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PubMed1992

Excimer laser photorefractive keratectomy in high myopia. A multicenter study.

Excimer photorefractive keratectomy was performed at three centers on 16 highly myopic eyes (8 diopters [D] or more) and followed up for 6 months. Ablation depths ranged from 137 to 230 microns. The preoperative spherical equivalent of myopia ranged from -8.62 D to -14.50 D (mean +/- SD, -11.57 +/- 1.62 D). Six months after surgery, the mean refraction (spherical equivalent) was -0.90 +/- 2.13 D. Eleven of 16 eyes achieved refractions within 2 D of that attempted. All eight patients at one site were treated with a maximum-beam diameter of 6.0 mm and were corrected to within 2 D of that attempted, and all were 20/40 or better uncorrected. Three of eight eyes at the other two sites were treated with a 5.5- or 5.6-mm maximum-beam diameter, which achieved corrections within 2 D of that attempted. The epithelium healed within 3 to 4 days, and there were no erosions. Mild subepithelial reticular haze, similar to that seen with excimer photorefractive keratectomy for lower myopia, was seen in all patients, with two patients experiencing more significant corneal haze. This peaked at 3 to 6 weeks and then gradually diminished. All but two patients had a return of their best corrected preoperative visual acuity to within one Snellen line at 6 months. This preliminary study shows excimer photorefractive keratectomy to be a promising surgical treatment for patients with higher myopia.

Adult↗
PubMed1993

Comparison of excimer laser treatment of astigmatism and myopia. The Excimer Laser and Research Group.

OBJECTIVE: To assess the safety and efficacy of excimer laser treatment of myopic astigmatism and to compare this with the excimer laser treatment of myopia. DESIGN: A prospective, open study of consecutive patients having excimer laser treatment of myopic astigmatism or myopia. SETTINGS: Patients were recruited from 18 private ophthalmic practices. PATIENTS: Fifty-four eyes received treatment for astigmatism and 66 eyes for myopia. One patient was lost to follow-up, and another underwent an ineffective ablation. INTERVENTIONS: A VISX Twenty/Twenty excimer laser was used to perform either photoastigmatic refractive keratectomy or photorefractive keratectomy. MAIN OUTCOME MEASURES: Refraction and visual acuity with and without correction were assessed preoperatively and postoperatively. RESULTS: At 6 months, 17 (85%) of the 20 patients receiving photoastigmatic refractive keratectomy were within 1 diopter of plano refraction, and 19 (95%) of 20 had uncorrected visual acuity of 6/12 (20/40) or better. For patients receiving photorefractive keratectomy, these figures were 28 (88%) of 32 patients and 28 (88%) of 32 patients, respectively. CONCLUSIONS: Excimer laser surgery offers an effective option in the treatment of myopic astigmatism.

Adult↗
PubMed1995

Excimer laser treatment for high and extreme myopia. The Melbourne Excimer Laser and Research Group.

OBJECTIVE: The excimer laser allows the controlled ablation of corneal tissue to correct refractive error. We assessed the efficacy of excimer laser treatment for persons with high (spherical equivalent between -5 and -10 diopters) and extreme (spherical equivalent greater than -10D) myopia. METHODS: Patients were assessed 1, 3, and 6 months postoperatively. A VisX Twenty/Twenty laser was used. Visual acuity, refraction, corneal clarity, and adverse reactions were evaluated at each visit. RESULTS: Six month follow-up data were available for 194 high myopes and 53 extreme myopes. Postoperative healing was similar for the two groups. Six months postoperatively, 89.2% of high myopes and 49% of extreme myopes were within 2D of planned refraction. At 6 months, 28% of high myopes had an uncorrected visual acuity of 20/20 and 71% had an uncorrected visual acuity of 20/40. Of extreme myopes, 4% had an uncorrected visual acuity of 20/20 and 30% had an uncorrected visual acuity of 20/40. Significantly more corneal haze was observed in the extreme myopes. Loss of 2 or more lines of best corrected visual acuity was observed in 13% of high myopes and 13% of extreme myopes at 6 months. CONCLUSIONS: Excimer laser photorefractive keratectomy is an alternative means of treating high and extreme myopia and can cause a significant reduction in myopia. There is a need to gather further information as more patients are followed up for greater time.

