LASIK in the Presbyopic Age Group
|
|
- Colleen Osborne
- 8 years ago
- Views:
Transcription
1 LASIK in the Presbyopic Age Group Safety, Efficacy, and Predictability in 40- to 69-Year-Old Patients Ramon C. Ghanem, MD, 1,2 Jose de la Cruz, MD, 1,2 Faisal M. Tobaigy, MD, 1 Leonard P. K. Ang, FRCS(Ed), MRCOphth, 1 Dimitri T. Azar, MD 1,2 Objective: To report the safety, efficacy, and predictability of LASIK in a presbyopic population and to examine possible differences between age groups. Design: Retrospective, descriptive, comparative consecutive case series. Participants: Seven hundred ten eyes of 424 patients between 40 and 69 years of age who underwent LASIK by the same surgeon between January 1999 and September Patients had manifest refractive spherical errors ranging from 10.5 to 6 diopters (D) and cylinder of up to 2.50 D. Methods: LASIK was performed with IntraLase femtosecond laser or Hansatome microkeratomes and VISX Star (S4 or S2; VISX Inc., Santa Clara, CA) or Baush & Lomb Technolas 217z (Zyoptix or PlanoScan; Bausch & Lomb, Claremont, CA) excimer lasers. There were 511 myopic eyes (spherical equivalent [SE], D) and 199 hyperopic eyes (SE, D). Patients were divided into 3 groups: group 1 (40 to 49 years old; n 359 eyes), group 2 (50 to 59 years old; n 293 eyes), and group 3 (60 to 69 years old; n 58 eyes). Main Outcome Measures: Uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA), retreatment rates, safety, efficacy, and predictability. Results: The mean age of patients in groups 1, 2, and 3 was 45, 53, and 63 years, respectively. With increasing age, there was a trend toward higher retreatment rates and more myopic end points. Safety, efficacy, and predictability were comparable between all groups. At the final follow-up (mean standard deviation, months), 80% to 100% of eyes had 20/30 or better UCVA and 81% to 90% were within 1.00 D. No eyes lost more than 2 lines of BSCVA, and only 9 eyes (1.3%) lost 2 lines. Subgroup analysis of eyes with a follow-up of 12 months or more was performed. The results were compared with those with shorter follow-up. Both subgroups had comparable outcomes; the duration of follow-up did not affect the visual outcomes. Conclusions: Despite a trend toward worse final BSCVA and higher retreatment rates in older patients, a greater risk of visual loss after LASIK was not observed. LASIK for myopia and hyperopia has reasonable safety, efficacy, and predictability profiles in the 40- to 69-year-old presbyopic population. Ophthalmology 2007;114: by the American Academy of Ophthalmology. Age-related changes in refractive error are the result of anatomic and functional changes in axial length, lens thickness, and lens opalescence. 1 4 In the Beaver Dam Eye Study, the prevalence of hyperopia increased from 22.1% among people aged 43 to 54 years to 50.2% in those aged 55 Originally received: May 27, Accepted: October 7, Manuscript no Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts. 2 Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois. Supported by the National Institutes of Health, Bethesda, Maryland (grant no. EY10101 [DTA]), and a Research to Prevent Blindness (New York, New York) Lew R. Wasserman Merit Award (DTA). The authors do not have a commercial or proprietary interest in the work. Correspondence to Dimitri T. Azar, MD, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 West Taylor Street, Chicago, IL dazar@uic.edu. to 64 years or older, whereas the prevalence of myopia and emmetropia decreased with age, from 42.9% to 25.1% and from 35% to 24.7% among the same age groups, respectively. 1 In the same population, the change in refraction was noted to occur over many decades. The 10-year change in refraction was 0.48, 0.03, and 0.19 diopters (D) for persons 43 to 59, 60 to 69, and 70 or more years of age, respectively. 3 Because of the improved safety and efficacy of corneal refractive surgery, there is an increasing demand for these procedures among presbyopes. Furthermore, presbyopes are often active, productive, and have high expectations from the outcome of their refractive surgical correction. Studies evaluating the visual outcomes of LASIK for myopia and hyperopia in presbyopic patients are limited. Despite the success of LASIK for the management of refractive errors in presbyopia, especially when combined with monovision, 5 8 some studies have reported suboptimal results with LASIK associated with increasing age Higher inci by the American Academy of Ophthalmology ISSN /07/$ see front matter Published by Elsevier Inc. doi: /j.ophtha
2 Ophthalmology Volume 114, Number 7, July 2007 dence of final uncorrected visual acuity (UCVA) of less than 20/40, 9 higher retreatment rates, decreased satisfaction, and increased night vision complaints 14,15 have been associated with LASIK in advancing age. Herein, we report the results of a retrospective analysis of the efficacy, predictability, and safety of LASIK performed in patients aged between 40 and 69 years. Patients and Methods Study Design We performed a retrospective chart review of 424 consecutive patients (710 eyes) between 40 and 69 years of age who were treated with LASIK in 1 or both eyes. All eyes were operated on by the same surgeon (DTA) between January, 1999, and September, This study was part of a retrospective review of refractive surgery approved by the Institutional Review Board of the Massachusetts Eye and Ear Infirmary. Patient Selection Patients were included if they were between 40 and 69 years old with a follow-up of at least 2 months, spherical refraction from D of myopia to 6.00 D of hyperopia, and refractive cylinder of up to 2.5 D. Only patients treated with VISX Star (S4 or S2; VISX, Inc., Santa Clara, CA) or Baush & Lomb Technolas 217z (Zyoptix or PlanoScan; Bausch & Lomb, Claremont, CA) excimer lasers and IntraLase femtosecond laser (IntraLase Corp., Irvine, CA) or Hansatome microkeratome (Bausch & Lomb) were included. Patients with monovision correction, where 1 eye was treated for near vision, also were included in the study. Patients were excluded if they had previous surgery or an initial best spectacle-corrected visual acuity (BSCVA) of less than 20/30. Patients were divided into 3 groups based on age. Group 1 included patients in the fifth decade (40 to 49 years of age), group 2 included patients in the sixth decade (50 to 59 years of age), and group 3 included patients in the seventh decade (60 to 69 years of age). Groups also were divided into myopia (including myopic astigmatism) and hyperopia (including hyperopic astigmatism) subgroups. Given the limitations of reporting visual acuity data from the final visit, 16 we performed a subgroup analysis of data obtained at time points of 12 months of follow-up or more (mean standard deviation, 18 3 months; n 280). Evaluation Protocol Monovision was discussed with the myopic presbyopes. Myopic patients with refractive errors of 2.50 D or less who were willing to accept monovision correction had only 1 eye operated on, usually the dominant eye, aiming at distance vision (full correction). After surgery, many of these patients had the option of having their other eye operated, knowing that they would need glasses for reading. Presbyopes with myopia of more than 2.50 D or with hyperopia in most cases had both eyes operated on with the choice of having 1 eye treated for near (monovision; near eye aiming at 35 to 50 cm) or for intermediate vision (minimonovision; near eye aiming at 60 to 70 cm), or both eyes treated for distance vision (full correction). The nondominant eye usually was treated for near vision and the dominant eye was treated for distance vision. The initial treatment plan reflected a consensus between the surgeon and the patient regarding the desired outcome. Patient daily activities and preferences were taken into consideration when choosing the amount of intended anisometropia. The age of the patient was one of the determinants of the approximate target refractions in patients who desired residual near vision: 40 to 44 years of age, near eye at 0.50 to 1.00 D; 45 to 48 years of age, near eye at 1.00 to 1.25 D; 49 to 53 years of age, near eye at 1.25 to 1.50 D; and more than 53 years of age, near eye at 1.50 to 1.75 D, respectively. The ocular dominance was identified by the Miles test, whereby the patient extends both arms, brings both hands together to create a small opening, and then with both eyes open views a distant object through the opening. The examiner then alternates covering each eye to determine which is viewing the object (i.e., the dominant eye). 