Small-incision lenticule extraction (SMILE): outcomes of 722 eyes treated for myopia and myopic astigmatism.

PURPOSE: To study the outcomes of small-incision lenticule extraction (SMILE) for treatment of myopia and myopic astigmatism. METHODS: Retrospective study of patients treated for myopia or myopic astigmatism with SMILE, using a VisuMax(®) femtosecond laser (Carl Zeiss Meditec, Jena, Germany), at the Department of Ophthalmology, Odense University Hospital, Odense, Denmark. Inclusion criteria were corrected distance visual acuity (CDVA) of 20/25 or better before surgery and no ocular conditions other than myopia up to -10.00 diopters (D) with astigmatism up to 3.00 D. RESULTS: Of the 729 treatments, 722 were included. The spherical equivalent (SE) refraction averaged -6.82 ± 1.66 diopters (D) before surgery. After 3 months, 88 % of eyes were within ±0.50 D of the intended refraction, whilst 98 % were within ±1.00 D. The mean difference between attempted and achieved SE refraction at 3 months after surgery was -0.06 ± 0.01 D (range: -1.25 to 1.25 D). In eyes with emmetropia as target refraction (n = 362), 63 % had uncorrected distance visual acuity (UDVA) of 20/25 or better 1 day after surgery, rising to 83 % at 3 months after surgery. The average gain in CDVA from before surgery to 3 months after surgery was 0.07 ± 0.03 (logMAR). However, 12 eyes (1.6 %) lost 2 or more lines of CDVA from before surgery to 3 months postoperatively. Simultaneous treatment of up to 3.00 D of astigmatism was not associated with less predictable refractive outcomes. CONCLUSIONS: In the short term, SMILE seemed predictable, efficient, and safe for treatment of myopia and myopic astigmatism.

Four-year to seven-year outcomes of advanced surface ablation with excimer laser for high myopia.

PURPOSE: We aimed to evaluate and compare outcomes after photorefractive keratectomy with cooling (cPRK) and laser-assisted subepithelial keratectomy (LASEK) for high myopia. METHODS: This was a retrospective, single-masked follow-up study of patients treated for myopia between 2007 and 2009 with cPRK or LASEK, using a high-frequency flying-spot excimer laser with eye-tracker (MEL80; Carl Zeiss, Jena, Germany). One eye of each patient was randomly chosen for analysis. Re-treated eyes were excluded. RESULTS: Forty-six cPRK patients and 35 LASEK patients were included. Spherical equivalent averaged -7.69 ± 1.47 diopters (D) in cPRK eyes and -7.98 ± 2.06 D in LASEK eyes (p = 0.31) before surgery. The average follow-up time was 4.6 years in cPRK patients and 6.0 years in LASEK patients (p < 0.05). At final follow-up, no cPRK eyes and one LASEK eye (p = 0.46) had lost two lines of corrected distance visual acuity (CDVA). No eyes had significant haze at final follow-up, although trace haze was found in four cPRK eyes and six LASEK eyes (p = 0.44). However, at 6 weeks after surgery, zero cPRK eyes and nine LASEK eyes (p < 0.05) had significant haze. At final follow-up, 63 % of cPRK eyes and 35 % of LASEK eyes (p = 0.17) were within ±1.0 D of intended refraction. Finally, 100 % of cPRK patients and 92 % of LASEK patients (p = 0.87) were satisfied or very satisfied with the surgery at final follow-up. CONCLUSION: cPRK and LASEK seemed safe and with high patient satisfaction 4 to 7 years after surgery for high myopia. However, cPRK was more effective than LASEK in reducing initial significant corneal haze.

Iodine content in bread and salt in Denmark after iodization and the influence on iodine intake.

OBJECTIVE: To measure the iodine content in bread and household salt in Denmark after mandatory iodine fortification was introduced and to estimate the increase in iodine intake due to the fortification. DESIGN: The iodine content in rye breads, wheat breads and salt samples was assessed. The increase in iodine intake from fortification of bread and the increase in total iodine intake after fortification were estimated. SUBJECTS: Iodine intake before and after fortification was estimated based on dietary intake data from 4,124 randomly selected Danish subjects. MAIN RESULTS: Approximately 98% of the rye breads and 90% of the wheat breads were iodized. The median iodine intake from bread increased by 25 (13-43) microg/day and the total median iodine intake increased by 63 (36-104) microg/day. CONCLUSIONS: The fortification of bread and salt has resulted in a desirable increase in iodine intake, and the current fortification level of salt (13 ppm) seems reasonable.

Ocular anisometropia and laterality.

PURPOSE: To study the difference in refraction between right and left eyes (anisometropia) in different age groups, look for evidence of eye laterality (more refractive error in one eye) and compare the size of anisometropia in the myopic and emmetropic ranges. METHODS: The study was based on children in Hong Kong (examined at the age of 6 years and again at the age of 8.5 years) and their parents (aged 26-60 years). RESULTS: In all age groups the difference between right and left eyes in sphere and cylinder was modest, in most cases < or = 0.25 D. In both children and their parents a tendency towards spherical right eye laterality was found in the myopic individuals (p < 0.05). This was not the case with the cylinder. In the 8.5-year-old children and in their parents, the numerical size of spherical anisometropia increased with myopia (p < 0.05 and p < 0.01, respectively). Cylindrical anisometropia did not exhibit such an increase. CONCLUSION: In Hong Kong children and their parents we found a tendency towards more spherical myopia in right eyes (laterality) in myopic cases. The numerical size of spherical anisometropia also increased in myopia in these groups. Cylindrical anisometropia appeared to be independent of spherical ametropia. In most cases right/left differences in both sphere and cylinder were small and our findings justify the use of data from one eye only in publications on refraction.