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refractive surgery in high risk cases

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
Hui-Juan Xia, Wei-Jun Wang, Feng'E Chen, Ying Wu, Zhen-Yuan Cai, Wei Chen, Su-Qin Yu, Ying Fan
Objective. To observe the fellow eye in patients undergoing surgery on one eye for treating myopic traction maculopathy. Methods. 99 fellow eyes of consecutive patients who underwent unilateral surgery to treat MTM were retrospectively evaluated. All patients underwent thorough ophthalmologic examinations, including age, gender, duration of follow-up, refraction, axial length, intraocular pressure, lens status, presence/absence of a staphyloma, and best-corrected visual acuity (BCVA). Fundus photographs and SD-OCT images were obtained...
2016: Journal of Ophthalmology
Mehrdad Mohammadpour, Hassan Hashemi, Mahmoud Jabbarvand, Kamran Rahmatnejad, Fatemeh Alsadat Sabet
PURPOSE: To evaluate the efficacy of photorefractive keratectomy (PRK) using the advanced personalized treatment (APT) nomogram for correction of moderate to high astigmatism. METHODS: This prospective interventional case series included 60 consecutive eyes of 30 patients undergoing wavefront-guided PRK (Zyoptix 217 Z100 excimer laser, Bausch & Lomb, Munich, Germany) using the APT nomogram and iris registration for myopic astigmatism. Mitomycin-C was applied intraoperatively in all eyes...
April 2016: Journal of Ophthalmic & Vision Research
Zeeshan Haq, Asim V Farooq, Andrew J W Huang
PURPOSE OF REVIEW: The purpose of the review is to provide a summary of the recent literature concerning infections after refractive surgery pertinent to each procedure category. RECENT FINDINGS: New data from a large retrospective study suggest that the incidence of post-laser assisted in-situ keratomileusis infectious keratitis is declining. Additionally, recent case studies have reported viral, fungal, and Acanthamoeba pathogens. Corneal collagen cross-linking is emerging as an alternative therapeutic option for early stage post-LASIK infectious keratitis...
July 2016: Current Opinion in Ophthalmology
Zi Ye, Zhaohui Li, Shouzhi He, Bing Chen, Xiaojuan Xing, Chunyan Ren
PURPOSE: The surgical risk and complication rate after cataract surgery are extremely high in patients with nanophthalmos. This study is designed to compare the visual and refractive outcomes before and after coaxial micro-incision phacoemulsification and evaluate postoperative complications. METHODS: Fifty nine patients (89 eyes) with axial length (AL) < 21 mm diagnosed with nanophthalmos were enrolled in this retrospective study. All patients underwent coaxial micro-incision phacoemulsification and IOL implantation...
September 2015: Eye Science
Preeti Mohanty, Vishnu Vahan Prasan, U Vivekanand
PURPOSE: A retrospective study aimed to evaluate high risk cases where conventional Extracapsular cataract extraction (ECCE) was performed, their intra-operative and post-operative outcomes. SETTING: Sri Srinivasa Sankara Nethralaya (Tirupati) Tirumala Tirupati Devastanams Central Hospital, Tirupati, India. SUBJECTS AND METHODS: Retrospective study of 207 patients who underwent ECCE at the hospital between august 2010 to June 2012. Operative data included details like grade of risk, intra and postoperative complications and visual outcome...
September 2015: Oman Journal of Ophthalmology
Servet Cetinkaya, Nursen Oncel Acir, Yasemin Fatma Cetinkaya, Zeynep Dadaci, Halil İbrahim Yener, Faik Saglam
PURPOSE: To evaluate the outcomes and complications following phacoemulsification surgery in eyes with cataract and high myopia. METHODS: We retrospectively evaluated the data of 43 eyes of 28 consecutive patients (12 males, 16 females) with cataract and high myopia who had undergone phacoemulsification and intraocular lens (IOL) implantation. The mean [± standard deviation (range)] age of the patients was 59.20 ± 11.08 (39-77) years. RESULTS: The frequency of nuclear cataract was significantly higher than that of other cataract types (P=0...
