PURPOSE: To compare forward shift of posterior corneal surface and higher-order aberration (HOA) changes after LASIK, LASEK, and wavefront-guided LASEK surgery in moderate myopia METHODS: One hundred eighty four eyes undergoing LASIK, LASEK and wavefront-guided LASEK with VISX STAR S4 were included in this study. The posterior corneal elevation was measured with Orbscan before, 2 and 4 months after surgery. Changes of the elevation were assessed using the difference map generated from preoperative and postoperative elevation maps. The values of higher-order aberrations were evaluated preoperatively and 2 months postoperatively with Wavefront aberrometer. RESULTS: The posterior corneal surface displayed forward shift of 27.2+/-11.45 micrometer, 24.3+/-9.76 micrometer in LASIK group, 23.4+/-10.5 micrometer, 23.6+/-10.55 micrometer in LASEK group, 24.0+/-14.95 micrometer, 28.4+/-14.72 micrometer in wavefront-guided LASEK group at 2 months and 4 months, respectively. There were no statistically significant differences among those three groups, and between 2 and 4 months. The root mean score (RMS) of HOA was increased after LASIK and LASEK (p=0.000, p=0.000, respectively). The mean change of HOA-RMS was significantly smaller in wavefront-guided LASEK than LASIK or LASEK (p=0.000, p=0.000, respectively, Bonferroni-corrected). CONCLUSIONS: The changes of posterior corneal surface forward shift showed no difference among LASIK, LASEK and wavefront-guided LASEK in moderate myopia. HOAs were significantly increased after LASIK and LASEK. The changes of HOAs were significant smaller in wavefront-guided LASEK than LASIK or LASEK.
Adult ; *Corneal Topography ; Humans ; Myopia/diagnosis/*physiopathology/*surgery ; Postoperative Period ; *Refractive Surgical Procedures ; Severity of Illness Index

OBJECTIVE: To investigate the pathogenesis and treatment of high myopia in patients with angle-closure glaucoma. METHODS: Clinic data of 692 patients with angle closure glaucoma were analyzed retrospectively. Eleven patients with high myopia and angle closure underwent surgery. RESULTS: Eleven patients with high myopia in the 692 angle-closure glaucoma were identified: 3 Weill-Marchesani syndrome, 1 plateau iris configuration and syndrome, 5 primary pupillary block, and 2 iris cyst. Intraocular pressure in 19 eyes of the 11 patients was successfully controlled after receiving phaco or filtering surgery. CONCLUSION Angle closure can occur in eyes with high myopia, and pupillary block may be the main cause of angle closure.
Adult ; Aged ; Female ; Glaucoma, Angle-Closure ; diagnosis ; etiology ; surgery ; Humans ; Male ; Middle Aged ; Myopia ; complications ; diagnosis ; Retrospective Studies ; Young Adult

A 42-year-old man was admitted to our clinic complaining of visual distortion in his left eye two months after bilateral myopic photorefractive keratectomy (PRK). Macular optical coherence tomography (OCT) showed a stage II macular hole in the left eye. Simultaneous OCT in the right eye showed vitreous traction and distortion of the outer retina. One month later, the patient underwent vitrectomy for the left eye, and the macular hole was closed. Two months after that, the patient complained of visual distortion in the right eye, and OCT revealed increased traction and accentuated outer retinal distortion indicating a stage IB macular hole. Traction attenuated later without any intervention. The short interval between PRK and hole formation, bilateral involvement, and the moderate refractive error in this case highlight the possible role of PRK in aggravating vitreoretinal interface abnormalities. We recommend the addition of PRK to the list of procedures that may be associated with the formation of a macular hole.
Adult ; Humans ; Male ; Myopia/*surgery ; Photorefractive Keratectomy/*adverse effects ; Retina/*pathology ; Retinal Perforations/diagnosis/*etiology ; Tomography, Optical Coherence ; *Visual Acuity

A 38-year-old woman developed diffusely distributed opacities with crystalline materials in the laser in situ keratomileusis (LASIK) interface of her eye after she was scratched by a sprig during mountain climbing. No sign of flap displacement was noted. Despite two days of topical and systemic antibiotics therapy, the corneal infiltration with interface opacities persisted. The following day, the distribution of the crystalline materials had rotated in a counterclockwise direction. Flap lifting and foreign body removal using sufficient irrigation were performed. One month after surgery, the patient's postoperative uncorrected visual acuity was 0.8 with cleared interface. No signs of epithelial ingrowth or flap striae were noted. Mild traumatic corneal scratching without flap displacement may threaten the integrity of the LASIK interface. If foreign bodies are suspected to be the cause of inflammation, early flap lifting with irrigation is imperative for successful treatment.
Adult ; Cornea/*injuries/pathology/surgery ; Eye Injuries/*complications/diagnosis/surgery ; Female ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ/*methods ; Myopia/surgery ; *Surgical Flaps ; Surgical Wound Dehiscence/diagnosis/*etiology/surgery ; Wounds, Nonpenetrating/*complications/diagnosis/surgery

