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Lasik Ectasia

Ying Wu, Lei Tian, Li-Qiang Wang, Yi-Fei Huang
This was a prospective controlled clinical trial. 48 myopia patients (96 eyes) were included in this study. After LASIK, accelerated corneal collagen cross-linking (ACXL) was used for myopia treatment. During 6-month follow-up, the results of LASIK-ACXL treatment were studied and compared to the LASIK-only procedure. The results showed that no statistically significant differences in UDVA, CDVA, MRSE, K mean, pachymetry, or ECD were found between the two groups at the visit after 6 months of follow-up (all P > 0...
2016: BioMed Research International
William Joseph Dupps, Ibrahim Seven
PURPOSE: To investigate biomechanical strain as a structural susceptibility metric for corneal ectasia in a large-scale computational trial. METHODS: A finite element modeling study was performed using retrospective Scheimpflug tomography data from 40 eyes of 40 patients. LASIK and PRK were simulated with varied myopic ablation profiles and flap thickness parameters across eyes from LASIK candidates, patients disqualified for LASIK, subjects with atypical topography, and keratoconus subjects in 280 simulations...
August 2016: Transactions of the American Ophthalmological Society
Alain Saad, Damien Gatinel
PURPOSE: To evaluate the accuracy of a new objective method based on Placido disk-derived data for the detection of eyes at risk of ectasia. METHODS: One hundred nineteen eyes of 176 patients were included and separated into two groups, normal and forme fruste keratoconus (FFKC), using automated corneal classification software. Normal eyes (n = 114) were classified as negative for keratoconus and keratoconus suspect and had undergone LASIK with unremarkable follow-up for 4 years...
August 1, 2016: Journal of Refractive Surgery
Milorad Milivojević, Vladimir Petrović, Miroslav Vukosavljević, Ivan Marjanović, Mirko Resan
BACKGROUND/AIM: Enlargement of optical zone (OZ) diameter during laser in situ keratomileusis (LASIK) correction of myopia postoperatively improves the optical outcome, however, it also leads to the increased stroma tissue consumption--progressive corneal thinning. The aim of this investigation was to present the possibility of safe OZ enlargement without impairing the structural stability of the cornea, while obtaining an improved optical outcome with LASIK treatment of short-sightedness...
June 2016: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
Albert Y Cheung, David G Heidemann
PURPOSE: To report a case of globe rupture in a patient with post-laser in situ keratomileusis (LASIK) ectasia after blunt trauma. METHODS: Observational case report. RESULTS: A 42-year-old man with a history of post-LASIK ectasia sustained paracentral corneal rupture secondary to blunt trauma from a fist to his left eye (OS). Slit-lamp examination revealed rupture in the posterior stroma (inferior paracentral) of the OS with an overlying intact LASIK flap; however, the inferior edges of the LASIK flap were Seidel positive...
July 27, 2016: Cornea
Sophia Z Mian, Joshua S Agranat, Deborah S Jacobs
OBJECTIVES: To report experience with Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) treatment for complications after laser in situ keratomileuisis (LASIK). METHODS: Retrospective review of clinical and manufacturing records. A database of patients who underwent PROSE treatment from 1992 to 2007 was searched to yield all patients with history of LASIK. Primary indication for PROSE treatment and year of LASIK is reported as well as history of contact lens intolerance and pretreatment and posttreatment best-corrected visual acuity (BCVA)...
July 27, 2016: Eye & Contact Lens
Prema Padmanabhan, Sudhir Rachapalle Reddi, Poornima Devi Sivakumar
PURPOSE: To report the refractive, topographic, tomographic, and aberrometric characteristics of post-LASIK ectasia; to compare these characteristics with normal post-LASIK controls; and to propose a comprehensive system to grade the severity of post-LASIK ectasia. METHODS: The refraction, corrected distance visual acuity (CDVA), magnitude, and location of the steepest and thinnest point on the cornea, the highest anterior and posterior surface elevation, the radius of best fit sphere, corneal asphericity, and corneal aberrations were measured in 50 eyes of 29 patients with post-LASIK ectasia...
