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Sample records for wavefront-guided photorefractive keratectomy

  1. Corneal-Wavefront guided transepithelial photorefractive keratectomy after corneal collagen cross linking in keratoconus

    OpenAIRE

    Camellin, Massimo; Guidotti, Jacopo Maria; Arba Mosquera, Samuel

    2016-01-01

    Purpose To evaluate the efficacy and safety of Corneal-Wavefront guided transepithelial photorefractive keratectomy (TransPRK) after corneal collagen cross linking (CXL) in keratoconic patients. Methods In this retrospective, non-comparative, consecutive case series, 39 keratoconic eyes underwent Corneal-Wavefront guided TransPRK for the correction of aberrations at least 4 months after conventional CXL at SEKAL Rovigo Microsurgery Centre, Rovigo, Italy. Two eyes (5%) underwent a secondary la...

  2. Corneal-Wavefront guided transepithelial photorefractive keratectomy after corneal collagen cross linking in keratoconus.

    Science.gov (United States)

    Camellin, Massimo; Guidotti, Jacopo Maria; Arba Mosquera, Samuel

    To evaluate the efficacy and safety of Corneal-Wavefront guided transepithelial photorefractive keratectomy (TransPRK) after corneal collagen cross linking (CXL) in keratoconic patients. In this retrospective, non-comparative, consecutive case series, 39 keratoconic eyes underwent Corneal-Wavefront guided TransPRK for the correction of aberrations at least 4 months after conventional CXL at SEKAL Rovigo Microsurgery Centre, Rovigo, Italy. Two eyes (5%) underwent a secondary laser retreatment for the improvement of post-operative visual acuity and were not included in this retrospective analysis. The mean age of the patients was 35±12 years (19-64 years) at the time of the surgery. Keratron-Scout (Optikon) topographer was used for diagnostic tests and a flying-spot laser (AMARIS; SCHWIND eye-tech-solutions) was used for the refractive surgery. Complete ophthalmic examinations were performed before and after the surgery (4-36 months postoperatively with a mean follow up time of 10±8 months). Preoperatively, eyes showed irregular astigmatism up to 8D. At last postoperative follow-up, 21 eyes (57%) had UDVA better than 20/40, and six eyes (16%) had UDVA of 20/20. Twenty-three eyes (62%) were within 1.50D of attempted correction in spherical equivalent (mean deviation from target was +1.09±2.36D, range -2.50 to +7.38D). No eye lost 2 Snellen lines of CDVA, and 15 eyes (41%) had an increase of more than 2 lines. Corneal-Wavefront guided transepithelial PRK ablation profiles after conventional CXL yields to good visual, optical, and refractive results. These treatments are safe and efficacious for the correction of refracto-therapeutic problems in keratoconic patients. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  3. Photorefractive Keratectomy in Keratoconus

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    Deepali Sandeep Tambe

    2015-08-01

    Full Text Available Purpose: To assess the efficacy and safety of topography-guided photorefractive keratectomy (PRK for keratoconus and to estimate the subsequent risk of progression. Methods: This is a retrospective follow-up study. Between 1998 and 2013, 28 eyes of 23 patients (age 17-60 with grade 1-3 keratoconus received topography-guided PRK. Corrected-distance visual acuity (CDVA, keratometry, pachymetry, and corneal topography were assessed before, after 3 months, and at a late follow-up of a median of 7 years after the procedure. Postoperative complications including subsequent keratoplasty were noted. Results: Of the 28 eyes, 5 (18% had undergone corneal transplantation at a median of 7 years (range 3-10 after PRK. Four eyes were not available for follow-up. In the remaining 19 eyes, CDVA was improved in 16 eyes (84.3%, reduced in 2 eyes (10.5%, and unchanged in 1 eye (5.2%. Thus, average CDVA had improved from 0.49 logMAR before PRK to 0.27 logMAR at 3 months, and to 0.24 at the long-term follow-up. The mean spherical equivalent was reduced from -6.2 to -3.7 dpt after 3 months and to -2.1 dpt at the late follow-up. Similarly, the mean cylinder was reduced from -4.2 to -3.0 dpt after 3 months and at the late follow-up. Conclusion: Topography-guided PRK in keratoconus may be effective for reducing myopia and astigmatism and may offer a temporary or permanent alternative to keratoplasty in contact lens-intolerant keratoconus. In the present study, we found a low risk of keratoconus progression after PRK.

  4. Contact lens fitting after photorefractive keratectomy.

    OpenAIRE

    Astin, C. L.; Gartry, D S; McG Steele, A. D.

    1996-01-01

    AIMS/BACKGROUND: This study evaluated contact lens fitting and the longer term response of the photorefractive keratectomy (PRK) cornea to lens wear. In PRK for myopia problems such as regression, anterior stromal haze, irregular astigmatism, halo aberration, and anisometropia have been reported. Certain patients therefore require contact lens correction to obtain best corrected visual acuity (BCVA). METHOD: From an original cohort of 80 patients, 15 were dissatisfied with their visual outcom...

  5. Corneal Regeneration After Photorefractive Keratectomy: A Review☆

    Science.gov (United States)

    Tomás-Juan, Javier; Murueta-Goyena Larrañaga, Ane; Hanneken, Ludger

    2014-01-01

    Photorefractive keratectomy (PRK) remodels corneal stroma to compensate refractive errors. The removal of epithelium and the ablation of stroma provoke the disruption of corneal nerves and a release of several peptides from tears, epithelium, stroma and nerves. A myriad of cytokines, growth factors, and matrix metalloproteases participate in the process of corneal wound healing. Their balance will determine if reepithelization and stromal remodeling are appropriate. The final aim is to achieve corneal transparency for restoring corneal function, and a proper visual quality. Therefore, wound-healing response is critical for a successful refractive surgery. Our goal is to provide an overview into how corneal wounding develops following PRK. We will also review the influence of intraoperative application of mitomycin C, bandage contact lenses, anti-inflammatory and other drugs in preventing corneal haze and post-PRK pain. PMID:25444646

  6. Corneal Regeneration After Photorefractive Keratectomy: A Review.

    Science.gov (United States)

    Tomás-Juan, Javier; Murueta-Goyena Larrañaga, Ane; Hanneken, Ludger

    2015-01-01

    Photorefractive keratectomy (PRK) remodels corneal stroma to compensate refractive errors. The removal of epithelium and the ablation of stroma provoke the disruption of corneal nerves and a release of several peptides from tears, epithelium, stroma and nerves. A myriad of cytokines, growth factors, and matrix metalloproteases participate in the process of corneal wound healing. Their balance will determine if reepithelization and stromal remodeling are appropriate. The final aim is to achieve corneal transparency for restoring corneal function, and a proper visual quality. Therefore, wound-healing response is critical for a successful refractive surgery. Our goal is to provide an overview into how corneal wounding develops following PRK. We will also review the influence of intraoperative application of mitomycin C, bandage contact lenses, anti-inflammatory and other drugs in preventing corneal haze and post-PRK pain. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  7. Changes in stereopsis after photorefractive keratectomy.

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    Jabbarvand, Mahmoud; Hashemian, Hesam; Khodaparast, Mehdi; Anvari, Pasha

    2016-06-01

    To evaluate the effects of photorefractive keratectomy (PRK) on the stereopsis of myopic and hyperopic patients. Farabi Eye Hospital, Tehran, Iran. Prospective case series. This study included patients having PRK to achieve emmetropia. The patients were divided into the following 3 groups: low myopia (-6.0 D), and hyperopia (<+4.0 D). Near stereoacuity was measured using the Randot test under photopic conditions (with corrective glasses) at 40 cm preoperatively (with corrective glasses) and 1, 3, and 12 months postoperatively. Repeated-measure analysis of variance was used to assess changes in stereopsis over time in the 3 groups. Each group comprised 60 patients. The mean preoperative stereoacuity was 121.16 seconds of arc (arcsec) ± 149.92 (SD), improving to 83.66 ± 75.84 arcsec 1 month postoperatively and 80.66 ± 64.31 arcsec at 3 months (both P < .001). It remained unchanged (83.33 ± 75.01 arcsec) at 12 months (P = .610). Patients with high myopia had the greatest improvement in stereopsis after PRK compared with low myopic and hyperopic patients (P < .001). The improvement in stereoacuity was significantly higher in the severe anisometropic group; the lowest improvement was in the group without anisometropia. Photorefractive keratectomy could result in an improvement in stereopsis. Patients with high myopia benefitted most from PRK in terms of improvement in stereopsis. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  8. IOLMaster versus Manual Keratometry after Photorefractive Keratectomy

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    Hasan Razmju

    2011-01-01

    Full Text Available Purpose: To compare keratometric measurements using a Javal type manual keratometer with IOLMaster in eyes undergoing photorefractive keratectomy (PRK for myopia. Methods: In this comparative case series, we studied patients aged 21 to 27 years scheduled for myopic PRK. Keratometry was performed preoperatively and three months after the procedure using a Javal type manual keratometer and the IOLMaster. We compared postoperative measurements obtained by both instruments with the clinical history method (CHM. Results: Seventy eyes of 35 patients with mean age of 23.45±1.55 years were studied. Mean preoperative spherical equivalent was -4.53±1.3 D. Average preoperative IOLMaster and manual keratometric readings were 45.95±1.23 D and 46.32±1.18 D, respectively. Postoperatively, mean IOLMaster measurements was 38.03±0.68 D and that of manual keratometry was 43.15±1.1 D. Compared to CHM measurements, the 95% limits of agreement were ‑5.95 to -0.85 for the IOLMaster and -1.44 to 4.04 for manual keratometry. Conclusion: Keratometric measurements with the IOLMaster and a Javal type manual device are comparable after PRK; both are largely deviant from the CHM and can yield misleading results.

  9. Describing the Corneal Shape after Wavefront-Optimized Photorefractive Keratectomy

    NARCIS (Netherlands)

    de Jong, Tim; Wijdh, Robert H. J.; Koopmans, Steven A.; Jansonius, Nomdo M.

    2014-01-01

    PURPOSE: To develop a procedure for describing wavefront-optimized photorefractive keratectomy (PRK) corneas and to characterize PRK-induced changes in shape. METHODS: We analyzed preoperative and postoperative corneal elevation data of 41 eyes of 41 patients (mean [±SD] age, 38 [±11] years) who

  10. Transepithelial photorefractive keratectomy for low to moderate myopia in comparison with conventional photorefractive keratectomy

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    Mostafa Naderi

    2016-01-01

    Full Text Available Purpose: To compare the effectiveness, safety and stability of the results of transepithelial photorefractive keratectomy (tPRK with conventional photorefractive keratectomy (PRK for low to moderate myopia. Methods: In this prospective non-randomized case-control study, patients with low to moderate myopia were assigned to the tPRK group (cases or the PRK group (controls. In the tPRK group, eyes were treated using the Amaris excimer laser (SCHWIND eye-tech-solutions GmbH and Co. KG, Germany. Outcome measures included postoperative pain using McGill Pain Questionnaire, epithelial healing time, uncorrected visual acuity (UCVA, best corrected visual acuity (BCVA, manifest refraction, and safety and efficacy indexes which were compared between the study groups. Results: Three hundred forty eyes of 170 patients were enrolled in this study. Each study group comprised of 170 eyes of 85 patients. There was a significant difference between the two groups regarding the postoperative pain scores in favor of the tPRK group (P = 0.04. The tPRK group had a shorter epithelial healing time than the conventional PRK group postoperatively (P = 0.01. Mean UCVA was significantly better in the case group than in the control group at the postoperative month 2 (P = 0.01. Regarding the safety and efficacy indexes, the tPRK group had better results than the conventional PRK group (P < 0.01 for both comparisons. Conclusion: Transepithelial PRK seems to be superior to conventional PRK for treatment of low to moderate myopia in terms of postoperative pain, epithelial healing time, visual recovery and safety and efficacy indexes.

  11. Prospective, randomized, fellow eye comparison of WaveLight® Allegretto Wave® Eye-Q versus VISX CustomVueTM STAR S4 IRTM in photorefractive keratectomy: analysis of visual outcomes and higher-order aberrations

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    Sikder S

    2011-08-01

    Full Text Available Majid Moshirfar1, Daniel S Churgin2, Brent S Betts3, Maylon Hsu1, Shameema Sikder4, Marcus Neuffer1, Dane Church5, Mark D Mifflin11University of Utah, John A Moran Eye Center, Department of Ophthalmology and Visual Sciences, Salt Lake City, UT, USA; 2University of Arizona College of Medicine, Phoenix, AZ; 3Temple University School of Medicine, Philadelphia, PA, USA; 4Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA; 5Virginia Commonwealth University School of Medicine, Richmond, VA, USABackground: The purpose of this study was to compare differences in visual outcomes, higher-order aberrations, contrast sensitivity, and dry eye in patients undergoing photorefractive keratectomy using wavefront-guided VISX CustomVue™ and wavefront-optimized WaveLight® Allegretto platforms.Methods: In this randomized, prospective, single-masked, fellow-eye study, photorefractive keratectomy was performed on 46 eyes from 23 patients, with one eye randomized to WaveLight Allegretto, and the fellow eye receiving VISX CustomVue. Three-month postoperative outcome measures included uncorrected distance visual acuity, corrected distance visual acuity, refractive error, root mean square of total and grouped higher-order aberrations, contrast sensitivity, and Schirmer’s testing.Results: Mean values for uncorrected distance visual acuity (logMAR were —0.03 ± 0.07 and —0.06 ± 0.09 in the wavefront-optimized and wavefront-guided groups, respectively (P = 0.121. Uncorrected distance visual acuity of 20/20 or better was achieved in 91% of eyes receiving wavefront-guided photorefractive keratectomy, and 87% of eyes receiving wavefront-optimized photorefractive keratectomy, whereas uncorrected distance visual acuity of 20/15 was achieved in 35% of the wavefront-optimized group and 64% of the wavefront-guided group (P ≥ 0.296. While root mean square of total higher-order aberration, coma, and trefoil tended to increase in the wavefront

  12. Use of loteprednol for routine prophylaxis after photorefractive keratectomy

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    Moshirfar M

    2012-05-01

    Full Text Available Mark D Mifflin1, Lisa L Leishman1, Steven M Christiansen1, Shameema Sikder2, Maylon Hsu1, Majid Moshirfar11Department of Ophthalmology, John A Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, 2Wilmer Eye Institute, Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD, USABackground: The purpose of this work is to report our experience using loteprednol 0.5% for routine prophylaxis after photorefractive keratectomy in an academic refractive surgery center.Materials and methods: Photorefractive keratectomy was performed on 579 eyes from 316 patients in this retrospective chart review of patients treated postoperatively with either fluorometholone 0.1% (273 eyes or loteprednol 0.5% (306 eyes. Primary outcome measures at 6 months included uncorrected distance visual acuity, corrected distance visual acuity, and manifest refraction spherical equivalent. Secondary outcome measures were incidence of corneal haze and increased intraocular pressure.Results: There were no statistically significant differences in preoperative characteristics between the two groups when comparing age, sex, best-corrected visual acuity, spherical equivalent, or keratometry. Both groups achieved excellent visual outcomes, with a mean uncorrected distance visual acuity (logMAR of 0.004 ± 1.4 in the fluorometholone group and –0.028 ± 1.1 in the loteprednol group (P = 0.013 at 6 months. Postoperative corneal haze and increased intraocular pressure were uncommon and not statistically different between the groups.Conclusion: Loteprednol 0.5% performed similarly to fluorometholone 0.1% when used for prophylaxis following photorefractive keratectomy. The incidence of haze and increased intraocular pressure were similar between the two groups.Keywords: loteprednol, fluorometholone, photorefractive keratectomy

  13. Use of loteprednol for routine prophylaxis after photorefractive keratectomy

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    Mifflin, Mark D; Leishman, Lisa L; Christiansen, Steven M; Sikder, Shameema; Hsu, Maylon; Moshirfar, Majid

    2012-01-01

    Background The purpose of this work is to report our experience using loteprednol 0.5% for routine prophylaxis after photorefractive keratectomy in an academic refractive surgery center. Materials and methods Photorefractive keratectomy was performed on 579 eyes from 316 patients in this retrospective chart review of patients treated postoperatively with either fluorometholone 0.1% (273 eyes) or loteprednol 0.5% (306 eyes). Primary outcome measures at 6 months included uncorrected distance visual acuity, corrected distance visual acuity, and manifest refraction spherical equivalent. Secondary outcome measures were incidence of corneal haze and increased intraocular pressure. Results There were no statistically significant differences in preoperative characteristics between the two groups when comparing age, sex, best-corrected visual acuity, spherical equivalent, or keratometry. Both groups achieved excellent visual outcomes, with a mean uncorrected distance visual acuity (logMAR) of 0.004 ± 1.4 in the fluorometholone group and −0.028 ± 1.1 in the loteprednol group (P = 0.013) at 6 months. Postoperative corneal haze and increased intraocular pressure were uncommon and not statistically different between the groups. Conclusion Loteprednol 0.5% performed similarly to fluorometholone 0.1% when used for prophylaxis following photorefractive keratectomy. The incidence of haze and increased intraocular pressure were similar between the two groups. PMID:22570546

  14. Photorefractive keratectomy in the cat eye: biological and optical outcomes.

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    Nagy, Lana J; MacRae, Scott; Yoon, Geunyoung; Wyble, Matthew; Wang, Jianhua; Cox, Ian; Huxlin, Krystel R

    2007-06-01

    To quantify optical and biomechanical properties of the feline cornea before and after photorefractive keratectomy (PRK) and assess the relative contribution of different biological factors to refractive outcome. Department of Ophthalmology, University of Rochester, Rochester, New York, USA. Adult cats had 6.0 diopter (D) myopic or 4.0 D hyperopic PRK over 6.0 or 8.0 mm optical zones (OZ). Preoperative and postoperative wavefront aberrations were measured, as were intraocular pressure (IOP), corneal hysteresis, the corneal resistance factor, axial length, corneal thickness, and radii of curvature. Finally, postmortem immunohistochemistry for vimentin and alpha-smooth muscle actin was performed. Photorefractive keratectomy changed ocular defocus, increased higher-order aberrations, and induced myofibroblast differentiation in cats. However, the intended defocus corrections were only achieved with 8.0 mm OZs. Long-term flattening of the epithelial and stromal surfaces was noted after myopic, but not after hyperopic, PRK. The IOP was unaltered by PRK; however, corneal hysteresis and the corneal resistance factor decreased. Over the ensuing 6 months, ocular aberrations and the IOP remained stable, while central corneal thickness, corneal hysteresis, and the corneal resistance factor increased toward normal levels. Cat corneas exhibited optical, histological, and biomechanical reactions to PRK that resembled those previously described in humans, especially when the OZ size was normalized to the total corneal area. However, cats exhibited significant stromal regeneration, causing a return to preoperative corneal thickness, corneal hysteresis and the corneal resistance factor without significant regression of optical changes induced by the surgery. Thus, the principal effects of laser refractive surgery on ocular wavefront aberrations can be achieved despite clear interspecies differences in corneal biology.

  15. Intrastromal photorefractive keratectomy with a new optically coupled laser probe.

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    Taboada, J; Poirier, R H; Yee, R W; Tio, F O

    1992-01-01

    Intrastromal photorefractive keratectomy is a new procedure in which compact linear or area regions of the corneal stroma can be vacuolized, yielding changes in corneal curvature. Diffraction-limited 1064-nanometer light pulses from a high rep rate Q-switched Nd-YAG laser were coupled through novel means into a probe with index-matched optical contact with the cornea. The resulting extremely reduced focal region initiated a plasma point that was free of shock front effects where tissue was reduced to liquid. This probe process was applied to the corneas of eye-bank eyes, and to living rabbit and primate eyes. The refractive effects were evaluated with slit-lamp microscopy, keratoscopy light and electron microscopy. Refractive effects similar to refractive keratotomy were observed immediately after treatment. Intrastromal highly localized vacuolized regions were observed at the depth of focus with variability of only 20 microns. The plasma point vacuoles were about 100 microns in diameter. Stromal material that occupied the vacuole space appeared completely reduced to liquid. The transition region between vacuole and normal tissue was less than 0.5 microns. The treatment vacuoles disappeared to the unaided eye 24 to 48 hours after treatment. Corneal refractive power can be achieved with intrastromal keratectomy.

  16. Screening of myopic photorefractive keratectomy in eye bank eyes by computerized videokeratography.

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    Lim-Bon-Siong, R; Williams, J M; Samapunphong, S; Chuck, R S; Pepose, J S

    1998-05-01

    In contrast to incisional keratotomy, corneas that have undergone photorefractive keratectomy may be difficult to detect by inspection with slitlamp biomicroscopy alone. Eye bank corneas that have undergone high myopic refractive surgical correction could potentially result in substantial postoperative hyperopic correction if used as donor tissue for corneal transplantation. Surface irregularities or displacement of the treated optical zone within the graft in relation to the entrance pupil of the recipient could result in significant induced astigmatism and distortion. This study examines computerized videokeratographic screening of eye bank globes as a strategy for detecting myopic photorefractive keratectomy. Preoperative and postoperative corneal topographic maps of freshly enucleated human and rabbit eyes that have undergone myopic photorefractive keratectomy with an excimer laser were placed in a globe-fixating device and analyzed using a vertically oriented videokeratoscope. The same system was applied in an actual eye bank setting, and potentially transplantable globes from donors without a history of corneal surgery were analyzed. Computerized videokeratography using a vertically mounted system reliably detected photorefractive keratectomy in 12 of 12 human eye bank corneas treated by excimer photorefractive keratectomy in a range between -1.5 to -6.0 diopters. This method also detected similar changes on lased rabbit corneas enucleated 6 weeks after excimer surgery. Data processed with the tangential mode yielded a "bull's-eye" topography pattern reflecting central corneal flattening that was more sensitive in detecting myopic corrections than the conventional axial formula-based color maps. False-positive results were not detected in 96 cadaver globes sequentially screened in the eye bank. Computerized videokeratography represents a feasible method to screen donor globes for myopic photorefractive keratectomy as shown by the in vitro and rabbit models

  17. Microbiological study of disposable soft contact lenses after photorefractive keratectomy.

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    Dantas, P E; Nishiwaki-Dantas, M C; Ojeda, V H; Holzchuh, N; Mimica, L J

    2000-01-01

    To evaluate the bacterial contamination of bandage disposable soft contact lenses used in patients following photorefractive keratectomy (PRK) and to correlate our findings with clinical data. Forty-six patients (81 eyes) underwent PRK. Immediately after each procedure, disposable soft contact lenses were positioned with sterile forceps. After 3 days, the lenses were removed in a sterile manner, placed in sterile Eppendorf pipettes containing 8 mL of enriched brain heart infusion broth, and analyzed for microbial contamination. Seven positive cultures were found: six gram positive cocci (7.4%) and one gram negative bacillus (1.2%). There was no clinical correlation with these findings. Isolated microorganisms were similar to those described in the literature as agents of bacterial keratitis and are components of the normal ocular flora. Klebsiela pneumoniae--considered an occasional or transient flora--was the exception. All isolated microorganisms but K. pneumoniae were sensitive to most of the antibiotics tested. Our findings suggest that the risk of infectious keratitis after PRK related to soft contact lens wear for 3 days seems to be low, which may be because lenses were not manipulated by the patient during the wearing period, and the postoperative antibiotic regimen was strictly followed by patients. However, care should be taken to instruct patients in proper lens care practices to reduce the risk of bacterial keratitis in contact lens wear following PRK.

  18. Epithelial healing and ocular discomfort after photorefractive keratectomy in children.

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    Paysse, Evelyn A; Hamill, M Bowes; Koch, Douglas D; Hussein, Mohamed A W; Brady McCreery, Kathryn M; Coats, David K

    2003-03-01

    To document the rate of healing of the corneal epithelial defect created by photorefractive keratectomy (PRK) and the degree of discomfort experienced by children treated with PRK. Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA. Ten patients between 3 and 10 years of age were treated with PRK for severe anisometropia. All had anisometropic amblyopia refractory to conventional therapy with glasses or contact lenses and occlusion therapy. The size of the corneal epithelial defect was documented daily until the defect healed completely. Postoperative discomfort was documented daily using a pain-assessment scale until the epithelial defect healed completely. Two children were treated with PRK for hyperopic anisometropia; the rest were treated for myopic anisometropia. Cumulatively, the corneal epithelium had healed completely by day 3 in 6 patients (60%), by day 4 in 9 patients (90%), and by day 5 in all patients. The mean healing time was 3.5 days. Patients experienced mild discomfort on the day of surgery and on the first postoperative day. They had minimal pain on day 2. After day 2, no patient reported pain or other discomfort. The corneal epithelial defect created by PRK healed promptly and was associated with minimal postoperative discomfort in children treated with the protocol described.

  19. Analysis of corneal esthesia in patients undergoing photorefractive keratectomy

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    Elmar Torres Neto

    2015-12-01

    Full Text Available ABSTRACT Purpose: To quantitatively analyze corneal esthesia in patients undergoing photorefractive keratectomy (PRK surgery. Methods: Forty-five patients selected for PRK in one eye underwent corneal esthesia using a Cochet-Bonnet esthesiometer preoperatively and 30 and 90 days postoperatively. Patients with a refractive diopter error of 4 or greater received intraoperative 0.02% mitomycin C for 20 s. Results: Twenty-four (53.3% of the 45 eyes received intraoperative 0.02% mitomycin. Decreased sensitivity was observed on postoperative day 30. By postoperative day 90, corneal esthesia had normalized but remained 14.9% lower than preoperative levels. In the mitomycin group, no recovery of corneal esthesia to normal sensitivity levels was observed. The mean esthesiometer level was 39.2 mm on postoperative day 90 (P<0.001. Conclusions: The results of the present study demonstrate recovery of corneal esthesia to normal levels at 90 days postoperatively in patients who did not receive mitomycin C. In patients administered mitomycin C, a 23.59% reduction in the corneal touch threshold was observed compared with preoperative levels indicating a failure of recovery to normal levels.

  20. Clinical observation of transepithelial photorefractive keratectomy for myopia

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    Xiao-Ning Yang

    2013-10-01

    Full Text Available AIM: To assess the effectiveness and safety of transepithelial photorefractive keratectomy(TransPRKusing the AMARIS laser platform. METHODS: Eighty myopic cases(156 eyeswith or without astigmatism were treated by TransPRK. In all eyes, treatments were planned with Custom Ablation Manager Software and ablations performed with the SCHWIND AMARIS system. Clinical outcomes of visual acuity, manifest refraction, intraocular pressure, and corneal topography were observed and analyzed. The follow-up period was one year.RESULTS: All patients completed the 1-year follow-up. After one-year follow-up, 47 cases(92 eyes, 58.8%achieved an uncorrected distance visual acuity(UDVA≥1.0. Twenty cases(40 eyes, 25%was 0.8 and 13 cases(24 eyes, 16.3%was 0.6. Sixty-three cases(121 eyes, 78.8%were close to or above best corrected visual acuity(BCVA. Seventeen cases(34 eyes, 21.2%were slightly lower than BCVA 1 row or two. Nine cases(18 eyes, 11.3%got dry eye postoperatively. 16 cases(32 eyes, 20%complain of glare and poor night vision. CONCLUSION: The results show that TransPRK for myopia with or without astigmatism is safe and effective. The postoperative visual outcomes are stable.

  1. [Photorefractive keratectomy in high myopic anisometropia in children].

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    Autrata, R; Rehůrek, J; Holousová, M

    1999-07-01

    The authors evaluate the results of photorefractive keratectomy in children with high myopic anisometropia proved by intolerance of a contact lens and intolerance of full correction by glasses. The objective was to maintain or improve the already achieved binocular vision without or with feasible correction by glasses. The group is formed by 13 children, mean age 11.5 years at the time of surgery (range 7-15 years). The mean preoperative value of myopia was -8.9 dpt (SE), within the range of -7.0 to -11.75 dpt (SE) on the operated eye. The preprequisite condition for surgery was confirmed intolerance of a contact lens, intolerance of complete correction by glasses and previous systematic pleoptic treatment with training of binocular functions. The operation was always implemented during hospitalization. The follow-up after surgery in all children of the group is more than 2 years. The mean value of the refraction defect two years after surgery is -1.12 dpt (SE). The mean non-corrected visual acuity improved from 0.021 before surgery to 0.48 two years after surgery and the mean best corrected visual acuity improved from 0.51 before surgery to 0.61 two years after surgery. The authors compare results of binocular functions before and after operation. Two years after surgery all children had superposition and a normal Bagolini test, 12 children had fusion I, 9 children fusion II, and 6 children fusion III and stereopsis. Based on the results of the trial PRK appears to be an effective and safe method for correction of high myopic anisometropia in intolerance of contact lenses or complete correction by glasses. This operation thus makes it possible to preserve further the degree of binocular vision practised in advance or to improve it. This is the first group, though small, of thus treated children published in our professional literature.

  2. Alcohol-assisted versus Mechanical Epithelium Removal in Photorefractive Keratectomy

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    Mohammad Ghoreishi,

    2010-01-01

    Full Text Available Purpose: To compare the outcomes and complications of alcohol-assisted versus mechanical corneal epithelial debridement for photorefractive keratectomy (PRK. Methods: This randomized controlled trial included 1,250 eyes of 625 patients undergoing PRK for correction of myopia and myopic astigmatism. Each patient was randomly assigned to alcohol-assisted or mechanical epithelial removal. Results: A total of 658 eyes underwent alcohol-assisted epithelial removal while the epithelium was removed mechanically in 592 eyes. Mean spherical equivalent was ‑4.37}2.3 D in the alcohol group and ‑3.8}1.3 D in the mechanical group (P = 0.78. There was no significant difference in postoperative pain between the study groups (P = 0.22. Uncorrected visual acuity ≥ 20/20 and ≥ 20/40 was achieved in 90.9% versus 93.4% (P = 0.08, and 98.9% versus 99.5% (P = 0.36 of eyes in the alcohol and mechanical groups, respectively. Final refractive error within 1D of emmetropia was achieved in 90% versus 92.2% of eyes in the alcohol and mechanical groups, respectively (P = 0.23. Alcohol-assisted debridement required less time than mechanical debridement (96±18 vs. 118±26 seconds, P=0.035. There was no significant difference between the two groups in terms of early and late postoperative complications. Conclusion: Alcohol-assisted and mechanical epithelium removal are comparable in terms of efficacy and side effects. The method of epithelial debridement in PRK may be left to the surgeon′s choice.

  3. Effect of Mitomycin C on Myopic versus Astigmatic Photorefractive Keratectomy

    Directory of Open Access Journals (Sweden)

    Ashwag A. Almosa

    2017-01-01

    Full Text Available Purpose. Long-term mitomycin C (MMC effects on photorefractive keratectomy (PRK were compared in simple myopic and astigmatic patients. Methods. In this observational cohort study, subjects were selected based on preoperative and postoperative data collected from medical records; they were divided into simple myopia with/without MMC and myopic astigmatism with/without MMC groups. Haze, uncorrected visual acuity (UCVA, best-corrected visual acuity (BCVA, subjective refraction, and K-reading were evaluated at 1-, 3-, 6-, and 12-month follow-ups. Results. One hundred fifty-nine eyes of 80 subjects (34 women and 46 men; mean age, 26.81 ± 7.74 years; range, 18–53 years; spherical powers, −0.50 to −8.00 DS; and cylindrical powers, −0.25 to −5.00 DC were enrolled. One year postoperatively, the simple myopia with/without MMC groups showed no difference in UCVA (P=0.187, BCVA (P=0.163, or spherical equivalent (P=0.163 and a significant difference (P=0.0495 in K-reading; the haze formation difference was nonsignificant (P=0.056. Astigmatic groups with/without MMC showed a significant difference in K-reading (P<0.0001. MMC groups had less haze formation (P<0.0001. Conclusion. PRK with intraoperative MMC application showed excellent visual outcomes. MMC’s effect on astigmatic patients was significantly better with acceptable safety and minimal side effects.

  4. Nodular Epithelial Hyperplasia after Photorefractive Keratectomy Followed by Corneal Collagen Cross-Linking

    Directory of Open Access Journals (Sweden)

    Ayla Bogoni

    2013-01-01

    Full Text Available This study describes a case of nodular epithelial hyperplasia and stromal alterations in a patient with keratoconus who was submitted to topography-guided photorefractive keratectomy (PRK followed by corneal collagen cross-linking. Debridement of the epithelial nodule was performed. After a 2-year followup, a new topography-guided PRK was indicated.

  5. Keratopathy and pachymetric changes after photorefractive keratectomy and vitrectomy with silicone oil injection

    DEFF Research Database (Denmark)

    Buch, H; Vesti Nielsen, N

    2000-01-01

    We present a man who, after bilateral excimer laser photorefractive keratectomy (PRK) for high myopia in the right eye, had repeated retinal detachment surgery with lensectomy and injection of silicone oil. Visual acuity fluctuated in accordance with significant central corneal thickness diurnal...

  6. Comparative study of two silicone hydrogel contact lenses used as bandage contact lenses after photorefractive keratectomy

    OpenAIRE

    Hasan Razmjoo; Elham Abdi; Sayna Atashkadi; Reza, Akhlaghi M; Peyman A Reza; Mojtaba Akbari

    2012-01-01

    Background: Silicon hydrogel bandage contact lenses are used to enhance epithelial healing, control surface-generated pain, and prevent epithelial erosions after refractive surgery. Considering the importance of faster reepithelialization in preventing complications of photorefractive keratectomy (PRK) and the fact that the features and specifications of these commercially-available lenses are different and their performance as a postoperative bandage lenses would be different also, the aim o...

  7. Comparative Study of Two Silicone Hydrogel Contact Lenses used as Bandage Contact Lenses after Photorefractive Keratectomy

    OpenAIRE

    Razmjoo, Hasan; Abdi, Elham; Atashkadi, Sayna; Reza, Akhlaghi M; Peyman A Reza; Akbari, Mojtaba

    2012-01-01

    Background: Silicon hydrogel bandage contact lenses are used to enhance epithelial healing, control surface-generated pain, and prevent epithelial erosions after refractive surgery. Considering the importance of faster reepithelialization in preventing complications of photorefractive keratectomy (PRK) and the fact that the features and specifications of these commercially-available lenses are different and their performance as a postoperative bandage lenses would be different also, the aim o...

  8. Customized photorefractive keratectomy for the correction of regular and irregular astigmatism after penetrating keratoplasty.

    Science.gov (United States)

    Ohno, Kenji

    2011-10-01

    To report visual, wavefront, and topographic outcomes in 5 post-penetrating keratoplasty patients who underwent customized aspheric topography-guided photorefractive keratectomy for high astigmatism or severe higher-order aberrations. A chart review was performed for data collection. The custom aspheric transition zone ablation algorithm (CATz) with the CX III excimer was used for all treatments. Ablations were calculated based on corneal elevation data. Phototherapeutic keratectomy was the first step of the procedure. Visual acuity, corneal higher-order wavefront aberrations (Zernike sixth order and 4-mm diameter), corneal topography, and patient satisfaction were evaluated preoperatively and at the last visit postoperatively (range, 3 months to 4.5 years). The paired t test was used for statistical comparison of higher-order aberrations, with P astigmatism after penetrating keratoplasty.

  9. Comparison of visual and refractive results after transepithelial and mechanical photorefractive keratectomy in myopia.

    Science.gov (United States)

    Yildirim, Yusuf; Olcucu, Onur; Alagoz, Nese; Agca, Alper; Karakucuk, Yalcin; Demirok, Ahmet

    2017-03-27

    To compare postoperative visual outcomes and higher-order aberrations (HOAs) following transepithelial photorefractive keratectomy (t-PRK) and mechanical photorefractive keratectomy (m-PRK). The medical records of patients who underwent photorefractive keratectomy (PRK) were retrospectively evaluated. Forty-five patients were treated with m-PRK, and 45 were treated with t-PRK. Visual acuity, subjective manifest refraction, and corneal topography were analyzed before surgery and 12 months after surgery for both groups. Total HOAs, spherical, coma, and trefoil aberrations were derived from topography data over the 6-mm corneal zone. In the m-PRK group, the mean preoperative spherical equivalence (SE) changed from -3.15 ± 0.70 D preoperatively to -0.24 ± 0.70 D 1 year postoperatively. Likewise, SE decreased from -3.36 ± 0.63 to -0.25 ± 0.63 D in the t-PRK group 1 year after the surgery. The number of eyes within ± 0.50 D of the target refraction was 89% for m-PRK and 87% for t-PRK groups (p = 0.20). Eighty-four percentage of eyes in the t-PRK group and 80% of eyes in the m-PRK group showed an uncorrected distance visual acuity of 20/25 or better (p = 0.24). Total HOAs, spherical aberration, coma, and trefoil aberrations increased in both groups after surgery, but no statistically significant differences were detected postoperatively among the corneal aberrations. t-PRK and m-PRK result in comparable refractive results for the correction of low and moderate myopia. Corneal aberrations induced by t-PRK and m-PRK were similar. Epithelial removal techniques do not affect visual, refractive results, or HOAs in PRK.

  10. Preliminary results of VISX excimer laser myopic photorefractive keratectomy at Cedars-Sinai Medical Center

    Science.gov (United States)

    Maguen, Ezra I.; Berlin, Michael S.; Hofbauer, John; Macy, Jonathan I.; Nesburn, Anthony B.; Papaioannou, Thanassis; Salz, James J.

    1992-08-01

    Sixty-two eyes underwent excimer laser photorefractive keratectomy (PRK) for the correction of myopia at Cedars-Sinai-Medical-Center. The first group of 12 patients are presented with follow up data of ten months postoperatively. The second group of 50 patients are presented with follow up data of three months postoperatively. An in-depth comparison of pre and postoperative refractive data is presented. Comparisons between pre and postoperative corrected and uncorrected Snellen visual acuities are provided in order to asses the functional visual result of the procedure.

  11. Laser-assisted subepithelial keratectomy (LASEK) versus photorefractive keratectomy (PRK) for correction of myopia.

    Science.gov (United States)

    Li, Shi-Ming; Zhan, Siyan; Li, Si-Yuan; Peng, Xiao-Xia; Hu, Jing; Law, Hua Andrew; Wang, Ning-Li

    2016-02-22

    Myopia (near-sightedness or short-sightedness) is a condition in which the refractive power of the eye is greater than required. The most frequent complaint of people with myopia is blurred distance vision, which can be eliminated by conventional optical aids such as spectacles or contact lenses, or by refractive surgery procedures such as photorefractive keratectomy (PRK) and laser epithelial keratomileusis (LASEK). PRK uses laser to remove the corneal stroma. Similar to PRK, LASEK first creates an epithelial flap and then replaces it after ablating the corneal stroma. The relative benefits and harms of LASEK and PRK, as shown in different trials, warrant a systematic review. The objective of this review is to compare LASEK versus PRK for correction of myopia by evaluating their efficacy and safety in terms of postoperative uncorrected visual acuity, residual refractive error, and associated complications. We searched CENTRAL (which contains the Cochrane Eyes and Vision group Trials Register) (2015 Issue 12), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to December 2015), EMBASE (January 1980 to December 2015), Latin American and Caribbean Health Sciences (LILACS) (January 1982 to December 2015), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 15 December 2015. We used the Science Citation Index and searched the reference lists of the included trials to identify relevant trials for this review. We included in this review randomized controlled trials (RCTs) comparing LASEK versus PRK for correction of myopia. Trial participants were 18 years of age or older and had no co

  12. Post-photorefractive keratectomy contact lens microbiological findings of individuals who work in a hospital environment.

    Science.gov (United States)

    Pereira, Carlos Eduardo Gonçalves; Hida, Richard Yudi; Silva, Cely Barreto; de Andrade, Marizilda Rita; Fioravanti-Lui, Giovana Arlene; Lui-Netto, Adamo

    2015-05-01

    To describe the microbiological findings from bandage contact lenses in patients who work in a hospital environment submitted to photorefractive keratectomy (PRK). This prospective comparative case series enrolled 43 eyes of 22 volunteers (28.05 ± 3.50 years). Fourteen individuals (n = 27) were health care professionals who work in health care facilities or community physician's offices. Eight individuals (n = 16) were patients who do not work in hospital environment. Photorefractive keratectomy was performed using standard technique, and a silicone hydrogel bandage contact lens was placed on the cornea and evaluated for adequate fit. Seven days after surgery, the bandage lenses were removed and imprinted in the following culture media: blood agar, chocolate agar, anaerobic-selective agar, and Sabouraud agar. When microbial growth was detected, the microorganism was identified, colony-forming units were quantified, and morphology and Gram-staining properties were analyzed. All isolates were tested for susceptibility to various antibiotics. Significance was assessed by Fisher exact test. Microbial growth was detected in 16.27% of all contact lenses samples. No fungi or anaerobes were found. Microbial growth was only observed in bandage lenses removed from patients who work in hospital environments. Most microorganisms found were sensitive to all antibiotics tested. These results suggest that working in hospital environments increase contamination of the contact lenses after PRK.

  13. Corneal biomechanical properties after laser-assisted in situ keratomileusis and photorefractive keratectomy

    Directory of Open Access Journals (Sweden)

    Hwang ES

    2017-10-01

    Full Text Available Eileen S Hwang,1 Brian C Stagg,1 Russell Swan,1 Carlton R Fenzl,1 Molly McFadden,2 Valliammai Muthappan,1 Luis Santiago-Caban,1 Mark D Mifflin,1 Majid Moshirfar1,3 1Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, 2Department of Internal Medicine, University of Utah, Salt Lake City, 3HDR Research Center, Hoopes Vision, Draper, UT, USA Background: The purpose of this study was to evaluate the effects of laser-assisted in situ keratomileusis (LASIK and photorefractive keratectomy (PRK on corneal biomechanical properties.Methods: We used the ocular response analyzer to measure corneal hysteresis (CH and corneal resistance factor (CRF before and after refractive surgery.Results: In all, 230 eyes underwent LASIK and 115 eyes underwent PRK without mitomycin C (MMC. Both procedures decreased CH and CRF from baseline. When MMC was used after PRK in 20 eyes, it resulted in lower corneal biomechanical properties at 3 months when compared to the other procedures, but all three procedures had similar values at 12 months.Conclusion: Significant but similar decreases in corneal biomechanical properties after LASIK, PRK without MMC, and PRK with MMC were noted. Keywords: corneal biomechanics, photorefractive keratectomy, laser-assisted in situ keratomileusis, corneal hysteresis, corneal resistance factor, mitomycin C

  14. Corneal topography six years after photorefractive keratectomy for myopia and myopic astigmatism.

    Science.gov (United States)

    Serrao, Sebastiano; Lombardo, Giuseppe; Lombardo, Marco; Palombi, Marino; Roberts, Cynthia J

    2009-05-01

    To analyze the 6-year response of corneal topography to photorefractive keratectomy (PRK) for myopia and myopic astigmatism. Twenty patients (40 eyes) who had PRK using the Technolas Keracor 217C excimer laser platform were followed up to 6 years after surgery. The eyes were subdivided into three groups according to the preoperative spherical equivalent refraction and astigmatism component. Corneal topographic maps were obtained with a Placido disk topographer (Keratron Scout). The pre- and postoperative topographical data were imported into custom software, which computed the average composite corneal map and average difference map for each study group to quantify the anterior corneal changes following laser ablation. The software defined three concentric zones of the surface topography, allowing characterization of the regional corneal response following surgery. At 6 years, no changes in the surface topographic configuration of the central cornea were assessed following spherical myopic ablations in comparison with 1 year postoperatively. A slight peripheral flattening of approximately 0.60 diopters (D) (P < .001) was measured following the higher myopic ablations at 6 years compared with 1 year postoperatively. Minimal changes, of approximately 0.30 D (P < .001), in the anterior central cornea were observed following astigmatic correction during follow-up. Photorefractive keratectomy for the correction of myopia provides stable comeal topography, with no clinically significant changes in the curvature profile at 6 years after surgery.

  15. Clinical observation on photorefractive keratectomy with epithelial removal by excimer laser

    Directory of Open Access Journals (Sweden)

    Dong-Mei Wang

    2016-03-01

    Full Text Available AIM:To investigate the clinical outcomes after photorefractive keratectomy(PRKwith epithelial removal by phototherapeutic keratectomy(PTKfor 1a. METHODS:A prospective analysis for 16 consecutive patients(30 eyeswith myopia and myopic astigmatism from July 2012 to July 2014 in our hospital underwent transepithelial photorefractive keratectomy(T-PRK, PRK with epithelial removal by PTK. Uncorrected distant visual acuity(UCVA, haze formation and remaining manifest refractive spherical equivalent(MRSEwere recorded before and at 1,3,6 and 12mo after operations. RESULTS:There were no significant differences(P>0.05in patients had an postoperative UCVA≥0.5 at 1, 3, 6 and 12mo compared with preoperative best corrected visual acuity(BCVA, and the same as the patients had an UCVA≥1.0(P>0.006. There were significant differences in haze values between different postoperative times(F=16.751, P=0.000. The haze value at 1mo was 0.71±0.25, which was gradually reduced with the time, and no more than 2 grades. Postoperative MRSE at 1mo was 0.9±0.87D, compared with 0.5±0.65D at 3mo, the difference was statistically significant(t=2.017, P=0.048. While the difference was not statistically significant(F=2.389, P=0.098among MRSE at 3, 6(0.5±0.45Dand 12mo(0.25±0.4D.CONCLUSION:The study obtained good clinical visual acuity. It shows slightly hyperopic shift and corneal haze at 1mo postoperatively. Large sample and grouped clinical research should be taken for the long-term stability of refraction and visual quality.

  16. Laser-assisted subepithelial keratectomy and photorefractive keratectomy for post-penetrating keratoplasty myopia and astigmatism in adults.

    Science.gov (United States)

    Huang, Paul Y C; Huang, Peter T; Astle, William F; Ingram, April D; Hèbert, Ania; Huang, John; Ruddell, Stacy

    2011-02-01

    To evaluate whether laser-assisted subepithelial keratectomy (LASEK) and photorefractive keratectomy (PRK) achieve effective targeted correction and the extent of post-treatment corneal haze after corneal transplantation. Nonhospital surgical facility, Calgary, Alberta, Canada. Evidence-based manuscript. This study evaluated visual acuity, refractive error correction, and potential complications after LASEK or PRK to eliminate refractive error differences after penetrating keratoplasty in adults. A Nidek EC-5000 or Technolas 217 excimer laser was used in all treatments. At last follow-up (mean 20.50 months post laser), the mean spherical equivalent (SE) decreased from -2.71 diopters (D) ± 4.17 (SD) to -0.54 ± 3.28 D in the LASEK group and from -4.87 ± 3.90 D to -1.82 ± 3.34 D in the PRK group. The mean preoperative uncorrected distance visual acuity (UDVA) was 1.63 ± 0.53 and 1.45 ± 0.64, respectively, and the mean postoperative UDVA, 0.83 ± 0.54 and 0.90 ± 0.55, respectively. The improvement in SE and UDVA was statistically significant in both groups (P < .01). The mean haze (0 to 3 scale) at the last follow-up was 0.46 ± 0.708 in the LASEK group and 0.58 ± 0.776 in the PRK group. The UDVA improved and refractive errors were effectively reduced after LASEK or PRK in eyes with previous PKP. There was no significant difference in the change in SE, UDVA, or corrected distance visual acuity between LASEK and PRK. Some patients had evidence of corneal haze, although the difference between the groups was not significant. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  17. Long-term outcomes of photorefractive keratectomy for anisometropic amblyopia in children.

