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Li J, Zhen J, Xie K, Yao K, Liu Z, Li X. Clin Optom. 2024:16:341-348. Our authors have advised that the institution name in the first sentence of the \"Methods\" section on page 342 should read from \"This retrospective study comprised patients who had a preoperative examination, SMILE surgery and postoperative follow-up at the Department of Ophthalmology, Peking University Third Hospital and Beijing Meiermu Hospital between February 2022 and July 2022\" to \"This retrospective study comprised patients who had a preoperative examination, SMILE surgery and postoperative follow-up at the Department of Ophthalmology, Beijing Meiermu Hospital between February 2022 and July 2022\". The authors apologize for this error.

To assess the safety and efficacy of a customized ablation treatment (InnovEyes) to correct myopia and myopic astigmatism with femtosecond laser-assisted in situ keratomileusis (Femto LASIK). In this prospective, nonrandomized, multicenter study, 113 patients (225 eyes) with preoperative myopia less than -9.0 diopters (D) and astigmatism 0 to -4.0 D (based on InnovEyes refraction) underwent wavefront, tomography, and biometry assessment using a single diagnostic device (InnovEyes sightmap). These data were imported and used unmodified by the InnovEyes algorithm to automatically calculate and optimize correction of lower- and higher‑order aberrations (HOAs) treated by the EX500 ablation profile. Visual acuity, refractive error, HOAs, and patient satisfaction were evaluated over 3 months. A total of 106 patients (212 eyes) completed the study and were included in the analysis. Mean preoperative manifest refraction spherical equivalent (MRSE) was -3.38±1.76 D. At Month 3, uncorrected distance visual acuity was 20/20 or better in 208/212 (98.1%) eyes, and it was the same as, or better than, the preoperative best-corrected distance visual acuity (CDVA) in 162/212 (76.4%) eyes; 76/212 (35.8%) eyes gained ≥1 line of CDVA. MRSE was within ±0.5 D in 195/212 (92.0%) eyes. Additionally, 201/209 (96.2%) eyes had no change (defined as a change between -0.1 μm and 0.1 μm, inclusive) in HOAs, and 105/106 (99.1%) patients reported to be satisfied with the results. Customizing ray-tracing Femto LASIK with this platform appeared safe and effective in correcting myopic astigmatism and also achieved a significant percentage of eyes gaining lines of vision, potentially by addressing HOAs, along with a consistently high level of patient satisfaction.

Avi Wallerstein,1,2,* Mathieu Gauvin1,2,* 1Department of Ophthalmology and Visual Sciences, McGill University, Montreal, QC, Canada; 2Department of Research & Development, LASIK MD, Montreal, QC, Canada*These authors contributed equally to this workCorrespondence: Avi WallersteinMD Level, 1250 Rene-Levesque Blvd W, Montreal, QC H3B 4W8, CanadaTel +1 514-908-9888 Ext 2273Email awallerstein@lasikmd.com We read with interest \"Topography-Guided Refractive Astigmatism Outcomes: Predictions Comparing Three Different Programming Methods.\"1 In the Manifest group, the calculated theoretical outcomes revealed an unexpectedly elevated postoperative refractive astigmatism average error of 0.56 ± 0.22 D.1 This large amount of theoretical postoperative cylinder was not replicated in a recent real-world clinical study by the same authors, comparing actual topography-guided LASIK outcomes in Phorcides versus manifest-treated eyes.2 The reported empirical postoperative astigmatism error average in the Manifest group was as low as 0.15 D, fourfold better than that reported in the current theoretical outcomes study.1 View the original paper by Stulting and colleagues

To compare the postoperative visual quality of patients undergoing small-incision lenticule extraction (SMILE) with spherical trial lens intervals of 0.05D and 0.25D in preoperative manifest refraction. The study included 196 eyes of 101 patients with 0.05D intervals to perform manifest refraction and 194 eyes of 98 patients with 0.25D intervals. Intraoperative lenticule thickness was compared in patients with different myopic grades. Postoperative examinations, including uncorrected distance visual acuity (UDVA) and manifest refraction results, were compared at 1-day, 1-week and 1-month follow-up. At the one-month follow-up, there was no significant difference in UDVA and spherical equivalent (SE) between the two groups ( =0.602 and 0.898, respectively). But the proportion of patients with a UDVA of more than 0.0 one month postoperatively was higher in the 0.05D intervals group ( =0.067). In patients with moderate myopia, the corneas with 0.05D interval manifest refraction had thinner maximum lenticule thickness compared with those in the control group ( =0.019). Compared with the 0.25D interval group, patients performed manifest refraction with 0.05D spherical lens interval obtained equally good postoperative visual quality. The moderate myopia patients in the 0.05D interval group had thinner cornea cut during SMILE.

