Refractive surgery Dotaz Zobrazit nápovědu
The leading topic of this particular paper is dedicated to available surgical options for refractive eye disorders treatment including surgery of cornea and intraocular surgery. Corneal Surgery includes laser refractive surgery - LASIK (Laser-Assisted In Situ Keratomileusis), FemtoLASIK (Femtosecond laser-assisted LASIK), PRK (Photorefractive keratectomy). This article describes relevant principles of particular procedures, indications and possible contraindications. The chapter dedicated to corneal implants provides information about ICRS (Intrastromal Corneal Rings Segment) and Inlays (corneal implants for presbyopia correction). Corneal interventions also include incision methods for astigmatism correction AK (Astigmatic Keratotomy) and LRI (Limbal relaxing Incisions). Intraocular refractive interventions preserving natural human lens also include phakic lenses. Relevant categorization, examples, indications and contraindications are listed in particular chapter of this paper. Intraocular refractive surgery which replaces the original human lens is also called RLE (Refractive Lens Exchange) or PRELEX (Presbyopic Lens Exchange). These interventions are usually accompanied with the multifocal intraocular lens implantation. This chapter provides the list of specific lens types, indications and contraindications related to this type of intervention. The last chapter describes Bioptics--the combination of corneal and intraocular surgery.
PURPOSE: To analyze refractive results after cataract surgery in relation to used type of monofocal intraocular lens, calculation formula, to age, gender and laterality. SETTINGS: Department of Ophthalmology, Comenius University and University hospital in Bratislava, Slovakia Methods: We analyzed 173 eyes (118 patients) after uneventful cataract surgery. We calculated prediction error (PE) and mean absolute error (MAE) of postoperative refraction. RESULTS AND CONCLUSION: We found no statistically significant differences in PE and MAE in relation to types of used IOL, calculation formulas, gender, age or laterality. Key words: Optical biometry, monofocal IOL, IOL calculation, refractive error.
- Klíčová slova
- IOL calculation, Optical biometry, monofocal IOL, refractive error,
- MeSH
- extrakce katarakty * škodlivé účinky MeSH
- implantace nitrooční čočky MeSH
- katarakta * MeSH
- lidé MeSH
- nitrooční čočky * MeSH
- refrakční vady * etiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Slovenská republika MeSH
Refractive surgery with excimer laser has been a very common surgical procedure worldwide during the last decades. Currently, patients who underwent refractive surgery years ago are older, with a growing number of them now needing cataract surgery. To establish the power of the intraocular lens to be implanted in these patients, it is essential to define the true corneal power. However, since the refractive surgery modified the anterior, but not the posterior surface of the cornea, the determination of the corneal power in this group of patients is challenging. This article reviews the different sources of error in finding the true corneal power in these cases, and comments on several approaches, including the clinical history method as described originally by Holladay, and a modified version of it, as well as new alternatives based on corneal tomography, using devices that are able to measure the actual anterior and posterior corneal curvatures, which have emerged in recent years to address this issue.
- Klíčová slova
- corneal power, Refractive surgery, clinical history method, corneal tomography, refractive surgery,
- MeSH
- laserová modelace rohovky pod rohovkovou lamelou * MeSH
- lasery excimerové * terapeutické užití MeSH
- lidé MeSH
- refrakce oka MeSH
- rohovka chirurgie MeSH
- rohovková topografie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
A corneal stromal lenticule (CSL) is a part of the corneal stroma that forms as a waste product during the refractive surgery ReLEx SMILE (Small Incision Lenticule Extraction) and is no longer used. With the increasing number of ReLEx SMILE procedures and the number of potentially available CSLs, two main aspects of their usage are currently being investigated. The first aspect includes the biological properties of CSLs and their proper preservation with respect to long-term storage. The second aspect is related to the potential clinical use of CSLs. As a high-quality biomaterial, CSLs have substantial potential to be used for alternative solutions in the treatment of specific eye diseases. In a number of studies it has been shown that RSL transplantation could be a safe and effective method that does not cause any serious complications, for example in terms of immune reaction. The aim of this article is to present an overview of the possibilities for using CSLs for transplantation purposes, and at the same time to discuss our methodology for processing and preserving CSLs with the protocol used at the Eye Tissue Bank of the Královské Vinohrady University Hospital.
