PubMed Health⌕ Search

Biomedical subjects

Edward E Manche

Publications and source records attributed to Edward E Manche.

At least 19 recordsLinked to original sources
PubMed2006

CustomVue laser in situ keratomileusis for myopia and myopic astigmatism using the Visx S4 excimer laser: Efficacy, predictability, and safety.

PURPOSE: To evaluate the efficacy, predictability, and safety of custom laser in situ keratomileusis (LASIK) using the Visx wavefront platform CustomVue for the treatment of myopia and myopic astigmatism. SETTING: Stanford University Eye Laser Center, Stanford, California, USA. METHODS: This retrospective analysis was of the initial 140 eyes of 78 patients treated consecutively with LASIK for myopia using the Visx Star S4 excimer laser. Primary outcome variables, including uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, and complications, were evaluated at 1 week and 1 and 3 months. Vector analysis was performed on eyes that received astigmatic correction. RESULTS: Mean preoperative spherical equivalent (SE) was reduced from -3.89 diopters +/- 1.48 (SD) to an SE of -0.21 +/- 0.36 D at 1 month and -0.28 +/- 0.36 D at 3 months (P < .001). At 1 and 3 months, UCVA was 20/20 or better in 84.3% and 87.9%, respectively. Eighty-six percent of eyes at 1 month and 81.4% of eyes at 3 months were within +/-0.5 D of emmetropia. No eyes lost more than 2 lines of BSCVA. Vector analysis yielded an index of success of 0.39, indicating a 61% success rate in achieving the astigmatic surgical correction at 3 months. The preoperative root-mean-square value of 0.28 +/- 0.08 microm increased slightly to 0.33 +/- 0.11 microm at 1 month and 0.34 +/- 0.11 microm at 3 months. CONCLUSION: Wavefront-guided LASIK using the Visx CustomVue system was effective, predictable, and safe for correction of low to moderate myopic refractive error.

Adult↗
PubMed2006

CustomVue laser in situ keratomileusis treatment after previous keratorefractive surgery.

PURPOSE: To evaluate the efficacy, predictability, and safety of Visx CustomVue wavefront-guided enhancement after previous keratorefractive surgery. SETTING: Stanford University Eye Laser Center, Stanford, California, USA. METHODS: A retrospective analysis was used to evaluate wavefront-guided enhancement in a preliminary set of 120 eyes of 102 patients. All eyes had previous keratorefractive surgery (photorefractive keratoplasty [PRK] in 1 eye, laser in situ keratomileusis [LASIK] in 119 eyes); the prekeratorefractive surgery spherical equivalent (SE) refraction ranged from -1.25 diopters (D) to -7.00 D. Primary outcome variables including uncorrected visual acuity (UCVA), manifest refraction, and complications were evaluated at 1 and 3 months. RESULTS: At 1 month, the mean pre-enhancement SE was reduced from -0.91 D +/- 0.40 (SD) (range -2.375 to -0.125 D) to -0.13 +/- 0.33 D (range -1.25 to 0.75 D) with 91% of eyes within +/-0.5 D of emmetropia and 100% within +/-1.0 D. All eyes showed equal or improved UCVA (range 20/15 to 20/30) with 20/20 or better in 84 of 91 eyes. At 3 months, the mean was -0.20 +/- 0.32 D (range -0.75 to 0.75 D) with 100% of eyes within +/-0.75 D of emmetropia. All eyes showed equal or improved UCVA (range 20/15 to 20/30) with 20/20 or better in 74 of 84 eyes. Higher-order wavefront aberration analysis showed that the mean root-mean-square error was reduced from 0.39 +/- 0.14 microm (range 0.16 to 0.86 microm) to 0.34 +/- 0.12 microm (range 0.12 to 0.78 microm). Coma was reduced from 0.22 +/- 0.13 microm (range 0.02 to 0.71 microm) to 0.16 +/- 0.11 microm (range 0.01 to 0.62 microm), and trefoil was reduced from 0.16 +/- 0.09 microm (range 0.01 to 0.62 microm) to 0.11 +/- 0.07 microm (range 0.01 to 0.27 microm). Spherical aberration was unchanged from 0.14 +/- 0.14 microm (range -0.18 to 0.59 microm) to 0.14 +/- 0.14 microm (range -0.16 to 0.5 microm). CONCLUSION: Preliminary data show that Visx CustomVue wavefront-guided enhancement after keratorefractive surgery is an effective, predictable, and safe procedure.

