Journal of refractive surgery (Thorofare, N.J.: 1995) (J REFRACT SURG)

Publisher: International Society of Refractive Surgery, Slack

Journal description

The Journal of Refractive Surgery, the official publication of the International Society of Refractive Surgery and its affiliated societies, is a bimonthly forum for original research, review, and evaluation of refractive and corneal surgical procedures. In addition to peer-reviewed scientific articles, regular features such as New Ideas, Case Reports, Consultations in Refractive Surgery, New Commentary, Abstracts, and Opinions help keep the surgeon abreast of this ever-changing specialty.

Current impact factor: 3.47

Impact Factor Rankings

2015 Impact Factor Available summer 2016
2014 Impact Factor 3.468
2013 Impact Factor 2.781
2012 Impact Factor 2.474
2011 Impact Factor 2.541
2010 Impact Factor 2.491
2009 Impact Factor 2.32
2008 Impact Factor 1.914
2007 Impact Factor 1.696
2006 Impact Factor 2.097
2005 Impact Factor 1.948
2004 Impact Factor 2.399
2003 Impact Factor 1.877
2002 Impact Factor 2.307
2001 Impact Factor 1.995
2000 Impact Factor 2.061
1999 Impact Factor 1.847
1996 Impact Factor 1.224

Impact factor over time

Impact factor

Additional details

5-year impact 3.15
Cited half-life 5.70
Immediacy index 0.57
Eigenfactor 0.01
Article influence 0.94
Website Journal of Refractive Surgery website
Other titles Journal of refractive surgery
ISSN 1081-597X
OCLC 56970461
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details


  • Pre-print
    • Author cannot archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo
  • Conditions
    • On Institutional Repositories
    • Publisher's version/PDF cannot be used
    • NIH authors may deposit in PubMed Central after 12 months
    • Must link to publisher version
    • Publisher last reviewed on 21/04/2015
  • Classification

