Journal of refractive and corneal surgery

Publisher: International Society of Refractive Keratoplasty

Journal description

Discontinued in 1994. Continued by the Journal of Refractive Surgery (1995) (1081-597X).

Current impact factor: 0.00

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5-year impact 0.00
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Other titles Journal of refractive and corneal surgery
ISSN 1081-0803
OCLC 30372788
Material type Periodical
Document type Journal / Magazine / Newspaper

Publications in this journal


  • No preview · Article · Jan 1998 · Journal of refractive and corneal surgery

  • No preview · Article · Sep 1994 · Journal of refractive and corneal surgery

  • No preview · Article · Jul 1994 · Journal of refractive and corneal surgery

  • No preview · Article · Jul 1994 · Journal of refractive and corneal surgery

  • No preview · Article · May 1994 · Journal of refractive and corneal surgery

  • No preview · Article · May 1994 · Journal of refractive and corneal surgery

  • No preview · Article · May 1994 · Journal of refractive and corneal surgery
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    ABSTRACT: The possible endothelial damage induced by photorefractive keratectomy was investigated in myopic eyes. A morphometric analysis of the endothelial cells was performed in 19 patients before and 2 months after photorefractive keratectomy for the correction of various degrees of myopia. Central ultrasonic pachometry was also recorded at the same examination times. No significant changes (p = .816) of the endothelial cell density were found between preoperative and postoperative measurements. The pleomorphic index did not show any significant changes after treatment (p = .955). Central corneal thickness was reduced to a various extent (range from 50 microns to 250 microns) according to the amount of myopic correction intended. Our preliminary data suggest that photorefractive keratectomy for the correction of myopia does not induce endothelial cell damage, at least in the short term.
    No preview · Article · Mar 1994 · Journal of refractive and corneal surgery
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    ABSTRACT: To date, there has been no systematic study of the effects of ablation zone diameter on the outcome of photorefractive keratectomy. To address these issues, we examined a series of eyes with bilateral corrections using different-sized ablation zones. Thirty-three patients underwent bilateral photorefractive keratectomy (Summit Excimed UV200, Waltham, Mass) with identical dioptric corrections in both eyes, except first eyes had 4.00-millimeter and second eyes had 5.00-millimeter ablation zones. Identical postoperative eyedrop regimens were used in both eyes of each subject and the interval between treatments was 12 months. The mean depth of the programmed central ablation was 24 microns in eyes treated with 4.00-millimeter and 39 microns with 5.00-millimeter zones. There was no statistically significant difference in the preoperative refraction between first and second eyes. Mean changes in refraction at 1, 3, 6, 9, and 12 months were significantly greater in eyes treated with 5.00-millimeter ablation diameters (p < .001). No eyes treated with 4.00-millimeter zones were overcorrected, but five eyes (15%) treated with 5.00-millimeter beams had a refraction greater than +1.00 diopter (D) at 12 months postoperatively. There was no significant difference in the amount of anterior stromal haze between the two eyes at any stage. In 14 patients, less night halo was noticed in the eye treated with a 5.00-millimeter zone. Using a computer program, halo measurements were made in both eyes of 12 patients whose pre- and postoperative refractions were within 0.50 D. The magnitude of halo was significantly less in eyes treated with 5.00-millimeter zones (p < .01). Despite greater depths of stromal ablation with 5.00-millimeter diameters, there was no increased anterior stromal haze or postoperative regression of refraction. The biological and physical constraints governing the optimum size of the photorefractive keratectomy ablation zone are discussed.
    No preview · Article · Mar 1994 · Journal of refractive and corneal surgery
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    ABSTRACT: Intrastromal corneal rings (ICRs) often exhibit small deposits in association with their suture holes. We assessed the morphology of four such deposits. Four ICRs, explanted from nonfunctional human eyes, were examined by scanning electron microscopy and transmission electron microscopy. The surface of the suture hole deposits consisted of a disorganized convolution of collagenous lamellae. Within individual lamellae, however, the collagen fibrils tended to orientate parallel with one another. The deposits consisted of an amorphous material interspersed with curved cellular processes, collagen fibrils of variable diameter, and proteoglycan macromolecules. We propose that the mechanism which regulates stromal remodeling is amended in the region of the ICR suture holes. Due to their location, suture hole deposits have no optical significance; however, evaluation of their morphology provides insights into the wound-healing properties of the corneal stroma following ICR insertion.
    No preview · Article · Mar 1994 · Journal of refractive and corneal surgery

