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ABSTRACT: BACKGROUND: The aim of this paper is to present the accuracy, predictability, and safety outcomes of LASIK enhancements performed with the FEMTO LDV femtosecond laser (Ziemer Ophthalmic Systems, Port, Switzerland) and the Allegretto Wave Concerto 500 Hz excimer laser (Wavelight AG, Erlangen, Germany), following previous LASIK treatments. METHODS: FEMTO LDV was used for flap creation in 85 previously LASIK-treated eyes of 62 patients. The intended flap thickness was 90 μm in 81 eyes and 140 μm in 4 eyes. The size of the suction ring was 9.0 mm in 72 eyes and 9.5 mm in 13 eyes. Flap dimensions were measured and correlated to preoperative characteristics. RESULTS: With the intended flap thickness of 90 μm in previously LASIK-treated eyes, the actual flap thickness was 90.2 ± 6.6 μm (range 80-122), and the flap diameter was 9.2 ± 0.2 mm (range 8.7-9.9). The mean hinge length was 4.0 ± 0.2 mm (range 3.0-4.8). Flap thickness correlated positively with patient age and hinge length. Complications were reported in 12 eyes (14.1 %). Most of the complications were very mild, and none of them prevented further refractive laser treatment. One eye lost two Snellen lines of best spectacle-corrected visual acuity. CONCLUSIONS: Femtosecond LASIK enhancement is warranted only in rare cases. Surgical experience is needed and special caution must be practiced. For cases of a primary free cap, femtosecond LASIK is not recommended.
Albrecht von Graæes Archiv für Ophthalmologie 07/2012; · 2.17 Impact Factor
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Acta ophthalmologica 05/2012; · 2.44 Impact Factor
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Clinical and experimental rheumatology 03/2012; 30(3):456-7. · 2.15 Impact Factor
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ABSTRACT: To investigate the cytotoxicity of benzalkonium chloride (BAC)-containing ophthalmic solutions of prostaglandin analogs (latanoprost, travoprost, bimatoprost, and preservative-free (PF) tafluprost), BAC mixture (BACmix) and BAC homologs with different alkyl chain lengths using human corneal epithelial (HCE) and conjunctival epithelial (IOBA-NHC) cell cultures. The distribution of BAC homologs in rabbit ocular surface tissues in vivo was examined.
The cells were exposed for one hour to prostaglandin analogs, BACmix and three homologs. Cytotoxicity was assessed with the WST-1 and lactate dehydrogenase (LDH) assays for cellular viability and cell membrane integrity. BAC 0.02% solution was instilled on the rabbit eye daily for 14 days and the concentrations of BAC homologs in external ocular tissues were determined.
The order of decreasing cytotoxicity in the WST-1 test was latanoprost ≥ travoprost > bimatoprost ≥ PF tafluprost. IOBA-NHC cells were more sensitive than HCE cells. In HCE, only latanoprost diluted to 10% increased LDH leakage. In IOBA-NHC, LDH leakage was statistically significant with 3-10% travoprost and 10% latanoprost. The order of decreasing cytotoxicity of preservatives was C14 > C12 > BACmix > C16 in HCE and C12 > C14 > BACmix > C16 in IOBA-NHC. Following treatment with BAC 0.02% solution, the amounts of BAC-C12, -C14 and -C16 in rabbit cornea and conjunctiva, respectively were: 0.37 ± 0.08 and 2.64 ± 0.27 ng/mg; 0.42 ± 0.07 and 4.77 ± 0.43 ng/mg; 0.04 ± 0.01 and 0.54 ± 0.05 ng/mg.
The cytotoxic effects of latanoprost, travoprost, and bimatoprost were dependent on the BAC concentration in their formulations. BACmix was cytotoxic at the concentrations above those corresponding to 0.001% BAC in ophthalmic medications. PF tafluprost was the least toxic of the drugs tested. Within studied BAC homologs, those with longer alkyl chain and higher lipophility penetrated effectively into rabbit external ocular tissues.
