Long-term Clinical Outcomes of Phototherapeutic Keratectomy in Corneas With Granular Corneal Dystrophy Type 2 Exacerbated After LASIK
Granular corneal dystrophy type 2 (GCD2) is an autosomal dominant disorder caused by a missense mutation in the transforming growth factor β-induced gene TGFBI (p.Arg124His).1 GCD2 presents with three types of corneal deposits: granular deposits at an early stage, linear deposits with progression, and diffuse stromal haze. Patients with GCD2 exhibit acceptable corrected distance visual acuity (CDVA) in the early stages.2–5 Trauma to the central cornea, including from LASIK, laser epithelial keratomileusis, and photorefractive keratectomy (PRK),6–11 has been reported to induce the exacerbation (Source: Journal of Refractive Surgery)
Source: Journal of Refractive Surgery - February 12, 2018 Category: Opthalmology Authors: Ikhyun Jun, MD, PhD Source Type: research
Corneal Apical Scar After Hyperopic Excimer Laser Refractive Surgery: Long-term Follow-up of Treatment With Sequential Customized Therapeutic Keratectomy
Hyperopic excimer laser refractive surgery involves the ablation of peripheral cornea to increase the curvature of the center.1 However, this abrupt increase in corneal curvature from the periphery to the center2 may result in complications. Despite several technical recommendations that have been proposed to prevent complications,3,4 the development of a whitish corneal apical scar may still be observed,5,6 especially after high hyperopic corrections,5 if not properly done. This corneal scar always occurs beneath the epithelium after excimer laser surface ablation regardless of whether the (Source: Journal of Refractive Surgery)
Source: Journal of Refractive Surgery - February 12, 2018 Category: Opthalmology Authors: Paolo Vinciguerra, MD Source Type: research
Factors Influencing Cyclotorsion During Photorefractive Keratectomy
Cyclotorsion occurs when changing from a sitting to a supine position (static cyclotorsion)1,2 and also intraoperatively (dynamic cyclotorsion) in eyes undergoing LASIK and photorefractive keratectomy (PRK).3 –5 average amount of absolute intraoperative cyclotorsion has been reported to be approximately 2° to 3°.6 It can exceed 10° in some patients,6,7 and instances of up to 24° have also been reported.4 Intraoperative cyclotorsion can negatively affect the refractive outcome and vision quality of patients undergoing refractive surgery.6 It leads to undercorrection and decreased precision for (Source: Journal of Refractive Surgery)
Source: Journal of Refractive Surgery - February 12, 2018 Category: Opthalmology Authors: Fateme Alipour, MD Source Type: research
Estimation of LASIK Flap Thickness
We read with great interest the article by Brenner et al.,1 which compares accuracy of visual estimation of LASIK flap thickness versus ultrasound measurements, and there are some concerns we would like to share. First of all, if the percent of tissue altered (PTA)2 is considered, a customized residual stromal bed should have been estimated for each patient, instead of setting the “safe level” at 300 µm. For instance, for a preoperative 600-µm central corneal thickness (CCT) cornea, a 300-µm residual stromal bed means that the PTA is 50%, clearly beyond the safe zone. Second, although it has (Source: Journal of Refractive Surgery)
Source: Journal of Refractive Surgery - February 12, 2018 Category: Opthalmology Authors: Alberto Parafita-Fern ández, MD Source Type: research
Intraoperative Patient Experience and Postoperative Visual Quality After SMILE and LASIK in a Randomized, Paired-Eye, Controlled Study
Fear and anxiety may affect patient cooperation during surgery, with increased risk of complications in uncooperative or fearful patients.1 Therefore, it is of great value to evaluate the patient intraoperative experience to improve preoperative patient counselling. Detailed information of what to expect during surgery may help to reduce patient anxiety and thereby reduce the risk of intraoperative complications. A previous study of LASIK and SMILE has shown patients' experience is more fearful during suction application, laser cutting, and tissue manipulation with LASIK than SMILE.2 However, (Source: Journal of Refractive Surgery)
Source: Journal of Refractive Surgery - February 12, 2018 Category: Opthalmology Authors: Iben B. Damgaard, MD Source Type: research
Incidence and Outcomes of Optical Zone Enlargement and Recentration After Previous Myopic LASIK by Topography-Guided Custom Ablation
Ablation-related complications following refractive surgery such as decentered ablations, small optical zones, or irregular ablations can produce irregular optics and compromise quality of vision.1 Over the past two decades, several excimer laser platforms have developed topography-guided treatments to treat corneal irregularities.2 –17 Published reports to date have found topography-guided treatment in general to be effective, successfully increasing uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), reducing corneal aberrations, and improving the regularity (Source: Journal of Refractive Surgery)
Source: Journal of Refractive Surgery - February 12, 2018 Category: Opthalmology Authors: Dan Z. Reinstein, MD, MA(Cantab), FRCSC Source Type: research
Risk Factors for Epithelial Ingrowth Following Microkeratome-Assisted LASIK
Epithelial ingrowth is one of the most common complications following LASIK1 and clinically apparent in up to 9.1% of cases.2 –4 Post-mortem histopathological studies have revealed that some degree of epithelial ingrowth is evident in nearly half of patients following LASIK.5 Clinical signs of epithelial ingrowth range from subtle interface epithelial pearls or fluorescein pooling at the edge of the flap to devastating complications such as keratolysis or melting of the flap edge.6,7 Clinically apparent epithelial ingrowth seems to occur when a route develops under the flap, which allows (Source: Journal of Refractive Surgery)
