bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined Corneal Topography and Corneal Wavefront Data in the Treatment of Corneal Irregularity and Refractive Error in LASIK or PRK Using the Carl Zeiss Meditec MEL 80 and CRS-Master
Authors: Reinstein Dan Z. , Archer Timothy J. , Gobbe Marine 
Published: December 2018

Purpose:
To assess the efficacy, safety, and accuracy of TOSCA II (Topography Supported Custom Ablation) treatments for the correction of high corneal aberrations and refractive error following previous ocular surgery.

Methods:
Forty-eight eyes of 32 patients were included for study. Indications for TOSCA II treatment included small optical zone, decentered ablation, subjective visually significant higher order aberrations, and irregularly irregular astigmatism induced by LASIK, photorefractive keratectomy, radial keratotomy, conductive keratoplasty, cataract surgery, and deep lamellar keratoplasty. An ablation profile based on corneal topography data and corneal wavefront and manifest refraction was created using the CRS-Master software (Carl Zeiss Meditec) to treat corneal irregularity and refractive error simultaneously. Postoperative assessments were performed at 1 week and 1, 2, 3, 6, and 12 months.

Results:

Mean attempted spherical equivalent refraction (SE) was −1.12 A 1.97 diopters (D) (range: +1.13 to −10.50 D). Mean attempted cylinder correction was 1.34±1.65 D (range: 0.00 to 7.75 D). Median age was 38 years (range: 19 to 68 years). Median follow-up was 9.4 months. Accuracy: mean deviation from the intended SE correction was −0.19±0.94 D, 60% of eyes were within ±0.50 D and 77% of eyes were within ±1.00 D of the intended SE. Cylinder: the correction ratio was 1.49±0.85 and the error ratio was 0.87±0.69. Efficacy: 56% of eyes achieved uncorrected visual acuity of 20/20 or better and 88% achieved 20/40 or better. Safety: 34% of eyes gained one or more lines of best spectacle-corrected visual acuity, 15% lost one line, and no eye lost two or more lines. Contrast sensitivity: for the subset of eyes with below normal contrast sensitivity preoperatively, there was a statistically significant improvement in contrast sensitivity at 3 cycles per degree (cpd), 6 cpd, and 12 cpd (
P
<.05). Stability: the average change in refraction between 3 months and 1 year was +0.38±0.30 D. Higher order aberrations: the average higher order root-meansquare decreased by 21% and the average spherical aberration decreased by 41%.

Conclusions:

The MEL 80 CRS-Master TOSCA II software appears to be an effective treatment for decentrations, optical zone enlargement, and reduction of higher order aberrations. The refractive outcome was satisfactory after one treatment. [
J Refract Surg
. 2009;25:503–515.]
Presbyopia Treatment by Monocular Peripheral PresbyLASIK
Authors: Epstein Robert Leonard , Gurgos Mark Andrew 
Published: December 2018

Purpose:
To investigate monocular peripheral presby-LASIK on the non-dominant eye with distance-directed monofocal refractive surgery on the dominant eye in treating presbyopia.

Methods:
One hundred three patients underwent treatment with a VISX S4 system and follow-up from 1.1 to 3.9 years (mean 27.4 months). Average patient age was 53.3 years. Preoperative refraction ranged from −9.75 to +2.75 diopters (D). Non-dominant eyes underwent peripheral presbyLASIK—an aspheric, pupil–size dependent LASIK to induce central corneal relative flattening and peripheral corneal relative steepening. Dominant eyes underwent monofocal refraction-based LASIK (75.8%), wavefront-guided LASIK, limbal relaxing incisions, or no treatment to optimize distance vision.

Results:
At final follow-up, 91.3% (94/103) of all patients, 89% (25/28) of hyperopes, and 92% (69/75) of myopes reported complete spectacle independence and 7.8% (8/103) used spectacles for less than 1 hour per week. Distance unaided visual acuity was at least 20/20 in 67.9% (19/28) of hyperopes and 70.7% (53/75) of myopes, at least 20/20 at 80 cm in 85.7% (24/28) of hyperopes and 84% (63/75) of myopes, and at least 20/20 at 40 cm in 71.4% (20/28) of hyperopes and 65.3% (49/75) of myopes. PresbyLASIK increased overall higher order aberrations similarly to refraction-based LASIK for myopes but to a greater extent in hyperopic cases. PresbyLASIK WaveScan spherical equivalent refraction was stable in myopes but migrated an average +0.31 D in hyperopes over the follow-up period.