Background Previous studies have suggested that, to improve refractive predictability in hyperopic LASIK treatments, preoperative cycloplegic or manifest refraction, or a combination of both, could be used in the laser nomogram. We set out to investigate (1) the prevalence of a high difference between manifest and cycloplegic spherical equivalent in hyperopic eyes preoperatively, and (2) the related predictability of postoperative keratometry. Methods Retrospective cross-sectional data analysis of consecutive treated 186 eyes from 186 consecutive hyperopic patients (mean age 42 [±12] years) were analyzed. Excimer ablation for all eyes was performed using a mechanical microkeratome (SBK, Moria, France) and an Allegretto excimer laser platform. Two groups were defined according to the difference between manifest and cycloplegic spherical equivalent which was defined as ≥1.00 diopter (D); the data was analyzed according to refractive outcome in terms of refractive predictability, efficacy, and safety. Results In 24 eyes (13 %), a preoperative difference of ≥1.00D between manifest spherical equivalent and cycloplegic spherical equivalent (= MCD) occurred. With increasing preoperative MCD, the postoperative achieved spherical equivalent showed hyperopic regression after 3 months. There was no statistically significant effect of age (accommodation) or optical zone size on the achieved spherical equivalent. Conclusions A difference of ≥1.00D occurs in about 13 % of hyperopia cases. We suggest that hyperopic correction should be based on the manifest spherical equivalent in eyes with preoperative MCD <1.00D. If the preoperative MCD is ≥1.00D, treatment may produce manifest undercorrection, and therefore we advise that the patient should be warrned about lower predictability, and suggest basing conclusions on the arithmetic mean calculated from the preoperative manifest and cycloplegic spheres.

The purpose of this article is to explore alternative ways of achieving optimal correction for myopic children who cannot cooperate to subjective manifest refraction (SR). The study included myopic children aged 9–12 years who underwent non-cycloplegic SR and autorefraction with and without cycloplegia using the Shin-Nippon Nvision-K 5001 autorefractor (AR) as well as non-cycloplegic autorefraction using the Topcon KR-800S AR. There were 21 children (mean age, 10.62 years) included. The spherical equivalent refractive error of SR was not significantly different from that of non-cycloplegic AR measurements, but it was significantly different from that of cycloplegic Shin-Nippon Nvision-K 5001 measurements (p < 0.001). Compared with SR, cycloplegic Shin-Nippon Nvision-K 5001 measured a less myopic refractive error (median: −2.44 D vs. −2.88 D, p < 0.001). For both ARs, the axis measurements and astigmatic dioptre values between SR and autorefraction were not significantly different. Compared with non-cycloplegic SR, cycloplegic measurements showed a lesser degree of myopic refractive error. There was no significant difference between SR and non-cycloplegic autorefraction. Therefore, the Topcon KR-800S and the Shin-Nippon Nvision-K 5001 ARs may be useful for prescribing glasses in myopic children who cannot cooperate during SR. However, caution should be taken with cylinders <0.75 D because the agreement in axis between SR and AR measurement is poor. Therefore, in such cases, we suggest to add half the cylinder to the spherical component.

The purpose of this retrospective study was to evaluate cylinder axis agreement between manifest refraction (MR), cycloplegic refraction (CR), Allegro Oculyzer ІІ and Allegro Topolyzer-Vario. We included 82 patients (32 males and 50 females, 28.1 ± 8.7 years old), with 156 eyes scheduled for wavefront optimized laser refractive surgery, photorefractive keratectomy (PRK) in 50 eyes and laser-assisted in situ keratomileusis (LASIK) in 106 eyes, for correction of simple, myopic, hyperopic or mixed astigmatism. Cylinder axis was determined under manifest and cycloplegic refractions and using Allegro Occulyzer ІІ and Allegro Topolyzer-Vario platforms. Cylinder axis agreement was assessed by intraclass correlation coefficient, Pearson correlation coefficient and by the method described by Bland and Altman. Intraclass correlation coefficient and Pearson correlation coefficient showed statistically significant cylinder axis agreement between manifest refraction, cycloplegic refraction, Allegro Oculyzer ІІ and Allegro Topolyzer-Vario (p <0.001). Despite statistically significant cylinder axis agreement between the four measuring tools, 4 of 156 eyes (2.5%) showed unexpected discrepancy between Allegro Oculyzer ІІ and Allegro Topolyzer-Vario cylinder axis. Although cylinder axis shows statistically significant agreement between manifest refraction, cycloplegic refraction, Allegro Oculyzer ІІ and Allegro Topolyzer-Vario, unexpected discrepancies occur.

