Humans ; Retinal Detachment/surgery* ; Myopia/surgery* ; Retrospective Studies ; Treatment Outcome

The accommodative function before and after laser in situ keratomileusis (LASIK) was observed, and the effect of LASIk on accommodation was investigated. In a prospective clinical trial, 48 myopic patients (96 eyes) subject to bilateral LASIK in Refractive Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (China) from March 2006 to June 2006 were selected and studied. Refractions, accommodative range, amplitude of accommodative response and high frequency component (HFC) of accommodative microfluctuations were measured with NEDIK-730A before and one week and 30 days after operation. Dominant and non-dominant eyes were determined by hole-in-card method. It was found that all of the operative eyes showed an uncorrected visual acuity of 0.8 or better one week postoperatively, and 1.0 or better 30 days postoperatively. Compared with those preoperatively, accommodative range and HFC had no significant difference at first week and 30th day after operation in both dominant eyes and non-dominant eyes (P>0.05), but there was a significant difference in the amplitude of accommodative response/accommodative stimulus ratio (A/S) after operation (P<0.01), and no significant difference was found in accommodation between one week and 30 days postoperation. No ocular dominance's change was noted. There was no significant difference in accommodative function between dominant eyes and non-dominant eyes. It was suggested that LASIK produced no significant effect on accommodation.
Accommodation, Ocular/*physiology ; Keratomileusis, Laser In Situ/*adverse effects ; Myopia/*physiopathology ; Myopia/*surgery ; Postoperative Period ; Prospective Studies ; Young Adult

BACKGROUNDFor some high myopic patients with posterior iris bowing, laser periphery iridectomy should be performed pre-operation to prevent pupil block glaucoma if these patients would have phakic intraocular lens implantation to correct high myopia. So we had the opportunity to analysis the influence of laser iridectomy on posterior iris bowing.

METHODSEighteen high myopic patients with posterior iris bowing (11 males and 7 females) were involved in the study in Beijing Tongren Eye Center from March 2008 to July 2008. Phakic intraocular lens were implanted to correct their ametropia. The mean age was (32 ± 6) years (range, 25 - 40 years). The center anterior chamber depth, the pupil diameter, the posterior iris bowing depth and the anterior chamber angle were measured with anterior segment coherence tomography (AS-OCT) under the normal condition, myosis condition induced by 2% pilocarpine, laser periphery iridectomy after myosis, and 2% pilocarpine eluting condition respectively.

RESULTSThere was no significant difference of center anterior chamber depth under the four conditions (P = 0.512). The pupil constricted after pilocarpine (P = 0.001). After laser iridectomy performed and pilocarpine eluted, posterior iris bowing depth reduced more than that in normal condition (P = 0.003). The anterior chamber angle reduced significantly after laser periphery iridectomy and pilocarpine eluted (P = 0.012).

CONCLUSIONLaser periphery iridectomy can reduce the posterior iris bowing, which might be due to the change in aqueous circulate pathway.

Adult ; Female ; Humans ; Iridectomy ; methods ; Iris Diseases ; surgery ; Male ; Myopia ; surgery

OBJECTIVES: To investigate angle Kappa and diopter distribution in myopic patients and the changes of angle Kappa and corneal morphology after Sub-Bowman-Keratomileusis (SBK), and to analyze the effects of the surgery on corneal morphologic changes and the patients' near fixation characteristics. METHODS: The clinical data of 134 myopic patients (268 eyes) undergoing SBK from August 2015 to August 2016 were retrospectively analyzed. Angle Kappa, corneal curvature in the central corneal region of 3 mm, and post-corneal Diff value were measured by Orbscan IIz Corneal Topography System before operation, 1 month and 6 months after operation. According to the values of angle Kappa before SBK, the patients were divided into 2 groups: the large K group (angle Kappa≥5°, 71 eyes) and the small K group (angle Kappa<5°, 197 eyes). Correlation analysis of the factors influencing angle Kappa at 6 months after operation was performed. RESULTS: In the large K group, angle Kappa was (5.67±0.65)°, spherical equivalent was (-4.84±2.32) D, and angle Kappa was decreased after operation (both CONCLUSIONS The angle Kappa is decreased in low-moderate myopia patients with large angle Kappa, while is increased in high myopia patients with small angle Kappa after SBK. Myopia patients after SBK will look for the new balance of the binocular accommodation and vergence function for improving the comfort in the near-work situations.
Cornea/surgery* ; Humans ; Keratomileusis, Laser In Situ ; Myopia/surgery* ; Refraction, Ocular ; Retrospective Studies