17 Table 1. Patient Demographics (424 Patients, 710 Eyes) Group 1, 40 to 49 Years Group 2, 50 to 59 Years Group 3, 60 to 69 Years No. eyes (% of total) 359 (50.6%) 293 (41.3%) 58 (8.2%) No. patients (% of total) 215 (50.7%) 175 (41.3%) 34 (8.0%) Laterality, n (% of group) Right 185 (51.5%) 153 (52.2%) 28 (48.3%) Left 174 (48.5%) 140 (47.8%) 30 (51.7%) Gender, n (% of group) Males 105 (48.8%) 86 (49.1%) 17 (50.0%) Females 110 (51.2%) 89 (50.9%) 17 (50.0%) Age (yrs) Mean SD Min max Follow-up (mos) Mean SD Min max (93.6%) 268 (91.5%) 51 (87.9%) (72.1%) 195 (66.6%) 41 (70.7%) (57.4%) 156 (53.2%) 36 (62.1%) (39.3%) 104 (35.5%) 35 (60.3%) Wave-front guided, n (% of group) 20 (5.6%) 19 (6.5%) 0 (0%) SD standard deviation. 1304
3 Ghanem et al LASIK in the Presbyopic Age Group Table 2. Preoperative and Postoperative Refractive Data on the 3 Groups Stratified According to Ametropia (n 710 Eyes) Ametropia* Group 1, 40 to 49 Years Group 2, 50 to 59 Years Group 3, 60 to 69 Years Myopia subgroups No. eyes (% of total) 312 (43.9%) 189 (26.5%) 10 (1.4%) Preoperative Mean SE SD Minimum maximum 11 to to to 1.25 Mean cylinder SD Minimum maximum 2.5 to to to 0 Postoperative Mean SE SD Minimum maximum 3.38 to to to 0 Mean cylinder SD Minimum maximum 1.75 to to 0 1 to0 Hyperopia subgroups No. eyes (% of total) 47 (6.6%) 104 (14.6%) 48 (6.7%) Preoperative Mean MRSE SD Minimum maximum 1 to to to 3.75 Mean cylinder SD Minimum maximum 2.5 to to to 0 Postoperative Mean MRSE SD Minimum maximum 2 to to to 1.50 Mean cylinder SD Minimum maximum 2.25 to to to 0 MRSE manifest refractive spherical equivalent; SD standard deviation; SE spherical equivalent. *All values are in diopters. LASIK Procedure and Retreatments For the LASIK procedure, a flap was created with the IntraLase femtosecond laser or Hansatome microkeratome. The flap was reflected and excimer laser ablation of the stromal bed was performed with the VISX Star (S4 or S2) or Bausch & Lomb Technolas 217z (Zyoptix or PlanoScan) laser. The flap was repositioned on the stromal bed and the interface was irrigated with balanced salt solution. After surgery, a combination of steroids and antibiotics was administered for 1 week. The LASIK surgeon-specific nomogram used in this study undercorrects older patients by approximately 2% for every 10 years of age up to the sixth decade. All retreatments were performed by lifting the flap and ablating the stromal bed. Criteria for retreatment included residual, correctable refractive error causing subjective patient dissatisfaction with the uncorrected postoperative vision, as well as a stable postoperative refraction. Predicted residual posterior stromal bed also was considered as a factor in deciding whether to proceed with LASIK enhancement. When monovision was chosen, the target myopia for near vision was determined based on the patient s age and initial refraction. Patient Examinations Data collection included age, gender, ocular dominance, preoperative BSCVA, manifest refraction, unilateral or bilateral treatment, date of surgery, type of laser and microkeratome, and whether treatment was wavefront guided. Postoperative data included date of the last follow-up visit, UCVA, BSCVA, manifest refraction, and need for retreatment. Data Acquisition and Analysis All visual acuity measurements were reported in negative logarithm of minimum angle of resolution units. For patients who did not read all of the letters on a single line correctly, the conversion was made by interpolating between the values of the logarithm of minimum angle of resolution acuity using the fraction of the Table 3. Characteristics of Patients with Intentional Myopic Endpoints (Monovision) Group 1, 40 to 49 Years (n 92 Patients) Group 2, 50 to 59 Years (n 85 Patients) Group 3, 60 to 69 Years (n 18 Patients) Right eye dominance (%) 55 (59.8%) 54 (63.5%) 13 (72.2%) Crossed MV (% of eyes) 17 (18.5%) 13 (15.3%) 1 (5.5%) Mean PO SE in distance-corrected eye Mean PO SE in near-corrected eye Needed enhancement (% of eyes) 10 (10.9%) 9 (10.6%) 2 (11.1%) MV monovision; PO postoperative; SE manifest refractive spherical equivalent. 1305
4 Parameter Table 4. Visual Outcomes and Retreatment Rates in Myopic Patients (n 511) Group 1, 40 to 49 Years Ophthalmology Volume 114, Number 7, July 2007 Group 1 vs. Group 2 Group 2, 50 to 59 Years Group 1 vs. Group 3 Group 3, 60 to 69 Years Group 2 vs. Group 3 Preoperative BSCVA Mean SD NS NS Minimum maximum 0.12 to to Mean Snellen acuity* 20/20 20/20 20/21 Postoperative UCVA Mean SD NS NS NS Minimum maximum 0.12 to to Mean Snellen acuity* 20/25 20/26 20/26 Postoperative BSCVA Mean SD NS NS Minimum maximum 0.12 to to Mean Snellen acuity* 20/20 20/20 20/22 Change in BSCVA Mean SD NS NS NS Minimum maximum 0.14 to to to 0.08 Retreatment rate, n (%) 56 (17.8%) NS 32 (16.9%) NS 2 (20%) NS BSCVA best spectacle-corrected visual acuity; NS not significant; SD standard deviation; UCVA uncorrected visual acuity. *Snellen acuity converted from logarithm of the minimum angle of resolution units. Without monovision. Independent samples t test. Chi-square test. number of letters correctly read on a visual acuity line, as suggested by Holladay. 18 Eyes treated for near vision (monovision) were excluded from the efficacy and predictability analysis. Data from the final visit were analyzed using SPSS software version 14.0 (SPSS, Inc., Chicago, IL) and are presented in this study. Independent-samples t tests and chi-square tests were applied. A P value of less than 0.05 was considered statistically significant. Results Demographics, Monovision, and Refractive Data A total of 710 eyes of 424 patients aged 40 to 69 years met the inclusion criteria for this study. There were 215 patients in group 1 (359 eyes), 175 patients in group 2 (293 eyes), and 34 patients in Parameter Table 5. Visual Outcomes and Retreatment in Hyperopic Patients (n 199) Group 1, 40 to 49 Years Group 1 vs. Group 2 Group 2, 50 to 59 Years Group 1 vs. Group 3 Group 3, 60 to 69 Years Group 2 vs. Group 3 Preoperative BSCVA Mean SD NS NS NS Minimum maximum 0.12 to to to 0.16 Mean Snellen acuity* 20/20 20/20 20/20 Postoperative UCVA Mean SD NS NS NS Minimum maximum 0 to to Mean Snellen acuity* 20/28 20/26 20/30 Postoperative BSCVA Mean SD NS Minimum maximum 0.12 to to Mean Snellen acuity* 20/22 20/20 20/22 Change in BSCVA Mean SD NS Minimum maximum 0.12 to to to 0.20 Retreatment rate, n (%) 4 (8.5%) NS 12 (11.5%) NS 10 (20.8%) NS BSCVA best spectacle-corrected visual acuity; NS not significant; SD standard deviation; UCVA uncorrected visual acuity. *Snellen acuity converted from logarithm of the minimum angle of resolution. Without monovision. Independent samples t test. Chi-square test. 1306