    Science.gov (United States)

    Paysse, Evelyn A; Coats, David K; Hussein, Mohamed A W; Hamill, M Bowes; Koch, Douglas D

    2006-02-01

    To evaluate the long-term visual acuity (VA) and refractive error responses to excimer laser photorefractive keratectomy (PRK) for treatment of anisometropic amblyopia in children. Prospective interventional case-control study. Eleven children, 2 to 11 years old, with anisometropic amblyopia who were noncompliant with conventional therapy with glasses or contact lenses and occlusion therapy were treated with PRK. A cohort derived retrospectively of 13 compliant and 10 noncompliant children with refractive errors similar to those of the PRK group who were treated with traditional anisometropic amblyopia therapy served as control groups. Photorefractive keratectomy for the eye with the higher refractive error. (1) Refractive error reduction and stability in the treated eye, (2) cycloplegic refraction, (3) VA, (4) stereoacuity, and (5) corneal haze up to 3 years after PRK. Compliant and noncompliant children with anisometropia amblyopia were analyzed as controls for refractive error and VA. Preoperative refractive errors were -13.70 diopters (D) (+/-3.77) for the myopic group and +4.75 D (+/-0.50) for the hyperopic group. Mean postoperative refractive errors at last follow-up (mean, 31 months) were -3.55 D (+/-2.2.5) and +1.41 D (+/-1.07) for the myopic and hyperopic groups, respectively. At last follow-up, cycloplegic refractions in 4 (50%) of 8 myopes and all hyperopes (100%) were within 3 D of that of the fellow eye. Five (63%) of 8 myopic children achieved a refraction within 2 D of the target refraction. Two (67%) of 3 hyperopic patients maintained their refractions within 2 D of the target. Refractive regressions (from 1 year after surgery to last follow-up) were 0.50+/-1.41 D (myopes) and 0.60+/-0.57 D (hyperopes). Seven children (77%) were able to perform psychophysical VA testing preoperatively and postoperatively. Five (71%) of the 7 children had uncorrected VA improvement of at least 2 lines, and 4 (57%) of 7 had best spectacle-corrected VA improvement of

  18. The Effect of Intraocular Pressure on the Outcome of Myopic Photorefractive Keratectomy: A Numerical Approach

    Directory of Open Access Journals (Sweden)

    Elena Lanchares

    2010-01-01

    Full Text Available Photorefractive Keratectomy (PRK is a surgical procedure widely performed to correct myopia. In this work, the effect of the intraocular pressure (IOP on the refractive correction achieved by the PRK surgery was analyzed using a numerical model. Simulations of PRK surgery at 10, 15 and 21 mmHg of IOP were performed and the post-surgical diopters were estimated. For low and medium values of IOP (10 and 15 mmHg, the computed results were close to those used by clinicians based on experience and defined without considering the IOP, while an undercorrection was predicted for the highest value of IOP (21 mmHg. From these results, we suggest that IOP should be considered in the determination of the depth of ablation, in addition to other factors such as the level of myopia or the corneal central thickness.

  19. Clinical research on high oxygen permeable contact lens used after photorefractive keratectomy surgery

    Directory of Open Access Journals (Sweden)

    Hao-Jiang Yang

    2013-07-01

    Full Text Available AIM: To evaluate the outcome of high oxygen permeable contact lens used after photorefractive keratectomy(PRKsurgery.METHODS: Totally 95 patients(190 eyesafter PRK were included. Patients were randomly assigned to wear high oxygen permeable contact lens in one eye and normal lens in the fellow eye after surgery. The subjective symptoms and corneal epithelial status after PRK were evaluated. Uncorrected visual acuity(UCVAand haze were assessed at 6 months after PRK.RESULTS: Complaints of blurred vision, pain and photophobia were statistically more among the normal lens group than high oxygen permeable contact lens group(PPP=0.35. There was no difference in UCVA and haze 6 months after surgery(P=0.55. CONCLUSION: High oxygen permeable contact lens can significantly produce less the corneal irritated symptoms, reduce the discomfort feeling and promote healing of corneal epithelium after PRK.

  20. The Incidence of Central Serous Chorioretinopathy after Photorefractive Keratectomy and Laser In Situ Keratomileusis

    Science.gov (United States)

    Moshirfar, Majid; Hsu, Maylon; Schulman, Julia; Armenia, Joseph; Sikder, Shameema; Hartnett, M. Elizabeth

    2012-01-01

    Purpose. To assess the incidence of central serous chorioretinopathy (CSCR) following laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). Methods. A chart review was performed to identify all patients with CSCR and a previous history of LASIK or PRK. Results. Over the 6-year study period, 1 of 4,876 eyes which had LASIK or PRK at the Moran Eye Center was diagnosed with CSCR. One other patient was referred from an outside center, developed CSCR symptoms one month after PRK. Both patients were managed conservatively with a final visual acuity of 20/20 or better. All other patients presented 4 or more years after refractive surgery. Conclusions. We report the first 2 CSCR cases developing within one month after PRK. The low incidence argues against a causal association. Topical corticosteroids or anxiety may elevate cortisol levels presenting therapeutic challenges for the management of CSCR after PRK or LASIK. PMID:22518278

  1. Photorefractive keratectomy: measuring the matrix metalloproteinase activity and chondroitin sulfate concentration in tear fluid

    Directory of Open Access Journals (Sweden)

    Tetsuya Mutoh

    2010-09-01

    Full Text Available Tetsuya Mutoh, Masaya Nishio, Yukihiro Matsumoto, Kiyomi Arai, Makoto ChikudaDepartment of Ophthalmology, Dokkyo Medical University Koshigaya Hospital, Saitama, JapanAbstract: We herein report the case of a 20-year-old man who underwent a photorefractive keratectomy (PRK. We measured matrix metalloproteinase-9 (MMP-9 activity and chondroitin 4 sulfate and chondroitin 6 sulfate concentrations in tear fluid. Tear fluid was collected preoperatively via microcapillary tube, and was collected postoperatively on the first and fourth days, and after one week, one month, three months, and six months. Samples were formulated by dilution with 200 µL of saline. MMP-9 activity was analyzed by an enzyme immunocapture activity assay, and the concentrations of chondroitin sulfate were analyzed by enzyme-linked immunosorbent assay. No complications were observed after surgery, except for a minimal subepithelial haze. Although MMP-9 activity changed on the fourth postoperative day, the activity changed only minimally at this time. Chondroitin 4 sulfate concentrations in tear fluid increased dramatically from one week to one month, decreased transiently at three months, and increased by six months. The chondroitin 6 sulfate concentration did not normalize within one week, and decreased from one week to three months compared with the preoperative score, and was close to the preoperative score at six months. We conclude that corneal wound healing was still incomplete six months after PRK, and chondroitin 4 sulfate appears to be critical in this process.Keywords: matrix metalloproteinase, chondroitin sulfate, human tear fluid, photorefractive keratectomy, corneal wound healing

  2. Customized photorefractive keratectomy to correct high ametropia after penetrating keratoplasty: A pilot study.

    Science.gov (United States)

    De Rosa, Giuseppe; Boccia, Rosa; Santamaria, Carmine; Fabbozzi, Lorenzo; De Rosa, Luigi; Lanza, Michele

    2015-01-01

    To evaluate preliminarily the safety and efficacy of customized photorefractive keratectomy (PRK) to correct ametropia and irregular astigmatism after penetrating keratoplasty (PK). This pilot study included five eyes of five patients with a mean spherical equivalent of -5.1±1.46D (range from -2.75 to -6.50D). In all cases, ametropia and irregular astigmatism was corrected with topography-guided customized PRK. Ocular examinations with topographic analysis were performed preoperatively as well as at 1, 3 and 6 months after surgery. All eyes gained postoperatively at least three Snellen lines of uncorrected visual acuity. Mean refractive spherical equivalent was 0.62±0.63D (range from -0.25 to -1.75D) at 6 months postoperatively. Our pilot study suggests that customized PRK can be a safe and effective method for treating ametropia and irregular astigmatisms after PK. Future studies with larger samples and longer follow-ups should be performed to confirm these results. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  3. Comparative Study of Two Silicone Hydrogel Contact Lenses used as Bandage Contact Lenses after Photorefractive Keratectomy.

    Science.gov (United States)

    Razmjoo, Hasan; Abdi, Elham; Atashkadi, Sayna; Reza, Akhlaghi M; Reza, Peyman A; Akbari, Mojtaba

    2012-10-01

    Silicon hydrogel bandage contact lenses are used to enhance epithelial healing, control surface-generated pain, and prevent epithelial erosions after refractive surgery. Considering the importance of faster reepithelialization in preventing complications of photorefractive keratectomy (PRK) and the fact that the features and specifications of these commercially-available lenses are different and their performance as a postoperative bandage lenses would be different also, the aim of this study was comparison the efficacy of senofilcon A and lotrafilcon A after PRK. In this prospective study, 44 patients with PRK in both eyes randomly received a silicon hydrogel contact lens of senofilcon A in one eye and lotrafilcon A in other eye. Then the epithelial defect size, visual acuity and subjective level of pain and discomfort were measured for both eyes and compared on day 1, 3 and 5 postoperatively. There was no statistical difference in rate of reepithelialization between senofilcon A and lotrafilcon A (P > 0.05). The mean pain and discomfort index was significantly lower in eyes with senofilcon A (P contact lenses (BCLs) (P > 0.05). Silicon hydrogel BCLs are safe and effective for corneal reepithelialization and have great therapeutic outcome on visual outcomes after PRK. But, senofilcon A had better effect on postoperative pain and discomfort which made it superior than lotrafilcon A. However for more conclusive results, it is recommended to study larger sample size with evaluation the possible factors responsible for the obtained findings regarding postoperative pain and discomfort.

  4. Biomechanical and optical behavior of human corneas before and after photorefractive keratectomy.

    Science.gov (United States)

    Sánchez, Paolo; Moutsouris, Kyros; Pandolfi, Anna

    2014-06-01

    To evaluate numerically the biomechanical and optical behavior of human corneas and quantitatively estimate the changes in refractive power and stress caused by photorefractive keratectomy (PRK). Athineum Refractive Center, Athens, Greece, and Politecnico di Milano, Milan, Italy. Retrospective comparative interventional cohort study. Corneal topographies of 10 human eyes were taken with a scanning-slit corneal topographer (Orbscan II) before and after PRK. Ten patient-specific finite element models were created to estimate the strain and stress fields in the cornea in preoperative and postoperative configurations. The biomechanical response in postoperative eyes was computed by directly modeling the postoperative geometry from the topographer and by reproducing the corneal ablation planned for the PRK with a numerical reprofiling procedure. Postoperative corneas were more compliant than preoperative corneas. In the optical zone, corneal thinning decreased the mechanical stiffness, causing local resteepening and making the central refractive power more sensitive to variations in intraocular pressure (IOP). At physiologic IOP, the postoperative corneas had a mean 7% forward increase in apical displacement and a mean 20% increase in the stress components at the center of the anterior surface over the preoperative condition. Patient-specific numerical models of the cornea can provide quantitative information on the changes in refractive power and in the stress field caused by refractive surgery. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  5. Comparison of 3 silicone hydrogel bandage soft contact lenses for pain control after photorefractive keratectomy.

    Science.gov (United States)

    Taylor, Kenneth R; Caldwell, Matthew C; Payne, Angeletta M; Apsey, Douglas A; Townley, J Richard; Reilly, Charles D; Panday, Vasudha A

    2014-11-01

    To evaluate the relative pain with 3 U.S. Food and Drug Administration-approved bandage soft contact lenses (SCLs) applied after photorefractive keratectomy (PRK). Joint Warfighter Refractive Surgery Center, Lackland Air Force Base, Texas, USA. Prospective comparative case series. Patients having PRK were randomized to a senofilcon A (Acuvue Oasys), balafilcon A (Purevision), or lotrafilcon A (Air Optix) bandage SCL in each eye postoperatively. Patients were evaluated 1 and 4 days postoperatively and completed a survey rating absolute pain in each eye on a visual analog scale. The study enrolled 54 patients. At 1 and 4 days, eyes with the senofilcon A lens had the lowest pain scores followed by eyes with the lotrafilcon A lens and then eyes with the balafilcon A lens. Averaging qualitative results from 1 and 4 days showed that eyes with the senofilcon A lens were reported as having more pain by 4% of patients, eyes with the lotrafilcon A lens by 27%, and eyes with the balafilcon A lens by 53%; 16% reported no difference (Pbandage SCLs. The senofilcon A lens caused the least pain. Dr. Reilly is a consultant to Alcon Laboratories, Inc. and Abbott Medical Optics, Inc. but was not at the time of the study. No other author has a financial or proprietary interest in any material or method mentioned. Published by Elsevier Inc.

  6. Post-photorefractive Keratectomy Pain and Corneal Sub-basal Nerve Density

    Science.gov (United States)

    Mohebbi, Masoumeh; Rafat-Nejad, Amin; Mohammadi, Seyed-Farzad; Asna-Ashari, Kosar; Kasiri, Maryam; Heidari-Keshel, Saeed; Askarizadeh, Farshad

    2017-01-01

    Purpose: The perceived and reported pain of patients receiving photorefractive keratectomy (PRK) widely varies. We assessed the potential role of the subbasal nerve plexus density as a predictor of postoperative pain level. Consecutive patients scheduled to undergo PRK at the Refractive Surgery Clinic of Farabi Eye Hospital, Tehran, were approached. Methods: Forty-nine myopic left eyes from 49 patients who consented to undergo scanning slit confocal microscopy assessments preoperatively were included. ImageJ (1.48v) was used to measure the captured subbasal nerve length. Postoperative pain intensity was assessed by the Visual Analog Scale (VAS) (score range: 0 for no pain to 10 for the maximum possible) on the next day of surgery. Results: The mean age of the patients was 27.55 (range: 19–40) years. The median reported pain level was 5. Approximately 32.7% of the subjects reported a pain score of 6 or higher. Mean nerve density was 19.54 (range: 14.34–24.73) mm/mm2. Nerve density was not correlated with the reported intensity of pain (P = 0.172). However, pain was correlated with the reported ocular discomfort, i.e., a pooled index of foreign body sensation, photophobia, burning sensation, and tearing (P bandage contact lenses. The predominant pain mechanism appears to be of an inflammatory nature (not nociceptive or neuropathic). PMID:28540005

  7. Efficacy of 2 types of silicone hydrogel bandage contact lenses after photorefractive keratectomy.

    Science.gov (United States)

    Grentzelos, Michael A; Plainis, Sotiris; Astyrakakis, Nikolaos I; Diakonis, Vasilios F; Kymionis, George D; Kallinikos, Panagiotis; Pallikaris, Ioannis G

    2009-12-01

    To compare the efficacy of 2 types of silicone hydrogel bandage contact lenses with high oxygen transmissibility after photorefractive keratectomy (PRK). Institute of Vision and Optics, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece. In this prospective study, 1 eye of patients having bilateral PRK was randomly fitted with a bandage contact lens of lotrafilcon A (Night & Day) and the fellow eye, with a bandage contact lens of lotrafilcon B (O(2)Optix). The patients and the examiner were masked to which bandage contact lens type was in which eye. Patients were examined on the day of surgery and 1, 3, and 5 days postoperatively. Postoperative examinations included uncorrected distance visual acuity and slitlamp biomicroscopy to assess epithelial defect size. Subjective evaluation of pain and vision was recorded 1, 2, 3, and 4 days postoperatively. The study enrolled 44 patients (88 eyes). The mean epithelial defect size immediately after surgery was 47.0 mm(2) with both types of bandage contact lenses. There was no statistically significant difference in epithelial defect size between the 2 lenses at any postoperative visit. Three days postoperatively, reepithelialization was complete in 75.0% of eyes in the lotrafilcon A group and 72.7% of the eyes in the lotrafilcon B group. There were no differences in corneal reepithelialization or subjective measurements after PRK between the 2 types of silicone hydrogel bandage contact lenses.

  8. Effects of lotrafilcon A and omafilcon A bandage contact lenses on visual outcomes after photorefractive keratectomy.

    Science.gov (United States)

    Edwards, Jayson D; Bower, Kraig S; Sediq, Denise A; Burka, Jenna M; Stutzman, Richard D; Vanroekel, Cameron R; Kuzmowych, Chrystyna P; Eaddy, Jennifer B

    2008-08-01

    To evaluate postoperative healing between bandage contact lenses with high and low oxygen permeability in patients having photorefractive keratectomy (PRK). Center for Refractive Surgery, Walter Reed Army Medical Center, Washington, DC, USA. This retrospective study compared patients receiving a high-oxygen-transmission bandage contact lens (Focus Night & Day [N&D], Ciba Vision; n = 92) and those receiving a low-oxygen-transmission lens (Proclear, Cooper Vision; n = 114) after PRK. Visual outcomes, safety, and efficacy were assessed postoperatively at 1, 4, and 7 days and 1, 3, 6, and 12 months. Overall pain scores were higher in the Proclear group at 1 day (P = .000) and 4 days (P = .027). The N&D group had an increase in corneal infiltrates at 4 days (P = .025) and 1 week (P = .017). At 1 month, 40.4% of patients in the Proclear group and 18.6% in the N&D group had a 1 or more line decrease in best spectacle-corrected visual acuity (BSCVA) (P = .002). Although there was a trend toward a higher haze rate in the Proclear group, it was not statistically significant (P = .064). There was no statistically significant difference in uncorrected visual acuity, goal of emmetropia, contrast sensitivity, or reepithelialization. The N&D lens produced less pain and better postoperative results in terms of haze and BSCVA at 1 month. However, it led to a higher incidence of corneal infiltrates. There was no difference between the lenses in the end result at 12 months.

  9. Comparative evaluation of Comfilcon A and Senofilcon A bandage contact lenses after transepithelial photorefractive keratectomy.

    Science.gov (United States)

    Mukherjee, Achyut; Ioannides, Antonis; Aslanides, Ioannis

    2015-01-01

    To evaluate and compare Comfilcon A and Senofilcon A silicone hydrogel contact lenses used as a therapeutic bandage following transepithelial excimer laser photorefractive keratectomy (PRK). Patients undergoing transepithelial PRK for myopia were prospectively recruited. Included patients had a Comfilcon A silicone hydrogel lens inserted in one eye, with a Senofilcon A lens in the contralateral eye. Postoperative assessment of subjective pain, epithelial healing and visual recovery was at day 1, 3 and 7. Contact lens factors including centration, movement and deposits were assessed. 48 eyes of 24 patients were included in the study. Mean age was 31 years (SD 11) and mean refractive error -4.5 D (SD 1.8). Mean pain score at day 1 was significantly higher in the Comfilcon group at 4.6 (SD 2.7) vs. 1.5 (SD2.5) in the Senofilcon group (Plenses affects their clinical characteristics in therapeutic roles. Other factors than oxygen permeability may affect pain and epithelial healing, with superior pain relief from the less permeable Senofilcon lens in this study. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  10. Effect of preemptive topical diclofenac on postoperative pain relief after photorefractive keratectomy.

    Science.gov (United States)

    Mohammadpour, Mehrdad; Jabbarvand, Mahmood; Nikdel, Mojgan; Adelpour, Mohsen; Karimi, Nasser

    2011-04-01

    To assess the prophylactic effect of preoperative application of topical diclofenac on postoperative pain control in patients having photorefractive keratectomy (PRK). Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Randomized masked clinical trial. In this paired-eye study, patients having bilateral PRK received 1 drop of diclofenac 0.1% in 1 eye and 1 drop of placebo in the fellow eye 2 hours before PRK. Postoperatively, both arms of the trial (both eyes of each patient) received topical diclofenac every 6 hours for 2 days. One day and 2 days postoperatively, patients were asked to rate the perceived pain in each eye using an 11-point verbal numerical rating scale. A trained examiner noted the eye-specific responses. All 70 patients (140 eyes) completed the study and were included in the statistical analysis. Twenty-four hours after PRK, patients reported pain scores that were clinically and statistically significantly lower in the eyes pretreated with diclofenac than in the fellow eyes (0.97 versus 2.09) (P=.018). Pain scores at 2 days did not differ significantly (P=.877). Administration of a single drop of topical diclofenac 0.1% 2 hours before PRK seemed to increase the efficacy of postoperative pain management in a clinically and statistically significant manner. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  11. Correlation of changes in refraction and corneal topography after photorefractive keratectomy.

    Science.gov (United States)

    Rosa, Nicola; Furgiuele, Dario; Lanza, Michele; Capasso, Luigi; Romano, Antonio

    2004-01-01

    To establish which corneal power evaluation measured with corneal topography correlates best with refractive changes after photorefractive keratectomy (PRK) for myopia. Two hundred fifty-one consecutive eyes of 171 patients who had PRK for myopia ranging from -14.80 to -0.50 D (mean -5.43 +/- 2.978 D), calculated at the corneal plane, were included in the analysis. Data included preoperative and postoperative (1, 3, and 6-mo) subjective refraction and videokeratography with a Keratron Scout (Optikon 2000). Statistical analysis was performed to determine the correlation between the change in subjective refraction at the corneal plane and changes in six corneal power measurements: best fit sphere, simulated keratometry (Sim K), corneal apex, and center of the pupil (last two evaluated for axial and meridional curvatures). The closest correlation between subjective refraction change and corneal power measurement during the three follow-up evaluations was found with Sim K (R2 = 0.904; 0.889; 0.854) and best fit sphere (R2 = 0.919; 0.909; 0.872), whereas the other measurements showed poor correlation with the different curvatures. The best fit sphere corneal topography parameter correlated best with the refractive changes, primarily for low treatment amounts, whereas it showed a clear-cut underestimation in eyes that had undergone high dioptric treatments.

  12. OCT layered tomography of the cornea provides new insights on remodeling after photorefractive keratectomy.

    Science.gov (United States)

    Chandapura, Rachana S; Shetty, Rohit; Shroff, Rushad; Shilpy, Neha; Francis, Mathew; Sinha Roy, Abhijit

    2018-02-01

    OCT (optical coherence tomography) of corneal layers was generated to analyze the remodeling of the epithelium and stroma after photorefractive keratectomy (PRK). Myopic PRK was performed in 15 patients. One eye underwent manual scraping of epithelium while the other was treated with Epi clear. Epi clear allowed a gentler removal of the epithelium compared to manual scraping. Scheimpflug (Pentacam, OCULUS Optikgerate Gmbh, Wetzlar, Germany) and OCT (RTVue, Optovue Inc., Fremont, California, USA) scans of the cornea were performed before and after PRK (3 months). The OCT scanner and Pentacam acquired 8 and 25 radial 2-D scans of the cornea, respectively. The results showed similar topographic changes on the anterior corneal surface between Scheimpflug and OCT imaging. The curvature of the underlying anterior surface of the stroma after PRK was similar to the anterior corneal surface (air-epithelium interface), when measured with OCT. Aberrometric changes were mostly similar between Scheimpflug and OCT. However, Scheimpflug imaging reported greater changes in spherical aberration and corneal higher order aberrations than OCT after PRK. This is the first study to quantify the curvatures of the stromal layers with OCT after PRK. New insights were gained, which could be useful for refinement of surgical ablation algorithms, refractive procedures and detection of ectasia. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. Photorefractive keratectomy in the management of postradial keratotomy hyperopia and astigmatism

    Directory of Open Access Journals (Sweden)

    Mohammad Ghoreishi

    2017-01-01

    Full Text Available Background: The aim of this study is to evaluate the results of photorefractive keratectomy (PRK in the management of postoperative hyperopia and astigmatism in patients with history of radial keratotomy (RK. Materials and Methods: This prospective nonrandomized noncomparative interventional case series enrolled consecutive eyes treated with PRK after RK. In cases, in which (1 wavefront (WF scan was undetectable during primary examinations; and/or, (2 WF data were not transferable to the excimer laser device, patients were treated with the tissue-saving (TS mode. Patients with detectable/transferable WF were assigned to WF-guided advanced personalized treatment (APT. Results: Thirty-two and 47 eyes were managed by APT and TS modes, respectively. Pooled analysis of both APT and TS groups showed improvement in uncorrected distant visual acuity and corrected distant visual acuity. The amount of sphere, cylinder, corneal cylinder, spherical equivalent, defocus equivalent, and total aberration showed improvement as well. Conclusion: PRK seems to bring favorable outcome and safety profile in the management of post-RK hyperopia and astigmatism. It is crucial for practitioners to warn their patients about the fact that they may still have progressive refractive instability regardless of their choice on the laser method of vision correction.

  14. Kinetic Profiles of Inflammatory Mediators in the Conjunctival Sac Fluid of Patients upon Photorefractive Keratectomy

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    Veronica Tisato

    2015-01-01

    Full Text Available Photorefractive keratectomy (PRK represents a therapeutic option to remodel corneal stroma and to compensate refractive errors, which involves inflammatory and/or regenerative processes. In this context, the modulation of cytokines/chemokines in the conjunctival sac fluid and their role in the maintenance of the corneal microenvironment during the healing process upon refractive procedures has not been deeply investigated. In this study, serial samples of conjunctival sac fluid of patients (n=25 undergoing PRK were harvested before and at different time points after surgery. The levels of 29 cytokines/chemokines/growth factors involved in inflammatory/immune processes were measured with a multiplex array system. The results have firstly highlighted the different pattern of cytokine expression between the microenvironment at the anterior surface of the eye and the systemic circulation. More importantly, the kinetic of modulation of cytokines/chemokines at the conjunctival level following PRK revealed that while the majority of cytokines/chemokines showed a significant decrease, MCP-1 emerged in light of its pronounced and significant increase soon after PRK and during the follow-up. This methodological approach has highlighted the role of MCP-1 in the healing process following PRK and has shown a potential for the identification of expression/modulation of soluble factors for biomarker profiling in ocular surface diseases.

  15. Long Term Followup of Photorefractive Keratectomy with Adjuvant Use of Mitomycin C

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    Vasilios F. Diakonis

    2014-01-01

    Full Text Available Purpose. To study the long term refractive and visual outcomes of photorefractive keratectomy (PRK with intraoperative application of mitomycin C (MMC. Methods. This study included 37 eyes who received myopic PRK; after photoablation, a sponge soaked in 0.02% MMC solution was applied in all corneas for 2 minutes. Efficacy, safety, predictability, and stability of PRK MMC were evaluated. Endothelial cell density was evaluated at the last postoperative interval. Results. Mean preoperative spherical equivalent (SEQ was −6.03±1.87 D (diopters and reduced to −0.09±0.53 D at the last postoperative examination. Mean followup was 44.73±18.24 months. All the eyes were in the ±1.00 D of attempted versus achieved SEQ at the one-year follow-up interval. Furthermore, 95% of the eyes did not lose lines or gained 1 to 2 lines of CDVA, while 5% lost 1 line. At the third postoperative month, 89% of the eyes either were clear or had trace haze, while 4 eyes had mild haze; by the 12-month postoperative interval, none of the eyes demonstrated haze. Mean endothelial cell density (ECD at the last postoperative interval was 2658±153 cells/mm2. Conclusions. PRK, with intraoperative use of MMC, demonstrates stable refractive and visual outcomes up to 44 months after surgery.

  16. Comparison of the changes in corneal biomechanical properties after photorefractive keratectomy and laser in situ keratomileusis.

    Science.gov (United States)

    Kamiya, Kazutaka; Shimizu, Kimiya; Ohmoto, Fumiko

    2009-08-01

    To compare the postoperative biomechanical properties of the cornea after photorefractive keratectomy (PRK) and after laser in situ keratomileusis (LASIK) in eyes with myopia. We retrospectively examined 27 eyes of 16 patients undergoing PRK and 31 eyes of 16 patients undergoing LASIK for the correction of myopia. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured with Ocular Response Analyzer before and 3 months after surgery. We also investigated the relationship between these biomechanical changes and the amount of myopic correction. The CH was decreased significantly from 10.8 +/- 1.3 (mean +/- SD) mmHg to 9.2 +/- 1.6 mmHg after PRK (P biomechanical properties after PRK (r = -0.61, P biomechanical strength of the cornea depending on the amount of myopic correction. The amount of biomechanical changes is larger after LASIK than after PRK. From a biomechanical viewpoint, PRK may be a less invasive surgical approach for the correction of myopia than LASIK.

  17. Results of excimer laser photorefractive keratectomy for the correction of myopia at Cedars-Sinai Medical Center: 1993

    Science.gov (United States)

    Maguen, Ezra I.; Salz, James J.; Nesburn, Anthony B.; Warren, Cathy; Macy, Jonathan I.; Papaioannou, Thanassis; Hofbauer, John; Berlin, Michael S.

    1994-06-01

    This report summarizes the authors' 3-year experience with excimer laser photorefractive keratectomy (PRK) on 240 eyes of 161 patients. With constant laser emission parameters, nitrogen (N2) flow across the cornea was used on 79 eyes while 161 eyes had no N2 flow. 74 eyes were operated on without fixation with a suction ring. Postoperative pain management included patching and oral analgesics in 77 eyes and the use of topical Diclofenac or Ketorolac, and a therapeutic soft contact lens in 163 eyes. Follow up ranged from 1 month (206 eyes) to 36 months (10 eyes).

  18. Bacterial contaminants of bandage contact lenses used after laser subepithelial or photorefractive keratectomy.

    Science.gov (United States)

    Liu, Xiaowei; Wang, Peng; Kao, Andrew A; Jiang, Yang; Li, Ying; Long, Qin

    2012-07-01

    To compare the locations and types of bacterial contamination of bandage disposable soft contact lenses after laser subepithelial keratectomy (LASEK) and photorefractive keratectomy (PRK). Bandage disposable soft contact lenses were collected with sterile forceps from 30 eyes of 15 consecutive patients treated with LASEK (LASEK group) and 30 eyes of 15 consecutive patients who underwent PRK (PRK group) to correct myopia. Immediately after collection, each lens was cut in two parts with sterile scissors and placed onto chocolate agar with one piece outer face down and the inner face down for the other piece. The lenses were analyzed for bacterial colonization and evaluated for the amount of growth on the inner face and outer face, respectively. The antibiotic susceptibility tests were performed for the isolates using disk diffusion. Five positive cultures (16.7%) were found in LASEK group: 4 appeared in the inner face of the lens and1 appeared in the outer face. In PRK group, 2 of the 30 contact lenses (6.67%) had positive cultures; both of them appeared in the outer face of the lens. The difference of positive culture rate in the two groups was not statistically significant (χ=1.46, P=0.228). When comparing the positive colonization rate in location, the positive culture rate in the inner face of LASEK group was statistically significantly higher than that of PRK group (13.3% vs. 0%, χ=4.29, P=0.038); however, no clinical finding of infection was noted. In both groups, methicillin-sensitive coagulase-negative staphylococci (MSSCoN) were the most common isolate. Besides MSSCoN, the growth of methicillin-resistant coagulase-negative staphylococci, Corynebacterium, and Micrococcus were also present in this study. All the microorganisms were sensitive to tobramycin, which was used in conjunction with dexamethasone to treat the cases. Previous literature reports that the risk of infectious keratitis after LASEK or PRK is relatively low. However, within this study, the

  19. Factors determining the refractive effects of intrastromal photorefractive keratectomy with the picosecond laser.

    Science.gov (United States)

    Vogel, A; Günther, T; Asiyo-Vogel, M; Birngruber, R

    1997-11-01

    To determine the relationship between laser parameters and tissue removal with picosecond laser intrastromal photorefractive keratectomy (ISPRK) and to assess the effect of the parameters on the healing process and the long-term refractive changes. Medical Laser Center Lübeck, Germany. A modified Intelligent Surgical Lasers (ISL) 2001 system with a cone angle of 30 degrees was used for in vitro investigations of the laser effects in water and on the porcine cornea. Photographic methods were used to determine the plasma volume and to investigate the thickness of the intrastromal bubble layer as a function of the laser pulse energy, the number of layers in which the pulses were applied, and the layer separation. The data were used to calculate the amount of tissue removal. Histologic evaluation was done by polarization microscopy after Sirius-red staining. The laser pulses produced a sponge-like appearance of the stroma in a layer extending through about one third the corneal thickness, accompanied by mechanical distortions of the stromal lamellae. Thermal changes were weak. Tissue removal was impaired by the cavitation bubbles from preceding laser pulses. The amount of evaporated tissue depended only weakly on laser pulse energy and number of layers in which the pulses were applied. The maximum amount of tissue that could be evaporated without damaging the outer corneal layers was a 10.0 microm thick layer. With a 6.0 mm optical zone, the tissue removal produced an immediate refractive effect of only 0.85 diopter. Intrastromal PRK does not work as originally envisioned because the amount of evaporated tissue is very small. The greater long-term refractive changes observed in animal experiments and clinical studies must therefore be due to the healing response of the cornea. Because the refractive effects are strongly influenced by the healing response of the cornea, they are poorly predictable.

  20. Wound healing in rabbit corneas after photorefractive keratectomy and laser in situ keratomileusis.

    Science.gov (United States)

    Miyamoto, Takeshi; Saika, Shizuya; Yamanaka, Akio; Kawashima, Yoshiji; Suzuki, Yoshitaka; Ohnishi, Yoshitaka

    2003-01-01

    To compare the wound-healing process in the rabbit cornea after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) with the same refractive correction. Department of Ophthalmology, Wakayama Medical University, Wakayama, Japan. Adult albino rabbits (N = 24) were used. One eye of each animal had PRK or LASIK with the same refractive correction. Each animal was killed after an interval of up to 6 months. The expression pattern of corneal stromal injury-related molecules with the 2 treatments were compared. Paraffin sections of the cornea were processed immunohistochemically for alpha-smooth muscle actin (alpha-SMA), collagen type IV [alpha1(IV)](2),alpha2(IV), and heat shock protein (HSP) 47 as well as other HSPs. Sections were also examined after hematoxylin and eosin or periodic acid-Schiff staining. Hematoxylin and eosin staining showed the central epithelium to be thick in PRK-treated corneas. The thick epithelium was restricted to the area around the corneal flap edge adhesion in LASIK-treated corneas at 3 months. Periodic acid-Schiff staining showed an absence of or interruption in the epithelial basement membrane in PRK-treated corneas for up to 6 months. Heat shock protein 47 was detected in keratocytes on day 3 but not after that in PRK-treated corneas. There was no difference in the expression of other HSPs. Alpha-smooth muscle actin was expressed in keratocytes repopulated in the central anterior cornea of PRK-treated corneas at 28 days. Keratocytes with immunoreactivity for these 2 proteins were not seen in LASIK-treated corneas. Collagen IV [alpha1(IV)](2),alpha2(IV) was not detected in either group of corneas. The central epithelium became transiently thicker in PRK-treated corneas. Keratocyte responses to laser stromal ablation were more marked in corneas treated with PRK than in those treated with LASIK.

  1. Efficacy of two silicone-hydrogel contact lenses for bandage use after photorefractive keratectomy.

    Science.gov (United States)

    Plaka, A; Grentzelos, M A; Astyrakakis, N I; Kymionis, G D; Pallikaris, I G; Plainis, S

    2013-10-01

    To evaluate the efficacy of two silicone hydrogel (SiH) contact lenses, approved for continuous wear for one week, following photorefractive keratectomy (PRK). Forty seven myopic patients (94 eyes) undergone bilateral PRK were enrolled in this prospective, double-masked, comparative study. One eye of each patient was fitted with a Lotrafilcon B lens (Ciba Vision, Duluth, US; 30-day recommended replacement) whereas the fellow eye was fitted with an Asmofilcon A lens (Menicon, Nagoya, Japan; 14-day recommended replacement). Epithelial defect size was assessed using slit lamp biomicroscopy on the day of surgery and at days 1-4 post-operatively. Uncorrected and best-corrected visual acuity and retinal straylight (C-Quant, Oculus Optigerate, Germany) were evaluated pre-operatively and one month post-operatively. Average epithelial defect size for Asmofilcon A and Lotrafilcon B was 25.5±11.0mm(2) vs. 27.1±9.9mm(2) at day 1 (p=0.007) and 6.3±7.0mm(2) vs. 9.2±9.5mm(2) at day 2 (p=0.012) post-operatively. Re-epithelialization at day 3 was completed in 87.2% of the eyes fitted with Asmofilcon A lenses, compared to 74.5% with Lotrafilcon B lenses (p=0.012). At the 3rd post-operative day 29.8% of re-epithelialized eyes showed irregular suture with Lotrafilcon B, compared to 12.8% eyes with Asmofilcon A lenses (plenses retinal straylight (p=0.98) and best-corrected visual acuity (p=0.68). SiH lenses can be used as an effective bandage after PRK due to the limited time requested for achieving complete corneal re-epithelialization. Faster and smoother epithelial healing is provided with Asmofilcon A over Lotrafilcon B lenses. Copyright © 2013 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  2. Risk factors of regression and undercorrection in photorefractive keratectomy:a case-control study

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    Seyed-Farzad Mohammadi

    2015-10-01

    Full Text Available AIM:To determine risk factors of regression and undercorrection following photorefractive keratectomy (PRK in myopia or myopic astigmatism.METHODS: A case-control study was designed in which eyes with an indication for re-treatment (RT were defined as cases; primary criteria for RT indication, as assessed at least 9mo postoperatively, included an uncorrected distance visual acuity (UDVA of 20/30 or worse and a stable refraction for more than 3mo. Additional considerations included optical quality symptoms and significant higher order aberrations (HOAs. Controls were chosen from the same cohort of operated eyes which had complete post-operative follow up data beyond 9mo and did not need RT. The cohort included patients who had undergone PRK by the Tissue-Saving (TS ablation profile of Technolas 217z100 excimer laser (Bausch & Lomb, Rochester, NY, USA. Mitomycin C had been used in all of the primary procedures.RESULTS:We had 70 case eyes and 158 control eyes, and they were comparable in terms of age, sex and follow-up time (P values:0.58, 1.00 and 0.89, respectively. Pre-operative spherical equivalent of more than -5.00 diopter (D, intended optical zone (OZ diameter of less than 6.00 mm and ocular fixation instability during laser ablation were associated with RT indications (all P values <0.001. These factors maintained their significance in the multiple logistic regression model with odd ratios of 6.12, 6.71 and 7.89, respectively.CONCLUSION:Higher refractive correction (>-5.00 D, smaller OZ (<6.00 mm and unstable fixation during laser ablation of PRK for myopia and myopic astigmatism were found to be strong predictors of undercorrection and regression.

  3. Post-photorefractive Keratectomy Pain and Corneal Sub-basal Nerve Density.

    Science.gov (United States)

    Mohebbi, Masoumeh; Rafat-Nejad, Amin; Mohammadi, Seyed-Farzad; Asna-Ashari, Kosar; Kasiri, Maryam; Heidari-Keshel, Saeed; Askarizadeh, Farshad

    2017-01-01

    The perceived and reported pain of patients receiving photorefractive keratectomy (PRK) widely varies. We assessed the potential role of the subbasal nerve plexus density as a predictor of postoperative pain level. Consecutive patients scheduled to undergo PRK at the Refractive Surgery Clinic of Farabi Eye Hospital, Tehran, were approached. Forty-nine myopic left eyes from 49 patients who consented to undergo scanning slit confocal microscopy assessments preoperatively were included. ImageJ (1.48v) was used to measure the captured subbasal nerve length. Postoperative pain intensity was assessed by the Visual Analog Scale (VAS) (score range: 0 for no pain to 10 for the maximum possible) on the next day of surgery. The mean age of the patients was 27.55 (range: 19-40) years. The median reported pain level was 5. Approximately 32.7% of the subjects reported a pain score of 6 or higher. Mean nerve density was 19.54 (range: 14.34-24.73) mm/mm 2 . Nerve density was not correlated with the reported intensity of pain ( P = 0.172). However, pain was correlated with the reported ocular discomfort, i.e., a pooled index of foreign body sensation, photophobia, burning sensation, and tearing ( P < 0.001), and also with the pooled index of ocular inflammatory signs (conjunctival injection and eyelid edema) ( P = 0.027). Crude density of corneal nerves may not be a good predictor of post-PRK pain while wearing bandage contact lenses. The predominant pain mechanism appears to be of an inflammatory nature (not nociceptive or neuropathic).

  4. Simulation of airbag impact on eyes after photorefractive keratectomy by finite element analysis method.

    Science.gov (United States)

    Uchio, Eiichi; Watanabe, Yoichiro; Kadonosono, Kazuaki; Matsuoka, Yasuhiro; Goto, Satoru

    2003-06-01

    A simulation model of the human eye which we have developed was applied to simulated airbag ocular injury, to determine the physical and mechanical conditions of the impacting airbag that would cause globe rupture in a post-photorefractive keratectomy (PRK) eye. Simulations were performed with a computer using the finite element analysis program PAM-CRASH()(Nihon ESI, Tokyo, Japan). The airbag was set to impact on the surface of post-PRK eyes-D3, D6, D10, and D15-and an intact eye at various impact velocities. Strain on the cornea and sclera exceeding 18.0% and 6.8%, respectively, was assumed to indicate the possibility of rupture of each tissue. In contrast to the intact eye, in post-PRK eyes, at the lowest velocity of 20 m/s, some of the element reached the strain threshold in D15. At the medium velocity of 30 m/s, limited corneal rupture was observed in all situations. At the high velocity, 40 m/s, scleral laceration was found in eyes with all diopters, and apparent corneal rupture was observed in D10 and D15, indicating that globe rupture was very likely to occur. These results suggest that severe ocular trauma can be caused in post-PRK eyes by airbags at high impact velocities. Preoperative discussion with candidates for laser refractive surgery regarding the potential for severe ocular injury if the normal integrity of the eye is compromised by surgery may be appropriate. Research on modification of airbag design and deployment to minimize the risk of ocular injury is important.

  5. Photorefractive Keratectomy for Residual Myopia after Myopic Laser In Situ Keratomileusis

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    Kamal A. M. Solaiman

    2017-01-01

    Full Text Available Purpose. To evaluate the safety, efficacy, and predictability of photorefractive keratectomy (PRK on the corneal flap for correction of residual myopia following myopic laser in situ keratomileusis (LASIK. Patients and Methods. A retrospective study on eyes retreated by PRK on the corneal flap for residual myopia after LASIK. All eyes had no enough stroma after LASIK sufficient for LASIK enhancement. Data included spherical equivalent (SE, uncorrected and best corrected visual acuity (UCVA and BCVA, central pachymetry, corneal higher order aberrations (HOAs, corneal hysteresis (CH, corneal resistance factor (CRF, and corneal haze. Results. The study included 64 eyes. Before PRK, the mean central pachymetry was 400.21±7.8 μm, the mean SE was −1.74±0.51 D, and the mean UCVA and BCVA were 0.35±0.18 and 0.91±0.07, respectively. 12 months postoperatively, the mean central corneal thickness was 382.41±2.61 μm, the mean SE was −0.18±0.32 D (P0.5, respectively. The safety index was 1.01 and the efficacy index was 0.86. No significant change was observed in corneal HOAs. Conclusions. Residual myopia less than 3 D after LASIK could be safely and effectively treated by PRK and mitomycin C with a high predictability. This prevents postoperative ectasia and avoids the flap related complications but has no significant effect on HOAs.

  6. Intraocular pressure and photorefractive keratectomy: a comparison of three different tonometers.

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    Garzozi, H J; Chung, H S; Lang, Y; Kagemann, L; Harris, A

    2001-01-01

    To evaluate the intraocular pressure (IOP) with three different instruments, Goldmann applanation tonometer (GAT), noncontact tonometer, and Tono-Pen after photorefractive keratectomy (PRK) for myopia. A prospective case series study to evaluate preoperative and postoperative IOP measurements of 149 eyes at 12 months. We performed GAT, noncontact tonometry, Tono-Pen central, and Tono-Pen temporal periphery measurements. We also performed measurements of the central corneal thickness (CCT) by ultrasonic pachymetry and keratometry. Pre-operative IOP reading served as control for all studies. After PRK, IOP reading was significantly reduced in the treated eyes when compared with the control measurements (11.87+/-1.73 vs. 13.37+/-1.52 mm Hg, pPen central; 13.48+/-1.65 vs. 13.71+/-1.56 Hg, pPen temporal periphery). There was also a significant correlation between IOP reading changes measured by GAT, noncontact tonometer, Tono-Pen central, and change of CCT and between reduction of IOP reading and keratometry (r2>0.39, pIOP reading change by Tono-Pen temporal periphery and CCT was also significant but r2 value was only 0.034. Tono-Pen temporal periphery postoperative IOP measurements had the best correlation with preoperative GAT IOP (r2 = 0.57, pIOP reading as measured by GAT, noncontact tonometer, and Tono-Pen central; less so when measured by Tono-Pen temporal periphery. Early detection of glaucoma and IOP follow-up in glaucoma patients may be done best by peripheral Tono-Pen measurements over the nonablated cornea.

  7. Femtosecond laser-assisted laser in situ keratomileusis versus photorefractive keratectomy: Effect on ocular surface condition.

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    Sauvageot, Paola; Julio, Gemma; Alvarez de Toledo, Juan; Charoenrook, Victor; Barraquer, Rafael I

    2017-02-01

    To compare ocular surface characteristics in eyes after femtosecond laser-assisted laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK). Centro de Oftalmologia Barraquer, Barcelona, Spain. Prospective comparative observational study. Patients with myopia who had femtosecond laser-assisted LASIK or PRK were included. Tear osmolarity, the Ocular Surface Disease Index questionnaire, Schirmer I, corneal sensitivity, tear breakup time (TBUT), and corneal fluorescein staining were evaluated preoperatively and 3, 6, and 12 months postoperatively. The Wilcoxon signed-rank test was used for temporal intragroup analysis, and the Mann-Whitney U test was used for intergroup comparisons. The study comprised 44 patients (44 eyes) with myopia. Comparison of the parameters between the femtosecond laser-assisted LASIK group (22 eyes) and the PRK group (22 eyes) showed a similar temporal progression postoperatively. Compared with the preoperative evaluation, corneal sensitivity decreased after 3 months (P = .002 and P = .02, respectively) and 6 months (P = .03 and P = .04, respectively). The TBUT reached the highest mean value after 12 months (P = .01 and P = .04, respectively), and tear osmolarity was slightly increased after 1 year, although the mean values remained within the normal range (P = .01 and P = .04, respectively). The only difference between the 2 groups was lower corneal sensitivity in the femtosecond laser-assisted LASIK group after 3 months (P = .02). The ocular surface condition could be considered clinically unaltered after 1 year in both groups. Femtosecond laser-assisted LASIK and PRK techniques seemed to be safe for the ocular surface condition and to have a similar effect on it. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  8. Photorefractive Keratectomy With Mitomycin-C for High Myopia: Three Year Follow-Up Results

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    Hassan Hashemi

    2017-02-01

    Full Text Available Photorefractive keratectomy (PRK is a safe and effective surgical keratorefractive technique which is done with the application of mitomycin-C (MMC in cases of high myopia to prevent the formation of corneal haze This study was conducted to evaluate 3-year visual acuity and quality outcomes of PRK-MMC in high myopia. This before-after study was conducted on 20 individuals (40 eyes with myopia more than 6.0 diopter (D. Visual acuity and quality indices were evaluated before and three years after the procedure and their stability was examined between the 1st and 3rd years. At 3 years after surgery, mean uncorrected visual acuity was 0.03±0.06 in the logarithm of minimum angle of resolution (logMAR unit which showed a significant improvement when compared to baseline (P<0.001 and means best corrected visual acuity was 0.03±0.06 logMAR, which showed no significant difference (P=0.730. Manifest refraction spherical equivalent (MRSE at 3 years (-0.12±0.2D was significantly decreased when compared to baseline (P<0.001, but it did not change significantly after the 1st year and was stable (P=0.368. Mean coma and spherical aberration 3 years postoperatively were -0.54±0.26 µm and 0.46±0.19 µm, respectively, and neither parameter showed significant differences when compared to baseline (P<0.001. No significant change was found in mesopic contrast sensitivity. The long-term results of this study showed that PRK-MMC could be regarded an effective, safe, and stable procedure in patients with myopia more than 6.0 D.

  9. Clinical study on photorefractive keratectomy for high myopia with mitomycin C

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    Hao-Jiang Yang

    2013-06-01

    Full Text Available AIM: To evaluate the efficacy, safety and stability of photorefractive keratectomy(PRKfor high myopia with 0.2g/L mitomycin C(MMC. METHODS: Totally 109 patients(201 eyesafter PRK were treated with intraoperative application of 0.2g/L MMC for 20 seconds. The recovery of cornea epithelium after surgery was regularly observed. The uncorrected visual acuity(UCVA, corrected distance visual acuity(CDVA, refraction, haze, complications and endothelial cell counts 1 month, 3, 6, 12 months after PRK were compared. RESULTS:The time of corneal epithelium recovery was 3.68±0.35 days. All eyes had a significant increase in UCVA. 12 months after surgery, 189 eyes(94%achieved UCVA better than 1.0 and 153 eyes(76%had a spherical equivalent(SEwithin±0.5D. 7 eyes(3%lost one line of CDVA. No one lost 2 or more lines of CDVA. Ninety-six percent eyes changed within±0.5D when comparing 3 month and 12 month. Postoperative endothelial cell density and coefficient of variability(CVdid not show a significant difference from preoperative measurements(P1=0.71; P2=0.83. Haze of grade 1 occurred in 12 eyes(6%and haze between grade 0.5 and 1 existed in 189 eyes(94%at 12 months. No eye developed haze over grade 2. No toxic effect and complications of MMC were found after surgery. CONCLUSION: PRK with intraoperative application of MMC for 20 seconds appears to be a safe and effective method for correction of high myopia.

