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Biomedical subjects

L Buratto

Publications and source records attributed to L Buratto.

17 recordsLinked to original sources
PubMed1997

Indications, techniques, results, limits, and complications of laser in situ keratomileusis.

In this article we describe the state of the art of laser in situ keratomileusis (LASIK) through a presentation of the principles, the advantages, the disadvantages, the indications, the techniques, and the main complications. LASIK, as it is known today, involves the creation of a corneal flap using a keratome; this is followed by the in situ photoablation of the exposed stromal bed with an excimer laser. The flap thickness is about 160 mm with a circumference of about 300 degrees, the idea being to leave a portion of tissue attached, thus creating a corneal hinge. The in situ stromal bed exposed by the lamellar cut is then photoablated and the flap is repositioned without sutures. Functional recovery and anatomical healing are rapid. The operation is painless, and it is performed under topical anesthesia in an outpatient environment.

Cornea↗
PubMed1992

Excimer laser intrastromal keratomileusis.

We studied 30 eyes in 22 patients with severe myopia who underwent myopic keratomileusis combined with excimer laser refractive correction. The goals of the study were to evaluate the efficacy of the procedure in decreasing myopia, to assess the response of the cornea to intrastromal photoablation, and to examine the relationship between the number of laser pulses and the refractive correction achieved. The patients were observed for six months. The technique demonstrated a marked refractive reduction (from 171.875 +/- 3.32 diopters to -2.125 +/- 1.40 diopters) and an excellent corneal response to photoablation. An average decrease of 7.63 diopters was observed in keratometry readings. No marked change in the degree of astigmatism was observed after the procedure. Intrastromal haze was observed biomicroscopically in three of 30 eyes (10%). Postoperative best-corrected visual acuity remained at the preoperative level in 22 eyes (74%), improved in five eyes (16%), and declined in three eyes (10%). At the end of the follow-up period, uncorrected visual acuity was 20/50 or better in three of 30 treated eyes (10%) and 20/100 or better in 25 of 30 treated eyes (83.3%). No intraoperative complications were observed, but the following postoperative complications were seen in seven of 30 (23.2%) eyes: four eyes (13.3%) developed irregular astigmatism, one eye (3.3%) had poor night vision, and two eyes (6.6%) had irregularities in Bowman's membrane. The operation was repeated with homoplastic material in one of the two eyes with Bowman's membrane irregularities after six months, because of central alterations in Bowman's membrane.

Adolescent↗
PubMed1992

Excimer laser intrastromal keratomileusis: case reports.

We report the results in six eyes on which we performed a new surgical method: intrastromal corneal excimer laser photoablation following lamellar corneal keratectomy with a microkeratome. The study was designed to evaluate the clinical and refractive efficacy of the procedure, to assess the behavior of the cornea following stromal photoablation, and to evaluate the relationship between the number of laser pulses and the decrease of myopia. The technique demonstrated an excellent corneal response to photoablation but a poor refractive predictability.

Adult↗
PubMed1985

Use of the YAG laser with a seven-micron spot in pseudophakic eyes.

We report on 216 cases of posterior capsulotomy performed with a LASAG Microruptor II YAG laser in patients with posterior chamber intraocular lenses. In 108 cases, the YAG laser was used in multimode with a 70-micron spot and 3.5 mJ to 5.0 mJ of energy; in the other 108 cases, the laser was used in fundamental mode with a 7-micron spot and 0.7 mJ to 1.2 mJ of energy. In the first group, IOL damage was seen in 10.2% of cases, uveitis developed in 0.4% of patients, and transient eye pressure elevation was noted in 6.5% of patients. In the second group, neither IOL damage nor uveitis occurred, and only two cases (1.8%) developed transient pressure elevation.

Aged↗
PubMedDate not supplied

Accommodative intraocular lenses: short-term visual results of two different lens types.