Current eye research 11/2011; 37(2):145-54. · 1.51 Impact Factor
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ABSTRACT: To investigate the conjunctival inflammatory alterations of patients with primary open-angle glaucoma (POAG) and exfoliation glaucoma (ExG) and correlate the findings with the success of deep sclerectomy (DS) surgery and with the patients' medical history.
Altogether 25 POAG and ExG patients of the prospective DS study were divided, based on the diagnosis and success of the operation, into 4 groups, POAG S (success), POAG F (failure), ExG S, and ExG F. Controls were obtained from other ophthalmologic surgery patients who did not have glaucoma, and their conjunctiva was examined to be normal. Inflammatory cell subtypes in the conjunctiva were identified and quantified by using immunohistochemistry and monoclonal antibodies: CD3 (T-lymphocyte marker), CD4 (T-helper lymphocyte marker), CD8 (T-cytotoxic lymphocyte marker), CD20 (pan-B cell marker), CD38 (plasma cell marker), CD45RA (naïve T-cell marker), and CD68 (macrophage marker).
Higher numbers of inflammatory cells were found in the conjunctiva of the glaucoma patients on medical treatment compared with the normal conjunctiva of the controls. Moreover, T-lymphocytes, T-helper lymphocytes, T-cytotoxic lymphocytes, B cells, plasma cells, and macrophages were found in significantly higher numbers in patients in whom DS failed during the follow-up period of 2.5 years than those with surgical success.
High numbers of cytotoxic and helper T-lymphocytes, plasma cells, and macrophages indicate a chronic inflammatory reaction in the conjunctiva of glaucoma patients. The chronic inflammation is most probably owing to the chronic topical treatment of the patients and seems to be a significant risk factor for DS surgery failure.
Journal of glaucoma 03/2011; 20(3):172-8. · 1.74 Impact Factor
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ABSTRACT: Retinal pigment epithelial (RPE) cells are continually exposed to oxidative stress that contributes to protein misfolding, aggregation and functional abnormalities during aging. The protein aggregates formed at the cell periphery are delivered along the microtubulus network by dynein-dependent retrograde trafficking to a juxtanuclear location. We demonstrate that Hsp90 inhibition by geldanamycin can effectively suppress proteasome inhibitor, MG-132-induced protein aggregation in a way that is independent of HDAC inhibition or the tubulin acetylation levels in ARPE-19 cells. However, the tubulin acetylation and polymerization state affects the localization of the proteasome-inhibitor-induced aggregation. These findings open new perspectives for understanding the pathogenesis of protein aggregation in retinal cells and can be useful for the development of therapeutic treatments to prevent retinal cell deterioration.
Journal of Biomedicine and Biotechnology 01/2011; 2011:798052. · 2.44 Impact Factor
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ABSTRACT: Biomaterials are widely used in ophthalmology, and biodegradable polymers have been evaluated for use in surgery, tissue engineering and targeted drug delivery. We examined the tissue reactions attributable to 3 biodegradable polymers in the rat eye.
Inion GTR™ membrane [a blend of 85:15 poly(L-lactide-coglycolide) and 70:30 poly(L-lactide-co-1,3-trimethylene carbonate) copolymers in a molar ratio of 70:30], a 50:50 molar ratio of poly(DL-lactide-coglycolide) (PDLGA 50:50), and a 85:15 molar ratio of poly(DL-lactide-coglycolide) (PDLGA 85:15) were surgically implanted into the subconjuctival space of rat eyes. Biocompatibility was evaluated by following the eyes clinically and with histo- and immunohistochemical techniques.
No clinical signs of inflammation were observed around the implants during follow-up. However, immunohistochemical sections revealed increased accumulation of magrophages around PDLGA 85:15 at 2 weeks and of myofibroblasts around GTR membrane material at 1 month. The order of the degradation time of the material was GTR membrane material > PDLGA 85:15 > PDLGA 50:50; Fourier transform infrared microscopy revealed some differences in the degradation behavior of the polymers. Immunohistochemical staining for plasma or cellular fibronectin was observed around all implants.