- Klíčová slova
- Cryopreservation, ReLEx SMILE, corneal stromal lenticule (CSL),
- MeSH
- laserová chirurgie rohovky metody MeSH
- lidé MeSH
- refrakční chirurgické výkony metody MeSH
- stroma rohovky * chirurgie MeSH
- transplantace rohovky * metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
PURPOSE: To evaluate the incidence of laser enhancement following cataract surgery and refractive lens exchange (RLE) with FineVision Micro F trifocal lens implantation (PhysIOL, Liège, Belgium). METHODS: Retrospective study of patients who had undergone cataract or RLE surgery and had received a FineVision Micro F intraocular lens. Laser enhancement of residual refractive error was determined. Visual acuity (VA) assessments were performed before and after surgery: uncorrected distance VA (UCDVA), best-corrected distance VA (BCDVA), uncorrected near VA (UCNVA), plus preoperative and postoperative spherical equivalent (SE) assessments. RESULTS: Of the 1129 eyes from 596 patients, 61 (5.4%) required laser enhancement to correct residual refractive error (by group: 30/679 eyes [4.4%] cataract; 31/450 eyes [6.9%] RLE). Eleven eyes received FemtoLASIK; 50 eyes received PRK. Mean UCDVA before laser enhancement was 0.26±0.19 logMAR and 0.24±0.14 in the FemtoLASIK and PRK groups, respectively. After laser enhancement, these were 0.04±0.05 logMAR and 0.13±0.19, respectively; BCDVA values were 0.00±0.00 logMAR in the FemtoLASIK group and 0.06±0.11 in the PRK group. Laser enhancement improved UCNVA (Jaeger) from 2-3 to 1-2 in both groups. Enhancement reduced preoperative SE of -0.39±0.99 D and -0.53±0.58 D (FemtoLASIK and PRK groups, respectively) to 0.24±0.36 D and 0.04±0.47 D. CONCLUSIONS: The FineVision Micro F trifocal lens is an effective solution for gaining increased spectacle independence. The incidence of residual refractive error requiring laser enhancement is low, and laser procedures are a safe and effective solution for improving the quality of vision and patient satisfaction. SYNOPSIS: Laser enhancement rates and outcomes were determined following cataract / refractive lens exchange surgery that used a trifocal IOL. Enhancement was safe and effective and rates were low (5.4%).
- Klíčová slova
- cataract surgery, laser enhancement, refractive lens exchange, trifocal IOL,
- MeSH
- fakoemulzifikace * MeSH
- implantace nitrooční čočky metody MeSH
- incidence MeSH
- lasery MeSH
- lidé MeSH
- protézy - design MeSH
- refrakční vady * MeSH
- retrospektivní studie MeSH
- spokojenost pacientů MeSH
- zkalení zadního pouzdra čočky * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
The authors present a case of a thirty-eight-year-old patient with Alport syndrome. The patient had several ocular symptoms of the disease and has been treated for systemic problems in connection with Alport syndrome since he was fifteen years old. At that age the patient also underwent a kidney transplant in order to deal with renal insufficiency. To date, he still uses immunosuppressants and antihypertensives. Furthermore, the patient suffers from perceptive deafness. The patient visited our clinic in 2021 with a request to solve his high refractive error, in which the diopters were so high that it was not possible to place them in spectacles. The patient's best corrected visual acuity was 0.6 with -8.0sph/-4.0cyl/ax15 in the right eye and 0.7partim with -8.0sph/-4.0cyl/ax155 in the left eye. The autorefractometer values were -6.25sph/-6.75cyl/ax17 in the right eye and -6.75sph/-6.5cyl/ax155 in the left eye. During the eye examination we found a number of ocular manifestations that are typical of Alport syndrome. On the cornea there were opacities as a residue of corneal erosions, and at one of the following check-ups we also found a newly developed corneal erosion. Subsequently, we found an anterior lenticonus and incipient cataract. Upon performing OCT, a typical temporal macular atrophy was evident. Fundus examination in artificial mydriasis showed just a minimal manifestation of fleck retinopathy. Due to the clinical manifestation we decided to perform cataract surgery and implant a monofocal toric intraocular lens in both eyes. There were no complications during the operations, however the surgeon registered a non-standard structure of the lens capsule. The capsule was more fragile, and performing capsulorhexis was much more complicated. A week after the surgery, higher cylinder diopters were still present. A decrease of the higher diopters was noticeable one month after surgery. The time interval between the first operation and the second operation was one month. The patient was highly satisfied with result, and uncorrected visual acuity improved by over four lines. After surgery the patient needed low diopters for near as well as far distance. In the case of this patient, the ocular manifestations were detected and treated in adulthood. Nevertheless, early detection of ocular symptoms of Alport syndrome in young patients before renal failure could lead to timely start of the treatment and delay a possible renal transplant. In case of any suspicion of Alport syndrome it is advised to send the patient to a pediatrician, and at an older age to an internal medicine specialist, for further examination.
- Klíčová slova
- Alport syndrome, cataract, lenticonus,
- MeSH
- dědičná nefritida * komplikace chirurgie diagnóza MeSH
- dospělí MeSH
- lidé MeSH
- refrakční chirurgické výkony MeSH
- zraková ostrost MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
AIMS: The purpose of this study is to evaluate an Altmetric analysis of the 50 most cited refractive surgery articles in Ophthalmology journals and to compare them with traditional metrics. METHODS: The term "refractive surgery" was searched, using a time filter between 2010-2020 in the Web of Science core collection database. The 50 most cited articles between 2010 and 2020 were recorded. Descriptive statistics were performed. The Spearman correlation test was used to evaluate the correlation between traditional metrics and Altmetrics. RESULTS: The Altmetric scores of the top 50 articles ranged from 0 to 25, and the median Altmetric score was 4. The citation numbers of the 50 articles ranged from 83 to 523, and the median citation number was 119.5. The most cited article topic was "Toric Intraocular Lens"; the topics with the highest Altmetric scores were "Toric Intraocular Lens" and "Trifocal Intraocular Lens". There was no significant correlation between Altmetric scores and number of citations. There was a weak correlation between Altmetric scores and the average citation per year. CONCLUSION: The Altmetric score is insufficient, compared with traditional metrics, to show the scientific value of articles on refractive surgery. Altmetrics can be used to supplement traditional metrics.