Conclusions:

Monocular peripheral presbyLASIK is a valuable option for presbyopic patients considering refractive surgery. [
J Refract Surg
. 2009;25:516–523.]
Wavefront-guided LASIK for Myopia: Effect on Visual Acuity, Contrast Sensitivity, and Higher Order Aberrations
Authors: Keir Nancy J. , Simpson Trefford , Jones Lyndon W. , Fonn Desmond 
Published: December 2018

Purpose:
To determine the impact of wavefront-guided LASIK for myopia with or without astigmatism on high and low contrast best spectacle-corrected visual acuity (BSCVA), photopic and mesopic contrast sensitivity, and higher order aberrations.

Methods:

Bilateral wavefront-guided LASIK (LADARVision4000; Hansatome microkeratome) was performed on 324 eyes (162 patients) with a mean spherical manifest refraction of −2.84±1.35 diopters (D) (range: −0.25 to −6.50 D) and astigmatism of −0.81±0.74 D (range: 0 to −4.00 D). Mean age was 37.7±9.3 years (range: 20 to 60 years). Best spectacle-corrected visual acuity and contrast sensitivity were assessed using ETDRS charts and vertical sinusoidal gratings, respectively. Higher order aberrations were measured using a Shack-Hartmann wavefront sensor, analyzed across a 5-mm pupil. Repeated measures and post hoc analyses determined statistical significance (
P
<.0025). Only right eyes were analyzed.

Results:

One hundred thirty-six eyes (84%) had uncorrected visual acuity of 20/20 or better 6 months postoperative; 80.9% (131 eyes) were within ±0.50 D of attempted correction. Statistically significant postoperative improvements were noted in high and low contrast BSCVA (both
P
⩽.001); in photopic contrast sensitivity at 3, 6, and 12 cycles per degree (cpd); and in mesopic contrast sensitivity at 12 and 18 cpd (all
P
⩽.001). With respect to higher order aberrations, a statistically significant change was seen in Zernike coefficients

Z

3

−
1

,

Z

3
1

,

Z

3

−
3

,

Z

3
3

, and

Z

4
4

following surgery (range of mean absolute change: 0.042 to 0.142 µm; all
P
⩽.001). All increased in magnitude except for

Z

3

−
3

, which decreased.

Conclusions:

Despite an increase in higher order aberrations, wavefront-guided LASIK yields excellent visual acuity and contrast sensitivity. Spherical aberration, which increases the most following non-wavefront-guided LASIK, showed no significant change. [
J Refract Surg.
2009;25:524–533.]
Agreement Between Pentacam and Videokeratography in Corneal Power Assessment
Authors: Savini Giacomo , Barboni Piero , Carbonelli Michele , Hoffer Kenneth J. 
Published: December 2018

Purpose:
To investigate agreement between a rotating Scheimpflug camera (Pentacam, Oculus Optikgeräte GmbH) and two corneal topographers (TMS-2 Topography System, Tomey; and Keratron Scout, Optikon 2000 SpA) in measuring the corneal power of normal eyes.

Methods:
The mean corneal powers calculated by simulated keratometry (SimK) with each topographer were compared to those provided by the Pentacam in 71 patients. Specifically, the corneal power values of the Pentacam included in this analysis were the SimK (calculated using the measured anterior corneal radius and standard keratometric index of 1.3375) and the True net power (calculated using the anterior and posterior corneal curvatures and Gaussian optics formula for thick lenses, where the actual refractive index of the air, cornea, and aqueous humor are entered). Bland-Altman plots were used to investigate agreement and analysis of variance (ANOVA) was performed to detect statistical differences.

Results:

Although ANOVA did not disclose a statistically significant difference among the mean SimK values (TMS-2: 43.20±1.51 diopters [D], Keratron Scout: 43.29±1.48 D, Pentacam: 43.25±1.53 D), the 95% limits of agreement between the TMS-2 and Pentacam and between the Keratron Scout and Pentacam were wide (−1.05 to +0.94 D and −0.95 to +1.02 D, respectively). Agreement was even poorer when considering the mean True net power (42.00±1.54 D), which was significantly lower than the mean Pentacam SimK (
P
<.001).

Conclusions:

Although corneal topography and the Pentacam provide similar SimK values, their data should not be used interchangeably as only moderate agreement exists between them. Corneal power values calculated by the True net power are significantly lower than any SimK and cannot be entered into intraocular lens power formulas. [
J Refract Surg
. 2009;25:534–538.]
Repeatability and Reproducibility of Corneal Curvature Measurements Using the Pentacam and Keratron Topography Systems
Authors: Kawamorita Takushi , Nakayama Nanami , Uozato Hiroshi 
Published: December 2018

Purpose:
To compare the repeatability and reproducibility of corneal curvature measurements using the Pentacam eye scanner (Oculus Optikgeräte GmbH) and Keratron corneal topographer (Optikon 2000 SpA).

