Biomedical subjects

Jorge L Alió

Publications and source records attributed to Jorge L Alió.

At least 19 recordsLinked to original sources

PubMed2006

Optical analysis of visual improvement after correction of anisometropic amblyopia with a phakic intraocular lens in adult patients.

PURPOSE: To analyze possible reasons for an increase in visual acuity observed in myopic patients with anisometropic amblyopia after implantation of a phakic intraocular lens (PIOL) using a theoretical eye model. DESIGN: Retrospective case series. PARTICIPANTS: Fifty-nine eyes of 48 patients with anisometropic amblyopia implanted with an angle-supported PIOL. METHODS: Inclusion criteria were anisometropia of at least 3 diopters (D) and a best spectacle-corrected visual acuity (BSCVA) of 0.7 or less in the best eye. Follow-up was performed at 1, 3, 6, and 12 months and then annually for up to 10 years. The theoretical analysis of mechanisms to explain the visual improvement was performed using a theoretical eye, based on the Kooijman model, in which the measured values of radii and thickness of the different surfaces were substituted. The magnification and spot size were calculated by a ray tracing process. MAIN OUTCOME MEASURES: Uncorrected visual acuity, improvement in best spectacle-corrected visual acuity, and spherical equivalent. RESULTS: Mean gain in visual acuity was 3 lines (range, 0-7 lines). Fifty-four eyes (91.5%) gained at least 1 line of visual acuity, whereas no eyes lost lines of vision. The change in BSCVA did not correlate with preoperative BSCVA (Pearson coefficient, r = 0.19) or with the degree of anisometropia (Pearson coefficient, r = 0.23). The calculations using a Kooijman eye model corrected with spectacles and with a PIOL accounted for the full increase in visual acuity in terms of the magnification (increased by a factor of 1.2) and the spot size (reduced by a factor of 2). CONCLUSIONS: After implantation of a PIOL, the visual acuity of myopic patients with anisometropic amblyopia showed a significant increase. This increase was explained using a theoretical eye model not only in terms of magnification but also including changes in aberrations. An evident role of neuroprocessing in this visual improvement was not identified.

Adult↗

PubMed2006

Femtosecond laser versus mechanical keratome LASIK for myopia.

OBJECTIVE: To assess efficacy, safety, predictability, stability, and changes in corneal higher-order aberrations (CHOAs) and contrast sensitivity (CS) after a femtosecond laser for LASIK and standard LASIK for myopia. DESIGN: Prospective, randomized, comparative clinical study. PARTICIPANTS: Two hundred eyes of 100 consecutive patients who underwent LASIK treatment using the VISX S2 laser system. A femtosecond laser for flap creation was used in 100 eyes (50 patients; spherical equivalent [SE], -2.85+/-1.79 diopters [D]), and a mechanical microkeratome was used in 100 eyes (50 patients; SE, -2.90+/-1.63 D). METHODS: Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, CS by means of the Functional Acuity Contrast Test, and CHOAs by means of custom software linked to topography were evaluated preoperatively and 6 months after treatment. MAIN OUTCOME MEASURES: Efficacy, safety, predictability, stability, CHOAs, and CS were evaluated before and after surgery at 6 months' follow-up. RESULTS: At 6 months postoperatively, UCVA was 1.0 or better in 100% of the eyes. Efficacy indexes were 1.07 for the femtosecond laser for LASIK patients and 1.00 for LASIK patients. No eye lost > or =1 lines of BCVA; for the femtosecond laser for LASIK group, 24 eyes gained 1 line, and 18 eyes gained > or =2 lines; for the LASIK group, 18 eyes gained 1 line. The femtosecond laser for LASIK group showed a percentage of eyes (98%) within the 0.5-D range in SE higher than that of the LASIK group (92%). For a 3.5-mm pupil, CHOAs' root-mean-square (RMS) increased for both the femtosecond laser for LASIK (2.21-fold) and LASIK (2.81-fold) groups. For a 6-mm pupil, CHOA RMSs were increased significantly after femtosecond laser for LASIK (4.18-fold) and LASIK (5.07-fold) surgeries (P<0.01). Contrast sensitivity improved only in the femtosecond laser for LASIK group at the highest spatial frequency (18 cycles/degree; P<0.01) after surgery. CONCLUSIONS: A femtosecond laser for LASIK surgery is an effective and, in this series, safe procedure for treatment of myopia. The improvements in UCVA and CS after the femtosecond laser for LASIK are related to the differences in postoperative CHOAs found with femtosecond and microkeratome flap creation.

