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At least 19 recordsLinked to original sources
PubMed2000

Topography changes associated with sublamellar epithelial ingrowth after laser in situ keratomileusis.

Laser in situ keratomileusis (LASIK) was performed in 1 eye of a patient for correction of myopia. The patient was evaluated postoperatively using both Placido-disk-based videokeratography and rasterstereography. The patient developed an epithelial defect and subsequent sublamellar epithelial ingrowth after LASIK. The Placido-disk system demonstrated an area of flattening over the area of epithelial ingrowth, and rasterstereography more specifically identified the area over the epithelial ingrowth as an area of relative elevation.

Cell Division↗
PubMed2000

Postoperative complications in laser in situ keratomileusis.

Laser in situ keratomileusis (LASIK) has become the most common procedure to correct refractive errors in North America. Increasing numbers of patients and surgeons are choosing LASIK in the management of low and moderate myopia, astigmatism, and hyperopia. LASIK presents a unique group of postoperative challenges and complications. It is important to be able to identify these complications in the early and late postoperative periods and to provide effective management. In this article, we review the most commonly encountered early and late postoperative complications after LASIK and the most current methods in prevention and treatment.

Humans↗
PubMed2006

[Reactivation of ocular toxoplasmosis after laser in situ keratomileusis].

Laser in situ keratomileusis (LASIK) is a safe and efficient refractive surgical procedure that provides excellent results in most cases. Several complications have been reported, most of them related to the posterior segment of the eye. Although they are quite rare, a growing number of vitreoretinal pathologic conditions after LASIK have been reported. To date no article has reported an inflammatory or infectious disease of the posterior segment after a LASIK procedure. We report a case of reactivation of toxoplasmic chorioretinitis that occurred 5 days after a LASIK procedure. Clinical outcome was spontaneously favorable after 1 month, with no loss of vision. Although a causal effect between LASIK and toxoplasmic chorioretinitis reactivation cannot be proven with a single case report, we stress the importance of dilated fundus examination in LASIK preoperative assessment: our case suggests that in the presence of preoperative toxoplasmic chorioretinitis scars, increased retinal monitoring is required.

Adult↗
PubMed2000

Ocular deviation after unilateral laser in situ keratomileusis.

Laser keratomileusis and excimer laser photorefractive keratectomy in situ are widely used therapies for treating myopia. The corrections of refractive error by glasses or contact lens result in a relatively equal refractive correction on both eyes. However, refractive surgery on a single eye can cause a focus disparity between both eyes and may result in the impairment of fusion leading to strabismus. This article aims to report a case where diplopia and esotropia occurred 1 month after laser keratomileusis (LASIK) in situ for the correction of myopia.

Adult↗
PubMed2003

Treatment of simple hyperopia: comparison of laser in situ keratomileusis and laser thermal keratoplasty.

PURPOSE: To evaluate and compare the efficacy, stability, and safety of laser in situ keratomileusis (LASIK) and laser thermal keratoplasty (LTK) for the treatment of simple hyperopia. SETTING: John Hill Eye and Laser Centre, Cape Town, South Africa. METHODS: This retrospective study comprised consecutive patients having primary treatment of simple hyperopia of up to 3.0 diopters (D) with astigmatism of 0.5 D or less. Treatment methods were as follows: Group 1 (81 eyes), LASIK with the Nidek EC-5000 excimer laser; Group 2 (69 eyes), LASIK with the LaserSight LSX excimer laser; and Group 3 (84 eyes), LTK with the Sunrise holmium:YAG laser. RESULTS: The hyperopia decreased in all 3 groups. Both LASIK groups were stable by 1 month; there was continued regression in the LTK group for up to 18 months. The percentage of eyes achieving uncorrected visual acuities of 20/20 and 20/40 at 3 months were Nidek, 41% and 92%, respectively; LaserSight, 50% and 90%, respectively; and LTK, 21% and 89%, respectively. No eye lost more than 2 lines of best spectacle-corrected visual acuity. Surgically induced astigmatism (SIA) was evident in all 3 groups; it was highest in the LTK group. The mean posttreatment astigmatism was -0.47 D +/- 0.40 (SD) (range 0 to -1.50 D) in the Nidek group, -0.45 +/- 0.40 D (range 0 to -1.25 D) in the LaserSight group, and -0.81 +/- 0.51 D (range 0 to -2.25 D) in the LTK group. The enhancement rates were 16.75%, 22.57%, and 38.30%, respectively. Because of the SIA, 61% of the LTK enhancements were corrected with LASIK. CONCLUSIONS: All 3 treatment methods corrected hyperopia, but stability was achieved early in both LASIK groups, allowing early enhancement when necessary. Because LTK cannot currently correct astigmatism, many of the LTK repeat treatments required LASIK procedures. For these reasons, LASIK remains my preferred method to treat simple hyperopia up to +3.0 D.