5 group 3 (58 eyes). Gender distribution was similar in all groups. The mean age of patients was 45 years in group 1, 53 years in group 2, and 63 years in group 3. Mean follow-up in groups 1, 2, and 3 was 11, 9, and 11 months, respectively. Patient demographics are shown in Table 1. Preoperative and postoperative refractive data in the 3 age groups stratified according to ametropia are shown in Table 2. There was a tendency toward a more myopic end point in group 3 (age range, years) compared with other groups in both myopia and hyperopia subgroups. In 195 patients (46%), a myopic end point was intended in 1 eye (monovision), including 43% in group 1, 49% in group 2, and 53% in group 3. The characteristics of patients with intentional myopic end point (monovision) are shown in Table 3. Visual Outcomes and Retreatment Rate Tables 4 and 5 show visual outcomes and retreatment rates stratified according to age groups for myopia and hyperopia, respectively. In hyperopic subgroups, no statistically significant differences were observed in preoperative BSCVA. The differences in postoperative BSCVA between the groups were not clinically significant. An increase in retreatment rates was observed in the hyperopic subgroup with increasing age; however, it was not statistically significant (Table 5). Efficacy The percentages of eyes with postoperative UCVA better than or equal to 20/20, 20/25, 20/30, and 20/40 according to ametropia are shown in Figure 1. Efficacy in the level of 20/30 was comparable between all groups. Predictability The percentages of eyes with postoperative manifest refractive spherical equivalent within 0.50 D and 1.00 D were evaluated in all groups according to ametropia (Fig 2). Ghanem et al LASIK in the Presbyopic Age Group Safety The distribution of the change in BSCVA is shown in Figure 3. In the myopic subgroups, 3 patients (1.0%) lost 2 lines of BSCVA in group 1. No patient lost 2 or more lines in groups 2 and 3. In hyperopic subgroups, patients who lost 2 lines were as follows: 3 patients (6.3%) in group 1, 1 patient (1.0%) in group 2, and 2 patients (4.2%) in group 3. No eyes lost more than 2 lines of BSCVA in any group. Subgroup Analysis of Patients with Follow-up of 12 Months or More Follow-up was 12 months or more in 141 eyes (39.3%), 104 eyes (35.5%), and 35 eyes (60.3%) in groups 1, 2, and 3, respectively. Efficacy, predictability, and safety profiles of this subgroup are described in Table 6. No statistically significant differences were observed comparing this subgroup with the eyes with shorter follow-up. Discussion Patient age has been considered as an important variable affecting the outcomes of various corneal refractive surgical Figure 1. Bar graphs demonstrating efficacy: uncorrected visual acuity after LASIK for (A) myopia (n 364) and (B) hyperopia (n 151) stratified according to age group. Eyes treated for near (monovision) were excluded. procedures, including radial keratotomy and photorefractive keratectomy. 19 Younger patients tend to have a more aggressive healing response, which may contribute to some regression of the effect of treatment. In LASIK, because of the decreased healing response, it is not clear whether age plays a significant role. Derived by linear regression analysis from previous treatments, nomogram adjustments usually are performed according to age to increase the amount of correction in younger patients. As described in Patients and Methods, our LASIK nomogram attempts to prevent overcorrection in patients older than 40 years of age by reducing the amount of treatment. Regardless of the healing process, LASIK correction can be problematic in presbyopic patients. Many presbyopic patients with myopia experience difficulties with near vision after their refractive error is corrected. Before surgery, many of these patients were able to read by taking off their eyeglasses; after surgery, they may find that they are no 1307
6 Ophthalmology Volume 114, Number 7, July 2007 patients had monovision LASIK in groups 1, 2, and 3, respectively. Five to eighteen percent of our patients had crossed monovision, which happens when the dominant eye is treated for near vision. 5 The rate of enhancement in the monovision-treated patients was approximately 10%, which compares favorably with the overall population in this study. Increased age also has been associated with decreased postoperative UCVA after LASIK. 9 In our study, the efficacy and predictability of LASIK for myopia and hyperopia were similar in all groups. The differences in mean postoperative UCVA were not statistically significant between groups. The postoperative mean manifest refractive spherical equivalent in the myopic and hyperopic subgroups showed that with increasing age, there was a tendency toward undercorrection of the myopia or overcorrection of the hyperopia. Because accommodative amplitude decreases with age, a myopic end point is desirable in older patients. It may also reflect LASIK nomogram adjustments. Figure 2. Bar graphs demonstrating predictability: manifest refraction spherical equivalent after LASIK for (A) myopia (n 364) and (B) hyperopia (n 151) stratified according to age group. Eyes treated for near (monovision) were excluded. D diopters. longer able to do so. Most patients choose to undergo refractive surgery to decrease their dependence on spectacles and therefore are not willing to wear reading glasses after surgery. Monovision has been used as a strategy to compensate for presbyopia by optically correcting one eye for distance vision and the other eye for near vision. This strategy, however, induces anisometropia with a consequent reduction in binocular visual acuity and stereopsis. 20 Thus, patients desiring good bilateral distance UCVA (e.g., professional drivers) are not good candidates for monovision. Patients have to understand that monovision is a compromise that does not restore accommodation but, rather, compensates for its loss and that there are drawbacks involved. When they understand the tradeoff, they are more likely to adapt to, and be happy with, monovision. LASIK monovision has been successful with rates between 86% to 97.8%. 5 8 In our study, 42.8%, 48.5%, and 52.9% of the Figure 3. Bar graphs demonstrating safety: change of best spectaclecorrected visual acuity after LASIK for (A) myopia (n 511) and (B) hyperopia (n 199) stratified according to age group. 1308
7 Ghanem et al LASIK in the Presbyopic Age Group Table 6. Efficacy, Predictability, and Safety Profiles for Eyes Followed Up for 12 Months or More Compared with Eyes with Less Than 12 Months of Follow-up <12 Months (n 430) >12 Months (n 280) P Value* Efficacy ( 20/30) Group 1 (40 49 yrs) 161 (73.85%) 107 (75.89%) 0.67 Group 2 (50 59 yrs) 141 (74.60%) 69 (66.35%) 0.13 Group 3 (60 69 yrs) 15 (65.22%) 26 (74.29%) 0.46 Predictability ( 0.5 D) Group 1 (40 49 yrs) 114 (52.29%) 71 (50.35%) 0.72 Group 2 (50 59 yrs) 99 (52.38%) 43 (41.35%) 0.07 Group 3 (60 69 yrs) 11 (47.83%) 16 (45.71%) 0.88 Predictability ( 1.0 D) Group 1 (40 49 yrs) 167 (76.61%) 112 (79.43%) 0.53 Group 2 (50 59 yrs) 148 (78.31%) 75 (72.12%) 0.84 Group 3 (60 69 yrs) 17 (73.91%) 25 (71.43%) 0.23 Safety Group 1 (40 49 yrs) 4 (1.83%) 2 (1.42%) 0.76 Group 2 (50 59 yrs) 0 (0%) 1 (0.96%) 0.18 Group 3 (60 69 yrs) 0 (0%) 2 (5.71%) 0.24 BSCVA best spectacle-corrected visual acuity; D diopters; UCVA uncorrected visual acuity. *Chi-square test. Percentage of eyes with UCVA 20/30. Percentage of eyes with spherical equivalent within 0.5 D and within 1 D from emmetropia, respectively. Percentage of eyes with a loss of 2 or more Snellen lines of BSCVA. Some studies showed a higher retreatment rate associated with increasing age In our study, retreatment rates were higher in the seventh decade group compared with others, but the differences were not statistically significant. Besides age, other factors have been associated with higher enhancement rates, namely higher initial corrections, residual astigmatism, 10 and history of rigid contact lens use. 13 The inability of older patients to accommodate small residual refractive errors, nomogram variables, healing response, and the higher incidence of refractive shift, nuclear sclerosis, and against-the-rule astigmatism 4 are among the factors that may explain the higher retreatment rates in older patients. Data from our series are limited by the retrospective nature of the study and the relatively heterogeneous sample. We analyzed the outcome of the last follow-up (final visual acuity). Reporting final vision instead of interval outcomes can introduce a potential bias. 16,21 An overestimation of the number of people with good visual acuity outcomes or an underestimation of the number of people with suboptimal visual acuity outcomes can occur when a specific condition may degenerate, with loss of visual acuity, beyond the time that final outcome was obtained. 