Adult↗

PubMed2006

Angle-supported anterior chamber phakic intraocular lens explantation causes and outcome.

PURPOSE: To investigate the reasons for explantation of angle-supported phakic intraocular lenses (IOLs) as well as the outcome and safety of the explantation procedure. DESIGN: Consecutive retrospective series. PARTICIPANTS: One hundred eyes of 66 patients who underwent phakic angle-supported IOL explantation. INTERVENTION: Surgical explantation of anterior chamber angle-supported phakic IOLs. MAIN OUTCOME MEASURES: Visual acuity, refraction, and endothelial cell density. RESULTS: The main causes of explantation were cataract development (64 cases [64%]), progressive endothelial cell loss (24 cases [24%]), and pupil ovalization (10 cases [10%]). According to the reason for phakic IOL explantation and the condition of the eye at time of explantation, 92 cases underwent bilensectomy (phakic IOL explantation followed by phacoemulsification of the crystalline lens), 2 cases underwent phakic IOL exchange, 4 cases underwent concomitant phakic IOL explantation and penetrating keratoplasty, and 2 cases underwent simple explantation of a phakic IOL. The mean time between phakic anterior chamber IOL implantation and explantation due to cataract was 10.04+/-3.66 years (range, 2-14). The mean time between implantation and secondary intervention due to progressive endothelial cell loss was 8.97+/-2.21 years (range, 2-14), and most of these cases were related to a specific model of angle-supported phakic IOL. CONCLUSION: Nuclear cataract was the most frequent reason for angle-supported phakic IOL explantation. Bilensectomy was effective and maintained the refractive benefits obtained with phakic IOL implantation. Few cases developed severe endothelial cell loss, most of them related to certain types of phakic IOLs.

Adult↗

PubMed2006

Analysis of results related to good and bad outcomes of Intacs implantation for keratoconus correction.

PURPOSE: To evaluate factors influencing good and poor outcomes after intracorneal ring segment implantation to correct keratoconus. SETTING: Instituto Oftalmológico de Alicante (Vissum Corporation), University of Miguel Hernandez, Alicante, Spain. METHODS: A retrospective comparative study of the visual outcome, 25 eyes of 21 patients were implanted after intracorneal ring segments (Intacs, Addition Technology) as a method to correct keratoconus. Outcomes were evaluated 6 months after implantation based on the visual results. Group A comprised 20 eyes that gained 3 lines or more of best spectacle-corrected visual acuity (BSCVA) to correct keratoconus, and Group B comprised 5 eyes that lost 1 line of BSCVA. RESULTS: In Group A, the preoperative mean BSCVA was 0.43 (20/50) and the postoperative mean BSCVA, 0.82 (20/20) (P< or =.0001). In Group B, the preoperative mean BSCVA was 0.36 (20/63) and the postoperative mean BSCVA, 0.24 (20/80) (P< or =.02). The preoperative mean sphere power was 3.90 diopters (D) greater in Group B than in Group A (P< or =.007); the mean spherical equivalent was 4.36 D greater (P< or =.007), and the mean K-reading was 6.91 D greater (P< or =.001). The postoperative reduction in spherical dioptric power was 2.11 D (P< or =.027) and the mean spherical equivalent, 2.81 D (P< or =.003), significant only in Group A. The reduction in mean central K-readings was 4.30 D (P< or =.0001) in Group A and 6.19 D (P< or =.014) in Group B. The correlation of the preoperative mean K value to the postoperative BSCVA was significant at the .01 level by the Pearson test (-0.67). In Group A, all eyes (100%) had a mean K-reading < or =53 D. In Group B, 4 eyes (80%) had a mean K-reading > or =55 D. CONCLUSION: Intacs provided better results in visual acuity and corneal topography quality and significantly reduced the spherical equivalent in eyes with keratoconus with relatively low mean K values (< or =53 D) and a relatively low spherical equivalent. In advanced keratoconus (mean K-reading > or =55 D), poor results can be anticipated.