PURPOSE: We classified the Orbscan anterior elevation maps in normal eyes (under myopic, emmetropic and hyperopic conditions) and in those after myopic refractive surgery. We did this classification to demonstrate how Orbscan anterior elevation maps are useful in screening for the existence and extent of previous myopic refractive surgery. Such a classification can help clinicians interpret preoperative and postoperative topographies. METHODS: We measured for visual acuity and refractive power in 4800 eyes. After a slit-lamp examination, a corneal topography exam was performed with an Orbscan corneal topography system. The eyes were divided into two groups, with Group I representing those who had not had refractive surgery (4438 eyes). Group II included those who had undergone previous refractive surgery to correct myopia (362 eyes). RESULTS: In Group I, the central island type (43.0%) was the most common, followed by the temporal ridge (25.8%), the with-the-rule regular ridge (16.7%), the against-the-rule regular ridge (6.6%), the nasal ridge (4.0%), and the saddle type (2.1%). In Group II, the depressed lake type (69.9%) was most common, followed by the de-centered ablation type (21.3%). The trend line of the postoperative central anterior surface elevation (E) and the ablation power of refractive surgery were calculated. Ablation power of refractive surgery=0.0047 E+0.0083 CONCLUSIONS: This study demonstrates that it is possible to use Orbscan anterior elevation maps to screen for the extent of previous refractory surgery used in the correction of myopia. This study may also be useful in understanding the shapes of Orbscan anterior elevation maps before and after myopic refractive surgery as well as in determining the degree of ablated myopic refractive power and decentration.
Vision Screening/*instrumentation ; Retrospective Studies ; Preoperative Care ; Postoperative Period ; Myopia/*diagnosis/surgery ; *Keratomileusis, Laser In Situ ; Humans ; Equipment Design ; *Corneal Topography ; Cornea/*pathology ; Adult

This study evaluated the visual quality after wavefront-guided laser in situ keratomileusis (LASIK) for treating myopia. Thirty-two eyes with moderate myopia (-5.78~-2.17D) and 25 eyes with high myopia (-7.78~-6.17D) were prospectively reviewed. The contrast sensitivity (CS), glare and the total higher order aberrations (HOA) were measured before and 1 week, 1 month and 2 months after LASIK. The pupil diameter was measured at day- and night-time illumination. The CS and glare at all spatial frequencies were not reduced after wavefront-guided LASIK (p<0.05) and the difference between the moderate and high myopia group was not significant. No significant correlation was found between the amounts of myopia and the postoperative CS (p>0.05). The area under the log contrast sensitivity function (AULCSF) showed no correlation with the total HOA (r2=-0.071, p=0.612, between the daytime AULCSF and the total HOA with a 4 mm entrance pupil, r2=-0.176, p=0.260, between the nighttime AULCSF and the total HOA with a 6 mm entrance pupil). There was no decrease in CS and glare after wavefront-guided LASIK for myopia. In conclusion, wavefront-guided LASIK based on the individual ablation patterns is a good option for refractive surgery to improve the visual quality in both moderate and high myopia cases.
Adult ; Comorbidity ; Female ; Humans ; Keratomileusis, Laser In Situ/*statistics and numerical data ; Korea/epidemiology ; Male ; Myopia/*diagnosis/epidemiology/*surgery ; Prognosis ; Recovery of Function ; Research Support, Non-U.S. Gov't ; Treatment Outcome ; Vision Disorders/*diagnosis/epidemiology/*prevention and control ; *Vision Tests ; *Visual Acuity

PURPOSE: To evaluate the change of accommodation-convergence parameters after implantation of Artisan phakic intraocular lens (PIOL). METHODS: Prospective study for the patients with the Artisan PIOL implantation was performed. A total of 37 patients (3 males and 34 females) enrolled the study. Preoperatively, convergence amplitude, the stimulus accommodative convergence per unit of accommodation (AC/A) ratio and the near point of convergence (NPC) were evaluated. After the Artisan PIOL implantation, the identical evaluations were repeated at 1 week, 1, 3, and 6 months after the surgery. RESULTS: Mean age was 24.3 +/- 4.8 years old, and preoperative refractive error was -8.92 +/- 4.13 diopters (D). After the implantation, mean refractive errors significantly decreased to within +/-1.00 D, and noticeable complications were not found. The convergence amplitude and the stimulus AC/A ratio increased 1 month after the surgery, but progressively stabilized afterward to near preoperative values. NPC didn't show any significant change over follow-up period up to 6 months. CONCLUSIONS: These results regarding implantation of the Artisan PIOL revealed the increase of accommodation-convergence relationship within first 1 month after the surgery, but progressive stabilization was noted during follow-up periods.
*Accommodation, Ocular ; Adult ; *Convergence, Ocular ; Female ; Follow-Up Studies ; Humans ; Lens Implantation, Intraocular/*methods ; Male ; Myopia/*diagnosis/*surgery ; *Phakic Intraocular Lenses ; Postoperative Period ; Prospective Studies ; Refractive Surgical Procedures/methods ; Treatment Outcome ; Visual Acuity ; Young Adult