  • No preview · Article · Mar 1994 · Journal of refractive and corneal surgery
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    ABSTRACT: Currently used corneal refractive procedures do not offer a perfect solution for high hyperopia. This article proposes clear lens extraction and intraocular lens (IOL) implantation for the correction of high hyperopia. Extracapsular clear lens extraction and posterior chamber IOL implantation was performed in 10 normally sighted eyes of five patients with a hyperopic spherical equivalent refraction between +7.88 and +9.75 D. The follow-up period was 18 months. Mean uncorrected visual acuity improved from count fingers to 20/25. All eyes saw 20/30 or better without correction. Postoperative correction ranged from -0.37 to +0.50 diopters (mean, 0.01). The mean endothelial cell loss percentage at 18 months was 11.2% +/- 1.87% (range, 8% to 13%). The excellent results of contemporary cataract surgery, the reduced morbidity, patient satisfaction, as well as accuracy and rapid stability of the refraction suggest that clear lens extraction and IOL implantation are useful refractive procedures for the correction of high hyperopia.
    No preview · Article · Mar 1994 · Journal of refractive and corneal surgery
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    ABSTRACT: Studies of corneal power changes resulting from photorefractive keratectomy generally rely on keratometer or videokeratograph measurements. These instruments convert corneal radius of curvatures values to optical powers by means of the single refracting surface formula, which incorporates an index of refraction value of 1.3375. This index approximates that of the tears but not the 1.376 index of the corneal epithelium or stroma. A hypothetical optical model was used to determine the most appropriate index to be chosen with respect to corneal power calculations relative to photorefractive keratectomy. The contribution of each refractive element in the tear lens-corneal surface to the total power of the eye was calculated in order to identify which index of refraction was most appropriate for the corneal power calculation. The outer tear surface has significant optical power but the tear layer as a whole has nearly zero power due to the offsetting negative power of the posterior test surface. There is no significant difference in the effective power of light leaving the corneal anterior surface when considered with or without the tear layer. Photorefractive keratectomy changes the epithelium and anterior surface of the corneal stroma, but does not affect the posterior stroma or other ocular media. Hence the refractive index for the corneal epithelium or stroma of 1.376 should be used in converting radius to optical power values. The error in assuming a corneal index of 1.3375 is a constant proportion equal to 11.4% of the corneal power reading. Photorefractive keratectomy presents a situation in which the actual corneal refractive index of 1.376 should be used for correct corneal radius to power conversions. This may be accomplished by changing the index value in the instrument algorithm for keratometry and videokeratography to 1.376 or by adding a correction factor of either 11.4% of the regular reading to its value or multiplying by the factor 1.114. In other applications of keratometry or videokeratography, the index 1.3375 may be more appropriate.
    No preview · Article · Mar 1994 · Journal of refractive and corneal surgery
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    ABSTRACT: To date, Snellen visual acuity and postoperative refraction have been used to evaluate the results of photorefractive keratectomy. However, other parameters, such as contrast sensitivity function and glare, may be affected by refractive surgery and lead to unsatisfactory visual performance. This prospective study is aimed at evaluating the effect of photorefractive keratectomy on contrast sensitivity function and glare. Static contrast sensitivity function, dynamic contrast sensitivity function, and glare sensitivity were evaluated in 22 myopic eyes before as well as 1, 3, and 6 months after photorefractive keratectomy. The eyes tested were divided into three groups, according to the amount of myopia: group I, from -4.00 to -8.00 diopters (D); group II, from -8.25 to -11.00 D; group III, from -11.25 to -20.00 D. Both static and dynamic contrast sensitivity function at the intermediate spatial frequencies were altered at 1 month after photorefractive keratectomy, with a trend toward recovery at 3 and 6 months postoperatively. Glare sensitivity was not significantly affected by surgery. Contrast sensitivity function and glare testing may show abnormalities in the presence of optimal visual and refractive results. These tests may result especially important for the evaluation of new refractive surgical procedures.
    No preview · Article · Mar 1994 · Journal of refractive and corneal surgery
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    ABSTRACT: Cyanoacrylate adhesive has been used to treat corneal perforations and stromal melting disorders. We examined the efficacy of aerosolization as a means of applying cyanoacrylate to the cornea. Central corneal perforations were created with a 1-millimeter trephine in cadaver eyes. A small amount of N-butyl cyanoacrylate was delivered to the perforation site via aerosol. Experiments were also conducted with cadaver eyes which had received lamellar keratectomies to stimulate corneal thinning disorders. Adequate seal of the 1-millimeter perforation was achieved following aerosol application of cyanoacrylate adhesive. In experiments conducted with eyes which had been perforated and those which received lamellar keratectomies, smooth anterior surface contours were achieved using the aerosol technique. Aerosolization may be an effective method of applying cyanoacrylate adhesive.
    No preview · Article · Mar 1994 · Journal of refractive and corneal surgery