Adult↗
PubMed1996

Overcorrection after excimer laser treatment of myopia and myopic astigmatism. Melbourne Excimer Laser Group.

OBJECTIVE: To study the incidence and associations of overcorrection after excimer laser treatment of myopia and myopic astigmatism. METHODS: The study cohort consisted of 645 patients who had photorefractive or photoastigmatic refractive keratectomy done by an excimer laser during a 2-year period. Patients were assessed 1,3,6, and 12 months postoperatively. The variables evaluated were visual acuity, refraction, keratometry, and corneal clarity. RESULTS: At 1 month, overcorrection of more than +1 diopter spherical equivalent (SEQ) was seen in 22% of the eyes. This progressively regressed so that only 8.6% of the 140 eyes that were overcorrected at 1 month were overcorrected at 1 year. Overall, 2.2% of eyes were overcorrected at 1 year. The magnitude of attempted correction and use of topical nonsteroidal anti-inflammatory drugs disclosed a notable association with occurrence of overcorrection at 1, 3, and 6 months. The use of bandage contact lenses also was associated with overcorrection at 1 and 3 months. After controlling for myopia and use of contact lenses, the odds of overcorrection for use of topical nonsteroidal anti-inflammatory drugs at 1,3, and 6 months were 2.21 (95% confidence limits [CL]=1.49, 3.44), 1.69 (95% CL=0.88, 3.24), and 2.01 (95% CL=0.88, 4.56), respectively. The odds of overcorrection with bandage contact lenses were 1.79 (95% CL=1.05, 3.05) at 1 month and 2.42 (95% CL=1.23, 4.75) at the end of 3 months. No associations were seen between overcorrection and age, gender, surgical technique, or simultaneous astigmatic corrections. CONCLUSIONS: Overcorrection is common during the early postlaser treatment period and is associated with degree of myopia, use of nonsteroidal anti-inflammatory drugs, and bandage contact lens wear.

Adult↗
PubMed1997

Regional scleral changes in form-deprivation myopia in chicks.

Similar neurochemical events appear to be involved in the development of myopia in chicks and mammals. The rapid post-hatching development of the chick is ideal for studying experimental myopia. In this investigation, one eye of 2-day-old chicks was deprived of form vision for 2 weeks and then compared to the fellow, non-deprived eye by immunohistochemistry and light and electron microscopy. All deprived eyes showed a high refractive error and ocular enlargement. In deprived eyes, the posterior cartilaginous sclera was thicker and the fibrous sclera of the same section was thinner than the control. Scleral morphological changes were restricted to a central button 6-7 mm in diameter (the posterior pole) within the posterior hemisphere, further divided into posterotemporal and posteronasal parts. The most enlarged, posterior cartilaginous structure of deprived sclera could be divided into an inner and an outer zone. The inner zone had many unevenly-arranged chondrocytes, each having a well-developed granular endoplasmic reticulum and Golgi complex and a very irregular cell surface. Numerous S-phase cells and isogenous groups were detected in the outer zone. Hypertrophic chondrocytes were often observed in the innermost region of the outer zone and the outermost region of the inner zone. The boundary between the outer fibrous sclera and the cartilaginous sclera was irregular and obscured in myopic eyes. Spindle-shaped chondrocytes were seen to be in contact with each other. Thick collagen fibrils, usually seen only in the outer fibrous sclera, were present among the chondrocytes. Results of this morphological study suggest an increased proliferation of chondrocytes and active synthesis of extracellular matrix in visually deprived eyes. The elongation of the ocular axis that accompanies myopia is caused primarily by an active remodeling and differentiation in a restricted section of the posterior scleral cartilage. These facts indicate the posterior scleral cartilage may be more immature than cartilage in anterior and lateral segments.