Despite the different decay times and influences on the expression levels of fibronectins, all polymers evoked rather similar tissue reactions during the observation period. This study provides new data on the biocompatibility of biomaterials in rat eyes. Our findings of the tissue decay of the implant and biomaterial-induced tissue reaction may help in the development of better biomaterials for eye surgery with optimal drug delivery properties.
Ophthalmic Research 01/2011; 46(2):55-65. · 1.56 Impact Factor
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ABSTRACT: To investigate calcium signaling in a rat experimental model of glaucoma.
A method for labeling ganglion cell layer (GCL) neurons with the calcium indicator Fura-2 in flat-mounted retinas of adult rats was established. Pharmacologically evoked responses in laser-induced glaucomatous and control retinas were imaged 2 weeks after the initial laser treatment. The optic nerves of the same eyes were evaluated for neurodegenerative changes.
After laser treatment, intraocular pressure (IOP) was elevated 1.5- to 4.9-fold (24.70 ± 15.57 mm Hg) compared with control eyes (8.71 ± 1.53 mm Hg), and the area of neurodegenerative axons in optic nerve sections of laser-treated eyes was increased by 1.2- to 13.3-fold. The basal intracellular Ca(2+) level, as revealed by the Fura-2 ratio, was elevated in GCL neurons of laser-treated eyes compared with controls. This might suggest a mild degree of damage at the level of the soma in the GCL neurons of eyes with elevated IOP. Although glaucomatous GCL neurons remained functional as assessed pharmacologically, analysis of imaging data revealed that responses evoked by a brief application of ATP were slightly reduced rather than increased in the cells of laser-treated eyes compared with controls. No significant relationships were found between IOP/optic nerve damage and functional characteristics (basal intracellular Ca(2+) level or response to carbachol/elevated K(+)/ATP) within cells of laser-treated eyes.
Ca(2+) imaging is a useful tool to map altered physiological characteristics of individual GCL neurons in the glaucomatous eye.
Investigative ophthalmology & visual science 12/2010; 51(12):6387-93. · 3.43 Impact Factor
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ABSTRACT: Since estrogen and selective estrogen receptor modulators can inhibit inflammatory responses, we studied the regulatory role of several selective estrogen receptor modulators on interleukin-6 (IL-6) expression in human retinal pigment epithelial cells (ARPE-19). ARPE-19 cells were exposed to lipopolysaccharide with simultaneous exposure to different selective estrogen receptor modulators with the secretion of IL-6 cytokine being analyzed by enzyme-linked immunosorbent assay (ELISA). We demonstrate that 17beta-estradiol and HM-D, a novel selective estrogen receptor modulator compound, clearly reduced the IL-6 expression levels after lipopolysaccharide exposure in ARPE-19 cells. Molecular effects of selective estrogen receptor modulators and estrogen on the estrogen response element-mediated transcription were studied using MCF-7 and ARPE-19 cell lines carrying the estrogen response element-luciferase reporter gene. Estrogen and HM-D stimulated the activity of estrogen response element-reporter gene in MCF-7 cells but did not affect the activity in ARPE-19 cells. In addition, HM-D did not activate estrogen receptor alpha when studied by nuclear receptor peptide estrogen receptor alpha ELISA in ARPE-19 cells. These results indicate that estrogen and HM-D can suppress the lipopolysaccharide-induced inflammatory response but signalling is not mediated through estrogen response element transcription in human retinal pigment epithelial cells.