  10. Comparison of Changes in Corneal Biomechanical Properties after Photorefractive Keratectomy and Small Incision Lenticule Extraction

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    Yusuf Yıldırım

    2016-04-01

    Full Text Available Objectives: To compare the postoperative biomechanical properties of the cornea after photorefractive keratectomy (PRK and small incision lenticule extraction (SMILE in eyes with low and moderate myopia. Materials and Methods: We retrospectively examined 42 eyes of 23 patients undergoing PRK and 42 eyes of 22 patients undergoing SMILE for the correction of low and moderate myopia. Corneal hysteresis (CH and corneal resistance factor (CRF were measured with an Ocular Response Analyzer before and 6 months after surgery. We also investigated the relationship between these biomechanical changes and the amount of myopic correction. Results: In the PRK group, CH was 10.4±1.3 mmHg preoperatively and significantly decreased to 8.5±1.3 mmHg postoperatively. In the SMILE group, CH was 10.9±1.7 mmHg preoperatively and decreased to 8.4±1.5 mmHg postoperatively. CRF was significantly decreased from 10.8±1.1 mmHg to 7.4±1.5 mmHg in the PRK group whereas it was decreased from 11.1±1.5 mmHg to 7.9±1.6 mmHg in the SMILE group postoperatively. There was a significant correlation between the amount of myopic correction and changes in biomechanical properties after PRK (r=-0.29, p=0.045 for CH; r=-0.07, p=0.05 for CRF and SMILE (r=-0.25, p=0.048 for CH; r=-0.37, p=0.011 for CRF. Conclusion: Both PRK and SMILE can affect the biomechanical strength of the cornea. SMILE resulted in larger biomechanical changes than PRK

  11. Corneal Epithelial Remodeling and Its Effect on Corneal Asphericity after Transepithelial Photorefractive Keratectomy for Myopia

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    Jie Hou

    2016-01-01

    Full Text Available Purpose. To evaluate the changes in epithelial thickness profile following transepithelial photorefractive keratectomy (T-PRK for myopia and to investigate the effect of epithelial remodeling on corneal asphericity. Methods. Forty-four patients (44 right eyes who underwent T-PRK were retrospectively evaluated. Epithelial thickness was measured using spectral-domain optical coherence tomography at different corneal zones (central, 2 mm; paracentral, 2–5 mm; and mid-peripheral, 5-6 mm preoperatively and at 1 week and 1, 3, and 6 months postoperatively. The correlation between the changes in corneal epithelial thickness (ΔCET and postoperative Q-value changes (ΔQ was analyzed 6 months postoperatively. Results. Epithelial thickness at 6 months showed a negative meniscus-like lenticular pattern with less central thickening, which increased progressively toward the mid-periphery (3.69±4.2, 5.19±3.8, and 6.23±3.9 μm at the center, paracenter, and mid-periphery, resp., P<0.01. A significant positive relationship was observed between epithelial thickening and ΔQ 6 months postoperatively (r=0.438, 0.580, and 0.504, resp., P<0.01. Conclusions. Significant epithelial thickening was observed after T-PRK and showed a lenticular change with more thickening mid-peripherally, resulting in increased oblateness postoperatively. Epithelial remodeling may modify the epithelial thickness profile after surface ablation refractive surgery for myopia.

  12. Effectiveness of Technolas torsional eye tracking system on visual outcomes after photorefractive keratectomy.

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    Gharaee, Hamid; Ghanavati, Siamak Zaree; Rad, Saeed Shokoohi; Omidtabrizi, Arash; Naseri, Hashem

    2015-01-01

    To investigate the efficacy of Technolas 217Z eye tracking system (torsional component) in corneal surface irregularity and high order aberrations (HOAs) after photorefractive keratectomy. Patients with compound myopic astigmatism among persons demanding refractive surgery in Khatam-al-Anbia Eye Hospital with the mean age of 29 years were enrolled in this double-blind randomized interventional study. The mean spherical equivalent (SE) of refractive error was -4.75 diopters(D) (range: -1.5 to -7.0), and the mean astigmatism was 3 D (range:1.0-4). Many studies were performed for each patient including: A complete eye examination, visual acuity and Monocular contrast sensitivity evaluation, and refraction. Corneal topography, Orbscan II, and wavefront aberrometry were conducted. One eye was randomly assigned for aspheric treatment and applying eye tracking system. The other eye was treated without torsional eye tracking system. The outcome measures were uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), contrast sensitivity, corneal irregularity index in 3 mm and 5 mm optical zones in Orbscan II, and mean total HOAs at the 6-monthvisit. Fifty eyes of 25 patients were enrolled. Mean UCVA was improved significantly in both the study and control groups in the 6-month post-operative follow-up. There was no significant difference between the 2 groups in UCVA and BCVA (P = 0.185 and P = 0.176, respectively). Total HOAs increased in both groups after PRK. However, they were lower in eyes treated with the eye tracking system (P eye tracker system (Bausch and Lomb Advanced) results in a more regular anterior surface of cornea. Therefore, we recommend it for surface laser refractive surgery.

  13. [Comparison of corneal wound healing of photorefractive keratectomy and laser in situ keratomileusis in rabbits].

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    Ma, Xiao-Hua; Li, Jing-Hai; Bi, Hong-Sheng; Zhou, Fang; Li, Yan

    2003-03-01

    To compare effects of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) on the cornea and corneal wound healing and to investigate the possible mechanism of corneal haze and myopic regression histopathologically. Twenty-four New Zealand white rabbits were allocated randomly to correct -4.00 and -8.00 diopters and were operated with PRK on right eyes and LASIK on left eyes. At 10 days and 1, 3, and 6 months, corneal haze was observed, refraction was evaluated, and 3 rabbits were randomly selected for each time point to be enucleated, and corneas to be bisected. One half of each cornea was evaluated using transmission electron microscopy, and the other half was evaluated using either light microscopy or immunohistochemical staining for collagen type III, IV, fibronectin (FN) and transforming growth factor-beta(1) (TGF-beta(1)). Different degrees of corneal haze and myopic regression were observed after PRK: the higher the desired myopic correction, the heavier the haze. Corneal wound healing response was greater and lasted longer after PRK than after LASIK. Various pathological findings such as epithelial hyperplasia, basal membrane reforming and extracellular matrix deposits were found in the ablation zone and repair mechanisms were still active at 6 months after PRK. Whereas after LASIK, the interface between the flap and stromal bed was transparent except for growing epithelial plugs and lightly proliferating stroma coinciding with the flap margins. After both PRK and LASIK, all corneal cell types were consistently positive for TGF-beta(1) antibody during the corneal wound healing time. TGF-beta(1) antibody positivity decreased as the wound healing approached completion. The histopathological changes of corneal haze and myopic regression are as follows: epithelial hyperplasia, basal membrane immaturity, anterior stromal keratocyte increase and activity, new collagen III production and irregular arrangement thereof, and FN deposition in the

  14. Multilayer amniotic membrane transplantation for bacterial keratitis with corneal perforation after hyperopic photorefractive keratectomy: case report and literature review.

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    Nubile, Mario; Carpineto, Paolo; Lanzini, Manuela; Ciancaglini, Marco; Zuppardi, Eduardo; Mastropasqua, Leonardo

    2007-09-01

    We report a case of corneal infection caused by Streptococcus pneumoniae after hyperopic photorefractive keratectomy (PRK) that produced severe corneal melting, ulceration, and multiple perforations. Treatment included antibiogram-based antibiotic topical therapy and multilayer amniotic membrane transplantation (AMT) performed to seal the perforations and restore the globe integrity. Clinical and anterior segment optical coherence tomography (Visante OCT, Carl Zeiss Meditec) examinations documented progressive integration of the amniotic membrane tissues within the cornea, stromal and epithelial healing, and recovery of a stable and regular anterior chamber. The cornea healed with an avascular leucoma; the best corrected visual acuity was reduced to 20/200. Severe pneumococcal ulcerative perforation is a potential complication of PRK. Penetrating keratoplasty, at high risk for failure in the acute settings of an infected and inflamed eye, can be delayed until the cornea is healed. Amniotic membrane transplantation may be an alternative surgical option to achieve this goal.

  15. Prospective, randomized, contralateral eye comparison of tetracaine and proparacaine for pain control in laser in situ keratomileusis and photorefractive keratectomy

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    Moshirfar M

    2014-06-01

    Full Text Available Majid Moshirfar,1 Mark D Mifflin,1 Michael V McCaughey,2 Adam J Gess1 1John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 2University of New Mexico School of Medicine, Albuquerque, NM, USA Background: Tetracaine and proparacaine are two of the most commonly used medications for providing topical anesthesia in laser in situ keratomileusis (LASIK and photorefractive keratectomy (PRK. These agents have not been previously compared in a prospective manner to determine their efficacy in these settings. Methods: This prospective, single-masked, randomized study comprised 256 eyes from 128 consecutive patients being treated with LASIK or PRK who were randomized to receive tetracaine in one eye and proparacaine in the other. The patients were blinded as to which anesthetic agent was used in each eye. Pain levels were graded on a 0–10 scale, and were assessed upon instillation, during surgery, immediately postoperatively, 30 minutes postoperatively, overnight, and on postoperative day 1. Patients were asked 30 minutes after surgery which anesthetic agent they would choose. Results: Both anesthetic agents resulted in diminished amounts of subjective pain in patients undergoing LASIK and PRK. Tetracaine caused significantly more pain upon instillation than proparacaine for both LASIK and PRK patients. LASIK patients noted significantly less pain 30 minutes after surgery when treated with tetracaine. Significantly more LASIK patients preferred the eye treated with tetracaine. These differences were not present in the PRK group. Conclusion: Both tetracaine and proparacaine are effective methods of topical anesthesia in LASIK and PRK. Tetracaine caused significantly more pain upon instillation in all patients, but resulted in greater analgesia 30 minutes after surgery in the LASIK group. Patients in the LASIK group expressed a preference for tetracaine over proparacaine. There was no significant drop preference among PRK patients

  16. Photorefractive keratectomy for the correction of residual refractive error with Intacs intrastromal corneal ring segments in place.

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    Tan, Bryan U; Purcell, Tracy L; Nalgirkar, Aniruddha; Ehrenhaus, Michael P; Torres, Luis F; Schanzlin, David J

    2008-06-01

    To evaluate the efficacy and safety of photorefractive keratectomy (PRK) for residual refractive errors in patients who had previous insertion of intrastromal corneal ring segments (Intacs, Addition Technology, Inc.) for treatment of low myopia. Shiley Eye Center, University of California San Diego, La Jolla, California, USA. This retrospective case series comprised patients who had Intacs segment implantation and subsequently developed myopic regression. Eight eyes of 5 patients had PRK over the Intacs in situ for the correction of the residual refractive error. Six (75%) of the 8 eyes had plano refraction with 20/20 or better uncorrected visual acuity (UCVA) 1 month after PRK enhancement. Three months postoperatively, all eyes had plano refraction with 20/20 or better acuity. At the last follow-up examination (up to 2 years), all eyes had near plano vision (20/10 to 20/25). The corneal surface epithelium in all eyes healed in 3 to 5 days. One patient had subepithelial haze in both eyes, which resolved with epithelial scraping with mitomycin-C (MMC) application and a phototherapeutic keratectomy enhancement. This small series showed that PRK can be used to treat residual refractive error after Intacs insertion. The UCVA was 20/25 or better in all cases after PRK enhancement. The incidence of post-PRK haze in this series of patients was high; topical MMC might be used in future cases to mitigate the problem.

  17. Topography-guided transepithelial photorefractive keratectomy for irregular astigmatism using a 213 nm solid-state laser.

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    Allan, Bruce D; Hassan, Hala

    2013-01-01

    To explore the use of the Pulsar Z1 solid-state 213 nm photorefractive laser platform in topography-guided transepithelial photorefractive keratectomy (PRK) for irregular astigmatism. Moorfields Eye Hospital, London, United Kingdom. Prospective clinical case series. Patients with irregular astigmatism after previous refractive surgery or corneal transplantation were treated with topography-guided transepithelial PRK. Preoperatively and 1-year postoperatively, corrected distance visual acuity (CDVA) and secondary outcome measures (including manifest refraction, contrast sensitivity, haze score, index of surface variation, root-mean-square higher-order aberrations, and subjective visual change) were compared between groups. Adjunctive mitomycin-C was not used. Seven patients had previous refractive surgery, and 7 had previous corneal transplantation. All but 2 patients with a marked haze response had subjective gains in vision and improved CDVA. Gains in CDVA for patients with irregular astigmatism after previous refractive surgery (median 2 lines gain; range 0 to 2 lines gained) were higher than for patients with irregular astigmatism after keratoplasty (median 0 lines; range 5 lines lost to 4 lines gained). Trends in secondary outcome measures were similar, with greater variation in post-keratoplasty patients. Haze scores were higher in post-keratoplasty patients. 213 nm topography-guided transepithelial PRK was easy to perform and well tolerated by patients with irregular astigmatism. Most patients gained CDVA; however, increased haze responses were observed in post-keratoplasty cases. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  18. Short-term visual result after simultaneous photorefractive keratectomy and small-aperture cornea inlay implantation

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    Moshirfar M

    2016-11-01

    Full Text Available Majid Moshirfar,1,2 Ryan T Wallace,3 David F Skanchy,4 Jordan D Desautels,5 Steven H Linn,1 Phillip C Hoopes Jr,1 Daniel S Durrie1,6 1Hoopes, Durrie, Rivera, Research Center, Hoopes Vision, Draper, UT, 2Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, 3Brigham Young University, Provo, UT, 4McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, 5Tufts University School of Medicine, Boston, MA, 6Durrie Vision, Overland Park, KS, USA Purpose: To report the short-term results of simultaneous photorefractive keratectomy (PRK and small-aperture cornea inlay implantation (KAMRA surgery in treating presbyopia. Methods: Simultaneous PRK and KAMRA inlay surgery was performed on 21 patients from July 2015 to March 2016. Follow-up exams were conducted at 1, 3, and 6 months postoperatively. Our patients were also divided preoperatively into three categories: myopic, hyperopic, and emmetropic. Over the 6-month period, the main outcome measures were uncorrected near visual acuity (UNVA, changes in best-corrected distance visual acuity, and mean spherical equivalent refraction. Results: At 6-month follow-up, 83% (10/12 of patients had a monocular UNVA of 20/40 or better, and 75% had a binocular UNVA of 20/40 (J5 or better. At 6 months, the overall mean refractive spherical equivalent (MRSE was -0.60 D (±0.42 standard deviation [SD], range: -1.38 to -0.13 with a mean change of -0.43 D (±1.19 SD, range: -1.5 to 2.63 compared to preoperative data. Overall, 91% (10/11 of patients were within a ±0.5 D range of our target -0.75 D for KAMRA use. One-hundred percent (5/5 of the hyperopes, 50% (1/2 of emmetropes, and 100% (4/4 of myopes met the targeted range. At 6 months, the MRSE for the hyperopic subgroup (n=5 was 0.33 D (±0.20 SD, the MRSE for the emmetropic subgroup (n=2 was -1.19 D (±0.19 SD, and the MRSE for the myopic

  19. Photorefractive keratectomy for correction of myopia: Our one-year experience

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    Resan Mirko

    2012-01-01

    Full Text Available Background/Aim. Photorefractive keratectomy (PRK, after laser in situ keratomileusis (LASIK, is commonly performed refractive surgical method worldwide. The aim of this study was to examine the effectiveness and safety of PRK in correction of various strengths of myopia and to assess how much corneal tissue is being removed with one diopter sphere (Dsph correction by using different optical zones (OZ. Methods. A prospective study with a follow-up period of 6 months included 55 patients of which 100 myopic eyes were treated by PRK method (one eye was included in 10 patients. Myopic eyes with a preoperative best corrected visual acuity (BCVA = 1.0 (20/20 were analysed. In order to assess the effectiveness of PRK operated myopic eyes were divided into four groups according to the dioptric power: 1≤ -1.75 Dsph (n = 26; 2 from -2 to -3.75 Dsph (n = 44; 3 from -4 to -6.75 Dsph (n = 23, and 4 ≥ -7 Dsph (n = 7. Myopic eyes with preoperative BCVA ≤ 0.9 (amblyopic eyes were excluded from the study, as well as eyes with astigmatism > -1.5 Dcyl. To assess the effectiveness of PRK we examined the percentage of eyes in the mentioned groups, which derived uncorrected visual acuity (UCVA 6 months after the intervention to the following: a UCVA = 1.0 (20/20 and b UCVA ≥ 0.5 (20/40. To assess the safety of PRK we examined the frequency of intraoperative and postoperative complications. To estimate how much corneal tissue was removed with one Dsph correction by using different OZ, we used preoperative and postoperative (after 6 months central pachymetry values expressed in μm and volume of cornea (central 7 mm expressed in mm³. In that sense, we used only the myopic eyes with clear preoperative spherical refraction. The total number of these eyes was 27, of which 16 eyes were treated using a 6.5 mm OZ and 11 eyes using a 7 mm OZ. Results. Refractive spherical equivalent (RSE for all eyes was in the range from -0.75 to -8.75 Dsph, and preoperative mean

  20. Prophylactic Effects of Mitomycin-C on Regression and Haze Formation in Photorefractive Keratectomy

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    Hassan Hashemi

    2008-12-01

    Full Text Available

    PURPOSE: To study the effect of prophylactic application of mitomycin-C on regression and corneal haze formation after photorefractive keratectomy (PRK for high myopia. METHODS: Fifty-four eyes of 28 high myopic patients were enrolled in this prospective study. All eyes underwent PRK with application of 0.02% mitomycin-C for two minutes and irrigation with 15-20 ml of normal saline. Follow-up visits were scheduled for the first 7 days and 1, 3 and 6 months after surgery. Hanna grading (in the scale of 0 to 4+ was used to assess corneal haze. RESULTS: Mean spherical equivalent refraction (SE was -7.08 ± 1.11 diopters (D, preoperatively. All eyes were examined on the first 7 days and one month after surgery; 48 eyes (88.9% were evaluated 3 and 6 months post-surgery. Six months after surgery, all eyes had uncorrected visual acuity (UCVA of 20/40 or better and 37 eyes (77.1 % achieved UCVA of 20/20 or better, 45 eyes (93.7% had SE within ±1.00D of emmetropia. One month postoperatively, 2 eyes (3.7% had grade 0.5 haze, while at 3 and 6 months after surgery no visited eye had haze at all. There was no decrease in best corrected visual acuity after 6 months. In spatial frequencies of 6 and 12 cycle/degree, contrast sensitivity decreased immediately after PRK but increased to the preoperative values by the 6th postoperative month

  1. A prospective, contralateral comparison of photorefractive keratectomy (PRK versus thin-flap LASIK: assessment of visual function

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    Hatch BB

    2011-04-01

    Full Text Available Bryndon B Hatch1, Majid Moshirfar1, Andrew J Ollerton1, Shameema Sikder2, Mark D Mifflin11John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 2Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USAPurpose: To compare differences in visual acuity, contrast sensitivity, complications, and higher-order ocular aberrations (HOAs in eyes with stable myopia undergoing either photorefractive keratectomy (PRK or thin-flap laser in situ keratomileusis (LASIK (intended flap thickness of 90 µm using the VISX Star S4 CustomVue excimer laser and the IntraLase FS60 femtosecond laser at 1, 3, and 6 months postoperatively.Methods: In this prospective, masked, and randomized pilot study, refractive surgery was performed contralaterally on 52 eyes: 26 with PRK and 26 with thin-flap LASIK. Primary outcome measures were uncorrected distance visual acuity (UDVA, corrected distance visual acuity (CDVA, contrast sensitivity, and complications.Results: At 6 months, mean values for UDVA (logMAR were -0.043 ± 0.668 and -0.061 ± 0.099 in the PRK and thin-flap LASIK groups, respectively (n = 25, P = 0.466. UDVA of 20/20 or better was achieved in 96% of eyes undergoing PRK and 92% of eyes undergoing thin-flap LASIK, whereas 20/15 vision or better was achieved in 73% of eyes undergoing PRK and 72% of eyes undergoing thin-flap LASIK (P > 0.600. Significant differences were not found between treatment groups in contrast sensitivity (P ≥ 0.156 or CDVA (P = 0.800 at postoperative 6 months. Types of complications differed between groups, notably 35% of eyes in the thin-flap LASIK group experiencing complications, including microstriae and 2 flap tears.Conclusion: Under well-controlled surgical conditions, PRK and thin-flap LASIK refractive surgeries achieve similar results in visual acuity, contrast sensitivity, and induction of HOAs, with differences in experienced complications.Keywords: photorefractive keratectomy, thin-flap LASIK, visual

  2. Comparison of the visual acuity after photorefractive keratectomy using Early Treatment Diabetic Retinopathy Study Chart and E-chart.

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    Ghorbanhosseini, Saeedeh; Hashemi, Hassan; Jafarzadehpur, Ebrahim; Yekta, Abbasali; Khabazkhoob, Mehdi

    2016-12-01

    To compare the visual responses of post refractive surgery's patients using Early Treatment Diabetic Retinopathy Study Chart (ETDRS) and E-chart with and without color filters. The uncorrected Logarithm of the Minimum Angle of Resolution Visual Acuity (LogMAR VA) of 70 patients with a mean age of 26.2 ± 3.76 years (from 19 to 34 years) who had undergone Photorefractive Keratectomy (PRK) (the range of post operation refractive error: ±0.5 D) was measured under the light conditions of with and without asymmetrical glare by using red, green, and yellow filters and ETDRS chart and E-chart. In both light conditions of with and without glare, the mean visual acuity of the three filters in the right and left eyes was significantly better with the E-chart versus the ETDRS chart (P charts using the red filter (P = 0.30). Visual acuity measurements were different with ETDRS chart and E-chart. These two charts cannot be used interchangeably.

  3. Update on excimer laser photorefractive keratectomy (PRK) at Cedars-Sinai Medical Center: two-year experience

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    Maguen, Ezra I.; Salz, James J.; Warren, Cathy; Papaioannou, Thanassis; Nesburn, Anthony B.; Macy, Jonathan I.; Hofbauer, John; Grundfest, Warren S.

    1993-06-01

    Our two year experience with excimer laser photorefractive keratectomy for the correction of myopia on 160 eyes of 128 patients is described. All eyes were treated with a VISX Twenty- Twenty excimer laser, with the following parameters: radiant exposure 160 mJ/cm2, frequency 5 Hz, ablation zone diameter 5.0 to 5.5 mm, and stromal ablation rate 0.18 to 0.33 (mu) /pulse. A suction fixation ring was used in all cases either with nitrogen flow (79 eyes) or without nitrogen flow (81 eyes) across the cornea. Follow-up ranged from one month (152 eyes) to 24 months (12 eyes). The results are stable between 3 and 24 months with less than 0.25 D change in the mean postoperative spherical equivalents. In eyes with a follow-up of 6 to 24 months, 77% to 100% were 20/40 or better uncorrected, and 84% to 92% were corrected to within +/- 1 D of emmetropia. Further follow-up is needed to assess the long term safety and efficacy of the procedure.

  4. Endothelin-1 enhances corneal fibronectin deposition and promotes corneal epithelial wound healing after photorefractive keratectomy in rabbits.

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    Lai, Yu-Hung; Wang, Hwei-Zu; Lin, Chang-Ping; Hong, Show-Jen; Chang, Shun-Jen

    2008-05-01

    The objective was to study the effects of endothelin-1 (ET1) on corneal wound healing after photorefractive keratectomy (PRK) in rabbit corneas. Following PRK, 18 New Zealand white rabbits were treated with ET1 in the right eyes and with phosphate-buffered salt solution (PBS) in the left eyes. Corneal epithelial wound size, corneal haze and corneal thickness were recorded. Corneal extracellular matrixes, including collagen types 3, 4 and 7, chondroitin sulfate and fibronectin, were investigated using immunohistochemistry study. ET1 increased the rate of healing of corneal epithelial wounds in rabbits. Anti-fibronectin fluorescence was present at week 12 and week 24 in ET1-treated eyes but not in the control eyes. There were no significant differences in corneal haze, corneal thickness and changes in other extracellular matrixes between ET1- and PBS-treated eyes. ET1 can enhance the deposition of fibronectin in corneal stroma and promote corneal epithelial wound healing after PRK. The increase in fibronectin probably explains the increased healing rate of corneal epithelial wounds.

  5. Endothelin-1 Enhances Corneal Fibronectin Deposition and Promotes Corneal Epithelial Wound Healing after Photorefractive Keratectomy in Rabbits

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    Yu-Hung Lai

    2008-05-01

    Full Text Available The objective was to study the effects of endothelin-1 (ET1 on corneal wound healing after photorefractive keratectomy (PRK in rabbit corneas. Following PRK, 18 New Zealand white rabbits were treated with ET1 in the right eyes and with phosphate-buffered salt solution (PBS in the left eyes. Corneal epithelial wound size, corneal haze and corneal thickness were recorded. Corneal extracellular matrixes, including collagen types 3, 4 and 7, chondroitin sulfate and fibronectin, were investigated using immunohistochemistry study. ET1 increased the rate of healing of corneal epithelial wounds in rabbits. Anti-fibronectin fluorescence was present at week 12 and week 24 in ET1-treated eyes but not in the control eyes. There were no significant differences in corneal haze, corneal thickness and changes in other extracellular matrixes between ET1- and PBS-treated eyes. ET1 can enhance the deposition of fibronectin in corneal stroma and promote corneal epithelial wound healing after PRK. The increase in fibronectin probably explains the increased healing rate of corneal epithelial wounds.

  6. The effect of silicone hydrogel bandage soft contact lens base curvature on comfort and outcomes after photorefractive keratectomy.

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    Taylor, Kenneth R; Molchan, Ryan P; Townley, J Richard; Caldwell, Matthew C; Panday, Vasudha A

    2015-03-01

    To evaluate the relative pain and the relative amount of contact lens loss experienced using two different base curvatures (BCs) of the Acuvue Oasys bandage soft contact lens (BSCL) after photorefractive keratectomy (PRK). One hundred forty patients undergoing PRK on either the Allegretto or the VISX laser at the Joint Warfighter Refractive Surgery Center in Lackland AFB, TX, were randomized to one of the two different BCs of the Acuvue Oasys BSCL: 8.4 or 8.8 mm. Patients were evaluated on postoperative days 1 and 4 during which they completed a survey rating absolute pain in each eye on a visual analog pain scale. Lens loss was recorded throughout the study. Patients treated on the Allegretto laser preferred the 8.4-mm BC lens, whereas comfort after treatment on the VISX depended on corneal shape. For VISX, patients with very flat corneas (steep K ≤42 preoperative or ≤38 postoperatively) preferred an 8.8-mm BC lens while patients with very steep corneas (steep K >45 preoperative or >42 postoperative) preferred an 8.4-mm BC lens, though these results were largely not statistically significant. Patients who lost their lenses prematurely tended to be those whose corneal curvature did not match their contact lens BC. Individuals treated with the Allegretto laser or individuals with more prolate corneas should likely be fit with an 8.4-mm BC Acuvue Oasys BSCL while individuals with more oblate corneas should likely be fit with an 8.8-mm BC lens to minimize postoperative pain and premature BSCL loss.

  7. Assessment of contrast sensitivity and aberrations after photorefractive keratectomy in patients with myopia greater than 5 diopters.

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    Alireza Fahim

    2013-08-01

    Full Text Available This study aimed to assess changes in contrast sensitivity and aberrations in cases of myopia greater than 5.0 diopter (D who had photorefractive keratectomy (PRK. In this semi-experimental study, 20 eyes of ten patients were studied. Inclusion criteria were at least 5.0 D of myopia, stable refraction in the past year, no history of refractive surgery, a minimum corneal thickness of 480 μm, and having surgery in both eyes. Exclusion criteria were the presence of any corneal condition. In addition to the routine tests, aberrometry and assessment of contrast sensitivity was done using the WaveLight Allegro Analyzer and the VectorVision CSV-1000. After PRK using the Concerto Excimer Laser (WaveLight, Alcon, patients were scheduled to have follow-up visits at 1 month, 3 months, and 1 year after surgery. Contrast sensitivity with glare showed an increasing trend only at the spatial frequency of 3 cycles per degree (cpd (P=0.013. Contrast sensitivity without glared increased postoperatively at special frequencies of 3, 6, and 18 cpd (P<0.05. The preoperative level of higher order aberrations root mean square (HOA RMS of 0.24±0.08 reached 0.71±0.25 at 12 months after surgery. Assessment of comma and trefoil showed no significant difference between preoperative and postoperative values, but the amount of spherical aberration changed from a mean preoperative value of 0.0±0.09 to 0.27±0.15 at 12 months after surgery. In the treatment of myopia greater than 5.0 D, PRK with the Concerto Excimer Laser can improve contrast sensitivity in certain spatial frequencies. This is while HOA RMS and spherical aberration increase.

  8. Comparison of 5468 retreatments after laser in situ keratomileusis by lifting the flap or performing photorefractive keratectomy on the flap.

    Science.gov (United States)

    Ortega-Usobiaga, J; Llovet-Osuna, F; Katz, T; Djodeyre, M R; Druchkiv, V; Bilbao-Calabuig, R; Baviera, J

    2017-06-23

    To assess visual outcomes of retreatment after laser in situ keratomileusis (LASIK) by lifting the flap or performing photorefractive keratectomy (PRK) on the flap, as well as to establish whether there was an increased risk of epithelial ingrowth (EIG) when LASIK and lifting of the flap are separated by a long time interval and to determine the incidence of corneal haze after PRK. Retrospective study of 4077 patients (5468 eyes) who underwent LASIK and subsequent retreatment were reviewed in order to study their visual results and identify cases of EIG and corneal haze. Enhancements included 5196 eyes from 3876 patients that were retreated by lifting the flap, and 272 eyes from 201 patients that were retreated by PRK on the flap. No statistically significant differences were found between the retreatments in terms of predictability, efficacy, and safety. A total of 704 cases of EIG were found after lifting the flap, for which surgical cleansing was necessary in 70. Surgical cleansing decreased the efficacy index when compared with patients with EIG who did not need cleansing (P=.01). Differences in terms of safety and predictability were not statistically significant. The incidence of corneal haze after ablation of the surface of the previous flap was 14.34%, although none of these cases were clinically relevant. Visual outcomes were similar between patients who were retreated by lifting the flap and those who underwent PRK. The incidence of EIG when the flap was lifted was 13.55%. The incidence of EIG increases with the time elapsed between the primary procedure and retreatment. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Does mitomycin C cause toxicity in the cornea after photorefractive keratectomy? A comparative wound-healing study in a refractive surgery animal model.

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    Blanco-Mezquita, Tomas; Espandar, Ladan; Torres, Rodrigo; Alvarez-Barcia, Angel; Cantalapiedra-Rodriguez, Roberto; Martinez-Garcia, Carmen; Merayo-Lloves, Jesus

    2014-11-01

    In this study, we investigated the wound-healing process after photorefractive keratectomy with mitomycin C (MMC) in hen corneas. In addition, we evaluated the synergistic effect of ethanol and MMC. Forty-eight adult hens were divided into 3 groups: A: ethanol-assisted debridement plus MMC; B: mechanical debridement plus MMC; and C: mechanical debridement (MMC-untreated control). Photorefractive keratectomy was performed, and the animals were followed up for up to 60 days. Epithelial healing was measured with fluorescein. Apoptosis was evaluated by terminal deoxynucleotidyl transferase dUTP nick end-labeling assay and proliferation was measured by BrdU incorporation. Both myofibroblast differentiation and collagen deposition were evaluated by immunofluorescence and histology. Epithelial wound closure was similar in all 3 groups (P > 0.05). Significant reduction in haze was observed in groups A and B compared with C (P 0.05). Furthermore, there was no difference in the number of apoptotic cells between groups. Proliferation was delayed in both groups A and B compared with C (P 0.05). Myofibroblasts, cellular density, and collagen deposition were lower in both groups A and B compared with C (P 0.05). Topical application of MMC in hen corneas reproduces the wound healing observed in humans by reducing haze, keratocyte proliferation, myofibroblast differentiation, and new collagen deposition. Synergistic cytotoxic effects of ethanol and MMC were not observed.

  10. Ceratectomia fotorrefrativa baseada em topografia para correção da hipermetropia secundária à ceratotomia radial Topographically-guided photorefractive keratectomy for the management of secondary hyperopia following radial keratectomy

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    Vinícius Coral Ghanem

    2007-10-01

    Full Text Available OBJETIVO: Descrever nova técnica de ceratectomia fotorrefrativa baseada em topografia para correção da hipermetropia secundária à ceratotomia radial. MÉTODOS: Estudo retrospectivo realizado em pacientes submetidos a ceratectomia fotorrefrativa baseada em topografia para a correção da hipermetropia secundária à ceratotomia radial. Os pacientes apresentavam, no mínimo, 3 dioptrias de hipermetropia no pré-operatório, e apresentavam acompanhamento mínimo de 3 meses. RESULTADOS: Neste estudo foram avaliados 24 olhos de 21 pacientes com idade entre 36 e 55 anos (média de 45,54 ± 6,03 anos. O período médio de acompanhamento foi de 7,71 ± 4,6 meses (variando de 3 a 17 meses. A média do EE no pré-operatório foi de +3.92 ± 1.57, com variação de +1,25 D a +7,75 D e após a ablação, a média foi -0,29 ± 1,43 variando de 3,75 D a +2,50 D (pPURPOSE: To describe a topographically guided photorefractive keratectomy technique for the management of secon dary hyperopia following radial keratectomy. METHODS: A retrospective study was carried out in patients where a topographically guided photorefractive keratectomy technique was performed for the management of secondary hyperopia following radial keratectomy. The patients had preoperatively at least 3 diopters of hyperopia. The minimum follow-up was 3 months. RESULTS: Twenty-four eyes of 21 patients were evaluated. The mean age was 45.54 ± 6.03 years (range 36 to 55 years. The average follow-up was 7.71 ± 4.6 months (range 3 to 17 months. Preoperatively the average spherical equivalent was +3.92 ± 1.57 (range +1.25 D to +7.75 D, and postoperatively it was -0.29 ± 1.43 (range -3.75 D to +2.50 D (p<0.01. Visual acuity of 20/25 or better was achieved in 45.83% of the eyes, 20/40 or better in 83.33% and 20/60 or better in 100%. All patients were satisfied with the results and stated subjective improvement in visual quality. CONCLUSION: Considering that it is a retreatment procedure

  11. Masked comparison of silicone hydrogel lotrafilcon A and etafilcon A extended-wear bandage contact lenses after photorefractive keratectomy.

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    Engle, Andrew T; Laurent, John M; Schallhorn, Steven C; Toman, Steven D; Newacheck, James S; Tanzer, David J; Tidwell, James L

    2005-04-01

    To compare the efficacy of 2 types of bandage contact lenses (BCLs) after photorefractive keratectomy (PRK). Navy Refractive Surgery Center, Naval Medical Center San Diego, San Diego, California, USA. In this prospective study, 100 patients received PRK in both eyes. Each patient received a BCL composed of etafilcon A (Acuvue [ACV], Vistakon Inc.) (14.0 diameter, 8.4/8.8 base curve) in 1 eye and lotrafilcon A (Focus Night & Day [N&D], Ciba Vision) (13.8 diameter, 8.4/8.6 base curve) in the fellow eye. The patient was masked to the lens type in each eye. The postoperative medication regimen was the same with both lenses. The epithelial defect size and subjective level of discomfort were measured at surgery and daily after surgery until both eyes had reepithelialized and the lenses were removed. The mean epithelial defect size at surgery was similar with both BCLs (ACV 57.07 mm(2) and N&D 57.53 mm(2); P=.422). On postoperative days 1 and 2, the mean defect size was significantly smaller in eyes with the N&D lens (day 1, ACV 21.53 and N&D 18.74; day 2, ACV 3.62 and N&D 2.12) (paired t test, Plenses and 13 eyes with ACV lenses had. On day 3, 70 eyes with N&D lenses and 66 eyes with ACV lenses had reepithelialized. The mean discomfort index was significantly higher in the eyes with ACV lenses on days 1 and 2 (paired t test, Plenses on days 1, 2, and 3 (paired t test, P<.001, P<.008, P<.003, respectively). No correlation between the use of tetracaine in the first 24 hours and the rate of reepithelialization was noted (R(2)=0.0025 for ACV and R(2)=0.0003 for N&D). The lotrafilcon A lens resulted in significantly faster corneal reepithelialization and reduced patient discomfort in most patients during the first 48 hours after PRK.

  12. Comparison of single-step reverse transepithelial all-surface laser ablation (ASLA to alcohol-assisted photorefractive keratectomy

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    Aslanides IM

    2012-06-01

    Full Text Available Ioannis M Aslanides,1 Sara Padroni,1 Samuel Arba Mosquera,2 Antonis Ioannides,1 Achyut Mukherjee11Emmetropia Mediterranean Eye Institute, Heraklion, Crete, Greece; 2Schwind eye-tech-solutions GmbH, Kleinostheim, GermanyPurpose: To evaluate postoperative pain, corneal epithelial healing, development of corneal haze, refractive outcomes, and corneal aberrations in a novel one-step, modified transepithelial photorefractive keratectomy (PRK, termed All-surface laser ablation (ASLA, compared to conventional, alcohol-assisted PRK.Materials and methods: Sixty eyes of 30 myopic patients were prospectively recruited to a randomized fellow eye study. Patients underwent conventional alcohol-assisted PRK in one eye (control group and ASLA-modified transepithelial PRK in the other (30 eyes in each treatment arm. Primary endpoints were postoperative pain and haze scores at 1 day, 3 days, 1 week, and 1, 3, 6, and 12 months. Secondary endpoints included visual acuity at 1, 3, 6, and 12 months, corneal aberrations at 3, 6, and 12 months, and early and late onset haze. Refractive predictability, safety, and efficacy of the two methods were considered.Results: The average age of the cohort was 29 years (standard deviation [SD]: 9; range: 18–46, and the average spherical equivalent refractive error was -4.18 diopters (SD: 1.9. At 3 days after surgery, the average pain score was 64% lower in the ASLA group (P < 0.0005. At this point, 96% of ASLA eyes had no epithelial defect, whereas 43% in the alcohol-assisted group did not achieve complete epithelial healing, and required replacement of bandage contact lens. The haze level was consistently lower in the ASLA group at all time points from 1 to 6 months.Conclusion: This study shows that the ASLA technique may have a future role in refractive surgery, due to the fact that it offers faster epithelial healing, lower pain scores, and significantly less haze formation.Keywords: cornea, ASLA, PRK, alcohol

  13. Stromal wound healing explains refractive instability and haze development after photorefractive keratectomy: a 1-year confocal microscopic study.

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    Moller-Pedersen, T; Cavanagh, H D; Petroll, W M; Jester, J V

    2000-07-01

    To evaluate the mechanism(s) producing refractive instability and corneal haze development after photorefractive keratectomy (PRK). Prospective, nonrandomized, comparative case series, self-controlled. Seventeen eyes of 17 patients with low- to moderate-grade myopia (-2.88 to -9.13 diopters [D]) were included. Surgical intervention was a standardized, 6-mm diameter PRK procedure using the Meditec MEL 60 excimer laser (Aesculap-Meditec, Heroldsberg, Germany). The photoablation center was evaluated before surgery and at 1, 3, 6, 9, and 12 months after PRK using rapid, continuous z-scans of confocal images, termed confocal microscopy through focusing (CMTF). Simultaneous epithelial and stromal thickness analysis and objective assessment of corneal light backscattering were obtained from digital image analysis of the CMTF scans. Corneal reinnervation and anterior stromal keratocyte density and wound healing morphologic features were evaluated on high resolution, in vivo confocal images. Manifest refraction was measured and corneal clarity was graded by slit-lamp biomicroscopy. Epithelial thickness averaged 45+/-10 microm at 1 month, 50+/-8 microm at 3 months, and 52+/-6 microm at 12 months after PRK, as compared with 51+/-4 microm before surgery, demonstrating complete restoration of the preoperative thickness without compensatory hyperplasia. Interestingly, epithelial rethickening had no significant correlation with refractive regression. By contrast, stromal regrowth (from 1-12 months) averaged 6+/-12 microm (range, 27 microm thinning-22 microm rethickening) and correlated closely (r = 0.84, Pwound healing mechanisms. In agreement with these findings, all "hazy" corneas showed increased numbers of anterior stromal wound healing keratocytes with increased reflectivity of both nuclei and cell bodies, suggesting that cellular-based reflections, as opposed to extracellular matrix deposition, are the major origin of increased corneal light scattering after PRK. Taken

  14. Segurança da ceratectomia fotorrefrativa com mitomicina-C para o tratamento de hipermetropia após ceratotomia radial Safety of photorefractive keratectomy with mitomycin-C for the treatment of hyperopia after radial keratotomy

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    Ramon Coral Ghanem

    2010-04-01

    Full Text Available OBJETIVO: Analisar a segurança da ceratectomia fotorrefrativa (PRK com mitomicina-C (MMC em olhos com hipermetropia consecutiva à ceratotomia radial. MÉTODOS: Foram avaliados prospectivamente 60 olhos de 36 pacientes consecutivos, submetidos à ceratectomia fotorrefrativa personalizada pela frente de onda corneana com o laser Esiris Schwind. Realizaram-se desepitelização mecânica, seguida da fotoabla ção, e utilização de MMC 0,02% por 20 ou 40 segundos. Em 16 olhos (26,7% a MMC foi aplicada por 40 segundos. Estes foram submetidos a ablações mais profundas do que 100 micra ou apresentavam córneas submetidas a suturas prévias. Os pacientes foram acompanhados por um ano. RESULTADOS: O equivalente esférico (EE médio antes do PRK era +4,27 D ± 2,18 e a acuidade visual corrigida (AVcc média era 0,174 ± 0,139 (logMAR. O EE médio programado no laser foi +4,74 D ± 2,11, resultando em uma profundidade de ablação de 78 ± 28 µm (de 33 a 148. Não foram observadas complicações intraoperatórias. Após um ano observaram-se: EE médio de + 0,04 D ± 1,03 (pPURPOSE: To evaluate the safety of photorefractive keratectomy (PRK with mitomycin-C (MMC in eyes with hyperopia after radial keratotomy. METHODS: Sixty eyes of 36 consecutive patients treated with corneal wavefront-guided PRK using an Esiris-Schwind excimer laser were prospectively evaluated. Corneal epithelium was mechanically removed, followed by photoablation and use of 0.02% MMC for 20 or 40 seconds. In 16 eyes (26.7%, MMC was applied for 40 seconds. These eyes underwent ablations deeper than 100 micron or had previous corneal sutures. Patients were followedup for 12 months. RESULTS: The mean spherical equivalent (SE before PRK was +4.27 D ± 2.18, and the mean bestcorrected visual acuity (BCVA was 0.174 ± 0.139 (logMAR. The planned laser SE correction was +4.74 D ± 2.11, resulting in an ablation depth of 78 ± 28 µm (from 33 to 148. No intraoperative complications were

  15. Effect of the combination of basic fibroblast growth factor and cysteine on corneal epithelial healing after photorefractive keratectomy in patients affected by myopia

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    Alessandro Meduri

    2014-01-01

    Full Text Available Background: This study sought to evaluate the effect of basic fibroblast growth factor eye drops and cysteine oral supplements on corneal healing in patients treated with photorefractive keratectomy (PRK. Materials and Methods: One hundred and twenty patients treated bilaterally with PRK for myopia were enrolled at one of two eye centers (Clinica Santa Lucia, Bologna, Italy and Department of Ophthalmology, University of Magna Graecia, Catanzaro, Italy and were treated at the former center. Sixty patients included in the study group (Group 1 were treated postoperatively with topical basic fibroblast growth factor plus oral L-cysteine supplements, whereas 60 subjects included in the control group (Group 2 received basic fibroblast growth factor eye drops. We recorded the rate of corneal re-epithelialization and patients were followed-up every 30 days for 6 months. Statistical analyses were performed on the collected data. Results: The eyes in Group 1 demonstrated complete re-epithelialization at Day 5, whereas the eyes in Group 2 achieved this status on Day 6. No side-effects were reported. Conclusions : Patients treated with basic fibroblast growth factor eye drops and L-cysteine oral supplements benefit from more rapid corneal re-epithelialization. In human eyes, this combination treatment appeared to be safe and effective in accelerating corneal surfacing after surgery. Financial Disclosure: No author has any financial or proprietary interest in any material or method used in this study. Trial Registration: Current Controlled Trials ISRCTN73824458.

  16. Comparison of LASIK and photorefractive keratectomy for myopia from -10.00 to -18.00 diopters 10 years after surgery.

    Science.gov (United States)

    Rosman, Mohamad; Alió, Jorge L; Ortiz, Dolores; Perez-Santonja, Juan J

    2010-03-01

    To compare the long-term outcomes of LASIK and photorefractive keratectomy (PRK) for high myopia (> or = -10.00 diopters [D]). This retrospective study included eyes with high myopia that underwent PRK (51 eyes) and LASIK (141 eyes) at the Instituto Oftalmologico de Alicante, Spain, and returned for 10-year follow-up. Ten years after surgery, 45.5% of eyes in the LASIK group achieved uncorrected visual acuity (UCVA) of 20/40 or better compared to 31.3% in the PRK group. Mean efficacy indices after 10 years in both groups were similar (0.87 in the LASIK group and 0.82 in the PRK group, P=.51). Twenty-one (41%) eyes in the PRK group were within +/-1.00 D whereas 60 (42.5%) eyes from the LASIK group were within +/-1.00 D 10 years after surgery. Six (14%) eyes from the PRK group lost 2 or more lines of BSCVA compared to 7 (6%) eyes from the LASIK group. LASIK and PRK have been shown to have similar visual acuity efficacy in the treatment of eyes with high myopia in the long-term, with LASIK having superior visual acuity efficacy and safety over PRK within the first 2 years after surgery. However, treatment of myopia > or =-10.00 D by LASIK is no longer routinely advocated whereas the treatment of high myopia by PRK is no longer performed due to potential complications associated with the treatment. Haze in postoperative PRK eyes was a significant long-term problem in our study. Copyright 2010, SLACK Incorporated.

  17. Compare the effects of two silicone-hydrogel bandage contact lenses on epithelial healing after photorefractive keratectomy with anterior segment optical coherence tomography.

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    Eliaçık, Mustafa; Erdur, Sevil Karaman; Gülkılık, Gökhan; Özsütçü, Mustafa; Karabela, Yunus

    2015-06-01

    To evaluate the efficacy of two silicone hydrogel bandage lenses (SiHy) on epithelial healing following photorefractive keratectomy (PRK) with anterior segment optical coherence tomography (AS-OCT). Forty-two eyes of 21 patients who underwent PRK were included in a contralateral eye comparison study. At the end of the procedure, one eye of each patient was fitted with a Lotrafilcon B contact lens whereas the fellow eye was fitted with a Comfilicon A lens. Patients were examined on the day of surgery and at days 1-5 postoperatively. Main outcome measures were number of reepithelialized eyes, epithelial defect size, patient discomfort score and average complete reepithelization time. The number of mean reepithelialized eyes was showed no statistical significance between both groups during the follow up. Average epithelial defect size for Comfilcon A and Lotrafilcon B was 32.7±12.2mm(2) vs. 33.3±12mm(2) at day 1 (p=0.279) and 13.1±6mm(2) vs. 14.5±9mm(2) at day 3 postoperatively (p=0.018). Average re-epithelialization time was 3.1 days for Comfilcon A and 3.6 days for Lotrafilcon B (p=0.03). Mean subjective discomfort score was 2.25±0.96 in eyes with Lotrafilcon B and 1.64±0.67 in eyes with Comfilcon A on the first exam the day after surgery and until third day the differences were statistically significant (p=0.011 and p=0.012, respectively). AS-OCT is a reliable and noncontact method for assessment of reepithelialization under contact lenses after PRK. Eyes with Comfilcon A showed a statistically significant better discomfort score and faster reepithelialization time. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  18. Comparison of postoperative higher-order aberrations and contrast sensitivity: tissue-saving versus conventional photorefractive keratectomy for low to moderate myopia.

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    Hashemi, Hassan; Nazari, Rahman; Amoozadeh, Javad; Beheshtnejad, Amir Houshang; Jabbarvand, Mahmoud; Mohammadpour, Mehrdad; Hashemian, Hesam

    2010-10-01

    To assess the efficacy, predictability, safety, contrast sensitivity, higher-order aberrations (HOAs), and patient satisfaction after tissue-saving photorefractive keratectomy (PRK) and conventional PRK. Department of Ophthalmology, Farabi Eye Hospital, Tehran Medical University, Tehran, Iran. Comparative case series. This prospective study evaluated eyes with low to moderate myopia that had PRK with a Technolas 217z excimer laser. Patients were randomly assigned to have surgery using a conventional algorithm (PlanoScan) or a tissue-saving algorithm (Zyoptix). Contrast sensitivity, HOAs, and patient satisfaction were analyzed preoperatively and 1, 3, and 6 months postoperatively. The conventional group comprised 42 eyes (21 patients) and the tissue-saving group, 62 eyes (31 patients). At 6 months, all eyes in both groups were within ±0.50 diopter of the attempted correction and had an uncorrected distance visual acuity of 20/25 or better. However, the tissue-saving group had a statistically significantly greater increase in the mean root mean square of total HOAs and more induced spherical aberration than the conventional group (P<.05). There was no significant difference between the 2 groups in mesopic or photopic contrast sensitivity. The level of satisfaction after surgery was the same in the 2 groups. Although the conventional and tissue-saving algorithms for PRK were both safe and effective in treating low to moderate myopia, tissue-saving PRK induced a greater increase in HOAs than conventional PRK; this may be because of the smaller blend zone of the tissue-saving algorithm. Contrast sensitivity and patient satisfaction were comparable between the 2 methods. Copyright © 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  19. Comparison of Lotrafilcon B and Balafilcon A silicone hydrogel bandage contact lenses in reducing pain and discomfort after photorefractive keratectomy: A contralateral eye study.