Adult↗
PubMed2004

Treatment of epithelial ingrowth after laser in situ keratomileusis with mechanical debridement and flap suturing.

OBJECTIVE: To evaluate the efficacy and safety of mechanical debridement and suturing of the laser in situ keratomileusis (LASIK) flap in the treatment of clinically significant epithelial ingrowth after LASIK. METHODS: In a retrospective study, 20 eyes (n = 19 patients) in which clinically significant epithelial ingrowth developed after LASIK were treated with lifting of the flap, scraping of the epithelial ingrowth, and flap suturing. Primary outcome measurements including recurrence of ingrowth, uncorrected visual acuity (VA), manifest refraction, best spectacle-corrected VA, and complications were evaluated at the last postoperative examination. RESULTS: At the last postoperative examination (mean +/- SD, 10.5 +/- 14.3 months; range, 1.5-64 months), 100% of eyes had no recurrence of clinically significant epithelial ingrowth. The uncorrected VA changed from 20/20 or better in 7 eyes (35%) and 20/40 or better in 15 eyes (75%) preoperatively to 20/20 or better in 9 eyes (45%) and 20/40 or better in 16 eyes (80%) at the last follow-up examination. There was no significant change in the mean logarithm of the minimum angle of resolution (logMAR) uncorrected VA before (mean +/- SD, 0.3 +/- 0.5; range, -0.1 to 1.7) and after surgery (mean +/- SD, 0.2 +/- 0.4; range, -0.1 to 1.7) (P =.40). Mean +/- SD spherical equivalent changed from -0.21 +/- 0.82 diopters (D) (range, -1.25 to 1.00 D) preoperatively to -0.53 +/- 0.89 D (range, -2.50 to 0.38 D) at last follow-up (P =.30). No eyes lost 2 or more lines of best spectacle-corrected VA, and there were no complications associated with the treatment. CONCLUSIONS: Suturing the LASIK flap in addition to mechanical debridement of epithelial ingrowth is a safe and effective treatment for clinically significant epithelial ingrowth after LASIK.

Adult↗
PubMed2004

Custom-contoured ablation pattern method for the treatment of decentered laser ablations.

PURPOSE: To evaluate the custom-contoured ablation pattern (C-CAP) method as a tool for providing customized laser ablations for decentered ablations based on corneal topography data. SETTING: Department of Ophthalmology, Stanford University, Stanford, California, USA. METHODS: In a prospective noncomparative interventional case series, 8 eyes from 7 post-laser in situ keratomileusis (LASIK) patients and 1 post-photorefractive keratectomy (PRK) patient with symptomatic laser decentration were treated with the C-CAP method. The Zeiss Humphrey topography system was used to identify and analyze decentered ablations. The computer software allowed the surgeon to preoperatively model the effect of various ablation schemes on the preoperative topography until a scheme that alleviated the decentration was identified. The planned ablation parameters, which included size, depth, and location of the ablation, were programmed into the Visx S4 excimer laser before treatment. RESULTS: The mean follow-up after C-CAP ablation was 4.2 months (range 1.8 to 6.3 months). At the last postoperative examination, no eye lost a line of best spectacle-corrected visual acuity (BSCVA). The uncorrected visual acuity (UCVA) improved by 3 lines in 1 eye (12.5%), by 2 lines in 1 eye (12.5%), and by 1 line in 3 eyes (37.5%); it remained unchanged in 2 eyes (25.0%) and decreased by 1 line in 1 eye (12.5%). The BSCVA improved by 3 lines in 1 eye (12.5%), by 2 lines in 2 eyes (25.0%), and by 1 line in 3 eyes (37.5%); it remained unchanged in 2 eyes (25.0%). In all eyes, including those without improvement in UCVA or BSCVA, a significant improvement in centration and subjective complaints was achieved. The pre-C-CAP and post-C-CAP root-mean-square (RMS) wavefront data were available in 5 of 8 eyes. The total and higher-order RMS aberrations decreased by 41.7% (P =.0027) and 45.5% (P =.039), respectively, after C-CAP treatment. CONCLUSIONS: Early U.S. results show the topography-driven C-CAP method is an effective tool to address untreatable postsurgical decentration. This method is presented as a technique to enhance the overall quality of vision, reduce patient-perceived visual aberrations, regularize the corneal surface, and maximize BSCVA.