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To evaluate the surface characteristics of lenticules extracted by continuous curvilinear lenticulerrhexis (CCL) in small incision lenticule extraction. Methods: Twelve eyes treated with small incision lenticule extraction were included in the study and divided into two groups: the CCL and traditional groups. The extracted lenticules were examined with scanning electron microscopy. Both the anterior and the posterior surfaces of the lenticules were accessed. A scoring system was used to evaluate surface characteristics of the lenticules with a full mark of 16. Results: All of the lenticules in the CCL group exhibited smoothness and regularity on both sides and received scores of 14 or 15. The average score of anterior surfaces was 14.83 ± 0.41 for the CCL group and 14.00 ± 2.45 for the traditional group. The average score for the posterior surfaces was 14.50 ± 0.55 for the CCL group and 14.83 ± 0.41 for the traditional group. Conclusions: The surfaces of lenticules extracted by the CCL technique in small incision lenticule extraction are of good quality. [J Refract Surg. 2015;31(11):732-735.].
    Journal of refractive surgery (Thorofare, N.J.: 1995) 11/2015; 31(11):732-735. DOI:10.3928/1081597X-20151029-01
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    ABSTRACT: Purpose: To investigate the feasibility of allogeneic corneal lenticule implantation using the femtosecond laser as a method for cornea remodeling. Methods: Small incision lenticule extraction was performed on the right eyes of 15 New Zealand white rabbits. Corneal intrastromal pockets were created with a femtosecond laser on the left eyes. Allogeneic corneal lenticule implantation was performed on the left eye immediately after the lenticule was extracted from the right eye. All animals had preoperative and postoperative slit-lamp photography, ultrasonic pachymetry, corneal endothelial cell count, anterior segment optical coherence tomography, in vivo confocal microscopy, and retinoscopy refraction during the observation period of 8 weeks. The rabbits were killed 8 weeks after surgery. Corneal wound healing response was analyzed by transmission electron microscopy, hematoxylin-eosin staining, TUNEL assay, and immunofluorescent staining. Results: Mild corneal edema and decreased clarity were noted the first few days after implantation, improving to normal 8 weeks after surgery. The corneal thickness and retinoscopy refraction were stable during the observation period. Viable keratocytes could be detected within the lenticule lamellae by ultrastructural analysis 8 weeks after surgery. The anterior and posterior border of the lenticule showed acellular layers with highly irregular collagen arrangement on transmission electron microscope images. Proliferating Ki-67 positive cells were present only in the epithelium layer. Conclusion: Femtosecond laser-assisted endokeratophakia using allogeneic corneal lenticule may be feasible for reshaping cornea, providing a new possibility in refractive surgery and keratoconus treatment. [J Refract Surg. 2015;31(11):775-782.].
    Journal of refractive surgery (Thorofare, N.J.: 1995) 11/2015; 31(11):775-782. DOI:10.3928/1081597X-20151021-07
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    ABSTRACT: Purpose: To assess the effectiveness of a keratoconus-detection algorithm derived from Artemis very high-frequency (VHF) digital ultrasound (ArcScan Inc., Morrison, CO) epithelial thickness maps in the fellow eye from a series of patients with unilateral keratoconus. Methods: The study included 10 patients with moderate to advanced keratoconus in one eye but a clinically and algorithmically topographically normal fellow eye. VHF digital ultrasound epithelial thickness data were acquired and a previously developed classification model was applied for identification of keratoconus to the clinically normal fellow eyes. Pentacam (Oculus Optikgeräte, Wetzlar, Germany) Belin-Ambrósio Enhanced Ectasia Display "D" score (BAD-D) data (5 of 10 eyes), and Orbscan (Bausch & Lomb, Rochester, NY) SCORE data (9 of 10 eyes) were also evaluated. Results: Five of the 10 fellow eyes were classified as keratoconic by the VHF digital ultrasound epithelium model. Five of 9 fellow eyes were classified as keratoconic by the SCORE model. For the 5 fellow eyes with Pentacam and VHF digital ultrasound data, one was classified as keratoconic by the VHF digital ultrasound model, one (different) eye by a combined VHF digital ultrasound and Pentacam model, and none by BAD-D alone. Conclusions: Under the assumption that keratoconus is a bilateral but asymmetric disease, half of the 'normal' fellow eyes could be found to have keratoconus using epithelial thickness maps. The Orbscan SCORE or the combination of topographic BAD-D criteria with epithelial maps did not perform better. [J Refract Surg. 2015;31(11):736-744.].