    Science.gov (United States)

    Mohammadpour, Mehrdad; Amouzegar, Afsaneh; Hashemi, Hassan; Jabbarvand, Mahmoud; Kordbacheh, Hamed; Rahimi, Firoozeh; Hashemian, Mohammad Naser

    2015-06-01

    To assess the effect of two silicone hydrogel contact lenses with high oxygen permeability in patients having photorefractive keratectomy (PRK). Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Sixty patients (120 eyes) who had bilateral PRK were enrolled in this double blind clinical trial. Each patient was fitted with a Lotrafilcon B (Air Optix(®)AQUA, Ciba Vision, Duluth, GA, USA) lens in one eye and a Balafilcon A (PureVision™ Bausch & Lomb, Rochester, NY, USA) lens in the fellow eye. Patients' responses to a subjective questionnaire in terms of pain, foreign body sensation, photophobia, blurred vision and epiphora were evaluated on the first and third postoperative days. Mean pain score for Lotrafilcon B and Balafilcon A contact lenses was 4.43±3.18 vs. 5.45±3.37 on the first postoperative day and 3.43±3.23 vs. 3.88±3.01 on the third postoperative day. However, the difference was only significant in the first 24h after surgery (P=0.032). Foreign body sensation was clinically higher with Balafilcon A contact lens (5.0±3.47 vs. 4.08±3.34 on day 1 and 4.98±3.52 vs. 3.55±3.20 on day 3) and the difference was statistically significant on the first and the third postoperative days (P=0.042 and 0.002, respectively). There was no statistically significant difference between two contact lenses in terms of photophobia, epiphora and blurred vision (P>0.05). The Lotrafilcon B lens resulted in significantly less postoperative pain and discomfort after PRK, especially in the first 24h after PRK. Copyright © 2015. Published by Elsevier Ltd.

  20. Evaluation of the prophylactic use of mitomycin-C to inhibit haze formation after photorefractive keratectomy in high myopia: a prospective clinical study

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    Fotouhi Akbar

    2004-09-01

    Full Text Available Abstract Background To study the effect of prophylactic application of mitomycin-C on haze formation in photorefractive keratectomy (PRK for high myopia. Methods Fifty-four eyes of 28 myopic patients were enrolled in this prospective study. All eyes were operated by PRK followed by 0.02% mitomycin-C application for two minutes and washed with 20 ml normal saline afterwards. All eyes were examined thoroughly on the first 7 days and one month after surgery; 48 eyes (88.9% at 3 and 6 months postoperatively. Hanna grading (in the scale of 0 to 4+ was used for assessment of corneal haze. Results The mean spherical equivalent refraction (SE was -7.08 diopters (D ± 1.11 (SD preoperatively. Six months after surgery, 37 eyes (77.1% achieved an uncorrected visual acuity (UCVA of 20/20 or better, all eyes had a UCVA of 20/40 or better and 45 (93.7% eyes had an SE within ± 1.00D. One month postoperatively, 2 eyes (3.7% had grade 0.5+ of haze, while at 3 and 6 months after surgery no visited eye had haze at all. All eyes had a best corrected visual acuity (BCVA of 20/40 or better and there were no lost lines in BCVA by 6 months after surgery. In spatial frequencies of 6 and 12 cycles per degree contrast sensitivity had decreased immediately after PRK and it had increased 1.5 lines by the 6th postoperative month compared to the preoperative data. Conclusions The results show the efficacy of mitomycin-C in preventing corneal haze after treatment of high myopia with PRK. This method- PRK + mitomycin-C – can be considered an alternative treatment for myopic patients whose corneal thicknesses are inadequate for laser in situ keratomileusis (LASIK. However, the results should be confirmed in longer follow-ups.

  1. Pain, wound healing and refractive comparison of mechanical and transepithelial debridement in photorefractive keratectomy for myopia: results of 1 year follow-up.

    Science.gov (United States)

    Celik, Ugur; Bozkurt, Ercüment; Celik, Burcu; Demirok, Ahmet; Yilmaz, Omer F

    2014-12-01

    To compare the efficacy, safety and postoperative pain of mechanical versus transepithelial photorefractive keratectomy (PRK) techniques. Cornea and refractive surgery subspecialty. Prospective clinical trial. This prospective comparative study included 84 eyes of 42 patients with myopia who received mechanical PRK (m-PRK) in 1 eye and transepithelial PRK (t-PRK) in the contralateral eye. The mean patient age was 28.5±6.3 years (range 20-46 years). Postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refractions, postoperative epithelial healing time, surgical time, postoperative pain rating and corneal haze were recorded. At week 1, statistically the UDVA was significantly better in the t-PRK eyes; however, at 3 months, similar refractive stability was achieved in both groups. The mean spherical equivalent (SE) decreased from -2.44±1.00D (m-PRK eyes) and -2.88±1.24D (t-PRK eyes) at baseline to -0.19±0.38D and -0.30±0.40D, respectively, after 1 year. Surgical time was 98.6±9.8s in m-PRK eyes and 58.0±6.4s in t-PRK eyes. On postoperative days 1 and 3, using the global assessment rating, 81% of mPRK eyes that had pain, reported more pain than that reported for the tPRK eyes. In addition, m-PRK treated eyes demonstrated higher mean pain scores based on the 11-point numerical rating scale and Visual Analogue Scale (VAS). The mean time to complete epithelial healing was 2.19±0.39 days (t-PRK) and 3.76±0.43 days (m-PRK). t-PRK for mild-to-moderate myopia was more comfortable than conventional m-PRK; patients had less pain, and faster healing time. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  2. One-Year Results of Simultaneous Topography-Guided Photorefractive Keratectomy and Corneal Collagen Cross-Linking in Keratoconus Utilizing a Modern Ablation Software

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    A. M. Sherif

    2015-01-01

    Full Text Available Purpose. To evaluate effectiveness of simultaneous topography-guided photorefractive keratectomy and corneal collagen cross-linking in mild and moderate keratoconus. Methods. Prospective nonrandomized interventional study including 20 eyes of 14 patients with grade 1-2 keratoconus that underwent topography-guided PRK using a Custom Ablation Transition Zone (CATz profile with 0.02% MMC application immediately followed by standard 3 mw/cm2 UVA collagen cross-linking. Maximum ablation depth did not exceed 58 μm. Follow-up period: 12 months. Results. Progressive statistically significant improvement of UCVA from 0.83±0.37 logMAR preoperative, reaching 0.25±0.26 logMAR at 12 months (P<0.001. Preoperative BCVA (0.27±0.31 logMAR showed a progressive improvement reaching 0.08±0.12 logMAR at 12 months (P=0.02. Mean Kmax reduced from 48.9±2.8 to 45.4±3.1 D at 12 months (P<0.001, mean Kmin reduced from 45.9±2.8 D to 44.1±3.2 D at 12 months (P<0.003, mean keratometric asymmetry reduced from 3.01±2.03 D to 1.25±1.2 D at 12 months (P<0.001. The safety index was 1.39 at 12 months and efficacy index 0.97 at 12 months. Conclusion. Combined topography-guided PRK and corneal collagen cross-linking are a safe and effective option in the management of mild and moderate keratoconus. Precis. To our knowledge, this is the first published study on the use of the CATz ablation system on the Nidek Quest excimer laser platform combined with conventional cross-linking in the management of mild keratoconus.

  3. A retrospective analysis of the postoperative use of loteprednol etabonate gel 0.5% following laser-assisted in situ keratomileusis or photorefractive keratectomy surgery

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    Salinger CL

    2015-11-01

    Full Text Available Clifford L Salinger,1 Michael Gordon,2 Mitchell A Jackson,3 Theodore Perl,4 Eric Donnenfeld5 1VIP Laser Eye Center, Palm Beach Gardens, FL, 2Gordon Weiss Schanzlin Vision Institute, San Diego, CA, 3Jacksoneye, Lake Villa, IL, 4Corneal Associates of New Jersey, Fairfield, NJ, 5Ophthalmic Consultants of Long Island, Garden City, NY, USA Background: While loteprednol etabonate ophthalmic gel 0.5% (LE gel is approved for treatment of postoperative ocular inflammation and pain, there have been no reported studies in patients undergoing laser-assisted in situ keratomileusis (LASIK or photorefractive keratectomy (PRK.Methods: This was a retrospective chart review conducted at five refractive surgical centers in the USA. Data were collected from primary LASIK or PRK surgery cases in which LE gel was used postoperatively as the clinician’s routine standard of care and in which patients were followed-up for up to 6 months. Data extracted from charts included patient demographics, surgical details, LE gel dosing regimen, pre- and postsurgical refractive characteristics, intraocular pressure (IOP measurements, and visual acuity. Primary outcomes included postoperative IOP elevations, adverse events, and early discontinuations.Results: Data were collected on 189 LASIK eyes (96 patients and 209 PRK eyes (108 patients. Mean (standard deviation [SD] years of age at surgery was 36.0 (11.7 and 33.9 (11.3 in LASIK and PRK patients. LE gel was prescribed most often four times daily during the first postoperative week, regardless of procedure; the most common treatment duration was 7–14 days in LASIK and ≥30 days in PRK patients. No unusual corneal findings or healing abnormalities were reported. Mean postoperative uncorrected distance visual acuity was 20/24 in LASIK and 20/30 in PRK eyes. Mild/trace corneal haze was reported in 20% of PRK patients; two PRK patients with moderate/severe corneal haze were switched to another corticosteroid. Mean postoperative

  4. Safety, Efficacy, Predictability and Stability Indices of Photorefractive Keratectomy for Correction of Myopic Astigmatism with Plano-Scan and Tissue-Saving Algorithms

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    Mehrdad Mohammadpour

    2013-10-01

    Full Text Available Purpose: To assess the safety, efficacy and predictability of photorefractive keratectomy (PRK [Tissue-saving (TS versus Plano-scan (PS ablation algorithms] of Technolas 217z excimer laser for correction of myopic astigmatismMethods: In this retrospective study one hundred and seventy eyes of 85 patients (107 eyes (62.9% with PS and 63 eyes (37.1% with TS algorithm were included. TS algorithm was applied for those with central corneal thickness less than 500 µm or estimated residual stromal thickness less than 420 µm. Mitomycin C (MMC was applied for 120 eyes (70.6%; in case of an ablation depth more than 60 μm and/or astigmatic correction more than one diopter (D. Mean sphere, cylinder, spherical equivalent (SE refraction, uncorrected visual acuity (UCVA, best corrected visual acuity (BCVA were measured preoperatively, and 4 weeks,12 weeks and 24 weeks postoperatively.Results: One, three and six months postoperatively, 60%, 92.9%, 97.5% of eyes had UCVA of 20/20 or better, respectively. Mean preoperative and 1, 3, 6 months postoperative SE were -3.48±1.28 D (-1.00 to -8.75, -0.08±0.62D, -0.02±0.57 and -0.004± 0.29, respectively. And also, 87.6%, 94.1% and 100% were within ±1.0 D of emmetropia and 68.2, 75.3, 95% were within ±0.5 of emmetropia. The safety and efficacy indices were 0.99 and 0.99 at 12 weeks and 1.009 and 0.99 at 24 weeks, respectively. There was no clinically or statistically significant difference between the outcomes of PS or TS algorithms or between those with or without MMC in either group in terms of safety, efficacy, predictability or stability. Dividing the eyes with subjective SE≤4 D and SE≥4 D postoperatively, there was no significant difference between the predictability of the two groups. There was no intra- or postoperative complication.Conclusion: Outcomes of PRK for correction of myopic astigmatism showed great promise with both PS and TS algorithms.

  5. Visual rehabilitation in low-moderate keratoconus:intracorneal ring segment implantation followed by same-day topography-guided photorefractive keratectomy and collagen cross linking

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    Ferial M. Zeraid

    2014-10-01

    Full Text Available AIM:To present the results of same-day topography-guided photorefractive keratectomy (TG-PRK and corneal collagen crosslinking (CXL after previous intrastromal corneal ring segment (ISCR implantation for keratoconus.METHODS:An experimental clinical study on twenty-one eyes of 19 patients aged 27.1±6.6y (range 19-43y, with low to moderate keratoconus who were selected to undergo customized TG-PRK immediately followed by same-day CXL, 9mo after ISCR implantation in a university ophthalmology clinic. Refraction, uncorrected distance visual acuities (UDVA and corrected distance visual acuities (CDVA, keratometry (K values, central corneal thickness (CCT and coma were assessed 3mo after TG-PRK and CXL.RESULTS:After TG-PRK/CXL:the mean UDVA (logMAR improved significantly from 0.66±0.41 to 0.20±0.25 (P<0.05; Kflat value decreased from:48.44±3.66 D to 43.71±1.95 D; Ksteep value decreased from 45.61±2.40 D to 41.56±2.05 D; Kaverage also decreased from 47.00±2.66 D to 42.42±2.07 D (P<0.05 for all. The mean sphere and cylinder decreased significantly post-surgery from, -3.10±2.99 D to -0.11±0.93 D and from -3.68±1.53 to -1.11±0.75 D respectively, while the CDVA, CCT and coma showed no significant changes. Compared to post-ISCR, significant reductions (P<0.05 or all in all K values, sphere and cylinder were observed after TG-PRK/CXL.CONCLUSION:Same-day combined topography-guided PRK and corneal crosslinking following placement of ISCR is a safe and potentially effective option in treating low-moderate keratoconus. It significantly improves all visual acuity, reduced keratometry, sphere and astigmatism, but causes no change in central corneal thickness and coma.

  6. Long-term results of photorefractive keratectomy for myopia and myopic astigmatism Resultados a longo prazo de ceratectomia fotorefrativa para miopia e astigmatismo miópico

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    Ester Sakae Yamazaki

    2007-12-01

    Full Text Available PURPOSE: To assess the long-term refractive outcomes of photorefractive keratectomy in myopia and myopic astigmatism. METHODS: A retrospective study of 120 photorefractive keratectomy operated eyes with at least four-year follow-up (maximum of 96 months, mean follow-up 55 months. We divided patients into group 1 (G1 spherical equivalent (SE up to -4.00 diopters (D and group 2 (G2 SE >-4.00 D. The Summit Apex Plus® excimer laser was used for ablation. All eyes were analyzed in terms of uncorrected and best spectacle corrected visual acuity (UCVA/BSCVA and cycloplegic refraction. Data were analyzed using the Refractive Surgery Consultant Elite database software. RESULTS: G1 with 85 eyes (49 patients presented mean SE -2.42 D and G2 with 35 eyes (22 patients and mean SE of -4.45 D. Ninety-four percent of eyes in G1 and 82.9% of G2 were within ±1.00 D of emmetropia at 4 years. The UCVA was 20/30 or better in 82.0% of G1 eyes and 77.0% of G2 in the last postoperative follow-up. No patient lost more than one line in G2 compared to 13.0% in G1. Eyes that gained one or more lines after 4-year follow-up were 11.9% G1 and 2.9% in G2, respectively. A statistically significant positive correlation was found between achieved versus attempted refractive correction in both groups (r=0.925, pOBJETIVO: Relatar os resultados a longo prazo da cirurgia de ceratectomia fotorefrativa em miopia e astigmatismo miópico. MÉTODOS: Estudo retrospectivo de120 olhos operados de ceratectomia fotorefrativa com um mínimo intervalo de 4 anos de seguimento pós-operatório (máximo de 96 meses e seguimento médio de 55 meses. Dividimos em grupo 1 (G1 com equivalente esférico (SE até -4.00 dioptrias (D e grupo 2(G2 SE > -4.00 D. O excimer laser Summit Apex Plus® foi usado na ablação. Foram obtidas acuidade visual não corrigida (UCVA e melhor acuidade visual corrigida (BSCVA e refração sob cicloplegia. Os dados foram analisados utilizando o programa Refractive Surgery

  7. Wavefront-guided refractive surgery after multifocal lens implantation.

    Science.gov (United States)

    Kuo, Irene C; Reviglio, Victor E

    2009-07-01

    To examine whether wavefront-guided refractive surgery has a role in correcting ametropia after implantation of multifocal intraocular lenses (IOLs). This review begins with an oversight of various multifocal IOLs to help understand how a wavefront might return from the IOL and be captured by an aberrometer. The accuracy of the wavefront may be compromised in eyes with multifocal IOLs by the fact that such lenses provide simultaneous vision--that is, a simultaneous projection of in-focus and out-of-focus images of an object on the retina--and hence returning wavefronts theoretically could be captured in a similar manner by an aberrometer. However, in isolated small series, reproducible wavefront refractions--in which the manifest refraction closely approximates the wavefront refraction and good results after refractive surgery--are attained in eyes with diffractive multifocal IOLs. Small studies suggest that it is possible to perform wavefront-guided excimer light amplification by stimulated emission of radiation (LASER) to correct ametropia following multifocal lens implantation. Larger studies with longer follow-up are needed to determine whether eyes with multifocal lenses derive an added benefit from wavefront-guided refractive surgery over conventional surgery. These studies may help determine whether some IOLs are better suited for subsequent refractive surgery. The age of the patient may affect the outcome of refractive surgery after multifocal IOL implantation.

  8. Risk factors for early-onset corneal haze after photorefractive keratectomy in an Asian population: Outcomes from the Singapore Armed Forces Corneal Refractive Surgery Programme 2006 to 2013.

    Science.gov (United States)

    Ang, Bryan Chin Hou; Foo, Reuben Chao Ming; Lim, Edmund Wei Long; Tan, Mellisa Mei Hui; Nah, Gerard Kwang Ming; Thean, Lennard See Yin; Tan, Clement Woon Teck; Zhao, Paul Song Bo

    2016-05-01

    To assess the incidence and risk factors for early corneal haze after myopic photorefractive keratectomy (PRK). Tertiary eye center, Singapore. Retrospective case series. The refractive results and corneal haze severity 3 months after PRK were analyzed. Eyes were categorized into 4 groups based on haze severity. Multivariate ordinal logistic regression analysis adjusting for age, ethnicity, sex, use of intraoperative mitomycin-C (MMC), preoperative sphere, and preoperative cylinder was performed. The study reviewed data from 177 patients (347 eyes) with a mean age of 22.6 years ± 4.1 (SD). The majority of the patients were Chinese (98.3%) and men (98.3%). The mean preoperative spherical equivalent (SE) was -3.34 ± 1.19 diopters (D). One hundred thirty-five eyes (38.9%) had PRK with MMC. Ten eyes (2.9%) had enhancement surgery. The overall efficacy index was 0.88 and the safety index was 1.07. At 3 months, 187 eyes (53.9%) had no haze, 76 eyes (21.9%) had a haze grade of more than 0 and less than 1, 76 eyes (21.9%) had a haze grade of 1 or more and less than 2, and 8 eyes (2.3%) had grade 2 haze. Higher degrees of myopia (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.13-1.63; P = .001) and astigmatism (OR, 1.56; 95% CI, 1.09-2.24; P = .014) were associated with increased severity of corneal haze, whereas older age (OR, 0.94; 95% CI, 0.88-0.99; P = .023) had a protective effect. Myopia and astigmatism were associated with increased severity of haze, and older age was protective against early corneal haze development after PRK in an Asian population. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  9. Efficacy and safety of a 3-month loteprednol etabonate 0.5% gel taper for routine prophylaxis after photorefractive keratectomy compared to a 3-month prednisolone acetate 1% and fluorometholone 0.1% taper

    Directory of Open Access Journals (Sweden)

    Mifflin MD

    2017-06-01

    Full Text Available Mark D Mifflin,1 Brent S Betts,1 P Adam Frederick,2 Jason M Feuerman,3 Carlton R Fenzl,4 Majid Moshirfar,1,5 Brian Zaugg1 1Department of Ophthalmology and Visual Sciences, John A Moran Eye Center, University of Utah, Salt Lake City, UT, 2The Eye Center, Huntsville, AL, 3Eye Institute of Austin, Austin, TX, 4Eye Surgeons Associates, Bettendorf, IA, 5Hoopes Vision, Draper, UT, USA Purpose: To compare the outcome of photorefractive keratectomy (PRK and complications in patients treated with either loteprednol etabonate 0.5% gel or prednisolone acetate 1% suspension and fluorometholone (fml 0.1% suspension.Setting: John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA.Design: Prospective, randomized, partially masked trial.Methods: PRK was performed on 261 eyes of 132 participants. Patients were randomized to a postoperative corticosteroid regimen of either loteprednol etabonate 0.5% gel (loteprednol or prednisolone 1% acetate suspension followed by fluorometholone 0.1% suspension (prednisolone/fml. Primary outcome measures included incidence and grade of postoperative corneal haze and incidence of increased intraocular pressure of 10 mmHg above baseline, or any intraocular pressure over 21 mmHg. Secondary outcome measures included uncorrected distance visual acuity, best corrected distance visual acuity, and manifest refraction spherical equivalent.Results: The incidence of haze in the first 3 months was 2.6% (3/114 eyes in the loteprednol group and 4.8% (7/147 eyes in the prednisolone/fml group and was not statistically significant between groups (P=0.37. The incidence of elevated intraocular pressure was 1.8% (2/114 eyes in the loteprednol group and 4.1% (6/147 eyes in the prednisolone/fml group, and was not statistically significant between the groups (P=0.12. The mean 3-month postoperative logMAR uncorrected visual acuity was −0.078±0.10 and −0.075±0.09 in the loteprednol and prednisolone/fml groups, respectively (P=0

  10. Development of EKC after Eximer Laser Photorefractive Surgery and Subsequent Recurrence of EKC-like Keratitis

    OpenAIRE

    Park, Sung Joon; Jang, Yoon Soo; Koh, Tae Hyuk; Kwon, Young A; Song, Sang Wroul

    2011-01-01

    This research focuses on four cases of patients having undergone eximer laser photorefractive surgery who were diagnosed with adenoviral keratoconjunctivitis during the postoperative period and who later developed epidemic keratoconjunctivitis (EKC)-like keratitis. Two of the patients had undergone laser-assisted subepithelial keratectomy (LASEK), one had undergone laser in situ keratomileusis and one had photorefractive keratectomy. After the surgery adenoviral keratoconjunctivitis and recur...

  11. PHOTOREFRACTIVE POLYMERS

    NARCIS (Netherlands)

    Morichere, D; Malliaras, G.G; Krasnikov, V.V.; Bolink, H.J; Hadziioannou, G

    The use of polymers as photorefractive materials offers many advantages : flexibility in synthesis, doping, processing and low cost. The required functionalities responsible for photorefractivity, namely charge generation, transport, trapping and linear electrooptic effect are given in the polymer

  12. Wavefront-Guided and Wavefront-Optimised Laser Treatments

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    Canan Aslı Utine

    2012-12-01

    Full Text Available Optical aberrations of the eye are the errors of the optical system that limit the resolution, contrast and amount of detail in the image formed on the retina. Wavefront technology allows us to measure these optical aberrations, calculate mathematically, and transfer this information into excimer laser system to perform customized treatment on the cornea. Two treatment algorithms developed to create low aberration-corneal profile are wavefront-optimised (WF-O and wavefront-guided (WF-G treatments. WF-O treatment, aims not to increase the existing spherical aberration while treatment is based on manifest refractive error as in conventional laser treatments. By increasing the number of laser spots applied peripherally in order to optimize the corneal asphericity, the preoperative central:peripheral keratometry ratio is preserved and optic zone shrinkage is prevented. On the other hand, WF-G treatment is based on aberrometry measurements and aims to correct the existing high-order aberrations in the eye. Thus, retinal image with high spatial details can be achieved. However, presence of postoperative defocus can abolish the successful results obtained with WF-G treatment. Clinical randomized controlled trials showed that in patients with preoperative RMS value of <0.3 μm, higher order aberration outcomes are similar after WF-G and WF-O treatments, but WF-G treatment yields better results when it is ≥0.4 μm. In normal eyes, very limited visual advantage can be achieved with WF-G treatment and preservation of asphericity value with WF-O treatment carries greater importance. On the other hand, in case of high astigmatism or higher order aberrations other than spherical aberration, decreasing aberrations with WF-G treatment becomes more important. In this study, we aimed to make a comparative analysis of characteristics and outcomes of the two treatment algorithms. (Turk J Ophthalmol 2012; 42: 474-8

  13. Influence of patient race on the outcome of photorefractive keratectomy for myopia correction Influência racial sobre os resultados da ceratectomia fotorrefrativa para a correção da miopia

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    Fernando Betty Cresta

    2002-03-01

    Full Text Available Purpose: To examine the effect of patient race on clinical outcomes following excimer laser surgery for myopia and myopic astigmatism. Methods: A total of 116 eyes from Caucasian patients, 16 eyes from Asian patients and 16 eyes from Hispanic patients who underwent PRK were evaluated retrospectively. PRK procedures were performed by the same surgeon using a 193 nm argon- fluoride excimer laser (VISX with 160 mJ/cm² fluence and a 6.5 Hz repetition rate at the Doheny Eye Institute. During 6 months of follow-up, changes in the uncorrected visual acuity (UCVA, refraction and spectacle-corrected visual acuity (SCVA were evaluated. Pairwise comparisons between races were performed for age, sphere and cylinder using independent sample t tests, while UCVA and SCVA were compared using Fisher's exact tests. The accepted level of significance for all tests was alpha = 0.05/3 = 0.0167. Results: The only differences found were between the Asian versus Caucasian groups related to the spectacle-corrected visual acuity of 20/15 (p=0.01 and in the Asian versus Hispanic groups related to the mean cylinder (p=0.04 at 3 months postoperatively. The comparison of the mean cylinder showed a statistically significant difference between the Asian versus Hispanic groups at 6 months postoperatively (p=0.04. After 6 months, 72.7% of the eyes in the Asian group, 85.7% of the eyes in the Hispanic group and 87.1% of the eyes in the Caucasian group had uncorrected visual acuity of 20/40 or better and the mean sphere and cylinder (±SD were: --0.55 (± 0.88 and 0.97 (± 0.79; --0.75 (± 1.24 and 0.40 (± 0.45; --1.21 (± 2.55 and 0.75 (± 0.89, respectively. Conclusion: In this study, there were no statistically significant differences between the three race groups related to the final visual outcome following photorefractive keratectomy. These preliminary results suggest that the clinical outcomes of PRK are not significantly affected by patient race. Larger populations and

  14. Biomechanics of the cornea and wavefront-guided laser refractive surgery.

    Science.gov (United States)

    Roberts, Cynthia

    2002-01-01

    Wavefront-guided laser refractive surgery induces postoperative optical aberrations that are not explained by the ablation profile. A conceptual model is presented for a potential mechanism of surgically-induced corneal shape change that is dependent on structural modification, rather than ablation profile. Examples are provided from clinical and basic studies that are consistent with the proposed model. Corneal biomechanical response to ablative surgery may significantly affect outcomes, and should be taken into account when planning customized procedures.

  15. Ceratectomia fotorrefrativa (PRK com mitomicina C a 0,02% para correção de grau acentuado de astigmatismo hipermetrópico composto secundário a cirurgia de ceratotomia radial (RK Photorefractive keratectomy (PRK with mitomicyn C 0,02% for the management of high degree of hyperopic astigmatism following radial keratectomy

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    Adamo Lui Netto

    2009-06-01

    Full Text Available Descrever o efeito da cirurgia fotorrefrativa (PRK associada ao uso de mitomicina C a 0,02% para correção de grau acentuado de astigmatismo hipermetrópico composto apresentado após cirurgia de ceratotomia radial (RK realizada há 12 anos.To describe PRK with mitomicyn C effects for the management of high-degree hyperopic astigmatism following Radial Keratectomy performed 12 years ago.

  16. Femtosecond laser versus mechanical keratome flaps in wavefront-guided laser in situ keratomileusis: prospective contralateral eye study.

    Science.gov (United States)

    Durrie, Daniel S; Kezirian, Guy M

    2005-01-01

    To compare the outcomes of wavefront-guided laser in situ keratomileusis (LASIK) performed using the IntraLase femtosecond laser with the outcomes using the Hansatome mechanical microkeratome. Private clinic, Overland Park, Kansas, USA. In a prospective contralateral-eye study performed under institutional review board supervision, 51 consecutive patients (102 eyes) had bilateral wavefront-guided LASIK for myopia using the Alcon LADARVision laser. One eye of each patient was randomized to have the flap created with the IntraLase femtosecond laser and the other flap using a standard compression head Hansatome microkeratome. All other treatment parameters were the same. The IntraLase group had significantly better mean uncorrected visual acuity (UCVA) at all intervals from 1 day to 3 months postoperatively. The mean spheroequivalent at 3 months was more myopic with the Hansatome (-0.34 diopter [D] +/- 0.28 [SD]) than with the IntraLase (-0.19 +/- 0.24 D) (Prefractive outcomes after LASIK with the IntraLase femtosecond laser may be the result of differences in postoperative astigmatism and trefoil. These findings are consistent with previous findings of better astigmatic outcomes with the IntraLase laser and may have clinical significance for wavefront-guided treatments.

  17. O impacto da cirurgia de ceratectomia fotorrefrativa (PRK e ceratomileuse assistida por excimer laser in situ (LASIK na qualidade visual e de vida em pacientes com ametropias The impact of photorefractive excimer laser keratectomy (PRK and laser in situ keratomileusis (LASIK on visual quality and life in patients with ametropias

    Directory of Open Access Journals (Sweden)

    Ricardo Belfort

    2008-02-01

    significantemente para melhor em relação ao préoperatório, com redução substancial do estresse psicológico.PURPOSE: To evaluate the quality of life, vision and stress before and after refractive surgery. METHODS: This is a longitudinal, observational study, where 100 patients were evaluated; 54 espectacles wearers, 21 contact lens users before surgery and 25 controls wearers spectacles or contact lenses, who did not want to undergo refractive surgery during one year despite refractive error. The applied questionnaires were Self Reporting Questionnaires SRQ-20 of quality of life and vision and National Eye Institute Visual Function Questionnaire NEI VFQ-25 for the assessment of mental health. The intervention group answered the questionnaires before surgery, three, six and twelve months after follow-up and the control group answered the questionnaires at six and twelve months after the baseline. The questionnaires of the intervention group were applied by an independent person. RESULTS: In the intervention group (54 spectacle wearers, 39 were treated by photorefractive excimer laserkeratectomy (PRK and 15 by laser in situ keratomileusis (LASIK, of the 21 contact lens users: 12 received photorefractive excimer laser keratectomy and nine were treated by laser in situ keratomileusis (LASIK. The control group remained stable during the study. After three months of follow-up the intervention group showed improvement in quality of life, vision and reduction of stress. After one year of follow-up the assessments of quality of life and mental health were similar to the control group. After three months there was a significant reduction of psychiatric symptomatology in the intervention group. CONCLUSION: Patients operated for correction of ametropia showed a significant improvement in quality of life and mental health assessments.

  18. Improved contrast sensitivity and visual acuity after wavefront-guided laser in situ keratomileusis: in-depth statistical analysis.

    Science.gov (United States)

    Tuan, Kuang-mon Ashley; Liang, Junzhong

    2006-02-01

    To evaluate changes in contrast sensitivity and visual acuity following wavefront-guided laser in situ keratomileusis (LASIK) procedures with the Visx CustomVue system. Six clinical sites that participated in an Investigational Device Exemption clinical study. Two hundred seventy-four myopic astigmatic eyes (spherical equivalent range -0.63 to -6.00 diopters) completed 6 months of follow-up examinations. Wavefront-guided procedures using the WaveScan aberrometer and Star S4 excimer laser system with variable spot scanning were performed at 6 clinical locations. Visual acuity and contrast sensitivity under photopic, mesopic, and mesopic-with-glare lighting conditions were tested preoperatively and over a 6-month follow-up period. This study was a retrospective analysis of contrast sensitivity data with controls for the effects of retinal magnification, mesopic pupil size, and the influence of prior soft contact lens wear on visual outcome. Patients experienced statistically significant improvements in contrast sensitivity at all spatial frequencies and under all lighting conditions (Ppatients. There was more improvement at higher (12 cycles per degree [cpd], 18 cpd) than lower (3 cpd) spatial frequencies. No correlation was found between mesopic pupil size and contrast sensitivity. Results stratified by spectacle or soft contact lens wear were similar. Soft contact lens wearers had slightly higher disability glare scores than spectacle wearers. A significant number of patients experienced improved corneal optical quality after wavefront-guided LASIK. The contrast sensitivity in most patients was unchanged. Contrast sensitivity improved in a significant number of patients. There was no correlation between mesopic pupil size and mesopic or mesopic-with-glare contrast performance. Spectacle wearers improved more than soft contact lens wearers.

  19. Pediatric photorefractive keratectomy for anisometropic amblyopia: A review

    Directory of Open Access Journals (Sweden)

    Somayeh Tafaghodi Yousefi

    2014-09-01

    Full Text Available Amblyopia is one of the most important reversible eye disorders in children and different treatments are suggested. Early diagnosis and effective treatment in amblyogenic age are important criteria. These critical periods correspond to the period when the child’s developing visual system is sensitive to abnormal input caused by stimulus deprivation, strabismus or significant refractive errors. Traditional treatments such as glass wearing, contact lens used with patch therapy have limitations. Laser corneal refractive surgeries introduce an alternative for the treatment of anisometropic amblyopia. Current indications for refractive surgery include anisometropia, bilateral high myopia and accommodative esotropia. Several reports confirmed that with recent development in keratorefractive surgery, it could be a safe method to be used in children. The goal of the permanent surgical treatment is to reduce refractive errors, treat amblyopia and make better the binocular function. Corneal haze is certainly a major concern in children receiving surface ablation, especially in high myopic treatments. However, controversies still exist on whether it could be done in this population or not. This article reviews the available data about refractive surgery for treating anisometropic amblyopia.

  20. Topographic steep central islands following excimer laser photorefractive keratectomy

    Science.gov (United States)

    Krueger, Ronald R.; McDonnell, Peter J.

    1994-06-01

    The purpose of this study is to demonstrate that topographic irregularities in the form of central islands of higher refractive power can be seen following excimer laser refractive surgery. We reviewed the computerized corneal topographic maps of 35 patients undergoing excimer laser PRK for compound myopic astigmatism or anisometropia from 8/91 to 8/93 at the USC/Doheny Eye Institute. The topographic maps were generated by the Computed Anatomy Corneal Modeling System, and central islands were defined as topographic areas of steepening of at least 3 diopters and 3 mm in diameter. A grading system was developed based on the presence of central islands during the postoperative period. Visually significant topographic steep central islands may be seen in over 50% of patients at 1 month following excimer laser PRK, and persist at 3 months in up to 24% of patients without nitrogen gas blowing. Loss of best corrected visual acuity or ghosting is associated with island formation, and may prolong visual rehabilitation after excimer laser PRK.

  1. Photorefractive keratectomy results in myopic patients with thin cornea eyes

    Directory of Open Access Journals (Sweden)

    Hassan Hashemi

    2015-01-01

    Conclusion: PRK is a safe, effective, and predictable procedure with desirable effects on mesopic CS in patients with corneal thickness <500 μm, which increases HOAs and decreases corneal integrity proportionate to its value before the procedure.

  2. Photorefractive keratectomy for patients with preoperative low Schirmer test value

    Directory of Open Access Journals (Sweden)

    Elham Tanbakouee

    2016-12-01

    Conclusion: These results demonstrated that tear function deteriorates after PRK. Therefore, patients with low preoperative Schirmer test values should be thoroughly assessed for dry eye before proceeding with refractive surgery to eliminate postoperative complication.

  3. Photorefraction of the Eye

    Science.gov (United States)

    Colicchia, Giuseppe; Wiesner, Hartmut; Zollman, Dean

    2015-01-01

    Photorefraction is a method to easily estimate the refractive state of the eye. The principle of photorefraction involves projecting light into the eye during flash photography and then examining the paths of light that emerge from the pupil after scattering on the back portion of the interior of the eyeball (fundus). We will explain the optical…

  4. Changes in higher order aberrations after wavefront guided FS-LASIK for myopia combined with moderate to high astigmatism

    Directory of Open Access Journals (Sweden)

    Cang-Yu Guan

    2018-02-01

    Full Text Available AIM: To assess the changes in higher order aberrations after wavefront guided femtosecond laser assisted laser in situ keratomileusis(FS-LASIKfor moderate to high astigmatism. METHODS: Eighty-eight eyes of 50 myopia patients with moderate to high astigmatism were included in this prospective study. There were 51 eyes with moderate astigmatism(≥-1.50D and RESULTS: At the 3mo after operation, the mean UDVA of all eyes was above 20/20, better than before operation(PP=0.36and no eyes lost ≥2 lines of CDVA. Mean astigmstism of 85 eyes(97%was reduced below -1.00D, mean astigmatism of 70 eyes(80%was reduced below -0.50D(PPP=0.078, 0.065. The spherical aberration, secondary astigmatism and the HOA root mean square(RMSincreased from 0.19±0.06, 0.05±0.02 and 0.42±0.12, preoperatively to 0.32±0.17, 0.26±0.08 and 0.78±0.28(PCONCLUSION: Wavefront-guided FS-LASIK is a safe and effective option for the patients with moderate to high astigmstism although parts of HOAs increased.

  5. Update on phototherapeutic keratectomy.

    Science.gov (United States)

    Stasi, Kalliopi; Chuck, Roy S

    2009-07-01

    To review all recent publications on the use of phototherapeutic keratectomy (PTK). Recent studies confirm the beneficial outcomes of PTK in a variety of anterior corneal disorder: anterior stromal scars, dystrophies of the corneal epithelium and the anterior stroma, and elevated corneal lesions. They also try to evaluate the biomechanical properties of eyes with granular corneal dystrophy undergoing PTK, in an effort to prevent iatrogenic ectasia. The different genotypes in patients with transforming growth factor, beta-induced linked corneal dystrophies have recently been correlated to the surgical outcome after PTK. An extensive review of recurrent corneal erosion syndrome identified PTK as the most effective treatment. In the developing world, the most common indication for PTK is still bullous keratopathy, as PTK can be successfully used while waiting for penetrating keratoplasty. PTK can successfully treat a variety of conditions of the anterior cornea. New studies may further expand its use.

  6. Development of EKC after eximer laser photorefractive surgery and subsequent recurrence of EKC-like keratitis.

    Science.gov (United States)

    Park, Sung Joon; Jang, Yoon Soo; Koh, Tae Hyuk; Kwon, Young A; Song, Sang Wroul

    2011-12-01

    This research focuses on four cases of patients having undergone eximer laser photorefractive surgery who were diagnosed with adenoviral keratoconjunctivitis during the postoperative period and who later developed epidemic keratoconjunctivitis (EKC)-like keratitis. Two of the patients had undergone laser-assisted subepithelial keratectomy (LASEK), one had undergone laser in situ keratomileusis and one had photorefractive keratectomy. After the surgery adenoviral keratoconjunctivitis and recurrent late-developing EKC-like keratitis were observed in the patients. Recurrent late-developing EKC-like keratitis occurred in one of the patients, who had received LASEK as many as three times. The others had only one or two episodes.The corneal infiltrates of keratitis mainly occurred in the central cornea. Successful resolution of recurrent late-developing EKC-like keratitis was achieved through the use of topical steroids without sequelae and the final best-corrected visual acuity was as good as the base line. These keratitis infiltrates have been presumed to represent an immune response to the suspected adenoviral antigens deposited in corneal stroma during the primary adenoviral infection. Previous reports argued that patients with a history of adenoviral ketatoconjunctivitis were succeptible to adenoviral keratoconjunctivitis becoming reactivated; however, in our research, our patients had their first adenoviral infections after the eximer laser photorefractive surgery and reactivation was confirmed. We recommend that attention be paid to adenoviral infection after laser refractive operations, because these patients seem to have more frequent recurrences.

  7. Corneal wound healing after excimer laser keratectomy.

    Science.gov (United States)

    Kaji, Yuichi; Yamashita, Hidetoshi; Oshika, Tetsuro

    2003-03-01

    Excimer laser keratectomy is widely used to correct refractive errors. Several complications of excimer laser keratectomy are reported including corneal infection, regression, corneal haze formation, glare and halo. Most of the complications are closely related to the corneal stromal wound healing process. In order to perform the excimer laser keratectomy with minimum complications, we should understand the mechanism of the corneal stroma wound healing process. In addition, such knowledge will help us to regulate the corneal stromal wound healing process in the future. In the present article, we discuss the molecular mechanism of the corneal stromal wound healing process after excimer laser keratectomy and its regulation by anti-inflammatory agents.

  8. Physics of photorefraction in polymers

    CERN Document Server

    West, Dave

    2004-01-01

    Photorefractive polymer composites are an unusually sensitive class of photopolymers. Physics of Photorefraction in Polymers describes our current understanding of the physical processes that produce a photorefractive effect in key composite materials. Topics as diverse as charge generation, dispersive charge transport, charge compensation and trapping, molecular diffusion, organic composite structure, and nonlinear optical wave coupling are all developed from a physical perspective. Emphasis is placed on explaining how these physical processes lead to observable properties of the polymers, and the authors discuss various applications, including holographic archiving.

  9. Successful treatment of Fusarium keratitis after photo refractive keratectomy

    Directory of Open Access Journals (Sweden)

    Gian Maria Cavallini

    2013-01-01

    Full Text Available A 39-year-old woman presented to our hospital with a history of photorefractive keratectomy (PRK, performed two weeks prior; slit-lamp examination revealed diffuse conjunctival congestion, corneal ulcer and stromal infiltration. After 5 days of antifungal and antibacteric treatment, the infiltrate progressively increased so that a therapeutic penetrating keratoplasty was necessary. The microbiological analyses revealed the presence of fungal filaments. Twenty days after surgery the patient had recurrent fungal infiltrate in the donor cornea with wound dehiscence. We performed a second penetrating keratoplasty. With the matrix-assisted-laser-desorption-ionization-time-of-flight analysis (MALDI-TOF we identified a Fusarium solani.Intravenous amphothericine B, a combination of intracameral and intrastromal voriconazole and intracameral amphotericine B were administered. After 6 months from the last surgery the infection was eradicated. The management of fungal keratitis after PRK depends on many factors: In our experience, a prompt keratoplasty and the use of intracameral antifungal medication proved to be very effective.

  10. Photorefractive Materials and Their Applications 2 Materials

    CERN Document Server

    Günter, Peter

    2007-01-01

    Photorefractive Materials and Their Applications 2: Materials is the second of three volumes within the Springer Series in Optical Sciences. The book gives a comprehensive review of the most important photorefractive materials and discusses the physical properties of organic and inorganic crystals as well as poled polymers. In this volume, photorefractive effects have been investigated at wavelengths covering the UV, visible and near infrared. Researchers in the field and graduate students of solid-state physics and engineering will gain a thorough understanding of the properties of materials in photorefractive applications. The other two volumes are: Photorefractive Materials and Their Applications 1: Basic Effects. Photorefractive Materials and Their Applications 3: Applications.

  11. Nanoparticles Doped, Photorefractive Liquid Crystals

    National Research Council Canada - National Science Library

    Kaczmarek, Malgosia

    2005-01-01

    ...: The main objectives of this exploratory, short project will concern the study of the quality of liquid crystal cells with diluted suspensions of ferroelectric nanoparticles and their photorefractive properties...

  12. Laser-induced corneal cross-linking upon photorefractive ablation with riboflavin.

    Science.gov (United States)

    Kornilovskiy, Igor M; Kasimov, Elmar M; Sultanova, Ayten I; Burtsev, Alexander A

    2016-01-01

    To estimate the biomechanical effect of the laser-induced cross-linking resulting from photorefractive ablation of the cornea with riboflavin. Excimer laser ablation studies were performed ex vivo (32 eyes of 16 rabbits) by phototherapeutic keratectomy (PTK) and in vivo (24 eyes of 12 rabbits) by transepithelial photorefractive keratectomy (TransPRK), with and without riboflavin saturation of the stroma. Then, we performed corneal optical coherence tomography on 36 eyes of 18 patients with varying degrees of myopia at different times after the TransPRK was performed with riboflavin saturation of the stroma. Biomechanical testing of corneal samples saturated with riboflavin revealed cross-linking effect accompanied by the increase in tensile strength and maximum strength. PTK showed increase in tensile strength from 5.1±1.4 to 7.2±1.6 MPa (P=0.001), while Trans-PRK showed increase in tensile strength from 8.8±0.9 to 12.8±1.3 MPa (P=0.0004). Maximum strength increased from 8.7±2.5 to 12.0±2.8 N (P=0.005) in PTK and from 12.8±1.6 to 18.3±1.2 N (P=0.0004) in TransPRK. Clinical optical coherence tomography studies of the biomicroscopic transparent cornea at different times after TransPRK showed increased density in the surface layers of the stroma and membrane-like structure beneath the epithelium. Photorefractive ablation of the preliminary corneal stroma saturation with riboflavin causes the effect of laser-induced cross-linking, which is attended with an increase in corneal tensile strength, maximum strength, increased density in the surface layers of the stroma, and formation of a membrane-like structure beneath the epithelium after TransPRK.

  13. Análise dos resultados de ceratectomia fotorrefrativa com mitomicina C e LASIK para correção miópica

    OpenAIRE

    Wallau, Anelise Dutra [UNIFESP

    2010-01-01

    Purpose: To compare visual acuity results, cycloplegic refraction, aberrometry and contrast sensitivity in eyes that underwent photorefractive keratectomy (PRK) with mitomycin C (MMC) or laser in situ keratomileusis (LASIK) for wavefront-guided myopic corrections during one year follow-up. To evaluate slit-lamp microscopy in both groups during follow-up. To evaluate subjective pain, visual complains and satisfaction with visual results in the two groups during follow-up. To analyse specular m...

  14. A new transepithelial phototherapeutic keratectomy mode using the NIDEK CXIII excimer laser.

    Science.gov (United States)

    Buzzonetti, Luca; Petrocelli, Gianni; Laborante, Antonio; Mazzilli, Emilio; Gaspari, Mario; Valente, Paola; Francia, Elisa

    2009-01-01

    To evaluate epithelial healing, postoperative pain, and best spectacle-corrected visual acuity (BSCVA) after transepithelial photorefractive keratectomy (PRK) performed with a new phototherapeutic keratectomy (PTK) mode using the NIDEK CXIII excimer laser. Fifteen eyes from 10 patients with myopia underwent transepithelial PRK using a multistage program to perform PTK followed by PRK. The PTK incorporated Flex Scan, which accounts for the loss of radial ablation efficiency on the peripheral cornea. The epithelium was removed with the excimer laser by monitoring the disappearance of blue fluorescence during the ablation. Epithelial healing was evaluated by taking slit-lamp photographs every 24 hours until complete reepithelialization. Postoperative pain was measured according to the Faces Pain Rating Scale. All outcomes are reported for 3 months postoperatively. Haze was graded by two ophthalmologists, each masked to the other's result. Mean reepithelialization took 3.50+/-0.85 days, mean pain score was 3.00+/-1.20, and BSCVA was 20/20 for 9 eyes, 20/30 for 3 eyes, and 20/40 for 3 eyes. All patients had haze below grade 2. The outcomes of the preliminary study show that the incorporation of the Flex Scan algorithm in the PTK mode is as safe and effective as conventional PTK algorithms. The primary advantage of this new PTK mode may be more consistent epithelial removal. Additional studies are needed to determine long-term outcomes.