Adult↗
PubMed2004

Analysis of the efficacy, predictability, and safety of LASEK for myopia and myopic astigmatism using the Technolas 217 excimer laser.

PURPOSE: To evaluate the efficacy, predictability, and safety of laser-assisted subepithelial keratectomy (LASEK) for the treatment of myopia and myopic astigmatism. SETTING: Stanford University Eye Laser Center, Stanford, California, USA. METHODS: This retrospective analysis comprised 102 eyes that had LASEK for myopia using the Bausch & Lomb Technolas 217 excimer laser. Primary outcome variables including uncorrected visual acuity (UCVA), best spectacle- corrected visual acuity (BSCVA), manifest refraction, and complications were evaluated at 3, 6, and 12 months. Vector analysis was performed on eyes that received astigmatic correction. RESULTS: The mean spherical equivalent was -7.03 diopters (D) +/- 2.61 (SD) preoperatively, +0.19 +/- 0.64 D at 3 months, +0.23 +/- 0.82 D at 6 months, and +0.03 +/- 0.63 D at 12 months (P<.001). At 3, 6, and 12 months, the UCVA was 20/20 or better in 66%, 67%, and 83% of eyes, respectively, and 20/40 or better in 98%, 99%, and 100%; 74%, 70%, and 83%, respectively, were within +/-0.5 D of emmetropia, and 89%, 86%, and 97%, respectively, were within +/-1.0 D. No eye lost more than 2 lines of BSCVA. At 3, 6, and 12 months, 10.0%, 8.7%, and 0% of eyes, respectively, had trace corneal haze. Vector analysis found a success rate of approximately 78% to 80% in achieving the astigmatic surgical correction at the 3 postoperative visits. CONCLUSIONS: Laser-assisted subepithelial keratectomy was an effective, predictable, and safe procedure for the treatment of myopia and myopic astigmatism. Further studies are needed to determine the role of LASEK in the refractive surgery spectrum.

Adult↗
PubMed2003

Two-year results of conductive keratoplasty for the correction of low to moderate hyperopia.

PURPOSE: To evaluate the 2-year postoperative safety, efficacy, predictability, and stability results of conductive keratoplasty (CK) to correct low to moderate hyperopia. SETTING: Department of Ophthalmology, Stanford University Medical Center, Stanford, California, USA. METHODS: In a prospective nonrandomized noncontrolled trial, 25 eyes of 14 patients with +0.75 to +3.00 diopters (D) of hyperopia and </=0.75 D of cylinder were treated with CK. Low-energy, radio-frequency current was applied to the peripheral corneal stroma through a probe inserted at 8 to 32 treatment spots. An early nomogram was used in 2 eyes, and a current nomogram was used in 23 eyes; the intended refraction was plano. The 23 eyes treated with the current nomogram were analyzed for efficacy, predictability, and stability. All 25 eyes were included in the safety and patient-satisfaction analyses. RESULTS: Preoperatively, the mean manifest refraction spherical equivalent (MRSE) in the 23 current-nomogram eyes was +1.55 D. At 2 years, the uncorrected visual acuity was 20/20 or better in 64% of eyes and 20/40 or better in 95%. The MRSE was within +/-0.50 D in 64% of eyes, within +/-1.00 D in 91%, and within +/-2.00 D in 100%. No eye lost more than 1 line of best spectacle-corrected visual acuity or had an induced cylinder greater than 0.75 D. The mean MRSE of the cohort with all follow-ups was +0.48 D, which reflected a 29% regression from the intended plano and 43% regression from the 1-month postoperative overcorrection. The rate of regression appeared to be low and decreasing, +0.024 D per month between 12 and 24 months. A patient survey revealed improved quality of vision and a high level of satisfaction. CONCLUSIONS: Conductive keratoplasty appeared to be safe, effective, and predictable for correcting low to moderate hyperopia. Mild hyperopic regression was observed; however, the rate of regression indicated by the mean change in MRSE per month was low and decreased over the 2-year follow-up. Longer follow-up may be necessary to further characterize the refractive stability of CK.