European journal of pharmacology 08/2010; 640(1-3):219-25. · 2.59 Impact Factor
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Hannu Uusitalo,
Enping Chen,
Norbert Pfeiffer,
Françoise Brignole-Baudouin,
Kai Kaarniranta,
Markku Leino,
Päivi Puska,
Elina Palmgren,
Thomas Hamacher,
Günter Hofmann,
Gernot Petzold,
Ulrich Richter,
Tobias Riedel,
Martin Winter,
Auli Ropo
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ABSTRACT: The purpose of this study was to investigate the tolerability and intraocular pressure (IOP) reducing effect of the first preservative-free prostaglandin tafluprost (Taflotan) in patients exhibiting ocular surface side-effects during latanoprost (Xalatan) treatment.
A total of 158 patients were enrolled in this open-label multicentre study. Eligible patients had to have at least two ocular symptoms, or one sign and one symptom, during treatment with latanoprost. At baseline, the patients were directly switched from latanoprost to preservative-free tafluprost for 12 weeks. The patients were queried for ocular symptoms, and ocular signs were assessed by using tear break-up time, Schirmer's test, fluorescein staining and evaluation of conjunctival hyperaemia and blepharitis. In addition, HLA-DR and MUC5AC in conjunctival impression cytology specimens were analyzed, and a drop discomfort/quality of life (QoL) questionnaire was employed. IOP was measured at all visits.
Preservative-free tafluprost maintained IOP at the same level after 12- weeks treatment (16.4 +/- 2.7 mmHg) as latanoprost at baseline (16.8 +/- 2.5 mmHg). During treatment with preservative-free tafluprost, the number of patients having irritation/burning/stinging (56.3%), itching (46.8%), foreign body sensation (49.4%), tearing (55.1%) and dry eye sensation (64.6%) decreased to 28.4%, 26.5%, 27.1%, 27.1% and 39.4% correspondingly. The number of the patients with abnormal fluorescein staining of cornea (81.6%) and conjunctiva (84.2%), blepharitis (60.1%), conjunctival hyperaemia (84.2%) and abnormal Schirmer's test (71.5%) was also reduced significantly to 40.6%, 43.2%, 40.6%, 60.0% and 59.4% correspondingly. The tear break-up time improved significantly from 4.5 +/- 2.5 seconds to 7.8 +/- 4.9 seconds. A reduction in the number of patients with abnormal conjunctival cells based on HLA-DR and MUC5AC was also detected.
Preservative-free tafluprost maintained IOP at the same level as latanoprost, but was better tolerated in patients having signs or symptoms while on preserved latanoprost. Preservative-free tafluprost treatment resulted in improved QoL, increased patient satisfaction and drop comfort.
Acta ophthalmologica 05/2010; 88(3):329-36. · 2.44 Impact Factor
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ABSTRACT: Tafluprost is a novel prostaglandin F(2alpha)-receptor agonist shown to lower intraocular pressure (IOP) in healthy humans and patients with elevated IOP. We investigated the efficacy, safety, and tolerability of tafluprost 0.0015% compared with latanoprost 0.005% in patients with primary open-angle glaucoma, exfoliation glaucoma, or ocular hypertension.
This was a randomized, double-masked, active-controlled, parallel-group, multinational, and multicenter phase II study. Patients received either tafluprost 0.0015% (n = 19) or latanoprost 0.005% (n = 19), both once daily. The extent and duration of action of the IOP-lowering effects at Day 42 and Day 43 were the primary efficacy endpoints. Efficacy and safety parameters were analyzed throughout.
Maximum IOP reduction was achieved by Day 7 and was sustained until Day 42 in both groups (mean [standard deviation] change from baseline -9.7 [3.3] mm Hg for tafluprost and -8.8 [4.3] mm Hg for latanoprost). The overall treatment group difference was 0.17 mm Hg (95% confidence interval -1.27 to 1.61; P = 0.811). The IOP-lowering effect was maintained for >or=24 h after the last dose in both groups. Most adverse events were ocular and were similar in frequency and severity between groups. There were 3 severe adverse events, all ocular, and all in the tafluprost group (3/19 = 16%).