16 This may occur in older patients with ocular comorbidities. Another limitation is the issue of patient satisfaction, which could not be assessed with accuracy. This is important in those presbyopic myopes who could read without glasses before surgery but may need them after distance correction. The varying lengths of follow-up, the inclusion of patients operated on with different lasers and microkeratomes, and the difficulty in having clear inclusion and exclusion criteria add to the limitations of this study. Despite these limitations, we were able to make certain observations in the myopic and hyperopic subgroups. Our low rate of vision loss is within the range of results presented by the Ophthalmic Technology Assessment Committee of the American Academy of Ophthalmology (average percent of eyes losing 2 or more lines for myopia and astigmatism, 1%; for hyperopia, hyperopic astigmatism, and mixed astigmatism, 1.4%) and Food and Drug Administration results (percent of eyes losing 2 or more lines, 0.61% after year 2000) In the myopic subgroups, the change in BSCVA, which reflects mean gain or loss of BSCVA, showed similar results in the 3 groups. Although clinically not significant, there was a trend toward having a slightly worse preoperative and postoperative BSCVA in older patients. Other ocular comorbidities, such as progression of nuclear sclerosis, glaucoma, dry eye, and macular degeneration, also may be present in older patients, which may influence the BSCVA. In the hyperopic subgroups, loss of BSCVA was significant, with a final worse BSCVA in groups 1 and 3 compared with group 2. This is probably the result of factors other than increasing age, because the greatest loss of BSCVA occurred in group 1, the youngest group, where the mean manifest refractive spherical equivalent ( 2.38 D) and cylinder ( 0.75 D) were greatest. Loss of BSCVA after LASIK for hyperopia and hyperopic astigmatism also has been associated with small ablation zones, flaprelated complications resulting from the necessity of larger flaps like free caps and buttonholes, decentered ablations, and others. 23 In conclusion, our study identified the visual and refractive results in an older, presbyopic population and examined possible differences between age groups. Despite a trend toward worse final BSCVA and higher retreatment rates in older patients, a greater risk of visual loss after LASIK was 1309
8 Ophthalmology Volume 114, Number 7, July 2007 not observed with increasing age. LASIK for myopia and hyperopia has reasonable safety, efficacy, and predictability profiles in the presbyopic age group. References 1. Wang Q, Klein BE, Klein R, Moss SE. Refractive status in the Beaver Dam Eye Study. Invest Ophthalmol Vis Sci 1994;35: Shufelt C, Fraser-Bell S, Ying-Lai M, et al. Refractive error, ocular biometry, and lens opalescence in an adult population: the Los Angeles Latino Eye Study. Invest Ophthalmol Vis Sci 2005;46: Lee KE, Klein BE, Klein R, Wong TY. Changes in refraction over 10 years in an adult population: the Beaver Dam Eye Study. Invest Ophthalmol Vis Sci 2002;43: Attebo K, Ivers RQ, Mitchell P. Refractive errors in an older population: the Blue Mountains Eye Study. Ophthalmology 1999;106: Jain S, Ou R, Azar DT. Monovision outcomes in presbyopic individuals after refractive surgery. Ophthalmology 2001;108: Miranda D, Krueger RR. Monovision laser in situ keratomileusis for pre-presbyopic and presbyopic patients. J Refract Surg 2004;20: Goldberg DB. Laser in situ keratomileusis monovision. J Cataract Refract Surg 2001;27: Reilly CD, Lee WB, Alvarenga L, et al. Surgical monovision and monovision reversal in LASIK. Cornea 2006;25: Hersh PS, Steinert RF, Brint SF, Summit PRK-LASIK Study Group. Photorefractive keratectomy versus laser in situ keratomileusis: comparison of optical side effects. Ophthalmology 2000;107: Hersh PS, Fry KL, Bishop DS. Incidence and associations of retreatment after LASIK. Ophthalmology 2003;110: Hu DJ, Feder RS, Basti S, et al. Predictive formula for calculating the probability of LASIK enhancement. J Cataract Refract Surg 2004;30: Netto MV, Wilson SE. Flap lift for LASIK retreatment in eyes with myopia. Ophthalmology 2004;111: Perlman EM, Reinert SE. Factors influencing the need for enhancement after laser in situ keratomileusis. J Refract Surg 2004;20: Bailey MD, Mitchell GL, Dhaliwal DK, et al. Patient satisfaction and visual symptoms after laser in situ keratomileusis. Ophthalmology 2003;110: Pop M, Payette Y. Risk factors for night vision complaints after LASIK for myopia. Ophthalmology 2004;111: Jabs DA. Improving the reporting of clinical case series. Am J Ophthalmol 2005;139: Miles WR. Ocular dominance in human adults. J Gen Psychol 1930;3: Holladay JT. Visual acuity measurements. J Cataract Refract Surg 2004;30: Loewenstein A, Lipshitz I, Levanon D, et al. Influence of patient age on photorefractive keratectomy for myopia. J Refract Surg 1997;13: Jain S, Arora I, Azar DT. Success of monovision in presbyopes: review of the literature and potential applications to refractive surgery. Surv Ophthalmol 1996;40: DiLoreto DA Jr, Bressler NM, Bressler SB, Schachat AP. Use of best and final visual acuity outcomes in ophthalmological research. Arch Ophthalmol 2003;121: Sugar A, Rapuano CJ, Culbertson WW, et al. Laser in situ keratomileusis for myopia and astigmatism: safety and efficacy. A report by the American Academy of Ophthalmology. Ophthalmology 2002;109: Varley GA, Huang D, Rapuano CJ, et al. LASIK for hyperopia, hyperopic astigmatism, and mixed astigmatism. A report by the American Academy of Ophthalmology. Ophthalmology 2004;111: Watson SL, Bunce C, Allan BD. Improved safety in contemporary LASIK. Ophthalmology 2005;112:
FIRST EXPERIENCE WITH THE ZEISS FEMTOSECOND SYSTEM IN CONJUNC- TION WITH THE MEL 80 IN THE US
FIRST EXPERIENCE WITH THE ZEISS FEMTOSECOND SYSTEM IN CONJUNC- TION WITH THE MEL 80 IN THE US JON DISHLER, MD DENVER, COLORADO, USA INTRODUCTION AND STUDY OBJECTIVES This article summarizes the first US
More informationLaser in situ keratomileusis (LASIK) has been. Retreatment of Hyperopia After Primary Hyperopic LASIK REPORTS
REPORTS Retreatment of Hyperopia After Primary Hyperopic LASIK Julio Ortega-Usobiaga, MD, PhD; Rosario Cobo-Soriano, MD, PhD; Fernando Llovet, MD; Francisco Ramos, MD; Jaime Beltrán, MD; Julio Baviera-Sabater,
More informationConductive keratoplasty (CK) utilizes radiofrequency energy. Original Article
Original Article Comparing the Rate of Regression after Conductive Keratoplasty with or without Prior Laser-Assisted in situ Keratomileusis or Photorefractive Keratectomy Majid Moshirfar, Erik Anderson
More informationVISX Wavefront-Guided LASIK for Correction of Myopic Astigmatism, Hyperopic Astigmatism and Mixed Astigmatism (CustomVue LASIK Laser Treatment)
