Assessment of contrast sensitivity and aberrations after photorefractive keratectomy in patients with myopia greater than 5 diopters.

This study aimed to assess changes in contrast sensitivity and aberrations in cases of myopia greater than 5.0 diopter (D) who had photorefractive keratectomy (PRK). In this semi-experimental study, 20 eyes of ten patients were studied. Inclusion criteria were at least 5.0 D of myopia, stable refraction in the past year, no history of refractive surgery, a minimum corneal thickness of 480 µm, and having surgery in both eyes. Exclusion criteria were the presence of any corneal condition. In addition to the routine tests, aberrometry and assessment of contrast sensitivity was done using the WaveLight Allegro Analyzer and the VectorVision CSV-1000. After PRK using the Concerto Excimer Laser (WaveLight, Alcon), patients were scheduled to have follow-up visits at 1 month, 3 months, and 1 year after surgery. Contrast sensitivity with glare showed an increasing trend only at the spatial frequency of 3 cycles per degree (cpd) (P=0.013). Contrast sensitivity without glared increased postoperatively at special frequencies of 3, 6, and 18 cpd (P<0.05). The preoperative level of higher order aberrations root mean square (HOA RMS) of 0.24±0.08 reached 0.71±0.25 at 12 months after surgery. Assessment of comma and trefoil showed no significant difference between preoperative and postoperative values, but the amount of spherical aberration changed from a mean preoperative value of 0.0±0.09 to 0.27±0.15 at 12 months after surgery. In the treatment of myopia greater than 5.0 D, PRK with the Concerto Excimer Laser can improve contrast sensitivity in certain spatial frequencies. This is while HOA RMS and spherical aberration increase.

Near Point of Accommodation and Convergence after Photorefractive Keratectomy (PRK) for Myopia.

PURPOSE: Near point of convergence (NPC) and near point of accommodation (NPA) were evaluated before and after photorefractive keratectomy (PRK) in normal myopic eyes. METHODS: In this prospective cross sectional study, NPC and NPA were measured in 120 myopic eyes (60 patients) before and 3 months after PRK. Excluding criteria were manifest tropia, previous eye surgery, amblyopia, and any other ocular pathology. All subjects were younger than35 years old. RESULTS: Fifty-one females (85%) and nine males (15%) participated in the study. The average age of the participants was 25.75 years. Before the operation, the average NPC and NPA were 4.35 cm and 6.9 cm (14.5 D), respectively. NPC and NPA increased significantly 5.63 (p = 0.025) and (p 0.05) to 7.983 cm (12.5 D) (p 0.001), respectively, after 3 months. CONCLUSION: NPC and NPA may increase significantly after PRK. Convergence and accommodation problems may affect near visual performance. Therefore, for any PRK candidate, accommodation and convergence should be evaluated.

Prevalence of the refractive errors by age and gender: the Mashhad eye study of Iran.

BACKGROUND: Refractive errors are a common eye problem. Considering the low number of population-based studies in Iran in this regard, we decided to determine the prevalence rates of myopia and hyperopia in a population in Mashhad, Iran. DESIGN: Cross-sectional population-based study. PARTICIPANTS: Random cluster sampling. Of 4453 selected individuals from the urban population of Mashhad, 70.4% participated. METHODS: Refractive error was determined using manifest (age > 15 years) and cycloplegic refraction (age ≤ 15 years). Myopia was defined as a spherical equivalent of -0.5 diopter or worse. An spherical equivalent of +0.5 diopter or worse for non-cycloplegic refraction and an spherical equivalent of +2 diopter or worse for cycloplegic refraction was used to define hyperopia. MAIN OUTCOME MEASURES: Prevalence of refractive errors. RESULTS: The prevalence of myopia and hyperopia in individuals ≤ 15 years old was 3.64% (95% CI: 2.19-5.09) and 27.4% (95% CI: 23.72-31.09), respectively. The same measurements for subjects > 15 years of age was 22.36% (95% CI: 20.06-24.66) and 34.21% (95% CI: 31.57-36.85), respectively. Myopia was found to increase with age in individuals ≤ 15 years and decrease with age in individuals > 15 years of age. The rate of hyperopia showed a significant increase with age in individuals > 15 years. The prevalence of astigmatism was 25.64% (95% CI: 23.76-27.51). CONCLUSIONS: In children and the elderly, hyperopia is the most prevalent refractive error. After hyperopia, astigmatism is also of importance in older ages. Age is the most important demographic factor associated with different types of refractive errors.

Confocal microscopy of corneal stroma and endothelium after LASIK and PRK.

PURPOSE: To compare with confocal microscopy the changes in stromal keratocyte density and endothelial cell count due to photorefractive keratectomy (PRK) and LASIK. METHODS: In this prospective study, 32 eyes (16 myopic patients) were examined with the NIDEK Confoscan 3 confocal microscope before and 6 months after PRK and LASIK. The preoperative mean myopia was -2.85+/-0.99 diopters (D) (range: -1.00 to -4.00 D) in 24 eyes that underwent PRK and -2.94+/-0.96 D (range: -2.00 to -4.25 D) in 8 eyes that underwent LASIK. Keratocyte density in the anterior and posterior stroma and the endothelial cell count were measured. Statistically significant changes were assessed using the t test. P<.05 was considered statistically significant. RESULTS: Preoperative hexagonal cell percentage in the LASIK group was 52.17+/-11.43 and 51.33+/-10.98 in the PRK group. Postoperatively, the percentages were 52.96+/-7.55 and 53.34+/-10.2, respectively. Six months postoperatively, keratocyte density changed by 367.12+/-103.35 cells/mm(2) (34.7% reduction) in the anterior stroma (P<.05) and 9.25+/-28.28 cells/mm(2) (1.31% reduction) in the posterior stroma (P>.05) for the LASIK group. In the PRK group, these values were 319.71+/-83.45 cells/mm(2) (31.13% reduction) in the anterior stroma (P<.05) and 0.17+/-38.97 cells/mm(2) (0.02% reduction) in the posterior stroma (P>.05). The changes in keratocyte densities were not statistically significant between groups (P>.05). The mean number of keratocytes decreased by 37.2% in the retroablation zone of the LASIK group (P<.05). No changes were noted in endothelial cell counts. CONCLUSIONS: A significant decrease occurred in the number of stromal keratocytes in the anterior stroma. Despite differences in surgery, the change in keratocyte density and endothelial cell counts were similar between LASIK and PRK groups (P>.05).

The histological and clinical effects of 630 nanometer and 860 nanometer low-level laser on rabbits' ear punch holes.

Low-level laser therapy (LLLT) studies on the musculoskeletal and cartilage tissues of rabbits have reported conflicting results. We aimed to investigate the effects of 630 nm and 860 nm low-level laser on injured rabbit cartilage. After punching 5 mm holes in both ears of ten rabbits, we grouped the rabbits randomly. The punched holes of the laser-treated group were irradiated with 630 nm and 860 nm diode laser on days 3-5 and then every other day until day 20. In both laser and control groups, the hole diameters were measured weekly. Histological evaluation was carried out on day 30. The inter-group difference in hole diameters was not significant. Mann-Whitney U tests showed significant inter-group differences in histological variables related to chondrocyte production and organization, growth rate, granulation tissue and pseudocarcinomatosis. LLLT improved cartilage formation and reduced inflammation and formation of granulation tissue. More accurate results on its healing effects warrant studies with larger sample sizes.