Correlation of visual outcome and patient satisfaction with preoperative keratometry after hyperopic laser in situ keratomileusis (original) (raw)
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Effect of preoperative keratometric power on intraoperative complications in LASIK in 34,099 eyes
Journal of refractive surgery (Thorofare, N.J. : 1995), 2007
To evaluate the effect of preoperative keratometric power on the intraoperative complications in LASIK for myopia, hyperopia, and astigmatism. In this retrospective study, the records of 34,099 eyes of 17,388 patients who underwent LASIK for myopia, hyperopia, and astigmatism using the Moria LSK One manual microkeratome and the Bausch & Lomb Technolas 217 Z excimer laser were reviewed. One thousand three hundred thirty-eight (3.92%) intraoperative microkeratome complications were identified in the total number of eyes: 571 (1.67%) free caps, 320 (0.93%) epithelial abrasions, 282 (0.82%) thin/irregular flaps, 126 (0.36%) incomplete flaps, and 39 (0.11%) flap buttonholes. When eyes were stratified according to preoperative keratometric power, eyes with flatter corneas usually had more free caps and incomplete flaps than eyes with steeper corneas (P < .05), whereas eyes with steeper corneas usually had more epithelial abrasions and thin/irregular flaps than eyes with flatter corneas...
Preoperative Keratometry Affecting Visual Outcome in Myopic LASIK
2015
Background: Multiple factors affect the visual outcome after myopic Laser in situ keratomileusis. However, the effect of preoperative keratometry still remains controversial. Aim: To assess the visual outcome in low, moderate and high myopia based on preoperative keratometry values. Setting & Design: A prospective, serial, comparative, interventional study conducted in Department of Ophthalmology, Dhiraj Hospital, Vadodara. Materials and methods: Our study included 170 eyes of 111 patients. Based on the preoperative spherical equivalent (SE), all eyes were divided into low (≤ -3 D), moderate (> -3 D to ≤ -6 D) and high (> -6 D) myopia and based on preoperative average keratometry (K) each group was further divided into flat ( 46 D) sub groups. Statistical Analysis: SPSS program (version 12.0) Results: At 6 months postoperatively changes in keratometric value K showed significant difference (P 0.05) in all three groups. UCVA of 20/20 at 6 months postoperative in low myopia gro...
Effect of preoperative keratometry on refractive outcomes after laser in situ keratomileusis 1 1 Non
J Cataract Refract Surg, 2001
To evaluate the effect of preoperative keratometry on the refractive outcome after laser in situ keratomileusis (LASIK) for myopia.Setting: University Eye Clinic, Prince of Wales Hospital, Hong Kong, China.Methods: In this retrospective study, the records of patients who had LASIK for myopia greater than –6.0 diopters (D) using the Chiron Automated Corneal Shaper and the Schwind Keratome-F excimer laser were reviewed.Results: Laser in situ keratomileusis was performed in 167 eyes of 103 patients (mean age 34.7 years ± 7.5 [SD]). Preoperative myopic spherical equivalent (SE) refraction was –9.0 ± 2.0 D (range –6.0 to –13.9 D). Three months after surgery, SE refraction was –0.04 ± 1.1 D (range +2.3 to –3.3 D); uncorrected visual acuity ≥20/40 was present in 91.8% of 110 eyes in which emmetropia was the postoperative goal. Mean preoperative keratometry was 43.9 ± 1.5 D (range 40.3 to 48.1 D). When eyes were stratified by the degree of preoperative myopia in 1.0 D steps, a trend toward greater undercorrection was noted in eyes with preoperative keratometry <43.5 D than in those with steeper keratometry (>44.5 D) in all myopia groups except the –7.0 to –7.9 D group. This difference was statistically significant in eyes with a preoperative SE of –10.0 to –10.9 D and –11.0 to –11.9 D.Conclusions: Preoperative keratometry appeared to influence the refractive outcome after myopic LASIK. Eyes with flatter corneas tended to have greater undercorrection than eyes with similar myopia and steeper corneas. Validation of these findings in larger data sets using the methodology described may improve the predictability of current LASIK nomograms, particularly in eyes with high myopia.
Six-month results of hyperopic and astigmatic LASIK in eyes with primary and secondary hyperopia
Transactions of the American Ophthalmological Society, 1999
To assess the safety and efficacy of laser in situ keratomileusis (LASIK) for hyperopia and hyperopic astigmatism and develop a LASIK nomogram for primary hyperopia or hyperopia secondary to myopic refractive surgery using the VISX STAR S2. Prospective evaluation of LASIK in 46 primary eyes and 29 secondary eyes with fogged manifest sphere from +0.5 diopters (D) to +6.0 D and cylinder from 0 to +5.0 D. Mean manifest spherical equivalent (SE) in patients with primary hyperopia was +2.50 D +/- 0.93 preoperatively and +0.70 D +/- 1.19 at 6 months. At 6 months, 79% of primary hyperopes had uncorrected visual acuity (UCVA) of 20/40 or better; 63% were within +/- 1 D of emmetropia. One primary hyperope lost 2 lines of best spectacle-corrected vision (BCVA) at 1 month. Complications included transient epithelial defect (6.5%), epithelial cells in the interface (4.3%), diffuse lamellar keratitis (4.3%), haze (2.2%), and mild irregular astigmatism (2.2%). In those with secondary hyperopia, m...