CustomVue Advantage Patient Information Sheet VISX Wavefront-Guided LASIK for Correction of Myopic Astigmatism, Hyperopic Astigmatism and Mixed Astigmatism (CustomVue LASIK Laser Treatment) Statements
More informationComparison Combined LASIK Procedure for Ametropic Presbyopes and Planned Dual Interface for Post-LASIK Presbyopes Using Small Aperture Corneal Inlay
Comparison Combined LASIK Procedure for Ametropic Presbyopes and Planned Dual Interface for Post-LASIK Presbyopes Using Small Aperture Corneal Inlay Minoru Tomita, MD, PhD 1,2 1) Shinagawa LASIK, Tokyo,
More informationThin-flap (sub-bowman keratomileusis) versus thick-flap laser in situ keratomileusis for moderate to high myopia: Case-control analysis
ARTICLE Thin-flap (sub-bowman keratomileusis) versus thick-flap laser in situ keratomileusis for moderate to high myopia: Case-control analysis Dimitri T. Azar, MD, Ramon C. Ghanem, MD, Jose de la Cruz,
More informationIncidence and Associations of Retreatment After LASIK
Incidence and Associations of Retreatment After LASIK Peter S. Hersh, MD, 1,2,3 Kristen L. Fry, OD,MS, 1,2,3 Douglas S. Bishop, BA 3 Purpose: To determine the incidence and risk factors for laser in situ
More informationPseudo-accommodative Cornea (PAC) for the Correction of Presbyopia
Pseudo-accommodative Cornea (PAC) for the Correction of Presbyopia Alaa El Danasoury, FRCS Magrabi Hospitals & Centers Surgical options for the Correction of Presbyopia Monovision Reversal of Presbyopia:
More informationRetreatment by Lifting the Original Laser in Situ Keratomileusis Flap after Eleven Years
Retreatment by Lifting the Original Laser in Situ Keratomileusis Flap after Eleven Years Hassan Hashemi, MD 1,2 Mehrdad Mohammadpour, MD 3 Abstract Purpose: To describe a case of successful laser in situ
More informationPresbyopia Treatment by Monocular Peripheral PresbyLASIK
Presbyopia Treatment by Monocular Peripheral PresbyLASIK Robert Leonard Epstein, MD, MSEE; Mark Andrew Gurgos, COA ABSTRACT PURPOSE: To investigate monocular peripheral presby- LASIK on the non-dominant
More informationLASIK. Complications. Customized Ablations. Photorefractive Keratectomy. Femtosecond Keratome for LASIK. Cornea Resculpted
Refractive Surgery: Which Procedure for Which Patient? David R. Hardten, M.D. Minneapolis, Minnesota Have done research, consulting, or speaking for: Alcon, Allergan, AMO, Bausch & Lomb, Inspire, Medtronic,
More informationWhat is Refractive Error?
Currently, about 55% of the civilian pilots in the United States must utilize some form of refractive correction to meet the vision requirements for medical certification. While spectacles are the most
More informationThe pinnacle of refractive performance.
Introducing! The pinnacle of refractive performance. REFRACTIVE SURGERY sets a new standard in LASIK outcomes More than 98% of patients would choose it again. 1 It even outperformed glasses and contacts
More informationCustomVue Treatments for Monovision in Presbyopic Patients with Low to Moderate Myopia and Myopic Astigmatism
CustomVue Treatments for Monovision in Presbyopic Patients with Low to Moderate and Myopic Introduction Pre-Operative Examination Surgical Technique 1 2 IMPORTANT INFORMATION CustomVue Monovision treatments
More informationWavefront-guided Custom Ablation for Myopia Using the NIDEK NAVEX Laser System
Wavefront-guided Custom Ablation for Myopia Using the NIDEK NAVEX Laser System Jan Venter, MD ABSTRACT PURPOSE: To determine the predictability, effi cacy, safety, and stability of LASIK using custom ablation
More informationRichard S. Hoffman, MD. Clinical Associate Professor of Ophthalmology Oregon Health & Science University
Zeiss Mel 80 and Visumax Refractive Laser Systems Richard S. Hoffman, MD Clinical Associate Professor of Ophthalmology Oregon Health & Science University No Financial Interest ZEISS Workstation CRS-Master
More informationEffect of Preoperative Keratometric Power on Intraoperative Complications in LASIK in 34,099 Eyes
Effect of Preoperative Keratometric Power on Intraoperative Complications in LASIK in 34,099 Eyes J. Carlos Albelda-Vallés, MD; Clara Martin-Reyes, MD; Francisco Ramos, MD; Jaime Beltran, MD; Fernando
More informationTechniques for Enhancing Cataract Surgery Patients with Residual Refractive Error. Director of Cornea Center For Excellence In Eye Care Miami, FL
Techniques for Enhancing Cataract Surgery Patients with Residual Refractive Error William Trattler, MD Director of Cornea Center For Excellence In Eye Care Miami, FL 1 Financial Disclosures Consulting
More informationCommon visual problems in older LASIK patients
丘 子 宏 LASIK 手 術 後 的 視 覺 Visual acuity:the measurement of high contrast Snellen acuity but not other functions under different condition Quality of vision: measure the visual functions in variable condition
More informationLASIK SURGERY OUTCOMES, VOLUME AND RESOURCES
MOH Information Paper: 2006/17 LASIK SURGERY OUTCOMES, VOLUME AND RESOURCES By Dr. Ganga Ganesan 1 I INTRODUCTION LASIK stands for Laser-Assisted In Situ Keratomileusis and is a surgical procedure that
More informationActive Cyclotorsion Error Correction During LASIK for Myopia and Myopic Astigmatism With the NIDEK EC-5000 CX III Laser
Active Cyclotorsion Error Correction During LASIK for Myopia and Myopic Astigmatism With the NIDEK EC-5000 CX III Laser Sudhank Bharti, MD; Harkaran S. Bains ABSTRACT PURPOSE: To investigate the predictability
More informationStraylight values 1 month after laser in situ keratomileusis and photorefractive keratectomy
ARTICLE Straylight values 1 month after laser in situ keratomileusis and photorefractive keratectomy Jeroen J.G. Beerthuizen, MD, FEBOphth, Luuk Franssen, MSc, Monika Landesz, MD, PhD, Thomas J.T.P. van
More informationComparing Femtosecond Lenticule Extraction (FLEx) and Femtosecond Laser In-situ Keratomileusis (LASIK) for Myopia and Astigmatism
Original Article Philippine Journal of OPHTHALMOLOGY Comparing Femtosecond Lenticule Extraction (FLEx) and Femtosecond Laser In-situ Keratomileusis (LASIK) for Myopia and Astigmatism Tina Marie Saban-Roa,
More informationRefractive Errors. Refractive Surgery. Eye Care In Modern Life. Structure of the Eye. Structure of the Eye. Structure of the Eye. Structure of the Eye
Structure of the Eye Eye Care In Modern Life Dr. Dorothy Fan Department of Ophthalmology & Visual Sciences September 2007 Information age > 90% of sensory input Blindness is one of the most fearful disabilities
More informationEye Care In Modern Life
Eye Care In Modern Life Dr. Dorothy Fan Department of Ophthalmology & Visual Sciences November 2009 dorothyfan@cuhk.edu.hk Structure of the Eye Information age > 90% of sensory input Blindness is one of
More informationComparison of Residual Stromal Bed Thickness and Flap Thickness at LASIK and Post-LASIK Enhancement in Femtosecond Laser-Created Flaps
Comparison of Residual Stromal Bed Thickness and Flap Thickness at LASIK and Post-LASIK Enhancement in Femtosecond Laser-Created Flaps Lingo Y. Lai, MD William G. Zeh, MD Clark L. Springs, MD The authors
More informationRefractive Surgery. Evolution of Refractive Error Correction
Refractive Surgery Techniques that correct for refractive error in the eye have undergone dramatic evolution. The cornea is the easiest place to place a correction, so most techniques have focused on modifying
More informationLASIK: Clinical Results and Their Relationship to Patient Satisfaction
LASIK: Clinical Results and Their Relationship to Patient Satisfaction Lien Thieu Tat A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy School of Applied Vision
More informationDr. Booth received his medical degree from the University of California: San Diego and his bachelor of science from Stanford University.
