ABSTRACT
BACKGROUND: The aim of this study is to evaluate three refractive procedures: LenSx® (Alcon, Fort Worth, TX, USA) femto-laser in situ keratomileusis (LASIK), FEMTO LDV Z4® (Ziemer, Port, Switzerland) femto-LASIK, and photorefractive keratectomy (PRK) in terms of refractive outcome, perioperative complications, pain, and patient satisfaction. MATERIALS AND METHODS: Data of 168 eyes (myopic n = 84) were included in this retrospective study. Of these, 54 eyes (n = 27, 33.85 ± 7.64 years) were treated with LenSx® femto-LASIK, 60 eyes (n = 30, 35.03 ± 7.46 years) with FEMTO LDV Z4® femto-LASIK, and 54 eyes (n = 27, 33.24 ± 8.52 years) with PRK. Photoablation was induced by a MEL80 Excimerlaser (Zeiss, Oberkochen, Germany). The corrected (Vsc) and uncorrected (Vcc) distance subjective visual acuity, corneal topography (Pentacam® HR; Wetzlar, Germany), and objective astigmatism (ARK-760A Refractometer ; Nidek, Fremont, CA, USA) were measured preoperatively, and 1 day, 1 week, 1 month, and 3 months postoperatively. Subjective pain (verbal rating scale) and patient satisfaction were also recorded. RESULTS: Subjective Vsc showed significantly better results in both femto-LASIK cohorts compared to PRK (p < 0.05) 1 day and 1 week postoperatively. There was no significant difference between the groups in terms of spherical equivalent and astigmatism 3 months postoperatively. The LenSx® femto-LASIK caused flap complications. The highest patient satisfaction results were shown in the LDV Z4® group, followed by the LenSx® and PRK cohorts (p = 0.072). LDV Z4® femto-LASIK showed the lowest pain score 1 day postoperatively (p < 0.001). There was no significant correlation between target refraction and preoperative corneal thickness and astigmatism. DISCUSSION: Femtosecond laser-assisted LASIK is an effective procedure enabling rapid rehabilitation of visual acuity with low postoperative pain compared to PRK. There is no difference between the three techniques regarding refractive outcome after 3 months follow-up. LDV Z4® femto-LASIK can be recommended, if available, due to its low intraoperative complication rate and higher patient satisfaction compared to LenSx® femto-LASIK.
Subject(s)
Keratomileusis, Laser In Situ , Lasers, Excimer , Photorefractive Keratectomy , Adult , Cornea , Germany , Humans , Refraction, Ocular , Retrospective Studies , Switzerland , Treatment Outcome , Young AdultABSTRACT
PurposeTo assess the anterior chamber (AC) characteristics and its correlation to laser flare photometry immediately after femtosecond laser-assisted capsulotomy and photodisruption.Patients and methodsThe study included 97 cataract eyes (n=97, mean age 68.6 years) undergoing femtosecond laser-assisted cataract surgery (FLACS). Three cohorts were analysed relating to the flare photometry directly post femtosecond laser treatment (flare <100 n=28, 69.6±7 years; flare 100-249 n=47, 67.7±8 years; flare >249 photon counts per ms cohort n=22, 68.5±10 years). Flare photometry (KOWA FM-700), corneal topography (Oculus Pentacam, Germany: AC depth, volume, angle, pachymetry), axial length, pupil diameter, and endothelial cells were assessed before FLACS, immediately after femtosecond laser treatment and 1 day postoperative (LenSx Alcon, USA). Statistical data were analysed by SPSS v19.0, Inc.ResultsThe AC depth, AC volume, AC angle, central and thinnest corneal thickness showed a significant difference between flare <100 vs flare 100-249 10 min post femtosecond laser procedure (P=0.002, P=0.023, P=0.007, P=0.003, P=0.011, respectively). The AC depth, AC volume, and AC angle were significantly larger (P=0.001, P=0.007, P=0.003, respectively) in the flare <100 vs flare >249 cohort 10 min post femtosecond laser treatment.ConclusionsA flat AC, low AC volume, and a narrow AC angle were parameters associated with higher intraocular inflammation. These criteria could be used for patient selection in FLACS to reduce postoperative intraocular inflammation.