Aged↗
PubMed2003

Ablation centration in myopic laser in situ keratomileusis. comparing the Visx S3 ActiveTrak and the Visx S2.

PURPOSE: To compare ablation centration and outcome measurements in myopic laser in situ keratomileusis (LASIK) using the eye-tracking Visx S3 ActiveTrak and the nontracking Visx S2 excimer lasers. SETTING: University-based refractive surgery practice. METHODS: In a retrospective study, 71 consecutively treated myopic eyes that had LASIK with the Visx Star S3 ActiveTrak were compared to 71 control-matched eyes treated with the Visx Star S2 without pupil tracking. Primary outcome variables including ablation centration, uncorrected visual acuity, best spectacle-corrected visual acuity, manifest refraction, complications, and induced cylinder analyzed by vector analysis were evaluated 3 months postoperatively. RESULTS: The myopia ranged from -1.50 to -11.25 diopters (D) and the cylinder, from +0.25 to +2.75 D. Ninety-four of 142 eyes (66%) were available for analysis at 3 months; 50 eyes could be used to analyze ablation centration. At 3 months, the mean decentration of the ablation zone from the entrance pupil was 0.22 mm +/- 0.20 (SD) in tracked eyes (n = 25) and 0.21 +/- 0.26 mm in nontracked eyes (n = 25) (P =.88). Three eyes (12%) in the tracked group were decentered 0.5 to 1.0 mm, and 1 eye (4%) in the nontracked group was decentered more than 1.0 mm. All other eyes were decentered less than 0.5 mm. There was an association in the tracked group between greater decentrations and higher levels of myopia (r = 0.67), but this association did not exist in the nontracked group (r = -0.03). CONCLUSION: Comparable ablation centration as well as visual and refractive outcomes can be achieved with and without active eye tracking during myopic and astigmatic myopic LASIK.

Adult↗
PubMed2002

Phototherapeutic keratectomy for anterior basement membrane dystrophy after laser in situ keratomileusis.

OBJECTIVE: To evaluate the efficacy and safety of phototherapeutic keratectomy (PTK) in the treatment of symptomatic anterior basement membrane dystrophy following laser in situ keratomileusis (LASIK). METHODS: In a retrospective study, 10 eyes of 10 patients that developed symptomatic anterior basement membrane dystrophy following LASIK for myopia were treated with PTK using the VISX S2 (VISX Inc, Santa Clara, Calif) excimer laser. Primary outcome measurements including corneal clarity, resolution of symptoms, uncorrected visual acuity (UCVA), manifest refraction, best spectacle-corrected visual acuity (BSCVA), and complications were evaluated preoperatively, 1 day postoperatively, and at the last postoperative follow-up visit. RESULTS: At the last follow-up visit (mean [SD], 8.8 [5.5] months; range, 4-22 months), 100% of the eyes had clear corneas with no evidence of anterior basement membrane dystrophy, and all eyes were asymptomatic. Mean spherical equivalent changed from -0.75 (0.99) diopters (D) (range, -2.75 to +0.25 D) preoperatively to -0.51 (0.80) D (range, -1.63 to +1.00 D) at the last follow-up visit (P =.64). Uncorrected visual acuity improved from 20/20 or better in 1 eye (10%) and 20/40 or better in 5 eyes (50%) preoperatively to 20/20 or better in 5 eyes (50%) and 20/40 or better in 7 eyes (70%) postoperatively. No eyes lost lines of BSCVA, 2 eyes gained 1 line, 2 eyes gained 2 lines, and 1 eye gained 4 lines. There was a statistically significant improvement in mean logMAR BSCVA postoperatively, improving from 0.06 (0.16) (range, -0.1 to +0.3) to -0.08 (0.07) (range, -0.1 to +0.1) (P =.04). Postoperative complications included diffuse lamellar keratitis that resolved after treatment without sequelae (20%) and induced myopia exceeding -1.50 D (10%). CONCLUSION: Phototherapeutic keratectomy for the treatment of symptomatic anterior basement membrane dystrophy following LASIK treatment is safe and effective.

Adult↗
PubMed2002

Conductive keratoplasty for the correction of low to moderate hyperopia: 1-year results on the first 54 eyes.