Methods:

Axial topography maps were used to acquire measurements. Twenty-six eyes of 26 healthy patients were measured to determine repeatability and reproducibility. Another 10 eyes of 10 healthy patients were included in a parallel study. Three measurements per eye were performed. Repeatability was assessed via the coefficient of variation. Reproducibility was assessed using Bland-Altman plots. Linear correlations were used to determine the agreement between devices. A
P
value <.05 was considered statistically significant.

Results:

The majority of coefficient of variations for both devices were within 1%. The coefficient of variation of the Pentacam was higher in the superior cornea (
P
<.01). The mean difference (95% limits of agreement) in the flattest meridian between examiners was −0.03±0.27 diopters (D) (range: −0.56 to +0.49 D) for the Pentacam and −0.08±0.21 D (range: −0.50 to +0.33 D) for the Keratron. The mean difference (95% limits of agreement) in the steepest meridian was −0.10±0.26 D (range: −0.60 to +0.41 D) for the Pentacam and −0.11±0.22 D (range: −0.53 to +0.31 D) for the Keratron. The mean axial power for the central 3.0 mm of the Pentacam was statistically significantly lower than that of the Keratron (
P
<.01).

Conclusions:

Although statistically significant differences were noted, both devices provided repeatable and reproducible corneal measurements centrally. Pentacam repeatability outcomes indicate that superior corneal measurements should be interpreted with caution. [
J Refract Surg.
2009;25:539–544.]
A 14-year Follow-up of Photorefractive Keratectomy
Authors: Bricola Graziano , Scotto Riccardo , Mete Maurizio , Cerruti Simonetta , Traverso Carlo E. 
Published: December 2018

Purpose:
To evaluate the long-term outcome of myopic photorefractive keratectomy (PRK).

Methods:
This prospective study included 31 patients (49 eyes) who underwent PRK between 1991 and 1993. A Summit UV200 excimer laser was used. Patients were divided into two groups—low myopia: preoperative <6.00 diopters (D) (range: −1.50 to −5.75 D) (n=19); and high myopia: preoperative ⩾6.00 D (range: −6.00 to −13.00 D) (n=12). Long-term postoperative follow-up was every 2 years up to 14 years. Refraction, visual acuity, corneal status, and intraocular pressure (IOP) were evaluated. At 14 years, corneal topography and endothelial cell count were performed.

Results:
At last follow-up, manifest refraction spherical equivalent (MRSE) for the low myopia group was −0.17±0.8, uncorrected visual acuity (UCVA) logMAR was −0.06±0.55, and best spectacle-corrected visual acuity (BSCVA) logMAR was 0.00±1.00. The high myopia group had a final MRSE of −0.67±1.4, UCVA log-MAR −0.11±0.55, and BSCVA logMAR −0.03±1.00. At 14 years, BSCVA for most eyes was at least equal to preoperative BSCVA. In both groups, haze increased between 3 and 6 months, then declined in the first year. A temporary increase of IOP was seen in 4 eyes. Complications were minor haze (2 eyes), transient anisocoria (9 eyes), and intraepithelial hemosiderin deposits (4 eyes). No abnormalities in endothelial cell count or morphology, astigmatism, or ectasia were noted. Three patients reported night vision disturbance, but the majority of patients were satisfied with the outcome based on subjective questionnaire (low myopia group: 84%; high myopia group: 75%).

Conclusions:

Our study demonstrates the safety of myopic PRK. [
J Refract Surg.
2009;25:545–552.]
Correlation of Aberrometry, Contrast Sensitivity, and Subjective Symptoms With Quality of Vision After LASIK
Authors: Bühren Jens , Martin Tim , Kühne Anja , Kohnen Thomas 
Published: December 2018

Purpose:
To compare which parameter category (wavefront data, psychophysical data, or subjective symptoms) predicts best subjective quality of vision after LASIK.

Methods:

Twenty-eight eyes (15 patients) were included. Twenty-three eyes (12 patients) underwent uneventful LASIK; 5 eyes (3 patients) were symptomatic eyes treated with myopic LASIK elsewhere. Mean preoperative spherical equivalent refraction was −4.79±1.92 diopters (D) (range: −1.63 to −7.13 D); mean patient age was 36.6±7.4 years (range: 18 to 48 years). All examinations were performed 1 month postoperatively. The wavefront error was described with Zernike polynomials (6-mm pupil). Psychophysical tests included high-contrast visual acuity and contrast sensitivity with and without glare at 167 cd/m
−2
, 1.67 cd/m
−2
, and 0.167 cd/m
−2
with best spectacle correction. Correspondingly, overall subjective quality of vision and frequency of visual symptoms (glare, halos, starbursts, ghosting, blur) were assessed for three lighting conditions (photopic, high-mesopic, and low-mesopic) using a questionnaire with a visual analog scale. For each parameter category and each lighting condition, a multiple stepwise backwards regression model with the overall quality of vision item value as dependent was applied.