Adult↗
PubMed2005

Influence of laser in situ keratomileusis and laser epithelial keratectomy on patients' reading performance.

PURPOSE: To evaluate the influence of laser in situ keratomileusis (LASIK) and laser-assisted subepithelial keratectomy (LASEK) on reading performance regarding reading acuity, reading speed based on print size, maximum reading speed, and critical print size. SETTING: Department of Ophthalmology, University of Vienna, Vienna, and Auge-und-Laser, Medicent Baden, Austria. METHODS: Fifty-two eyes of 34 patients (26 eyes per group) were studied. Best corrected LogMAR visual acuity (Early Treatment Diabetic Retinopathy Study charts), reading acuity, and reading speed were tested monocularly before LASIK or LASEK and 3 weeks after surgery. Reading acuity (LogRAD) and reading speed were determined with the standardized Radner reading charts. RESULTS: Preoperatively, the distance visual acuity and reading acuity were comparable between the LASIK and LASEK patients. Reading speed measurements also showed no statistical difference. Three weeks after refractive surgery, no statistically significant differences in the preoperative measures and between the 2 surgical procedures could be found in any tested parameters. The mean distance visual acuity was LogMAR -0.02 +/- 0.06 (SD) (LASIK) and LogMAR -0.05 +/- 0.07 (LASEK). The mean reading acuity was LogRAD 0.00 +/- 0.12 (97.7% of LogMAR) (LASIK) and LogRAD 0.04 +/- 0.16 (93.7% of LogMAR) (LASEK). The mean maximum reading speed was 235 +/- 35 words per minute (LASIK) and 240 +/- 37 words per minute (LASEK), and the mean critical print size was at LogRAD 0.48 +/- 0.19 (LASIK) and 0.49 +/- 0.17 (LASEK). CONCLUSIONS: In a standardized reading test setting, no significant effects of LASIK and LASEK on individual reading performance could be evaluated. This indicates that patients can expect to retain their normal visual function after refractive surgery with these 2 procedures under full light conditions.

Adult↗
PubMedDate not supplied

Laser in situ keratomileusis vs. laser epithelial keratomileusis (LASIK vs. LASEK).

PURPOSE: To compare results of laser in situ keratomileusis (LASIK) and laser epithelial keratomileusis (LASEK) for the treatment of myopia. METHODS: Two groups of fifteen patients (30 eyes) each were assigned to either the LASIK group or the LASEK group. LASIK procedure: A Hansatome microkeratome with the ring at 9.5 mm was used to create the corneal flap (depth, 160 microm). The myopic correction was then registered on the Nidek EC-5000 excimer laser and the appropriate ablation performed. LASEK procedure: Twenty percent ethyl alcohol was placed within the corneal epithelial ring. An intact epithelial flap was retracted. The Nidek EC-5000 excimer laser was applied in a similar manner to the LASIK procedure. Patients from both groups were followed postoperatively for 6 months, measuring best spectacle-corrected visual acuity, contrast sensitivity, and corneal topographic meridians of 3 mm, 5 mm, and 7 mm. RESULTS: Comparing corneal topography, best spectacle-corrected visual acuity, and contrast sensitivity data, refractive results in the LASEK group were better than the LASIK group. CONCLUSION: Objective data show that with the Nidek EC-5000 excimer laser, the LASEK method of corneal splitting may prove superior to the LASIK method.

Adult↗
PubMedDate not supplied

Prospective, paired comparison of laser in situ keratomileusis and laser epithelial keratomileusis for myopia less than -6.00 diopters.