Animals↗
PubMed2001

A study on the prevention and treatment of myopia with nacre on chicks.

The contents of mineral elements and amino acids in the hydrolysate of the traditional Chinese mineral medicine nacre have been determined. It has long since been proved by the practice of doctors of traditional Chinese medicine that pearl can be used to treat eye diseases. Based on such an understanding, a study is made of the influence of the said medicine on the incidence of myopia. First a form-sense-deprived model (FDM) for chicks is developed and the effect of the said medicine on the elongation of axis oculi is determined with an Abbe's comparator and an A-mode ultrasound instrument. The activity of superoxide dismutase (SOD), nitric oxide synthetase (NOS), and the content of nitric oxide (NO) in the retino-pigmental epithelium choroid homogenate are also analysed. The role of the said traditional Chinese mineral medicine in preventing and treating myopia is explained with respect to the above findings. The results obtained will provide a basis for using nacre, a traditional Chinese mineral medicine, to prevent and treat myopia.

Amino Acids↗
PubMedDate not supplied

Wide-spread myelinated nerve fibers of the optic disc: do they influence the development of myopia?

PURPOSE: To find correlations between the extent of myelinated nerve fibers with refraction anomalies. METHOD: Searching for myelinated nerve fibers in the slide collection of the University Eye Hospital Freiburg we found 13 patients. We distinguished between eyes with wide-spread myelinated nerve fibers located on and around the optic disc which extended to the midperiphery of the retina (6 patients; Group A) and eyes with circumscribed myelinated nerve fibers, localized merely around the optic disc (7 patients, Group B). In Group A myelinated nerve fibers spared the macula area, but were localized very close to the macula. Color fundus photographs were taken by the Zeiss Fundus camera SK50 (30 degrees and 50 degrees picture size) and by the Olympus Fundus camera GRC-W (same picture size). RESULTS: The myelinated nerve fibers were found to be unilateral in all 13 patients. In all 6 patients of Group A, a strabismus was present. The affected eye had a severe amblyopia and a unilateral myopia (-5.75 to -25.0 D). The nonaffected fellow eye showed a normal visual acuity with no or only a slight refractive error. In the 7 patients of the Group B, no strabismus was present and a normal or a slightly decreased visual acuity of the affected eye was found. No distinct refractive error was present in the affected and non-affected eyes of this group. CONCLUSIONS: Myopia only occurred in eyes with wide-spread myelinated nerve fibers but not in eyes with circumscribed myelinated nerve fibers. We assume that myelinated nerve fibers, if wide-spread, cause myopia.

Adolescent↗
PubMed1988

Visual rehabilitation of patients with advanced stages of glaucoma, optic atrophy, myopia or retinitis pigmentosa.