Results:

Under all lighting conditions, subjective symptom scores predicted subjective quality of vision best (adjusted R
2
=0.83–0.92) with blur as the main predictor throughout all conditions. Psychophysical tests did not significantly predict postoperative subjective quality of vision. The adjusted R
2
for the Zernike coefficients was highest for low-mesopic (0.56) and lowest for photopic conditions (0.31).

Conclusions:
Different parameter categories for the description of optical quality did not predict subjective quality of vision after LASIK equally. Subjective symptom scores had the highest predictability, whereas psychophysical tests with spectacle correction had no predictability. The latter probably do not reflect all dimensions of subjective quality of vision.

[
J Refract Surg
. 2009;25:559–568.]
Stability of LASIK in Topographically Suspect Keratoconus Confirmed Non-keratoconic by Artemis VHF Digital Ultrasound Epithelial Thickness Mapping: 1-year Follow-up
Authors: Reinstein Dan Z. , Archer Timothy J. , Gobbe Marine 
Published: December 2018

Purpose:
To determine the 1-year stability of LASIK in corneas with topographic suspect keratoconus confirmed as non-keratoconic by epithelial thickness mapping.

Methods:
This was a retrospective case/control comparative study. Eyes suspected of keratoconus using criteria based mainly on Atlas (Carl Zeiss Meditec AG) and Orbscan II (Bausch & Lomb) topography were scanned by Artemis very high-frequency digital ultrasound (ArcScan Inc). Keratoconus was confirmed if the epithelial thickness profile showed relative epithelial thinning coincident with an eccentric posterior elevation best-fit sphere apex. Laser in situ keratomileusis was performed in all eyes where keratoconus was excluded by finding relatively thicker epithelium or not finding localized thinning over the topographically suspected cone. Patients were followed for 1 year after LASIK. A control group was generated matched within 0.50 diopter (D) for sphere, cylinder, and spherical equivalent refraction (SEQ) to compare refractive stability.

Results:
The average change in SEQ between 3 and 12 months was −0.10±0.30 D for the suspect keratoconus group and −0.10±0.28 D for controls. No statistically significant difference in shift from 3 months to 12 months in SEQ or cylinder between groups was noted. No statistically significant change in best spectacle-corrected visual acuity between groups was noted, with no eye losing 2 lines and 5% in the suspect keratoconus group and 2% of controls losing 1 line. No cases of ectasia were observed in either group.

Conclusions:

Suspect keratoconus, confirmed to be non-keratoconic by epithelial thickness profile criteria demonstrated equal stability to control eyes 1 year after LASIK. Epithelial thickness profiles may enable LASIK to be performed in eyes that would otherwise have been excluded due to topographic suspect keratoconus. Further follow-up is being carried out. [
J Refract Surg.
2009;25:569–577.]
Objective Evaluation of the Visual Benefit in Contact Lens Fitting After Complicated LASIK
Authors: Villa-Collar César , González-Méijome José Manuel , Gutiérrez-Ortega Ramón 
Published: December 2018

Purpose:
To report the clinical application of the measurement of luminous distortion under scotopic conditions and wavefront aberrations to objectively corroborate the optical and visual benefit of contact lens fitting to rehabilitate vision after complicated LASIK.

Methods:
Seven eyes (four patients) that underwent LASIK for the correction of myopia with different postoperative visual complaints are reported in this observational case series. Luminous distortion index with the Starlights System v1.0 (Novosalud) and total wavefront aberration using a Hartmann-Shack aberrometer were used to objectively quantify the benefit of contact lens fitting to corroborate subjective improvements in terms of patient satisfaction and photopic visual acuity. Uncorrected visual acuity, best spectacle and contact lens corrected visual acuity, root-mean-square for higher order aberrations, and luminous distortion under scotopic conditions were obtained.

Results:
Visual complaints were attributed to a small optical zone, decentered ablation, and iatrogenic ectasia, and patients were fit with contact lenses of different materials, designs, and fitting approaches. Reverse geometry rigid gas permeable contact lenses are beneficial in reducing higher order aberrations to less than one half of the cornea and total aberrometry, with a positive effect in reducing luminous distortion up to 100% associated with complaints of night vision distortion to less than 5% in patients with small optical zones or decentered ablations. Artificial pupil cosmetic soft contact lens also decreased the luminous distortion index.