    Journal of refractive surgery (Thorofare, N.J.: 1995) 11/2015; 31(11):736-744. DOI:10.3928/1081597X-20151021-02
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    ABSTRACT: Purpose: To compare the visual and refractive results obtained after photorefractive keratectomy (PRK) in patients who underwent one of three different epithelial removal techniques. Methods: The authors reviewed the medical files of consecutive eyes with myopia and myopic astigmatism that were treated during a 10-year period by mechanical PRK, alcohol-assisted PRK, or transepithelial PRK (in the phototherapeutic keratectomy mode), and observed for more than 1 year. Results: A total of 3,417 patients (3,417 eyes) were included in this study. At 3 and 6 months postoperatively, the outcome of alcohol-assisted PRK was superior both in efficacy (P < .01) and safety (P < .001) to those of both mechanical PRK and transepithelial PRK, which were similar. At more than 1 year postoperatively, the mean efficacy index was still high for alcohol-assisted PRK, but low for the transepithelial PRK, corresponding to a mean uncorrected visual acuity of more than one Snellen line lower than those of the other two techniques (P < .0001). All three techniques showed a regression toward myopia more than 1 year postoperatively, with significant undercorrection obtained in eyes treated with transepithelial PRK (P < .0001). Conclusions: Significant differences were detected in both the visual outcomes and the refractive results of the three epithelial removal techniques. The long-term outcomes were best for alcohol-assisted PRK. [J Refract Surg. 2015;31(11):760-766.].
    Journal of refractive surgery (Thorofare, N.J.: 1995) 11/2015; 31(11):760-766. DOI:10.3928/1081597X-20151021-05
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    ABSTRACT: Purpose: To investigate the long-term visual outcomes and optical quality after femtosecond laser small incision lenticule extraction (SMILE) for moderate to high myopia correction. Methods: Fifty-four patients (37 women, 17 men) who underwent SMILE were enrolled in this prospective clinical study. Patient ages ranged from 18 to 40 years, with a mean spherical equivalent of -6.50 ± 1.64 diopters. Data including refractive parameters, retinal image quality, intraocular scattering, and aberrations were collected at 6 and 18 months after surgery. Patient satisfaction was also evaluated. Results: At 18 months after surgery, both the mean safety index and the efficacy index were 1.23 ± 0.23 (range: 0.80 to 1.50); there was no significant difference with indices measured at 6 months (P > .05). No patient lost two or more lines of corrected distance visual acuity. Total higher-order aberrations (HOAs) and coma significantly increased after SMILE (P < .05), whereas total spherical aberrations and trefoil changed only slightly. The mean modulation transfer function cutoff frequency was 36.66 ± 8.54 cycles per degree (cpd) before surgery and 37.81 ± 6.89 cpd at 18 months postoperatively; the mean objective scatter index was 0.62 ± 0.33 before surgery and 0.71 ± 0.38 at 18 months postoperatively. No significant difference was found between the three time points (P > .05). Mean patient satisfaction was 9.31 ± 0.64 (with a maximum score of 10). Conclusions: SMILE showed good safety, efficacy, and stability in correcting moderate to high myopia, and patients were highly satisfied. HOAs increased after SMILE, mainly due to the increase of coma, whereas retinal image quality and intraocular scattering barely changed. [J Refract Surg. 2015;31(11):726-731.].
    Journal of refractive surgery (Thorofare, N.J.: 1995) 11/2015; 31(11):726-731. DOI:10.3928/1081597X-20151021-01