OBJECTIVE: To document the 1-year postoperative clinical results of the safety, efficacy, and stability of conductive keratoplasty (CK) to correct low to moderate hyperopia. DESIGN: Prospective, nonrandomized, self-controlled trial. PARTICIPANTS: Five surgeons at four centers performed CK on the first 54 eyes of a multicenter, 2-year clinical trial. Treated eyes had +0.875 to +4.00 diopters (D) of hyperopia and < or =0.75 D of cylinder. The nature of this procedure was explained to all participating patients who signed informed consent forms prior to undergoing the procedure. INTERVENTION: Low energy, high-frequency current was applied directly into the peripheral corneal stroma through a delivery tip inserted at 16 or more treatment spots. An early nomogram was used for the first 54 eyes with an intended refraction of plano. MAIN OUTCOME MEASURES: Data from all 54 eyes were analyzed for safety and stability. A subset of 30 of the 54 eyes was found that had been treated with the appropriate number of spots with the early nomogram. These eyes were categorized as current nomogram eyes; the data for these eyes were analyzed for efficacy and predictability, as well as stability and safety. All patients reported on satisfaction and quality of vision after surgery. RESULTS: Preoperatively, the manifest refractive spherical equivalent refraction (MRSE) of the 30 current nomogram eyes was +1.57 D. At 1 year postoperatively, uncorrected visual acuity was 20/20 or better in 57% of the eyes and 20/40 or better in 93%. The MRSE was within 0.50 D in 46%, within +/-1.00 D in 93%, and within +/-2.00 D in 100%. No eye lost > or =2 lines of best spectacle-corrected visual acuity at 1 year postoperatively nor had an induced cylinder of > or =2.00 D. The MRSE changed a mean of 0.25 D +/- 0.43 between 3 and 6 postoperative months, 0.16 D +/- 0.38 between 6 and 9 postoperative months, and 0.07 D +/- 0.38 between 9 and 12 postoperative months. Refractive stability appeared to be attained by 6 months postoperatively. CONCLUSIONS: Conductive keratoplasty appears to be safe, effective, and stable for correcting low to moderate spherical hyperopia. Stability appeared by the 6-month follow-up visit. For the eyes treated with the current CK nomogram, uncorrected visual acuity, predictability, and stability are as good as or better than those obtained with hyperopic laser in situ keratomileusis or noncontact laser thermal keratoplasty.

Adult↗
PubMed2002

Steroid-induced glaucoma after laser in situ keratomileusis associated with interface fluid.

PURPOSE: To report the ocular manifestations and clinical course of eyes developing interface fluid after laser in situ keratomileusis (LASIK) surgery from a steroid-induced rise in intraocular pressure. DESIGN: Retrospective, noncomparative interventional case series. PARTICIPANTS/INTERVENTION: We examined six eyes of four patients who had diffuse lamellar keratitis develop after uneventful myopic LASIK surgery and were treated with topical corticosteroids. PRINCIPAL OUTCOME MEASURE: Slit-lamp findings, intraocular pressure measurements, and visual field loss. RESULTS: All eyes had a pocket of fluid develop in the lamellar interface between the flap and the stromal bed associated with a corticosteroid-induced rise in intraocular pressure. However, because of the interface fluid, intraocular pressure was normal or low by central corneal Goldmann applanation tonometry in all eyes. The elevated intraocular pressure was diagnosed by peripheral measurement in several cases after months of elevated pressure. All six eyes had visual field defects develop. Three eyes of two patients had severe glaucomatous optic neuropathy and decreased visual acuity develop as a result of undiagnosed steroid-induced elevated intraocular pressure. CONCLUSIONS: A steroid-induced rise in intraocular pressure after LASIK can cause transudation of aqueous fluid across the endothelium that collects in the flap interface. The interface fluid leads to inaccurately low central applanation tonometry measurements that obscure the diagnosis of steroid-induced glaucoma. Serious visual loss may result.

Adult↗
PubMed2002

Conductive keratoplasty for the correction of low to moderate hyperopia: U.S. clinical trial 1-year results on 355 eyes.