We've developed this handbook to help our patients become better informed about the entire process of laser vision correction. We hope you find it helpful and informative. Dr. Booth received his medical
More informationTopographically-guided Laser In Situ Keratomileusis to Treat Corneal Irregularities
Topographically-guided Laser In Situ Keratomileusis to Treat Corneal Irregularities Michael C. Knorz, MD, Bettina Jendritza, MD Objective: To evaluate the predictability and safety of topographically guided
More informationKERATOCONUS IS A BILATERAL, ASYMMETRIC, CHRONIC,
Comparison of and Intacs for Keratoconus and Post-LASIK Ectasia MUNISH SHARMA, MD, AND BRIAN S. BOXER WACHLER, MD PURPOSE: To evaluate the efficacy of single-segment Intacs and compare with double-segment
More informationTreatment of Myopia and Myopic Astigmatism by Customized Laser In Situ Keratomileusis Based on Corneal Topography
Treatment of Myopia and Myopic Astigmatism by Customized Laser In Situ Keratomileusis Based on Corneal Topography Michael C. Knorz, MD, 1 Thomas Neuhann, MD 2 Objective: To evaluate the predictability,
More informationExcimer Laser Eye Surgery
Excimer Laser Eye Surgery This booklet contains general information that is not specific to you. If you have any questions after reading this, ask your own physician or health care worker. They know you
More informationEarly Flap Displacement after LASIK
Early Flap Displacement after LASIK Gerry Clare, FRCOphth, Tara C. B. Moore, PhD, Claire Grills, PhD, Antonio Leccisotti, MD, PhD, Johnny E. Moore, FRCOphth, PhD, Steve Schallhorn, MD Purpose: To evaluate
More informationInitial Supervised Refractive Surgical Experience: Outcome of PRK and LASIK
Initial Supervised Refractive Surgical Experience: Outcome of PRK and LASIK Urmil Shah 1, Mahesh Shah 2, Bharati Shah 3 1 DO, DNB, FICO Resident, Aravind eye hospital, Tirunelveli 627001, Tamilnadu, India
More informationLASIK SURGERY IN AL- NASSIRYA CITY A CLINICOSTATISTICAL STUDY
Thi-Qar Medical Journal (TQMJ): Vol(4) No(4):1(14-21) SUMMARY: LASIK SURGERY IN AL- NASSIRYA CITY A CLINICOSTATISTICAL STUDY Dr. Ali Jawad AL- Gidis (M.B.Ch.B., D.O., F.I.C.O.)* Background: LASIK which
More informationRefractive Surgery. Common Refractive Errors
Refractive Surgery Over the last 25 years developments in medical technology and Refractive Surgery allow almost all need for glasses and contact lenses to be eliminated. Currently there are a number of
More informationInformed Consent for Refractive Lens Exchange (Clear Lens Replacement)
Mark Packer, M.D. Informed Consent for Refractive Lens Exchange (Clear Lens Replacement) This surgery involves the removal of the natural lens of my eye, even though it is not a cataract. The natural lens
More informationIntraoperative Complications of Laser in Situ Keratomileusis in Yazd
Ophthalmology Research: An International Journal 2(4): 196-203, 2014, Article no. OR.2014.003 SCIENCEDOMAIN international www.sciencedomain.org Intraoperative Complications of Laser in Situ Keratomileusis
More informationBitoric Laser In Situ Keratomileusis for the Correction of Simple Myopic and Mixed Astigmatism
Bitoric Laser In Situ Keratomileusis for the Correction of Simple Myopic and Mixed Astigmatism Arturo S. Chayet, MD, 1 Miguel Montes, MD, 1 Laura Gómez, MD, 1 Xavier Rodríguez, MD, 1 Nora Robledo, OD,
More informationWhen To Laser, When To Implant, When To Do Both
When To Laser, When To Implant, When To Do Both Scott MacRae, MD Professor of Ophthalmology Professor of Visual Sciences StrongVision Refractive Surgery Center University of Rochester Eye Institute Refractive
More informationTABLE OF CONTENTS: LASER EYE SURGERY CONSENT FORM
1 BoydVision TABLE OF CONTENTS: LASER EYE SURGERY CONSENT FORM Risks and Side Effects... 2 Risks Specific to PRK... 3 Risks Specific to LASIK... 4 Patient Statement of Consent... 5 Consent for Laser Eye
More informationINFORMED CONSENT TO HAVE LASIK
A Division of Scott & Christie and Associates INFORMED CONSENT TO HAVE LASIK This information is to help you make an informed decision about having Laser Assisted Intrastromal Keratomileusis (LASIK), an
More informationTucson Eye Care, PC. Informed Consent for Cataract Surgery And/Or Implantation of an Intraocular Lens
Tucson Eye Care, PC Informed Consent for Cataract Surgery And/Or Implantation of an Intraocular Lens INTRODUCTION This information is provided so that you may make an informed decision about having eye
More informationINTRODUCTION. Trans Am Ophthalmol Soc 2006;104:402-413
ORBSCAN II ASSISTED INTRAOCULAR LENS POWER CALCULATION FOR CATARACT SURGERY FOLLOWING MYOPIC LASER IN SITU KERATOMILEUSIS (AN AMERICAN OPHTHALMOLOGICAL SOCIETY THESIS) BY Henry Gelender MD ABSTRACT Purpose:
More informationADDENDUM to the Informed Consent for Cataract Surgery with Intraocular Lens Implant
ADDENDUM to the Informed Consent for Cataract Surgery with Intraocular Lens Implant INTRODUCTION Except for unusual situations, a cataract operation is indicated only when you cannot function satisfactorily
More informationINFORMED CONSENT FOR LASIK SURGERY
IMPORTANT: READ EVERY WORD! This information is to help you make an informed decision about having laser assisted in-situ keratomileusis (LASIK) surgery to treat your nearsightedness, farsightedness and/or
More informationMichael J. Collins, Jr., M.D., F.A.C.S. Professional Background
Michael J. Collins, Jr., M.D., F.A.C.S Main Office: Fort Myers Office 6900 International Center Blvd. Fort Myers, FL 33912 (239) 936-4706 Fax: (239) 225-6775 www.collinsvision.com Professional Background
More informationLife Science Journal 2014;11(9) http://www.lifesciencesite.com. Cross cylinder Challenging cases and their resultswith Nidek Quest (EC-5000)
Cross cylinder Challenging cases and their resultswith Nidek Quest (EC-5000) Gamal Mostafa Abo El Maaty, Mohamed Elmoddather, Mahmoud Ibrahem Ghazy, Mohamed Al-Taher Ophthalmology Department, Faculty of
More informationLASIK. What is LASIK? Eye Words to Know. Who is a good candidate for LASIK?
2014 2015 LASIK What is LASIK? LASIK (laser in situ keratomileusis) is a type of refractive surgery. This kind of surgery uses a laser to treat vision problems caused by refractive errors. You have a refractive
More informationFaster recovery of visual acuity at all distances
news Special issue PresbyMAX Faster recovery of visual acuity at all distances PresbyMAX μ-monovision: The latest technique for treating presbyopia SCHWIND now offers PresbyMAX µ-monovision as a new option
More informationUniquely Safe. predictably better for our patients. enhancement, may be significantly reduced.