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    ABSTRACT: Purpose: To investigate the characteristics of forward light scatter changes after small incision lenticule extraction (SMILE) and to compare these changes with those after femtosecond laser-assisted LASIK (femto-LASIK) and epipolis LASIK (epi-LASIK). Methods: A total of 303 eyes (SMILE group = 118 eyes, femto-LASIK group = 90 eyes, epi-LASIK group = 95) of 157 patients were included in this study. Forward straylight was measured preoperatively and 1 month, 6 months, and 1 year postoperatively using a C-Quant straylight meter (Oculus Optikgeräte, Wetzlar, Germany). Results: A significant increase in straylight was found in the femto-LASIK group only at 1 month after the procedure (P = .002), whereas significant increases were found in the epi-LASIK group at 1 month, 6 months, and 1 year after the procedure (P < .001). There were no significant increases in the straylight values after SMILE (P = .310) compared with the preoperative values, although the straylight values were slightly increased at 1 month. Significant differences in the postoperative-preoperative straylight value (Δlog[s]) changes were found between the SMILE, femto-LASIK, and epi-LASIK groups over the follow-up period (P < .001 for all). The correlations between the ablation depth/central corneal thickness ratios and the straylight values were statistically significant in the femto-LASIK and epi-LASIK groups, whereas no significant correlation between the lenticule thickness/central corneal thickness ratios and the stray-light values was found in the SMILE group. Conclusions: Forward straylight was slightly increased in the early stage after the femto-LASIK procedure and was significantly increased throughout the follow-up period after epi-LASIK surgery. The SMILE procedure appeared to have a smaller effect on forward light scatter within the 1-year follow-up period. [J Refract Surg. 2015;31(11):752-758.].
    Journal of refractive surgery (Thorofare, N.J.: 1995) 11/2015; 31(11):752-758. DOI:10.3928/1081597X-20151021-04
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    ABSTRACT: Purpose: To evaluate differences in straylight between eyes implanted with a hydrophilic multifocal IOL (Seelens MF; Hanita Lenses, Hanita, Israel) and a hydrophobic multifocal IOL (SN6AD1; Alcon Laboratories, Inc., Fort Worth, TX). Methods: In a prospective cohort study, routinely obtained straylight measurements (C-Quant; Oculus Optikgeräte, Wetzlar, Germany) 3 months after standard phacoemulsification for either cataract or refractive lens procedures were compared. Patients were implanted with either the SeeLens MF IOL or the SN6AD1 IOL. Postoperative straylight values, visual acuity, and refractive outcomes were compared. Results: The SeeLens MF IOL was implanted in 84 eyes and the SN6AD1 IOL in 79 eyes. The difference in straylight was 0.08 (P = .01), with the SeeLens MF IOL having less straylight. Postoperative CDVA was logMAR -0.03 ± 0.06 in the SeeLens MF group, and logMAR -0.02 ± 0.08 in the SN6AD1 group. Mean postoperative refraction was +0.01 ± 0.43 and +0.06 ± 0.35 D, respectively. Conclusions: The Seelens MF IOL showed a stray-light of log(s) 0.08 lower than the SN6AD1 IOL. In terms of spherical equivalent and visual acuity the lenses performed equally. More study will aid in understanding the causes and clinical impact of this difference. [J Refract Surg. 2015;31(11):746-751.].
    Journal of refractive surgery (Thorofare, N.J.: 1995) 11/2015; 31(11):746-751. DOI:10.3928/1081597X-20151021-03
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    ABSTRACT: Purpose: To describe a modified small incision lenticule extraction (SMILE) procedure called sub-cap-lenticule-extraction (Sub-Cap-LE) for refractive enhancement after SMILE. Methods: Case report. Results: A 53-year-old woman who underwent bilateral SMILE for moderate myopia complained of blurred vision at distance postoperatively. The manifest postoperative refraction in the eye targeted for distance was -1.0 -1.0 × 5°. She was scheduled for an enhancement applying a new technique that permits the surgeon to use the previously created interface as the new superior plane of the new lenticule. Postoperatively, uncorrected visual acuity improved from 20/63 to 20/16. Conclusions: This first case report demonstrates the feasibility of an enhancement with the SubCap-LE procedure after a primary SMILE procedure. More cases are needed to develop a consistent surgical protocol. [J Refract Surg. 2015;31(10):708-710.].
    Journal of refractive surgery (Thorofare, N.J.: 1995) 10/2015; 31(10):708-710. DOI:10.3928/1081597X-20150928-04

