3928/1081-597X-19940501-09","DOIUrl":"https://doi.org/10.3928/1081-597X-19940501-09","url":null,"abstract":"BACKGROUND\u0000Map-dot-fingerprint epithelial changes of the cornea have been reported to occur as a consequence of trauma or surgical procedures, such as radial keratotomy.\u0000\u0000\u0000METHODS\u0000We describe a case of dot-like changes in the corneal epithelium following excimer laser photorefractive keratectomy for the correction of myopia. Because the lesions were located centrally, possibly reducing visual acuity, the epithelium was removed mechanically.\u0000\u0000\u0000RESULTS\u0000Dot-like changes recurred in the same areas 4 weeks after epithelial debridement. Best spectacle-corrected visual acuity improved from 20/200 to 20/100 and remained stable thereafter.\u0000\u0000\u0000CONCLUSIONS\u0000Photorefractive keratectomy can lead to abnormal regeneration of epithelium basement membrane, possibly resulting in dot-like changes of corneal epithelium.","PeriodicalId":79348,"journal":{"name":"Journal of refractive and corneal surgery","volume":"9 1","pages":"357-9"},"PeriodicalIF":0.0,"publicationDate":"1994-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70145524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}