Adult↗

PubMed2006

Intracorneal ring segments for keratoconus correction: long-term follow-up.

PURPOSE: To evaluate long-term results and stability of intracorneal ring segment (Intacs) implantation for keratoconus correction. SETTING: Vissum, Instituto Oftalmológico de Alicante and University of Miguel Hernandez, Alicante, Spain. METHODS: This retrospective study comprised 13 eyes operated on between April 2000 and December 2001 that had Intacs implantation for keratoconus correction. The outcomes were evaluated at 6, 12, 24, and 36 months in all eyes and at 48 months (6 eyes). RESULTS: Mean best spectacle-corrected visual acuity (BSCVA) increased from 0.46 (20/50) preoperatively to 0.66 (20/30) postoperatively (P< or =.001). Mean decrease of inferior-superior (I-S) asymmetry was 2.81 diopters (D) (P< or =.02), and the average K-value was 3.13 D (P< or =.001). Mean difference between 6 and 36 months (stability) showed no significant difference regarding BSCVA (P< or =.5) and I-S asymmetry (P< or =.6). Although a significant increase was noticed in the average K by 1.67 D (P< or =.002), at 36 months it did not reach the initial preoperative values. CONCLUSION: Intacs increased the BSCVA and decreased I-S asymmetry with stability up to 36 months. In spite of the decrease of the K-values at 6 months, a further significant increase was detected 36 months after surgery.

Adult↗

PubMed2006

Spherical aberration and contrast sensitivity after cataract surgery with the Tecnis Z9000 intraocular lens.

PURPOSE: To determine whether implantation of an intraocular lens (IOL) with a modified prolate anterior surface (Tecnis Z9000, AMO) results in reduced spherical aberration and improved contrast sensitivity after cataract surgery. SETTING: Hospital NISA Virgen del Consuelo, Valencia, Spain. METHODS: In an intraindividual randomized prospective study of 30 patients with bilateral cataract, the Tecnis Z9000 IOL was compared with 2 IOLs with spherical surfaces, the AR40e (AMO) and the Stabibag (Ioltech). Ocular aberrations for a 4.0 mm pupil and 6.0 mm pupil were measured with a Hartmann-Shack aberrometer. Quality of vision was measured by visual acuity and contrast sensitivity under mesopic and photopic conditions. RESULTS: Eyes with the Tecnis Z9000 IOL had significantly less spherical aberration and a greater Strehl ratio after surgery. Significant reduction in coma aberration was also found in some cases. Refraction, visual acuity, and contrast sensitivity were not significantly different between the 3 IOL groups. CONCLUSION: A significant reduction in spherical aberration after Tecnis Z9000 IOL implantation was achieved, but visual acuity and contrast sensitivity were not affected by the aspheric silicone IOL compared to spherical acrylic IOLs.

Aged↗

PubMed2006

Femtosecond laser in situ keratomileusis after radial keratotomy.

