Biomedical subjects

G M Stafford

Publications and source records attributed to G M Stafford.

4 recordsLinked to original sources

PubMed1997

Casebeer System for refractive keratotomy: patient satisfaction.

PURPOSE: To evaluate patient satisfaction 3 years after radical keratotomy (RK) using the Casebeer nomograms. SETTING: The Werblin Center, Princeton, West Virginia. METHODS: This study assessed the satisfaction of 96 patients who had bilateral distance correction by RK using the Casebeer System. The cases were part of the first 241 consecutive refractive keratotomy procedures (N = 128 patients) performed by one surgeon. Ninety-nine percent of the 96 patients in this study completed a questionnaire on satisfaction and visual symptoms 3 years postoperatively. A separate control population of 105 consecutive patients about to have RK surgery were asked to complete a questionnaire about their preoperative symptoms. RESULTS: Ninety-eight percent of patients were very to moderately satisfied 3 years after the procedure, 99% said they would have surgery again if given the chance, and 96% said they would recommend it to others. However, 69% stated they had mild to very severe symptoms 3 years postoperatively compared with 28% in the control group. CONCLUSION: Despite an extremely high degree of patient satisfaction, about 99%, the 1% dissatisfaction rate seen in this study could have be very significant in this young, potentially litigious patient population.

Adult↗

PubMed1996

Three year results of refractive keratotomy using the Casebeer System.

PURPOSE: To analyze the results of one surgeon's first refractive keratotomy surgeries. SETTING: The Werblin Center, Princeton, West Virginia. METHODS: The three year results of 241 consecutive surgical procedures (128 patients) using Casebeer nomograms were examined. The average preoperative myopia was -4.07 +/- 1.89 diopters.(D). Two hundred twenty-two eyes were corrected with a goal of emmetropia. Two hundred of 241 eyes (83%) were followed for 3 years; 35 eyes (15%) were followed for fewer than 3 years after the last enhancement procedure, and 6 eyes (2%) were lost to follow-up. RESULTS: At 3 years postoperatively (range 30 to 44 months), excluding postoperative suture and ALK procedures, mean residual manifest refractive error (spherical equivalent) was -0.04 +/- 0.67 D (-2.25 to + 3.13 D). Mean residual cycloplegic error was + 0.45 +/- 0.76 D (-1.00 to + 4.13 D). Eighty-seven eyes (36%) required between one and six enhancement procedures. One hundred fifteen eyes (52%) had 20/20 or better visual acuity and 214 eyes (96%), 20/40 or better. One hundred fifty-two eyes (84%) were within +/- 1.0 D and 120 eyes (66%) were within +/- 0.5 D. Ten eyes (4%) lost one or more lines of best corrected acuity. CONCLUSION: Using the Casebeer system for refractive keratotomy, we obtained 20/40 or better uncorrected visual acuity in 96% of eyes with low to moderate levels of myopia. However, a significant number of enhancement procedures, 36% overall, were required to achieve this level of success. Hyperopic shift remains a significant concern following radial keratotomy procedures.

Adult↗

PubMed1996

Hyperopic shift after refractive keratotomy using the Casebeer System.

PURPOSE: To determine the degree of hyperopic shift following refractive keratotomy. SETTING: The Werblin Center, Princeton, West Virginia. METHODS: The results of 241 consecutive radial/astigmatic keratotomy procedures in 128 patients were studied. All procedures were performed using Casebeer nomograms. Refractive follow-up information was obtained for 78% of patients at 3 months (range 1 to 6 months), 1 year (range 6 to 21 months), and 3 years (range 30 to 44 months). RESULTS: Overall, the amount of hyperopic change decreased significantly (P < .05) during the 3 year period, from + 0.34 diopters (D) per year to + 0.12 D per year. Eyes with more than 6.0 D of preoperative intended correction were more unstable (+ 0.49 D in the first year and + 0.44 D in the second and third years) than eyes with less than 5.0 D (+ 0.27 D and + 0.05, respectively). CONCLUSION: Because the average magnitude of the hyperopic shift was + 0.6 D in the first 3 years after surgery, a slight undercorrection, -0.5 D to -0.7 D, should be the refractive endpoint for primary and enhanced refractive keratotomy surgery.

Follow-Up Studies↗

PubMed1993

The Casebeer system for predictable keratorefractive surgery. One-year evaluation of 205 consecutive eyes.

PURPOSE: This study documents the results of current radial keratotomy (RK) surgical technology, using the Casebeer keratorefractive system. These results are contrasted to those of the Prospective Evaluation of Radial Keratotomy (PERK) keratorefractive system, developed approximately 12 years ago. METHODS: Two hundred five consecutive surgical procedures were examined, which was the first year of experience with RK for one of the authors (TPW). All procedures fit within the Casebeer nomograms. Enhancement procedures were performed following the Casebeer system nomograms. RESULTS: Follow-up for 100% of patients was achieved. Postoperative cycloplegic refractions yielded an average of +0.27 +/- 0.58 diopters (D) of residual refractive correction (range, -0.88 to +2.50 D). One year postoperatively, 20/25 or better uncorrected visual acuity was achieved in 86% of patients and 20/40 or better uncorrected visual acuity was achieved in 99% of patients. Bothersome but not incapacitating side effects, such as glare, starbursting, and fluctuating vision, have been commonly observed with RK. CONCLUSION: The Casebeer system for keratorefractive surgery, which is easy to learn, can yield an extremely accurate surgical result. The major reason for increased accuracy compared with the PERK system is the surgeon's ability to titrate the primary surgical procedure with enhancement operations. Although RK is by no means a perfect surgical technique, side effects tend to be relatively minimal, and patient satisfaction tends to be extremely high.

Adult↗