ABSTRACT
Purpose: To compare femtosecond laser-assisted sub-Bowman keratomileusis (FSBK) versus laser-assisted subepithelial keratomileusis (LASEK) to correct moderate to high myopic astigmatism. Methods: Retrospective, nonrandomized, interventional, comparative case series. A total of eight hundred and fifty-two eyes with myopic astigmatism of -1.5 diopters (D) or higher were included in the study. We compared 427 eyes treated with FSBK versus 425 eyes treated with LASEK with or without mitomycin C. Visual and refractive results were evaluated 1 day, 1 week, 3 and 6 months postoperatively. Results: Six months postoperatively, the residual spherical defect was slightly but significantly higher in the LASEK group (+0.15 ± 0.62 D) than in the FSBK group (+0.09 ± 0.35 D) (P = 0.05). The postoperative residual astigmatism was also slightly but significantly higher in the LASEK group (-0.38 ± 0.52 D) than in the FSBK group (-0.26 ± 0.45 D) (P = 0.0005). No significant differences were found in the efficacy (0.98 ± 0.17 versus 0.98 ± 0.36, P = 0.6) and safety indexes (1.04 ± 0.16 versus 1.05 ± 0.37, P = 0.1) between FSBK and LASEK. The enhancement rate was significantly higher in the FSBK group (22.6%) than in the LASEK group (15.5%) (P = 0.01). Conclusions: Both FSBK and LASEK are safe and effective procedures to correct moderate to high myopic astigmatism. Slightly better visual and refractive results were observed in FSBK-treated eyes in a 6-month follow-up (AU)
Objetivo: Comparar la queratomileusis sub-Bowman asistida por láser de femtosegundo (FSBK) y la queratomileusis sub-epitelial asistida por láser (LASEK) para corregir el astigmatismo miópico de moderado a elevado. Métodos: Series de casos retrospectivas, no aleatorizadas, intervencionistas y comparativas. Se incluyó en el estudio a un total de ochocientos cincuenta y dos ojos con astigmatismo miópico de -1,5 dioptrías (D), o valores superiores. Comparamos 427 ojos tratados con FSBK frente a 425 ojos tratados con LASEK, con o sin mitomicina C. Se compararon postoperatoriamente los resultados visuales y refractivos al cabo de un día, una semana, tres y seis meses. Resultados: Transcurridos seis meses de la operación, el defecto esférico residual fue ligera aunque significativamente superior en el grupo LASEK (+0,15 ± 0,62D) en comparación al grupo FSBK (+0,09 ± 0,35D) (P = 0,05). El astigmatismo residual postoperatorio fue también ligera aunque significativamente superior en el grupo LASEK (-0,38 ± 0,52D) en comparación al grupo FSBK (-0,26 ± 0,45D) (P = 0,0005). No se hallaron diferencias significativas en relación a los índices de eficacia (0,98 ± 0,17 vs 0,98± 0,36, P = 0,6) y seguridad (1,04 ± 0,16 Vs 1,05 ± 0,37, P = 0,1) entre FSBK y LASEK. La tasa de retratamiento fue significativamente más elevada en el grupo FSBK (22,6%) que en el grupo LASEK (15,5%) (P = 0,01). Conclusiones: Tanto FSBK como LASEK resultan procedimientos seguros y eficaces en la corrección del astigmatismo miópico de moderado a elevado. Durante el seguimiento a seis meses en los ojos tratados con FSBK se observaron mejores resultados visuales y refractivos (AU)
Subject(s)
Humans , Adult , Middle Aged , Keratectomy, Subepithelial, Laser-Assisted/methods , Keratectomy, Subepithelial, Laser-Assisted , Astigmatism/therapy , Myopia/therapy , Laser Therapy/methods , Retrospective Studies , Postoperative Care/methods , Visual Acuity/radiation effects , 28599ABSTRACT
PURPOSE: To compare femtosecond laser-assisted sub-Bowman keratomileusis (FSBK) versus laser-assisted subepithelial keratomileusis (LASEK) to correct moderate to high myopic astigmatism. METHODS: Retrospective, nonrandomized, interventional, comparative case series. A total of eight hundred and fifty-two eyes with myopic astigmatism of -1.5 diopters (D) or higher were included in the study. We compared 427 eyes treated with FSBK versus 425 eyes treated with LASEK with or without mitomycin C. Visual and refractive results were evaluated 1 day, 1 week, 3 and 6 months postoperatively. RESULTS: Six months postoperatively, the residual spherical defect was slightly but significantly higher in the LASEK group (+0.15±0.62D) than in the FSBK group (+0.09±0.35D) (P=0.05). The postoperative residual astigmatism was also slightly but significantly higher in the LASEK group (-0.38±0.52D) than in the FSBK group (-0.26±0.45D) (P=0.0005). No significant differences were found in the efficacy (0.98±0.17 versus 0.98±0.36, P=0.6) and safety indexes (1.04±0.16 versus 1.05±0.37, P=0.1) between FSBK and LASEK. The enhancement rate was significantly higher in the FSBK group (22.6%) than in the LASEK group (15.5%) (P=0.01). CONCLUSIONS: Both FSBK and LASEK are safe and effective procedures to correct moderate to high myopic astigmatism. Slightly better visual and refractive results were observed in FSBK-treated eyes in a 6-month follow-up.
Subject(s)
Astigmatism/surgery , Cornea/surgery , Keratectomy, Subepithelial, Laser-Assisted/methods , Keratomileusis, Laser In Situ/methods , Lasers, Excimer/therapeutic use , Myopia/surgery , Refraction, Ocular/physiology , Adolescent , Adult , Astigmatism/complications , Astigmatism/physiopathology , Female , Humans , Male , Middle Aged , Myopia/complications , Myopia/physiopathology , Retrospective Studies , Visual Acuity , Young AdultABSTRACT
PURPOSE: Our purpose was to assess our outcomes in involutional lower eyelid ectropion and entropion surgery after horizontal eyelid tightening by a modified tarsal strip technique. METHODS: A prospective study of 88 eyelids with ectropion and 96 with entropion was performed. Patients were randomly distributed into two groups: the control group included 90 eyelids (46 entropion and 44 ectropion) and the other group of 94 eyelids (50 entropion and 44 ectropion). The control group was treated with a conventional tarsal strip, whereas the second group underwent the same surgery except for a modified suture placement of the tarsal strip different in patients with ectropion and entropion. The mean follow-up was 5.4 years. Horizontal eyelid laxity, orbicularis muscle and lower eyelid retractors function were measured prior and after surgery. Recurrence rate was also evaluated. RESULTS: Recurrent entropion occurred in eight eyelids (17.4 %) treated with conventional tarsal strip, while only two eyelids (4 %) showed recurrence after surgery in the group treated with the modified technique. Recurrence ectropion was only found in one eyelid (2.3 %) in the control group. Pathological horizontal laxity was present in all patients at the baseline study. After surgery, the horizontal laxity improved in both groups, we found significant differences in the patients treated with the modified technique (P=0.04). CONCLUSIONS: The modified suture placement of the tarsal strip reported in this work improves the lower eyelid stability and prevents future recurrences after surgery. This modified technique is useful for the management of patients with entropion and moderate eyelid dysfunction retractors without other surgical procedures.
