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Tromsø, Norway

Stojanovic A.,SynsLaser Kirurgi | Stojanovic A.,University of Tromso | Chen S.,Wenzhou Medical College | Chen S.,Key Laboratory of Vision Science | And 7 more authors.
PLoS ONE | Year: 2013

Purpose:To evaluate one-step topography-guided transepithelial ablation in the treatment of low to moderate myopic astigmatism using a 1KHz excimer laser.Methods:Retrospective study of 117 consecutive eyes available for evaluation 12 months after surgery. Pre- and post-operative visual and refractive data as well as post-operative pain and haze were analyzed. A novel technique integrating custom refractive- and epithelial- ablation in a single uninterrupted procedure was used.Results:The mean pre-operative spherical equivalent (SE) and the mean cylinder were: -3.22 diopters (D) ±1.54 (SD) (range -0.63 to -7.25 D) and -0.77 D ±0.65 (range 0 to -4.50 D), respectively. At 12 months after surgery: no eyes lost ≥2 lines of corrected distant visual acuity (CDVA). Safety and efficacy indexes were 1.27 and 1.09, respectively. Uncorrected distant visual acuity (UDVA) was ≥20/20 in 96.6% of the eyes. Manifest refraction spherical equivalent was within ±0.5 D of the desired refraction in 93.2% of the eyes. Average root mean square (RMS) wavefront error measured at central 6 mm, increased from 0.38 pre-operatively to 0.47 μm post-operatively. Refractive stability was achieved and sustained 1 month after surgery. No visually significant haze was registered during the observation period. Post-operative pain was reported in 4.5% of patients.Conclusions:One-step transepithelial topography-guided treatment for low to moderate myopia and astigmatism performed with a 1 KHz laser, provided safe, effective, predictable and stable results with low pain and no visually significant haze. © 2013 Stojanovic et al.

Chen X.,SynsLaser Kirurgi | Chen X.,SynsLaser Kirurgi AS | Stojanovic A.,SynsLaser Kirurgi | Stojanovic A.,SynsLaser Kirurgi AS | And 9 more authors.
Journal of Refractive Surgery | Year: 2012

PURPOSE: To evaluate the residual registration error after limbal-marking-based manual adjustment in cyclotorsional tracker-controlled laser refractive surgery. METHODS: Two hundred eyes undergoing custom surface ablation with the iVIS Suite (iVIS Technologies) were divided into limbal marked (marked) and non-limbal marked (unmarked) groups. Iris registration information was acquired preoperatively from all eyes. Preoperatively, the horizontal axis was recorded in the marked group for use in manual cyclotorsional alignment prior to surgical iris registration. During iris registration, the preoperative iris information was compared to the eye-tracker captured image. The magnitudes of the registration error angle and cyclotorsional movement during the subsequent laser ablation were recorded and analyzed. RESULTS: Mean magnitude of registration error angle (absolute value) was 1.82°±1.31° (range: 0.00° to 5.50°) and 2.90°±2.40° (range: 0.00° to 13.50°) for the marked and unmarked groups, respectively (P<.001). Mean magnitude of cyclotorsional movement during the laser ablation (absolute value) was 1.15°±1.34°(range: 0.00° to 7.00°) and 0.68°±0.97° (range: 0.00°to 6.00°) for the marked and unmarked groups, respectively (P=.005). Forty-six percent and 60% of eyes had registration error >2°, whereas 22% and 20% of eyes had cyclotorsional movement during ablation >2° in the marked and unmarked groups, respectively. CONCLUSIONS: Limbal-marking-based manual alignment prior to laser ablation significantly reduced cyclotorsional registration error. However, residual registration misalignment and cyclotorsional movements remained during ablation. Copyright © SLACK Incorporated.

Chen X.,SynsLaser Kirurgi | Chen X.,University of Oslo | Stojanovic A.,SynsLaser Kirurgi | Stojanovic A.,University of Oslo | And 7 more authors.
PLoS ONE | Year: 2014

Purpose: To determine the measurement reliability of CorVis ST, a dynamic Scheimpflug analyser, in virgin and post-photorefractive keratectomy (PRK) eyes and compare the results between these two groups. Methods: Forty virgin eyes and 42 post-PRK eyes underwent CorVis ST measurements performed by two technicians. Repeatability was evaluated by comparing three consecutive measurements by technician A. Reproducibility was determined by comparing the first measurement by technician A with one performed by technician B. Intraobserver and interobserver intraclass correlation coefficients (ICCs) were calculated. Univariate analysis of covariance (ANCOVA) was used to compare measured parameters between virgin and post-PRK eyes. Results: The intraocular pressure (IOP), central corneal thickness (CCT) and 1stapplanation time demonstrated good intraobserver repeatability and interobserver reproducibility (ICC≥0.90) in virgin and post-PRK eyes. The deformation amplitude showed a good or close to good repeatability and reproducibility in both groups (ICC≥0.88). The CCT correlated positively with 1stapplanation time (r = 0.437 and 0.483, respectively, p<0.05) and negatively with deformation amplitude (r = -0.384 and -0.375, respectively, p<0.05) in both groups. Compared to post-PRK eyes, virgin eyes showed longer 1stapplanation time (7.29±0.21 vs. 6.96±0.17 ms, p<0.05) and lower deformation amplitude (1.06±0.07 vs. 1.17±0.08 mm, p<0.05). Conclusions: CorVis ST demonstrated reliable measurements for CCT, IOP, and 1stapplanation time, as well as relatively reliable measurement for deformation amplitude in both virgin and post-PRK eyes. There were differences in 1stapplanation time and deformation amplitude between virgin and post-PRK eyes, which may reflect corneal biomechanical changes occurring after the surgery in the latter. © 2014 Chen et al.

Stojanovic A.,University of Tromso | Chen X.,SynsLaser Kirurgi | Jin N.,Wenzhou Medical College | Zhang T.,Wenzhou Medical College | And 5 more authors.
Journal of Ophthalmology | Year: 2012

Purpose. To evaluate the efficacy and safety of epithelium-on corneal collagen cross-linking (CXL) using a multifactorial approach to achieve proper stromal riboflavin saturation. Methods. This non-randomized retrospective study comprised 61 eyes with progressive keratoconus treated with epithelium-on CXL. Chemical epithelial penetration enhancement (benzalkonium chloride-containing local medication and hypotonic riboflavin solution), mechanical disruption of the superficial epithelium, and prolongation of the riboflavin-induction time until verification of stromal saturation were used before the UVA irradiation. Uncorrected and corrected distance visual acuity (UDVA, CDVA), refraction, corneal topography, and aberrometry were evaluated at baseline and at 1, 3, 6, and 12 months postoperative. Results. At 12-month, UDVA and CDVA improved significantly. None of the eyes lost lines of CDVA, while 27.4% of the eyes gained 2 or more lines. Mean spherical equivalent decreased by 0.74 D, and mean cylindrical reduction was 1.15 D. Irregularity index and asymmetry from Scheimpflug-based topography and Max-K at the location of cone from Placido-based topography showed a significant decrease. Higher-order-aberration data demonstrated a slight reduction in odd-order aberrations S 3, 5,7 (P=0.04). Postoperative pain without other complications was recorded. Conclusion. Epithelium-on CXL with our novel protocol appeared to be safe and effective in the treatment of progressive keratoconus. © 2012 Aleksandar Stojanovic et al.

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