July 6, 2016: Optometry and Vision Science: Official Publication of the American Academy of Optometry
M El-Husseiny, L Daas, A Langenbucher, B Seitz
BACKGROUND AND PURPOSE: Implantation of intracorneal ring segments (ICRS) using a femtosecond laser is a minimally invasive procedure which represents a reliable option to widen the spectrum of the stage-related therapy of keratoconus in patients with contact lens intolerance, or with post-LASIK-keratectasia or pellucide marginale degeneration (PMD). METHODS: From August 2011 to September 2015, 84 eyes of 69 patients were implanted with ICRS. 74 eyes were implanted with INTACS-SK (Intacs, Addition Technology, Inc...
June 2016: Klinische Monatsblätter Für Augenheilkunde
Reena Dave, David P S O'Brart, Vijay K Wagh, Wei S Lim, Parul Patel, Jennifer Lee, John Marshall
PURPOSE: To assess the long-term efficacy and safety of hyperopic laser in situ keratomileusis (LASIK). SETTING: Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom. DESIGN: Prospective cohort study. METHODS: Hyperopic LASIK was performed using a mechanical microkeratome, an optical zone of 6.5 mm, and a blend zone of 1.5 mm. Simple hyperopia was treated. RESULTS: The mean patient age was 51...
May 2016: Journal of Cataract and Refractive Surgery
Minoru Tomita
PURPOSE OF REVIEW: The purpose is to review the literature of combined laser in-situ keratomileusis (LASIK) and accelerated corneal collagen cross-linking (CXL) in context of its indications-contraindications, kerato-refractive, visual and safety outcomes, particularly with reference to preventing the development of post-LASIK ectasia. RECENT FINDINGS: LASIK + accelerated CXL has been developed with the rationale that the addition of CXL after LASIK may strengthen the LASIK compromised corneal biomechanics and minimize the complications such as post-LASIK ectasia...
July 2016: Current Opinion in Ophthalmology
Marcony R Santhiago, Natalia T Giacomin, David Smadja, Samir J Bechara
This review outlines risk factors of post-laser in situ keratomileusis (LASIK) ectasia that can be detected preoperatively and presents a new metric to be considered in the detection of ectasia risk. Relevant factors in refractive surgery screening include the analysis of intrinsic biomechanical properties (information obtained from corneal topography/tomography and patient's age), as well as the analysis of alterable biomechanical properties (information obtained from the amount of tissue altered by surgery and the remaining load-bearing tissue)...
2016: Clinical Ophthalmology
David Tabibian, Cosimo Mazzotta, Farhad Hafezi
BACKGROUND: Corneal cross-linking (CXL) using ultraviolet light-A (UV-A) and riboflavin is a technique developed in the 1990's to treat corneal ectatic disorders such as keratoconus. It soon became the new gold standard in multiple countries around the world to halt the progression of this disorder, with good long-term outcomes in keratometry reading and visual acuity. The original Dresden treatment protocol was also later on used to stabilize iatrogenic corneal ectasia appearing after laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK)...
2016: Eye and Vision (London, England)
Allan Luz, Bernardo Lopes, Marcela Salomão, Renato Ambrósio
Ectasia after refractive surgery represents a major concern among refractive surgeons. Corneal abnormalities and preexisting corneal ectasia are the most important risk factors. Corneal topography and central corneal thickness are the factors traditionally screening for in refractive surgery candidates. Study of the anterior surface by Placido topography allows for identification of keratoconus before biomicroscopy. However, this is insufficient for the evaluation of pre-operative refractive surgery. There are cases of ectasia after laser in situ keratomilusis (LASIK) without identifiable risk factors such that there is a need to go beyond the corneal surface...