  15. Photorefractive Materials and Their Applications 3 Applications

    CERN Document Server

    Günter, Peter

    2007-01-01

    In this third volume a series of applications on photorefractive nonlinear optics and optical data storage are presented. This and the other two volumes on photorefractive effects, materials and applications have been prepared mainly for researchers in the field, but also for physics, engineering and materials science students. Several chapters contain sufficient introductory material for those not so familiar with the topic to obtain a thorough understanding of the photorefractive effect. We hope that researchers active in the field will find these books to be a very valuable reference source. The other two volumes are: Photorefractive Materials and Their Applications 1: Basic Effects Photorefractive Materials and Their Applications 2: Materials

  16. Laser-induced corneal cross-linking upon photorefractive ablation with riboflavin

    Directory of Open Access Journals (Sweden)

    Kornilovskiy IM

    2016-04-01

    Full Text Available Igor M Kornilovskiy,1 Elmar M Kasimov,2 Ayten I Sultanova,2 Alexander A Burtsev1 1Department of Eye Diseases, Federal State Budgetary Institution “National Pirogov Medical Surgical Centre”, Ministry of Health, Moscow, Russia; 2Department of Eye Diseases, Zarifa Aliyeva National Ophthalmology Center, Ministry of Health, Baku, Azerbaijan Aim: To estimate the biomechanical effect of the laser-induced cross-linking resulting from photorefractive ablation of the cornea with riboflavin.Methods: Excimer laser ablation studies were performed ex vivo (32 eyes of 16 rabbits by phototherapeutic keratectomy (PTK and in vivo (24 eyes of 12 rabbits by transepithelial photorefractive keratectomy (TransPRK, with and without riboflavin saturation of the stroma. Then, we performed corneal optical coherence tomography on 36 eyes of 18 patients with varying degrees of myopia at different times after the TransPRK was performed with riboflavin saturation of the stroma.Results: Biomechanical testing of corneal samples saturated with riboflavin revealed cross-linking effect accompanied by the increase in tensile strength and maximum strength. PTK showed increase in tensile strength from 5.1±1.4 to 7.2±1.6 MPa (P=0.001, while TransPRK showed increase in tensile strength from 8.8±0.9 to 12.8±1.3 MPa (P=0.0004. Maximum strength increased from 8.7±2.5 to 12.0±2.8 N (P=0.005 in PTK and from 12.8±1.6 to 18.3±1.2 N (P=0.0004 in TransPRK. Clinical optical coherence tomography studies of the biomicroscopic transparent cornea at different times after TransPRK showed increased density in the surface layers of the stroma and membrane-like structure beneath the epithelium.Conclusion: Photorefractive ablation of the preliminary corneal stroma saturation with riboflavin causes the effect of laser-induced cross-linking, which is attended with an increase in corneal tensile strength, maximum strength, increased density in the surface layers of the stroma, and formation of

  17. Infrared-Sensitive Photorefractive Polymer Composite Devices

    National Research Council Canada - National Science Library

    Peyghambarian, Nasser N

    2007-01-01

    .... We have accomplished these goals by developing highly efficient one photon sensitive photorefractive devices operating at about 1 micrometer with high diffraction efficiency, near video rate response...

  18. Interaction of spatial photorefractive solitons

    DEFF Research Database (Denmark)

    Królikowski, W.; Denz, C.; Stepken, A.

    1998-01-01

    We present a review of our recent theoretical and experimental results on the interaction of two-dimensional solitary beams in photorefractive SBN crystals. We show that the collision of coherent solitons may result in energy exchange, fusion of the interacting solitons, the birth of a new solita...... that a soliton pair may experience both attractive and repulsive forces; depending on their mutual separation. We also show that strong attraction leads to periodic collision or helical motion of solitons depending on initial conditions.......We present a review of our recent theoretical and experimental results on the interaction of two-dimensional solitary beams in photorefractive SBN crystals. We show that the collision of coherent solitons may result in energy exchange, fusion of the interacting solitons, the birth of a new solitary...

  19. [Glycosaminoglycans in subepithelial opacity after excimer laser keratectomy].

    Science.gov (United States)

    Nakayasu, K; Gotoh, T; Ishikawa, T; Kanai, A

    1996-05-01

    We evaluated histochemically the characteristics of glycosaminoglycans and proteoglycans in the corneal subepithelial opacity after excimer laser keratectomy on rabbit corneas. We also performed the same evaluations on the cornea after mechanical keratectomy. Twenty days after the operations, the area immediately subjacent to the epithelium showed strong staining with toluidine blue, alcian blue, and colloidal iron. However, after treatment with chondroitinase ABC or chondroitinase AC, alcian blue staining in this area decreased dramatically. Antilarge proteoglycan antibody also reacted strongly in this area. Histochemical and immunohistochemical examination of the cornea where mechanical keratectomy was done showed basically similar findings with the cornea of excimer laser keratectomy. These results suggest that large-molecula proteoglycans with chondroitine sulfate side chains become localized in the subepithelial area after two different kinds of keratectomies. We presume from histochemical and immunohistochemical observations that the subepithelial opacity observed after excimer laser keratectomy is not a special reaction to excimer laser but simply a corneal scar formed after stromal resection.

  20. [Riboflavin photoprotection with cross-linking effect in photorefractive ablation of the cornea].

    Science.gov (United States)

    Kornilovskiy, I M; Sultanova, A I; Burtsev, A A

    2016-01-01

    Photorefractive ablation is inevitably accompanied by oxidative stress of the cornea and weakening of its biomechanical and photoprotective properties. To validate the expediency of riboflavin use in photorefractive ablation for photoprotection of the cornea and cross-linking. The effects of riboflavin use in photorefractive ablation was first studied in a series of in vitro and in vivo experiments performed on 56 eyes of 28 rabbits, and then on 232 eyes of 142 patients with different degrees of myopia. Biomechanical testing of corneal samples was performed with Zwick/RoellВZ 2.5/TN1S tensile-testing machine. Transepithelial photorefractive keratectomy (TransPRK) and femtosecond laser-assisted in situ keratomileusis (Femto-LASIK) were performed on Wavelight-Allegretto200, MEL-80, and WaveLight-EX500 excimer laser systems and also VisuMax and WaveLight-FS200 femtosecond lasers. For preliminary examinations, an appropriate set of diagnostic tools was used. In vivo experiments have proved that, in the absence of conservative therapy, riboflavin is able to produce both photoprotective and cross-linking effects to the cornea. Corneal syndrome was thus reduced and re-epithelialization after TransPRK accelerated. Biomechanical testing of corneal samples revealed an increase in tolerated load from 12.9±1.4 N to 18.3±1.2 N (p=0.0002) and tensile strength from 8.6±1.7 MPa to 12.4±1.7 MPa (p=0.007). Clinical studies conducted in a group of patients with mild to moderate myopia have also confirmed the photoprotective effect of riboflavin at months 1-12 after TransPRK. There were no significant differences in uncorrected visual acuity (ranged from 0.80±0.16 to 0.85±0.15) and corrected visual acuity at baseline (0.83±0.14). Evaluation of the optical and refractive effect achieved after Femto-LASIK with riboflavin photoprotection in the fellow eye has shown that this technique is not inferior to the traditional one as to its refractive accuracy, but provides better

  1. Perceived Pain During Photorefractive Keratectomy in the First Eye Operated on Compared to the Second

    Science.gov (United States)

    2017-01-10

    the date (month, day and year) along with the location of your presentation. Jt is important to update this information so that we can provide quality...The !59 CR~ and Preaentatlonl Sedlon wlll route the request form to dlnlcal inveatlgatlona, 502 ISG/JAC ( Ethics Review) and Public Affairs (59 MCJW...oD c:ommeftial entity or an entity seeking to do business with the goverrvnenl then your presentatlon should have an ethlca review. If your travel

  2. Comparative study of two silicone hydrogel contact lenses used as bandage contact lenses after photorefractive keratectomy

    Directory of Open Access Journals (Sweden)

    Hasan Razmjoo

    2012-01-01

    Conclusion: Silicon hydrogel BCLs are safe and effective for corneal reepithelialization and have great therapeutic outcome on visual outcomes after PRK. But, senofilcon A had better effect on postoperative pain and discomfort which made it superior than lotrafilcon A. However for more conclusive results, it is recommended to study larger sample size with evaluation the possible factors responsible for the obtained findings regarding postoperative pain and discomfort.

  3. The Incidence of Central Serous Chorioretinopathy after Photorefractive Keratectomy and Laser In Situ Keratomileusis

    Directory of Open Access Journals (Sweden)

    Majid Moshirfar

    2012-01-01

    A chart review was performed to identify all patients with CSCR and a previous history of LASIK or PRK. Results. Over the 6-year study period, 1 of 4,876 eyes which had LASIK or PRK at the Moran Eye Center was diagnosed with CSCR. One other patient was referred from an outside center, developed CSCR symptoms one month after PRK. Both patients were managed conservatively with a final visual acuity of 20/20 or better. All other patients presented 4 or more years after refractive surgery. Conclusions. We report the first 2 CSCR cases developing within one month after PRK. The low incidence argues against a causal association. Topical corticosteroids or anxiety may elevate cortisol levels presenting therapeutic challenges for the management of CSCR after PRK or LASIK.

  4. Evaluation of Topical Cyclosporine in Preventing the Development of Corneal Haze after Photorefractive Keratectomy

    Science.gov (United States)

    2014-05-13

    moxifloxacin 0.5% and fluoromethalone 0.1% four times daily, frequent preservative-free artificial tears, oral vitamin C, and oral oxycodone...effectively by artificial tears and ointments were permitted to restart Restasis (in both eyes) for the treatment of dry eyes after completing the...easily visible opacity; 3-denser opacity that significantly decreases the visualization of intraocular structures (such as the iris and retina ); 4

  5. Effectiveness of Technolas torsional eye tracking system on visual outcomes after photorefractive keratectomy

    Directory of Open Access Journals (Sweden)

    Hamid Gharaee

    2015-09-01

    Conclusion: Our study findings suggest that applying ‘Technolas 217z’ eye tracker system (Bausch and Lomb Advanced results in a more regular anterior surface of cornea. Therefore, we recommend it for surface laser refractive surgery.

  6. Preparation and thickness profile of endothelial keratoplasty lenticules from donated whole eyes with previous photorefractive keratectomy

    Directory of Open Access Journals (Sweden)

    Mozhgan Rezaei Kanavi

    2017-01-01

    Conclusion: PRK donor whole eyes are potential sources for preparation of microkeratome-assisted thin endothelial keratoplasty lenticules with a high endothelial cell count. Although an asymmetric and significant increase in thickness was present at the peripheral cornea, neither attachment nor clarity of transplanted lenticules was affected by variations in thickness of precut corneas.

  7. Comparison between Pentacam HR and Orbscan II after hyperopic photorefractive keratectomy

    Directory of Open Access Journals (Sweden)

    Mahmoud Jabbarvand

    2017-01-01

    Conclusion: Pentacam HR and Orbscan II after PRK for hyperopia show reasonable agreement for determining A-BFS, P-BFS, A-TG3, and CCT, but not for A-CE, P-CE, A-TG5, or ACD. CCT measurements with Pentacam HR have reasonable agreement with US pachymetry.

  8. Long term results of no-alcohol laser epithelial keratomileusis and photorefractive keratectomy for myopia

    Directory of Open Access Journals (Sweden)

    Leopoldo Spadea

    2015-06-01

    Full Text Available RESULTS: Twenty-one eyes and 22 eyes completed follow-up of 60mo in LASEK and PRK group respectively. Manifest refraction at 60mo follow-up was -0.01 and 0.26 in LASEK and PRK group respectively. In the LASEK group mean UDVA and mean CDVA after 60mo were 20/22 and 20/20 respectively (P>0.01. In the PRK group mean UDVA and mean CDVA at 60mo follow-up were 20/20 and 20/20 after 60mo (P>0.01. The efficacy indexes were 0.87 and 0.95, and the safety indexes were 1.25 and 1.4 respectively for LASEK group and PRK group.CONCLUSION:Both standard PRK and no-alcohol LASEK offer safe and effective correction of low-moderate myopia in the long term without any statistically significant difference between the two groups.

  9. Post-photorefractive keratectomy pain and corneal sub-basal nerve density

    Directory of Open Access Journals (Sweden)

    Masoumeh Mohebbi

    2017-01-01

    Conclusion: Crude density of corneal nerves may not be a good predictor of post-PRK pain while wearing bandage contact lenses. The predominant pain mechanism appears to be of an inflammatory nature (not nociceptive or neuropathic.

  10. Fellow eye treatment in excimer photo refractive keratectomy

    Directory of Open Access Journals (Sweden)

    Rao Srinivas

    2000-01-01

    Full Text Available Purpose: To describe symmetry of response in fellow eyes of patients undergoing photorefractive keratectomy (PRK for myopia, analyse the risk factors leading to asymmetry in response and to determine if delayed treatment of the second eye increases safety and predictability of PRK. Methods: Retrospective review of case records of 133 patients who underwent bilateral myopic PRK and had a minimum follow up of 6 months in both eyes. Results: Postoperative uncorrected visual acuity, spherical equivalent (SE refraction within ±1D of emmetropia, best-corrected visual acuity (BCVA and corneal haze were not significantly different in fellow eyes of patients undergoing PRK for myopia. Of 87 eyes in group 1 (myopia <6D, 96.6% had uncorrected visual acuity ≥6/ 12, 89.7% were within ±1D of emmetropia, none lost ≥1 line BCVA, and none had haze ≥grade 3. Similar results for 98 eyes in group II (myopia 6 to 9.9D were 75.6%, 55.1%, 2.0% and 2.0% respectively. For 81 eyes in group III (myopia ≥ 10D the results were 42.7%, 33.3%, 8.6%, and 4.9% respectively. Among 84 patients with similar preoperative myopia in both eyes, 54 (64.3% patients had a postoperative SE difference ≤ ID in fellow eyes. Risk factors for asymmetric response among fellow eyes included increasing preoperative myopia (p<0.001 and dissimilar treatment technique in the two eyes (p=0.03. Corneal haze did not increase significantly after the third postoperative month. Conclusion: This study demonstrates that considerable symmetry of response exists in fellow eyes of patients undergoing myopic PRK. Early PRK in the fellow eye of patients with < 6 D myopia is safe and allows quick visual rehabilitation of the patient. In patients with myopia ≥6D, a 3-month interval before treating the second eye may improve the safety of the procedure.

  11. Photorefractive optics materials, properties, and applications

    CERN Document Server

    Yu, Francis T S

    1999-01-01

    The advances of photorefractive optics have demonstrated many useful and practical applications, which include the development of photorefractive optic devices for computer communication needs. To name a couple significant applications: the large capacity optical memory, which can greatly improve the accessible high-speed CD-ROM and the dynamic photorefractive gratings, which can be used for all-optic switches for high-speed fiber optic networks. This book is an important reference both for technical and non-technical staffs who are interested in this field. * Covers the recent development in materials, phenomena, and applications * Includes growth, characterization, dynamic gratings, and liquid crystal PR effect * Includes applications to photonic devices such as large capacity optical memory, 3-D interconnections, and dynamic holograms * Provides the recent overall picture of current trends in photorefractive optics * Includes optical and electronic properties of the materials as applied to dynamic photoref...

  12. Early Keratectomy in the Treatment of Moderate Fusarium Keratitis

    Science.gov (United States)

    Lin, Hsin-Chiung; Lin, Ja-Liang; Lin-Tan, Dan-Tzu; Ma, Hui-Kang; Chen, Hung-Chi

    2012-01-01

    Purpose To evaluate the treatment outcomes and costs of early keratectomy in the management of moderate Fusarium keratitis. Methodology/Principal Findings Consecutive cases of culture proven Fusarium keratitis treated at our hospital between January 2004 to December 2010 were included in this retrospective study. There were 38 cases of moderate keratitis with infiltrates between 3 to 6 mm in diameter and depth of infiltration not exceeding the inner 1/3 of the cornea. After excluding 5 patients with incomplete follow-up data, 13 patients who received early keratectomy within 1 week of admission were compared with a group of 20 patients treated medically. The significance of the association between early keratectomy and visual acuity, progression to perforation, secondary glaucoma and cataract formation, adjuvant therapy, hospitalization days and cost were assessed. There were no differences between the keratectomy and medication groups in regards to age, sex, presence of systemic diseases, and hypopyon formation on presentation. The early keratectomy group had a shorter hospital stay than the medical therapy group. Disease duration was significantly lower in the early keratectomy group (median: 29.0 vs. 54.5 days, Pkeratitis may reduce length of hospital stay, hospital costs, and perforation rates. PMID:22936982

  13. [Infectious corneal ulcers--once with endophthalmitis--after photorefractive keratotomy with disposable contact lens].

    Science.gov (United States)

    Faschinger, C; Faulborn, J; Ganser, K

    1995-02-01

    Infections of the cornea with or without involvement of intraocular tissues are severe complications after photorefractive keratectomy. We report on three cases with ulcerative keratitis and one case with severe endophthalmitis, which developed some days after laser treatment. After 39 photo-therapeutic and 118 photo-refractive treatments without complications four young treated persons suffered from corneal infiltrations. Three of them developed severe corneal ulcerations, one a severe endophthalmitis. We used the laser machine of the company Schwind (193 nm wavelength, repetition rate 10 Hz, fluence 180-200 mJ/cm2). One part of the treatment which all patients had in common was the application of a disposable contact lens postoperatively, which was worn overnight. THERAPY AND FOLLOW-UP: Because all three patients with ulcerations revealed hyphen of fungi in their corneal-scratch material they were treated with antifungal agents locally and systemically. Due to the local and temporal connection the patient with the endophthalmitis was treated with antifungal agents, too. All corneal ulcerations healed with scars similar to a haze graded 3 to 4, the eye with the endophthalmitis healed almost completely. Probably the use of disposable contact lenses postoperatively, especially the overnight wear, during an extremely hot and humid summer lead to the described severe infections of the eyes after the "traumatisation" of the cornea by the excimer laser. A known higher concentration of Aspergillus in the air due to renovations of buildings in the clinical area might have been an additional negative effect. The avoidance of the use of disposable contact lenses postoperatively, especially the overnight wear, is emphasized.

  14. Evaluation of Optical Propagation in Photorefractive Materials

    Science.gov (United States)

    Liu, Jaw-Jueh

    Photorefractive materials, such as BSO, BaTiO _3, LiNbO_3, etc. are known to exhibit high nonlinearity at low optical intensities. The laser beam illumination changes the optical characteristics of the crystals and gives rise to a nonuniform distribution of the refractive index, thereby leading to distortion of the beam. In this thesis, we analyze the nature of the photorefractive effect using the nonlinearly coupled Kukhtarev equations. Starting from the photorefractive holographic write-in and read-out process, we study the diffraction efficiency as a function of the applied electric field, the grating period and the light intensity, and also investigate the signal-to-noise ratio for a diffracted Gaussian reading beam under the influence of noise. In this connection, the propagation of a Gaussian beam through a thick sample of a previously dark photorefractive material is first investigated. Two different materials, BaTiO _3, LiNbO_3, have been considered. Because the light intensity creates a strong internal electric field and hence an induced refractive index, the incident light is deflected in phase and amplitude resulting to a distorted far field pattern, often termed beam fanning. These results are then used to analyze beam fanning in the case when a Gaussian reading beam is incident on a photorefractive material in which a sinusoidal phase grating has previously been stored. Finally, we examine multiple beam interaction in a photorefractive crystal. We analyze subharmonic amplification during the interaction between two pump beams and a seed beam, incident along the bisector of the pumps, in BSO. We then evaluate the fractional change in the intensity of the seed team at the output in the presence of the suhharmonic grating as a function of the angle between the pump teams. Experimental results agree well with the theory.

  15. Novel bifunctional molecule for photorefractive materials

    NARCIS (Netherlands)

    Bolink, H.J; Arts, C.; Krasnikov, V.V.; Malliaras, G.G; Hadziioannou, G

    We report on the synthesis and characterization of a novel photorefractive polymer composite that consists of a bifunctional molecule based on the charge-transport molecule N,N'-diphenyl-N,N'-bis(3-methylphenyl)-[1,1'-biphenyl]-4,4'-diamine (TPD). It is shown that the low values obtained for the

  16. Excimer laser phototherapeutic keratectomy for keratoconus nodules.

    Science.gov (United States)

    Elsahn, Ahmed F; Rapuano, Christopher J; Antunes, Victor A; Abdalla, Yasmine F; Cohen, Elisabeth J

    2009-02-01

    To report the outcomes of contact lens-intolerant patients with keratoconus (KCN) with subepithelial nodules treated with excimer laser phototherapeutic keratectomy (PTK). The charts of all contact lens-intolerant patients with KCN who underwent excimer laser PTK for subepithelial nodules were identified using a computer database and were retrospectively reviewed. Preoperative and postoperative visual acuity and method of correction, surgical treatment, epithelial healing, complications, and KCN nodule recurrence were all analyzed. Fifteen eyes of 15 patients with a minimum follow-up of 3 months were reviewed. Mean follow-up time was 23.1 months (SD +/- 42.5 months, range 3-143 months). In 9 eyes, the epithelial defect healed by postoperative day 3 and all eyes healed by postoperative day 6. There was no infection or corneal melting in any of the eyes. After PTK, 11 patients were refit successfully with rigid gas-permeable contact lenses and 4 wore glasses. Three patients had a recurrence of the KCN nodule at 3, 8, and 23 months postoperatively. One of them had a repeat PTK 23 months after the initial surgery, improving to 20/40 with contact lenses at 55 months postoperatively. Another patient decided to have a penetrating keratoplasty, and the third patient is considering repeat PTK or penetrating keratoplasty. PTK effectively removed KCN nodules without recurrences in most patients and can be a successful modality to improve contact lens tolerance and delay or avoid more invasive surgery.

  17. Some aspects of optical spatial solitons in photorefractive media and ...

    Indian Academy of Sciences (India)

    2015-10-22

    Oct 22, 2015 ... Some important properties of photorefractive spatial solitons and their applications have been reviewed in the present paper. Using band transport model, the governing principle of photorefractive nonlinearity has been addressed and nonlinear dynamical equations of spatial solitons owing to this ...

  18. Some aspects of optical spatial solitons in photorefractive media and ...

    Indian Academy of Sciences (India)

    photorefractive optical spatial solitary waves may coalesce to form a single solitary wave ... converters [26,27]. The unique features of photorefractive nonlinearity have opened up immense possibilities for new and novel devices, such as all-optical switching ..... tion band by another signal beam with photon energy ¯hω2.

  19. Phototherapeutic Keratectomy Outcomes in Superficial Corneal Opacities

    Directory of Open Access Journals (Sweden)

    Khalid Al Arfaj

    2011-01-01

    Full Text Available Purpose Compare the effectiveness of Phototherapeutic keratectomy (PTK in treatment corneal dystrophies versus superficial corneal scars: visual outcomes, recurrence rate and safety profile. Methods PTK was performed in 51 eyes of 51 patients. Data regarding the indications for PTK, ablation depth, symptomatic relief, pre-and postoperative best spectacle-corrected visual acuity (BSCVA, spherical equivalent changes, recurrence and complications were analyzed. The indications for PTK in our study were classified into two categories – group A: patients with corneal dystrophies (n = 23 and the other group B (n = 28 with other indications. Results The average age of the patients was 47 years (±16.4. The mean follow up period was 15.16 months (±10.01 months. Post operatively, there were no significant complications. While the overall BSCVA in the patients improved from 20/41 (0.484 to 20/32 (0.645, group A showed improvement from 20/35 (0.561 to 20/29 (0.687, as compared to group B in which BSCVA improved from 20/47 (0.421 to 20/33 (0.611. The most common indication in group A was granular corneal dystrophy (n = 10 and the most common indication in group B was post traumatic/infectious corneal scar or opacity (n = 10. Eighty-six percent (n = 44 of all patients had alleviation of symptoms. Recurrence of symptoms was seen in 3 eyes of recurrent corneal erosions which required retreatment. Conclusion PTK is a safe and effective procedure. The outcome of this study suggests that PTK improves BSCVA. PTK appears to improve ocular surface health. Furthermore, PTK can be recommended to most patients with corneal dystrophies as a treatment modality prior to other more invasive procedure (viz. penetrating keratoplasty.

  20. A Questionnaire-based Long-term Follow-up of Photorefractive Keratectomy for Low to High Myopia

    DEFF Research Database (Denmark)

    Vestergaard, Anders; Hjortdal, Jesper; Ivarsen, Anders

    (0 to 2.5), negative (>2.5 to 5), positive (>5 to 7.5) and very positive (>7.5 to 10). No neutral responses were allowed in this categorisation. Patients were prior to surgery informed that there were no guaranties of spectacle independence, and that long-term side-effects were not known. This study...... in quality of life, mean score was 7.3 ± 2.5 and 89% felt an improvement in quality of life after PRK. Thirty-nine percent had problems or many problems with backlight glare, and 48% with nighttime glare. Eleven percent had problems or many problems with halos around light sources in daylight and 40...... preoperative patient education is important to establish realistic expectations and satisfaction concerning overall outcome. Financial disclosures: None....

  1. Comparison of bandage contact lens removal on the fourth versus seventh postoperative day after photorefractive keratectomy: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Mehrdad Mohammadpour

    2017-06-01

    Conclusion: Following PRK surgery, BCL removal on the seventh postoperative day yields faster visual rehabilitation and lower rate of postoperative complications with no increase in eye pain, discomfort or infection.

  2. Epithelial healing and clinical outcomes in excimer laser photorefractive surgery following three epithelial removal techniques: mechanical, alcohol, and excimer laser.

    Science.gov (United States)

    Lee, Hyung Keun; Lee, Kyung Sub; Kim, Jin Kook; Kim, Hyeon Chang; Seo, Kyung Ryul; Kim, Eung Kweon

    2005-01-01

    To evaluate epithelial healing, postoperative pain, and visual and refractive outcomes after photorefractive keratectomy (PRK) using three epithelial removal techniques. Prospective, nonrandomized, comparative trial. Department of Ophthalmology, Yonsei University College of Medicine and Balgensesang Ophthalmology Clinic, Seoul, Korea. For the PRK procedure, the corneal epithelium was removed in one of three ways: mechanically (conventional PRK [PRK]) in 88 eyes of 44 patients; using excimer laser (transepithelial PRK [tPRK]) in 106 eyes of 53 patients; or using 20% diluted alcohol, laser-assisted subepithelial keratomileusis (LASEK) in 106 eyes of 53 patients. Epithelial healing, postoperative pain, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and remaining refractive error. The mean postoperative pain scores were 4.84 +/- 1.45 for PRK, 4.71 +/- 1.62 for tPRK, and 4.63 +/- 1.52 for LASEK (P = .125). The mean epithelial healing rates were 12.3 +/- 4.6 for PRK, 15.2 +/- 4.9 for tPRK, and 18.1 +/- 5.2 mm2/day for LASEK (P refractive outcomes. Using the same nomogram, tPRK resulted in a slight overcorrection, and LASEK resulted in a slight undercorrection.

  3. Resultados refracionais do retratamento de LASIK com ablação personalizada versus ablação convencional Refractional results of LASIK retreatment with wavefront-guided ablation versus standard ablation

    Directory of Open Access Journals (Sweden)

    Andréia Peltier Urbano

    2008-10-01

    Full Text Available OBJETIVO: Avaliar os resultados do retratamento personalizado (Zyoptix, Bausch & Lomb e do retratamento convencional (Planoscan, Bausch & Lomb em olhos submetidos a LASIK primário convencional. MÉTODOS: Foi realizado estudo prospectivo, randomizado, de 74 olhos de 37 pacientes submetidos a retratamento de LASIK para correção de miopia e astigmatismo. Cada paciente foi submetido a retratamento de LASIK com ablação personalizada em um olho e ablação convencional no olho contralateral. Foram comparadas a acuidade visual de alto contraste e refração manifesta, com acompanhamento de seis meses. RESULTADOS: Os retratamentos personalizados de LASIK (Zyoptix e os retratamentos convencionais de LASIK (Planoscan apresentaram valores estatisticamente similares para a acuidade visual, ganho/perda de linhas da melhor acuidade visual corrigida, índices de segurança e eficácia e porcentagem de olhos com equivalente esférico (EE entre ± 0,50 D e 1,00 D no período pós-operatório de seis meses. Houve diferença significativa para os valores do componente esférico e do equivalente esférico nos períodos pós-operatórios de uma semana, um, três e seis meses entre os grupos Zyoptix e Planoscan. Os olhos do grupo Zyoptix apresentaram valores mais hipermétropes do que os olhos do grupo Planoscan. A previsibilidade da correção do equivalente esférico no grupo Zyoptix foi superior à do grupo Planoscan. CONCLUSÕES: A ablação personalizada proporciona melhores resultados refracionais do que a ablação convencional para os retratamentos de LASIK convencional. A medida da acuidade visual de alto contraste não é parâmetro sensível para evidenciar a melhor técnica cirúrgica.PURPOSE: To evaluate refractive outcomes of wavefront-guided LASIK (Zyoptix, Bausch & Lomb versus standard LASIK (PlanoScan, Bausch & Lomb in retreatment of primary LASIK for myopia and myopic astigmatism. METHODS: A prospective, randomized trial with paired eye control

  4. New Meta and Nanomaterials for Photorefractive Enhancement and Photorefractive Two-Beam Coupling

    Science.gov (United States)

    2010-03-12

    Centro de Investigacion de Quimica Aplicada Blvd. Enrique reyna, No. 140 Saltillo, Coahuila, Mexico 25253 AFOSR FA9550-09-1-0023 12 March 2010...ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER CENTRO DE INVESTIGACION EN QUIMICA APLICADA BLVD ENRIQUE REYNA NO 140 SALTILLO 25253...Photorefractive Two-Beam Coupling Ronald F. Ziolo Centro de Investigacion de Quimica Aplicada Saltillo, Coahuila, Mexico 25253 Grant

  5. Ultraviolet photorefraction at 325 nm in doped lithium niobate crystals

    Science.gov (United States)

    Xin, Feifei; Zhang, Guoquan; Bo, Fang; Sun, Haifeng; Kong, Yongfa; Xu, Jingjun; Volk, Tatyana; Rubinina, Natalia M.

    2010-02-01

    We studied the photorefractive effect of lithium niobate (LiNbO3) doped with Mg, Zn, In, Hf, or codoped with Mg and Fe at an ultraviolet (UV) wavelength down to 325 nm. It is found that the UV photorefraction of LiNbO3 doped with Mg, Zn, In, or Hf was enhanced significantly as compared to that of the nominally pure LiNbO3. Our results show that the property of resistance against photorefraction in highly Mg, Zn, In, or Hf doped LiNbO3 is true only in the visible and near-infrared wavelength range. By contrast, these crystals exhibit excellent photorefractive characteristics at UV wavelength of 325 nm, even better than those at 351 nm. For example, the photorefractive two-wave coupling gain coefficient Γ and the photorefractive recording sensitivity at 325 nm were measured to be ˜38 cm-1 and 37.7 cm/J, respectively, in a LiNbO3 crystal doped with 9 mol % Zn. The photorefractive response time of a Mg:LiNbO3 with a 9 mol % Mg was measured to be 73 ms with a total recording intensity of 614 mW/cm2 at 325 nm. In highly Mg, Zn, In, or Hf doped LiNbO3 crystals, diffusion dominates over photovoltaic effect and electrons are the dominant charge carriers in UV photorefraction at 325 nm. The results are also of interest to the study on the defect structure of LiNbO3 near to the absorption edge.

  6. Spatial frequency mixing by nonlinear charge transport in photorefractive materials

    DEFF Research Database (Denmark)

    Limeres, J.; Carrascosa, M.; Arizmendi, L.

    2002-01-01

    We present a theoretical investigation of the nonlinear phenomenon of spatial frequency mixing in photorefractive materials. In particular, we study the kinetics of the second harmonics and the sum and difference (combinational) gratings when two photorefractive gratings are recorded in the mater......-order gratings is analyzed. We found remarkable differences in the kinetics of these gratings depending on the multiplexing procedure. Our theoretical predictions are in good agreement with a number of previously reported experimental results....

  7. [Effects of amniotic extraction on epithelial wound healing and stromal remodelling after excimer laser keratectomy in rabbit cornea].

    Science.gov (United States)

    Xiao, Qiguo; Chen, Yuan; Du, Juan; Wang, Hua; Li, Wei; Liu, Zuguo

    2014-01-01

    To investigate the effects and mechanism of amniotic extraction on corneal healing after photorefractive keratectomy (PRK). Experimental Study. Thirty-six New Zealand rabbit corneas were performed with PRK models (-10 diopters, 6.5 mm diameter). According to random number table, all eyes were divided into three groups, including treated with amniotic extraction, 0.1% dexamethasone and excipient respectively after operation. Clinical and histopathologic examinations were taken by slit-lamp microscope and light microscope. Corneal epithelium reparation was observed by fluorescent staining. Corneal stroma cell apoptosis was evaluated by terminal deoxyribonucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) assay. Myofibroblast generation was evaluated by immunofluorescence checking the expression of alpha-smooth muscle actin (α-SMA). The number of TUNEL and α-SMA positive cells was analyzed to explore the effects on corneal haze. The haze grading was compared between groups using Kruskal-Wallis H test. Mean values for each experiment were compared between groups using a one-way analysis of variance and LSD-t test.Spearman rank analysis was used to evaluate the correlation between the haze grading and the expression of TUNEL positive cells and α-SMA. The corneas of seventy-two eyes reepithelialized in 6 days after operation. The average epithelium repair time of the AE group was (4.12 ± 0.62) d, the dexamethasone group was (5.25 ± 0.78) d, and the excipient group was (4.96 ± 0.73) d. The progression of reepithelialization was significantly faster in the AE group than the other two groups (F = 14.144, P healing of epithelial cell by interacting with the corneal cell factors, reducing the cell apoptosis, corneal wound healing response and rebuilding the corneal matrix with less myofibroblast, collagen and scar and finally reduce the formation of haze.

  8. Recent advancements in photorefractive holographic imaging

    Science.gov (United States)

    Lynn, B.; Blanche, P.-A.; Bablumian, A.; Rankin, R.; Voorakaranam, R.; St. Hilaire, P.; LaComb, L., Jr.; Yamamoto, M.; Peyghambarian, N.

    2013-02-01

    We have recently demonstrated several improvements in material properties and optical design to increase the resolution, size, brightness, and color range of updatable holograms using photorefractive materials. A compact system has been developed that is capable of producing holograms with brightness in excess of 2,500 cd/m2 using less than 20mW of CW laser power. The size of the hologram has been increased to 300mm × 150mm with a writing time of less than 8 seconds using a 50 Hz pulse laser. Optical improvements have been implemented to reduce the hogel size to less than 200 μm. We have optimized the color gamut to extend beyond the NTSC CIE color space through a combination of spatial and polarization multiplexing. Further improvements could bring applications in telemedicine, prototyping, advertising, updatable 3D maps and entertainment.

  9. Optical Programmable Radio Frequency Matched Filtering Using Photorefractive Effect.

    Science.gov (United States)

    Lee, Byoungho

    In this thesis the feasibility of optical programmable radio frequency (rf) matched filtering using the photorefractive effect is studied. The optical rf matched filter system proposed in this thesis is based on the use of a photorefractive crystal with a unique interface that provides easy input of rf signals for programming and for the correlation operation. The rf signals are given to an acousto-optic modulator. Laser beams deflected from the modulator have wavefronts which contain the information of the rf signals. The beams illuminate a photorefractive crystal to form reference gratings or to be correlated with the holograms. Reference holograms are stored by angular multiplexing one of the pump beams. This is performed by using a mode-locked laser and letting the pulse repetition rate be integrally related to the electrical signal frequencies given to the acousto-optic modulators. This method allows stable grating formation with nondegenerate waves. An orthogonal signal storage and reading method is devised, which enables one to distinguish different beams illuminating the same hologram region. Experiments were performed with a mode-locked argon ion laser and a cerium-doped strontium barium niobate crystal which is used as a photorefractive medium. The results verify the ideas on which the optical programmable rf matched filter is based. This study raises the possibility of forming a large number of parallel matched filters in a single photorefractive crystal which would allow easy signal storage and rapid correlation analyses.

  10. Optical reconstruction of non-diffracting beams via photorefractive holography

    Science.gov (United States)

    Vieira, Tárcio A.; Yepes, Indira S. V.; Suarez, Rafael A. B.; Gesualdi, Marcos R. R.; Zamboni-Rached, Michel

    2017-04-01

    This work presents the optical reconstruction of non-diffracting beams via photorefractive holography. Optical generation of non-diffracting beams using conventional optical components is difficult and, in some circumstances, unfeasible, as it is the case of wave fields given by superposition of non-diffracting beams, which have been successfully generated through computer-generated holograms reproduced in spatial light modulators. With the photorefractive holography technique, the hologram of a non-diffracting beam is optically constructed (recorded) and reconstructed (read) in a nonlinear photorefractive medium. The experimental realizations of non-diffracting beams (Bessel, Mathieus and Parabolic), the Bessel beam arrays and superposition of co-propagating Bessel beams (Frozen waves) are made in a photorefractive holography setup using a photorefractive Bi12SiO20 (BSO) crystal as the holographic recording medium. The results are in agreement with the theoretical predictions and are presenting excellent prospects for the implementation of this technique in dynamical systems with applications in optics and photonics.

  11. Microwave signal processing with photorefractive dynamic holography

    Science.gov (United States)

    Fotheringham, Edeline B.

    Have you ever found yourself listening to the music playing from the closest stereo rather than to the bromidic (uninspiring) person speaking to you? Your ears receive information from two sources but your brain listens to only one. What if your cell phone could distinguish among signals sharing the same bandwidth too? There would be no "full" channels to stop you from placing or receiving a call. This thesis presents a nonlinear optical circuit capable of distinguishing uncorrelated signals that have overlapping temporal bandwidths. This so called autotuning filter is the size of a U.S. quarter dollar and requires less than 3 mW of optical power to operate. It is basically an oscillator in which the losses are compensated with dynamic holographic gain. The combination of two photorefractive crystals in the resonator governs the filter's winner-take-all dynamics through signal-competition for gain. This physical circuit extracts what is mathematically referred to as the largest principal component of its spatio-temporal input space. The circuit's practicality is demonstrated by its incorporation in an RF-photonic system. An unknown mixture of unknown microwave signals, received by an antenna array, constitutes the input to the system. The output electronically returns one of the original microwave signals. The front-end of the system down converts the 10 GHz microwave signals and amplifies them before the signals phase modulate optical beams. The optical carrier is suppressed from these beams so that it may not be considered as a signal itself to the autotuning filter. The suppression is achieved with two-beam coupling in a single photorefractive crystal. The filter extracts the more intense of the signals present on the carrier-suppressed input beams. The detection of the extracted signal restores the microwave signal to an electronic form. The system, without the receiving antenna array, is packaged in a 13 x 18 x 6″ briefcase. Its power consumption equals that

  12. Volume holographic storage in photorefractives: material peculiarities and memory performances

    Science.gov (United States)

    Tao, Shiquan

    1998-08-01

    In this paper we review the currently achievable performances of holographic memories stored in photorefractive crystals. We discuss the dependence of the memory performances on the material peculiarities in three major aspects: storage capacity, data transfer rate,and image fidelity. In the recent years the research at Beijing Polytechnic University on the photorefractive holographic storage has been focused to the optimization of the storage capacity and diffraction efficiency, as well as the influence of noises on the fidelity of reconstructed images. Our research shows again that the realization of volume holographic storage technology requests materials with perfect properties.

  13. Optical image processing by using a photorefractive spatial soliton waveguide

    Energy Technology Data Exchange (ETDEWEB)

    Liang, Bao-Lai, E-mail: liangbaolai@gmail.com [College of Physics Science & Technology, Hebei University, Baoding 071002 (China); Wang, Ying; Zhang, Su-Heng; Guo, Qing-Lin; Wang, Shu-Fang; Fu, Guang-Sheng [College of Physics Science & Technology, Hebei University, Baoding 071002 (China); Simmonds, Paul J. [Department of Physics and Micron School of Materials Science & Engineering, Boise State University, Boise, ID 83725 (United States); Wang, Zhao-Qi [Institute of Modern Optics, Nankai University, Tianjin 300071 (China)

    2017-04-04

    By combining the photorefractive spatial soliton waveguide of a Ce:SBN crystal with a coherent 4-f system we are able to manipulate the spatial frequencies of an input optical image to perform edge-enhancement and direct component enhancement operations. Theoretical analysis of this optical image processor is presented to interpret the experimental observations. This work provides an approach for optical image processing by using photorefractive spatial solitons. - Highlights: • A coherent 4-f system with the spatial soliton waveguide as spatial frequency filter. • Manipulate the spatial frequencies of an input optical image. • Achieve edge-enhancement and direct component enhancement operations of an optical image.

  14. Holographic gratings in photorefractive polymers without external electric field

    DEFF Research Database (Denmark)

    Kukhtarev, N.; Lyuksyutov, S.; Buchhave, Preben

    1997-01-01

    Using anomalous large diffusion we report a recording of reflection type gratings in a PVK-based photorefractive polymer without any external electric field. The diffraction efficiency of the gratings was measured to be 7%. An efficient modulation of beams during two-beam coupling up to 12...

  15. Influence of surroundings on photorefractive effect in lithium niobate crystals

    Energy Technology Data Exchange (ETDEWEB)

    Tarjanyi, Norbert, E-mail: tarjanyi@fyzika.uniza.sk [Department of Physics, Faculty of Electrical Engineering, University of Zilina, Univerzitna 1, Zilina, 01026 (Slovakia); Turek, Ivan [Berlinska 4, Zilina, 01008 (Slovakia)

    2012-11-01

    In the paper results of the investigation of the influence of electric properties of the environment surrounding LiNbO{sub 3} crystals on photorefractive effect induced in these crystals by Gaussian Ar{sup +} laser beam with various intensities are presented. We show spatial and temporal dependences of changes of the refractive index obtained experimentally in LiNbO{sub 3}: Fe and LiNbO{sub 3}: Fe:Mn samples surrounded by media with different electric conductivities and different permittivities (water, air, water solution of CaCl{sub 2}). The space and time dependences of the refractive index changes induced by the Ar{sup +} laser beam are observed by means of the Mach-Zehnder interferometer using light from HeNe laser. The experimentally obtained results are in a good agreement with those following from numerical calculations using the manifold mirroring method. The agreement between calculated and experimental results indicates that the polarization charge at the photorefractive crystal/surrounding medium boundary significantly influences the photorefractive process in the crystal. The experimentally observed slow spontaneous decrease of the refractive index change in a sample placed into a slightly conducting medium (air) after switching off the beam also indicates that the polarization charge in the sample's surroundings affects the photorefraction.

  16. Optoelectronic correlation processors with photorefractive crystals for the storage elements

    Directory of Open Access Journals (Sweden)

    Lipinskii A. Y.

    2011-12-01

    Full Text Available The paper presents review of optical and acousto-optic correlation processors that contain photorefractive crystals. Optical correlators are the efficient devices for the image recognition due to the parallel way high operation rate processing of significant data amount. The shift-invariant holographic joint-transform correlators, dynamic holographic correlator, acousto-optic correlation processors with memory were considered.

  17. Multiple-pattern stability in a photorefractive feedback system

    DEFF Research Database (Denmark)

    Schwab, M.; Denz, C.; Saffman, M.

    1999-01-01

    We report on the observation of a multiple-pattern stability region in a photorefractive single-feedback system. Whereas hexagonal patterns are predominant for feedback with positive diffraction length we show that a variety of stable non-hexagonal patterns are generated for certain negative...

  18. Photoconductivity and Charge-Carrier Photogeneration in Photorefractive Polymers

    NARCIS (Netherlands)

    Däubler, Thomas K.; Kulikovsky, Lazar; Neher, Dieter; Cimrová, Vera; Hummelen, J.C.; Mecher, Erwin; Bittner, Reinhard; Meerholz, Klaus; Lawson, M.; Meerholz, Klaus

    2002-01-01

    We have studied photogeneration, transport, trapping and recombination as the governing mechanisms for the saturation field strength and the time response of the photorefractive (PR) effect in PVK-based PR materials, utilizing xerographic discharge and photoconductivity experiments. Both the charge

  19. Photorefractive dynamic holography using self-pumped phase ...

    Indian Academy of Sciences (India)

    conjugate beam of the object beam itself as the other writing beam is proposed. Our detailed theoretical analysis shows ..... Since, in photorefractive holography both writing and reading holograms are done simultaneously in real-time, the light will ... So, it becomes essential to improve the space-charge field using low ...

  20. Observation of non-degenerate photorefractive parametric amplification

    DEFF Research Database (Denmark)

    Pedersen, H.C.; Johansen, P.M.

    1996-01-01

    We report on the first experimental observation of so-called nondegenerate photorefractive parametric amplification. We show that due to this effect it is possible for a weakly modulated photoinduced grating to be parametrically amplified via nonlinear interaction with a strongly modulated...

  1. Linearity and Non-linearity of Photorefractive effect in Materials ...

    African Journals Online (AJOL)

    In this paper we have studied the Linearity and Non-linearity of Photorefractive effect in materials using the band transport model. For low light beam intensities the change in the refractive index is proportional to the electric field for linear optics while for non- linear optics the change in refractive index is directly proportional ...

  2. Photorefractive dynamic holography using self-pumped phase ...

    Indian Academy of Sciences (India)

    2015-11-27

    Home; Journals; Pramana – Journal of Physics; Volume 66; Issue 3. Photorefractive dynamic holography using self-pumped phase ... Proceedings of the International Workshop/Conference on Computational Condensed Matter Physics and Materials Science (IWCCMP-2015). Posted on November 27, 2015. Guest Editors: ...

  3. Photorefractive grating formation in piezoelectric La3Ga5SiO14:Pr3+ crystals

    DEFF Research Database (Denmark)

    Dam-Hansen, C.; Johansen, P.M.; Fridkin, V.M.

    1996-01-01

    Photorefractive grating formation and erasure in piezoelectric crystals of La3Ga5SiO14:Pr3+ are presented. The specific photoconductivity and the photorefractive sensitivity are determined. The polarization dependence of the grating formation due to the bulk photovoltaic effect is shown and compa......Photorefractive grating formation and erasure in piezoelectric crystals of La3Ga5SiO14:Pr3+ are presented. The specific photoconductivity and the photorefractive sensitivity are determined. The polarization dependence of the grating formation due to the bulk photovoltaic effect is shown...

  4. Future of photorefractive based holographic 3D display

    Science.gov (United States)

    Blanche, P.-A.; Bablumian, A.; Voorakaranam, R.; Christenson, C.; Lemieux, D.; Thomas, J.; Norwood, R. A.; Yamamoto, M.; Peyghambarian, N.

    2010-02-01

    The very first demonstration of our refreshable holographic display based on photorefractive polymer was published in Nature early 20081. Based on the unique properties of a new organic photorefractive material and the holographic stereography technique, this display addressed a gap between large static holograms printed in permanent media (photopolymers) and small real time holographic systems like the MIT holovideo. Applications range from medical imaging to refreshable maps and advertisement. Here we are presenting several technical solutions for improving the performance parameters of the initial display from an optical point of view. Full color holograms can be generated thanks to angular multiplexing, the recording time can be reduced from minutes to seconds with a pulsed laser, and full parallax hologram can be recorded in a reasonable time thanks to parallel writing. We also discuss the future of such a display and the possibility of video rate.

  5. Updateable 3D Display Using Large Area Photorefractive Polymer Devices

    Science.gov (United States)

    2013-04-01

    holograms requires 2 key elements: large photorefractive devices, and the ability to print the entire surface, which is enabled by the optical setup...recording. Holographic setup The second part of the creating large hologram is to develop an optical printer setup capable of recording such...0009 Page 33 Figure 37: Picture of the setup where the optics are mounted on a translation stage. Examples of hologram recorded with the pulsed

  6. Simultaneous coherent imaging and strain measurement using coupled photorefractive holography and shearography.

    Science.gov (United States)

    Rosso, Vanessa; Béland, Rémy; Renotte, Yvon; Habraken, Serge; Lion, Yves; Charette, Paul

    2008-04-15

    By coupling photorefractive holography with speckle shearography, it is possible to simultaneously perform both coherent imaging and strain measurement. Use of the photorefractive effect, which is insensitive to incoherently scattered light, is a significant advantage in coherent imaging as described. Experimental results obtained from a centrally loaded steel plate are presented.

  7. Optical wave-mixing and photorefractivity in liquid crystals

    Science.gov (United States)

    Ding, Jianwu

    Optical wave-mixing has a lot of applications such as optical amplification, adaptive optics, harmonic wave generation, and multi-photon microscopy. Photorefractivity has been utilized in many important applications including high density optical data storage, image processing, spatial light modulation, phase conjugation, and optical limiting. They have been investigated, theoretically and experimentally, in this thesis, in the contexts of stimulated orientational scattering and photorefractivity in liquid crystals. Stimulated orientational scattering is a unique optical wave-mixing phenomenon that a scattered noise beam, generated by liquid crystal director oscillation, gets amplified through its interaction with the transmitted beam and director reorientation grating under an intense laser illumination. In this research work, I developed the first steady-state SOS theory without the compromise of non-pump-depletion approximation. I successfully implemented polarization conversion in the infrared wavelength regime and the experimental observations agree well with our developed theory. The control of an external AC field to the stimulated orientational scattering was also experimentally investigated. Furthermore, I investigated the dynamics of this liquid crystal director reorientational process by analyzing the Fourier spectrum of the stimulated signal. The influence of a modulating AC field to the stimulated signal was also studied. The oscillating frequency of the liquid crystal director grating agreed with theoretically calculated characteristic frequency. In addition, I have theoretically and experimentally studied the photorefractivity in liquid crystals. Based on the transport band model, the generated space charge field was developed. With the help of an externally applied DC field, the space charge field is able to induce liquid crystal director reorientation and analytical solutions have been derived for both the director reorientational angle and the

  8. Influence of magnetic field on terahertz wave generation in photorefractive periodically poled lithium niobate crystal.

