Keratotomy

AIMS: To compare the refractive and visual outcomes of femtosecond laser-assisted astigmatic keratotomy (FSAK) and toric intraocular lens (IOL) implantation for correcting astigmatism in cataract patients. METHODS: Studies were retrieved from the Ovid-Medline, EMBASE, Cochrane Central Register of Controlled Trials and Scopus which compared FSAK and toric IOL for astigmatism correction in cataract patients. Outcome measures included postoperative refractive cylinder, correction index, uncorrected distance visual acuity (UDVA), the proportion of patients achieving a residual refractive cylinder of 1...

PURPOSE: To report a case of ulcerative keratopathy following implantation of acellular porcine corneal stroma (APCS) in a patient with keratoconus (KC). METHODS: A 58 year-old patient initially presented with an ulcerative keratopathy in the left eye. Previously, several corneal procedures (including radial keratotomy, laser-in-situ keratomileusis, crosslinking) were performed for KC. Eight months ago, an APCS lenticule (Xenia corneal implant, Gebauer Medizintechnik GmbH, Neuhausen, Germany) was implanted into a stromal pocket because of progressive keratectasia...

PURPOSE: To describe a novel treatment for dissolving calcareous corneal degeneration (CCD)-associated mineral in 17 dogs with 13.8% ethylenediaminetetraacetic acid (EDTA) solution. METHODS: Cases seen between 2021 and 2023 were reviewed. Seventeen dogs with CCD associated with corneal ulcerations were treated with a mineral dissolution procedure using 13.8% EDTA solution. A diamond burr keratotomy (DBK) was subsequently performed in some cases when residual mineralization remained present...

Laser vision correction for residual refractive errors in patients with previous radial keratotomy (RK) presents a challenging task. Different techniques have been used with varying outcomes. This study aimed to systematically review published manuscripts on refractive surgeries in post-RK patients search in PubMed, Scopus, and Web of Science. The final analysis included 35 studies that described a total of 888 eyes. Our systematic review and meta-analysis demonstrated a significant improvement in uncorrected distance visual acuity (UDVA) for photorefractive keratectomy, topography-guided-PRK, wavefront-guided-PRK, and femtosecond- laser-assisted in situ keratomileusis (LASIK), while mechanical microkeratome LASIK did not yield such significant improvements...

PURPOSE: The study aims to assess if Zone 1 globe injuries hold a favorable prognosis for all situations, including wound dehiscence, or just primary traumatic injuries. METHODS: Retrospective cross-sectional chart review of patients who underwent open globe repair from 1/1/2019 to 12/1/2020 at an urban hospital setting was evaluated for final visual outcomes, associated ocular pathology, long-term complications, and need for further surgeries. RESULTS: Fifty-eight eyes were identified-38 primary trauma and 20 dehisced wounds (11 penetrating keratoplasties, five clear corneal incisions, one laceration, one extracapsular cataract extraction, one radial keratotomy, and one tectonic graft)...

Femtosecond laser-assisted arcuate keratotomy (FSAK) is an effective, long-term stable, and safe surgical procedure for astigmatism correction. Its application in cataract surgery and the correction of astigmatism combined with cataracts is becoming increasingly widespread. Apart from its application in key steps of cataract surgery, both domestic and international research indicates that the introduction of femtosecond laser technology has enhanced the precision of arcuate incisions in keratotomy, reducing the risk of intraoperative or postoperative complications...

PURPOSE: The aim of this study was to evaluate outcomes using total corneal astigmatism (TCA) to calculate arcuate keratotomy(ies) (AK) parameters performed with femtosecond laser-assisted cataract surgery to reduce low corneal astigmatism. METHODS: Patients who had femtosecond laser-assisted cataract surgery and AK with 0.50 diopter (D) to 1.30 D of TCA were included. Exclusion criteria were intraoperative complications, preexisting corneal surgery, and comorbidities that might adversely affect outcomes...

In this review, we presented the principles of radial keratotomy (RK), its evolution, enhancement, and complications, and strategies to manage the consequences of RK in the present day. It is essential to understand the RK procedure f, the theoretical background that supported this surgery, the current effect on the cornea, and how to approach patients needing vision improvement. These patients are developing cataracts that need to be handled well, from the IOL calculation to the surgical procedure. Guided keratorefractive surgery is the most accurate procedure to improve these patient's vision and life...

Corneal alterations due to radial keratotomy (RK) complicate intraocular lens calculations, which may explain why there have been few reports of toric intraocular lens (TIOL) implantation after excessive or multiple operations. A 71-year-old male with a history of repeated RKs and at least 30 corneal incisions in each eye was referred for cataract surgery. Preoperatively, the best-corrected distance visual acuity was 0.7 decimal (0.15 logMAR) in the right eye and 0.9 decimal (0.05 logMAR) in the left eye. The refractive errors were -8...