Background Several planning algorithms have been developed for topography-guided custom ablation treatment (T-CAT), but each has its own deficiencies. The purpose of this study is to demonstrate the potential of a novel mutual comparative analysis (MCA) informed by manifest refraction and corneal topographic data and the patient’s subjective perception in correcting ametropia. Methods This retrospective review included patients with significant preoperative differences in the power or axis of astigmatism according to the manifest refraction and corneal topographic data (power > 0.75 D and/or axis > 10°). T-CAT planning was designed using MCA. Follow-ups were conducted for at least 6 months. Results Seventy-nine patients (121 eyes) were included. The mean preoperative deviation in the astigmatic power and axis were 0.72 ± 0.43 D and 20.18 ± 23.68°, respectively. The average oculus residual astigmatism (ORA) was 0.81 ± 0.32 D (range: 0.08–1.66 D). Six months postoperatively, the mean spherical equivalent refraction was 0.04 ± 0.42 D, and the mean cylinder was − 0.27 ± 0.24 D. The mean efficacy and safety indices were 1.10 and 1.15, respectively. The uncorrected distance visual acuity in 92% of the eyes was the same or better than the corrected distance visual acuity. The angle of error was ±5° in 61% of eyes and ± 15° in 84% of eyes. Residual astigmatism was ≤0.5 D in 91% of eyes. Optical quality and photopic contrast sensitivity did not change significantly ( p  > 0.05), and the scotopic contrast sensitivity decreased at 3, 6, and 12 cpd ( p  < 0.05). The vertical coma and horizontal coma of the anterior corneal surface significantly decreased postoperatively but increased during follow-up. Conclusions The MCA demonstrated safety, efficacy, accuracy, predictability, and stability and can be used as a complementary and feasible method for T-CAT.

Background To evaluate accuracy of WASCA wavefront aberrometry (WA) refraction in comparison to manifest refraction (MR) in an older population awaiting cataract surgery. Methods Prospectively, refractive errors of 130 eyes were determined by WA and MR. Mean age was 65.9 (SD 11.81), corrected distance visual acuity (CDVA) averaged 0.20 logMar (SD 0.57), mean manifest sphere was 0.23 dioptres (D, SD 3.39) and manifest astigmatism amounted to −1.25 D (SD 1.21). For further analysis, refractive values were transformed into power vector components: spherical equivalent (SE), Jackson cross cylinder at 0° and 45° (J0 and J45). The ‘limits of agreement’ approach, regression analysis, correlation analysis, and ANOVA were applied and additionally compared to 28 healthy eyes (mean VA −0.1 logMAR) of a group of young subjects (mean age 33.9). Results SE measures in myopia correlated highly between WA and MR ( r  = 0.917, p  < .001). In hyperopia this correlation was moderately high ( r  = 0.800, p  < .001). For all subjects, correlations between WA and MR for J0 and J45 were r  = 0.742 ( p  < .001) and r  = 0.760 ( p  < .001) respectively. WA measurements revealed larger agreement ranges with increasing myopia and astigmatism. Controlled for possible confounding variables of age, VA, and refractive state, no statistically significant effects were found. Across nearly all conditions, WA measured significantly higher myopic and astigmatic values than MR. Most effects were replicated in the reference group. Conclusions WA refraction can provide valuable information in previously under-researched conditions such as reduced VA (cataract-related), advanced age, and hyperopia. However, loss of optical media transparency will inherently reduce accuracy of WA. Further studies are needed to define cut-off values for automated wavefront quality grading and intra-operative application of WA in refractive surgery.

One hundred eyes from 55 adult patients with myopia were retrospectively studied to determine the comparative safety, efficacy, and predictability of aberration smart ablation (ASA) and a new advanced ablation algorithm (Triple-A) using the MEL(®) 80 excimer laser. Fifty myopic eyes with a manifest refraction spherical equivalent (MRSE) between -1.0 diopters (D) and -9.75 D were consecutively treated with photorefractive keratec-tomy ASA, and 50 myopic eyes with an MRSE between -1.38 D and -11.0 D with photorefractive keratectomy Triple-A. Uncorrected distance visual acuity, MRSE, the absolute value of the cylinder, corrected distance visual acuity, and postoperative complications at 1 month, 3 months, 6 months, and 12 months (1 year) were descriptively analyzed and compared at 1 year. After 12 months, the MRSE variance was statistically significantly better in patients triaged to receive Triple-A compared with patients receiving ASA (ASA, ±0.7 D; Triple-A, ±0.15 D; P<0.001). Furthermore, no patient in the Triple-A group had any cylinder postoperatively. Patients in the Triple-A treatment arm achieved a superior result. No statistically significant difference in the two treatment arms was noted for the analysis of the mean MRSE at 12 months (P=0.78). Triple-A was more effective than standard aspherical surgical intervention in a number of treatment outcome parameters (eg, MRSE, astigmatism, efficacy index). The two surgical procedures were equivalent in terms of safety.