May 2016: Journal of Biophotonics
Afrim Shabani, Minir Asani, Gazmend Kaçaniku, Valbon Ajazaj, Ermal Dida, Pajtim Lutaj
PURPOSE: In this study, we have researched the possible parametrically changes before and after LASIK (laser-assisted in situ keratomileusis) and the influence of these changes in the cause of post LASIK ectasia. MATERIALS AND METHODS: In this study 204 eyes with different refractive anomalies were included. Candidates that underwent refractive surgery first have to undergo many ophthalmological examinations, firstly by evaluating their visual acuity, subjective and objective refraction with and without cycloplegia, slight lamp evaluation, computerized topography, pupillometry, retina examination and measurement of intraocular pressure...
December 2015: Acta Informatica Medica: AIM
Vincent Qin, Alain Saad, Damien Gatinel
PURPOSE: To report a case of iatrogenic unilateral post-LASIK corneal ectasia with contralateral spontaneous ectatic evolution. METHODS: Case report with preoperative and postoperative measurements including uncorrected visual acuity, corrected distance visual acuity, refraction, slit-scanning topographic and pachymetric maps, and differential maps. RESULTS: Six months after unilateral LASIK, the operated eye progressively developed signs of post-LASIK ectasia with increased inferior corneal steepening and corneal thinning and decrease in corrected distance visual acuity...
February 2016: Journal of Refractive Surgery
Theo G Seiler, Isaak Fischinger, Tobias Koller, Viktor Derhartunian, Theo Seiler
PURPOSE: To determine the safety of superficial corneal crosslinking after laser in situ keratomileusis (LASIK). SETTING: Institut für Refraktive und Ophthalmo-Chirurgie, Zurich, Switzerland. DESIGN: Prospective study. METHODS: Eyes with an ectasia risk score of 2 or higher were treated with standard LASIK (90 μm flap) for myopia correction, after which a rapid corneal crosslinking was performed in the interface (riboflavin 0...
October 2015: Journal of Cataract and Refractive Surgery
T Kohnen, M Remy
Techniques available for corneal lamellar refractive surgery are laser-assisted in situ keratomileusis (LASIK) using a microkeratome or femtosecond laser incision followed by excimer laser corneal ablation, and femtosecond laser-assisted refractive lenticule extraction (ReLEx). These treatments are nowadays considered to be safe and effective standard procedures for surgical correction of mild to moderate ametropia. Possible complications include too small or decentered optical zones, intraoperative flap cutting errors and postoperative inflammation (e...
December 2015: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Tamer Adel Refai
INTRODUCTION: Apical protrusion in the central 4-mm ring in the Scheimflug imaging (Pentacam), both for the anterior and posterior floats as well as Corneal Hysteresis and Corneal Resistance Factor by Ocular Response Analyzer (ORA), generally are considered important predictors for post-Lasik ectasia. The aim of this work was to find out if there is a statistically significant correlation between these different predictors and their correlation with the central corneal thickness for refractive non-keratoconic Egyptian patients trying to achieve a better decision and avoiding ectasia...
October 2015: Electronic Physician
Marcony R Santhiago, David Smajda, Steven E Wilson, J Bradley Randleman
PURPOSE: To evaluate the contribution of flap thickness and ablation depth to the percentage of tissue altered (PTA) (flap thickness plus ablation depth divided by central corneal thickness) in determining the risk for ectasia after laser in situ keratomileusis (LASIK). SETTING: University of São Paulo, São Paulo, Brazil; Cleveland Clinic, Cleveland, Ohio, and Emory Vision at Emory University, Atlanta, Georgia, USA. DESIGN: Retrospective comparative study...
November 2015: Journal of Cataract and Refractive Surgery
Larissa Rossana Souza Stival, Belquiz R do Amaral Nassaralla, Marisa Novaes Falleiro Chaves de Figueiredo, Frederico Bicalho, João Jorge Nassaralla Junior
PURPOSE: To evaluate the clinical outcomes of intrastromal corneal ring segment (ICRS) implantation to correct ectasia in eyes with prior refractive surgery. METHODS: Forty-one eyes of 25 patients (13 men, 12 women; mean age, 28.66 years) with ectasia after refractive surgery [photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK)] were included in a nonrandomized, retrospective, observational case series. Corneal tunnels were created by mechanical dissection in all eyes...
July 2015: Arquivos Brasileiros de Oftalmologia
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