Tafluprost and latanoprost have comparable effects on the extent, duration, and stability of IOP reduction, and are well tolerated in patients.
Journal of ocular pharmacology and therapeutics: the official journal of the Association for Ocular Pharmacology and Therapeutics 02/2010; 26(1):97-104. · 1.46 Impact Factor
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ABSTRACT: The objective of the study was to compare the long-term efficacy and safety of tafluprost 0.0015% with latanoprost 0.005% eye drops in patients with open-angle glaucoma or ocular hypertension.
This double-masked, active-controlled, parallel-group, multinational, multicentre, phase III study was conducted at 49 centres in 8 countries. Eligible patients were assigned to treatment administered once daily at 20:00 hrs for up to 24 months. Change from baseline intraocular pressure (IOP) was the primary efficacy variable. Adverse events were recorded and ocular safety was evaluated. Both tafluprost and latanoprost were preserved with benzalkonium chloride.
From 533 patients randomized, 402 patients completed 24 months of therapy. Both treatments had a substantial IOP-lowering effect which persisted throughout the study (-7.1 mmHg for tafluprost and -7.7 mmHg for latanoprost at 24 months). Although the IOP-lowering effect during the study was slightly larger with latanoprost, this difference was clinically small and the noninferiority of tafluprost to latanoprost over all diurnal IOP measurements was shown with anova and almost reached with ancova (upper limits of the 95% confidence intervals 1.38 and 1.52 for the overall period, respectively). The noninferiority limit was 1.5 mmHg.
Tafluprost is a new effective and well-tolerated treatment for glaucoma and ocular hypertension.
Acta ophthalmologica 02/2010; 88(1):12-9. · 2.44 Impact Factor
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ABSTRACT: To present the flap characteristics and short-term efficacy and safety of 787 consecutive LASIK procedures with the FEMTO LDV femtosecond laser (Ziemer Ophthalmic Systems) for the treatment of refractive errors.
Seven hundred eighty-seven consecutive eyes of 405 previously non-operated patients were treated with the FEMTO LDV. Intended flap thickness was 110 microm and intended flap diameter varied from 8.5 to 9.5 mm. Refractive treatment was performed with the WaveLight ALLEGRETTO WAVE Concerto 500 Hz excimer laser. All eyes were wavefront-optimized.
The mean flap thickness, measured by ultrasound pachymetry, was 90.0+/-5.5 microm (range: 67 to 107 microm) in right eyes and 90.1+/-4.6 microm (range: 77 to 106 microm) in left eyes. Mean flap diameter was 9.1+/-0.2 mm (range: 8.4 to 9.9 mm) in right eyes and 9.1+/-0.2 mm (range: 8.0 to 10.0 mm) in left eyes. Increasing flap thickness was correlated with increasing corneal thickness in right eyes and flatter keratometric value K(1) in left eyes. The most common complication was minor bleeding during the procedure (12.7%). All other complications were rare (8.4%), and none prevented further laser ablation.
The Ziemer FEMTO LDV laser created thinner LASIK flaps than intended but with a low standard deviation and minimal intraoperative complications.
Journal of refractive surgery (Thorofare, N.J.: 1995) 01/2010; 26(1):7-16. · 2.54 Impact Factor
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ABSTRACT: Primary Sjögren's syndrome (pSS) is an autoimmune disease in which the concentration of the acute-phase protein serum C-reactive protein (CRP) is low. We investigated whether levels of another acute-phase protein, serum amyloid A (SAA), are increased in patients with pSS and whether the immunological markers in patients with pSS are associated with variation in SAA levels.
Serum SAA concentrations were measured by ELISA in 74 patients with pSS and in 56 control subjects with sicca symptoms.
Median SAA levels did not differ significantly between patients with pSS and subjects with sicca symptoms. In patients with pSS SAA concentrations correlated significantly with age, leukocyte count, CRP, interleukin 6, and C4. Unlike CRP, there was a significant inverse correlation between SAA and serum IgG levels and anti-SSA antibody titers, as well as a trend towards an inverse correlation between SAA and antinuclear antibody and rheumatoid factor titers.