Conclusions:

The visual benefit reported by patients after contact lens fitting in postoperative complications secondary to LASIK can be objectively measured through the luminous distortion under scotopic conditions. [
J Refract Surg
. 2009;25:591–598.]
Clinical Results of a Corneal Radius Correcting Factor in Calculating Intraocular Lens Power After Corneal Refractive Surgery
Authors: Rosa Nicola , Capasso Luigi , Lanza Michele , Borrelli Maria 
Published: December 2018

Purpose:
To describe the clinical results of a corneal radius correcting factor (CRCF), which is based on the axial length and independent of knowledge from the previous surgical procedure, in calculating intraocular lens (IOL) power in eyes that developed cataract after corneal refractive surgery.

Methods:
Intraocular lens power for 62 eyes that previously underwent corneal refractive surgery was calculated with the SRK/T and SRK II formulas using an axial length–related CRCF, and the expected refractive errors were compared with the actual postoperative refractive errors.

Results:
Using the CRCF, the refractive outcomes ranged between −3.25 and +1.00 diopters (D) (mean −0.41±0.75 D), with 37 (60%) eyes within ±0.50 D and 53 (85%) eyes within ±1.00 D of the intended refraction. Using the raw data, without the correcting factor, the refractive outcomes would have ranged between −2.00 and +5.00 D (mean +2.17±1.45 D) with 7 (11%) eyes within ±0.50 D and 15 (24%) eyes within ±1.00 D of the intended refraction.

Conclusions:

Pending further validation through a larger prospective evaluation, the CRCF combined with the SRK/T formula is recommended in eyes with an axial length up to 30 mm and the average IOL power calculated with the SRK/T and SRK II formulas when the axial length is >30 mm. [
J Refract Surg
. 2009;25:599–603.]
Late-onset Severe Diffuse Lamellar Keratitis Associated With Uveitis After LASIK in a Patient With Ankylosing Spondylitis
Authors: Díaz-Valle David , Arriola-Villalobos Pedro , Benitez-del-Castillo Sánchez José M. , Bueso Enrique Santos , Martínez de la Casa José M. , Sardiña Ricardo Cuiña 
Published: December 2018

Purpose:
To report a case of diffuse lamellar keratitis (DLK) associated with acute anterior uveitis that occurred 3 years after uneventful LASIK in a patient with a history of ankylosing spondylitis and recurrent acute anterior uveitis.

Methods:
A 36-year-old man presented with pain and decreased vision in the left eye. Left eye visual acuity was 20/100. He had undergone bilateral LASIK 3 years prior to presentation to treat moderate myopia.

Results:
Slit-lamp examination revealed aqueous flare and cells, vertical corneal folds, and cell aggregates at the central interface. Flattening and thinning of the cornea were observed with Pentacam (Oculus Optikgeräte GmbH). Diffuse lamellar keratitis stage III was diagnosed and intensive corticosteroid and anticollagenolytic treatment was started with satisfactory results.

Conclusions:

Acute anterior uveitis may be a predisposing factor for late-onset DLK after LASIK surgery. Indication of LASIK in patients at high risk of developing recurrent flares of acute anterior uveitis, such as those with spondyloarthropathies, should be carefully considered. [
J Refract Surg
. 2009;25:623–625.]
Bilateral Complicated Stromal Dissections During Mechanical Epikeratome Separation of the Corneal Epithelium
Authors: Chen Yan-Ming , Hu Fung-Rong , Su Pei-Yuang , Chen Wei-Li 
Published: December 2018

Purpose:
To present a case of bilateral inadvertent stromal cuts during mechanical epikeratome separation of the corneal epithelium using a Centurion SES epikeratome (Norwood EyeCare Pty Ltd).

Methods:
A 25-year-old woman underwent epi-LASIK surgery. Preoperative examinations showed no remarkable findings. After epithelial flap creation, a linear stromal cut near the temporal upper flap edge was found in the right eye. An irregular stromal cut involving the central cornea was found in the left eye after undergoing epi-LASIK with a new separator. Excimer laser ablation was continued in both eyes without flap reposition.

Results:
Six months postoperatively, best spectacle-corrected visual acuity was 20/20 in the right eye and 20/25 in the left eye. Corneal topographic examination revealed a regular pattern in the right eye and irregularities in the left.

Conclusions:

Stromal dissection during mechanical separation of the corneal epithelium with a Centurion SES epikeratome is a potential complication of epi-LASIK. Visual impairment can result from such complications. [
J Refract Surg.
2009;25:626–628.]