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Journal of Refractive Surgery

Sara Catalan-Lopez, Alba Mariña Portas-Ferradas, Luis Cadarso-Suarez, Adriana Rodriguez-Rodriguez
PURPOSE: To report the case of a residual refractive error after LASIK for moderate myopia successfully re-treated several years later using the small incision lenticule extraction (SMILE) technique. METHODS: Case report. RESULTS: Following LASIK, the patient showed a central flap thickness of 269 microns, whereas residual stromal bed thickness under the flap was 210 microns. SMILE was performed within the flap. In this less invasive surgical procedure, the residual stromal bed is not manipulated and ablation is conducted on the existing flap...
October 1, 2016: Journal of Refractive Surgery
Jing Zhao, Huamao Miao, Tian Han, Yang Shen, Yu Zhao, Ling Sun, Xingtao Zhou
PURPOSE: To evaluate the corneal morphology and surface characteristics of concave lenticules after small incision lenticule extraction (SMILE) for hyperopia. METHODS: SMILE procedures were performed on two human autopsy corneas in vitro to correct +4.00 diopters of hyperopia. Slit-lamp microscopy and anterior optical coherence tomography (OCT) were performed after lenticule creation and extraction. The extracted lenticules and modified corneas were sent for transmission electron microscopy imaging...
October 1, 2016: Journal of Refractive Surgery
Su-Yeon Kang, Youngsub Eom, Jay Won Rhim, Jong Suk Song, Hyo Myung Kim
PURPOSE: To report a case of intraocular lens (IOL) glistening after uneventful cataract surgery and in-the-bag implantation of an enVista MX60 IOL (Bausch & Lomb, Rochester, NY) in a patient with uncontrolled diabetes mellitus. METHODS: Case report. RESULTS: A 76-year-old woman with non-insulin-dependent diabetes mellitus underwent uncomplicated phacoemulsification with in-the-bag implantation of an enVista MX60 IOL. After 6 months, glistening formation within the IOL optic was observed...
October 1, 2016: Journal of Refractive Surgery
Tim Schultz, H Burkhard Dick
PURPOSE: To report a small-aperture intraocular lens (IOL) implantation after corneal trauma. METHODS: Case report. RESULTS: A 17-year-old boy with corneal scars, iris defect, and aphakia after perforating trauma in the right eye was scheduled for small-aperture IOL (IC-8; AcuFocus, Irvine, CA) implantation under general anesthesia. No intraoperative complications were observed. Six months after surgery, the uncorrected distance and near visual acuity increased significantly...
October 1, 2016: Journal of Refractive Surgery
Ronald N Gaster, J Ben Margines, David N Gaster, Xiaohui Li, Yaron S Rabinowitz
PURPOSE: To compare the visual, refractive, keratometric, topographic, and pachymetric outcomes of corneal collagen cross-linking (CXL) for progressive keratoconus following epithelial removal by transepithelial phototherapeutic keratectomy (PTK) or manual debridement. METHODS: In this analysis, 339 eyes (78% male, 22% female) that had undergone CXL following manual epithelial debridement (n = 180) or ablation via PTK (n = 159) were evaluated preoperatively and at 6, 12, and 24 months postoperatively for uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), maximum corneal keratometry, pachymetry, and spherical equivalent...
October 1, 2016: Journal of Refractive Surgery
Kenneth J Hoffer, Giacomo Savini
PURPOSE: To investigate agreement between the ocular biometry measurements provided by a newer optical biometer, the AL-Scan (Nidek Co, Ltd., Gamagori, Japan) and those provided by the IOLMaster 500 (Carl Zeiss Meditec, Jena Germany), which are both based on partial coherence interferometry. METHODS: Axial length, corneal power, and anterior chamber depth (corneal epithelium to lens) were measured in 86 eyes of 86 patients scheduled for cataract surgery using both biometers...
October 1, 2016: Journal of Refractive Surgery
Manli Liu, Jianchao Wang, Wen Zhong, Danyang Wang, Yugui Zhou, Quan Liu
PURPOSE: To evaluate the clinical results of suction loss in eyes during small incision lenticule extraction (SMILE). METHODS: This prospective paired-eye case study enrolled 8,490 eyes of 4,296 patients, of which 35 eyes experienced suction loss during the SMILE procedure while being treated for myopia or myopic astigmatism. The eyes with suction loss were re-treated with SMILE, femtosecond laser-assisted LASIK (FS-LASIK), or pseudo SMILE, and the fellow eyes were treated with SMILE...