- Klíčová slova
- Altmetric score, articles, citation number, refractive surgery, social media,
- MeSH
- altmetrika MeSH
- bibliometrie * MeSH
- impakt faktor časopisů MeSH
- lidé MeSH
- oftalmologie * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
AIM: To evaluate the potential of the Support Vector Machine Regression model (SVM-RM) and Multilayer Neural Network Ensemble model (MLNN-EM) to improve the intraocular lens (IOL) power calculation for clinical workflow. BACKGROUND: Current IOL power calculation methods are limited in their accuracy with the possibility of decreased accuracy especially in eyes with an unusual ocular dimension. In case of an improperly calculated power of the IOL in cataract or refractive lens replacement surgery there is a risk of re-operation or further refractive correction. This may create potential complications and discomfort for the patient. METHODS: A dataset containing information about 2,194 eyes was obtained using data mining process from the Electronic Health Record (EHR) system database of the Gemini Eye Clinic. The dataset was optimized and split into the selection set (used in the design for models and training), and the verification set (used in the evaluation). The set of mean prediction errors (PEs) and the distribution of predicted refractive errors were evaluated for both models and clinical results (CR). RESULTS: Both models performed significantly better for the majority of the evaluated parameters compared with the CR. There was no significant difference between both evaluated models. In the ±0.50 D PE category both SVM-RM and MLNN-EM were slightly better than the Barrett Universal II formula, which is often presented as the most accurate calculation formula. CONCLUSION: In comparison to the current clinical method, both SVM-RM and MLNN-EM have achieved significantly better results in IOL calculations and therefore have a strong potential to improve clinical cataract refractive outcomes.
- Klíčová slova
- Artificial neural networks, Cataract, Cataract surgery, IOL calculation, Machine learning, Refractive results, Support vector machine,
- Publikační typ
- časopisecké články MeSH
Objective: To evaluate the prevalence of refractive errors among members of the Armed Forces of the Czech Republic, to recommend a safe way of correcting refractive errors with regard to the specific needs of military personnel (especially members of combat units and flying personnel), and to propose a system for solving these errors in order to increase combat effectivity. Methodology: Questionnaire to determine previous refractive surgery and spectacle correction wear. Measurement of refraction with a hand-held autorefractometer and evaluation of current visual acuity on ETDRS optotypes (Landolt rings). Results: 259 servicemen (518 eyes) were investigated. The return rate of the questionnaires was 100%. The incidence of myopia greater than -0.75D was 22% (113 eyes), myopia greater than -0.5D 32% (166 eyes). The mean value of myopia was -0.78 D (SD ±0.6). Hypermetropia values ranged from +0.25 to +5.0 D. The mean value of hypermetropia was 0.63 D (SD ±0.7). Astigmatism values ranged from -0.25 to -3.75. The mean value of astigmatism was -0.55 Dcyl (SD ±0.49). The average visual acuity was 84.1 letters ETDRS SD (±6.1), visual acuity worse than 80 letters was manifested by 23% of the members of the monitored group. 25 people (10%) had undergone laser refractive surgery. Visual acuity after laser refractive surgery was measured in 19 people (38 eyes). Mean uncorrected post-laser visual acuity was 83.87 (SD ±6.1) ETDRS letters. The mean follow-up period after laser refractive surgery was 6.78 (SD ±4.8) years. Conclusion: Despite the initial selection of military personnel and entry limitations, the prevalence of refractive errors is comparable to the general population. However, in contrast with the general population, refractive errors larger than -3.0 D were not represented in the group. Due to the finding of insufficient correction of refractive errors, increased emphasis should be placed on identifying and regularly observing military personnel with refractive errors
- Klíčová slova
- refractive errors, myopia, laser refractive surgery,
- MeSH
- lidé MeSH
- ozbrojené síly * MeSH
- refrakční vady * epidemiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
Since 1991 the chief specialist evaluates different spheres of ophthalmology based on data provided by all departments in Slovakia. In the submitted article the author summarizes the 10-year period of refractive surgery in Slovakia.
- MeSH
- fotorefrakční keratektomie statistika a číselné údaje MeSH
- implantace nitrooční čočky statistika a číselné údaje MeSH
- laserová modelace rohovky pod rohovkovou lamelou statistika a číselné údaje MeSH
- lasery excimerové MeSH
- lidé MeSH
- refrakční chirurgické výkony * MeSH
- transplantace rohovky statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Geografické názvy
- Slovenská republika MeSH