OBJECTIVE: To document the 1-year safety, efficacy, and stability results of 355 eyes treated in the multicenter study of conductive keratoplasty (CK) used to correct low to moderate hyperopia. DESIGN: Nonrandomized comparative (self-controlled) trial. PARTICIPANTS: Twenty surgeons at 13 centers performed CK on the eyes of all patients enrolled in a multicenter, 2-year, U.S. phase III clinical trial. Treated eyes had +0.75 to +3.00 diopters (D) of hyperopia and < or =0.75 D of cylinder. Patients were 40 years of age or older. INTERVENTION: Low-energy, high-frequency current was applied directly into the peripheral corneal stroma through a delivery tip inserted at 8 to 32 treatment spots. The number of treatment spots was increased for increasing levels of hyperopia, but the amount of radiofrequency energy remained constant. Emmetropia was intended. All eyes were treated once (there were no retreatments). MAIN OUTCOME MEASURES: Data from 355 eyes with 1 year of follow-up were analyzed for safety and stability, and data from 318 eyes were analyzed for efficacy and predictability, as well as stability and safety. All patients reported on satisfaction and quality of vision after surgery. RESULTS: At 1 year, uncorrected visual acuity was < or =20/20 in 56%, < or =20/25 in 75%, and < or =20/40 in 92% of eyes. The manifest refractive spherical equivalent refraction was within 0.50 D in 63%, within +/-1.00 D in 89%, and within +/-2.00 D in 99%. Seven of 355 eyes lost 2 lines of best spectacle-corrected visual acuity at 1 year, but no eye lost >2 lines. One eye of 355 had induced cylinder of >2.00 D. The cycloplegic refractive spherical equivalent changed a mean of 0.25 +/- 0.50 D between months 3 and 6, 0.11 +/- 0.41 D between months 6 and 9, and 0.11 +/- 0.35 D between months 9 and 12. Refractive stability seemed to be attained by 6 months and remained stable through 12 months. Histology and confocal microscopy showed deep penetration of the treatment into the stroma. Endothelial cell counts were not changed by the treatment. CONCLUSIONS: CK seems to be safe, effective, and stable for correcting low to moderate spherical hyperopia in patients 40 years old or older. Treatment penetration is deep and cylindrical in shape, and it does not damage the corneal endothelium. Uncorrected visual acuity, predictability, and stability are as good as or better than those obtained with other techniques used to correct hyperopia.

Adult↗
PubMed2002

Laser in situ keratomileusis enhancement for consecutive hyperopia after myopic overcorrection.

PURPOSE: To assess the efficacy, predictability, and safety of laser in situ keratomileusis (LASIK) for the treatment of consecutive hyperopia after myopic LASIK. SETTING: Stanford University School of Medicine, Stanford, California, USA. METHODS: In a retrospective study, 36 eyes of 30 patients with consecutive hyperopia after myopic LASIK had LASIK retreatment using the VISX S2 excimer laser. Primary outcome variables including uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, complications, and vector analysis were evaluated preoperatively and 1 day and 3 months postoperatively. RESULTS: The mean spherical equivalent decreased from +1.52 diopters (D) +/- 0.55 (SD) (range +0.63 to +2.63 D) preoperatively to -0.10 +/- 0.52 D (range -1.25 to +1.50 D) 3 months after retreatment. The UCVA was 20/20 or better in 24 eyes (66.7%) and 20/40 or better in 34 eyes (94.4%). Twenty eyes (55.5%) were within +/-0.5 D of the intended correction and 34 eyes (94.4%), within +/-1.0 D. No eye lost 2 or more lines of BSCVA. One eye (2.8%) developed diffuse lamellar keratitis that resolved without sequelae, and 2 eyes (5.6%) developed nonprogressive epithelial ingrowth that did not require removal. CONCLUSIONS: Laser in situ keratomileusis retreatment for consecutive hyperopia following myopic LASIK was an effective, predictable, and safe procedure. Long-term follow-up is needed to assess stability.

Adult↗
PubMed2002

Laser in situ keratomileusis for myopia and compound myopic astigmatism using the Technolas 217 scanning-spot laser.