PURPOSE: To compare visual and refractive results, contrast sensitivity, and tear stability after laser in situ keratomileusis (LASIK) in one eye and laser epithelial keratomileusis (LASEK) in the fellow eye for low myopia. METHODS: Patients diagnosed with low myopia, with a maximum difference of 1 D between their two eyes, were randomly assigned to receive LASEK on one eye and LASIK on the other eye. A total of 64 eyes of 32 patients with a mean age of 26.83 +/- 5.33 years were included in the study. Preoperative myopia ranged from -1.00 to -6.00 D. Follow-up was 6 to 12 months. Uncorrected (UCVA) and best spectacle-corrected visual acuity (BSCVA), Schirmer test results, tear break-up time, corneal asphericity, corneal uniformity index, predicted corneal acuity, and contrast sensitivity values were compared with preoperative values. A Wilcoxon test was used for statistical comparisons and a P-value less than .05 was considered significant. RESULTS: At 6 months after surgery, there was no statistically significant difference in UCVA, BSCVA, spherical and cylindrical refractive error, Schirmer test, or tear break-up time between groups. Contrast sensitivity values in the LASIK eyes were lower in comparison to preoperative values, but there was no change in the LASEK group. CONCLUSIONS: Based on 6-month results, LASEK for low myopia was safe and effective with predictable results, offered early refractive stability, and may be considered an alternative for LASIK.

Adult↗
PubMed2000

[Clinical outcome after in situ laser keratomileusis (LASIK) for myopia: a series of 390 eyes].

PURPOSE: We report our personal experience with LASIK for myopia to study its efficacy, safety, predictability and stability for low, moderate and high myopia. PATIENTS AND METHODS: Between January 1996 and December 1997, 390 eyes were treated. Follow-up was 6 months for 254 and one year for 136. Initial myopia ranged from -1.5 to -16 diopters with a spherical equivalent of -8.49D. The surgical procedure with topical anesthesia used the Chiron ALK-E automated corneal shaper for the initial flap of 160 microns thick, and the Chiron Excimer Laser Keracor 117 Technolas with an active eye tracking system for the stromal photoablation. Preoperative refraction, uncorrected (UVA) and best corrected visual acuity (BCVA) were compared to postoperative results. RESULTS: They are reported overall and for sub-groups of myopia. (A<=-5 D, -5 D =20/40 at 6 months. Average UVA was 0.65 D at one year and was as better as preoperative myopia was lower (group A 0.65D, group B0.5 at 6 months). Mean spherical equivalent was +0.08 D at J1 and -1.02 D at one year (group A -0.8 D, group B -0.67 D, and group C -3.92 D). Safety was correct and only a few per and postoperative complications were observed with only two patients losing more than two lines of BCVA. Mean BCVA was 0.72 at one year. Predictability demonstrated that 90% of group A eyes were at +/-1 D from emmetropia and 74% in group B at 6 months. More than 95% of eyes were stable at 6 months and 90% at one year. CONCLUSION: LASIK is a safe and efficient surgical treatment for low, moderate and high myopia, and should be improved with new software and new corneal shapers.

Female↗
PubMedDate not supplied

Nomogram for treatment of astigmatism with laser in situ keratomileusis.

PURPOSE: Laser in situ keratomileusis (LASIK) is a mainstay in refractive surgery. Myopes and compound myopic astigmats generally have a good result after LASIK. However, simple myopic astigmats are sometimes not as pleased with their visual outcome. METHODS: We analyzed 40 patients who underwent LASIK with the Nidek EC-5000 excimer laser and the Hansotome microkeratome. The key to successful LASIK in these patients was proper analysis of corneal topography. RESULTS AND CONCLUSION: We found that 37 of the 40 patients studied had an excellent result, but poor topographic interpretation gave a poorer result in the remaining three patients. We discuss how to correctly interpret corneal topography and proper case selection and patient counseling.

Adolescent↗
PubMed2002

Complications of laser-in-situ-keratomileusis.