Uniquely Safe Clinical Support: Six different studies verify the improved safety of flap creation with the INTRALASE FS laser when compared to traditional microkeratomes. Clinical studies validate the
More informationIntraocular Lens Power Calculation after Myopic Refractive Surgery
Intraocular Lens Power Calculation after Myopic Refractive Surgery Theoretical Comparison of Different Methods Giacomo Savini, MD, Piero Barboni, MD, Maurizio Zanini, MD Objective: To evaluate the reliability
More informationLASIK & Refractive Surgery
LASIK & Refractive Surgery LASIK PRK ICL RLE Monovision + + + For over 30 years, The Eye Institute of Utah has been giving people vision for life... The Eye Institute of Utah was the first medical facility
More informationKeratorefractive Surgery for Post-Cataract Refractive Surprise. Moataz El Sawy
Keratorefractive Surgery for Post-Cataract Refractive Surprise Moataz El Sawy Departmentof Ophthalmology, Faculty of Medicine,MenoufiyaUniversity, Egypt mfelsawy@yahoo.co.uk Abstract: Purpose: To evaluate
More informationOverview of Refractive Surgery
Overview of Refractive Surgery Michael N. Wiggins, MD Assistant Professor, College of Health Related Professions and College of Medicine, Department of Ophthalmology Jones Eye Institute University of Arkansas
More informationWe look forward to see you & thanks for trusting us your eyes to us.
MEDICATIONS VIGAMOX (OCUFLOX) PURPOSE PREVENTS INFECTION DOSAGE USE 1 DROP 4 TIMES DAILY STARTING 1 DAY PRIOR TO SURGERY VALIUM (Diltiazem 5 mg) AMBIEN (ZOLPIDEM) RESTASIS (if prescribed) Provides relaxation
More informationPatient-Reported Outcomes with LASIK (PROWL-1) Results
Patient-Reported Outcomes with LASIK (PROWL-1) Results Elizabeth M. Hofmeister, MD CAPT, MC, USN Naval Medical Center San Diego Refractive Surgery Advisor for Navy Ophthalmology Assistant Professor of
More informationAsymmetrical Supracor for hyperopic presbyopes: short term results
ARTICLE Asymmetrical Supracor for hyperopic presbyopes: short term results José Ramón Soler Tomás, MD, PhD 1 ; Graciana Fuentes-Páez, MD 1 ; Sergio Burillo, DDO 1 PURPOSE: To report the pre- and postoperative
More informationPATIENT CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK)
INTRODUCTION: You have been diagnosed with myopia (nearsightedness) or hyperopia (farsightedness) with or without astigmatism, or astigmatism alone. Myopia is a result of light entering the eye and focusing
More informationFactors Affecting Long-term Myopic Regression after Laser In Situ Keratomileusis and Laser-assisted Subepithelial Keratectomy for Moderate Myopia
pissn: 111-8942 eissn: 292-9382 Korean J Ophthalmol 216;3(2):92-1 http://dx.doi.org/1.3341/kjo.216.3.2.92 Original Article Factors Affecting Long-term Myopic Regression after Laser In Situ Keratomileusis
More informationInformed Consent for Refractive Lens Exchange (Clear Lens Extraction)
Informed Consent for Refractive Lens Exchange (Clear Lens Extraction) This form is designed to ensure that you have all the information you need to make a decision about whether or not you wish to undergo
More informationAdvanced personalized nomogram for myopic laser surgery: First 100 eyes
ARTICLE Advanced personalized nomogram for myopic laser surgery: First 1 eyes Ruth Lapid-Gortzak, MD, Jan Willem van der Linden, BOpt, Ivanka J.E. van der Meulen, MD, Carla P. Nieuwendaal, MD PURPOSE:
More informationPresbyMAX For visibly younger eyesight
PresbyMAX For visibly younger eyesight Contents 2 3 SCHWIND eye-tech-solutions So you can still read stories aloud tomorrow CONTENTS Presbyopia 4 5 PresbyMAX 6 7 Visual acuity at all distances 8 9 Your
More informationINFORMED CONSENT FOR LASER ASSISTED SUBEPITHELIAL KERATOMILEUSIS (LASEK)/PHOTO-REFRACTIVE KERATECTOMY (PRK)
INFORMED CONSENT FOR LASER ASSISTED SUBEPITHELIAL KERATOMILEUSIS (LASEK)/PHOTO-REFRACTIVE KERATECTOMY (PRK) Please read the following consent form very carefully. Please initial each page where indicated.
More informationIntraLase and LASIK: Risks and Complications
No surgery is without risks and possible complications and LASIK is no different in that respect. At Trusted LASIK Surgeons, we believe patients can minimize these risks by selecting a highly qualified
More informationPatient outcomes of refractive surgery
articles Patient outcomes of refractive surgery The Refractive Status and Vision Profile Oliver D. Schein, MD, MPH, Susan Vitale, PhD, MHS, Sandra D. Cassard, ScD, Earl P. Steinberg, MD, MPP ABSTRACT Purpose:
More informationrefractive surgery a closer look
2011-2012 refractive surgery a closer look How the eye works Light rays enter the eye through the clear cornea, pupil and lens. These light rays are focused directly onto the retina, the light-sensitive
More informationReferrals to the Wills Eye Institute Cornea Service after laser in situ keratomileusis: Reasons for patient dissatisfaction
ARTICLE Referrals to the Wills Eye Institute Cornea Service after laser in situ keratomileusis: Reasons for patient dissatisfaction Brett A. Levinson, MD, Christopher J. Rapuano, MD, Elisabeth J. Cohen,
More informationINFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK)
Lasik Center 2445 Broadway Quincy, IL 62301 217-222-8800 INFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK) INTRODUCTION This information is being provided to you so that you can make an informed
More informationLASIK LASER VISION How LASIK works Myopia (Nearsightedness)
LASIK LASER VISION Are you seeking a Houston LASIK surgeon who is dedicated to excellence in ophthalmology? LASIK is a laser eye surgery procedure that can improve your vision and overall quality of life.
More informationLaser in situ keratomileusis for mixed astigmatism using a modified formula for bitoric ablation
European Journal of Ophthalmology / Vol. 18 no. 6, 2008 / pp. 869-876 Laser in situ keratomileusis for mixed astigmatism using a modified formula for bitoric ablation D. DE ORTUETA, C. HAECKER Augenlaserzentrum
More informationLASIK Eye Surgery Report
LASIK Eye Surgery Report LASIK eye surgery can be a liberating experience for people hoping to reduce or eliminate their dependence on glasses and contact lenses. Most patients do not realize how evolved
More informationConsumer s Guide to LASIK
Consumer s Guide to LASIK A Community Service Project brought to you by Price Vision Group Your Guide To A Successful LASIK Procedure The purpose of this educational guide is to help prospective patients
More informationLaser Vision Correction
The Austin Diagnostic Clinic Ophthalmology Department Laser Vision Correction Frequently Asked Questions Laser Vision Correction Frequently Asked Questions What is Laser Vision Correction? Laser vision
More informationExcimer Laser Refractive Surgery
Excimer Laser Refractive Surgery In the field of ophthalmology has achieved great technological advances and, undoubtedly, the most representative have focused on refractive surgery, which aims to eliminate
More informationWHAT IS A CATARACT, AND HOW IS IT TREATED?