Ninety-six patients with advanced stages of glaucoma, optic atrophy, myopia or retinitis pigmentosa (RP) who could not manage with ordinary spectacles or simple magnifying aids were taken care of at the Low Vision Clinic for rehabilitation and followed for an average of 3.6 years (the glaucoma group) up to an average of 6.0 years (the optic atrophy group). They were given high power optical aids and subjected to educational training in the proper use of these aids for best utilization of residual vision. Many of them (for optic atrophy as high a percentage as 40.7) were taught to use extra macular retina by means of eccentric viewing technique. The mean age of the oldest group, the glaucoma patients, was 69.3 years. The three other groups were about 20 to 25 years younger, on an average. (Another 35 patients were seen for the first series of visits but could not be followed up, the main reasons being death (13 patients) and moving out of the area (9 patients). The mean power of the aids (mainly telescopes) used for distance vision was 2.1 x (RP)-5.3 x (optic atrophy). Increased near addition and hyperocular lenses were the main aids for reading and near vision, the mean power being 17.0 dioptres (glaucoma)-23.5 dioptres (RP)(4.3 x -5.9 x). Aids were also provided for intermediate distance and for "spot use". The mean number of series of visits was 3.1 (myopia)-3.5 (glaucoma) and the average number of 1 h training sessions 2.2 (glaucoma)-2.5 (optic atrophy, RP) per series of visits. With aids and educational training, the mean visual acuity improved on the first series of visits from 0.31 to 0.60 for the glaucoma group, from 0.19 to 0.70 for the optic atrophy group, from 0.12 to 0.68 for the myopes and from 0.35 to 0.52 for the RP group. After the last series of visits acuity was still as good as 0.51, 0.61, 0.73 and 0.45, respectively. The number of individuals able to read newspaper text increased from 16.1% to 100.0% for the glaucoma patients, from 14.8% to 100.0% for the optic atrophy patients, from 75.0% to 100.0% for the myopes, and from 50.0% to 95.5% for the RP patients. The results show clearly that the methods used for rehabilitation of patients with glaucoma, optic atrophy, myopia or RP through optical aids and sessions of educational training are very successful, with substantial improvement of life quality.

Adolescent↗
PubMed1992

Myopia progression in young school children and intraocular pressure.

Studies of the literature have given the impression that intraocular pressure (IOP) may influence the refractive error (RE); the reason being that the IOP in some studies is higher among myopic subjects than among emmetropes and hypermetropes. The progression of myopia was studied in 49 children, aged 9-12 years, over a period of 2 years. The rate of progression was 1.14 D/2 years and the IOP 16.6 mmHg. Comparison of the rate of progression between children with an IOP above 16 mmHg and those with an IOP of 16 mmHg or less showed a statistically significant difference: 1.32 D/2 years as compared to 0.86 D/2 years. These results are supported by ultrasound measurement of the axial length. The author recommends that measurement of IOP should be included in the design of studies of myopia progression. The reason for this is, that it would appear that those persons most at risk of developing higher degrees of myopia have a high IOP.

Anthropometry↗
PubMed1992

Axial myopia in eyes with optic nerve hypoplasia.

Given that abnormal visual experience during post natal development interferes with emmetropization, we proposed that eyes with hypoplastic optic nerves were predisposed to the development of refractive errors. Six of 14 patients with unilateral optic nerve hypoplasia and 5 of 22 patients with bilateral involvement had at least 4 D of myopia. Nine of the 11 patients with asymmetric bilateral involvement had relative myopia in the eye with the more abnormal optic nerve; none of the patients with symmetric bilateral involvement had a significant interocular refractive difference. Analysis of axial length measurements obtained in 10 of the 11 patients with high myopia showed a significant increase in total axial length. The presumed normal eye of patients with unilateral involvement was significantly smaller than the mean value for age-adjusted normals. We suspect that visual input to the central nervous system is one of the feedback signals involved in the regulation of ocular growth.

Adolescent↗
PubMed1993

Diurnal growth rhythms in the chicken eye: relation to myopia development and retinal dopamine levels.

1. If the eyes of young chickens are deprived of clear vision by translucent occluders, they develop considerable amounts of axial myopia within days. At the same time, the day time retinal dopamine levels drop by about 30%. Because the retinal dopamine levels of normally sighted chicks also differ diurnally and are low at night, we expected that the rate of axial eye growth might also differ during this time. 2. Unexpectedly, eyes grew in length only during the day (about 0.13 mm/day) and even shrank during the night (about -0.04 mm/night, average net growth +0.09 mm in 24 h). 3. If the eyes were occluded, they grew both during the day and also at night (average net growth: +0.16 mm in 24 h). Therefore, development of deprivation myopia was a result of the lack of growth inhibition at night rather than of excessive growth during the day when the actual deprivation occurred. 4. Suppression of dopaminergic retinal pathways by intravitreal injections of the neurotoxin 6-hydroxy-dopamine (6-OHDA) also suppressed development of deprivation myopia and it restored the growth inhibition at night. With normal visual experience, the drug had no effect on axial eye growth and refractive state. 5. Diurnal growth rhythms of the eyes disappeared under continuous light.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2004

[Laser epithelial keratomileusis (LASEK) for treatment of myopia up to -6.0 D. Results from 108 eyes after 12 months].