  • No preview · Article · Mar 1994 · Journal of refractive and corneal surgery

  • No preview · Article · Mar 1994 · Journal of refractive and corneal surgery
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    ABSTRACT: Plasminogen activator has been shown to be released by epithelial cells following corneal injury. The demonstration of the release of plasminogen activator from cultured corneal epithelial cells has been used for developing a cytotoxicity test, the Corneal Epithelial Plasminogen Activator test, which compares changes in the level of plasminogen activator in tissue culture media following chemical exposure as an index of chemical injury. Cultured rabbit corneal epithelial cells were exposed to varying concentrations of several viscoelastics for 1 hour. Release of plasminogen activator into the tissue culture media following exposure to the viscoelastic agent was studied as an index of chemical injury. The least cytotoxicity to cultured rabbit epithelium was associated with those viscoelastic agents containing methylcellulose. A 1-hour exposure to most concentrations of methylcellulose and chondroitin sulfate (Phacote) and methylcellulose (Occucoat) demonstrated release of greater amounts of plasminogen activator than was seen following a similar exposure to balanced salt solution, suggesting the greatest protective effect of these two viscoelastics. In contrast, sodium hyaluronate and chondroitin sulfate (Viscoat) showed decreased amounts of plasminogen activator release after a 1-hour exposure to cultured corneal epithelial cells demonstrating cytotoxicity. Polyacrylamide (Orcolon) and most diluted preparations of sodium hyaluronate (Healon and Healon Yellow) showed only mild reductions in the release of plasminogen activator, whereas undiluted sodium hyaluronate preparations were nearly as cytotoxic as Viscoat. This study suggests that viscoelastic agents containing methylcellulose (Phacote and Occucoat) may be most protective of the corneal epithelium during ophthalmic surgery. The clinical success of several dilute viscoelastic solutions as tear substitutes was corroborated by the lack of cytotoxicity seen in this study. Viscoat and undiluted sodium hyaluronate preparations showed the greatest cytotoxicity to cultured rabbit corneal epithelium.
    No preview · Article · Mar 1994 · Journal of refractive and corneal surgery
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    ABSTRACT: We present 3 eyes that underwent photorefractive keratectomy (PRK) for residual myopia after penetrating keratoplasty, and 1 eye that was treated for recurrent granular dystrophy and myopia following penetrating keratoplasty. The 3 refractive eyes experienced improvements in visual acuity and refractive error through 3 months postoperative, but exhibited regression of effect after 6 months postoperative. One eye also exhibited substantial corneal haze at three months postoperative that was not responsive to steroid retreatment. The eye with granular dystrophy obtained symptomatic relief as well as improvement in vision. We tentatively conclude that the corneal transplant reacts to photorefractive keratectomy in much the same way as a normal cornea. Eyes with substantial degrees of post-graft myopia exhibit regression of refractive effect, much like high myopes following primary photorefractive keratectomy. Photorefractive was unable to prevent the recurrence of granular dystrophy in the transplanted tissue. The eyes reported here achieved only modest long-term visual and refractive improvements.
    No preview · Article · Jan 1994 · Journal of refractive and corneal surgery

  • No preview · Article · Jan 1994 · Journal of refractive and corneal surgery