    Science.gov (United States)

    Li, Gaofang; Li, Dong; Ma, Guohong; Liu, Weimin; Tang, Sing Hai

    2011-03-10

    By employing femtosecond pump-probe configuration, we successfully realized narrowband terahertz wave generation and detection in both photorefractive periodically poled lithium niobate (PPLN) and periodically poled Mg:LiNb(3) (PP-Mg:LN) crystal. Using an applied magnetic field, we achieved modulation of the terahertz wave in a photorefractive PPLN crystal. The terahertz wave depends strongly on the magnitude of the applied magnetic field in the photorefractive PPLN crystal. Terahertz wave independence of the magnetic field in PP-Mg:LN crystal was also identified. The interaction of the magnetic field and photorefractive PPLN crystal is believed to occur due to the Lorentz force, which results in the buildup of a space-charge field in a photorefractive PPLN crystal.

  9. Photorefractive lithium niobate crystals for applications in photonics; Photorefraktive Lithiumniobatkristalle fuer Anwendungen in der Photonik

    Energy Technology Data Exchange (ETDEWEB)

    Hartwig, U.

    2006-12-15

    Lithium niobate crystals (LiNbO{sub 3}) generally show a photorefractive response, i.e., light-induced refractive index changes. Crystals are investigated at room temperature and at elevated temperatures. As a result 'classical' photorefractive holographic volume-phase gratings, originating from space charge fields and the electro-optic effect, and 'non-classical' photorefractive volume-phase gratings, which can be traced back to strong absorption gratings, emerge. Single domain and periodically poled crystals (PPLN) are investigated. PPLN is typically used in non-linear optics for frequency conversion. The crystals also show non-linear photorefractive response during holographic recording with isotropically polarized light beams of equal intensity and, in the case of PPLN, by mixing of domain and holographic gratings. The results are important for applications combining the photorefractive and non-linear optical properties of LiNbO{sub 3}. (orig.)

  10. Adhesion complex formation after small keratectomy wounds in the cornea.

    Science.gov (United States)

    Stock, E L; Kurpakus, M A; Sambol, B; Jones, J C

    1992-02-01

    The adhesion complex of the corneal epithelium consists of the hemidesmosome and its associated structures, such as anchoring filaments, lamina densa of the basement membrane, and anchoring fibrils. It contributes to the adhesion of the corneal epithelium to Bowman's layer. To understand the adhesion complex better, an electron microscopic and immunofluorescence analysis was done of the reformation of the adhesion complex in small (1 mm) keratectomy wounds in the guinea pig cornea. In these wounds, the epithelium, hemidesmosomes, basal lamina, anchoring fibrils, and anterior stroma were removed. The wound bed was epithelialized completely by 24 hr after wounding. Immunofluorescence analyses involved the use of antibodies against plaque components of the hemidesmosome, an antibody against laminin, and an antibody against the collagen VII component of anchoring fibrils. At 18 hr after wounding, there was no morphologic evidence of hemidesmosomes at the epithelial-stromal interface. At 24 hr, hemidesmosomes were observed, with or without subjacent lamina densa. Furthermore, plaque components were detected by immunofluorescence in those cells in contact with the wound bed. In contrast, no type VII collagen was detected. On day 7, collagen VII, laminin, and bullous pemphigoid autoantibody markers colocalized along the wound bed as determined by immunofluorescence. However, at the ultrastructural level, even though the lamina densa of the basal lamina was observed primarily where hemidesmosomes were present, it remained incomplete. In this study, the precise temporal sequence in which components are incorporated into the assembling adhesion complex was described during wound healing. Furthermore, the possibility that the hemidesmosomal plaque nucleates the formation of the underlying basal lamina was discussed.

  11. Analysis of photoastigmatic keratectomy with the cross-cylinder ablation

    Directory of Open Access Journals (Sweden)

    Nicola Rosa

    2012-01-01

    Full Text Available Aim: The aim was to evaluate the safety and efficacy of the "cross-cylinder" technique in the correction of astigmatism. Setting and Design: A prospective interventional study from a university eye department was conducted. Material and Methods: The photoastigmatic refractive keratectomy (PARK using the "cross-cylinder" technique was performed in 102 eyes of 84 patients with at least 0.75 D of astigmatism. The study population was divided into two groups: in the first group the preoperative astigmatic power ranged from −0.75 D to −3.00 D (group 1, in the second group it ranged from −3.25 D to −6.00 D (group 2. Group 1 included 82 eyes of 67 patients (29 males and 38 females with a mean cylinder power of −1.90 ± 0.63 D, group 2 included 20 eyes of 17 patients (13 males and 4 females with a mean cylinder power of -4.28 ± 0.76 D. All eyes were targeted for emmetropia. The results were evaluated using Calossi′s vector analysis method. Six-month postoperative outcomes are presented. Results: Six months after PARK the mean sphere for the entire cohort was +0.28 ± 0.75 D (range +2.5 to −2 D, the mean cylindrical power was +0.33 ± 0.51 D (range +2.5 to −1.25 D and the mean spherical equivalent refraction was +0.73 ± 0.81 D (range +1.75 to −2 D. Conclusions: The cross-cylinder technique may be safely used with predictable results for the correction of astigmatism.

  12. Retrospective Analysis Comparing the Preoperative and Postoperative "Q" Values for 2 Different Lasers in Refractive Surgery.

    Science.gov (United States)

    Molchan, Ryan P; Taylor, Kenneth R; Panday, Vasudha A; Caldwell, Matthew C; Reilly, Charles D

    2015-11-01

    To compare the presurgical and postsurgical corneal asphericity, or "Q value," between VISX Wavefront-guided treatment and Allegretto Wave Wavefront-optimized treatment in photorefractive keratectomy for the correction of myopia. This is a retrospective database analysis performed at the Joint Warfighter Refractive Surgery Center, Lackland Air Force Base, TX. All data were accessed through the Institutional Review Board-approved Joint Warfighter Refractive Surgery Center database. Fifty-one patient records (102 eyes) were reviewed to determine the change in the Q value after photorefractive keratectomy for the correction of myopia. The average change in the Q value per diopter of treatment sphere over the entire study population was 0.12 (±0.04) for Allegretto and 0.14 (±0.04) for VISX (P = 0.004). There was no statistical difference among the preoperative and postoperative best-corrected visual acuities (BCVAs), low-contrast BCVA (BCVA 5%), or quality of vision complaints between both platforms. Low to moderate myopic correction with the Allegretto laser was associated with a smaller change in the Q value per diopter of treatment and therefore more closely maintained the original prolate shape of the cornea when compared with VISX. No difference in the postoperative visual outcome between both groups was detected.

  13. Enhanced semiconductor photorefractivity in the presence of a magnetic field

    Science.gov (United States)

    Aghamkar, Praveen; Nepal, Sunayana; Suta, Suta

    2002-04-01

    Using single-defect single band mode, a large value of the exponential gain coefficient is obtained by degenerate two- picosecond light pulses in a photorefractive GaAs:EL2 crystal in the presence of an applied magneto-static field. The influences of a cd magnetic field on the temporal recording and erasure of the grating are analytically analyzed. A significant enhancement of the diffraction efficiency of the recorded hologram by a factor of 2 is obtained. The results are good qualitatively in agreement with the experimental observations.

  14. Past and present of corneal refractive surgery: a retrospective study of long-term results after photorefractive keratectomy and a prospective study of refractive lenticule extraction.

    Science.gov (United States)

    Vestergaard, Anders Højslet

    2014-03-01

    Surgical correction of refractive errors is becoming increasingly popular. In the 1990s, the excimer laser revolutionized the field of corneal refractive surgery with PRK and LASIK, and lately refractive lenticule extraction (ReLEx) of intracorneal tissue, using only a femtosecond laser, has become possible. Two new procedures were developed, ReLEx flex (FLEX) and ReLEx smile (SMILE). Until this thesis, only a few long-term studies of PRK with a relatively limited number of patients had been published; therefore, this thesis intended to retrospectively evaluate long-term outcomes after PRK for all degrees of myopia for a large number of patients. Furthermore, a prospective contralateral eye study comparing FLEX and SMILE, when treating high to moderate degrees of myopia, had not been performed prior to this study. This was the second aim of this thesis. In the first study, results from 160 PRK patients (289 eyes) were presented. Preoperative spherical equivalent ranged from -1.25 to -20.25 D, with 78% having low myopia (corneas, etc.). The results also highlight that treatment of higher degrees of myopia with standard PRK should only be done today under special circumstances, due to low refractive predictability, and high risk of corneal haze. Technological advances since then should be taken into account when comparing these results with contemporary techniques. In the second study, 35 patients were randomized to receive FLEX in one eye and SMILE in the other. Preoperative spherical equivalent refraction ranged from -6 to -10 D with low degrees of astigmatism. A total of 34 patients completed the 6 month follow-up period. Refractive and visual outcomes were very similar for the two methods, as well as tear film measurements and changes in corneal biomechanics. Ninety-seven percent were within ± 1.00 D of target refraction, no eyes lost two lines or more of CDVA, and contrast sensitivity was unaffected after both procedures. The changes in higher-order aberrations were also very similar. There were also no differences in tear film parameters 6 months after surgery, although less postoperative foreign body sensation was reported within the first week after surgery in SMILE eyes. Corneal sublayer pachymetry measurements demonstrated equally increased epithelial thickness 6 months after surgery. Contrary to expectations, it was not possible to measure the theoretical biomechanical advantages of a small corneal incision in SMILE as compared to a corneal flap in FLEX. The main differences between FLEX and SMILE were found when the corneal nerves and intraoperative complications were evaluated. Thus, corneal sensitivity was better preserved and corneal nerve morphology was less affected after SMILE, but intraoperative complications occurred more frequently, although without visual sequela. Finally, 97% were satisfied or very satisfied with both their surgeries. The results support the continued use of both FLEX and SMILE for treatment of up to high degrees of myopia. Overall, refractive and visual results for both procedures were good and similar, but from a biological point of view, the less invasive SMILE technique is more attractive, as demonstrated in this study, despite being slightly more surgically demanding than FLEX. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  15. The U.S. Air Force Photorefractive Keratectomy (PRK) Study: Evaluation of Residual Refractive Error and High- and Low-Contrast Visual Acuity

    Science.gov (United States)

    2006-07-01

    undercorrection, overcorrection, induced astigmatism, and anisometropia . Low to moderate residual refractive error after refractive surgery may be...19 7 Incidence of Anisometropia in PRK-Treated Subjects at Baseline and After Surgery...overcorrection, induced astigmatism, and anisometropia . The primary concern for distance visual acuity was undercorrection and/or regression over time similar

  16. Technique Development Results for the Study of a Novel Dexamethasone Impregnated Bandage Contact Lens in a Rabbit Model After Photorefractive Keratectomy

    Science.gov (United States)

    2017-10-22

    Richard Townley I I. San Antonio Uniformed Services Health Education Consortium, San Antonio, TX 2. Massachusetts Eye and Ear, Boston, MA Introduction...Wesley Brundridge1, Gary Legault1, Matthew Caldwell 1, Joseph Ciolino2, Richard Townley1 1. San Antonio Uniformed Services Health Education ...Institute of Health Publication No. 80-23, Guide for the Care and Use of Laboratory Animals and the Animal Welfare Act of 1966, as amended."

  17. Past and present of corneal refractive surgery: a retrospective study of long-term results after photorefractive keratectomy and a prospective study of refractive lenticule extraction

    National Research Council Canada - National Science Library

    Vestergaard, Anders Højslet

    2014-01-01

    Surgical correction of refractive errors is becoming increasingly popular. In the 1990s, the excimer laser revolutionized the field of corneal refractive surgery with PRK and LASIK, and lately refractive lenticule extraction (ReLEx...

  18. Photorefractive keratectomy with corneal collagen cross-linking 1 year after intrastromal corneal ring segment implantation for the treatment of keratoconus

    Directory of Open Access Journals (Sweden)

    Maha Elfayoumi

    2016-01-01

    Conclusion PRK with CXL can be used to enhance aided and unaided visual acuity after treatment of keratoconus with Intacs implants, with a stable refractive outcome, and could postpone penetrating or lamellar keratoplasty in patients with the visually disabling disease of moderate keratoconus.

  19. Effect of photorefractive keratectomy on optic nerve head topography and retinal nerve fiber layer thickness measured by heidelberg retina tomograph 3

    Directory of Open Access Journals (Sweden)

    Naveed Nilforushan

    2016-01-01

    Conclusion: PRK can affect some HRT3 parameters. Although the most important stereometric parameters for differentiating normal, suspect or glaucomatous patients such as rim and cup measurements in stereometric parameters were not changed.

  20. Preoperative topical diclofenac and ketorolac in prevention of pain and discomfort following photorefractive keratectomy: A randomized double-masked placebo-controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Hassan Razmju

    2012-01-01

    Conclusions: Either diclofenac or ketorolac instilled at a dose of one drop 30 minutes in advance of the operation would be equally beneficial in the short-term prevention of post-PRK pain and discomfort.

  1. [Western Blot analysis of type I, III, V, VI collagen after laser epithelial keratomileusis and photorefractive keratectomy in cornea of rabbits].

    Science.gov (United States)

    Cui, Xin; Bai, Ji; He, Xiangge; Zhang, Yi

    2005-12-01

    Use immunohistochemical staining and Western Blot analysis to observe and compare the accurate dynamic changes of type I, III, V, VI collagen in the wound healing processes of the rabbit cornea which underwent LASEK or PRK to investigate the possible mechanism of corneal haze and myopic regression. New Zealand White rabbits were divided into 8 groups: normal control group (n=6), 1 day, 7 days, 1, 3, 4, 5 and 6 month groups (n=14). Every rabbit underwent LASEK in one eye while the other one with PRK. We use immunohistochemical staining and Western Blot analysis to compare the wound healing process of dynamic change of the type I, III, V and VI collagen in rabbit cornea of every time point. The results were analysised with data analysis software. Immunohistochemical staining and Western Blot analysis showed that after LASEK, the cornea wound healing with type I and III collagen were much faster than PRK, and the wound response was also much weaker. Whereas for type V and VI collagen, their dynamic changes were resemble between LASEK and PRK, they both reached the peak value after 3 months since the surgery, but LASEK group returned to normal earlier than PRK. The value of these two types of collagen after PRK were higher than LASEK. The changes of these four types of collagen may offer us at least partial explaination to the difference between formation between corneal haze and refractive regression. There were significant differences between LASEK and PRK on type I, III, V and VI collagens or the time of reacting, reaching apex and returning to normal . LASEK had slighter intensity of reaction. The results indicate that there is excessive aggradation of collagens after PRK, it may be the histological foundation of obvious haze and myopia regression.

  2. Optical topographic technique to material characterization of photorefractive crystals

    Science.gov (United States)

    Bugaychuk, S.; Mandula, G.; Koávcs, L.; Rupp, R. A.

    2005-11-01

    Nonlinear transmission wave-mixing problem in a photorefractive medium that include both local and non-local responses is solved not traditionally but with using a new variable namely the dynamic grating amplitude. The dynamics of the wave-mixing is described by a modified sine-Gordon equation that have soliton-like solutions for the dynamic grating amplitude. For the first time the solution for the grating amplitude distribution in a medium with complex response is obtained. The shape of the grating amplitude profile is determined only by the value of the non-local response in the steady state, and both by local and by non-local components of the response in a transient process. Complete analytical solutions with taking into consideration the complex medium response as well as the absorption in two-wave mixing are obtained. The described theoretical predictions can be a base for a novel topographical method to material characterization of photorefractive crystals that allows one to study contributions local and non-local components of the medium response more precisely.

  3. Faraday Rotation in Photorefractive InP:Fe

    Science.gov (United States)

    Syed, Maarij; Siahmakoun, Azad

    2001-05-01

    We report on the investigation of Faraday rotation (FR) in photorefractive (PR) indium phophide (InP:Fe) conducted at several different wavelengths at room temperature. Appreciable FR, yielding Verdet constant values at 980, 1064, and 1300 nm at room temperature, has been observed. The choice of these wavelengths was guided by two important considerations. Firstly, these are wavelengths of interest for communication purposes and secondly FR in more conventional magnetic and iron doped materials has shown a dependence on the band gap. The role of excitation energy in FR has yielded important information regarding the differences that exist between FR models for conventional materials and photorefractive InP:Fe. We have also investigated the role of the intensity of the incident beam and its initial polarization state. Verdet constant values were found to be the highest for the incident beam wavelength of 980 nm. At 980 nm and applied magnetic field of 1.5 ± 0.05 tela, polarization rotation of 45 ± 1.0 degrees has been observed. This value of 45o is a benchmark for optical isolator applications. In this study we will provide important clues about the magnetic properties of semi-insulating PR InP:Fe crystal.

  4. Geometrical theory to predict eccentric photorefraction intensity profiles in the human eye

    Science.gov (United States)

    Roorda, Austin; Campbell, Melanie C. W.; Bobier, W. R.

    1995-08-01

    In eccentric photorefraction, light returning from the retina of the eye is photographed by a camera focused on the eye's pupil. We use a geometrical model of eccentric photorefraction to generate intensity profiles across the pupil image. The intensity profiles for three different monochromatic aberration functions induced in a single eye are predicted and show good agreement with the measured eccentric photorefraction intensity profiles. A directional reflection from the retina is incorporated into the calculation. Intensity profiles for symmetric and asymmetric aberrations are generated and measured. The latter profile shows a dependency on the source position and the meridian. The magnitude of the effect of thresholding on measured pattern extents is predicted. Monochromatic aberrations in human eyes will cause deviations in the eccentric photorefraction measurements from traditional crescents caused by defocus and may cause misdiagnoses of ametropia or anisometropia. Our results suggest that measuring refraction along the vertical meridian is preferred for screening studies with the eccentric photorefractor.

  5. Light amplification by photorefractive ferroelectric liquid crystal blends containing quarter-thiophene photoconductive chiral dopant

    Science.gov (United States)

    Sasaki, T.; Hara, T.; Yamamoto, Y.; Naka, Y.; Le, K. V.

    2017-05-01

    The photorefractive effect is a phenomenon that forms a rewritable hologram in a material. This phenomenon can be utilized in devices including 3D displays, optical tomography, novelty filters, phase conjugate wave generators, and optical amplification. Ferroelectric liquid crystal blends composed of a smectic liquid crystalline mixture, a photoconductive chiral dopant, and an electron trap reagent exhibit significant photorefractivity together with rapid responses. As such, they allow the dynamic amplification of moving optical signals. The photoconductive chiral dopants used in the previous study are ter-thiphene derivatives so that the photorefractive effect was examined at 488 nm. In the present work, chiral dopants possessing quarter-thiphene chromophore were synthesized and the photorefractive effect of the FLC blends at longer wavelength was demonstrated.

  6. Effect of Particular Nonlinear Dispersion in Photorefractive Four wave Mixing on Slow and Fast Light (Preprint)

    Science.gov (United States)

    2018-01-31

    coupling strength increases. The conclusions of the theoretical analysis are confirmed experimentally for photorefractive four-wave mixing in...fast light Konstantin Shcherbin*a, Pierre Matheyb, and Dean R. Evansc aInstitute of Physics , National Academy of Sciences, Prospekt Nauki 46, 03680...conclusions of the theoretical analysis are confirmed experimentally for photorefractive four-wave mixing in barium titanate. Keywords: slow light

  7. Management of canine corneal squamous cell carcinoma with lamellar keratectomy and strontium 90 plesiotherapy: 3 cases.

    Science.gov (United States)

    Nevile, Jessica C; Hurn, Simon D; Turner, Andrew G; McCowan, Christina

    2015-05-01

    To report three cases of canine corneal squamous cell carcinoma (SCC) treated with strontium 90 beta radiation as an adjunct to surgical excision. Corneal SCC was excised with lamellar keratectomy. This was followed by local application of strontium 90 beta radiation. Available case follow-up times range from 3 to 50 months. One case suffered a recurrence 5 months following initial excision and strontium 90 treatment. Strontium 90 beta radiation has been used extensively as an adjunctive treatment for equine corneal SCC and in other canine ocular tumors; however, there is a paucity of information regarding use in canine corneal SCC. The cases presented here suggest its use following keratectomy may be helpful in preventing disease recurrence. At the dosage used, severe adverse effects were not observed. © 2014 American College of Veterinary Ophthalmologists.

  8. Laser-assisted subepithelial keratectomy (LASEK) versus laser-assisted in-situ keratomileusis (LASIK) for correcting myopia.

    Science.gov (United States)

    Kuryan, Jocelyn; Cheema, Anjum; Chuck, Roy S

    2017-02-15

    Near-sightedness, or myopia, is a condition in which light rays entering the eye along the visual axis focus in front of the retina, resulting in blurred vision. Myopia can be treated with spectacles, contact lenses, or refractive surgery. Options for refractive surgery include laser-assisted subepithelial keratectomy (LASEK) and laser-assisted in-situ keratomileusis (LASIK). Both procedures utilize a laser to shape the corneal tissue (front of the eye) to correct refractive error, and both create flaps before laser treatment of corneal stromal tissue. Whereas the flap in LASEK is more superficial and epithelial, in LASIK it is thicker and also includes some anterior stromal tissue. LASEK is considered a surface ablation procedure, much like its predecessor, photorefractive keratectomy (PRK). LASEK was developed as an alternative to PRK to address the issue of pain associated with epithelial debridement used for PRK. Assessing the relative benefits and risks/side effects of LASEK and LASIK warrants a systematic review. To assess the effects of LASEK versus LASIK for correcting myopia. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), which contains the Cochrane Eyes and Vision Trials Register (2016, Issue 10); MEDLINE Ovid (1946 to 24 October 2016); Embase.com (1947 to 24 October 2016); PubMed (1948 to 24 October 2016); LILACS (Latin American and Caribbean Health Sciences Literature Database; 1982 to 24 October 2016); the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), last searched 20 June 2014; ClinicalTrials.gov (www.clinicaltrials.gov); searched 24 October 2016; and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 24 October 2016. We did not use any date or language restrictions in the electronic searches for trials. We considered only randomized controlled trials (RCTs) for the purposes of this review. Eligible RCTs were those in which myopic participants were

  9. Excimer Laser Phototherapeutic Keratectomy for the Treatment of Clinically Presumed Fungal Keratitis

    OpenAIRE

    Liang-Mao Li; Li-Quan Zhao; Ling-Hui Qu; Peng Li

    2014-01-01

    This retrospective study was to evaluate treatment outcomes of excimer laser phototherapeutic keratectomy (PTK) for clinically presumed fungal keratitis. Forty-seven eyes of 47 consecutive patients underwent manual superficial debridement and PTK. All corneal lesions were located in the anterior stroma and were resistant to medication therapy for at least one week. Data were collected by a retrospective chart review with at least six months of follow-up data available. After PTK, infected cor...

  10. Immunofluorescence study of corneal wound healing after excimer laser anterior keratectomy in the monkey eye.

    Science.gov (United States)

    Malley, D S; Steinert, R F; Puliafito, C A; Dobi, E T

    1990-09-01

    We performed anterior keratectomies on six monkey eyes, four by excimer laser large-area ablation at 193 nm and two by mechanical keratectomy. Immunofluorescence was used to study the wound healing response histopathologically. The distribution of fibrinogen, fibronectin, laminin, collagen types III, IV, and VI, and keratan sulfate was determined at postoperative intervals of 24 hours, 6 days, and 1 month. At 24 hours, fibrinogen and fibronectin coated the ablated surface, but corneal epithelial cells had not yet migrated over the wound. By 6 days and persisting at 1 month, an epithelial ingrowth of seven to 10 layers, mild stromal hypercellularity, and new collagen formation were present in the repair region. At 1 month, fibrinogen, fibronectin, laminin, and type III collagen were strongly detected in the repair region. Type VI collagen was present in both normal and healed corneal stroma at all intervals, and type IV collagen was present in Descemet's membrane only. Sulfated keratan sulfate was absent from the newly synthesized collagen stroma at all intervals. Slit-lamp photographs demonstrated corneal haze in the ablation zone in all cases at 24 hours, persisting for 1 month. The fluorescence patterns produced by excimer laser ablation and mechanical keratectomy were qualitatively identical.

  11. Interactions between self-accelerating beams in photorefractive media.

    Science.gov (United States)

    Zhang, Meizhi; Huo, Guangwen; Zhong, Hua; Hui, Zhanqiang

    2017-09-04

    We investigate interactions between in-phase or out-of-phase Airy beams and nonlinear accelerating beams in photorefractive crystals by means of direct numerical simulations. Since self-accelerating beams possess infinite energy, we evaluated the propagation of two shifted counter beams by truncating the oscillating tails. The numerical results show that the external bias electric field has a profound effect on the propagation dynamics and the solitons shed from the Airy beam. We also found that during interactions between two nonlinear accelerating beams, single solitons, soliton pairs, and bound breathing solitons were produced. When the nonlinear accelerating beam collides with a soliton beam, the main lobe continues accelerating while the soliton intensity fluctuates with the lobes.

  12. Airy beam self-focusing in a photorefractive medium

    Science.gov (United States)

    Wiersma, Noémi; Marsal, Nicolas; Sciamanna, Marc; Wolfersberger, Delphine

    2016-10-01

    The unique bending and shape-preserving properties of optical Airy beams offer a large range of applications in for example beam routing, optical waveguiding, particle manipulation and plasmonics. In these applications and others, the Airy beam may experience nonlinear light-matter interactions which in turn modify the Airy beam properties and propagation. A well-known example is light self-focusing that leads to the formation of spatial soliton. Here, we unveil experimentally the self-focusing properties of a 1D-Airy beam in a photorefractive crystal under focusing conditions. The transient evolution involves both self-bending and acceleration of the initially launched Airy beam due to the onset of an off-shooting soliton and the resulting nonlocal refractive index perturbation. Both the transient and stationary self-focusing properties can be tuned by varying the bias electric field, the injected Airy beam power and the background illumination.

  13. Improving sensitivity of photorefractive polymer composites for holographic display applications

    Science.gov (United States)

    Christenson, Cory W.

    This work presents recent progress in the area of organic photorefractive polymer composites. These materials have been previously shown to be a suitable medium for dynamic holographic displays, with multiple colors and single frame writing times on the order of seconds. However, these materials still require large electric fields and high intensity lasers to function effectively. Recent advancements in improving these areas are discussed, including a review of the history and state-of-the-art in photorefractive polymer composites. The addition of electron traps via low loading of the electron-transporting molecule Alq3 is shown to dramatically improve the diffraction efficiency and reduce the required field. The grating formation also proceeds faster by more than one order of magnitude, leading to an increase in sensitivity by a factor of 3. The dynamics of these materials also show evidence of competing gratings indicative of bipolar charge transport and trapping. The addition of an amorphous polycarbonate (APC) buffer layer is reported to have a similar effect on the steady-state diffraction efficiency, and the further doping with a fullerene derivative (PCBM) allows a 3x increase in the efficiency in the reflection geometry, which is normally poor due to the small grating spacing. These composites reveal the fundamental limits of the reflection geometry, based on the physics of high frequency gratings. A reversal in the direction and increase in the magnitude of the two-beam coupling energy transfer is also observed. The use of interdigitated coplanar electrodes, instead of the standard uniform electrodes in a parallel-plate geometry, is shown to result in large diffraction efficiency with symmetric writing beams due to the increased projection field. The efficiency is similar to that achieved in the standard samples with large slant angles and much better than those geometries typically used in applications, with the benefit that the writing beams do not have

  14. Simultaneous strain and coherent imaging using coupled photorefractive holography and shearography through scattering media.

    Science.gov (United States)

    Rosso, Vanessa; Béland, Rémy; Lecler, Sylvain; Renotte, Yvon; Habraken, Serge; Lion, Yves; Charette, Paul

    2008-01-01

    The direct simultaneous acquisition of coherent imaging and strain information is of particular importance in the biomechanical characterization of biological tissue. This type of simultaneous information acquisition can be accomplished using a coupled photorefractive holography and shearography system for imaging and strain measurements, respectively. Optical scattering in a conventional speckle shearing interferometer rapidly reduces the contrast of the shearing fringes, thereby limiting the use of such interferometers with opaque surfaces. By coupling photorefractive holography with speckle shearing interferometry, properties of the photorefractive effect (spatial high-pass filtering and temporal low-pass filtering) combine to restore the shearing fringe contrast and enable strain imaging in diffusing media. This effect is demonstrated using synthetic scattering phantoms built from suspensions of silica spheres in water.

  15. Orientational photorefractive properties in polymer-dispersed liquid crystals with different polymer matrixes

    Science.gov (United States)

    Ono, Hiroshi; Saito, Isao; Kawatsuki, Nobuhiro

    1998-10-01

    We report orientational photorefractive effects observed in photoconductive liquid crystals (LCs) contained with three kinds of polymer, i.e., poly(methyl methacrylate) (PMMA), poly(vinyl alcohol) (PVA) and a side-chain liquid crystalline polymer (SLCP1). The morphology of the photorefractive composites depended on the kind of polymer strongly. In both PMMA and PVA cases, LC and polymer were phase-separated and the composite showed memory effects. In SLCP1 case, the phase-separation in the composite dose not occur and the high resolution could be achieved. In this case, the photorefractive Bragg gratings were generated and a high two-beam coupling gain coefficient with a low applied field of 4 V/micrometers was observed.

  16. [Keratectomy combined with intrastromal injection of voriconazole in treating fungal keratitis].

    Science.gov (United States)

    Li, S X; Biang, J; Li, X; Zhang, L T; Shi, W Y

    2017-09-11

    Objective: To investigate the treatment effect of keratectomy combined with intrastromal injection of voriconazole on fungal keratitis. Methods: Retrospective study. Ninety-eight fungal keratitis patients (98 eyes) were treated by keratectomy combined with intrastromal injection of voriconazole in Shandong Eye Hospital from January 2013 to May 2015. The corneal ulcers were mostly located in the paracentral or peripheral cornea, which incompletely blocked the pupil area. Slit lamp and anterior segment optical coherence tomography (AS-OCT) were used for lesion detection. The maximum lesion diameter was ≤5 mm, and the maximum depth was not more than half of the full corneal thickness. Because the anti-fungal drug treatment for 3-7 days was not effective, keratectomy was performed with intrastromal injection of voriconazole. The excision extension was 0.5 mm greater than the ulcer diameter, and keratectomy could be repeated until the infiltrative tissues were completely removed. Anti-fungal drug therapy was carried on after surgery. The wound healing and complications were observed. Results: All the subjects were diagnosed as fungal keratitis by corneal scraping and confocal microscopy. With an average lesion diameter of (3.72±1.23) mm, the corneal ulcers were located in the paracentral cornea in 30 patients (30.6%) and in the peripheral cornea in 68 patients (69.4%). The infiltrative depth of 74.5% of the cases detected by AS-OCT were ≤1/2 corneal thickness. The fungal keratitis in 95 cases was cured successfully. Conjunctival flap covering surgery (2 cases) and penetrating keratoplasty (1 case) were performed when the conditions were poorly controlled. Among the 95 cured cases, the ulcer healing time ranged from 3 to 19 days, and ≤7 days in more than half of the cases (48 cases). The average corneal thickness was (433.2±119.3) μm at 3 months, and the corneal endothelial cell density was (2 344.0±404.6) cells/mm(2). The uncorrected visual acuity was improved

  17. Keratoconus and corneal stability after radial keratectomy in the fellow eye: case report

    Directory of Open Access Journals (Sweden)

    Jacqueline Martins Sousa

    2013-06-01

    Full Text Available Keratoconus has usually been described as bilateral but asymmetric disease. Corneal ectasia is one of the long-term complications of modern refractive surgery, especially those submitted to laser in situ keratomileusis (LASIK. We describe a patient with keratoconus in the right eye that was submitted to radial keratectomy (RK in the left eye 19 years ago with no progression of the ectatic cornea and no complications related to the refractive surgery. Because unilateral keratoconus is rare, we believe that RK was performed on an already ectatic cornea (not clinically detected or with fruste keratoconus. However, neither corneal ectasia progressed, nor ectasia was induced by RK in the fellow eye.

  18. Nonuniform dynamic gratings in photorefractive media with nonlocal response

    Science.gov (United States)

    Bugaychuk, S.; Kovács, L.; Mandula, G.; Polgár, K.; Rupp, R. A.

    2003-04-01

    The amplitude of the phase dynamic grating is a nonuniform space distributed in photorefractive crystals with nonlocal response as a result of energy transfer between the interacted waves. The dynamical process of grating formation in the case of transmission two- and four-wave mixing is described by the damped sine-Gordon equation that governs the soliton propagation. A stationary soliton solution for the grating amplitude profile was obtained. Experiments on observation of a nonuniform distribution of the grating amplitude through the crystal volume are presented. It is experimentally shown that the changes of the grating amplitude profile in dependence of input intensity ratio match the solutions of the damped sine-Gordon equation in steady state. The diffraction efficiency of energy transfer is determined by the value of the integral under the grating amplitude profile. The soliton profile is altered with changing input intensity ratio of recorded beams. It provides the effect of diffraction efficiency management by changing the half-width and the position of the soliton. The theory predicts a multisoliton behavior in reversible media with strong amplitifcaiton gain that leads to auto-oscillations of output wave intensities.

  19. Understanding the optical and electrical properties of a new photorefractive potassium niobate crystal

    Energy Technology Data Exchange (ETDEWEB)

    Evans, D.R. [Air Force Research Laboratory, Materials and Manufacturing Directorate Wright-Patterson Air Force Base, OH 45433 (United States)]. E-mail: dean.evans@wpafb.af.mil; Cook, G. [Air Force Research Laboratory, Materials and Manufacturing Directorate Wright-Patterson Air Force Base, OH 45433 (United States); Universal Technology Corporation, 1270 N. Fairfield Road, Dayton, OH 45432 (United States); Carns, J.L. [Air Force Research Laboratory, Materials and Manufacturing Directorate Wright-Patterson Air Force Base, OH 45433 (United States); Anteon Corporation, 5100 Springfield Pike Suite 509, Dayton, OH 45431 (United States); Saleh, M.A. [Air Force Research Laboratory, Materials and Manufacturing Directorate Wright-Patterson Air Force Base, OH 45433 (United States); UES, Inc., 4401 Dayton-Xenia Road, Dayton, OH 45432 (United States); Basun, S.A. [A. F. Ioffe Physico-Technical Institute, Polytechnicheskaya 26, 194021, St. Petersburg (Russian Federation); Seim, J.M. [VLOC, 7826 Photonics Drive, New Port Richey, FL 34655 (United States); Mizell, G.J. [VLOC, 7826 Photonics Drive, New Port Richey, FL 34655 (United States)

    2006-07-15

    Optical and electrical measurements have been made on a new codoped potassium niobate crystal that yields a significant increase in linear absorption, photocurrent, and photorefractive beam coupling efficiency. The Ag impurity enters the K site, changing the local field in the lattice. The Fe in the Nb site, perturbed by the replacement of the next near-neighbor K with Ag, is responsible for the enhanced linear and nonlinear properties. The modified material parameters result in an increase of the photorefractive counter-propagating two-beam coupling efficiency.

  20. Effect of onion extract on corneal haze suppression after air assisted lamellar keratectomy

    Science.gov (United States)

    KIM, Soohyun; PARK, Young Woo; LEE, Euiri; PARK, Sang Wan; PARK, Sungwon; NOH, Hyunwoo; KIM, Jong Whi; SEONG, Je Kyung; SEO, Kangmoon

    2015-01-01

    This study evaluated the effect of onion extract on corneal haze suppression after applying the air assisted lamellar keratectomy. The air assisted lamellar keratectomy was performed on 24 canine eyes. They were treated with an artificial tear (group C), prednisolone acetate (group P), onion extract (group O) and TGF-β1 (group T) three times per day from 7 to 28 days after the surgery. Corneal haze occurred on the all eyes and was observed beginning 7 days after the surgery. The haze was significantly decreased in groups P and O from day 14 compared with the group C using the clinical (group P; P=0.021, group O; P=0.037) and objective evaluation method (group P; P=0.021, group O; P=0.039). In contrast, it was significantly increased in group T from day 14 compared with group C based on the clinical (P=0.002) and objective evaluation method (P<0.001). Subsequently, these eyes were enucleated after euthanasia, and immunohistochemistry with α-SMA antibodies was done. The total green intensity for α-SMA was significantly more expressed in group T and significantly less expressed in groups P and O than in group C. Onion extract could have potential as a therapeutic in preventing corneal haze development by suppressing the differentiation of fibroblasts into myofibroblasts. PMID:26607134

  1. Is Noncycloplegic Photorefraction Applicable for Screening Refractive Amblyopia Risk Factors?

    Directory of Open Access Journals (Sweden)

    Zhale Rajavi

    2012-01-01

    Full Text Available Purpose: To compare the accuracy of noncycloplegic photorefraction (NCP with that of cycloplegic refraction (CR for detecting refractive amblyopia risk factors (RARFs and to determine cutoff points. Methods: In this diagnostic test study, right eyes of 185 children (aged 1 to 14 years first underwent NCP using the PlusoptiX SO4 photoscreener followed by CR. Based on CR results, hyperopia (≥ +3.5 D, myopia (≥ -3 D, astigmatism (≥ 1.5 D, and anisometropia (≥ 1.5 D were set as diagnostic criteria based on AAPOS guidelines. The difference in the detection of RARFs by the two methods was the main outcome measure. Results: RARFs were present in 57 (30.8% and 52 (28.1% of cases by CR and NCP, respectively, with an 89.7% agreement. In contrast to myopia and astigmatism, mean spherical power in hyperopic eyes was significantly different based on the two methods (P < 0.001, being higher with CR (+5.96 ± 2.13 D as compared to NCP (+2.37 ± 1.36 D. Considering CR as the gold standard, specificities for NCP exceeded 93% and sensitivities were also acceptable (≥ 83% for myopia and astigmatism. Nevertheless, sensitivity of NCP for detecting hyperopia was only 45.4%. Using a cutoff point of +1.87 D, instead of +3.5 D, for hyperopia, sensitivity of NCP was increased to 81.8% with specificity of 84%. Conclusion: NCP is a relatively accurate method for detecting RARFs in myopia and astigmatism. Using an alternative cutoff point in this study, NCP may be considered an acceptable device for detecting hyperopia as well.

  2. Dynamic spatial structure of spontaneous beams in photorefractive bismuth sillicon oxide

    DEFF Research Database (Denmark)

    Buchhave, Preben; Lyuksyutov, S.; Vasnetsov, M.

    1996-01-01

    We report the domain structure of spontaneously occurring beams (subharmonics) in photorefractive bismuth silicon oxide with an applied electric field from 1 to 6 kV/cm and a running grating. The subharmonic beams are generated in a pattern of domains that evolve dynamically as they move through...

  3. Implementation of a photorefractive correlator based on a fake zoom lens

    Science.gov (United States)

    Rueda, Jorge Enrique; Tebaldi, Myrian; Granieri, Sergio; Bolognini, Nestor

    A space-variant optical correlator is experimentally implemented based on the fractional Fourier transform. The proposed arrangement employs a fake zoom lens that enables to vary the degree of the fractional Fourier transform continuously between -1 to +1. The optical device uses as a recording medium for the holographic filter a photorefractive BTO crystal. The experimental results confirm the shift-variance properties.

  4. Longitudinal parametric oscillation in photorefractive sillenites: Comparison between theory and experiment

    DEFF Research Database (Denmark)

    Pedersen, H.C.; Johansen, P.M.; Webb, D.J.

    1999-01-01

    By using an alternative setup for photorefractive parametric oscillation in which wave mixing between the recording beams is avoided it has become possible to make more detailed comparisons with the space-charge wave theory. In the present paper we compare the experimental features of longitudinal...

  5. Photorefractive solitons and light-induced resonance control in semiconductor CdZnTe.

    Science.gov (United States)

    Schwartz, Tal; Ganor, Yaniv; Carmon, Tal; Uzdin, Raam; Shwartz, Sharon; Segev, Mordechai; El-Hanany, Uri

    2002-07-15

    We demonstrate the formation of (1+1) - and (2+1) -dimensional solitons in photorefractive CdZnTe:V, exploiting the intensity-resonant behavior of the space-charge field. We control the resonance optically, facilitating a 10-mus soliton formation times with very low optical power.

  6. Image processing by four-wave mixing in photorefractive GaAs

    Science.gov (United States)

    Gheen, Gregory; Cheng, Li-Jen

    1987-01-01

    Three image processing experiments were performed by degenerate four-wave mixing in photorefractive GaAs. The experiments were imaging by phase conjugation, edge enhancement, and autocorrelation. The results show that undoped, semiinsulating, liquid-encapsulated Czochralski-grown GaAs crystals can be used as effective optical processing media despite their small electrooptic coefficient.

  7. Rotational diffusion model of orientational enhancement in AC field biased photorefractive polymers

    DEFF Research Database (Denmark)

    Pedersen, T.G.; Jespersen, K.G.; Johansen, P.M.

    2001-01-01

    The response of photorefractive (PR) polymers subject to AC field biasing is analyzed within the space-charge field formalism. The frequency dependence of orientational enhancement is taken into account using a rotational diffusion model for the angular distribution of chromophores. The possibili...... for simultaneous utilization of AC and orientational enhancement techniques in polymers is discussed for different values of the rotational diffusion time....

  8. Optical homogeneity, defects, and photorefractive properties of stoichiometric, congruent, and zinc-doped lithium niobate crystals

    Science.gov (United States)

    Sidorov, N. V.; Yanichev, A. A.; Palatnikov, M. N.; Gabain, A. A.; Pikoul, O. Yu.

    2014-07-01

    Using the laser-conoscopy method, the photorefractive light-scattering method, and the Raman light-scattering method, we have studied the structural and optical homogeneities and photorefractive properties of (i) stoichiometric lithium niobate crystals (LiNbO3(stoich)), which were grown from a melt with 58.6 mol % of Li2O; (ii) congruent crystals (LiNbO3(congr)); and (iii) congruent crystals that were doped with Zn2+ cations (LiNbO3:Zn; [Zn] = 0.03-1.59 mol %). We have shown that the speckle-structure of the photorefractive light scattering in all the crystals is three-layer. The shapes of the second and third layers repeat in general the shape of the first layer. We have shown that the differences that are observed between the Raman spectra, the photorefractive light scattering, and the conoscopic patterns of the examined crystals are caused by the fact that defects are distributed inhomogeneously over the volume of these crystals and that Zn2+ cations are incorporated inhomogeneously into the lattice. This leads to the appearance of local changes in the elastic characteristics of the crystal and to the appearance of mechanical stresses, which locally change the optical indicatrix and, correspondingly, the conoscopic pattern and the Raman spectrum.

  9. Recurrence rate and subjective symptoms after standardized (Hamburg protocol) phototherapeutic keratectomy on recurrent corneal erosions.

    Science.gov (United States)

    Mehlan, J; Steinberg, J; Traber, L; Katz, T; Linke, S J

    2016-10-01

    To evaluate the objective and subjective outcome after phototherapeutic keratectomy (PTK) on recurrent corneal erosions (Hamburg protocol). For the standardized PTK according to Hamburg protocol a manual abrasio corneae performed with 20 % alcohol is followed by an excimer ablation depth of ≥15 μm (group1 15 μm; group 2 > 15 μm ablation depth) and 7 mm optical zone. All patients (N = 48) were invited for follow-up examinations and the evaluation of changes concerning subjective symptoms. A significantly reduced subjective impairment of night vision, significantly less pain and less foreign body sensations (for all p Hamburg Schema) is a safe and effective procedure to reduce subjective symptoms and improve discomfort in recurrent corneal erosion.

  10. Visual and subjective outcomes of phototherapeutic keratectomy after Descemet’s stripping endothelial keratoplasty

    Directory of Open Access Journals (Sweden)

    Lee BS

    2014-05-01

    Full Text Available Bryan S Lee,1,2 David R Hardten21Department of Ophthalmology, University of Washington, Seattle, WA, 2Minnesota Eye Consultants, Minneapolis, MN, USABackground: Patients with endothelial disease also often have scarring or surface corneal disease. This study examined the outcomes of phototherapeutic keratectomy (PTK performed in patients with prior Descemet’s stripping endothelial keratoplasty (DSEK.Methods: This retrospective case series examined all patients undergoing PTK after DSEK in a single private practice. The primary outcome was best-corrected visual acuity, with secondary outcomes of change in spherical equivalent versus targeted change, change in endothelial cell count, improvement in corneal topography, and subjective satisfaction with vision.Results: For the ten patients who met the inclusion criteria, mean best-corrected visual acuity improved from logarithm of the minimum angle of resolution (logMAR 0.43 to 0.36 (P=0.24 at the most recent postoperative visit. PTK treatments that included a refractive component showed good predictability of 1.13 diopters spherical equivalent/diopter attempted. There was no evidence of a decrease in endothelial cell count from PTK, even with the use of mitomycin C (P=0.95. Subjectively, 80% of patients noted improvement in their vision. Conclusion: PTK after DSEK has the potential to improve patients’ vision with high levels of patient satisfaction, even though many patients had significant ocular comorbidities. Surgeons should consider using PTK to treat anterior corneal pathology following DSEK.Keywords: phototherapeutic keratectomy, Descemet’s stripping endothelial keratoplasty, anterior basement membrane dystrophy, irregular astigmatism

  11. Estudo comparativo entre duas plataformas para realização de Lasik personalizado para correção de miopia e astigmatismo: Alcon CustomCornea® versus Bausch & Lomb Zyoptix® Wavefront-Guided Lasik for low to moderate myopia: CustomCornea® versus Zyoptix®

    Directory of Open Access Journals (Sweden)

    Telma Pereira Barreiro

    2009-08-01

    Full Text Available OBJETIVO: Comparar os resultados obtidos após o Lasik personalizado utilizando duas plataformas diferentes. MÉTODOS: Estudo prospectivo, randomizado com 50 pacientes míopes submetidos a cirurgia refrativa em ambos os olhos. Foram selecionados para o estudo, pacientes com equivalente esférico semelhante entre os olhos. Todos foram submetidos a Lasik bilateral e simultâneo, sendo que um olho foi operado pela plataforma CustomCornea® e o outro pela Zyoptix®. Acuidade visual sem e com correção, refração dinâmica e estática, medida das aberrações oculares, teste de sensibilidade ao contraste foram realizados no período pré-operatório e pós-operatório de 1, 3 e 6 meses. RESULTADOS: No período pré-operatório a média do equivalente esférico era de -3,29 ± 1,56 D no grupo CustomCornea® e de -3,22 ± 1,50 D no Zyoptix® (p=0,267. No sexto mês de pós-operatório, a média do equivalente esférico no grupo CustomCornea® era de -0,077 ± 0,23 D e -0,282 ± 0,30 D no Zyoptix® (p 20/20 foi alcançada em 86% dos olhos no grupo CustomCornea® e 70% no grupo Zyoptix® (p=0,094. Nenhum paciente perdeu duas ou mais linhas da melhor acuidade visual corrigida. Cem por cento dos olhos CustomCornea® e 88% dos Zyoptix® ficaram entre ± 0,50 D da emetropia (p=0,014*. Melhora da sensibilidade ao contraste em todas as frequências espaciais testadas foi observada em ambos os grupos. A aberração esférica apresentou aumento em ambos os grupos, porém este foi estatisticamente maior na plataforma Zyoptix® (pPURPOSE: To compare the visual and clinical outcomes of Wavefront-guided laser in situ keratomileusis (Lasik with Alcon CustomCornea® and Zyoptix® systems. METHODS: A prospective, randomized, masked and bilateral study was conducted. Fifty patients with preoperative spherical equivalent ranging from -1.00 to -6.50 D were enrolled for customized ablation in both eyes. All of them were submitted to Lasik CustomCornea® treatment in one

  12. Photorefractive damage resistance in Ti:PPLN waveguides with ridge geometry

    Science.gov (United States)

    Pal, Shantanu; Das, Bijoy Krishna; Sohler, Wolfgang

    2015-09-01

    A theoretical analysis of the photorefractive sensitivity of Ti:PPLN ridge waveguides in comparison with conventional Ti:PPLN channel waveguides is presented. In particular, intensity-dependent photorefraction, effective indices, waveguide modes and power-dependent SHG in Ti:PPLN ridge and channel waveguides are modeled for a wide range of parameters. Results predict a much better damage resistance of Ti:PPLN waveguides with ridge geometry in comparison with conventional indiffused channels. This superiority of ridge waveguides is attributed to their higher effective refractive index contrast and more tightly confined guided modes. The theoretical predictions are supported by experimental results for second harmonic generation (SHG) at room temperature and for light-induced detuning characteristics of the phase-matching wavelength.