BACKGROUND: Laser epithelial keratomileusis (LASEK) is a new keratorefractive procedure for the correction of myopia and myopic astigmatism, which may combine advantages and eliminate disadvantages of photorefractive keratectomy (e.g. pain, corneal haze) and laser in situ keratomileusis (e.g. flap and interface complications, dry eye, keratectasia). We present the results of 108 consecutively LASEK-treated eyes with a follow-up period of 12 months. PATIENTS AND METHODS: LASEK was performed on 108 consecutive eyes with myopia or myopic astigmatism using a keracor 117 excimer laser. The mean preoperative refraction was -4.12+/-1.30 diopters (D) spherical equivalent range: -1.75 to -6.0 D and maximal cylinder was 3.25 D. Results of the 12 months visit are available for 101 eyes (93.5%). RESULTS: No serious complications were observed. After 12 months, SE was within +/-1.0 D of emmetropia in 96% and within +/-0.5 D in 86% of the eyes; 6 eyes had to be retreated. None of the eyes showed haze worse than grade 1 or lost more than one line of best-corrected visual acuity. Uncorrected visual acuity (UCVA) was > or =20/20 in 80% and > or =20/40 in 98%. CONCLUSIONS: Laser epithelial keratomileusis (LASEK) seems to be safe and effective in treatment of myopia and myopic astigmatism of up to -6.0 D. Preliminary results compare favourably with those after photorefractive keratectomy and laser in situ keratomileusis. Haze formation after LASEK seems to be low. Coverage of the stromal wound with a vital epithelial flap could positively influence postoperative wound healing reactions.

Adolescent↗
PubMed1999

[Twilight visual acuity after correction of myopia with LASIK].

BACKGROUND: Data on mesopic vision after LASIK are not available to date. We therefore evaluated mesopic vision in myopic eyes before and after LASIK. PATIENTS AND METHODS: Sixty-seven eyes (34 patients) treated using the Automatic Corneal Shaper and the Keracor 117CT spot-scanning excimer laser were included. All eyes had best-corrected vision of 20/25 or better preoperatively. We measured spectacle refraction, visual acuity, and mesopic vision without and with glare (Nyktometer, Rodenstock) both preoperatively and 1 year after LASIK. Results were evaluated in three groups with reference to baseline refraction, and numbers of patients who saw a contrast of 1:5 or less were compared. RESULTS: Myopia -1 to -5 D (group 1; n = 26): Preoperatively (postoperatively), 89% (96%) (P = 0.03) of eyes identified a contrast of 1:5 or less without glare, while 65% (73%) achieved that level with glare. Myopia -5.1 to -10 D (group 2; n = 24): Preoperatively (postoperatively), 83% (75%) of eyes identified a contrast of 1:5 or less without glare, while 50% (21%) achieved that level with glare. Myopia -10.1 to -15 D (group 3; n = 11): Preoperatively (postoperatively), 73% (55%) of eyes identified a contrast of 1:5 or less without glare, while 46% (27%) achieved that level with glare. CONCLUSIONS: LASIK seems to cause a reduction of mesopic vision under glare conditions in corrections of more than -5 D. In corrections of more than -10 D, mesopic vision without glare is reduced, too. However, differences were not statistically significant when comparing vision at contrasts of 1:5 and lower. In addition, mesopic is considerably reduced in high myopes even preoperatively.

Adult↗
PubMed1999

[Correction of myopia with the intracorneal ring].