  • Journal of refractive surgery (Thorofare, N.J.: 1995) 10/2015; 31(10):648-649. DOI:10.3928/1081597X-20150928-05
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    ABSTRACT: Purpose: To evaluate the long-term visual, refractive, and corneal aberrometric outcomes and regression of the achieved correction of hyperopia with a sixth-generation excimer laser. Methods: This retrospective, consecutive, observational case series study comprised 86 eyes of 44 patients who underwent LASIK to correct hyperopia with a postoperative follow-up of 3 years. LASIK procedures were performed using the sixth-generation Amaris excimer laser (Schwind eye-tech-solutions GmbH and Co., Kleinostheim, Germany). Visual acuity, manifest refraction, corneal topography, and aberrometry were evaluated in the follow-up. Results: Three years postoperatively, 65 eyes (76%) had an uncorrected distance visual acuity of 20/20 or better. Five eyes (6.2%) lost one or more lines of corrected distance visual acuity. Sixty eyes (70%) had a spherical equivalent within ±0.50 diopters (D). There was regression of 0.47 D between 3 and 36 months postoperatively. Statistically significant differences were found in spherical equivalent between 3 and 36 months (P < .01), but no differences were observed between 12 and 36 months (P = .08). A flattening of 0.16 D was observed between 3 and 36 months after surgery in the mean simulated keratometry. A significant increase of root mean square spherical-like, coma-like, and higher-order aberrations (P < .01) were observed postoperatively. Twenty-five eyes (29%) required re-treatment. Conclusions: Treatment of hyperopia using the sixth-generation Amaris excimer laser provides good results in terms of efficacy, safety, predictability, and visual outcomes after 3 years. The refractive stability shows a significant regression in the first 12 months after surgery with more stable results from 12 months postoperatively. [J Refract Surg. 2015;31(10):674-681.].
    Journal of refractive surgery (Thorofare, N.J.: 1995) 10/2015; 31(10):674-682. DOI:10.3928/1081597X-20150928-06
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    ABSTRACT: Purpose: To compare the optical quality under large apertures among three multifocal intraocular lenses (IOLs): the TECNIS Symfony ZXR00 (Abbott Laboratories, Abbott Park, IL), the AT LISA tri 839MP (Carl Zeiss Meditec, Jena, Germany), and the Finevision (PhysIOL, Liège, Belgium). Methods: The in vitro optical quality of each lens was assessed with an instrument that measured the modulation transfer function (MTF). The optical quality of each lens was described in terms of MTF and through focus average MTF. The Strehl ratio, cut-off frequency, area of visibility, and percentage energy were calculated to objectively describe the optical quality of each lens. These metrics were assessed for the best lens distance focus and at four vergences (from -1.50 to -3.00 D in 0.50-D steps) at a 4.5-mm aperture. Results: The through focus average MTF of the AT LISA and Finevision IOLs showed three mean areas corresponding to distance, intermediate, and near vision. The TECNIS Symfony IOL showed two main areas corresponding to distance and intermediate vision. All metrics revealed that the Finevision IOL showed the best optical quality at distance vision, the TECNIS Symfony IOL at intermediate vision, and the AT LISA IOL at near vision. The TECNIS Symfony IOL showed the most homogeneous light distribution between its best vision foci. Conclusions: The TECNIS Symfony IOL is less vergence dependent than the AT LISA and Finevision IOLs under dim conditions. These results may help clinicians to choose the proper lens depending on the patient's visual requirements. [J Refract Surg. 2015;31(10):666-672.].
    Journal of refractive surgery (Thorofare, N.J.: 1995) 10/2015; 31(10):666-676. DOI:10.3928/1081597X-20150928-01
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    ABSTRACT: Purpose: To evaluate and compare the accuracy of three toric intraocular lens (IOL) calculators using keratometry measurements derived from the anterior corneal curvature and direct measurements of the posterior corneal curvature. Methods: Postoperative corneal astigmatism was measured by the IOLMaster (Carl Zeiss Meditec, Jena, Germany) and Pentacam (Oculus Optikgeräte, Wetzlar, Germany). The data were processed by the Alcon, Holladay, and Barrett toric IOL calculators. The error in predicted residual astigmatism (PredRA) was calculated by subtracting the PredRA from the postoperative subjective refraction by vector analysis. Results: The centroid errors in PredRA were against-the-rule (ATR) with the Alcon (0.56 diopters [D]) and Holladay (0.55 D) toric calculators using the IOLMaster (Carl Zeiss Meditec, Jena, Germany) measurements. The centroid errors in PredRA were lower when Pentacam (Oculus Optikgeräte, Wetzlar, Germany) measurements were used (0.38 D, ATR). The Barrett toric calculator using the IOLMaster measurements had the lowest centroid errors in PredRA (0.02 D, P < .001) and achieved the most accurate results: 75.8% and 92.9% of eyes were within 0.50 and 0.75 D of the PredRA, respectively. Conclusions: The prediction of the postoperative astigmatic outcome can be improved by using appropriate methods of adjustment for posterior corneal astigmatism. [J Refract Surg. 2015;31(10):699-706.].
    Journal of refractive surgery (Thorofare, N.J.: 1995) 10/2015; 31(10):699-707. DOI:10.3928/1081597X-20150928-03
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    ABSTRACT: Purpose: To assess the 3-year refractive and visual outcomes after small incision lenticule extraction (SMILE) in patients with high myopia and to evaluate the optical changes from 3 months to 3 years after surgery. Methods: A total of 87 eyes (87 patients) undergoing SMILE for high myopia were included. Preoperative and 3-month and 3-year postoperative follow-up examinations included manifest refraction and uncorrected and corrected distance visual acuities. Pentacam HR (Oculus Optikgeräte, Wetzlar, Germany) was used to evaluate the total corneal refractive power and the root mean square of spherical aberration, coma, and total higher-order aberrations. The paired t test and Wilcoxon signed rank test were used. Results: The preoperative spherical equivalent averaged -7.30 ± 1.40 diopters (D); no significant changes occured between 3 months and 3 years after surgery (-0.30 ± 0.50 D vs -0.40 ± 0.60 D, P = .071). Uncorrected distance visual acuity was stable from 3 months to 3 years after SMILE (0.04 ± 0.17 logMAR vs 0.03 ± 0.19 logMAR; P = .28), whereas corrected distance visual acuity improved from -0.05 ± 0.15 to -0.08 ± 0.11 logMAR (P < .001). At 3 months, 82% and 93% of eyes were within ±0.50 and ±1.00 D, respectively. At 3 years, 78% and 90% were within ±1.00 D of the attempted refraction, respectively. Spherical and higher-order aberrations significantly decreased from 3 months to 3 years, whereas coma remained stable. A significant regression of 0.36 ± 0.29 D was seen in total corneal refractive power (P < .001). Conclusions: The refractive and visual outcomes seemed stable years after SMILE. A minor myopic regression was observed in total corneal refractive power but not in subjective refraction. There seems to be a significant long-term improvement in higher-order aberrations after surgery. [J Refract Surg. 2015;31(10):XX-XX.].
    Journal of refractive surgery (Thorofare, N.J.: 1995) 10/2015; DOI:10.3928/1081597X-20150923-11

