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      Posterior Corneal Surface Stability after Femtosecond Laser-Assisted Keratomileusis

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          Abstract

          The purpose of this study was to evaluate posterior corneal surface variation after femtosecond laser-assisted keratomileusis in patients with myopia and myopic astigmatism. Patients were evaluated by corneal tomography preoperatively and at 1, 6, and 12 months. We analyzed changes in the posterior corneal curvature, posterior corneal elevation, and anterior chamber depth. Moreover, we explored correlation between corneal ablation depth, residual corneal thickness, percentage of ablated corneal tissue, and preoperative corneal thickness. During follow-up, the posterior corneal surface did not have a significant forward corneal shift: no significant linear relationships emerged between the anterior displacement of the posterior corneal surface and corneal ablation depth, residual corneal thickness, or percentage of ablated corneal tissue.

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          Corneal ectasia after laser in situ keratomileusis in patients without apparent preoperative risk factors.

          J Bradley Randleman, R Doyle Stulting, John Klein … (2006)
          To evaluate patients who developed ectasia with no apparent preoperative risk factors. Potential cases of patients who developed ectasia without apparent risk factors were identified by contacting participants in the Kera-Net (n = 580), ASCRS-Net (n = 450), and ISRS/AAO ISRS-Net (n = 525) internet bulletin boards from April to October 2003. Cases were included if ectasia developed after laser in situ keratomileusis in the absence of apparent preoperative risk factors. Reported cases were excluded for the following reasons: (1) calculated residual stromal bed less than 250 microm, (2) preoperative central pachymetry less than 500 microm, (3) any keratometry reading greater than 47.2 diopters (D), (4) a calculated inferior-superior value greater than 1.4, (5) more than 2 retreatments, (6) attempted initial correction greater than -12.00 D, (7) an Orbscan II "posterior float" (if obtained) greater than 50 microm, and (8) surgical/flap complications. A total of 27 eyes of 25 patients were submitted for consideration. Eight eyes (8 patients) met our inclusion criteria. Mean age was 27.7 years (range, 18-41 years). Preoperative manifest refraction spherical equivalent was -4.61 D (range, -2.00 to -8.00 D); steepest keratometric reading was 43.86 D (range, 42.50-46.40 D); keratometric astigmatism was 0.93 D (range, 0.25-1.90 D); and preoperative central pachymetry was 537 microm (range, 505-560 microm). The mean calculated ablation depth was 82.8 microm (range, 21-125.4 microm), and mean calculated residual stromal bed was 299.5 microm (range, 254-373 microm). Mean time to recognition of ectasia onset was 14.2 months (range, 3-27 months) postoperatively. At the time of ectasia diagnosis, the mean manifest refraction spherical equivalent was -1.23 D (range, +0.125 to -3.00) with a mean of 2.72 D (range, 0.75-4.00 D) of astigmatism. Ectasia can occur after an otherwise uncomplicated laser in situ keratomileusis procedure, even in the absence of apparent preoperative risk factors.
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            Femtosecond laser technology in corneal refractive surgery: a review.

            George D Kymionis, Vardhaman Kankariya, Argyro D. Plaka … (2012)
            To discuss current applications and advantages of femtosecond laser technology over traditional manual techniques and related unique complications in corneal refractive surgical procedures, including LASIK flap creation, intracorneal ring segment implantation, astigmatic keratotomy, presbyopic treatments, and intrastromal lenticule procedures.
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              Changes in the posterior cornea after laser in situ keratomileusis and photorefractive keratectomy.

              M W Belin, Joseph Ciolino (2006)
              To study the changes in posterior corneal elevation after laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) using Scheimpflug topography with the Pentacam anterior segment imaging system (Oculus, Inc.). Department of Ophthalmology, Albany Medical Center, and a private clinical practice, Albany, New York, USA. In this prospective study, 121 consecutive myopic eyes (103 LASIK and 18 PRK) were evaluated preoperatively and postoperatively with the Pentacam to determine elevation changes in the posterior corneal surface. Changes in posterior elevation were calculated by comparing the best-fit sphere preoperatively and postoperatively to a fixed reference sphere using the central 9.0 mm preoperative cornea. Statistical and graphic analyses were performed. The 103 LASIK eyes had a mean correction of -3.76 diopters (D) and a mean ablation depth of 62.1 microm. The mean estimated residual bed thickness (RBT) (329 microm) demonstrated a mean posterior displacement of 2.64 +/- 4.95 microm. The 18 PRK eyes had a mean correction of -2.69 D and a mean ablation depth of 53.2 microm. The mean estimated RBT (464 microm) had a mean posterior displacement of -0.88 +/- 4.64 microm. The difference in the mean posterior corneal displacement between the LASIK and the PRK eyes was not statistically significant (P>.05, Student t test). There was no statistically significant difference in posterior corneal displacement between the LASIK and PRK patients. The changes in PRK and LASIK eyes appeared to be within acceptable measurement variation. Contrary to previous reports, ectatic changes to the posterior corneal surface did not routinely occur after LASIK surgery.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Ophthalmol
                Journal ID (iso-abbrev): J Ophthalmol
                Journal ID (publisher-id): JOPH
                Title: Journal of Ophthalmology
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 2090-004X
                ISSN (Electronic): 2090-0058
                Publication date (Print): 2015
                Publication date (Electronic): 21 September 2015
                Volume: 2015
                Electronic Location Identifier: 184850
                Affiliations
                1Department of Surgery and Biomedical Science, University of Perugia and S. Maria della Misericordia Hospital, Sant'Andrea delle Fratte, 06156 Perugia, Italy
                2Centre Ophtalmologique de l'Odéon, 113 Boulevard Saint-Germain, 75006 Paris, France
                3Department of Economics, Finance and Statistics, University of Perugia, 06156 Perugia, Italy
                4Department of Biotechnology and Medical-Surgical Sciences, “Sapienza” University of Rome, 04100 Latina, Italy
                Author notes

                Academic Editor: Jorge Aliò

                Article
                DOI: 10.1155/2015/184850
                PMC ID: 4592910
                SO-VID: 34400d1f-294d-483e-a71a-d88fa21bf18f
                Copyright © Copyright © 2015 Carlo Cagini et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 7 March 2015
                Date accepted : 17 August 2015
                Categories
                Subject: Clinical Study

                ScienceOpen disciplines: Ophthalmology & Optometry
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry

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