Our data imply that high SAA production could constitute a protective element in pSS: high SAA levels inhibit in particular various signs of B cell hyperreactivity, i.e., IgG and autoantibody production.
The Journal of Rheumatology 11/2009; 36(11):2487-90. · 3.69 Impact Factor
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ABSTRACT: Dacryocystorhinostomy (DCR) is an effective and safe procedure for patients with post-saccal obstruction of the nasolacrimal pathway. The aim of DCR is to relieve symptoms by creating a bypass between the lacrimal sac and the nasal cavity. The most common reason for failure is stenosis caused by a fibrotic process at the rhinostomy site. In this prospective study we assessed the expression of heat shock protein 47 (HSP47), a regulator of fibrosis, in the biopsies of nasal mucosa isolated from patients undergoing primary endoscopic DCR (EN-DCR).
Thirty consecutive primary EN-DCR procedures in 30 patients were performed using the powered instrumentation technique. The nasal mucosa specimens over the rhinostomy site were collected for histological analysis at the beginning of the operation and the expression of HSP47 was evaluated by immunohistochemistry. The outcome of EN-DCR was estimated in follow-up visits at 1 week, 2 months and 6 months after surgery.
At the 6-month follow-up, the overall success rate after primary EN-DCR was 83%. A metaplastic change and strong expression of HSP47 in nasal mucosa were associated with EN-DCR failure (p = 0.009).
HSP47 may be regarded as a novel marker to predict impaired EN-DCR outcome.
Acta ophthalmologica 09/2009; 89(2):e132-6. · 2.44 Impact Factor
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ABSTRACT: An experimental uveitis was produced by immunizing albino and pigmented rabbits with heterologous (rat) lens protein six times at two-week intervals. After sensitization the anterior lens capsules were disrupted in an operation. After operation the rabbits were examined repeatedly with a slit-lamp. On the seventh day after operation the animals were sacrificed and both eyes were enucleated. The inflammatory reaction in the uveal tract was verified histo-pathologically. Thymus and spleen lymphocytes were purified using BSA-gradients. Ecto-5′-nucleotidase (AMP-ase) activity on the intact lymphocytes was measured biochemically and B-cells were counted using the fluorescent anti-IgG technique. Purified spleen and thymus lymphocytes were also analyzed using transmission electron microscopy. The AMP-ase activity of purified spleen lymphocytes was significantly decreased in albino rabbits suffering from experimental lens-induced uveitis when compared to that observed in control animals. The AMP-ase activity was also decreased in pigmented rabbits suffering from a very mild uveitis. Moreover, a decreased AMP-ase activity was observed in albino rabbits which were only immunized but not operated on and did not show any signs of uveitis. Differences in neither the B-cell proportions nor the ultrastructure of the purified lymphocytes could be observed in any of these experimental groups. It is proposed that the biochemical change in spleen lymphocytes observed in the present work is a reflection of the general immunological state which in certain conditions may lead to uveitis.
07/2009; 3(3):407-415.
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ABSTRACT: This study aimed to compare and study potential factors that affect the accuracy of corneal flap thickness created in laser-assisted in situ keratomileusis (LASIK) using the Moria model 2 (M2) head 130 microkeratome with the Med-Logics calibrated LASIK blades Minus 20 (ML -20) and Minus 30 (ML -30).
Corneal thickness in 200 (164 myopic and 36 hyperopic) eyes (100 patients) was measured by ultrasonic pachymetry preoperatively and intraoperatively after flap cutting. A total of 100 eyes were treated with the ML -20 and 100 with the ML -30. The right eye was operated before the left eye in each patient, using the same blade. In an additional group of 40 eyes, the left eye was operated first.