PURPOSE: To assess the safety, efficacy, and predictability of femtosecond laser in situ keratomileusis (LASIK) in eyes with previous radial keratotomy (RK). SETTING: Hospital Virgen del Consuelo de Valencia, Valencia, and Vissum Instituto Oftalmológico de Alicante, Alicante, Spain. METHODS: This prospective study comprised 11 eyes of 7 patients with residual low myopia after previous RK who had surgery with the IntraLase femtosecond laser (IntraLase Corp.) and the Star 2 excimer laser (Visx, Inc.). Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), defocus equivalent, refraction, flap thickness, flap diameter, and intraoperative complications were evaluated over a minimum 6-month follow-up. RESULTS: Although the RK incisions opened in all eyes when the flap was lifted, LASIK was successfully completed in all cases. Mean flap thickness was 119 microm +/- 13 (SD). There were no cases of slipped flaps, microstriae, or epithelial ingrowth. Defocus equivalent was reduced from a mean of 2.51 +/- 0.62 diopters (D) to 0.52 +/- 0.28 D; 7 eyes (63.6%) were within +/-0.50 D, and 11 eyes (100%) were within +/-1.00 D. All eyes had 20/40 or better UCVA, although 2 eyes (18.1%) lost 1 line of BSCVA. CONCLUSIONS: The femtosecond laser was safely used to create thin LASIK flaps in eyes with previous RK. An increased postoperative inflammatory response may explain the loss of BSCVA in some cases. Efficacy and predictability of the procedure were comparable to those of LASIK after RK with mechanical microkeratomes.

Adult↗

PubMed2006

Conductive keratoplasty to correct residual hyperopia after cataract surgery.

PURPOSE: To evaluate the efficacy, predictability, safety, and stability of conductive keratoplasty (CK) for correcting residual hyperopia after cataract surgery with intraocular lens implantation. SETTING: Vissum-Instituto Oftalmologico de Alicante, Alicante, and Vissum-Instituto de Albacete, Albacete, Spain. METHODS: Sixteen eyes of 16 patients had CK for the correction of residual hyperopia after cataract surgery. The CK was performed with the CK View Point Refractec (RCS-200, Refractec, Inc.). The follow-up was 12 months. RESULTS: One year after CK, 10 eyes (62.5%) achieved an uncorrected visual acuity (UCVA) of 0.50 or better. The mean UCVA was 0.50 +/- 0.21 (SD), and the mean best spectacle-corrected visual acuity (BSCVA) was 0.68 +/- 0.24. One eye lost 1 line of BSCVA, and none lost 2 or more lines. The mean spherical equivalent refraction was +0.39 +/- 0.84 D 1 year after CK. No vision-threatening complications occurred. CONCLUSIONS: One-year data show that CK for the correction of low to moderate hyperopia after cataract surgery was safe, stable, relatively predictable, and efficient. No complications occurred when CK was performed after phacoemulsification.

Aged↗

PubMed2006

Polymerase chain reaction and DNA typing for diagnosis of infectious crystalline keratopathy.

A 63-year-old man developed infectious crystalline keratopathy (ICK) in his right eye 1 year after phacoemulsification. The white peripheral lesion was adjacent to the corneal phacoemulsification incision. Infiltrates in the form of creamy-white, midstromal branching, needle-like opacities without evidence of inflammatory cells were noted. A corneal biopsy by double lamellar flap was done and studied by 3 techniques: microbiological culture, stain, and polymerase chain reaction (PCR). Fungal and bacterial PCR were positive. A second sample was necessary to obtain a positive stain and culture. The DNA sequence analysis showed Candida parapsilosis and Staphylococcus aureus as the causal agents of the crystalline keratopathy. Treatment was started with amphotericin B 1% and cefazolin 6 times a day, and systemic voriconazole was recommended. This is the first reported case of ICK after cataract surgery. Polymerase chain reaction amplification and subsequent DNA typing were useful tools in detecting and identifying the ocular pathogens involved in this case.

Anti-Bacterial Agents↗

PubMed2006

Transient light-sensitivity syndrome after laser in situ keratomileusis with the femtosecond laser Incidence and prevention.

