PubMed · 16246760
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2005. Consultation section. Refractive surgical problem.. https://doi.org/10.1016/j.jcrs.2005.08.003
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We have developed an automatic keratometer module for slit lamps that provides automatic measurements of the radii of the corneal curvature. The system projects 72 light spots displayed in a precise circle at the examined cornea. The displacement and deformation of the reflected image of these light spots are analysed providing the keratometry. Measurements in the range of 26.8-75 D can be obtained and a self-calibration system has been specially designed in order to keep the system calibrated. Infrared LEDs indicate automatically which eye is being examined. Volunteer patients (492) have been submitted to the system and the results show that our system has a high correlation factor with the commercially available manual keratometers and the keratometry measurements from a topographer. Our developed system is 95% in agreement with the corneal topographer (Humphrey--Atlas 995 CZM) and the manual keratometer (Topcon OM-4). The system's nominal precision is 0.05 mm for the radii of curvature and 1 degree for the associated axis.
Several laser and non-laser refractive surgical procedures have been used to modify the shape of the cornea and correct myopia, hyperopia, astigmatism, and presbyopia. Introduction of the excimer laser to reshape the cornea has resulted in remarkable developments in the correction of these refractive errors. Combined with other advanced ophthalmological instruments, laser refractive eye surgery has resulted in a substantial rise in the safety, efficacy, and predictability of surgical outcomes. Despite these advances, certain limitations and complications persist. In this review, we describe the history, preoperative assessment, surgical techniques, outcomes, and complications of laser refractive surgery.
PURPOSE: To provide an evidence-based overview of wavefront-guided refractive surgery outcomes, benefits, and limitations. DESIGN: Literature review. METHODS: Review of FDA study reports and indexed, peer-reviewed literature. RESULTS: More than 400 reports investigating wavefront applications in refractive surgery exist, but studies comparing the outcomes of wavefront-guided treatment with conventional treatment are few in number. Available studies do not overwhelmingly demonstrate superior visual results attributable to a wavefront-guided approach. CONCLUSIONS: While wavefront-guided refractive surgery provides excellent results, evidence is limited that it outperforms conventional laser in situ keratomileusis that incorporates broad ablation zones, smoothing to the periphery, eye-trackers, and other technological refinements. However, it is evident that wavefront-customized ablation holds a promising future and merits ongoing investigation.