Strabismus fixus is very rare and the convergent form is rarely accompanied by blepharoptosis. We successfully treated one patient with high myopia whose convergent strabismus fixus, accompanied by blepharoptosis, became severe after cataract surgery. We report the case with a discussion of its pathology. We performed levator advancement operation, bilateral lateral rectus 11 mm resection, and bilateral medial rectus 8 mm recession. The suture was removed after maintaining temporary traction suture for 6 days. Blepharoptosis was completely corrected by postoperative 2 months. Esodeviation was 15PD, which was not increased compared with immediately after surgery. Satisfactory cosmetic outcome was obtained.
Aged ; Blepharoptosis/complications/*surgery ; Female ; Humans ; Myopia/complications ; Oculomotor Muscles/*surgery ; Ophthalmologic Surgical Procedures/methods ; Strabismus/complications/*surgery ; Treatment Outcome

The purpose of this study is to assess the efficacy of the multi-zone cross-cylinder method as compared with the single method for astigmatism correction using LASIK. This prospective study enrolled 40 patients (52 eyes) who underwent the cross-cylinder method using LASIK, and 52 patients (60 eyes) who underwent the single method using LASIK: all patients were given a diagnosis of complex myopic astigmatism from the department of ophthalmology of this hospital between January 2002 and July 2003. Preoperatively, the mean spherical equivalent refraction was .3.85 +/- 1.13 D in the cross-cylinder group and .4.05 +/-1.20 D in the single method group (p = 0.23). The mean cylinder was .2.05 +/-1.58 D in the cross-cylinder group and .1.95 +/-1.12 D in the single method group (p = 0.31). 6 months after treatment the results were a mean spherical equivalent refraction of .0.26 +/-0.30 D in the crosscylinder group and -0.34 +/-0.35 D in the single method group (p = 0.13). The mean cylinder was .0.38 +/-0.29 D in the cross-cylinder group and .0.45 +/-0.30 D in the single method group (p = 0.096). There were no statistically significant differences between the two groups. The mean BCVA was not different from mean preoperative BCVA in both groups (i.e., 0.98 +/-0.10, 0.96 +/-0.25, p = 0.86). Postoperatively, patient complications that included night halo, glare and corneal haze were not noted in either group. In conclusion, the results of cross-cylinder method are no different from the single method for the correction of a complex astigmatism. In the future, studies will have to be conducted to assess the efficacy of the cross-cylinder method in consideration of those factors that can affect the postoperative outcome.
Adult ; Astigmatism/*surgery ; Corneal Stroma/surgery ; Humans ; Keratomileusis, Laser In Situ/*methods ; Myopia/*surgery ; Postoperative Complications ; Prospective Studies

OBJECTIVETo evaluate the static and dynamic contrast sensitivity changes in myopic patients before and after laser in situ keratomileusis (LASIK).

METHODSSeventy-three eyes in 37 patients with myopia (with or without astigmatism) who received LASIK were tested for static and dynamic contrast sensitivities using the METRO VISION MON ELEC I system at 0.7, 1.4, 2.7, 5.5, 11, and 22 cpd and cps prior to LASIK, and at one-, three-, and six-month intervals after LASIK.

RESULTSAll eyes gained naked visual acuity of more than 0.5 after LASIK. The contrast sensitivity was depressed at all frequencies 1 month after LASIK, as compared to one week prior to LASIK. The depression at 2.7, 5.5, 11 (P < 0.01) and 22 cpd (P < 0.05) was statistically significant for static contrast sensitivity, and also at 5.5 (P < 0.01) and 11 cps (P < 0.05) for dynamic contrast sensitivity. Myopic eyes between 6.25 D and 14.0 D, and astigmatic eyes 2 DC and more, suffered more static and dynamic contrast sensitivity depression than the myopic eyes between 1.25 D and 6.00 D and astigmatic eyes less than 2 DC. Contrast sensitivities were improved and exceeded preoperative levels 3 months after LASIK, and improved even more 6 months after LASIK. All sequences were statistically significant for static contrast sensitivity (P < 0.01), while only 2.7, 5.5, and 11 cps were statistically significant for dynamic contrast sensitivity (P < 0.01). The astigmatic eyes 2 DC and more showed less improvement, even below the preoperative level at 1.4 cps of dynamic contrast sensitivity.

CONCLUSIONSWhile temporary depression of contrast sensitivity for myopic eyes after LASIK was seen, contrast sensitivity soon returned to exceed preoperative levels at 3 months after LASIK, while improving even more 6 months after LASIK.

Adolescent ; Adult ; Astigmatism ; surgery ; Contrast Sensitivity ; Cornea ; surgery ; Female ; Humans ; Keratomileusis, Laser In Situ ; Male ; Myopia ; physiopathology ; surgery ; Visual Acuity

OBJECTIVEA systematic review of literature was performed to compare various visual function parameters including the final visual acuity outcome and/or adverse events between corneal refractive surgery (CLRS) and phakic intraocular lens implantation (p-IOLi) in the treatment of refractive amblyopic children.

DATA SOURCESTwo reviewers independently searched the PubMed, EMBASE, and Controlled Trials Register databases for publications from 1991 to 2013.