Laser-in-situ-keratomileusis (LASIK) has become a popular technique of refractive surgery because of lower postoperative discomfort, early visual rehabilitation and decreased postoperative haze. Compared to photorefractive keratectomy (PRK), LASIK involves an additional procedure of creating a corneal flap. This may result in complications related to the flap, interface and underlying stromal bed. The common flap-related complications include thin flap, button holing, free caps, flap dislocation and flap striae. The interface complications of diffuse lamellar keratitis, epithelial ingrowth and microbial keratitis are potentially sight threatening. Compared to PRK, there is less inflammation and faster healing after LASIK, but there is a longer period of sensory denervation leading to the complication of dry eyes. The refractive complications include undercorrection, regression, irregular astigmatism, decentration and visual aberrations. Honest and unbiased reporting is important to understand the aetiology and redefine the management.

Cornea↗
PubMedDate not supplied

Visual rehabilitation with contact lenses after laser in situ keratomileusis.

PURPOSE: Laser in situ keratomileusis (LASIK) has become the surgical treatment of choice for moderate myopia and is in widespread use globally. Visual potential is sometimes limited due to irregular corneal topography following surgery. METHODS: A retrospective chart review of 35 eyes of 22 patients requiring visual rehabilitation following LASIK was performed. Four contact lens designs were used and evaluated for appropriate cornea-contact lens fitting relationship. RESULTS: Mean best contact lens-corrected visual acuity of 20/25 was significantly better than best spectacle-corrected visual acuity of 20/40. The average time from surgery to contact lens fitting was 8 months, with almost half (10/22) being fitted at 4 months. An aspheric design with 0.17 mm of axial edge lift was used most commonly. Lens diameters ranged from 9.2 to 10.9 mm, with a mean diameter of 10.2 mm. The contact lens base curve to cornea relationship would suggest an initial base curve selection to be approximately 2.1 D steeper than the mean postoperative keratometric power. CONCLUSIONS: Rigid gas permeable contact lenses can improve visual function in patients with irregular corneal topography after LASIK.

Adult↗
PubMed2001

[Epithelial scraping for corneal epithelial ingrowth after laser in situ keratomileusis].

BACKGROUND: Laser in situ keratomileusis (LASIK) is an effective method for correcting a wide range of myopia. However, complications sometimes occur. We report here a case treated with epithelial scraping two years and 4 months after surgery for epithelial ingrowth in the central cornea after LASIK. CASE: A 32 year-old woman who had undergone LASIK one year and 4 months before visited our hospital because of visual loss. At the first examination in our clinic, her best-corrected visual acuity was 20/60 in the right eye and 20/15 in the left eye. Epithelial ingrowth was observed in both eyes, but in the right eye, the epithelial ingrowth had reached the central cornea leading to the visual loss. The increased corneal stromal opacity decreased the visual acuity to 20/400. The patient decided to undergo epithelial scraping. The corneal flap was dissected again and epithelial scraping was performed on the stromal bed and back of the corneal flap. The visual acuity was improved from 20/400 to 20/40. However, the stromal opacity and the corneal astigmatism still remained. CONCLUSION: This case suggests that epithelial scraping should be performed immediately when ingrowing epithelium after LASIK begins to invade the central cornea.

Adult↗
PubMed2004

Laser in situ keratomileusis versus laser-assisted subepithelial keratectomy for the correction of high myopia.

PURPOSE: To compare the visual and refractive outcomes of laser in situ keratomileusis (LASIK) and laser-assisted subepithelial keratectomy (LASEK) in the treatment of high myopia. SETTING: Institute of Vision Research, Department of Ophthalmology, College of Medicine, Yonsei University, and Balgeunsesang Ophthalmology Clinic, Seoul, South Korea. METHODS: Four hundred seventy eyes of 240 patients with manifest refraction spherical components greater than -6.00 diopters (D) were assigned to 2 groups: 324 eyes (167 patients) were treated with LASIK and 146 eyes (73 patients), with LASEK. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), remaining refractive error, corneal haze, and complications were followed in both groups for 12 months. RESULTS: At 12 months, the mean spherical equivalent (SE) was within +/-0.50 D of emmetropia in 205 eyes (63.3%) in the LASIK group and 81 eyes (55.5%) in the LASEK group and within +/-1.00 D in 261 eyes (80.6%) and 104 eyes (71.2%), respectively. The UCVA was 20/25 or better in 269 LASIK eyes (83.0%) and 111 LASEK eyes (76.0%). There was more than a 1-line loss of BSCVA in 4 LASIK eyes (1.2%) and 21 LASEK eyes (14.3%). The between-group differences in SE, magnitude of cylinder, UCVA, and haze were statistically significant (P<.05). CONCLUSIONS: Both LASIK and LASEK were safe and effectively treated eyes with high myopia. Laser in situ keratomileusis provided superior results in visual predictability and corneal opacity.