PURPOSE: To compare the ability of two types of accommodative intraocular lenses (IOLs) to provide uncorrected near and distance visual acuity (VA) after cataract surgery. METHODS: A total of 108 eyes of 75 patients underwent cataract surgery by phacoemulsification and IOL implantation either bilaterally or monocularly with one of two types of accommodative IOLs: the AT-45 lens (69 eyes) or the 1-CU lens (39 eyes). Patients were followed for up to 1 year after cataract surgery. Near VA was measured through the distance correction to obtain the true near vision effect of the accommodating IOL. RESULTS: Uncorrected distance VA of 20/30 or better was achieved by 84.6% of the bilaterally implanted 1-CU patients and 73.6% of the bilaterally implanted AT-45 IOL patients 1 year following surgery. Uncorrected near VA of J1 or better was achieved by 42% of the patients with the bilateral 1-CU implant and 36.8% of the patients with the bilateral AT-45 implant. For J3 or better near acuity, the values were 92.3% for the bilateral 1-CU patients and 84.2% for the bilateral AT-45 patients at 1 year. A total of 54% of the eyes with 1-CU implants underwent a mild myopic shift (<1.0 D), 21% had a mild hyperopic shift, and 45% of the eyes were emmetropic at 1 year. CONCLUSIONS: Both accommodative IOLs provided good near and distance vision postoperatively. The 1-CU IOL appears clinically to provide slightly better uncorrected distance and distance-corrected near VA than the AT-45 lens.

Accommodation, Ocular↗
PubMedDate not supplied

Excimer laser lamellar keratoplasty of augmented thickness for keratoconus.

PURPOSE: We describe a modified surgical technique for the treatment of patients in the early stage of keratoconus, when it is still possible to correct the astigmatic ametropia with contact lenses. METHODS: Excimer laser lamellar keratoplasty of augmented thickness (ELLKAT) is a procedure in which a deep plano excimer laser ablation is done on the host cornea and a donor lamellar button--with or without an excimer laser refractive ablation on the posterior surface--is sutured into the recipient bed. In 12 of 20 eyes, the homoplastic button, which had parallel faces and was devoid of any dioptric power, was treated refractively on its stromal face with a Chiron Keracor 116 excimer laser to correct the axial and/or induced myopia present due to the weakened cornea. RESULTS: The 8 eyes that received donor buttons without excimer laser ablation had improved spectacle-corrected visual acuity from a mean preoperative value of 20/100 (no eye saw 20/40 or better before surgery) to a mean postoperative value of 20/30 after 18 months. Mean refractive astigmatism was reduced from 4.84 +/- 2.34 D to 1.00 +/- 0.46 D. Mean keratometric power was reduced from 56.75 +/- 8.01 D to 44.21 +/- 2.12 D. The associated mean spherical equivalent refraction was reduced from -4.75 to -3.00 D. Mean corneal thickness increased from 422.25 +/- 83 microns preoperatively to 562.87 +/- 57.81 microns postoperatively. The 12 eyes that received donor lamellar buttons treated with excimer laser also had improved spectacle-corrected visual acuity from a mean preoperative value of 20/100 to a mean postoperative value of 20/30 after 18 months. Astigmatism was reduced from a mean 4.84 +/- 2.77 D to 1.66 +/- 1.30 D; mean keratometric power was reduced from 56.08 +/- 7.00 D to 45.31 +/- 2.08 D; and the associated mean spherical equivalent refraction was reduced from -8.75 to -1.75 D. Corneal thickness increased from a mean 414.25 +/- 64.75 microns preoperatively to 576.75 +/- 28.23 microns postoperatively. CONCLUSION: Compared to penetrating keratoplasty, excimer laser lamellar keratoplasty of augmented thickness for keratoconus has the advantage of preserving the host endothelium and of reducing the refractive error in keratoconus.

Adult↗
PubMedDate not supplied

Retrospective comparison of freeze and non-freeze myopic epikeratophakia.