September 2015: Arquivos Brasileiros de Oftalmologia
Ling Shen, Ronald B Melles, Ravikanth Metlapally, Lisa Barcellos, Catherine Schaefer, Neil Risch, Lisa J Herrinton, Christine Wildsoet, Eric Jorgenson
PURPOSE: To evaluate the association between refractive error and the prevalence of glaucoma by race or ethnicity. DESIGN: Cross-sectional study. PARTICIPANTS: Kaiser Permanente Northern California Health Plan members with refractive error measured at 35 years of age or older between 2008 and 2014 and with no history of cataract surgery, refractive surgery, or a corneal disorder. METHODS: We identified 34 040 members with glaucoma or ocular hypertension (OHTN; cases) and 403 398 members without glaucoma (controls)...
January 2016: Ophthalmology
M Kohlhaas
Iatrogenic corneal ectasia is a rare complication but also one of the most feared situations that can occur after uneventful corneal laser surgery. Ectatic changes can occur as early as 1 week or can be delayed up to several years after LASIK. The actual incidence of ectasia is undetermined, an incidence rate of 0.04 to almost 2.8 % has been reported. Ectasia is most common following LASIK; however, cases have been reported following PRK and other corneal refractive procedures. Keratectasia shows progressive myopia, irregular astigmatism, ghosting, fluctuating vision and problems with scotopic vision...
June 2015: Klinische Monatsblätter Für Augenheilkunde
Jorge L Alio, Andrzej Grzybowski, Amr El Aswad, Dorota Romaniuk
Advances in small incision surgery have enabled cataract surgery to evolve from being concerned primarily with the safe removal of the opaque crystalline lens to a procedure refined to yield the best possible postoperative refractive result. As the outcomes of cataract surgery have improved, the use of lens surgery as a refractive modality in patients without cataracts (clear lens extraction) has increased in popularity. The removal of the crystalline lens for refractive purposes, or so-called refractive lens exchange (RLE), offers distinct advantages over corneal refractive surgery in selected cases...
November 2014: Survey of Ophthalmology
Miriam Keane, Douglas Coster, Mohammed Ziaei, Keryn Williams
BACKGROUND: Keratoconus is an ectatic (weakening) disease of the cornea, which is the clear surface at the front of the eye. Approximately 10% to 15% of patients diagnosed with keratoconus require corneal transplantation. This may be full-thickness (penetrating) or partial-thickness (lamellar). OBJECTIVES: To compare visual outcomes after deep anterior lamellar keratoplasty (DALK) and penetrating keratoplasty for keratoconus, and to compare additional outcomes relating to factors which may contribute to poor visual outcomes (e...
2014: Cochrane Database of Systematic Reviews
Ling-ling Wu
Patients with high myopia are at high risk of glaucoma and are difficult to be discovered at early stage in the case of existing glaucoma. Myopic excimer laser corneal refractive surgery changes the structure of the eye, which makes early glaucoma diagnosis more difficult. Furthermore, refractive surgery may aggravate existing condition of glaucoma. To prevent the exacerbation of glaucoma, it is great important to perform the preoperative glaucoma risk assessment. In this paper, we presented the key diagnostic points of glaucoma assessment before and after excimer laser refractive surgery and discussed the postoperative intraocular pressure measurements and its impact on the diagnosis and treatment of glaucoma including characterization of open angle glaucoma and long-term follow up in patients with high myopia...
November 2013: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
Hugo Y Hsu, Sean L Edelstein, John T Lind
PURPOSE: To report a small series of pediatric patients with ectopia lentis that underwent limbal-approach lensectomy and vitrectomy and scleral-fixated intraocular lens implantation and to review the literature on the topic of surgical management of ectopia lentis. METHOD: A retrospective review of 13 eyes of seven patients that underwent lensectomy, vitrectomy, and scleral-fixated intraocular lens implantation and a review of the ophthalmic literature. RESULTS: In our series, the average age at surgery was 70...