Hyperopic laser in situ keratomileusis to treat overcorrected myopic LASIK
Journal of Cataract & …, 2001
Purpose: To evaluate the safety and efficacy of hyperopic laser in situ keratomileusis (LASIK) in treating hyperopia caused by overcorrected myopic LASIK and to evaluate a new technique to place the hyperopic treatment after lifting the initial myopic flap. Setting: Open-access outpatient excimer laser surgical facility. Methods: A retrospective analysis was performed of 54 eyes in 47 patients who had spherical hyperopic LASIK by 21 surgeons for the treatment of significant hyperopia after overcorrected LASIK for myopia. In 42 eyes, the initial LASIK flaps were lifted and in 12 eyes, new flaps were cut. The mean age of the 25 men (53%) and 22 women (47%) was 48.2 years Ϯ 8.4 (SD). Outcome measures included refractive error, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and complications. The mean follow-up was 2.97 months. Results: In eyes in which postoperative emmetropia was attempted (n ϭ 45), the mean spherical equivalent improved from ϩ1.21 Ϯ 0.49 diopters (D) preoperatively to-0.38 Ϯ 0.50 D postoperatively (P Ͻ .001). The mean UCVA improved from 20/38.6 Ϯ 16.3 to 20/27.4 Ϯ 9.4 (P Ͻ .001). At the last follow-up, 69% of eyes were within Ϯ0.5 D and 96% were within Ϯ1.0 D of emmetropia; 42% had a UCVA of 20/20 and 96% had a UCVA of 20/40 or better. No eyes lost 2 or more lines of BSCVA. No vision-threatening complications occurred. Results in patients who had initial flaps lifted and those who had new flaps cut were statistically indistinguishable. On average, achieved hyperopic corrections were 18% greater than intended. Conclusion: Hyperopic LASIK was safe, predictable, and effective in the treatment of hyperopia caused by overcorrected myopic LASIK. Results were similar whether the original flap was lifted or a new one was cut.
Clinical implications for the optometrist when assessing post LASIK patients
African Vision and Eye Health, 2013
Laser assisted in situ keratomileusis (LASIK) has dominated the field of refractive surgery in the new millennium with many patients opting for it as an alternative to spectacles or contact lenses. LASIK appears to have been largely successful from a patient’s perspective. Research in the area of refractive surgery has also been extensive with many studies highlighting the successes while others cautioning against its widespread use. Due to its popularity optometrists are bound to encounter patients that have had LASIK. Most often optometrists are not directly involved in the surgical process although some are involved in co-management. Irrespective of their involvement the optometrist should be knowledgeable in this field. This review highlights some aspects that all optometric clinicians should be aware of when managing post LASIK patients. (S Afr Optom 2013 72(4) 173-184)
Journal of Ophthalmology, 2021
Purpose. To determine the incidence and outcomes in patients who underwent penetrating keratoplasty (PK) resulting from complications related to contact lens (CL) use and laser in situ keratomileusis (LASIK) in a metropolitan area of the United States. Methods. Population data was obtained from the United States Census Bureau and the Centers for Disease Control. A retrospective, cross-sectional chart review was performed on all patients who underwent keratoplasty in a specific metropolitan geographic area over a ten-year period. e main outcome was best-corrected visual acuity (BCVA) at 2 years in patients who underwent PK secondary to complications related to CL use and LASIK. e secondary outcome was the relative risk of undergoing PK secondary to a complication related to CL use versus LASIK. Results. e study's geographic area had 46,545 CL users in one or both eyes during any given year and 10,285 patients who underwent LASIK in one or both eyes during the study interval. ere were 24 CL users (0.52 per 1,000) and 3 post-LASIK patients (0.29 per 1,000) who underwent PK secondary to complications during the study interval (OR 1.77 [0.53-5.87, 95% CI]; p � 0.35). BCVA at 2 years was 1.45 [1.0-1.90] logMAR (20/564 Snellen) in the CL using cohort and 0.07 [−1.19-1.33] logMAR (20/23 Snellen) in post-LASIK cohort following PK (p � 0.04). Conclusions. Patients who underwent PK secondary to complications related to CL use had worse visual outcomes at 2 years compared to those related to LASIK. Complications leading to PK were rare in both cohorts, but the incidence of undergoing PK secondary to CL use trended higher than LASIK.