PURPOSE: To evaluate the safety, efficacy, predictability, and visual results of laser in situ keratomileusis (LASIK) using the Bausch & Lomb Technolas(R) 217 scanning-spot laser for the treatment of myopia and compound myopic astigmatism. SETTING: Stanford Eye Laser Center, Stanford, California, USA. METHODS: In a prospective study, 110 eyes of 58 patients with a mean spherical equivalent (SE) of -4.87 diopters (D) +/- 2.5 (SD) (range -1.0 to -11.4 D) had LASIK for myopia and compound myopic astigmatism using the Technolas 217 scanning-spot laser. The primary outcome variables included preoperative and postoperative best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), achieved versus attempted correction, vector analysis of astigmatism, and complications. RESULTS: One hundred ten eyes were available for analysis at 3 months. The mean SE refraction was reduced 95% (mean -0.23 +/- 0.4 D), and astigmatism was reduced 70% (mean 0.28 +/- 0.3 D). One day postoperatively, 100% of eyes had a UCVA of 20/40 or better, 96% had 20/25 or better, 77% had 20/20 or better, and 39% had 20/15 or better. At the 3-month examination, 100% of eyes had a UCVA of 20/40 or better, 95% had 20/25 or better, 83% had 20/20 or better, and 48% had 20/15 or better. Ninety percent of eyes were within +/-0.5 D of emmetropia. No eye lost 2 or more lines of BSCVA. CONCLUSIONS: The Technolas 217 scanning-spot laser produced excellent postoperative UCVA and BSCVA. It was predictable, safe, and effective for the treatment of myopia and compound myopic astigmatism. Long-term follow-up is needed to assess the stability of the procedure.

Adult↗
PubMedDate not supplied

Comparison of videokeratographic functional optical zones in conductive keratoplasty and laser in situ keratomileusis for hyperopia.

PURPOSE: To compare the videokeratographic functional optical zone of eyes treated with conductive keratoplasty to eyes treated with laser in situ keratomileusis (LASIK) for hyperopia. METHODS: Sixteen eyes treated with conductive keratoplasty for hyperopia were retrospectively evaluated to determine the size of the videokeratographic functional optical zone. The functional optical zone of these eyes was compared to the functional optical zone of 16 eyes that underwent LASIK for hyperopia with the VISX S2 excimer laser, for comparable amounts of hyperopia. The functional optical zone was measured at the edge of central corneal steepening and paracentral flattening on videokeratography 3 to 6 months after surgery. RESULTS: The functional optical zone after surgery measured an average of 5.6 mm horizontally and 5.6 mm vertically in the conductive keratoplasty eyes, and 4.7 mm horizontally and 5.1 mm vertically in the hyperopic LASIK eyes (P<.001 and P<.005). The mean functional optical zone area was 31.1 mm2 in the conductive keratoplasty eyes and 24.6 mm2 in the hyperopic LASIK eyes (P<.001). The functional optical zone created by conductive keratoplasty had more uniform central steepening and less peripheral blending than the functional optical zone created by hyperopic LASIK. CONCLUSION: Conductive keratoplasty was effective at creating central steepening in the cornea. The functional optical zone resulting from conductive keratoplasty was significantly larger than that obtained with hyperopic LASIK using the VISX S2 excimer laser.

Adult↗
PubMedDate not supplied

Diameters of topographic optical zone and programmed ablation zone for laser in situ keratomileusis for myopia.

PURPOSE: To compare topographic optical zones with programmed ablation zone settings of eyes treated with laser in situ keratomileusis (LASIK) for myopia using the VISX S2 excimer laser. METHODS: Two-hundred three eyes treated with LASIK using the VISX S2 excimer laser were retrospectively evaluated to determine the size of the topographic optical zone. Three to six months after LASIK, the topographic optical zone was measured at the zone of highest curvature on topography and subtraction topography. Eyes were divided into four groups (A, B, C, D) in order of increasing myopia. RESULTS: When the topographic optical zone was compared with the programmed ablation zone, an optical zone reduction of 0.5 +/- 0.1 mm and 0.4 +/- 0.1 mm was found for the longest and shortest diameters, respectively. For eyes with spherical ablation zones, this reduction was 0.6 +/- 0.1 mm and 0.4 +/- 0.1 mm shorter than the programmed horizontal and vertical dimensions. Groups A, B, C, and D, in order of increasing myopia, all showed reductions of approximately 0.5 +/- 0.1 mm for the longest and 0.3 to 0.4 +/- 0.1 mm for the shortest diameters of the optical zone. CONCLUSIONS: The topographic optical zone was reduced from the programmed ablation zone. This reduction was statistically significant for both elliptical and spherical ablations, and seemed to be independent of the amount of myopia.

Cornea↗