October 1, 2016: Journal of Refractive Surgery
Ting Zhang, Yuan Sun, Shengbei Weng, Manli Liu, Yugui Zhou, Xiaonan Yang, Aleksandar Stojanovic, Quan Liu
PURPOSE: To analyze early clinical outcomes of aspheric micro-monovision LASIK for correction of presbyopia and myopia with or without astigmatism. METHODS: Prospective, non-comparative case series of 80 eyes of 40 patients with a mean age of 43.4 ± 4.9 years (range: 38 to 63 years) treated bilaterally using an aspheric micro-monovision protocol. The target refraction was plano for the distance eye and between -0.75 and -2.25 diopters (D) for the near eye. Visual acuity, ocular aberrations, contrast sensitivity, corneal topography, amplitude of accommodation, binocular sensorial function, and satisfaction score questionnaires were evaluated at 3 months after surgery...
October 1, 2016: Journal of Refractive Surgery
Paolo Vinciguerra, Vito Romano, Pietro Rosetta, Emanuela F Legrottaglie, Raffaele Piscopo, Claudia Fabiani, Claudio Azzolini, Riccardo Vinciguerra
PURPOSE: To compare 1-year transepithelial corneal collagen cross-linking with iontophoresis (I-CXL) outcomes with standard CXL (S-CXL) epithelium-off for progressive keratoconus. METHODS: Forty eyes of 40 patients with progressive keratoconus were included in this comparative, prospective clinical study. Corrected distance visual acuity (CDVA), spherical equivalent, cylinder refraction, corneal topography, Scheimpflug tomography, aberrometry, and endothelial cell count were assessed at baseline and at 1, 3, 6, and 12 months of follow-up...
October 1, 2016: Journal of Refractive Surgery
Tommy C Y Chan, Marco C Y Yu, Alex L K Ng, George P M Cheng, Jiamei Zhang, Yan Wang, Vishal Jhanji
PURPOSE: To analyze the visual and refractive outcomes of LASIK with and without simultaneous cross-linking for correction of myopia. METHODS: Patients who received femtosecond laser-assisted LASIK with and without adjunctive cross-linking according to patient's preference were examined longitudinally for 6 months. Patients with myopic manifest refraction spherical equivalent of 5.00 diopters (D) or greater and estimated residual stromal thickness of greater than 250 µm were included...
October 1, 2016: Journal of Refractive Surgery
Rafael Bilbao-Calabuig, Felix González-López, Ferrer Amparo, Gemma Alvarez, Sunni R Patel, Fernando Llovet-Osuna
PURPOSE: To investigate the visual outcomes between mix-and-match bifocal intraocular lenses (IOLs) (ReSTOR +2.50 and +3.00 diopters [D]; Alcon Laboratories, Inc., Fort Worth, TX) versus bilateral implantation of a trifocal IOL (FineVision; PhysIOL, Liège, Belgium). METHODS: Twenty-three patients (average age: 56.3 ± 6.9 years; range: 45 to 71 years) referred for lens phacoemulsification and IOL implantation were included in this study. Patients were randomly assigned to two groups...
October 1, 2016: Journal of Refractive Surgery
Malik Y Kahook, Robert J Cionni, Michael J Taravella, Robert E Ang, Aaron N Waite, Jonathan D Solomon, Harvey S Uy
PURPOSE: To compare size, circularity, and centration outcomes of continuous curvilinear capsulorhexis (CCC) performed with or without assistance from the VERUS ophthalmic caliper (Mile High Ophthalmics, Denver, CO). METHODS: This was a multicenter retrospective consecutive case controlled series review. RESULTS: Data from 40 consecutive cases using the VERUS device for CCC were compared to 40 consecutive cases with standard manual CCC. VERUS-assisted CCC size, circularity, and centration were closer to target compared to that of manual only procedures (P < ...
October 1, 2016: Journal of Refractive Surgery
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August 1, 2016: Journal of Refractive Surgery
Bu Ki Kim, Su Joung Mun, Dae Gyu Lee, Young Taek Chung
PURPOSE: To report a case of successful bilateral small incision lenticule extraction (SMILE) performed on a patient who had penetrating keratoplasty and astigmatic keratotomy in the right eye and penetrating keratoplasty in the left eye. METHODS: Case report. RESULTS: Astigmatic keratotomy was used to reduce astigmatism of the right eye because astigmatism was higher than the maximum correction limitation of SMILE. Bilateral SMILE was performed afterward...
