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Corneal Disorders
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
Darren S. J. Ting, Rashmi Deshmukh, Daniel S. W. Ting, Marcus Ang
Refractive surgery is one of the most common ophthalmic surgeries performed in the world. It has been shown to improve spectacle independence, cosmesis, and, more importantly, the quality of life of many people.146 However, meticulous preoperative assessment is critical to optimize the visual and refractive outcomes, patient satisfaction, and safety, as well as to minimize postoperative complications such as corneal ectasia following corneal refractive surgery.146 AI has demonstrated its clinical potential in detecting patients who are at higher risk of developing post-laser in situ keratomileusis (LASIK) ectasia.147,148 For instance, Xie et al.148 developed a DL-based AI classification, using Pentacam InceptionResNetV2 Screening System (PIRSS), to screen candidates for corneal refractive surgery. Based on 1,385 patients and 6,465 corneal tomographic images, the AI algorithm was able to achieve an overall detection accuracy of 95%, which was comparable to senior refractive surgeons. Another study similarly demonstrated a detection accuracy of 93% in predicting suitability for corneal refractive surgery.149
Management of Ophthalmic Injuries by the Forward Surgical Team
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
Richard J. Blanch, Johno Breeze, William G. Gensheimer
Corneal injury after refractive surgery can rarely dislocate the surgical flap after laser-assisted in situ keratomileusis (LASIK) surgery and remains to be a small long-term risk afterwards. A dislocated flap should not be confused with a contact lens or a foreign body.
Refractive Surgery and Binocularity
Published in Jan-Tjeerd de Faber, 28th European Strabismological Association Meeting, 2020
A. Dickmann, P. Valente, M.T. Rebecchi, G. Savino, A. Salerni, L. Buzzonetti
Refractive surgery may induce problems in the binocular condition of some patients (Bagolini et Al. 1991, Kowal et Al 2002, Sugar et Al. 2002). Laser in situ keratomileusis (LASIK) has become a standard procedure for the correction of moderate or severe myopia (Sugar et Al. 2002).
Corneal Biomechanics Losses Caused by Refractive Surgery
Published in Current Eye Research, 2023
FangJun Bao, Bernardo T. Lopes, XiaoBo Zheng, YuXin Ji, JunJie Wang, Ahmed Elsheikh
Corneal refractive surgeries (CRS) reshape the anterior corneal surface to adjust the refractive power of the eye, enable light rays to focus on the retina and correct the various forms of refractive error. Keratectasia, although relatively rare (between 0.04 and 0.6%)1 is always considered a serious complication of CRS. 96% of keratectasia cases develop after laser-assisted in situ keratomileusis (LASIK),1 while small incision lenticule extraction (SMILE) and other surface ablation procedures, such as laser-assisted subepithelial keratomileusis (LASEK), photorefractive keratectomy (PRK) and trans PRK (tPRK) are rarely associated with the condition. These trends and the increased demand for CRS in recent years have now made it essential to better understand the effect of various CRS procedures on corneal integrity and effectively identify patients at high risk of developing iatrogenic ectasia. A further purpose of research would be to develop less invasive CRS options with reduced biomechanical effect, such as those involving surface ablation, or solutions that integrate corneal cross-linking or use scleral contact lenses.2
Outcomes of toric intraocular lens implantation after femtosecond laser and traditional cataract surgery
Published in Clinical and Experimental Optometry, 2021
Vasilios F Diakonis, George A Kounis, Nilufer Yesilirmak, Daniel Warren, Konstantinos T Tsaousis, Zachary Davis, Sonia H Yoo, Kendall E Donaldson
Recent literature reveals that around 30 per cent of eyes receiving cataract surgery demonstrate corneal astigmatism of 1.00 D or more.15 In cases where astigmatism remains untreated, this residual refractive error leads to spectacle dependence and suboptimal uncorrected distance visual acuity. The procedures for the management of pre‐existing corneal astigmatism may be categorised into corneal‐based and lens‐based.16–21 At the level of the cornea, these include incisional procedures (selective positioning of phacoemulsification incisions, paired clear corneal incisions, astigmatic keratotomy [penetrating or intrastromal] and limbal relaxing incisions),16–18 and corneal photoablation procedures (laser in situ keratomileusis or photorefractive keratectomy).19,20 At the level of the lens, the implantation of a toric IOL is our only option.19
MiRNA-155-5p Reduces Corneal Epithelial Permeability by Remodeling Epithelial Tight Junctions during Corneal Wound Healing
Published in Current Eye Research, 2020
Feng Wang, Duomei Wang, Meng Song, Qing Zhou, Rongfeng Liao, Yuan Wang
The cornea is very important for maintaining the transparency of the eye and refracting light onto the lens to form an image for vision. As the outer layer of the eyeball, the corneal epithelium is constantly facing various chemical, physical and pathological exposure. To protect and ensure a smooth optical surface, corneal epithelium continually renews itself with stem cells and functions as a protective barrier.1 Poor corneal epithelia wound healing is a critical clinical problem due to frequent corneal injuries and increasing numbers of refractive surgeries. Although the procedure of laser in situ keratomileusis (LASIK) is generally safe, it has a complication rate of 1%, with abnormal wound healing, flap detachment, and ectasia.2 In China, the estimated annual number of eye injuries is over two million, and 20% of the population may suffer from eye trauma in their lifetime. These numbers highlight the need for a better understanding of the mechanism of corneal wound healing in order to develop an effective way to enhance wound healing.1,3