PURPOSE: To describe the incidence of transient light-sensitivity syndrome (TLSS) after laser in situ keratomileusis (LASIK) with the femtosecond laser and to identify preventive strategies. SETTING: Hospital NISA Virgen del Consuelo, Valencia, Spain. METHODS: The first 765 eyes operated on with the 15 KHz femtosecond laser were prospectively analyzed for subjective complaints and clinical findings compatible with TLSS. Intraoperative settings, postoperative treatment, and development of complications were analyzed. RESULTS: Overall, TLSS developed in 10 eyes (incidence 1.3%). However, the incidence decreased from 2.8% to 0.4% when aggressive topical steroids were used during the first 3 postoperative days. Postoperative interface inflammation and postoperative use of a low-dose topical steroid regimen were associated with a higher incidence of TLSS. CONCLUSIONS: Transient light-sensitivity syndrome is a relatively uncommon complication related to the use of the femtosecond laser. Postoperative interface inflammation may increase the probability of developing TLSS, whereas an aggressive postoperative steroid regimen seemed to provide protection against it.

Adult↗

PubMed2006

Evidence for delayed presbyopia after photorefractive keratectomy for myopia.

PURPOSE: To evaluate uncorrected near visual acuity (NVA), accommodation, corneal aberrations, and the optical quality of the retinal image in presbyopic eyes after photorefractive keratectomy (PRK). DESIGN: Nonrandomized comparative retrospective study. PARTICIPANTS: Ten post-PRK patients and 10 normal patients. METHODS: Twenty eyes (10 right and 10 left after PRK for myopia, minimum of 10 years after the operation; group A) were compared with 20 eyes (10 right and 10 left age- and gender-matched normal controls; group B). All subjects were over 40 years of age. MAIN OUTCOME MEASURES: With best distance correction, NVA was measured at 40 cm (Jaeger, J series), and the range of accommodation (diopters [D]) was measured subjectively (negative relative amplitude and positive relative amplitude). The modulation transfer function (MTF) and corneal aberrations such as comalike, spherical (SAs), and higher order (HOAs) were measured with a Hartmann-Shack aberrometer. From the MTF curves, the spatial frequencies corresponding to contrast values of 0.1 and 0.5 were noted. RESULTS: Mean ages (+/- standard deviations [SDs]) were 46.3 years (4.7) for group A and 47.6 years (4.9) for group B (P>0.05). Near acuity was J1 or better in 12 of 20 post-PRK and 4 of 20 control eyes. Mean accommodations (+/- SDs) were 3.2 D (1.14) for right group A eyes and 2.1 D (0.94) for right group B eyes (P = 0.0152), and 3.4 D (0.99) for left A eyes and 2.3 D (1.02) for left B eyes (P = 0.0168). Total HOA indexes (+/- SDs) were 1.449 (0.409) for right group A eyes and 0.824 (0.241) for right group B eyes (P = 0.008), and 1.464 (0.388) for left A eyes and 1.067 (0.542) for left B eyes (P = 0.0752). Pooling the data from post-PRK and control eyes, a significant correlation was found between near acuity and SA (right eyes, r = -0.535, P = 0.015; left eyes, r = -0.493, P = 0.027). Significant associations were found between accommodation, near acuity, HOA, and comalike aberration for right eyes only. Mean spatial frequencies (+/- SDs) corresponding to contrast values of 0.1 for right and left eyes were 14.96 (5.71) for right group A eyes and 22.02 (6.85) for right group B eyes (P = 0.074), and 15.11 (7.80) for left A eyes and 21.41 (9.00) for left B eyes (P = 0.271). Mean spatial frequencies (+/- SDs) corresponding to contrast values of 0.5 for right and left eyes were 2.86 (0.63) for right group A eyes and 3.21 (0.35) for right group B eyes (P = 0.596), and 2.76 (0.98) for left A eyes and 3.22 (0.27) for left B eyes (P = 0.194). CONCLUSIONS: Compared with normal eyes, in previously myopic eyes treated with first-generation PRK lasers there is a tendency for (1) the optical quality of the retinal image to be reduced at low contrast, (2) the aberrations attributed to the corneal surface to increase, and (3) both measured subjective accommodation and near acuity to be greater than expected. We postulate that the corneal aberrations induced by PRK for myopia may reduce the quality of the retinal image for distance but enhance near acuity by way of a multifocal effect that can delay the onset of age-related near vision symptoms.