  • Journal of refractive surgery (Thorofare, N.J.: 1995) 09/2015; 31(9):638-9. DOI:10.3928/1081597X-20150821-01
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    ABSTRACT: Purpose: To determine the characteristics and risk factors for occurrence of opaque bubble layer (OBL) during femtosecond laser-assisted flap creation for LASIK. Methods: One hundred ninety-eight eyes of 102 consecutive patients who underwent LASIK flap creation performed with the Alcon WaveLight FS200 laser (Alcon Laboratories, Inc., Fort Worth, TX) were retrospectively analyzed in a cohort study. Preoperative manifest refraction, corneal keratometry, central corneal thickness, white-to-white corneal diameter, corneal hysteresis, corneal resistance factor, and programmed flaps parameters were collected. Digital images automatically recorded after flap creation were analyzed to measure OBL areas. Correlation tests were performed between preoperative corneal parameters and OBL areas. Results: The incidence rate of OBL was 48% (103 eyes). The mean OBL area as a percentage of the corneal flap area in the OBL group was 4.25% ± 7.16% (range: 0% to 32.9%). The central corneal thickness, corneal resistance factor, and corneal hysteresis were significantly positively correlated with the OBL area (r = 0.242, P = .001; r = 0.254, P = .028; and r = 0.351, P < .0001, respectively). Corneal hysteresis and OBL area were positively correlated, independently of the central corneal thickness and other confounder factors with standardized coefficient (r = 0.353 ± 0.227, P = .002). Conclusions: This study confirms the already known OBL risk factors with a larger cohort and suggests for the first time that an elevated corneal hysteresis is an independent predictive risk for OBL occurrence. [J Refract Surg. 2015;31(9):608-612.].
    Journal of refractive surgery (Thorofare, N.J.: 1995) 09/2015; 31(9):608-12. DOI:10.3928/1081597X-20150820-06
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    ABSTRACT: Purpose: To determine long-term changes in corneal transparency after riboflavin-ultraviolet A-induced corneal collagen cross-linking (CXL). Methods: Charts and anterior segment data of patients after CXL for progressive keratoconus were retrospectively reviewed. Patients were examined using the Scheimpflug-based Pentacam corneal densitometry module (Oculus Optikgeräte, Wetzlar, Germany) before CXL and at five postoperative follow-up visits: 1 to 3, 3 to 6, 6 to 12, 12 to 24, and 24 to 36 months. Results: Forty-two eyes of 28 patients (mean age: 27.9 ± 8.6 years) were included. Total corneal light backscatter was higher 1 to 3 months after CXL than before CXL (P < .001). There were significant differences, especially in the anterior (P < .001) and central (P < .001) layer at total diameter and posterior layer (P = .014) and the three central annuli at total corneal thickness (0 to 2 mm: P < .001; 2 to 6 mm: P < .001; 6 to 10 mm: P = .002). Total corneal light backscatter at total corneal thickness and total diameter faded over time following CXL. The backscatter was significantly lower 24 to 36 months after CXL than before CXL (P < .001). Conclusions: Corneal densitometry peaks in the first months after CXL and returns to preoperative values approximately 1 year after CXL. Two years after CXL, corneal densitometry reaches values obtained for healthy, untreated corneas, thus achieving an improvement in corneal clarity over untreated keratoconic corneas. [J Refract Surg. 2015;31(9):614-618.].
    Journal of refractive surgery (Thorofare, N.J.: 1995) 09/2015; 31(9):614-618. DOI:10.3928/1081597X-20150820-07
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    ABSTRACT: Purpose: To study the feasibility of performing myopic femtosecond small incision lenticule extraction (SMILE) with four different cap thicknesses (130, 140, 150, and 160 μm). Methods: In this retrospective, comparative, non-randomized clinical trial, a refractive lenticule of intrastromal corneal tissue was cut with the VisuMax femtosecond laser system (Carl Zeiss Meditec AG, Jena, Germany) using different depths of the non-refractive lenticule cut. Manifest refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and Objective Scattering Index (OSI) were evaluated. Minimum follow-up time was 1 year. Results: Ninety-four eyes of 47 patients with myopia with (14 patients) and without (33 patients) astigmatism were treated. One year after the surgery, mean log-MAR UDVA, logMAR CDVA, SE, and OSI were 0.07 ± 0.12, 0.01 ± 0.37, 0.07 ± 0.57, and 0.88 ± 0.17, respectively (P < .05). There were no significant statistical differences in logMAR UDVA, logMAR CDVA, SE, or OSI (P > .05) variables when the different groups were compared for the same periods of time. Conclusions: No differences in visual acuity, refractive outcomes in optical visual quality, or complications were observed when using SMILE at four different depths. [J Refract Surg. 2015;31(9):580-585.].
    Journal of refractive surgery (Thorofare, N.J.: 1995) 09/2015; 31(9):580-585. DOI:10.3928/1081597X-20150820-02