4089 TAMIAMI TRAIL NORTH SUITE A103 NAPLES, FL 34103 TELEPHONE (239) 262-2020 FAX (239) 435-1084 DOES THE PATIENT NEED OR WANT A TRANSLATOR, INTERPRETOR OR READER? YES NO TO THE PATIENT: You have the right,
More informationINFORMED CONSENT LASER IN SITU KERATOMILEUSIS (LASIK)
Edward C. Wade, M. D Christopher D. Allee, O. D. Ting Fang-Suarez, M. D. Jill Autry, O. D. Mark L. Mayo, M. D. Amanda Bachman, O. D. Randall N. Reichle, O. D Julie Ngo, O. D. INFORMED CONSENT LASER IN
More informationInformed Consent Enhancement Laser In Situ Keratomileusis (Lasik)
Edward C. Wade, M. D Christopher D. Allee, O. D. Ting Fang-Suarez, M. D. Jill Autry, O. D. Mark L. Mayo, M. D. Amanda Bachman, O. D. Randall N. Reichle, O. D. Julie Ngo, O. D. 6565 West Loop South Suite
More informationWhat now, when Presbyopia sets in? Minoru Tomita, MD, PhD Executive Director Shinagawa LASIK Center, Tokyo, JAPAN
What now, when Presbyopia sets in? Minoru Tomita, MD, PhD Executive Director, Tokyo, JAPAN Financial disclosure Travel expenses for the ASCRS meeting were paid by Ziemer and AcuFocus, Inc. Presbyopia:
More informationREFRACTIVE ERROR AND SURGERIES IN THE UNITED STATES
Introduction REFRACTIVE ERROR AND SURGERIES IN THE UNITED STATES 150 million wear eyeglasses or contact lenses 2.3 million refractive surgeries performed between 1995 and 2001 Introduction REFRACTIVE SURGERY:
More informationbringing life into focus
bringing life into focus Our Vision Serves To Enhance Yours Every day, you participate in activities that require focused vision. Whether it s reading a newspaper, driving a car or hitting a golf ball,
More informationLaser-assisted In Situ Keratomileusis for Correction of Astigmatism and Increasing Contact Lens Tolerance after Penetrating Keratoplasty
pissn: -9 eissn: 9-9 Korean J Ophthalmol ;(5):59- http://dx.doi.org/./kjo...5.59 Original Article Laser-assisted In Situ Keratomileusis for Correction of Astigmatism and Increasing Contact Lens Tolerance
More informationIntraLase Corp. Clinical Studies Fact Sheet
Page 1 of 12 Contact: Liana Miller (949) 595-4320 liana@goolsbygroup.com IntraLase Corp. Clinical Studies Fact Sheet Clinical data validates IntraLase as a superior technology for creating corneal flaps
More information...You Need to know about
What......You Need to know about LASIK Our Eyes Eyes are the windows to our world. They are so important to us that for many years we have looked for better ways to fix visual problems and improve our
More informationTHE GUIDE TO REFRACTIVE LENS EXCHANGE SEE CLEARLY.
THE GUIDE TO REFRACTIVE LENS EXCHANGE SEE CLEARLY. EVERYBODY WANTS TO SEE CLEARLY Many of us take our sight for granted, whether it s forgetting how often we rely on it to guide us through our day-to-day
More informationSimple regression formula for intraocular lens power adjustment in eyes requiring cataract surgery after excimer laser photoablation
J CATARACT REFRACT SURG - VOL 32, MARCH 26 Simple regression formula for intraocular lens power adjustment in eyes requiring cataract surgery after excimer laser photoablation Samuel Masket, MD, Seth Everett
More informationSupraCor Lasik Treatment for Presbyopia
Review Article SupraCor Lasik Treatment for Presbyopia 1 * 1 Al Hindia general hospital, Kerbala, Iraq Abstract P resbyopia, the gradual loss of accommodation that becomes clinically significant during
More informationCross-Linking with Refractive Surgery: Pros and Cons
Cross-Linking with Refractive Surgery: Pros and Cons Raj K. Rajpal, M.D. Medical Director and Founder See Clearly Vision Group Mclean, Virginia Clinical Associate Professor Georgetown University Washington,
More informationConsent for LASIK (Laser In Situ Keratomileusis) Retreatment
Consent for LASIK (Laser In Situ Keratomileusis) Retreatment Please read the following consent form very carefully. Please initial at the bottom of each page where indicated. Do not sign this form unless
More informationCommon Co-management Questions
Issue 037 efocus Innovation. Leadership. Passion for Perfection 415.922.9500 --- www.pacificvision.org Common Co-management Questions Top questions recently asked by optometrists co-managing refractive
More informationLong-term Outcomes of Photorefractive Keratectomy for Anisometropic Amblyopia in Children
Long-term Outcomes of Photorefractive Keratectomy for Anisometropic Amblyopia in Children Evelyn A. Paysse, MD, David K. Coats, MD, Mohamed A. W. Hussein, MD, M. Bowes Hamill, MD, Douglas D. Koch, MD Purpose:
More informationINTRACOR. An excerpt from the presentations by Dr Luis Ruiz and Dr Mike Holzer and the Round Table discussion moderated by Dr Wing-Kwong Chan in the
INTRACOR An excerpt from the presentations by Dr Luis Ruiz and Dr Mike Holzer and the Round Table discussion moderated by Dr Wing-Kwong Chan in the 1 Dr Luis Ruiz Presbyopia treatment with INTRACOR Luis
More informationsignificantly different from that of sequential treatments. Methods: Data were obtained from 254 consecutive patients that were
PROSPECTIVE, RANDOMIZED COMPARISON OF SIMULTANEOUS AND SEQUENTIAL BILATERAL LASIK FOR THE CORRECTION OF MYOPIA* BY G. 0. Waring III, MD, FACS, FRCOPHTH, J. D. Carr, MD, MA, FRCOPHTH, R. D. Stulting, MD,
More informationStandardized Analyses of Correction of Astigmatism With the Visian Toric Phakic Implantable Collamer Lens
Standardized Analyses of Correction of Astigmatism With the Visian Toric Phakic Implantable Collamer Lens Donald R. Sanders, MD, PhD; Edwin J. Sarver, PhD ABSTRACT PURPOSE: To demonstrate the methodology
More informationAnterior Elevation Maps as the Screening Test for the Ablation Power of Previous Myopic Refractive Surgery
Anterior Elevation Maps as the Screening Test for the Ablation Power of Previous Myopic Refractive Surgery Soo Yong Jeong, MD, Hee-Seung Chin, MD, PhD, Jung Hyub Oh, MD, PhD Department of Ophthalmology,
More informationThe Efficacy of Multi-Zone Cross-Cylinder Method for Astigmatism Correction
Korean J Ophthalmol Vol. 18:29-34, 2004 The Efficacy of Multi-Zone Cross-Cylinder Method for Astigmatism Correction Seong Joo Shin, MD, Hae Young Lee, MD Department of Ophthalmology, Seoul Adventist Hospital,
More informationLASIK and PRK in refractive accommodative esotropia: a retrospective study on 20 adolescent and adult patients
European Journal of Ophthalmology / Vol. 19 no. 2, 2009 / pp. 188-195 LASIK and PRK in refractive accommodative esotropia: a retrospective study on 20 adolescent and adult patients ADRIANO MAGLI 1, ANTONELLO
More informationWavefront technology has been used in our
Wavefront Customized Ablations With the WASCA Asclepion Workstation Sophia I. Panagopoulou, BSc; Ioannis G. Pallikaris, MD ABSTRACT PURPOSE: WASCA (Wavefront Aberration Supported Cornea Ablation) is a
More informationALTERNATIVES TO LASIK
EYE PHYSICIANS OF NORTH HOUSTON 845 FM 1960 WEST, SUITE 101, Houston, TX 77090 Office: 281 893 1760 Fax: 281 893 4037 INFORMED CONSENT FOR LASER IN-SITU KERATOMILEUSIS (LASIK) INTRODUCTION This information
More information