Accommodation, Ocular↗

PubMed2006

Hyperopic LASIK following intracorneal hydrogel lens explantation.

PURPOSE: To report hyperopic LASIK results after intracorneal hydrogel lens explantation in a bilateral hyperopic patient. METHODS: Slit-lamp examination showed diffuse corneal opacity around the lens edge and over the anterior lens surface affecting both eyes with uncorrected visual acuity of 0.4 in the right eye and 0.5 in the left eye. RESULTS: The intracorneal hydrogel lenses were explanted, and 6 months later hyperopic LASIK using the Schwind ESIRIS excimer laser (Schwind, Kleinostheim, Germany) was performed after lifting the same flap for the intracorneal hydrogel lens implantation. Six months after hyperopic LASIK, visual acuity recovered to the initial preoperative best spectacle-corrected levels: right eye 0.8 with +1.50 D sphere and left eye 0.9 with +1.00 -0.50 x 90 degrees. Central corneal transparency also fully recovered. CONCLUSIONS: Hyperopic LASIK is a possible alternative after intracorneal hydrogel lens explantation in hyperopic eyes.

Anterior Eye Segment↗

PubMed2006

Retinal detachment in myopic eyes after phakic intraocular lens implantation.

PURPOSE: To analyze the risk of retinal detachment in highly myopic patients who underwent implantation of phakic intraocular lenses (PIOLs). METHODS: In a retrospective, non-comparative, interventional case series, the occurrence of retinal detachment was analyzed in 522 consecutive highly myopic eyes (323 patients) that underwent PIOL implantation. Treatment and results were reviewed. Parameters evaluated were best corrected visual acuity before and after retinal detachment surgery and time between refractive surgery and retinal detachment. RESULTS: Fifteen (2.87%) eyes presented with retinal detachment after PIOL implantation, with a mean time between surgery and detachment of 24.4 +/- 24.4 months (range: 1 to 92 months). The risk of retinal detachment in patients with high myopia corrected by PIOL implantation was 0.57% at 3 months, 1.64% at 12 months, 2.73% at 36 months, and 4.06% at 92 to 145 months (Kaplan-Meier analysis). A comparative study between the group of patients with retinal detachment and the remaining patients without retinal detachment was performed. Differences were found in axial length (30.65 +/- 1.97 vs 29.51 +/- 2.02; P=.028, one factor-analysis of variance test). CONCLUSIONS: The risk of retinal detachment in eyes implanted with phakic lenses for the correction of high myopia is higher in eyes with axial length >30.24 mm.

Adolescent↗

PubMed2006

Intracorneal asymmetrical rings for keratoconus: where should the thicker segment be implanted?

PURPOSE: To report a 20-year-old man who presented with monocular diplopia in the right eye with uncorrected visual acuity (UCVA) of 0.3 and best spectacle-corrected visual acuity (BSCVA) of 1.0 with -0.50 -3.00 x 45 degrees. METHODS: Clinical examination and corneal topography revealed grade I keratoconus in the right eye. Intracorneal ring segments (INTACS; Addition Technology, Des Plaines, III) were implanted in May 2004 without surgical complications at 415 microm (70% of the corneal thickness), with the 450-microm segment implanted superiorly and the 250-microm segment inferiorly. RESULTS: For 2 months postoperatively, BSCVA remained at 0.4 with +1.50 -4.50 x 25 degrees. The segments were reversed, implanting the 450-microm (thick) segment inferiorly and the 250-microm (thin) segment superiorly. One week later, UCVA was 1.0 and remained stable for 3 months after reimplantation. CONCLUSIONS: This report shows that implanting the thicker segment inferiorly provides better visual results.

Adult↗

PubMed2006

Correction of presbyopia by technovision central multifocal LASIK (presbyLASIK).