PROBLEM: The Implantation of intracorneal ring segments (ICRS) offers the possibility of reversible, refractive surgery for correction of lower myopia up to -5.0 D. We report our first results 1 year after implantation of ICR segments. PATIENTS AND METHODS: From April 1997 to August 1998 we implanted ICRS in 48 eyes of 31 patients (12 male, 19 female) to correct myopia. The preoperative refraction (spherical equivalent) was between -1.0 and -5.0 D (astigmatism < 1.0 D). The average age was 34.0 years (range 19-48 years). ICRS implantation was performed in peribulbar anaesthesia. All operations were done by the same surgeon. RESULTS: The average follow-up was 10 months (ranges 1-12 months). After 6 months the deviation from the target refraction of all eyes was < 1.5 D; 26 of 27 eyes (96.3%) showed a deviation of < or = 1.0 D. Six months after surgery, 18 of 27 eyes (66.6%) showed an uncorrected visual acuity of 20/20 or better, 23 of 26 eyes (88.4%) showed 20/25 or better, and 25 of 26 eyes (96.2) 20/40 and better. Only 1 of 16 eyes showed an uncorrected visual acuity of 20/50. In all eyes, the best-corrected visual acuity was 20/20 or better. In 2 eyes an ICRS exchange and implantation of a thicker ring was necessary because the target refraction could not be achieved with the first implanted ring. In 2 eyes an ICRS reposition was done to optimize the location of the ring within the cornea. In 4 eyes we explanted the ring due to double vision (1 x) and distorted vision (3 x) caused by induced astigmatism. After explantation the preoperative refraction (+/- 0.15 D) was reached within 1 to 1.5 months. There was no regression after 6 months (n = 27) or after 1 year (n = 7). CONCLUSION: Our 1-year results of ICRS implantation show that myopia correction with the advantage of reversibility and lower complication rate is possible by this refractive surgical method. Ring exchange and explantation are possible. Earlier postoperative complaints like photophobia, unstable visual acuity or discomfort usually disappear rapidly. The decision of 95.0% of the patients to have ICRS implantation also into the second eye shows the high degree of satisfaction.

Adult↗
PubMed2006

Aberrations of chick eyes during normal growth and lens induction of myopia.

Understanding the control of eye growth may lead to the prevention of nearsightedness (myopia). Chicks develop refractive errors in response to defocusing lenses by changing the rate of eye elongation. Changes in optical image quality and the optical signal in lens compensation are not understood. Monochromatic ocular aberrations were measured in 16 chicks that unilaterally developed myopia in response to unilateral goggles with -15D lenses and in 6 chicks developing naturally. There is no significant difference in higher-order root mean square aberrations (RMSA) between control eyes of the goggled birds and eyes of naturally developing chicks. Higher-order RMSA for a constant pupil size exponentially decreases in the chick eye with age more slowly than defocus. In the presence of a defocusing lens, the exponential decrease begins after day 2. In goggled eyes, asymmetric aberrations initially increase significantly, followed by an exponential decrease. Higher-order RMSA is significantly higher in goggled eyes than in controls. Equivalent blur, a new measure of image quality that accounts for increasing pupil size with age, exponentially decreases with age. In goggled eyes, this decrease also occurs after day 2. The fine optical structure, reflected in higher-order aberrations, may be important in understanding normal development and the development of myopia.

Age Factors↗
PubMed2004

Verteporfin photodynamic therapy for extrafoveal choroidal neovascularisation in pathologic myopia.

BACKGROUND: To report long-term functional and morphological outcome of verteporfin photodynamic therapy (PDT) for classic extrafoveal choroidal neovascularisation (CNV) secondary to pathologic myopia. METHODS: This retrospective case series included three eyes of three consecutive patients with classic extrafoveal CNV secondary to pathologic myopia, who underwent PDT at a tertiary retinal referral centre. Change in visual acuity and fluorescein leakage was the main outcome criteria. RESULTS: The patients were followed up an average of 36 months (33-40 months). In all eyes increase of visual acuity (one eye 1 ETDRS line, two eyes 2 ETDRS line) and no fluorescein leakage of the CNV were seen. CONCLUSIONS: PDT can achieve long-term improvement of the visual acuity and morphological stability in selected cases with classic extrafoveal CNV in pathologic myopia. Large scale randomised studies are warranted for assessment of the benefit of PDT in such eyes.