  13. Major improvements of the photorefractive and photovoltaic properties in potassium niobate

    Science.gov (United States)

    Evans, D. R.; Cook, G.; Carns, J. L.; Saleh, M. A.; Basun, S. A.; Seim, J. M.; Mizell, G. J.

    2006-01-01

    Optical and electrical measurements have been made on a new codoped potassium niobate crystal (KNbO3:Fe,Ag) that yields a significant enhancement of the photorefractive and photovoltaic effects when compared with the published results for singly doped potassium niobate crystals. The codoped Ag impurity enters the K site, rather than the typical Nb site, thus changing the local field in the lattice. It is believed that Fe perturbed by the Ag in the K site is responsible for an enhancement of the linear absorption and photocurrent, as well as a probable increase in the effective trap density. An enhanced trap density is likely the cause of the increased photorefractive counterpropagating two-beam coupling efficiency.

  14. Two Beam Energy Exchange in Hybrid Liquid Crystal Cells with Photorefractive Field Controlled Boundary Conditions (Postprint)

    Science.gov (United States)

    2016-09-12

    photorefractive layers. The cell is illuminated by two intersecting coherent light beams E1 =A1 (z) e1 exp (ik1r − iω t) and E2 = A2 (z) e2 exp (ik2r − iω t). The...photorefractive substrates and LC possess non-linear properties that require A1(z), A2 (z) to change as a function of position. The bisector of the...anchoring energy w: w =1 - dotted , 10 - dashed, 102 - solid. The modulation parameters m(−L/2)=m(L/2)= 0.1, parameters α1 = 0.02, α2 =−0.02, cell

  15. Photo-electromotive-force from vibrating speckled pattern of light on photorefractive CdTe:V

    Science.gov (United States)

    Santos, T. O.; Launay, J. C.; Frejlich, J.

    2008-04-01

    We report the use of the photo-electromotive force (photo-emf) effect produced by a vibrating speckle pattern of light, generated by laser radiation at 1064nm, in the volume of a photorefractive vanadium doped CdTe crystal. This effect is used to measure the sample's photocondutivity and the vibration amplitude of the pattern of light. When the vibrations are much faster than the photorefractive material reponse time the photocurrent is independent of the response time. The theoretical model predicts a maximum value for the first temporal harmonic term of the photocurrent at a fixed value for the vibration amplitude-to-speckle size ratio. This prediction was experimentally confirmed and this maximum can be used to calibrate the setup in order to facilitate practical applications.

  16. Photorefractive writing and probing of anisotropic linear and non-linear lattices

    CERN Document Server

    Allio, Raphaël; Cantillano, Camilo; Morales-Inostroza, Luis; Lopez-Gonzalez, Dany; Etcheverry, Sebastián; Vicencio, Rodrigo A; Armijo, Julien

    2014-01-01

    We experimentally study the writing of one- and two-dimensional photorefractive lattices and the propagation of linear and nonlinear waves inside them. Using plane waves, we perform a time-resolved study of lattice writing and find good agreement with transient and steady-state photorefractive theory. In particular, the ratio of the drift to diffusion terms is proportional to the lattice period. We then analyze various wave propagation schemes. For focussed linear waves with broad transverse spectrum, we note that both the intensity distributions in real space ("discrete diffraction") and Fourier space ("Brillouin zone spectroscopy") reflect the Bragg planes and band structure. For non-linear waves, we observe modulational instability and time-domain discrete solitons formation. We discuss also the non-ideal effects inherent to the photo-induction technique : anisotropy, parasitic nonlinearity, diffusive term, and non-stationarity.

  17. Laser-induced corneal cross-linking upon photorefractive ablation with riboflavin

    OpenAIRE

    Kornilovskiy IM; Kasimov EM; Sultanova AI; Burtsev AA

    2016-01-01

    Igor M Kornilovskiy,1 Elmar M Kasimov,2 Ayten I Sultanova,2 Alexander A Burtsev1 1Department of Eye Diseases, Federal State Budgetary Institution “National Pirogov Medical Surgical Centre”, Ministry of Health, Moscow, Russia; 2Department of Eye Diseases, Zarifa Aliyeva National Ophthalmology Center, Ministry of Health, Baku, Azerbaijan Aim: To estimate the biomechanical effect of the laser-induced cross-linking resulting from photorefractive ablation of the cornea with r...

  18. Direct microscopic observation of hologram build-up in photorefractive crystals

    Science.gov (United States)

    Bányász, István; Mandula, Gábor

    2006-05-01

    A method, based on phase-contrast and interference microscopy, was developed for direct microscopic observation of temporal evolution of phase holograms in photorefractive crystals. Interference microscopy was adapted to the study of photorefractive holograms. First a hologram was recorded in the sample, and diffraction efficiency was monitored during hologram build-up using inactinic laser light. Thus kinetics of hologram build-up could be determined. The initial hologram was erased using white light. Then a series of write-erase cycles were performed with increasing exposure times up to an exposure corresponding to saturation of the grating. Holograms were observed by interference microscope after each exposure. The time elapsed between the exposure and the microscopic observation was negligible compared to the relaxation time of the hologram. The obtained temporal evolution of grating profile gives a deeper insight into the physical mechanism of hologram formation in photorefractive materials than diffraction efficiency measurements. Congruently grown samples of LiNbO 3: Fe, with Fe concentrations in melting of 10 -3 were studied by the above method. Sample thickness was set to 300 μm to allow correct microscopic observation. Plane-wave holograms were recorded in the samples using an Ar-ion laser at λ=514 nm of grating constants of 3.3 and 7.0 μm.

  19. Phase-shifting holography using Bragg and non-Bragg orders in photorefractive lithium niobate

    Science.gov (United States)

    Abeywickrema, Ujitha; Banerjee, Partha

    2014-09-01

    Holographic interferometry is an effective and rich method for measuring very small (order of a wavelength) deformations of an object and is widely used for non-destructive testing. In this work, the use of photorefractive materials for implementing real time phase shifting holographic interferometry is examined in detail. Bragg and non-Bragg orders generated during two- and multi-beam coupling in a photorefractive material can be used to retrieve the deformation of the object, or the phase information of the object. In previous work, it has been shown that object deformation can be determined from monitoring Bragg and non-Bragg orders. Preliminary experiments for determining the depth profile of an object have been reported, along with approximate analytic solutions for the Bragg and non-Bragg orders for the case of interacting plane waves. In this work, the exact solutions of Bragg and non-Bragg orders are found from numerically solving the interaction equations in a photorefractive material. It is shown that if the grating written in the material using two waves is read out by a reference and the object, the resulting Bragg and non-Bragg orders contain the information of the object phase, and is dependent on material parameters and the writing and reading beam intensities. Similarities and differences between this dynamic holographic technique and the traditional phase shifting digital holography are extensively discussed.

  20. Two-Photon Optical Storage in Photorefractive Polymers in the Near-Infrared Spectral Range

    Science.gov (United States)

    Day, Daniel; Gu, Min; Smallridge, Andrew

    We report the use of a polymer-based photorefractive material for three-dimensional bit optical data storage using near-infrared illumination. The research was conducted using photorefractive materials that were fabricated in two polymer matrices: poly(N-vinylcarbazole) (PVK) and poly(Methyl Methacrylate) (PMMA). The recording samples also consisted of the following compounds in various proportions: 2,5-dimethyl-4-(p-nitrophenylazo)anisole (DMNPAA), 2,4,7-trinitro-9-fluorenone (TNF) and N-ethylcarbazole (ECZ). Two-photon excitation was used as the recording mechanism to achieve rewritable bit data storage in a photorefractive polymer. As a result of two-photon excitation, the quadratic dependence of the excitation on the incident intensity produces an excitation volume that is confined to the focal region in both the transverse and axial directions. The use of ultrashort pulsed lasers, while effective, is not a practical solution for an optical data storage system. This research demonstrates the ability to produce three-dimensional rewritable bit data storage using continuous-wave illumination. Using this technology it has been possible to achieve a density of 88 Gbits/cm3, which in the future could be increased to 3.5 Tbits/cm3.

  1. Emerging trends for procedure selection in contemporary refractive surgery: consecutive review of 200 cases from a single center.

    Science.gov (United States)

    Waring, George O; Durrie, Daniel S

    2008-04-01

    To quantify emerging refractive surgery trends in a single refractive surgery practice. A retrospective chart review was performed of 200 consecutive candidates (377 eyes) for refractive surgery from July 20, 2007 to October 31, 2007. Patient age, manifest refraction spherical equivalent, pachymetry at the thinnest location (CCT), topographic symmetry patterns, and comeal apex location were analyzed. Patients were recommended sub-Bowman's keratomileusis (SBK), photorefractive keratectomy (PRK), conductive keratoplasty (CK), phakic intraocular lens implants (PIOL) or refractive lens exchange (RLE). Corneal excimer procedures were either wavefront-optimized or wavefront-guided ablations. Mean patient age for refractive surgery was 44+/-12 years (range: 18 to 68 years). The mean MRSE was -2.78+/-3.37 diopters (D) (range: -12.75 to +6.25 D). Of the 200 patients, 75% (n=151, 288 eyes) were recommended corneal excimer procedures. Of these, the mean CCT was 548+/-36 microm (range: 466 to 628 microm). Symmetric topographic patterns were observed in 54% (n=155) of eyes, whereas 32% (n=92) were borderline and 14% (n=41) were asymmetric. The corneal apex was centered in 79% (n=226) of eyes, whereas 18% (n=51) were borderline and 3% (n=10) were decentered (>2.5 mm from the center). Overall, 69% (n=139) of patients were recommended SBK, 16% (n=32) RLE, 6% (n=12) PRK, 5% (n=9) CK, and 4% (n=8) PIOL. Of the corneal excimer group, 88% (n=132) were scheduled for wavefront-optimized ablations and 12% (n=18) for wavefront-guided ablations. Sub-Bowman's keratomileusis was the predominant refractive surgical procedure offered in this practice, followed by RLE, PRK, CK, and finally PIOL. Of the corneal excimer procedures recommended, the majority of patients were scheduled for a wavefront-optimized ablation.

  2. Microbiologic study of soft contact lenses after laser subepithelial keratectomy for myopia.

    Science.gov (United States)

    Hondur, Ahmet; Bilgihan, Kamil; Cirak, Meltem Yalinay; Dogan, Ozgur; Erdinc, Alper; Hasanreisoglu, Berati

    2008-01-01

    To evaluate the extent and agents of bacterial contamination of bandage disposable soft contact lenses after laser subepithelial keratectomy (LASEK) and to correlate the findings with clinical data. Disposable soft contact lenses were collected from 52 eyes of 26 consecutive patients treated with LASEK for myopia. The patients were treated with a fixed combination of tobramycin and diclofenac until epithelial closure. The lenses were removed on the fourth or fifth postoperative day with sterile forceps and immediately placed in sterile tubes containing culture media brain-heart infusion broth. The lenses were evaluated for microbial colonization. Of the 52 contact lenses analyzed, six (11.5%) had positive cultures. However, no clinical finding of infection was noted. Isolated microorganisms were coagulase-negative staphylococci (two lenses), Stenotrophomonas maltophilia (two lenses), Acinetobacter species (one lens), and Aeromonas hydrophila (one lens). Except for one case, the microorganisms were sensitive to the administered antibiotic. The risk of infectious keratitis after LASEK seems to be low. Except for staphylococci, the isolated microorganisms have not been previously reported to colonize the ocular surface or cause keratitis after refractive surgery. These findings may suggest a changing trend of potentially infectious agents after surface ablation.

  3. Excimer laser phototherapeutic keratectomy for the treatment of clinically presumed fungal keratitis.

    Science.gov (United States)

    Li, Liang-Mao; Zhao, Li-Quan; Qu, Ling-Hui; Li, Peng

    2014-01-01

    This retrospective study was to evaluate treatment outcomes of excimer laser phototherapeutic keratectomy (PTK) for clinically presumed fungal keratitis. Forty-seven eyes of 47 consecutive patients underwent manual superficial debridement and PTK. All corneal lesions were located in the anterior stroma and were resistant to medication therapy for at least one week. Data were collected by a retrospective chart review with at least six months of follow-up data available. After PTK, infected corneal lesions were completely removed and the clinical symptoms resolved in 41 cases (87.2%). The mean ablation depth was 114.39 ± 45.51  μ m and diameter of ablation was 4.06 ± 1.07 mm. The mean time for healing of the epithelial defect was 8.8 ± 5.6 days. Thirty-four eyes (82.9%) showed an improvement in best spectacle-corrected visual acuity of two or more lines. PTK complications included mild to moderate corneal haze, hyperopic shift, irregular astigmatism, and thinning cornea. Six eyes (12.8%) still showed progressed infection, and conjunctival flap covering, amniotic membrane transplantation, or penetrating keratoplasty were given. PTK is a valuable therapeutic alternative for superficial infectious keratitis. It can effectively eradicate lesions, hasten reepithelialization, and restore and preserve useful visual function. However, the selection of surgery candidates should be conducted carefully.

  4. Excimer laser phototherapeutic keratectomy : Indications, results and its role in the Indian scenario

    Directory of Open Access Journals (Sweden)

    Rao Srinivas

    1999-01-01

    Full Text Available PURPOSE: To report indications, technique, and results of excimer phototherapeutic keratectomy (PTK, and describe possible reasons for the small numbers of such procedures performed in a referral institute in India. METHODS: Retrospective review of case records of 10 patients (11 eyes who underwent excimer PTK at our institute between February 1994 and September 1997. RESULTS: Corneal scars were the most common indication for treatment. Best-corrected visual acuity (BCVA improved in 6 eyes (mean: 2 lines of Snellen acuity. All eyes had BCVA > or = 6/12 after treatment. None of the patients experienced loss of BCVA after treatment. Unaided visual acuity improved in 3 eyes and decreased in 2 eyes. Change in spherical equivalent refraction > or = 1 diopter occurred in 77.8% of eyes after treatment. Treating central corneal scars resulted in a significant hyperopic shift in refraction. CONCLUSIONS: Excimer PTK is a safe and effective procedure for the treatment of superficial corneal opacities. Post-treatment ametropia may require further correction with optical aids. Inappropriate referrals, deep corneal scars, and cost of the procedure could have contributed to the small numbers of PTK performed at our institute. Improved understanding of procedural strengths and limitations could lead to increased use of this procedure, with satisfying results in selected patients.

  5. Excimer Laser Phototherapeutic Keratectomy for the Treatment of Clinically Presumed Fungal Keratitis

    Directory of Open Access Journals (Sweden)

    Liang-Mao Li

    2014-01-01

    Full Text Available This retrospective study was to evaluate treatment outcomes of excimer laser phototherapeutic keratectomy (PTK for clinically presumed fungal keratitis. Forty-seven eyes of 47 consecutive patients underwent manual superficial debridement and PTK. All corneal lesions were located in the anterior stroma and were resistant to medication therapy for at least one week. Data were collected by a retrospective chart review with at least six months of follow-up data available. After PTK, infected corneal lesions were completely removed and the clinical symptoms resolved in 41 cases (87.2%. The mean ablation depth was 114.39±45.51 μm and diameter of ablation was 4.06±1.07 mm. The mean time for healing of the epithelial defect was 8.8±5.6 days. Thirty-four eyes (82.9% showed an improvement in best spectacle-corrected visual acuity of two or more lines. PTK complications included mild to moderate corneal haze, hyperopic shift, irregular astigmatism, and thinning cornea. Six eyes (12.8% still showed progressed infection, and conjunctival flap covering, amniotic membrane transplantation, or penetrating keratoplasty were given. PTK is a valuable therapeutic alternative for superficial infectious keratitis. It can effectively eradicate lesions, hasten reepithelialization, and restore and preserve useful visual function. However, the selection of surgery candidates should be conducted carefully.

  6. The simultaneous enhancement of photorefraction and optical damage resistance in MgO and Bi2O3 co-doped LiNbO3 crystals

    Science.gov (United States)

    Zheng, Dahuai; Kong, Yongfa; Liu, Shiguo; Chen, Muling; Chen, Shaolin; Zhang, Ling; Rupp, Romano; Xu, Jingjun

    2016-02-01

    For a long time that optical damage was renamed as photorefraction, here we find that the optical damage resistance and photorefraction can be simultaneously enhanced in MgO and Bi2O3 co-doped LiNbO3 (LN:Bi,Mg). The photorefractive response time of LN:Bi,Mg was shortened to 170 ms while the photorefractive sensitivity reached up to 21 cm2/J. Meanwhile, LN:Bi,Mg crystals could withstand a light intensity higher than 106  W/cm2 without apparent optical damage. Our experimental results indicate that photorefraction doesn’t equal to optical damage. The underground mechanism was analyzed and attributed to that diffusion dominates the transport process of charge carriers, that is to say photorefraction causes only slight optical damage under diffusion mechanism, which is very important for the practical applications of photorefractive crystals, such as in holographic storage, integrated optics and 3D display.

  7. M input radix p optical logic operations in a photorefractive BaTiO(3) crystal.

    Science.gov (United States)

    Park, H K; Kwon, W H; Lee, K Y; Eom, S Y

    1990-09-10

    A generalized coding algorithm for multiple inputs multiple-valued logic operations is proposed. This algorithm can reduce the unused pixels generated in the encoding process of the odd number of inputs. Using circle-type coded patterns and the correlation property in a photorefractive BaTiO(3) crystal, m input radix p logic operations are made possible. Detailed descriptions and advantages of the proposed method are presented and its effectiveness is demonstrated in the case of a three-input binary system. Uses for the proposed method, including binary half-adder/subtractor and binary multiplier, are given.

  8. Photorefractive damage resistance threshold in stoichiometric LiNbO₃:Zr crystals.

    Science.gov (United States)

    Kovács, László; Szaller, Zsuzsanna; Lengyel, Krisztián; Péter, Ágnes; Hajdara, Ivett; Mandula, Gábor; Pálfalvi, László; Hebling, János

    2013-08-01

    Several optical methods including ultraviolet absorption, infrared absorption of the hydroxyl ions, Raman spectroscopy, and the Z-scan method have been used to determine the damage resistance threshold in 0-0.72 mol. % Zr-containing, flux-grown, nearly stoichiometric LiNbO₃ single crystals. All spectroscopical methods used indicate that samples containing at least ≈0.085 mol. % Zr in the crystal are above the threshold while Z-scan data locate the photorefractive damage threshold between 0.085 and 0.314 mol. % Zr.

  9. Holographic scattering as a technique to determine the activation energy for thermal fixing in photorefractive materials

    Science.gov (United States)

    Ellabban, M. A.; Mandula, G.; Fally, M.; Rupp, R. A.; Kovács, L.

    2001-02-01

    We introduce holographic scattering as a technique to determine the activation energy for thermal fixing of refractive index patterns in photorefractive crystals. After recording a parasitic hologram at ambient temperature, we measured the time dependence of the transmitted intensity at the fixing temperature, to determine the time constant. The temperature dependence of the latter allowed us to evaluate the thermal activation energy. For comparison, we performed an equivalent experiment employing the standard two-wave mixing method. The values obtained using the two techniques agree very well.

  10. Optical Formation of Waveguide Elements in Photorefractive Surface Layer of a Lithium Niobate Sample

    Science.gov (United States)

    Bezpaly, A. D.; Shandarov, V. M.

    Formation of channel optical waveguides due to the sequential point-to-point exposure of local stripe-like regions of Y-cut lithium niobate sample surface is experimentally investigated. The surface layer of the sample is thermally doped with Cu ions to increase its photorefractive sensitivity. The laser radiation with wavelength of 532 nm and optical power of 10 mW is used for the crystal exposure in experiments. The optical inhomogeneities formed during the sample exposure are studied with their probing by laser beams with wavelength of 633 nm.

  11. Topography-guided customized laser-assisted subepithelial keratectomy for the treatment of postkeratoplasty astigmatism.

    Science.gov (United States)

    Rajan, Madhavan S; O'Brart, David P S; Patel, Parul; Falcon, Mike G; Marshall, John

    2006-06-01

    To assess topography-assisted corneal wavefront excimer laser surface ablation for the correction of ametropia and irregular astigmatism after keratoplasty. Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom. In this pilot study, 15 patients (16 eyes) who were intolerant of spectacle and contact lens correction due to astigmatic anisometropia after keratoplasty (15 penetrating and 1 lamellar) had topography-assisted customized excimer laser treatments. Corneal topographic data using a Keratron Scout, Placido disk system allowed for preoperative analysis of wavefront anomalies of the anterior corneal surface from which a customized excimer laser correction of both lower-order aberrations (LOAs) and higher-order aberrations (HOAs) was prepared (ORK software) for treatment with a Schwind Esiris flying-spot laser. All eyes had laser-assisted subepithelial keratectomy (LASEK) using 15% alcohol with a 20-second to 30-second application. Four eyes received an application of mitomycin-C (MMC) 0.2 mg/mL for 1 minute after stromal ablation. The mean preoperative spherical equivalent (SE) was -3.50 diopters (D) +/- 3.97 (SD) (range +1.625 to -9.25 D). The preoperative cylindrical error was -7.2 D (range -2.75 to -13.5 D). The programmed laser correction was -3.14 D (range +1.62 to -9 D) with a maximum attempted cylindrical correction of -7 D. Adherent LASEK epithelial flaps along suture lines and the graft-host junction were noted in 9 eyes (56%), although it was possible to obtain and replace a partial flap. A follow-up of 18 months was achieved in all eyes. At the final follow-up visit, the mean postoperative SE was -1.08 +/- 1.85 D (range +3 to -4.78 D) (P<.01, F<.01). Ten eyes (62.5%) were within +/-1 D of the intended correction. The mean postoperative cylindrical error was -2.72 D (range -0.5 to -6.5 D) (P<.001), with vector analysis demonstrating a mean 6.23 D correction. Analysis of HOAs using a 6.0 mm pupil size demonstrated a significant

  12. Intraocular lens power calculations for cataract surgery after phototherapeutic keratectomy in granular corneal dystrophy type 2.

    Science.gov (United States)

    Jung, Se Hwan; Han, Kyung Eun; Sgrignoli, Bradford; Kim, Tae-Im; Lee, Hyung Keun; Kim, Eung Kweon

    2012-10-01

    To investigate the predictability of various intraocular lens (IOL) power calculation methods in granular corneal dystrophy type 2 (GCD2) with prior phototherapeutic keratectomy (PTK) and to suggest the more predictable IOL power calculation method. Medical records of 20 eyes from 16 patients with GCD2, all having undergone cataract surgery after PTK, were retrospectively evaluated. Postoperative cataract refractive errors were compared with target diopters (D) using IOL power calculation methods as follows: 1) myopic and 2) hyperopic Haigis-L formula in IOLMaster (Carl Zeiss Meditec); 3) SRK/T formula using 4.5-mm zone Holladay equivalent keratometry readings (EKRs) (single-K Holladay EKRs method); 4) central keratometry power of true net power map in the Pentacam system (Oculus Optikgeräte GmbH); and 5) clinical history, Aramberri double-K, and double-K Holladay EKRs methods. Topographic status of corneal curvature after PTK was evaluated. Fourteen (70%) of 20 eyes showed central island formation after PTK. When central island was present, the mean absolute error (MAE) using the hyperopic Haigis-L formula was 0.25±0.15 D. When central island was not present, the myopic Haigis-L formula showed MAE of 0.33±0.16 D. When central island formation and IOLMaster keratometry underestimation were present, the hyperopic Haigis-L formula showed the least MAE of 0.26±0.08 D when switching the IOL-Master keratometry values equal to 4.5-mm zone Holladay EKRs. In planning for cataract surgery after PTK in GCD2, topographic analysis for central island formation is necessary. With or without central island formation, the hyperopic or myopic Haigis-L formula can be applied. When IOLMaster keratometry shows underestimation, the Haigis-L formula using 4.5-mm zone Holladay EKRs can be considered. Copyright 2012, SLACK Incorporated.

  13. Ten-year results of phototherapeutic keratectomy on recurrent corneal erosions

    Directory of Open Access Journals (Sweden)

    Belquiz Rodrigues do Amaral Nassaralla

    2012-02-01

    Full Text Available PURPOSE: To determine the ten-year visual results and outcomes of excimer laser phototherapeutic keratectomy (PTK for recurrent corneal erosions. METHODS: Twenty-six eyes of 23 patients with recurrent corneal erosions were treated by PTK from 1996 to 2000 at the Goiania Eye Institute, Brazil. All eyes had failed to respond to conventional therapy. Data regarding preoperative and postoperative best-spectacle-corrected visual acuity (BSCVA, spherical equivalent (SE, symptomatic relief, incidence of recurrence, and complications arising from the laser treatment were analyzed. The mean duration of symptoms prior to PTK was 18 months (range, 8 to 36 months. The corneal epithelium was debrided, and laser ablation was performed to a depth of 5 micron with an ablation zone of 7 to 9 mm, using the Technolas 217C Plano Scan excimer laser. Mean postoperative follow-up was 12 years (range, 10 to 14 years. RESULTS: At the last follow-up visit, 15 eyes (57.69% were symptomsfree. Five eyes (19.2% had occasional mild symptoms of irritation and photophobia upon awakening. Recurrence of painful corneal erosions occurred in six eyes (23.07%, which required a PTK retreatment. Twenty-four eyes had a preserved or improved BCVA, while 2 eyes showed deterioration of 1 line on Snellen test. Eleven eyes (42.3% had no change in SE, and the others (57.69% had a change of less than +/-0.75 diopters (D. There were no major complications during the follow-up period. CONCLUSION: Ten-year data show that PTK is a safe, fast, effective and minimal invasive choice of treatment for recurrent corneal erosions in patients who do not respond to conventional treatments.

  14. [Epi-Bowman Keratectomy: Clinical Evaluation of a New Method of Surface Ablation].

    Science.gov (United States)

    Taneri, S; Kießler, S; Rost, A; Schultz, T; Elling, M; Dick, B

    2017-02-10

    Purpose A new device for epithelial abrasion before excimer laser surface ablation or corneal cross-linking (CXL) has recently been introduced (Epi-Clear™, Orca Surgical, Kiryat-Shmona, Israel). We have reviewed the literature on the clinical results, potential benefits and drawbacks of this instrument, compared to other methods of epithelial removal. Method Literature search for "Epi-Bowman Keratectomy", "Epi-clear", and "Epikeratome" yielded 1 peer-review publication, 1 non-peer-review publication, 18 posters and presentations at international conferences (European Society of Cataract and Refractive Surgeons [ESCRS] and American Society of Cataract and Refractive Surgery [ASCRS]) on the use of the Epi-Clear™ device before surface ablation, 2 posters on the use of Epi-Clear before corneal crosslinking and 1 presentation on the experimental use of Epi-Clear for removal of a pterygium. Results Comparison of laser ablation after epithelial removal with the Epi-Clear device (Epi-Bowman Keratectomy™, EBK™) to other established methods of surface ablation, i.e. alcohol-assisted PRK or PRK with a metallic scraper, EBK, suggests that the results are generally similar. Pain perception, haze formation, and epithelial healing are reported to be better than with conventional surface ablation methods. Studies evaluating the use of the Epi-Clear device before CXL report that the healing time is significantly reduced and that less pain is perceived. Conclusion The Epi-Clear device seems to be a promising new option for epithelial removal before refractive laser ablation, although a convincing explanation for its potential superiority is still missing. In contrast, when the Epi-Clear device is used before CXL, then the Bowman's layer remains intact; this may provide an adequate explanation for the reported benefits of this application. However, currently available studies are of low level of evidence, so that more prospective randomised trials are needed for a robust

  15. Holographic injection-locking of a broad-area laser diode via a photorefractive thin film device

    NARCIS (Netherlands)

    van Voorst, P.D.; de Wit, M.R.; Offerhaus, Herman L.; Tay, S.; Thomas, J.; Peyghambarian, N.; Boller, Klaus J.

    2007-01-01

    We demonstrate locking of a high power broad area laser diode to a single frequency using holographic feedback from a photorefractive polymer thin-film device for the first time. A four-wave mixing setup is used to generate feedback for the broad area diode at the wavelength of the single frequency

  16. Ceratectomia fotorrefrativa associada à ceratotomia lamelar pediculada (LASIK para correção de miopias, com ou sem secagem do estroma Photorefractive keratectomy associated with lamellar keratotomy (LASIK for correction of myopia, with or without drying the stroma

    Directory of Open Access Journals (Sweden)

    Cesar K. Suzuki

    2000-12-01

    Full Text Available Objetivo: Avaliar os resultados clínicos da ceratectomia fotorrefrativa associada à ceratotomia lamelar pediculada (LASIK, para miopia moderada e alta, com ou sem secagem do leito estromal durante a foto-ablação. Pacientes e Métodos: Estudo retrospectivo de 39 olhos de 30 pacientes submetidos a LASIK sem secagem do leito estromal durante a foto-ablação no período de abril de 1996 a abril de 1997 (Grupo I e 42 olhos de 28 pacientes com secagem do leito estromal durante a foto-ablação a cada 80 pulsos, no período de abril de 1997 a setembro de 1997 (Grupo II. Após a ceratotomia lamelar pediculada corneana com um microcerátomo automatizado (Chiron Corneal Shaper ®, foi realizada a foto-ablação com excimer laser de fluoreto de argônio de 193 nm da Summit modelo Apex Plus®. Em 2 olhos do Grupo I, a foto-ablação não foi realizada, devido a complicações durante a ceratotomia lamelar. Resultados: O tempo médio de seguimento pós-operatório foi de 8,7 meses no Grupo I e 7,7 meses no Grupo II. A média de tratamento foi de -10,81D (±2,38 no grupo I e -8,73D (±2,82 no grupo II. As médias das variações dos equivalentes esféricos obtidos em relação ao tratamento desejado nos meses 1, 3, 6 e 12 foram respectivamente, -0,96D (±1,19, -1,19D (±1,37, -1,06D (±1,41 e -1,10D (±0,66 no Grupo I e -0,23D (±1,02, -0,41D (±1,34, -0,75D (±1,16 e -1,03D (±1,31 no Grupo II. Três olhos do total (3,7%, todos do Grupo I, perderam 2 ou mais linhas de visão. Na visita mais recente, 17 olhos (45,9% do Grupo I e 31 olhos (73,8% do Grupo II apresentaram Acuidade Visual sem correção de 20/40 ou melhor. Ocorreram 4 complicações intra-operatórias no grupo I, sendo que 2 casos tiveram a foto-ablação não-efetuada e uma complicação intra-operatória no Grupo II. Conclusão: A secagem do leito estromal possibilitou recuperação visual mais rápida, devido a menor hipocorreção primária. O seguimento a longo prazo não evidenciou diferenças estatisticamente significantes entre os dois tratamentos.Purpose: To evaluate the clinical results of LASIK for moderate and high degrees of myopia, with and without drying the stroma during photoablation. Patient and Methods: Retrospective analysis of 39 eyes of 30 patients submitted to LASIK, without drying the stroma during photoablation, in the period from April 1996 to April 1997 (Group I and analysis of 42 eyes of 28 patients with drying of the stromal bed at each 80 pulses during photoablation in the period of April of 1997 to September of 1997 (Group II. After lamellar keratotomy with an automated microkeratome (Chiron Corneal Shaper ®, photoablation with fluoride-argon excimer laser, 193 nm, Summit model Apex Plus ® was carried out. In 2 eyes of the Group I, the photoablation was not possible due to compli- cations during the lamellar keratotomy. Results: The average follow-up was 8.7 months in Group I and 7.7 months in Group II. The mean treatment was -10.81D (±2.38 in Group I and -8.73D (±2.82 in Group II. The average variations of the achieved spherical equivalent in relation to the attempted treatment in months 1, 3, 6 and 12 were respectively, -0.96D (±1.19, -1.19D (±1.37, -1.06D (±1.41 and -1.10D (±0.66 in Group I and -0.23D (±1.02, -0.41D (±1.34, -0.75D (±1.16 and -1.03D (±1.31 in Group II. On the last visit 17 eyes (45.9% of Group I and 31 eyes (73.8% of Group II showed uncorrected VA of 20/40 or better. Four intraoperative complications occurred in Group I, in 2 of them the photoablations were not performed and one intraoperative complication occurred in Group II. There was a loss of 2 or more lines in 3 eyes (3.7% ot Group I. Conclusion: Drying of the stroma led to a faster visual recovery due to smaller hypocorrection. No significant differences were observed in the long-term follow-up.

  17. Light-induced charge transport processes in photorefractive barium titanate doped with rhodium and iron

    Science.gov (United States)

    van Stevendaal, U.; Buse, K.; Kämper, S.; Hesse, H.; Krätzig, E.

    1996-10-01

    Absorption, light-induced absorption changes, photo and dark conductivities, bulk photovoltaic currents and two-beam coupling gain coefficients are measured for oxidized, as grown and reduced BaTiO3:Rh,Fe crystals. The oxidized sample shows hole conductivity and three photorefractive levels are present: Rh4+/5+ Fe4+/5+ and Rh3+/4+. The measurements indicate that Rh3+/4+ is responsible for the photo conductivity and that its energy level is located (0.9 ± 0.1) eV above the valence band edge. The as grown sample also shows hole conductivity and two photorefractive levels are involved: Rh3+/4+ and Fe 3+/4+. The results yield that the Fe3+/4+ level is located (0.95 ± 0.05) eV above the valence band edge. In the reduced sample electrons are the dominant charge carriers and two levels are of importance. The shallow one is located (0.39 ± 0.05) eV below the conduction band edge. Here the performance of this crystal is strongly impaired by a pronounced sublinear photo conductivity.

  18. Nanosecond electrical and optical pulses and self phase conjugation from photorefractive lithium niobate fibers and crystals

    Science.gov (United States)

    Kukhtarev, N.; Kukhtareva, T.; Curley, M.; Jaenisch, H. M.; Edwards, M. E.; Gu, M.; Zhou, Z.; Guo, R.

    2007-09-01

    We have observed nanosecond electrical and optical pulsations from photorefractive lithium-niobate optical fibers using CW green and blue low-power lasers. Fourier spectra of the pulsations have a maximum at ~900 MHz with peaks separated by ~30MHz. We consider free-space and fiber supported illumination of the fiber crystal. Strong nonlinear enhanced backscattering with phase conjugation was observed from bulk crystals and crystal fibers along the C-axis. Model of transformation of CW laser irradiation of ferroelectric crystals into periodic nanosecond electrical and optical pulsations is suggested. This model includes combinations of photorefractive, pyroelectric, piezoelectric, and photogalvanic mechanisms of the holographic grating formation and crystal electrical charging. Possible applications of these short photo-induced electrical pulses for modulation of holographic beam coupling, pulsed electrolysis, electrophoresis, focused electron beams, X-ray and neutron generation, and hand-held micro X-ray devices for localized oncology imaging and treatment based on our advanced sensor work are discussed.

  19. The Effect of Ptosis on Cataract Surgical Planning

    Directory of Open Access Journals (Sweden)

    Irene C. Kuo

    2015-04-01

    Full Text Available Purpose: To describe a patient complaining of ‘ghosting' and ‘shadowing' after bilateral, sequential cataract extraction with toric intraocular lens (IOL implantation who was found to have significant eyelid ptosis. Methods: The following is a case report. Results: The patient's complaints arose a few weeks after surgery. By the second postoperative month, the patient's keratometry had changed compared to preoperative measurements. Because of significant ptosis, the patient underwent upper eyelid surgery. Four months later, he was found to have less corneal astigmatism than had been measured prior to cataract surgery. Following 2 stable examinations, a Prevue lens based on Hartmann-Shack wavefront aberrometry was made for each eye, which the patient said significantly improved his quality of vision. Wavefront-guided photorefractive keratectomy (PRK was performed 6 months after cataract surgery. One year after PRK, the patient's symptoms had disappeared, his uncorrected visual acuity was 20/20 in the right eye and 20/15 in the left, and he was satisfied with his quality of vision. Conclusions: Bilateral toric IOLs were implanted in this patient based on measurements of corneal astigmatism that changed after cataract surgery and changed further after ptosis repair. This case demonstrates the importance of evaluating eyelid position in cataract surgical planning as ptosis can contribute significantly to corneal astigmatism. Patient education is important in the setting of higher expectations from purchase of premium lens implants.

  20. Clinical study of two kinds of bandage contact lenses after laser-assisted subepithelial keratectomy

    Directory of Open Access Journals (Sweden)

    Wan-Ting Zhang

    2016-07-01

    Full Text Available AIM: To investigate the clinical safety and effectiveness of the two kind of bandage contact lenses: Senofilcon A(Johnson & Johnson Acuvue Oasysand Balafilcon A(Bausch& Lomb pure visionafter laser-assisted subepithelial keratectomy(LASEK. METHODS: Thirty-eight patients(76 eyeswho had undergone the LASEK were divided into two groups. One group of patients wore Balafilcon A, the other group of patients fitted with Senofilcon A. The lenses were worn continuously for 7d. This was a seven-day experience and the patients scored for the symptom of the eyes(sore eyes, foreign body sensation and tearingon the third day and the seventh day. Both of the two groups of patients taken off the soft contact lens on the seventh day and let their vision and corneal staining checked.RESULTS: The symptoms of eye sore and tearing of the two groups patients were different. The patients who wore the Senofilcon A were better. The pain of eyes were also different at 3 and 7d after surgeries(Z=-4.146, P=0.000; Z=-2.814, P=0.005. The difference on tearing between the two groups at 3 and 7d after surgeries were significant(Z=-2.309, P=0.021; Z=-3.276, P=0.001. There was no difference on sensation of dryness between the two groups at 3 and 7d after surgeries(Z=-0.447, P=0.655; Z=-0.966, P=0.334. After the lenses were taken off, the visual acuity of patients wearing Senofilcon A was better(t=3.800, P=0.001; corneal staining showed limited spots in 1-2 quadrants with significant difference(Z=-2.384,P=0.017. CONCLUSION: The Senofilcon A(Johnson & Johnson Acuvue Oasysand Balafilcon A(Bausch& Lomb pure visionbandage contact lenses are safe and effective after LASEK, and the former is better than the latter in epithelial regeneration.

  1. Decay of photorefractive gratings in LiNbO3:Fe by neutron irradiation

    Science.gov (United States)

    Mandula, G.; Rupp, R. A.; Balaskó, M.; Kovács, L.

    2005-04-01

    The effect of neutron irradiation on photorefractive gratings in LiNbO3:Fe single crystals is studied experimentally. The observed phenomena result from the large effective cross section of Li6 for thermal and cold neutrons and from the large number of the electrons excited to the conduction band by the high kinetic energy that is released during the neutron generated fission of Li6 nuclei. The excited electrons erase the previously recorded holographic grating. The sensitivity threshold of the effect is better than 160mSv (1.2×1010cm-2 fluence) at neutron energy of 0.17eV. Potential applications of the phenomena are discussed.

  2. Transition between superluminal and subluminal light propagation in photorefractive Bi12SiO20 crystals.

    Science.gov (United States)

    Bo, Fang; Zhang, Guoquan; Xu, Jingjun

    2005-10-03

    We demonstrated superluminal light propagation with a negative group velocity of -5.7 m/s in a photorefractive Bi 12SiO20 crystal by using the dispersive phase coupling effect in a nondegenerate two-wave mixing process. To the best of our knowledge, this is the first experimental demonstration of superluminal light propagation at room temperature in solids by using a classical wave mixing technique. In addition, we showed the tunability of the group velocity of light between the negative (superluminal light) and the positive (subluminal light) by simply tuning the experimental conditions such as the frequency of the coupling beam, the incident intensity, and the externally applied electric fields.

  3. Real-time holographic interferometry using photorefractive sillenite crystals with phase-stepping technique

    Science.gov (United States)

    Gesualdi, M. R. R.; Soga, D.; Muramatsu, M.

    2006-01-01

    This work presents a holographic interferometer that uses the photorefractive sillenite crystals in diffusive regimen whose configuration exhibits diffraction anisotropy for real-time holographic interferometry. The writing-reading process of holographic interferogram was done in real-time, connected with an interferogram-analysis method that uses the phase-stepping technique for quantitative measurement of changes on an object. The holographic interferograms from the analyzed surface were captured and they were used to calculate the phase map with four-frame technique. The unwrapping process used was the cellular-automata technique. We obtained quantitative results for some applications: measurements of micro-rotation of surfaces, punctual micro-displacements on an aluminum plate, stress on a dog's jaw, among others; adding new promising applications possibilities for basic research, dentistry and technological areas.

  4. Photovoltaic effect in Bi{sub 2}TeO{sub 5} photorefractive crystal

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Ivan de, E-mail: ivan@ft.unicamp.brg; Capovilla, Danilo Augusto [GOMNI-Faculdade de Tecnologia/UNICAMP, Limeira (Brazil); Carvalho, Jesiel F.; Montenegro, Renata; Fabris, Zanine V. [Instituto de Física/Universidade Federal de Goiás, Goiânia (Brazil); Frejlich, Jaime [Instituto de Física “Gleb Wataghin”/UNICAMP, Campinas (Brazil)

    2015-10-12

    We report on the presence of a strong photovoltaic effect on nominally undoped photorefractive Bi{sub 2}TeO{sub 5} crystals and estimated their Glass photovoltaic constant and photovoltaic field for λ = 532 nm illumination. We directly measured the photovoltaic-based photocurrent in this material under λ = 532 nm wavelength laser light illumination and compared its behavior with that of a well known photovoltaic Fe-doped Lithium Niobate crystal. We also show the photovoltaic current to strongly depend on the polarization direction of light. Holographic diffraction efficiency oscillation during recording and the behavior of fringe-locked running holograms in self-stabilized experiments are also demonstrated here as additional indirect proofs of the photovoltaic nature of this material.

  5. Enhanced photorefractive performance of bulk cu-doped KNSBN crystals through surface electrostatic modification

    Science.gov (United States)

    Li, Liang; Zhang, Jingwen; Zhao, Hua

    2017-01-01

    The remarkable photorefractivity enhancement was observed and investigated in copper-doped (K0.5Na0.5)0.2(Sr0.75Ba0.25)0.9Nb2O6 (Cu:KNSBN) crystals due to charge accumulation on the surface, stemming from electrostrictive effect. This electrostatic modification to the surface was studied with conventional two beam coupling experiment and over 17 high diffraction orders were observed. To estimate the amount of charge accumulation, the surface charge density was measured through direct current measurement using a close loop circuit. It was believed that a thin phase grating was responsible for the diffraction pattern, which was confirmed by the related reading experiment. Corresponding calculation and analysis were given to highlight the strong refractive index modulation of the gratings.

  6. Impact of the photorefractive and pyroelectric-electro-optic effect in lithium niobate on whispering-gallery modes.

    Science.gov (United States)

    Leidinger, Markus; Werner, Christoph S; Yoshiki, Wataru; Buse, Karsten; Breunig, Ingo

    2016-12-01

    Whispering-gallery resonators made of undoped and MgO-doped congruently grown lithium niobate are used to study electro-optic refractive index changes. Hereby, we focus on the volume photovoltaic and the pyroelectric effect, both providing an electric field driving the electro-optic effect. Our findings indicate that the light-induced photorefractive effect, combining the photovoltaic and electro-optic effect, is present only in the non-MgO-doped lithium niobate for exposure with light having wavelengths of up to 850 nm. This leads to strong resonance frequency shifts of the whispering-gallery modes. No photorefractive effect was observed in the MgO-doped material. One has to be aware that surface charges induced by the pyroelectric effect result in a similar phenomenon and are present in both materials.

  7. Optical Sensitizing of Photorefractive Sn2P2S6 With CW and Pulsed Pre-Exposure (Preprint)

    Science.gov (United States)

    2015-06-16

    nonlinear scattering, and recovery to the initial transmission, respectively. 1 Distribution A. Approved for public release (PA): distribution... antimony doping. The second conclusion is in line with our published data on the identification of secondary centers in Sn2P2S6:Sb using the EPR...optical sensitizing of photorefraction in antimony doped Sn2P2S6 crystals. AKNOWLEDGMENTS The financial support of the European Office of

  8. Sol–Gel-Derived Glass-Ceramic Photorefractive Films for Photonic Structures

    Directory of Open Access Journals (Sweden)

    Anna Lukowiak

    2017-02-01

    Full Text Available Glass photonics are widespread, from everyday objects around us to high-tech specialized devices. Among different technologies, sol–gel synthesis allows for nanoscale materials engineering by exploiting its unique structures, such as transparent glass-ceramics, to tailor optical and electromagnetic properties and to boost photon-management yield. Here, we briefly discuss the state of the technology and show that the choice of the sol–gel as a synthesis method brings the advantage of process versatility regarding materials composition and ease of implementation. In this context, we present tin-dioxide–silica (SnO2–SiO2 glass-ceramic waveguides activated by europium ions (Eu3+. The focus is on the photorefractive properties of this system because its photoluminescence properties have already been discussed in the papers presented in the bibliography. The main findings include the high photosensitivity of sol–gel 25SnO2:75SiO2 glass-ceramic waveguides; the ultraviolet (UV-induced refractive index change (Δn ~ −1.6 × 10−3, the easy fabrication process, and the low propagation losses (0.5 ± 0.2 dB/cm, that make this glass-ceramic an interesting photonic material for smart optical applications.

  9. The Antifibrosis Effects of Peroxisome Proliferator-Activated Receptor δ on Rat Corneal Wound Healing after Excimer Laser Keratectomy

    Directory of Open Access Journals (Sweden)

    Yun Gu

    2014-01-01

    Full Text Available Corneal stromal fibrosis characterized by myofibroblasts and abnormal extracellular matrix (ECM is usually the result of inappropriate wound healing. The present study tested the hypothesis that the ligand activation of peroxisome proliferator-activated receptor (PPAR δ had antifibrosis effects in a rat model of corneal damage. Adult Sprague-Dawley rats underwent bilateral phototherapeutic keratectomy (PTK. The eyes were randomized into four groups: PBS, GW501516 (a selective agonist of PPARδ, GSK3787 (a selective antagonist of PPARδ, or GW501516 combined with GSK3787. The agents were subconjunctivally administered twice a week until sacrifice. The cellular aspects of corneal wound healing were evaluated with in vivo confocal imaging and postmortem histology. A myofibroblast marker (α-smooth muscle actin and ECM production (fibronectin, collagen type III and collagen type I were examined by immunohistochemistry and RT-PCR. At the early stages of wound healing, GW501516 inhibited reepithelialization and promoted angiogenesis. During the remodeling phase of wound healing, GW501516 attenuated the activation and proliferation of keratocytes, which could be reversed by GSK3787. GW501516 decreased transdifferentiation from keratocytes into myofibroblasts, ECM synthesis, and corneal haze. These results demonstrate that GW501516 controls corneal fibrosis and suggest that PPARδ may potentially serve as a therapeutic target for treating corneal scars.

  10. Two-step two-color recording in a photorefractive praseodymium-doped La3Ga5SiO14 crystal

    DEFF Research Database (Denmark)

    Nikolajsen, T.; Johansen, P.M.; Yue, X.

    1999-01-01

    Two-step two-color recording is demonstrated in a photorefractive La3Ga5SiO14:Pr3+ crystal using cw laser radiation. The 488 nm line from an Ar-ion laser is used for gating and gratings are written using a Ti:sapphire laser operating in the range from 788 to 840 nm. The dependence of holographic ...

  11. Surface plasmon polariton boosted photorefractive scattering in indium tin oxide coated Fe-doped lithium niobate slabs

    Science.gov (United States)

    Wang, Hao; Zhao, Hua; Li, Liang; Xu, Chao; Zhang, Jingwen

    2015-03-01

    To study the impact of surface plasmon polaritons on photorefractive effect, indium tin oxide (ITO) thin films were deposited onto Fe-doped lithium niobate (Fe: LiNbO3, LN) slabs. Striking scattering near surface normal (SNSN) of the slabs was observed, increasing with the incident angle of laser beam. The SNSN was so strong that it depleted the transmitted beam. Based on a tentative physical picture of photovoltaic (PV) effect induced electrostatic modification, the electron density of skin layer of ITO film was raised to such a level that surface plasmon polaritons (SPPs) were excited in LN/ITO interface via phase grating mediation. Consequently, the localized intensified electromagnetic fields exerted on the LN slabs and resulted in the SNSN. The impact of the SPPs and SNSN on the photorefractive effect can be seen from over 2.5 times SNSN enhancement in power and as high as 6.0 times boosting of the ratio of the SNSN power to the remaining transmitted one.