Mean corneal flap thickness using the ML -20 blade for an intended flap thickness of 140 μm was 129.1 μm (standard deviation [SD] 15.6, range 104-165 μm) in right eyes and 111.5 μm (SD 14.5, range 78-144 μm) in left eyes. Mean corneal flap thickness using the ML -30 blade for an intended flap thickness of 130 μm was 127.1 μm (SD 16.6, range 90-168 μm) in right eyes and 109.9 μm (SD 16.8, range 72-149 μm) in left eyes.
Both microkeratome blade types cut thinner flaps than were intended. There was substantial variation in flap thickness. The first flap to be cut with a particular blade was considerably thicker than the second flap cut with the same blade. Based on these data, we recommend the use of disposable single-use microkeratomes rather than these ML blades.
Acta ophthalmologica 06/2009; 87(7):754-8. · 2.44 Impact Factor
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Acta ophthalmologica 05/2009; 68(S195):9 - 12. · 2.44 Impact Factor
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ABSTRACT: The aim of the study was to evaluate the histopathology of neovascular tufts and vitreous samples collected from patients with diabetes.
Vitreous samples and neovascular tufts were collected from patients with type 1 (n = 13) and (n = 17) type 2 diabetes with proliferative retinopathy, and from controls with a macular hole (n = 5). Neovessels were analysed using immunohistochemistry and vitreous samples with an enzyme-linked immunosorbent assay (ELISA). The main outcome measure was to examine differences in the levels of growth factors in patients with type 1 and type 2 diabetes with proliferative retinopathy.
Vascular endothelial growth factor (VEGF)-A was most strongly present in the samples from patients with type 1 diabetes. In type 2 diabetes, VEGF-D was more abundantly present than in type 1 diabetes. Angiopoietin (ANG)-2 was also abundantly present. Macrophages and nuclear factor kappa B (NFkappaB) were found, indicating the presence of an inflammatory process in the neovascular tissues.
VEGF-A and ANG-2 are equally important in the neovascular process in both type 1 and type 2 diabetes. VEGF-D is abundantly present in type 2 diabetes. In order to achieve better control of diabetic retinopathy, it might be beneficial to develop treatments that prevent the actions of ANG-2 and VEGF-D.
The British journal of ophthalmology 04/2009; 93(8):1109-15. · 2.92 Impact Factor
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ABSTRACT: To compare the Moria Model Two (M2) automated microkeratome with the head 90 (intended to create a 120-microm flap) to the head 130 (intended to create a 160-microm flap) in reoperations following previous photorefractive keratectomy (PRK) or laser-assisted in situ keratomileusis (LASIK) in terms of accuracy, predictability, safety and complications of the procedure.
Eighty-five eyes of 70 consecutive patients received LASIK with the Moria M2 microkeratome. Nine previously PRK-operated eyes were reoperated with the head 90 and 37 eyes were reoperated with the head 130. Repeated LASIK was performed on 16 eyes with the head 90 and on 23 eyes with head the 130. Flap dimensions were measured and correlated to preoperative parameters.
The average flap thickness in the previously PRK-operated eyes was 115.1 microm [range 82-137 microm, standard deviation (SD) 17.9] with the head 90 and 131.2 microm (range 105-171 microm, SD 19.8) with the head 130. In the previously LASIK-operated eyes, the mean flap thickness was 139.2 microm (range 92-182 microm, SD 23.8) with the head 90 and 141.9 microm (range 109-179 microm, SD 15.2) with the head 130. There were no free or incomplete flaps or flaps with buttonholes in the study. There was no statistically significant difference in postoperative uncorrected visual acuity (UCVA) between the groups.
In eyes with previous PRK or LASIK, LASIK reoperation offers a safe alternative for improving refractive outcomes. The Moria M2 head 90, especially in LASIK-operated eyes, does not cut thinner flaps compared to the head 130.
Acta ophthalmologica 04/2009; 88(3):352-7. · 2.44 Impact Factor