STUDY SELECTIONThere were 25 articles, including 597 patients and 682 eyes, was included in CLRS group. Among them, 21 articles reported the use of CLRS in the treatment of myopic anisometropia for 318 patients (13 photorefractive keratectomy or laser epithelial keratomileusis and eight laser in situ keratomileusis). And 11 articles had the results of CLRS in treating hyperopic anisometropic amblyopia children. Eleven articles reported the effect of p-IOLi for treating high myopia or anisometropic amblyopia, including 61 patients (75 eyes). Age, pre- and postoperation best-corrected vision acuity (BCVA), and spherical equivalent (SE) were compared in CLRS and p-IOLi groups.

RESULTSThe average age of CLRS group and p-IOLi group has no statistically significant difference. The SE in CLRS group for myopic anisometropia amblyopia patients was (-10.13 ± 2.73) diopters (D) and for hyperopic anisometropia amblyopia patients was (5.58 ± 1.28) D. In p-IOLi group the SE was (-14.01 ± 1.93) D. BCVA was improved significantly in both groups, and even better in p-IOLi group. Refractive errors were corrected in both groups, but there was no clinically significant difference in final SE between each group. More than one-half of the children had improved binocular fusion and stereopsis function in both groups.

CONCLUSIONSBoth CLRS group and p-IOLi group showed their advantage in treating refractive amblyopia in children. In comparing p-IOLi with CLRS for treatment of refractive amblyopia, no statistically significant difference in final BCVA was observed.

Amblyopia ; etiology ; surgery ; therapy ; Anisometropia ; complications ; Child ; Child, Preschool ; Humans ; Myopia ; complications

OBJECTIVETo evaluate the clinical outcome among three different laser in situ keratomileusis (LASIK) ablations: Q-factor customized ablation (aberration smart ablation, ASA), wave-front guided ablation (WASCA) and ablation under wave-front guiding plus iris recognition system (IR+WASCA).

METHODSThis prospective study comprised 96 eyes of 96 patients, and they were randomly divided into three groups: 30 patients in ASA group, 32 in WASCA group, and 34 in IR+WASCA group. There were no any statistical differences in spherical equivalent (SE), age, sex, pupil diameter, higher-order aberrations (HOA) among three groups preoperatively. Wave-front analysis was performed before and 1, 3 months after operation.

RESULTAll patients got an uncorrected visual acuity (UCVA) ≥ 0.8 1 and 3 months after operation. The residual SE was in ± 0.50D both at 1 and 3 months after surgery. There was no statistical difference in SE value, HOA, change of HOA, and coma aberration postoperatively among three groups. Horizontal coma (Z3¹) aberration took the majority of coma. HOA, total coma aberrations and spherical aberration increased postoperatively (P = 0.000), but without significant difference between 1 month and 3 months after surgery.

CONCLUSIONThat three customized LASIK are all effective, safe, accurate and stable; meanwhile WASCA may have better UCVA than the other two groups postoperatively.

Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ ; methods ; Myopia ; surgery ; Prospective Studies ; Treatment Outcome

PURPOSETo verify whether there exists any difference in higher order aberrations after undergoing myopic LASIK (laser in situ keratomileusis) with conventional ablation and customized ablation in different eyes of the same patient.

METHODSThis was a prospective randomized study of 54 myopic eyes (27 patients) that underwent LASIK using the Nidek EC-5000 excimer laser system (Nidek, Gamagori, Japan). Topography-guided customized aspheric treatment zone (CATz) was used in the first eye of the patient (study group) and the other eye of the same patient was operated on with conventional ablation (control group). Higher order aberrations [root-mean-square (RMS) in the 5-mm zone] of both groups were observed with the Nidek OPD-Scan aberrometer before and 3 months after LASIK. Preoperative mean refractive error was similar between two eyes of the same patient (t=-0.577, P>0.05).

RESULTSPreoperatively, higher order aberrations (RMS in the 5-mm zone) in the CATz ablation and conventional groups were (0.3600+/-0.0341) microm and (0.2680+/-0.1421) microm, respectively. This difference was not statistically significant (t=1.292, P>0.05). Three months after LASIK, higher order aberrations (RMS in 5-mm zone) in the CATz ablation and conventional groups were (0.3627+/-0.1510) microm and (0.3991+/-0.1582) microm, respectively. No statistically significant difference was noted between pre- and postoperative higher order aberrations in the CATz group (t=-0.047, P>0.05). However, a statistically significant increase in higher order aberrations was observed after conventional ablation (t=-5.261, P<0.05). A statistically significant difference was noted in the increase of higher order aberrations after LASIK between groups (t=-2.050, P=0.045).

CONCLUSIONLASIK with conventional ablation and topography-guided CATz ablation resulted in the same BSCVA (best spectacle-corrected visual acuity) 3 month after LASIK. Higher order aberrations were increased, but the increase of higher order aberrations after customized ablation treatment was less than that after conventional ablation.

Adolescent ; Adult ; Humans ; Keratomileusis, Laser In Situ ; methods ; Myopia ; surgery ; Prospective Studies ; Visual Acuity