Adult↗
PubMed2006

Effect of laser in situ keratomileusis and laser-assisted subepithelial keratectomy on retinal nerve fiber layer thickness.

PURPOSE: To evaluate and compare the influence of laser in situ keratomileusis (LASIK) and laser-assisted subepithelial keratectomy (LASEK) on the peripapillary retinal nerve fiber layer (RNFL) thickness. SETTING: Observational case series. METHODS: Twenty nonglaucomatous patients with mild to moderate myopia were included. One eye in each patient was randomly selected to have LASIK (Group 1, n = 20), and LASEK was performed in the fellow eye (Group 2, n = 20). The RNFL thickness measurements were performed using optical coherence tomography (OCT) preoperatively and 1 day and 1 month postoperatively. The RNFL thickness parameters were compared using repeated-measures 1-way analysis of variance (ANOVA) followed by multiple comparison tests in both groups. The main outcome parameter was RNFL thickness as determined by OCT before and after LASIK and LASEK. RESULTS: The mean age of the patients was 21 years +/- 3.2 (SD). The mean preoperative spherical equivalent was -4.23 +/- 1.71 diopters (D) in Group 1 and -4.16 +/- 1.68 D in Group 2. The mean ablation depth was 73.35 +/- 27.85 microm and 66.35 +/- 23.64 microm in groups 1 and 2, respectively. In Group 1, the mean average RNFL thickness, inferior average, superior average, temporal average, and nasal average were 98.2 +/- 5.6 microm, 128.6 +/- 11.9 microm, 120.38 +/- 10.2 microm, 65. 8+/- 7.1 microm, and 80.5 +/- 18.8 microm, respectively. None of the RNFL thickness parameters or RNFL ratios were found to have a significant change after surgery. In Group 2, the average RNFL thickness, inferior average, superior average, temporal average, and nasal average were 98.47 +/- 5.9 microm, 128.38 +/- 14.3 microm, 125.1 +/- 8.8 microm, 66.4 +/- 8.2 microm, 73.6 +/- 15.8 microm, respectively. No significant change was observed in any of the parameters following surgery. No significant alterations were noted in the RNFL parameters following LASIK or LASEK. CONCLUSIONS: Laser in situ keratomileusis and LASEK did not significantly affect the RNFL thickness parameters postoperatively.

Adult↗
PubMed1998

Removal of flap striae following laser in situ keratomileusis.

While laser in situ keratomileusis (LASIK) offers advantages over photorefractive keratectomy (PRK), creation of the corneal flap has been associated with postoperative flap striae. These result from misalignment of the corneal flap after flap replacement, movement of the corneal flap during the first postoperative day, or the "tenting effect" of the corneal flap over the ablated stromal bed. Flap striae become more difficult to remove as the postoperative course progresses; therefore, identifying the striae on the first postoperative day is imperative. We describe techniques of flap hydration, refloating, stretching, and smoothing that we use to remove visually significant flap striae.

Corneal Transplantation↗
PubMedDate not supplied

Peripheral melt of flap after laser in situ keratomileusis.

BACKGROUND: Laser in situ keratomileusis (LASIK) is an effective procedure to correct myopia. It may have complications related to the flap, such as epithelial ingrowth and stromal melt. METHODS: We report on a patient who developed extensive epithelial ingrowth and partial keratolysis of the flap following LASIK. This complication was treated by lifting the flap and removing the epithelium from within the interface. RESULTS: Progressive keratolysis (stromal melt) can result in irregular astigmatism and loss of vision as well as photophobia and ciliary injection. The pathogenesis is not completely understood although the epithelial ingrowth in the interface is always present, and epithelial-stromal interaction with production of proteases may be involved. CONCLUSION: Epithelial ingrowth may develop in the lamellar interface after LASIK and be associated with melting of the edge of the flap. This undesirable complication can be successfully managed with early surgical removal of the epithelium and proper attachment of the flap.

Adult↗