PURPOSE: To investigate central multifocal presbyLASIK based on the creation of a central hyperpositive area. METHODS: Twenty-five patients (50 eyes) underwent presbyLASlK in an open-label, prospective, non-comparative pilot study. Mean patient age was 58 years (range: 51 to 68 years), mean preoperative spherical equivalent refraction was +1.6 +/- 0.63 diopters (D) (range: +0.50 to +3.00 D), and mean spectacle near addition was +2.27 +/- 0.37 D (range: +1.75 to +3.00 D). The ablation pattern was performed with proprietary software from Technovision using an H. Eye Tech. excimer laser platform. RESULTS: Mean postoperative spherical equivalent refraction was -0.37 +/- 0.55 D (range: -1.50 to + 1.00 D) and mean spectacle near addition was +1.72 +/- 0.34 D (range: +1.25 to +2.25 D). After 6 months, 16 (64%) patients achieved a distance uncorrected visual acuity (UCVA) of > or = 20/20 and 18 (72%) patients achieved a near UCVA of > or = 20/40. Seven (28%) patients lost a maximum of 2 lines of best spectacle-corrected visual acuity (BSCVA). The safety index for distance was 0.98 binocular and for near was 0.99 binocular. After 6 months, no significant change was noted in contrast sensitivity at 1.5 cycles/degree. A significant mean reduction was found at spatial frequencies of 3, 6, 12, and 18 cycles/degree (P<.001). There was a significant change in corneal aberrations after surgery. The coefficients for coma increased and the coefficients for spherical aberrations decreased. A significant decrease was noted in point spread function values (P=.0018). CONCLUSIONS: Central presbyLASIK may be used to provide improvement in functional near vision in patients with presbyopia associated with low and moderate hyperopia. However, factors involved in the loss of BSCVA in some cases and loss in vision quality should be further clarified prior to its general use.

Adult↗

PubMed2006

LASIK in myopic patients with dermatological keloids.

PURPOSE: To evaluate the visual and refractive out come of LASIK in myopic patients with a known history of dermatological keloid scar. METHODS: This retrospective case series included 10 eyes of 5 white patients with a known history of dermatological keloids. All patients had low to moderate myopia with no corneal or limbal keloid. All underwent uneventful bilateral LASIK. Postoperatively, visual outcomes, refractive outcomes, and complications were evaluated. Minimum 1-year follow-up was indicated for all patients in this study. RESULTS: Mean preoperative uncorrected visual acuity (UCVA) was 20/320 and 1 year postoperative 20/20. Mean preoperative best spectacle-corrected visual acuity (BSCVA) was 20/25 and 1 year postoperative was 20/20. The mean preoperative spherical equivalent refraction was -5.00 +/- 2.6 diopters (D) and +0.1 +/- 0.2 D 1 year postoperative. The safety index was 1.02 and the efficacy index was 1.02. None of the included in this study underwent retreatment for correction of residual error or regression up to 1 year postoperatively. No sight-threatening complications were reported. No patient reported postoperative haze, severe dry eye syndrome, or flap-related problems. CONCLUSIONS: LASIK is a safe, effective, and predictable technique for correcting low and moderate myopia in patients with dermatological keloids.

Adult↗

PubMed2006

Corneal higher order aberrations: a method to grade keratoconus.