Adult↗
PubMed2006

Treatment frequency and visual outcome in subfoveal choroidal neovascularization related to pathologic myopia treated with photodynamic therapy.

BACKGROUND: The purpose of this study was to examine the influence of treatment frequency on visual acuity of patients with PDT treatment for subfoveal predominantly classic CNV related to pathological myopia. DESIGN: Retrospective case series. METHODS: Thirty-seven patients with subfoveal predominantly classic CNV caused by pathologic myopia and treated with PDT were included. All patients received a full ophthalmic examination, including best-corrected visual acuity, slit-lamp biomicroscopy, fundus photography and fluorescein angiography, before first treatment and every 3 months thereafter. Photodynamic therapy was performed according to standard protocol. Main outcome measurements were visual acuity and treatment frequency. RESULTS: The number of treatments received was 3.35+/-1.83 (average: 1-7). In 12 eyes (32.43%); the BCVA was stable or increased during the entire follow-up period. In eight eyes (21.62%), the BCVA decreased and did not return to the baseline values. A transient loss of visual acuity (over 3-9 months) with subsequent improvement in visual function was found in 68% (17 eyes). A gain of three or more lines compared with lowest BCVA was found in 56% (14 eyes). The number of treatments did not correlate with baseline BCVA, greatest linear dimension of CNV at baseline or with the change of BCVA from baseline. In cases with transient worsening of BCVA, the recovery of visual acuity correlated significantly with the number of treatments (r=-0.522, P<0.05; Spearman rank correlation) received. CONCLUSION: Visual acuity recovery correlates with the number of PDT re-treatments; in many cases, an improvement in visual function after temporary decrease of BCVA can be observed after re-treatment according to current treatment guidelines. The number of PDT treatments has no negative effect on the visual outcome in subfoveal CNVs caused by pathological myopia.

Adult↗
PubMed2005

Tear film function and corneal sensation in the early postoperative period after LASEK for the correction of myopia.

PURPOSE: Subepithelial nerves and stromal nerves of the cornea are damaged during LASEK surgery for the correction of myopia. This leads to a reduction in corneal sensation and to alterations of the tear film function in the early postoperative period. The aim of this study was to evaluate tear film function, corneal sensation and subjective symptoms of dry eye in the early postoperative period after LASEK for the correction of myopia. METHODS: LASEK surgery was performed in 20 eyes of 10 consecutive patients for the correction of myopia (-1.0 to -9.0 D, mean -4.86 D). Subjective symptoms of a dry eye were evaluated with a standardised questionnaire. Schirmer test with and without local anaesthesia, tear film break-up time, fluorescein staining of the cornea and corneal esthesiometry (Cochet-Bonnet) were performed before surgery and 1 week, 1 month, 2 months and 3 months after LASEK. Additionally corneal staining and subjective symptom severity scores were assessed 3 days after surgery. RESULTS: Corneal sensation was reduced 1 week after LASEK and recovered during the first month after LASEK. The tear film break-up time was reduced 1 week and 1 month after LASEK and reached preoperative values 2 months after surgery. Fluorescein staining was increased 3 days and 1 week after LASEK. Subjective symptom severity scores were increased 3 days, 1 week, 1 month and 2 months after LASEK. Schirmer tests values with local anaesthesia were significantly reduced at 3 months after surgery, but not at 3 days, 1 month, or 2 months. Schirmer test values without local anaesthesia were significantly decreased 2 and 3 months after LASEK, but not after 3 days and 1 month after LASEK. CONCLUSIONS: LASEK alters ocular surface haemostasis and reduces corneal sensation in the early postoperative period. Subjective symptoms of dry eye were described during the first 2 months after surgery.

Adult↗