PubMed Health⌕ Search

Biomedical subjects

James Andrew Hiatt

Publications and source records attributed to James Andrew Hiatt.

3 recordsLinked to original sources

Reversal of laser in situ keratomileusis-induced ectasia with intraocular pressure reduction.

A 40 year-old woman had laser in situ keratomileusis for --7.75 --0.75 x 20 in the right eye. Preoperative examinations, including topography, pachymetry, and intraocular pressures (IOPs), were normal, and best spectacle-corrected visual acuity (BSCVA) was 20/20 in each eye. By 4 months postoperatively, the uncorrected visual acuity and BSCVA in the right eye had decreased to 20/40. Corneal topography of that eye was consistent with ectasia. One drop per day of timolol 0.5% (Timoptic XE) was prescribed. Five months postoperatively, the IOP had decreased and BSCVA and topography had improved. At 11 months, BSCVA returned to 20/20 and corneal topography normalized. Topographic difference maps were used to monitor corneal shape changes. In this case, early reduction in IOP completely reversed the ectasia.

Adult↗

Establishing analysis parameters for spherical aberration after wavefront LASIK.

PURPOSE: To compare preoperative and postoperative spherical aberration, coma, and other higher order aberrations from wavefront LASIK at varying pupil analysis diameters and different myopic corrections, and to determine acceptable parameters for wavefront measurements. DESIGN: Nonrandomized retrospective chart review. PARTICIPANTS: Twenty-one eyes of 12 patients who had CustomCornea LASIK with the LADARVision 4000 (Alcon, Fort Worth, TX). METHODS: Wavefront analyses were performed before and 3 months after CustomCornea LASIK using a 6.5-mm central optical zone and blend zone to 9.0 mm. Wavefront measurements were made with pupil analysis diameters of 5.5, 6.0, 6.5, and 7.0 mm. Myopic corrections were divided into 3 spherical equivalent subgroups: low (<3 diopters [D]), medium (3-6 D), and high (>6 D). Main outcome measures were compared based on myopic subgroup within each analysis diameter. Results were analyzed with analysis of variance and paired t tests. MAIN OUTCOMES MEASURES: Spherical aberration, coma, and other higher order aberrations. RESULTS: There were no significant increases in coma or other higher order aberrations postoperatively or with larger analysis diameters. There was a significant increase in postoperative differences in spherical aberration between 6.5 and 7.0 mm for the >6-D myopic correction subgroup (P = 0.03). Differences between other 0.5-mm intervals and other subgroups were not significant. CONCLUSIONS: The largest difference between preoperative and postoperative spherical aberration occurred at the analysis diameter 0.5 mm greater than the laser optical zone for the subgroup with high myopic correction. To detect larger degrees of induced spherical aberrations, analysis diameters 0.5 mm larger than the central laser optical zone should be considered.

Adult↗

Complex wavefront-guided retreatments with the Alcon CustomCornea platform after prior LASIK.

PURPOSE: To report the results of complex wavefront-guided LASIK retreatments. METHODS: Twenty eyes (15 patients) with histories of conventional LASIK surgery and significant visual complaints of glare and halos due to higher order aberrations were treated. Wavefront-guided retreatments were performed with the LADARVision CustomCornea system (Alcon, Ft Worth, Tex). Pre- and postoperative topographies, wavefront measurements, and subjective reports were analyzed. RESULTS: Postoperatively, patients had an expanded optical zone, many with improved centration. Lower and higher order aberrations decreased following wavefront-guided ablation. Mean higher order root-mean-square decreased from 1.01 +/- 0.25 microm preoperatively to 0.84 +/- 0.23 microm postoperatively. Mean coma decreased from 0.59 +/- 0.26 microm to 0.43 +/- 0.21 microm. Mean spherical aberration decreased from 0.66 +/- 0.25 microm to 0.54 +/- 0.27 microm. Subjective reports of glare and halo symptoms improved in all patients. CONCLUSIONS: CustomCornea wavefront-guided treatments are effective in reducing lower and higher order aberrations, expanding optical zones, and improving subjective reports of adverse aberration sequelae such as glare and halos.

Adult↗