Source: Journal of Refractive Surgery - February 12, 2018 Category: Opthalmology Authors: Asaf Friehmann, MD Source Type: research
White Ring Sign and Sequential Segmental Terminal Lenticular Side Cut Dissection for Uneventful and Complete Lenticular Extraction in SMILE
We wanted to congratulate Ng et al.1 for describing an effective lenticular hydration technique for identification and extraction of a lenticular remnant after small incision lenticule extraction (SMILE). We also agree with their observation that prevention is the best solution for this condition and we would like to add here two techniques described by one of us (SJ) to facilitate easy extraction and to prevent lenticular tears. The first is the white ring sign, which prevents unintentional initial posterior dissection and thereby a lenticule adherent to the cap.2 This sign uses the (Source: Journal of Refractive Surgery)
Source: Journal of Refractive Surgery - February 12, 2018 Category: Opthalmology Authors: Soosan Jacob, MS, FRCS, DNB Source Type: research
Analysis of Accommodative Performance of a New Accommodative Intraocular Lens
Satisfactory vision for both reading and far distances in presbyopic or pseudophakic eyes implanted with intraocular lenses (IOLs) can be achieved by extending the depth of focus of the eye (ie, by pseudoaccommodation).1,2 The extended depth of focus can be achieved by multifocal IOLs,3 –5 corneal inlays,6 and IOLs employing the pinhole effect.7 However, such devices do not change the refractive power of the eye in response to the accommodative stimulus and usually cause side effects, including reduced visual acuity, loss of contrast sensitivity, and unwanted photic phenomena (eg , glare and (Source: Journal of Refractive Surgery)
Source: Journal of Refractive Surgery - February 12, 2018 Category: Opthalmology Authors: Jorge L. Ali ó, MD, PhD, FEBOphth Source Type: research
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Source: Journal of Refractive Surgery - January 13, 2018 Category: Opthalmology Authors: J. Bradley Randleman, MD Source Type: research
Erratum for “In Vivo Early Corneal Biomechanical Changes after Corneal Cross-Linking in Patients with Progressive Keratoconus”
The article “In Vivo Early Corneal Biomechanical Changes After Corneal Cross-linking in Patients With Progressive Keratoconus” by Vinciguerra et al., which was published in the December 2017 issue of the Journal of Refractive Surgery (volume 33, number 12, pp. 840–846), has been amended to include a factu al correction. An error was identified subsequent to its original printing. In Table 1 on page 841, the parameter “Fluence (total) (mJ/cm2)” should read “Fluence (total) (J/cm2)” This error was acknowledged on page 68, volume 34, issue 1. The online article and its erratum are considered the (Source: Journal...
Source: Journal of Refractive Surgery - January 10, 2018 Category: Opthalmology Authors: TBD Source Type: research
Energy Setting and Visual Outcomes in SMILE: A Retrospective Cohort Study
Since their introduction, femtosecond lasers have played a large role in the field of refractive corneal surgery, with the newest application being small incision lenticule extraction (SMILE).1,2 The energy needed to cause this reaction has been the focus of significant study.3 –6 The functional parameters of femtosecond lasers, such as the repetition rate of the laser system, energy, and spot-track-distance, significantly affect the interaction of the laser with the corneal tissue. De Medeiros et al.7 reported that femtosecond laser energy level had an effect on corneal stromal cell death and (Source: Journal of Refractive Surgery)
Source: Journal of Refractive Surgery - January 10, 2018 Category: Opthalmology Authors: Liuyang Li, MD Source Type: research
2017 Reviewers
Each individual listed has donated time, effort, and thought toward reviewing manuscripts written by his or her colleagues. This is a labor of personal and academic dedication, as reviewers receive no pay or recognition for their efforts —except this simple listing. The peer-review process is an essential element in the veracity of papers published in the Journal of Refractive Surgery, an element that cannot be avoided, truncated, or subverted. The reviewers' comments help guide the editors in selecting articles for publication; w e emphasize that it is the editors—not the reviewers—who make (Source: Journal of Refractive Surgery)
Source: Journal of Refractive Surgery - January 10, 2018 Category: Opthalmology Authors: TBD Source Type: research
Unusual Internal Astigmatism Due to Severe Capsule Contraction Syndrome
Capsule contraction syndrome is a complication of continuous curvilinear capsulorhexis created during phacoemulsification that usually occurs within the first 3 months following surgery.1 More than its optic or haptic design, the intraocular lens (IOL) material appears to be a major risk factor for capsule contraction syndrome.2 Silicon and acrylic hydrophilic2 IOLs seem to be more frequently associated with such a complication. Some preexisting disorders, such as retinitis pigmentosa,3 exfoliation syndrome, diabetes melitus,4 myotonic muscular dystrophy, pars planitis, and high myopia,5 also (Source: Journal of Refractive Surgery)
Source: Journal of Refractive Surgery - January 10, 2018 Category: Opthalmology Authors: Pierre Z éboulon, MD Source Type: research