We conducted a retrospective study of 20 eyes of 20 selected patients with preoperative myopia of -14 to -28 diopters who were treated with myopic epikeratophakia and followed for 8 weeks. Seven eyes were treated with frozen-lyophilized donor lenticules by the Kaufman-McDonald technique and 13 eyes were treated with freshly prepared donor lenticules using the Barraquer-Krumeich-Swinger (BKS) technique. All lenticules were sutured into a circular keratotomy without keratectomy. Postoperatively, all eyes had a refraction between -4.00 and +2.00 D, and there was no meaningful difference in the refractive outcome of the two groups. The freeze-lyophilized technique showed a greater overall loss of best spectacle corrected visual acuity, although no eyes in the entire series lost more than two lines of Snellen visual acuity compared to preoperative values. Uncorrected visual acuity after surgery was 20/40 or better in 5% of each group. The rate of postoperative epithelialization was slower in the freeze-lyophilized group, but all eyes were re-epithalialized by 3 weeks after surgery. No lenticules had to be removed for complications, but there was one case of epithelial ingrowth into the interface that required a second operative procedure. Our clinical experience with this small group of eyes shows that both techniques of myopic epikeratophakia can safely and effectively reduce high amounts of myopia, but that the refractive outcome is less predictable than desired. The technical requirements for the non-freeze (BKS) technique are high, but the rate of visual recovery is faster.

Adult↗
PubMedDate not supplied

Myopic keratomileusis with the excimer laser: one-year follow up.

BACKGROUND: The possibility of using an argon fluoride excimer laser to perform the refractive incision in keratomileusis spurred us to develop the present surgical technique of using a microkeratome to make a primary corneal incision that yields a corneal disc, then making the refractive excision of stroma with excimer laser ablation, and finally suturing the corneal disc in place. METHODS: We describe the procedures and a prospective study of 30 consecutive eyes from 22 consecutive patients with high myopia (range, -11.20 D to -24.50 D) who underwent excimer laser myopic keratomileusis. A plano corneal disc was cut with a BKS 1000 microkeratome, followed by argon fluoride excimer laser ablation of the stroma with the Summit Eximed UV 200LA laser (Summit Technology, Inc, Waltham, Mass), either of the resected disc (28 eyes) or in situ on the stromal bed (two eyes). RESULTS: By 3 weeks after surgery, 83% of the corneas were considered clear. In 17 eyes (57%), the difference between the intended and achieved refraction was < 1.00 D; in 9 eyes (30%), the difference was 1.00 to 3.00 D; in 4 eyes (13%), the difference was 3.00 to 6.00 D. At 12 months after surgery, uncorrected visual acuity was 20/40 or better in 3 (10%) eyes, and 20/50 to 20/100 in the remaining 27 (90%) eyes, in contrast to 100% of eyes that saw worse than 20/200 before surgery. Two eyes had a very deep ablation of the lenticule that led to irregularities in Bowman's layer. CONCLUSIONS: Excimer laser myopic keratomileusis is an effective way to correct high myopia and may be more accurate than other methods of keratomileusis. A new nomogram for the procedure is presented.

Adolescent↗
PubMedDate not supplied

Keratomileusis for myopia with the excimer laser (Buratto technique): short-term results.

We present a prospective clinical study based on the results of 150 consecutive cases of myopic intrastromal keratomileusis cases using the Exci-Med UV200 193 nm excimer laser 193-nanometer (Summit Technology, Inc, Waltham, Mass) to reduce high myopia. The mean and standard deviation of the follow up considered was 3.13 +/- 1.12. The mean preoperative spheroequivalent was -18.96 +/- 3.70 D and -2.32 +/- 2.36 D postoperatively. One hundred twenty-eight eyes (85.3%) were within +/- 1.00 D from the intended correction. In a majority of cases the best spectacle corrected visual acuity was unchanged or improved. No cases of intraoperative complications were observed; postoperative complications are reported. The Buratto technique to correct or reduce high myopia is efficient and safe, while the predictability is satisfactory.

Adolescent↗
PubMedDate not supplied

Photorefractive keratectomy for myopia from 6.00 D to 10.00 D.

Surgical correction of mild and high myopia using excimer laser photorefractive keratectomy (PRK) remains controversial. We present a retrospective study of 40 consecutive PRK procedures performed to reduce myopia ranging from -6.00 D to -10.00 D. Postoperative follow up was 24 months. The mean preoperative spheroequivalent refraction was -8.12 +/- 1.52 D; postoperatively it was -2.31 +/- 1.25 D. In 26 of 40 eyes (65%) we observed a regression of the refraction effect after 6 months. In 85% of eyes a persistent corneal haze (+1 grading) was observed at the end of follow up. Photorefractive keratectomy to correct or reduce mild or high myopia is simple and safe but had poor predictability and significant refractive regression in this series.

Adolescent↗