AIM: To evaluate the effect of symmetrical arc incision correcting corneal astigmatism in femtosecond laser-assisted phacoemulsification (FLACS). METHODS: This study enrolled patients with cataract combined with regular corneal astigmatism of >0.75 D, who underwent FLACS. Symmetrical arc incision was set at 8 mm diameter and 85% depth. The follow-up time was 3-24mo (4.92±3.49mo). Pentacam recorded the corneal astigmatism and higher-order aberration at pre-operation and post-operation...

PURPOSE: To analyze different tomographic and refractive parameters for predicting successful visual outcome following femtosecond laser-assisted arcuate keratotomy (FSAK) for post-keratoplasty astigmatism. DESIGN: Retrospective. METHODS: Retrospective study evaluating patients with astigmatism following penetrating keratoplasty (PKP) or deep anterior lamellar keratoplasty (DALK) who underwent FSAK. Vector analysis using the Alpins method was done to calculate surgically induced astigmatism (SIA)...

Femtosecond laser (FSL) applications in corneal surgery have increased since its inception. Corneal surgery has undergone a tremendous transformation thanks to the introduction of FSL technology. This laser makes precise, three-dimensional incisions while causing minimal damage to surrounding tissue. This review updates and summarizes current and upcoming FSL applications in corneal surgery, current commercially available FSL, and its respective applications. Refractive surgery applications include laser in-situ keratomileusis flaps, refractive corneal lenticule extraction such as small incision lenticule extraction, astigmatic keratotomy, intracorneal ring segments tunnels for keratoconus including corneal allogenic intrastromal ring segments, and presbyopia treatments with intrastromal pockets for corneal inlays and intrastromal incisions (INTRACOR)...

PURPOSE: To evaluate the outcome of sequential customized therapeutic keratectomy (SCTK) in reducing higher order aberrations (HOAs) and improving quality of vision in highly aberrated corneas consequent to previous radial keratotomy (RK). METHODS: A retrospective review of patients undergoing SCTK treatment from January 2012 to October 2020 was conducted in the Eye Center, Humanitas Clinical and Research Center (Rozzano, Italy). Indications for treatment in patients who had RK were significantly and/or progressively reduced corrected distance visual acuity (CDVA) combined with visual symptoms critically affecting quality of life...

Laser refractive surgery (LRS) is a specialized surgical discipline within ophthalmology that focuses on vision correction via laser techniques. LRS requires a high rate of accuracy and exactitude to improve the visual outcome and minimize complications, which may lead to delayed visual recovery. Keratitis, either infectious or noninfectious, is a post-LRS complication that requires early diagnosis and proper interventional measures. In this narrative review, we summarize different aspects of keratitis following LRS...

PURPOSE: To compare the accuracy of formulas for calculating intraocular lens power in eyes after myopic laser refractive surgery or radial keratotomy. DESIGN: Bayesian network meta-analysis. METHODS: PubMed, EMBASE, the Cochrane Data Base of Systematic Reviews, and the Cochrane Central Register of Controlled Trials databases were searched for retrospective and prospective clinical studies published from Jan 1, 2012 to Aug 24, 2022. The outcome measurement was the percentage of eyes with a predicted error within the target refractive range (± 0...

Even after a successful corneal transplant, patients experience severe refractive errors, impeding their rehabilitation and satisfaction. Refractive errors can be caused by recipient pathology and corneal thickness, as well as intraoperative factors such as donor-host discrepancy, recipient's eccentric trephination, vitreous length, wound apposition, technique of suturing, and suture material. Also, wound healing and the interim between keratoplasty and suture removal contribute to astigmatism. Lamellar keratoplasty outperforms penetrating keratoplasty in terms of endothelial cell loss and endothelial graft rejection, yet the risk of developing refractive errors is comparable...

PURPOSE: We evaluate the reduction of corneal astigmatism and the improvement of visual outcomes of this surgical method in the Indonesian population. We also assess the accuracy and predictability of using femtosecond laser astigmatic keratotomy (FLAK) combined with cataract surgery. PATIENTS AND METHODS: In a retrospective study, a total of 275 subjects (78 with against-the-rule (ATR) astigmatism, 178 with with-the-rule (WTR) astigmatism, and 19 with oblique (OBL) astigmatism) with preexisting corneal astigmatism ranging from 0...

PURPOSE: To compare the efficacy of femtosecond laser-assisted arcuate keratotomy (FSAK) combined with non-toric intraocular lens (IOL) implantation versus Toric IOL (TIOL) implantation in correcting corneal astigmatism in cataract patients. METHODS: Relevant literature was searched in databases including PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and SinoMed. Data from the included studies were extracted. A meta-analysis was conducted to compare the correction performance of FSAK combined with non-toric IOL implantation and TIOL implantation using postoperative refractive astigmatism, correction index, and uncorrected distance visual acuity (UDVA) outcomes...

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PURPOSE: To describe an approach using sequential excimer laser ablation of the stromal surface of the corneal flap with or without subsequent excimer ablation to the stromal bed to reduce presbyopic inlay-associated corneal haze. METHODS: Twelve patients who underwent KAMRA inlay (Acufocus) explantation due to corneal haze were included. The mean interval between explantation and the primary surgery (phototherapeutic keratotomy [PTK] to corneal flap) was 16.2 ± 29...