PURPOSE: To use the anterior corneal surface higher order aberrations as a tool to detect and grade keratoconus using corneal map analysis videokeratoscopy. METHODS: A prospective observational comparative study of 80 eyes was performed. The eyes were divided into two groups. Group A comprised 40 eyes of 20 asymptomatic individuals with no ocular pathology. Mean sphere was -0.03 diopters (D) (range: +0.75 to -0.75 D), mean cylinder was -0.27 D, mean average K was 43.28 D, and mean uncorrected visual acuity (UCVA) was 1.01. Group B comprised 40 eyes of 25 patients with keratoconus. Mean sphere was -3.70 D (range: +2.00 to -10.00 D), mean cylinder was -3.82 D, mean average K was 49.29, and mean best spectacle-corrected visual acuity (BSCVA) was 0.61. RESULTS: In group A, mean root-mean-square (RMS) of spherical (Z4 and Z6), coma-like (Z3, Z5, and Z7), and higher order aberrations (Z3-7) were 0.38 microm, 0.35 microm, and 0.52 microm, respectively. In group B, mean RMS of spherical, coma-like, and higher order aberrations were 1.06 microm, 2.90 microm, and 3.14 microm, respectively, for a 6.0-mm simulated pupil diameter. Mean RMS differences between the two groups were 0.68 microm (P < or = .0002), 2.55 microm (P < or = .0001), and 2.61 microm (P < or = .0001) for spherical, coma-like, and total higher order aberrations, respectively. In group B, according to Amsler-Krumeich classification, the mean RMS of coma-like aberration was 1.87 microm in grade I (14 eyes), 2.97 microm in grade II (11 eyes), 3.46 microm in grade III (12 eyes), and 5.20 microm in grade IV (3 eyes). CONCLUSIONS: Corneal higher order aberrations, especially coma-like aberrations, are significantly higher in eyes with keratoconus than normal eyes. Coma-like aberrations, with the aid of a corneal aberrometry map, are good indicators for early detection and grading of keratoconus.

Adult↗

PubMed2006

Hyperopic LASIK retreatments with the Technolas laser.

PURPOSE: To evaluate the safety, efficacy, and predictability of hyperopic LASIK retreatments. METHODS: This retrospective, consecutive, non-comparative, observational study included 85 eyes that underwent hyperopic LASIK retreatment with 1-year follow-up. Complete ophthalmic examination included distance uncorrected (UCVA) and best spectacle-corrected visual acuity (BSCVA), cycloplegic refraction, and pachymetry. Patients were divided into two groups according to the preoperative spherical equivalent refraction: group 1, < or = +3.9 diopters (D) and group 2, > or = +4.0 D. RESULTS: The UCVA improved from 0.31 +/- 0.2 to 0.7 +/- 0.2 in group 1 and from 0.2 +/- 0.2 to 0.6 +/- 0.2 in group 2 following retreatment. Mean spherical equivalent refraction improved from +2.8 +/- 0.85 to +0.2 +/- 0.9 in group 1 and from +5.3 +/- 0.9 to +0.3 +/- 1.3 in group 2 after retreatment. In group 1, 32 (72.7%) of 44 eyes had BSCVA > or = 20/25, and in group 2, 24 (58.5%) of 41 eyes had BSCVA > or = 20/25. After primary hyperopic LASIK, 25 (56.8%) of 44 eyes in group 1 and 19 (46.3%) of 41 eyes in group 2 maintained BSCVA or gained > or = 1 lines postoperatively in contrast to 21 (47.7%) of 44 eyes in group 1 and 22 (53.9%) of 41 eyes in group 2 after retreatment. In group 1, 11 (25%) of 44 eyes lost > or = 2 lines of BSCVA after initial hyperopic LASIK compared to 14 (31.8%) of 44 eyes after retreatment. In group 2, 10 (24.4%) of 41 eyes lost > or = 2 lines of BSCVA after initial hyperopic LASIK compared to 12 (29.2%) of 41 eyes after retreatment. After hyperopic LASIK retreatment, 31 (70.5%) of 44 eyes in group 1 and 19 (46.4%) of 41 eyes in group 2 were within +/- 0.5 D of emmetropia. Safety was 0.9 in both groups and efficacy was 0.8 and 0.7 in groups 1 and 2, respectively. Complications included epithelial ingrowth of 1 to 3 mm (30%) and flap edge melting (2%). CONCLUSIONS: Hyperopic LASIK retreatment improved the refractive results of initial hyperopic LASIK surgery with 20% to 30% of eyes gaining > or = 1 lines of BSCVA. The loss of BSCVA was greater after primary hyperopic LASIK than after retreatment.

Adult↗