August 1, 2016: Journal of Refractive Surgery
David Donate, Rozenn Thaëron
PURPOSE: To compare the visual outcomes with energy close to the plasma threshold and energy at the standard set-up in small incision lenticule extraction (SMILE). METHODS: This retrospective, non-randomized, consecutive clinical case series included 486 eyes of 243 patients who underwent SMILE and were subdivided into two groups depending on the laser energy settings: the standard energy group (164 eyes) using a laser cut energy index of 36 (180 nJ), and the plasma threshold group (322 eyes) using a cut energy index of 20 (100 nJ, close to plasma threshold)...
August 1, 2016: Journal of Refractive Surgery
Xiangjun Chen, Aleksandar Stojanovic, Xiaorui Wang, Jing Liang, Di Hu, Tor Paaske Utheim
PURPOSE: To evaluate corneal epithelial remodeling after topography-guided transepithelial photorefractive keratectomy (PRK) combined with corneal collagen cross-linking (CXL) in the treatment of keratoconus. METHODS: Retrospective analysis of the epithelial thickness distribution changes in 53 keratoconic eyes of 44 patients. Manifest refraction, maximum (Kmax) and minimum (Kmin) keratometry obtained by Placido topography, corneal irregularity index (IRI) measured by Scheimpflug topography, and the epithelial thickness profile over the central 5-mm zone obtained by anterior-segment spectral domain optical coherence tomography (SD-OCT) were evaluated preoperatively and at 1 to 3, 3 to 6, and more than 6 months postoperatively...
August 1, 2016: Journal of Refractive Surgery
Tamer Tandogan, Mike P Holzer, Chul Young Choi, Gerd U Auffarth, Georg Gerten, Ramin Khoramnia
PURPOSE: To conduct a material analysis of spontaneously subluxated iris-fixated phakic intraocular lenses (IOLs) using light and scanning electron microscopy. METHODS: Six explanted Artisan/Verisyse and Artiflex/Veriflex IOLs (Ophtec, Groningen, Netherlands/AMO, Santa Ana, CA) were analyzed in a laboratory using light and scanning electron microscopy. Four of the IOLs had been explanted after spontaneous subluxation leading to a decrease in visual acuity, whereas the remaining two IOLs did not demonstrate signs of disenclavation but had been explanted in the course of planned cataract surgery and thus served as the control in this study...
August 1, 2016: Journal of Refractive Surgery
José R Jiménez, Aixa Alarcón, Rosario G Anera, Luis Jiménez Del Barco
PURPOSE: To model the effect of pupil size, optical zone, and initial myopic level on the retinal image quality after Q-optimized myopic corneal refractive surgery. METHODS: Different Q-optimized and paraxial Munnerlyn algorithms were tested using a schematic myopic eye model to analyze the optical quality of the final retinal image for initial myopic errors from -1.00 to -7.00 diopters (D). Different optical zones (5.5, 6, and 6.5 mm in diameter) and two pupil diameters (5 and 7 mm, mesopic-scotopic conditions) were included in the comparison...
August 1, 2016: Journal of Refractive Surgery
Yusuf Yildirim, Onur Olcucu, Cengiz Alagoz, Abdurrahman Basci, Alper Agca, Dilek Yasa, Engin Bilge Ozgurhan, Ahmet Demirok
PURPOSE: To compare the refractive outcomes of small incision lenticule extraction (SMILE) with photorefractive keratectomy (PRK) using an aberration-free ablation profile. METHODS: One eye of patients diagnosed as having myopia for bilateral refractive correction was randomly allocated to either PRK or SMILE. The primary outcome measures included refractive efficacy, predictability, safety, stability, corneal aberrations, and adverse events. Patients were followed up for 1 year postoperatively; postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, and corneal aberrations were recorded and compared with preoperative data...
August 1, 2016: Journal of Refractive Surgery
Noel Alpins, James K Y Ong, George Stamatelatos
PURPOSE: To determine whether the flattening effect of corneal incisions differs between the right and left eye. METHODS: A retrospective study of preoperative and postoperative corneal astigmatism was performed for patients who had bilateral cataract surgery by a right-handed surgeon. The change in corneal astigmatism was attributed to the 2.2-mm phacoemulsification incision, and the incisional flattening effect was calculated. The incisions were grouped by position on the eye and whether they were performed on the preoperative steep corneal meridian...
August 1, 2016: Journal of Refractive Surgery
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