July 2012: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
Ramon C Ghanem, Marcielle A Ghanem, Ayla Bogoni, Vinícius C Ghanem
PURPOSE: To present a case of corneal ectasia after LASIK in a patient with previous arcuate keratotomy. METHODS: Case report. RESULTS: The patient underwent arcuate keratotomy in both eyes in 1997 for with-the-rule regular hyperopic astigmatism and uneventful bilateral LASIK for residual astigmatism 5 years later. Visual acuity and refraction remained stable for 5 years, when the patient noticed worsening visual acuity. Corneal topography showed progressive inferior steepening, confirming the diagnosis of ectasia...
June 2013: Journal of Refractive Surgery
Daan Steijns, Ward R Bijlsma, Allegonda Van der Lelij
PURPOSE: To report the visual outcomes and complications of cataract surgery in a large series of patients with nanophthalmos. DESIGN: Retrospective, interventional case series. PARTICIPANTS: Forty-three eyes with an axial length ≤ 20.5 mm of 32 adult patients who underwent cataract surgery in a tertiary clinic. METHODS: Medical records of patients undergoing cataract surgery between 1994 and 2010 were reviewed. MAIN OUTCOME MEASURES: Best-corrected visual acuity (BCVA) at 6 months after surgery and postoperative complications occurring during the entire follow-up period...
February 2013: Ophthalmology
(no author information available yet)
OBJECTIVE: The objective of this analysis is to review the effectiveness, safety, and cost-effectiveness of phakic intraocular lenses (pIOLs) for the treatment of myopia, hyperopia, and astigmatism. CLINICAL NEED: CONDITION AND TARGET POPULATION REFRACTIVE ERRORS: Refractive errors occur when the eye cannot focus light properly. In myopia (near- or short-sightedness), distant objects appear blurry because the axis of the eye is too long or the cornea is too steep, so light becomes focused in front of the retina...
2009: Ontario Health Technology Assessment Series
(no author information available yet)
OBJECTIVE: The purpose of this project was to determine the role of corneal implants in the management of corneal thinning disease conditions. An evidence-based review was conducted to determine the safety, effectiveness and durability of corneal implants for the management of corneal thinning disorders. The evolving directions of research in this area were also reviewed. SUBJECT OF THE EVIDENCE-BASED ANALYSIS: The primary treatment objectives for corneal implants are to normalize corneal surface topography, improve contact lens tolerability, and restore visual acuity in order to delay or defer the need for corneal transplant...
2009: Ontario Health Technology Assessment Series
(no author information available yet)
OBJECTIVE: To assess the effectiveness, and cost effectiveness of EECP in patients with severe anginal symptoms, secondary to chronic coronary disease, who are unresponsive to exhaustive pharmacotherapy and not candidates for surgical/percutaneous revascularization procedures (e.g., angioplasty, coronary bypass surgery). To assess the effectiveness, and cost effectiveness of EECP in patients with heart failure. CLINICAL NEED: ANGINA: Angina is a clinical syndrome characterized by discomfort in the chest, jaw, shoulder, back or arm...
2006: Ontario Health Technology Assessment Series
G Pron, L Ieraci, K Kaulback
OBJECTIVE: The main objectives for this evidence-based analysis were to determine the safety and effectiveness of photochemical corneal collagen cross-linking with riboflavin (vitamin B(2)) and ultraviolet-A radiation, referred to as CXL, for the management of corneal thinning disease conditions. The comparative safety and effectiveness of corneal cross-linking with other minimally invasive treatments such as intrastromal corneal rings was also reviewed. The Medical Advisory Secretariat (MAS) evidence-based analysis was performed to support public financing decisions...
2011: Ontario Health Technology Assessment Series
Ramana S Moorthy, Shailaja Valluri, Narsing A Rao
The nontuberculous (also called "atypical") mycobacteria have become increasingly important causes of systemic as well as ocular morbidity in recent decades. All ocular tissues can become infected with these organisms, particularly in patients who are predisposed following ocular trauma, surgery, use of corticosteroids, or are immunocompromised. Because of their relative resistance to available antibiotics, multidrug parenteral therapy continues to be the mainstay of treatment of more serious ocular and adnexal infections caused by nontuberculous mycobacteria (NTM)...
May 2012: Survey of Ophthalmology
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