  12. Surgical outcome after phototherapeutic keratectomy in patients with TGFBI-linked corneal dystrophies in relation to molecular genetic findings.

    Science.gov (United States)

    Gruenauer-Kloevekorn, Claudia; Braeutigam, Saskia; Froster, Ursula G; Duncker, Gernot I W

    2009-01-01

    To evaluate the correlation between surgical outcome after phototherapeutic keratectomy in patients with autosomal dominant transforming growth factor, beta-induced (TGFBI)-linked corneal dystrophies (CD) and molecular genetic findings regarding the TGFBI gene. Twelve patients were examined to investigate genotype by direct sequencing of the TGFBI gene. Twenty eyes of 12 patients were treated with phototherapeutic keratektomy (PTK) to remove superficial corneal opacifications and to decrease recurrent erosions. Surgical outcome, including visual improvement, recurrence of opacifications, postoperative complications, and additional therapeutic proceedings were reported and compared with the molecular genetic results. Four different missense mutations were identified within the coding region of the TGFBI gene: Arg124Cys in one eye, Arg555Trp in nine eyes, Arg124His in four eyes and Gly623Arg in six eyes. In all eyes the PTK was successful without clinically significant recurrent opacifications after a mean follow-up time of 17.6 months (min 3 months, max 42 months). The best corrected visual acuity (BCVA) improved with an average increase of 3.1 lines (minimum 2 lines, maximum 5 lines). In one eye (Arg124Cys), we observed delayed wound healing and a delayed increase in BCVA, in two eyes we performed an Epilasik to correct remaining hyperopia, and in four eyes we fitted rigid gas-permeable tricurve contact lenses to correct the remaining irregular astigmatism. The variable genotypes in patients with TGFBI-linked corneal dystrophies lead to significantly different results after surgical treatment. The Gly623Arg mutation seems to be an optimum genotype on which to perform PTK even in older patients. It is essential to determine the genotype in order to standardize the PTK treatment and to evaluate the success in TGFBI-linked corneal dystrophies.

  13. Customized Finite Element Modelling of the Human Cornea

    National Research Council Canada - National Science Library

    Simonini, Irene; Pandolfi, Anna

    2015-01-01

    ... and stress caused by photorefractive keratectomy (PRK). Corneal elevation maps of five human eyes were taken with a rotating Scheimpflug camera combined with a Placido disk before and after refractive surgery...

  14. Epithelium-on photorefractive intrastromal cross-linking (PiXL for reduction of low myopia

    Directory of Open Access Journals (Sweden)

    Lim WK

    2017-06-01

    Full Text Available Wee Kiak Lim,1,2 Zhi Da Soh,1 Harold Kah Yen Choi,1 Julian Thiam Siew Theng1,3 1Eagle Eye Centre, Mount Alvernia Hospital, 2Department of Ophthalmology, Tan Tock Seng Hospital, 3Department of Ophthalmology, Khoo Teck Puat Hospital, Singapore Purpose: To report the 9–12-month outcomes of a novel procedure for reduction of low myopia through epithelium-on photorefractive intrastromal cross-linking (PiXL with customized control of topographic distribution of ultraviolet (UV-fluence. Method: Myopic patients with normal (non-ectatic corneas underwent the PiXL procedure for reduction of low myopia. PiXL treatments were delivered through selective application of UVA light based on the refractive error of each patient. Clinical evaluation included safety (corrected distance visual acuity, endothelial cell count, central corneal thickness, anterior ocular health and efficacy (uncorrected distance visual acuity, manifest refraction, K-mean examinations. In addition, a patient satisfaction survey was conducted at 9 months post-procedure to evaluate patients’ subjective experience with the procedure. Results: Fourteen myopic eyes (mean manifest refraction spherical equivalent –1.62±0.6D; range –0.75 to –2.65D of 8 subjects (mean age 30 years old; range 24–51 years old were enrolled in the study. At 12 months post-procedure, a mean manifest refraction spherical equivalent reduction of 0.72±0.43D (P<0.001 was observed, with a corresponding gain in uncorrected visual acuity of 0.25 logMAR and mean K-mean flattening of 0.47±0.46D. All patients achieved best corrected visual acuity of 20/20 or better from 1 month onward. There were no cases of ocular infection or secondary changes to the crystalline lens and retina due to UV exposure, while transient corneal haze subsided gradually. Conclusion: The epithelium-on PiXL procedure was safe and effective in reducing myopic refractive error in this study with up to 12 months follow-up. Early results of

  15. Predictability and stability of laser-assisted subepithelial keratectomy with mitomycin C for the correction of high myopia.

    Science.gov (United States)

    Iu, Lawrence P L; Fan, Michelle C Y; Chen, Ivan N; Lai, Jimmy S M

    2017-06-01

    The purpose of this study was to evaluate the predictability and stability of laser-assisted subepithelial keratectomy (LASEK) with mitomycin C (MMC) in correction of high myopia (≤-6.0 diopters [D]) as compared to low-to-moderate myopia (>-6.0 D).This is a retrospective, comparative, cohort study which included 43 eyes of 43 consecutive patients who underwent LASEK with MMC in a private hospital in Hong Kong by a single surgeon. Twenty-five eyes had high myopia (mean spherical equivalent [SE] = -8.53 ± 1.82 D) and 18 eyes had low-to-moderate myopia (mean SE = -3.99 ± 1.37 D) before surgery.In terms of refractive predictability, mean SE was significantly better in eyes with preoperative low-to-moderate myopia than high myopia at 6 months (0.04 ± 0.23 vs 0.31 ± 0.52 D, P = .035). In terms of refractive stability, between 1 and 3 months, both groups had mean absolute change of SE of around 0.25 D. Between 3 and 6 months, preoperative low-to-moderate myopia group had significantly less absolute change of SE compared to high myopia group (0.07 vs 0.23 D, P = .003). More eyes with preoperative high myopia changed SE by more than 0.25 D than those with low-to-moderate myopia between 3 and 6 months (32.0% vs 5.6%, P = .057).In conclusion, LASEK with MMC is more unpredictable and unstable in correction of high myopia than low-to-moderate myopia. The refractive outcome of most low-to-moderate myopia correction stabilizes at 3 months. Stability is not achieved until after 6 months in high myopia correction.

  16. Growth and photorefractive properties of an Fe-doped near-stoichiometric LiNbO3 crystal

    Science.gov (United States)

    Zhang, Tao; Wang, Biao; Fang, Shuangquan; Ma, Decai

    2005-06-01

    A near-stoichiometric LiNbO3 crystal with 0.02 wt% Fe2O3 doping was grown from a Li-rich melt (Li/Nb = 1.38, atomic ratio) by the Czochralski method in air atmosphere. The OH- absorption band was characterized by infrared transmittance spectra. The appearance of the 3466 cm-1 absorption band (2.89 µm) manifests that the composition of the grown crystal is close to the stoichiometric ratio. The photorefractive properties were measured by a two-wave coupling experiment. The measured results show that the Fe-doped near-stoichiometric LiNbO3 crystal has a larger exponential gain coefficient than the Fe-doped congruent LiNbO3 crystal. The remarkable gain can be attributed to the photovoltaic field being comparable with the effective limiting space-charge field.

  17. High-speed photorefraction at telecommunication wavelength 1.55 microm in Sn2P2S6:Te.

    Science.gov (United States)

    Mosimann, Roger; Marty, Patrick; Bach, Tobias; Juvalta, Flurin; Jazbinsek, Mojca; Günter, Peter; Grabar, Alexander A

    2007-11-15

    We demonstrated for what is the first time to our knowledge photorefractive two-wave mixing in a bulk ferroelectric crystal using cw light at the telecommunication wavelength 1.55 microm. In the Te-doped ferroelectric semiconductor Sn2P2S6 with absorption constant <0.1 cm(-1) at 1.55 microm, grating recording times of 10 ms and a two-beam coupling gain of 2.8 cm(-1) have been measured at 350 mW power (intensity 440 W/cm(2)) without a necessity to apply an external electric field. With a moving grating technique, a maximal gain of 6.0 cm(-1) has been obtained.

  18. Near-infrared sensitive photorefractive device using polymer dispersed liquid crystal and BSO:Ru hybrid structure.

    Science.gov (United States)

    Liu, Ren Chung; Marinova, Vera; Lin, Shiuan Huei; Chen, Ming-Syuan; Lin, Yi-Hsin; Hsu, Ken Yuh

    2014-06-01

    A near-infrared sensitive hybrid device, based on a Ru-doped BSO photorefractive substrate and polymer dispersed liquid crystal (PDLC) layer, is reported. It is found that the photoexcited charge carriers generated in the BSO:Ru substrate create an optically induced space charge field, sufficient to penetrate into the PDLC layer and to re-orient the LC molecules inside the droplets. Beam-coupling measurements at the Bragg regime are performed showing prospective amplification values and high spatial resolution. The proposed structure does not require indium tin oxide (ITO) contacts and alignment layers. Such a device allows all the processes to be controlled by light, thus opening further potential for real-time image processing at the near-infrared range.

  19. Self-deflection suppression of bright spatial solitons in absorbing photovoltaic photorefractive crystals by periodic diffusion management

    Science.gov (United States)

    Zheng, Cheng-Zhang; Luo, Man-Qiao; Lin, Guang; Cui, Hu; Luo, Ai-Ping

    2017-03-01

    The propagation behavior of bright spatial solitons under the diffusion effect in photovoltaic (PV) photorefractive (PR) crystals poled periodically is investigated by considering the optical absorption of the crystals. The numerical simulations show that, soliton beams follow a wiggling trajectory under the combined influence of the crystal absorption and the diffusion effect which is properly managed by designing the periodic domain inversion structure of periodically poled PV PR crystals. Moreover, the oscillation amplitude of the wiggling trajectory of a low-intensity soliton decreases gradually with the propagation distance, but the situation for a high-intensity soliton is contrary. Furthermore, the recursive equations describing the propagation trajectory are formulated and the analytical result of the propagation trajectory is in good agreement with the numerical one. The research results contribute to enriching the dynamics of PR spatial solitons and provide a method to suppress the self-deflection of soliton beams arising from the diffusion effect.

  20. Holographic recording and characterization of photorefractive Bi{sub 2}TeO{sub 5} crystals at 633 nm wavelength light

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Ivan de, E-mail: ivan@ft.unicamp.br [Grupo de Óptica e Modelagem Numérica (GOMNI)-Faculdade de Tecnologia/UNICAMP, Limeira-SP (Brazil); Carvalho, Jesiel F., E-mail: carvalho@if.ufg.br; Fabris, Zanine V. [Instituto de Física/Universidade Federal de Goiás, Goiânia-GO (Brazil); Frejlich, Jaime, E-mail: frejlich@ifi.unicamp.br [Instituto de Física “Gleb Wataghin”/UNICAMP, Campinas-SP (Brazil)

    2014-04-28

    We report on the holographic recording on photorefractive Bi{sub 2}TeO{sub 5} crystals using λ=633 nm wavelength light. We studied the behavior of this material under the action of this low photonic energy light and found out the presence of a fast and a slow hologram, both of photorefractive nature and exhibiting rather high diffraction efficiencies. The faster and the slower holograms are based on the excitation and diffusion of oppositely charged carriers (likely electrons and holes). Relevant parameters for the photoactive centers responsible for both kind of holograms were characterized using purely holographic techniques. No evidences of non-photosensitive ionic charge carriers being involved in the recording process at room temperature nor self-fixing effects were found.

  1. Transepithelial Phototherapeutic Keratectomy Using a 213-nm Solid-State Laser System Followed by Corneal Collagen Cross-Linking with Riboflavin and UVA Irradiation

    Directory of Open Access Journals (Sweden)

    George D. Kymionis

    2010-01-01

    Full Text Available Purpose. To present a case of a keratoconic patient who underwent epithelial removal with transepithelial phototherapeutic keratectomy (t-PTK using a 213-nm solid-state laser system followed by corneal collagen cross-linking (CXL with riboflavin and ultraviolet-A (UVA irradiation. Methods. Case report. Results. A twenty-four-year-old male with keratoconus underwent CXL treatment after epithelial removal with t-PTK using a solid-state laser system. No intra- or early postoperative complications were found. One month postoperatively, uncorrected visual acuity (UCVA improved from 20/63 to 20/32 while best spectacle- corrected visual acuity (BSCVA improved from 20/40 to 20/25. Corneal topography revealed a significant improvement which remained stable during the six-month followup period. Conclusions. Epithelial removal with t-PTK before CXL could improve patient's visual outcome.

  2. Simulation of pattern and defect detection in periodic amplitude and phase structures using photorefractive four-wave mixing

    Science.gov (United States)

    Nehmetallah, Georges; Banerjee, Partha; Khoury, Jed

    2015-03-01

    The nonlinearity inherent in four-wave mixing in photorefractive (PR) materials is used for adaptive filtering. Examples include script enhancement on a periodic pattern, scratch and defect cluster enhancement, periodic pattern dislocation enhancement, etc. through intensity filtering image manipulation. Organic PR materials have large space-bandwidth product, which makes them useful in adaptive filtering techniques in quality control systems. For instance, in the case of edge enhancement, phase conjugation via four-wave mixing suppresses the low spatial frequencies of the Fourier spectrum of an aperiodic image and consequently leads to image edge enhancement. In this work, we model, numerically verify, and simulate the performance of a four wave mixing setup used for edge, defect and pattern detection in periodic amplitude and phase structures. The results show that this technique successfully detects the slightest defects clearly even with no enhancement. This technique should facilitate improvements in applications such as image display sharpness utilizing edge enhancement, production line defect inspection of fabrics, textiles, e-beam lithography masks, surface inspection, and materials characterization.

  3. Reversible holography and optical phase conjugation for image formation/correction using highly efficient organic photorefractive polymers

    Directory of Open Access Journals (Sweden)

    José-Luis Maldonado

    2015-12-01

    Full Text Available In this work, we report the reversible reconstruction of holographic and distorted transmission images through the four wave mixing (FWM technique and optical phase conjugation (OPC, an alternative method to adaptive optics, by using highly efficient Photorefractive (PR polymers fabricated in our laboratories. These PR polymers are based on our synthesized nonlinear chromophore 4-[4-(diethylamino-2 hydroxybenzylideneamino] benzonitrile (Dc. For the PR devices, diffraction efficiencies as high as 90% at 25 wt.% doping level of Dc at an external applied electric field (Eext around 56 V/μm are achieved. The reconstruction implementation is simple, of low cost, all-optical and it is capable of recovering 90% of the original images. The real-time holographic experiments were performed at Eext of just 27 V/μm, which is one of the lowest reported values. Reversible holographic imaging is showed with a rise-time around 0.35 s.

  4. Enhanced photorefractive properties in Hf, Ce and Cu co-doped LiNbO{sub 3} crystals for holographic application

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Tao, E-mail: tzhang_hit02@yahoo.com [Key Laboratory of In-fiber Integrated Optics, Ministry of Education of China, Harbin Engineering University, Harbin 150001 (China); College of Science, Harbin Engineering University, Harbin 150001 (China); Postdoctoral Research Station of Mechanical Engineering, College of Mechanical and Electrical Engineering, Harbin Engineering University, Harbin 150001 (China); Wang, Xin; Geng, Tao; Tong, Chengguo [Key Laboratory of In-fiber Integrated Optics, Ministry of Education of China, Harbin Engineering University, Harbin 150001 (China); College of Science, Harbin Engineering University, Harbin 150001 (China); Kang, Chong [Key Laboratory of In-fiber Integrated Optics, Ministry of Education of China, Harbin Engineering University, Harbin 150001 (China); College of Science, Harbin Engineering University, Harbin 150001 (China); Postdoctoral Research Station of Mechanical Engineering, College of Mechanical and Electrical Engineering, Harbin Engineering University, Harbin 150001 (China)

    2015-04-25

    Graphical abstract: Correlation spots of 200 holograms in a Hf, Ce and Cu co-doped LiNbO{sub 3}. - Highlights: • Several doped LiNbO{sub 3} crystals with various level of Hf doping were grown by Cz method. • IR peak shift is attributed to the complex defect change at different level of Hf. • Enhanced photorefractive properties have been got with higher Hf-doping level. • Reduced defect and increased photoconductivity are responsible for optical properties. • 200 holograms’ experiment is realized in a coherent volume 0.073 cm{sup 3}. - Abstract: Hf, Ce and Cu co-doped LiNbO{sub 3} crystals with various level of Hf doping were grown in air by a conventional Cz method. The infrared spectra were measured to discuss the defect structures and the mechanism of the absorption peak shift in these crystals. The light-induced scattering of the crystals was evaluated by the transmitted light method. The influence of the Hf-doping level on the photorefractive properties of Hf, Ce and Cu co-doped LiNbO{sub 3} crystals was studied via two-beam coupling. It is found that proper doping Hf is an efficient method to enhance the comprehensive photorefractive properties of the LiNbO{sub 3}. Using one of these crystals as medium, 200 holograms storage and correlation experiments based on angle fractal multiplexing have been realized in a coherent volume 0.073 cm{sup 3}. Moreover the diffraction efficiency is uniform and the storage density has reached 2.2 Gb/cm{sup 3}.

  5. Temporal Dynamics of Two Beam Coupling and the Origin of Compensation Photorefractive Gratings in Sn2P2S6:Sb (Postprint)

    Science.gov (United States)

    2017-03-29

    Shumelyuk, A. Hryhorashchuk, and S. Odoulov, “Coherent optical oscillator with periodic zero-Pi phase modulation ,” Phys. Rev. A 72, 023819 (2005). 13...the square of the index modulation , diminishes two times faster than the signal intensity when two interacting waves are present at the crystal input...unlimited. of photorefractive semiconductor CdTe (Ne f f = 2.4·1016 cm−3 at 1.064 µm and 1.1·1016 cm−3 at 1.55 µm [26]). Finally, it is orders of magnitude

  6. Comparison of wavefront aberration changes in the anterior corneal surface after laser-assisted subepithelial keratectomy and laser in situ keratomileusis: preliminary study.

    Science.gov (United States)

    Buzzonetti, Luca; Iarossi, Giancarlo; Valente, Paola; Volpi, Marzia; Petrocelli, Gianni; Scullica, Luigi

    2004-09-01

    To compare changes in anterior corneal wavefront aberrations after myopic laser-assisted subepithelial keratectomy (LASEK) and laser in situ keratomileusis (LASIK). Institute of Ophthalmology, Catholic University, Rome, Italy. This prospective study included 36 eyes of 25 myopic patients: 18 eyes of 12 patients had LASEK and 18 eyes of 13 patients, LASIK. The topography data (CSO EyeMap, version 6.2) were used to calculate corneal aberrations with 3.0 mm and 7.0 mm pupils before and 3 months after surgery. Total corneal aberrations increased similarly after LASEK and LASIK with the 7.0 mm pupil but did not change with the 3.0 mm pupil. Coma-like and spherical-like aberrations changed similarly after both procedures, but spherical-like aberrations increased after LASEK with the 3.0 mm pupil (P.05, independent t test), in individual eyes with an achieved correction less than 7.50 diopters (D), spherical-like aberrations increased more after LASEK than after LASIK. In this preliminary study, myopic LASEK and LASIK changed total and higher-order corneal aberrations. In both procedures, changes in spherical-like aberrations were dependent on the achieved correction. However, in individual eyes, spherical-like aberrations increased more after LASEK than after LASIK for low-moderate achieved correction, suggesting that these procedures may induce the same optical changes in the anterior corneal surface in different ways.

  7. Light-induced charge-transport properties of photorefractive barium-calcium-titanate crystals doped with iron

    Science.gov (United States)

    Veenhuis, H.; Börger, T.; Buse, K.; Kuper, C.; Hesse, H.; Krätzig, E.

    2000-07-01

    Nominally pure and iron doped, as-grown, and thermally annealed photorefractive barium-calcium-titanate crystals of the congruently melting composition Ba0.23Ca0.77TiO3 (BCT) are investigated by holographic and conventional electrical techniques. Refractive-index changes, two-beam-coupling gains, photoconductivities, dark conductivities, and bulk-photovoltaic current densities are measured. As-grown and oxidized crystals are hole conductive and at usual illumination conditions (light wavelength 514.5 nm, light intensity between 0.1 and 1 W/cm2) all measured properties are excellently described by an one-center charge-transport model. The effective electrooptic coefficient r333 is only about 30 pm/V and thus much smaller than the value obtained from interferometric measurements. Two-beam-coupling gains as high as 7 cm-1 are achieved. Doping with iron increases considerably the effective trap density, and bulk-photovoltaic fields of the order of some kilovolts per centimeter are observed in iron-doped crystals. Typical response times of iron-doped, as-grown, or oxidized crystals are about 0.5 s at 1 W/cm2. Reduction yields electron-conductive BCT. The dark storage time increases from 6 min in the as-grown state to 3 h upon a slight reduction treatment, but decreases for strongly reduced samples. The investigation reveals that BCT will become a very promising alternative to barium-titanate crystals (BaTiO3) for many applications.

  8. Sulfur vacancies in photorefractive Sn{sub 2}P{sub 2}S{sub 6} crystals

    Energy Technology Data Exchange (ETDEWEB)

    Golden, E. M.; Giles, N. C. [Department of Engineering Physics, Air Force Institute of Technology, Wright-Patterson Air Force Base, Ohio 45433 (United States); Basun, S. A. [Air Force Research Laboratory, Materials and Manufacturing Directorate, Wright-Patterson Air Force Base, Ohio 45433 (United States); Azimuth Corporation, 4134 Linden Avenue, Suite 300, Dayton, Ohio 45431 (United States); Grabar, A. A.; Stoika, I. M. [Institute of Solid State Physics and Chemistry, Uzhgorod National University, 88 000 Uzhgorod (Ukraine); Evans, D. R. [Air Force Research Laboratory, Materials and Manufacturing Directorate, Wright-Patterson Air Force Base, Ohio 45433 (United States); Halliburton, L. E. [Azimuth Corporation, 4134 Linden Avenue, Suite 300, Dayton, Ohio 45431 (United States); Department of Physics and Astronomy, West Virginia University, Morgantown, West Virginia 26506 (United States)

    2014-12-28

    A photoinduced electron paramagnetic resonance (EPR) spectrum in single crystals of Sn{sub 2}P{sub 2}S{sub 6} (SPS) is assigned to an electron trapped at a sulfur vacancy. These vacancies are unintentionally present in undoped SPS crystals and are expected to play an important role in the photorefractive behavior of the material. Nonparamagnetic sulfur vacancies are formed during the initial growth of the crystal. Subsequent illumination below 100 K with 442 nm laser light easily converts these vacancies to EPR-active defects. The resulting S = 1/2 spectrum shows well-resolved and nearly isotropic hyperfine interactions with two P ions and two Sn ions. Partially resolved interactions with four additional neighboring Sn ions are also observed. Principal values of the g matrix are 1.9700, 1.8946, and 1.9006, with the corresponding principal axes along the a, b, and c directions in the crystal. The isotropic parts of the two primary {sup 31}P hyperfine interactions are 19.5 and 32.6 MHz and the isotropic parts of the two primary Sn hyperfine interactions are 860 and 1320 MHz (the latter values are each an average for {sup 117}Sn and {sup 119}Sn). These hyperfine results suggest that singly ionized sulfur vacancies have a diffuse wave function in SPS crystals, and thus are shallow donors. Before illumination, sulfur vacancies are in the doubly ionized charge state because of compensation by unidentified acceptors. They then trap an electron during illumination. The EPR spectrum from the sulfur vacancy is destroyed when a crystal is heated above 120 K in the dark and reappears when the crystal is illuminated again at low temperature.

  9. Medium- to Long-Term Results of Corneal Cross-Linking for Keratoconus Using Phototherapeutic Keratectomy for Epithelial Removal and Partial Stromal Ablation.

    Science.gov (United States)

    Chen, Xiangjun; Stojanovic, Aleksandar; Xu, Yangyang; Zhou, Wen; Raeder, Sten; Enayati, Sam; Utheim, Tor Paaske

    2017-07-01

    To evaluate the medium- to long-term outcomes of corneal cross-linking in treatment of keratoconus using transepithelial phototherapeutic keratectomy (PTK-CXL) for epithelial removal and partial stromal ablation to stabilize the cornea, reduce corneal irregularity, and improve corrected vision. Retrospective analysis of 46 keratoconic eyes that underwent PTK-CXL. Corrected distance visual acuity (CDVA), manifest refraction, steep and flat simulated keratometry (Kmax and Kmin), corneal irregularity index (IRI), corneal higher order aberrations (HOAs), epithelial thickness profile, and corneal biomechanical characteristics were evaluated preoperatively and postoperatively. At a mean follow-up time of 21.0 ± 7.6 months (range: 10 to 43 months) postoperatively, CDVA improved from 0.25 ± 0.24 to 0.18 ± 0.22 logMAR (P = .002). CDVA remained unchanged in 32.6% (15 eyes) and 56.5% (26 eyes) gained up to five Snellen lines of CDVA, whereas 6.5% (3 eyes) lost two or more lines of CDVA, respectively. Postoperatively, flattening of Kmax from 50.58 ± 5.26 to 48.96 ± 4.00 diopters (D) and Kmin from 45.80 ± 3.11 to 44.77 ± 2.63 D (P biomechanical measurements did not show statistically significant change. Two eyes demonstrated slight topographic regression. PTK-CXL seems to be effective in arresting the progression of keratoconus, improving CDVA, flattening the cornea, regularizing corneal surface, and reducing corneal HOAs. [J Refract Surg. 2017;33(7):488-495.]. Copyright 2017, SLACK Incorporated.

  10. Comparison of higher order aberrations after wavefront-guided LASIK and PRK: One year follow-up results

    Directory of Open Access Journals (Sweden)

    Seyed Hamid Reza Jahadi Hosseini

    2016-01-01

    Conclusion: For the 6mm pupil size, the total HOA increased following both personalized PRK and LASIK with no significant difference between the two groups. Change of the total HOA RMS was influenced by the preoperative values. The known influencing factors could predict nearly 50% of the changes in total HOA.

  11. Thin-flap laser-assisted in situ keratomileusis.

    Science.gov (United States)

    Slade, Steven G

    2008-07-01

    Concerns regarding the increasing incidence of corneal ectasia following laser in situ keratomileusis procedures, together with increased understanding of the biomechanics of the cornea, has resulted in many refractive surgeons returning to surface ablation techniques such as photorefractive keratectomy. Even if surface ablation techniques offer a higher degree of safety than LASIK, they are associated with more pain and a slower visual recovery in the immediate postoperative period. This highlights the need for alternative procedures that offer the combined advantages of laser in situ keratomileusis and photorefractive keratectomy. Sub-Bowman's keratomileusis is a new procedure that provides the biomechanical stability and associated safety of photorefractive keratectomy with the visual results and reduced pain experience of laser in situ keratomileusis. This technique involves the use of the femtosecond laser to create a customized corneal flap of between 90 and 110 mum with a diameter based on the requirements of the individual patient and the type of excimer laser being used. This review outlines the rationale for sub-Bowman's keratomileusis and describes the efficacy, tolerability and safety of the procedure compared with photorefractive keratectomy.

  12. Evaluation and diffusion of excimer laser treatment of myopia in the United States and in the Netherlands

    NARCIS (Netherlands)

    Vondeling, H.; Rosendal, H.; Banta, D.

    1995-01-01

    Excimer laser photorefractive keratectomy (PRK) is an experimental treatment to correct myopia (short-sightedness) that is diffusing into use without convincing evidence of safety and efficacy. It has been claimed that PRK may render conventional methods of correcting myopia, such as wearing glasses

  13. UTILIZATION OF THE AQUEOUS EXTRACT OF Triticum vulgare (BANDVET® AFTER SUPERFICIAL KERATECTOMY IN DOMESTIC CATS AFFLICTED WITH CORNEAL SEQUESTRUM. UTILIZAÇÃO DO EXTRATO AQUOSO DE Triticum vulgare (BANDVET® APÓS CERATECTOMIA SUPERFICIAL EM SEQÜESTRO CORNEAL FELINO

    Directory of Open Access Journals (Sweden)

    José Luiz Laus

    2008-10-01

    Full Text Available

    Corneal sequestrum is an affliction of cats, which is not well defined. The lesion is characterized by degeneration of collagen, followed by accumulation in the cornea of a darkened pigment of variable intensity. Various treatments are adopted taking into account the depth and stage of the lesion, where lamellar keratectomy is the option most often taken. In the present work, four cases are described of Persian breed cats afflicted with corneal sequestrum, that were submitted to lamellar keratectomy followed by third eyelid flap or conjunctival pedicle flap, and afterward treated topically with the aqueous extract of Triticum vulgare (Bandvet®, without adverse effects. The results obtained showed that Bandvet®, despite that it is a pharmaceutical not for ophthalmic use, can be employed in cats after superficial keratectomy.

    KEY WORDS: Corneal sequestrum, feline, keratectomy, Triticum vulgare

    De causa não bem definida, o seqüestro de córnea é uma afecção que incide sobre os felinos. A lesão caracteriza-se pela degeneração do colágeno, seguida de acúmulo de pigmento enegrecido, de intensidade variável, na córnea. As alternativas terapêuticas são adotadas levando-se em conta a profundidade e o estágio da lesão, sendo a ceratectomia lamelar a opção mais utilizada. No presente trabalho, descrevem-se quatro casos de felinos da raça Persa acometidos por seqüestro de córnea, que foram submetidos à ceratectomia lamelar seguida de flap de terceira pálpebra ou de enxerto pediculado de conjuntiva e, posteriormente, tratados com extrato aquoso de Triticum vulgare (Bandvet®, topicamente, sem resultados adversos. Os resultados obtidos mostraram que o Bandvet®, a despeito de não se tratar de fármaco para uso oftálmico, pode ser empregado em felinos ap

  14. Diamond burr superficial keratectomy in the treatment of visually-significant anterior corneal lesions Ceratectomia superficial com broca de diamante no tratamento de lesões anteriores da córnea

    Directory of Open Access Journals (Sweden)

    João Baptista Nigro Santiago Malta

    2008-06-01

    Full Text Available PURPOSE: To evaluate the efficacy and safety of diamond burr superficial keratectomy in the treatment of visually-significant anterior corneal lesions. METHODS: A retrospective review of 23 eyes (23 patients. Pre- and postoperative visual acuities and refractions, slit-lamp biomicroscopic findings, and the incidence of recurrence of disease after keratectomy were studied. RESULTS: Nineteen eyes had map-dot-fingerprint basement membrane dystrophy and 4 had Salzmann's nodular degeneration. All patients presented with decreased vision, as well as varying degrees of glare, halos, and monocular diplopia. Postoperative follow-up ranged from 3 to 39 months (mean 10.6 months, and no recurrence of the original disease occurred within this period. This procedure improved the best-corrected visual acuity from 20/36 (LogMar 0.250 to 20/24 (LogMar 0.076 by LogMar statistical evaluation (pOBJETIVO: Avaliar a eficácia e segurança da ceratectomia superficial com broca de diamante no tratamento das lesões anteriores da córnea. MÉTODOS: Foi realizado estudo retrospectivo de 23 olhos de 23 pacientes. Foram avaliados acuidade visual e refração pré e pós-operatório, biomicroscopia e incidência de recorrência da doença após ceratectomia. RESULTADOS: Dos 23 olhos avaliados, 19 olhos apresentavam distrofia da membrana basal (map-dot-fingerprint e 4 degeneração nodular de Salzmann. Todos os pacientes apresentavam diminuição da acuidade visual, assim como graus variados de ofuscamento, halos e diplopia monocular. O seguimento pós-operatório variou entre 3 e 39 meses (média de 10,6 meses e não houve recorrência da doença original nesse período. O procedimento melhorou a acuidade visual com melhor correção de 20/36 (LogMar 0,250 para 20/24 (LogMar 0,076 com p<0,001. Em relação as mudanças refracionais não houve significância (p=0,232 sendo o equivalente esférico pré-operatório de - 0,36 ± 2,28DE e pós-operatório de -0,71 ± 2,26DE. As

  15. Topical 1% Nalbuphine on corneal sensivity and epitheilization after experimental lamellar keratectomy in rabbits Nalbufina 1% tópica sobre a sensibilidade e a epitelização corneal após ceratectomia lamelar experimental

    Directory of Open Access Journals (Sweden)

    Miguel Ladino Silva

    2012-04-01

    Full Text Available The present study was aimed to evaluate the effects of topical 1% nalbuphine on corneal sensitivity and re-epithelialization, after lamellar keratectomy in rabbits. All protocols were approved by the Animal Care Comission of São Paulo State University (Protocol 028793-08 and were conducted in accordance with the Institutional Animal Committee and the Association for Research in Vision and Ophthalmology (ARVO statement for the use of animals in research. Surgeries were performed on the left eye (Nalbuphine Group and on the right eye (Control Group. Two groups were formed (n=10 and corneas received either 30µl of 1% nalbuphine (NG or 30µl of 0,9% saline (CG. Treatments occurred at 7, 11, 15 and 19 hours. After the surgery, the corneas were stained with fluorescein and photographed daily; corneal touch threshold (CTT was assessed with Cochet-Bonnet aesthesiometer, at 7 and 19 hours, 20 minutes after treatments. Data were statistically compared with repeated measures ANOVA and Bonferroni post-hoc test, and T test (P0.05; however, a higher area under the curve for both parameters was observed in the NG (2771, in comparison to CG (2164. Topical 1% nalbuphine did not change significantly corneal sensitivity and re-epithelialization, after experimental lamellar keratectomy in rabbits.Avaliaram-se os efeitos da nalbufina 1% sobre o limiar de sensibilidade corneal (LSC e a epitelização corneal em coelhos submetidos à ceratectomia lamelar unilateral. Os procedimentos foram aprovados pela Comissão de Ética no Uso de Animais da Faculdade de Ciências Agrarias e Veterinárias da Universidade Estadual Paulista (Protocolo no 028793-08, de acordo com as normas do Institutional Animal Committee and the Association for Research in Vision and Ophthalmology (ARVO. Conceberam-se dois grupos (n=10 e os olhos foram tratados com 30µl de Nalbufina 1% (Olho esquerdo - GN ou com 30µl de solução salina (Olho direito - GC, às 7, 11, 15 e 19 horas das

  16. Epilasik versus Lasek con queratectomía refractiva optimizada y ablación customizada por topografía Epilasik versus Lasek with optimized refractive keratectomy and topography-customized ablation

    Directory of Open Access Journals (Sweden)

    Raúl Gabriel Pérez Suárez

    2010-06-01

    , disminuyeron la esfera y el cilindro promedio de forma muy similar. La variación de la aberración esférica y el coma en ambas técnicas no fue significativa. Se recuperaron más rápidamente, desde el punto de vista anatómico, los ojos operados con la técnica de Epilasik.OBJECTIVE: To assess the effectiveness of Excimer laser surgery, using either epithelial laser in situ keratomileusis (Epilasik or laser-assisted epithelial keratectomy as surgical techniques, on the basis of a topoaberrometric study of patients with compound myopic astigmatism. METHODS: A prospective study was conducted in the Anterior Segment Service of "Camilo Cienfuegos" International Center of Pigmentary Retinitis. Eighty eyes from 40 patients with compound myopic astigmatism (-1 to -6 dioptres were studied, with a minimal follow-up of 6 months. Visual acuity without correction, keratometry, dynamic refraction, cycloplexic refraction, corneal topography, pachymetry, tonometry, biomicroscopy, study of the tear and funduscopy were all evaluated. The corneal waterfront analysis software was used for all the cases. Lasek was the chosen technique for right eyes whereas Epilasik was used for left eyes, using optimized refractive keratectomy in both procedures. RESULTS: In those cases treated with Lasek technique, visual acuity without correction changed from 0,12 to 0,93; preoperative sphere average changed -2,77 to -0,08 dioptres at the postoperative phase, the cylinder went from -79 to -0,37 dioptres, spheral aberration at 6mm slightly changed from 0,22 to 0,24 um and the coma varied from 0,19 to 0,20 um. In the cases subjected to Epilasik, visual acuity without correction varied from 0,07 to 0,93; the preoperative sphere average modified from -3,79 to 0,01 dioptres in the postoperative period, the cylinder went from -1,25 to -0,35 dioptres, spheral aberration at 6mm changed from 0,26 to 0,39 um, and the coma varied from 0,19 to 0,22 um. As to confocal microscopy, it was observed that recovery was faster

  17. Four-year to seven-year outcomes of advanced surface ablation with excimer laser for high myopia

    DEFF Research Database (Denmark)

    Hansen, Rasmus Søgaard; Lyhne, Niels; Grauslund, Jakob

    2015-01-01

    Purpose: To evaluate and compare long-term outcomes ofafter photorefractive keratectomy with cooling (cPRK) and laser-assisted subepithelial keratectomy (LASEK) for high myopia. Methods: Retrospective single-masked follow-up study of patients treated for myopia between 2007 and 2009 with c...... ±1.0 D of intended refraction. Finally, 100% of cPRK patients and 92% of LASEK patients (P=0.87) were satisfied or very satisfied with the surgery at final follow-up. Conclusion: cPRK and LASEK seemed safe and with high patient satisfaction 4 to 7 years after surgery for high myopia. However, c...

  18. Indications, results, and complications of refractive corneal surgery with mechanical methods.

    Science.gov (United States)

    Hoffmann, F; Schüler, A

    1995-08-01

    Radial keratotomy (RK) incisions permanently weaken the cornea. This structural weakening can cause several complications and side effects, including diurnal fluctuation, progressive hyperopic shift, and the potential for traumatic rupture of the keratotomy scars. Minimally invasive-RK may be a useful alternative to reduce the invasiveness of RK while retaining its efficacy. Mild myopia can be treated by either RK or photorefractive keratectomy. Patients treated by RK in the first eye and photorefractive keratectomy in the second eye preferred the speed of recovery and the clarity of vision with RK. Combining the microkeratome and the excimer laser appears to be an ideal technique to correct high myopia. Laser ablation of the corneal lenticule while securely fixed by the suction ring in the Berlin microkeratome offers the advantage of perfect centration and fixation. Hexagonal keratotomy, used to treat hyperopia, appears to be an unpredictable, unsafe surgical procedure.

  19. Customized finite element modelling of the human cornea

    OpenAIRE

    Irene Simonini; Anna Pandolfi

    2015-01-01

    Aim To construct patient-specific solid models of human cornea from ocular topographer data, to increase the accuracy of the biomechanical and optical estimate of the changes in refractive power and stress caused by photorefractive keratectomy (PRK). Method Corneal elevation maps of five human eyes were taken with a rotating Scheimpflug camera combined with a Placido disk before and after refractive surgery. Patient-specific solid models were created and discretized in finite elements to esti...

  20. Wound healing after keratorefractive surgery: review of biological and optical considerations.

    Science.gov (United States)

    Azar, Dimitri T; Chang, Jin-Hong; Han, Kyu Yeon

    2012-11-01

    The introduction of the excimer laser for keratorefractive surgery in the 1990 s permanently reshaped the treatment landscape for correcting refractive errors, such as myopia, hyperopia, and astigmatism. Until that point, these treatments had relied on less predictable techniques, such as radial keratotomy and automated lamellar keratectomy. In recent years, other new technologies, along with increased understanding of the basic science of refractive errors, higher-order aberrations, biomechanics, and the biology of corneal wound healing, have allowed for a reduction in the surgical complications of keratorefractive surgery. Novel technologies, such as eye tracking, anterior segment imaging, the femtosecond laser, and asphericity-optimized and wavefront-guided custom laser in situ keratomileusis, have assisted refractive surgeons in achieving greater predictability of their laser vision correction procedures. Understanding the cascade of events involved in the corneal wound healing process and examination of how corneal wound healing influences corneal biomechanics and optics are crucial to improve the efficacy and safety of laser vision correction.

  1. NonLinear Effects in Photorefractive Crystals

    Science.gov (United States)

    1988-01-01

    f.( I F-cT iJ, MS THESIS LE -oT0 -, (LNCl"\\ V Cil -y IAL.5 6. PERFORMING O’RG. REPORT NUMBER AU THOR (. ) S. CONTRACT OR GRANT NUMBER(s) OONALI9 f(0s5...virgin-he on wings of love, and she on wings of fear. The Legend of Apollo and Daphne Bullfinch ’s Mythology In Chapter 2 we learned that the phases of

  2. Computer simulation of multiple dynamic photorefractive gratings

    DEFF Research Database (Denmark)

    Buchhave, Preben

    1998-01-01

    The benefits of a direct visualization of space-charge grating buildup are described. The visualization is carried out by a simple repetitive computer program, which simulates the basic processes in the band-transport model and displays the result graphically or in the form of numerical data....... The simulation sheds light on issues that are not amenable to analytical solutions, such as the spectral content of the wave forms, cross talk in three-beam interaction, and the range of applications of the band-transport model. (C) 1998 Optical Society of America....

  3. Development of New Photorefractive Polymer Materials

    Science.gov (United States)

    2015-05-19

    and the Di-OH-C8-PDI (Pery-OH) provided by Dr. Ziolo at Centro de Investigacion en Quimica Aplicada. Figure 19 shows absorbance measurements of the...Additional sensitizers were provided by Dr. Ziolo at Centro de Investigacion en Quimica Aplicada, Fe5PPV and 3BzC60, with molecules

  4. Bifurcating optical pattern recognition in photorefractive crystals

    Science.gov (United States)

    Liu, Hua-Kuang

    1993-01-01

    A concept of bifurcating optical pattern rocognizer (BIOPAR) is described and demonstrated experimentally, using barium titanate crystal. When an input is applied to BIOPAR, the output may be directed to two ports.

  5. Corneal collagen cross-linking (CXL) combined with refractive procedures for the treatment of corneal ectatic disorders: CXL plus.

    Science.gov (United States)

    Kymionis, George D; Grentzelos, Michael A; Portaliou, Dimitra M; Kankariya, Vardhaman P; Randleman, J Bradley

    2014-08-01

    To discuss current combined corneal collagen cross-linking (CXL) and refractive surgical techniques (herein termed "CXL plus") for the treatment of corneal ectatic disorders to improve functional visual acuity in addition to corneal stability from CXL alone. Literature review. Efficacious combined treatments with CXL include: photorefractive keratectomy, transepithelial phototherapeutic keratectomy, intrastromal corneal ring segments implantation, phakic intraocular lens implantation, and multiple combined procedures. Some uncertainty remains as to the optimal strategies for each patient. A decision tree is proposed to facilitate optimal patient management. With multiple adjuvant techniques, CXL plus is likely to benefit many patients with corneal ectatic disorders. The appropriate combined procedure will depend on multiple factors, such as refraction, corneal thickness, and degree of irregular astigmatism. Copyright 2014, SLACK Incorporated.

  6. Static and dynamic cyclotorsion measurement and evaluation of related factors in patients candidates for PRK

    Directory of Open Access Journals (Sweden)

    Mohammadreza Shayegan

    2016-10-01

    Full Text Available To evaluate the degree of static and dynamic cyclotorsion and related factors in patients candidate for photorefractive keratectomy. In this analytic-descriptive study, 400 patients (aged 18-55 years who were candidates for photorefractive keratectomy with laser excimer (zyoptix 100 HZ by a single ophthalmologist in Khatam-al-Anbia Hospital were enrolled. The patients' age, sex, myopic and astigmatism degrees and static and dynamic cyclotorsion degree were measured and registered. Finally, the data was analyzed statistically. 73% of patients (n=146 were female and the mean age of all patients was 29.8±5.7 years (19-49. The mean preoperative sphere and cylinder degree of patients was -3.24±1.72 and -1.06±1.04, respectively. The mean spheric equivalent (SE was -3.78±1.69, the mean total static excyclotorsion and incyclotorsion were 3.81±2.65 (48.5% and - 2.99±2.13 (27.8%, respectively and 23.8% had no static cyclotorsion. The mean dynamic excyclotorsion and incyclotorsion were 3.66±2.65 (65.8% and -2.62±2.13 (27.5%, respectively, and 23% had no dynamic cyclotorsion. There was no significant relationship between static or dynamic cyclotorsion and age and no significant relationship between static cyclotorsion and sex, but women showed higher degrees of dynamic cyclotorsion (P=0.04. Also, sphere and cylinder degree had no significant relationship with cyclotorsion, however, there was a linear significant correlation between static and dynamic cyclotorsion (p=0.05. The amount of dynamic cyclotorsions during photorefractive keratectomy is higher in female and correlate straight with static cyclotorsions.

  7. LASIK and PRK in hyperopic astigmatic eyes: is early retreatment advisable?

    OpenAIRE

    Frings A; Richard G; Steinberg J; Druchkiv V; Linke SJ; Katz T

    2016-01-01

    Andreas Frings,1 Gisbert Richard,1,2 Johannes Steinberg,1,3,4 Vasyl Druchkiv,1,4 Stephan Johannes Linke,1,3,4 Toam Katz1,4 1Department of Ophthalmology, University Medical Centre Hamburg-Eppendorf, 2Ophthalmologikum an der Alster, 3zentrumsehstärke, 4CARE Vision Germany GmbH, Hamburg, Germany Purpose: To analyze the refractive and keratometric stability in hyperopic astigmatic laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) during the first 6 mont...

  8. Advances in Refractive Surgery: June 2014 to July 2015.

    Science.gov (United States)

    Pillar, Angelique; Krueger, Ronald

    2016-05-01

    The objective of this study was to review the advances in the field of refractive surgery as reported in the peer-reviewed literature during the previous year. A literature review. In this review, we highlight the most pertinent articles in the field from June 2014 to the end of July 2015. This past year has seen a growing body of research on small-incision lenticule extraction, presbyopic inlays, and phakic intraocular lenses, as more clinicians are adopting these techniques into their armamentarium. Laser-assisted in situ keratomileusis and photorefractive keratectomy continue to dominate the keratorefractive literature, as they remain the most frequently performed refractive surgeries.

  9. Contact lens management of patients who have had unsuccessful refractive surgery.

    Science.gov (United States)

    Zadnik, K

    1999-08-01

    The advent of corneal refractive surgery has, inevitably, resulted in the occasional need for contact lens fitting after surgery. For each new, developing procedure, new contact lens fitting challenges arise. The literature on contact lens use after radial keratotomy is rich and well known, but reports on the use of contact lenses after photorefractive keratectomy or laser-assisted in situ keratomileusis are few and far between. This review summarizes the prevailing clinical opinions on the contact lenses and contact lens fitting methods that are most effective after refractive surgery that results in high refractive error, irregular astigmatism, or anisometropia.

  10. Visual stability of laser vision correction in an astronaut on a Soyuz mission to the International Space Station.

    Science.gov (United States)

    Gibson, C Robert; Mader, Thomas H; Schallhorn, Steven C; Pesudovs, Konrad; Lipsky, William; Raid, Elias; Jennings, Richard T; Fogarty, Jennifer A; Garriott, Richard A; Garriott, Owen K; Johnston, Smith L

    2012-08-01

    This report documents the effects of photorefractive keratectomy (PRK) in an astronaut during a 12-day Russian Soyuz mission to the International Space Station in 2008. Changing environmental conditions of launch, microgravity exposure, and reentry create an extremely dynamic ocular environment. Although many normal eyes have repeatedly been subject to such stresses, the effect on an eye with a relatively thin cornea as a result of PRK has not been reported. This report suggests that PRK is a safe, effective, and well-tolerated procedure in astronauts during space flight. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. All rights reserved.

  11. Efficient ultraviolet photorefraction in LiNbO3

    Science.gov (United States)

    Jungen, R.; Angelow, G.; Laeri, F.; Grabmaier, C.

    1992-07-01

    A nominally undoped LiNbO3 crystal with a slightly broadened absorption edge is used to study beam coupling effects in the UV at 351 nm. At this wavelength the crystal exhibits a diffusion-dominated charge transport mechanism, which allows steady state beam amplification of up to 700 times, comparable to BaTiO3 in the visible. The used crystal material was characterized by an absorption coefficient α=2.68 cm-1 at 351 nm and a maximal gain coefficient Г=13.94 cm-1. This high gain value in the UV can be attributed to a hole diffusion-dominated charge transport mechanism together with a low bulk photovoltaic effect. We measured photovoltaic fields of the order of 550 V/cm.

  12. Wave-mixing solitons in bulk photorefractive crystals

    Science.gov (United States)

    Bugaychuk, S. A.; Kovács, Laszlo; Mandula, Gabor; Polgár, Katalin; Rupp, Romano A.

    2003-12-01

    Instead of unstable solutions for conventional four-wave mixing equation set, we obtain the stationary soliton solution for the dynamic grating amplitude and stable auto-oscillations of the dynamic grating. The dynamics of grating recording is described by the sine-Gordon equations in transmission four-wave mixing with non-local grating. The method to calculate the grating amplitude profile and the both steady state and oscillation regimes is developed.

  13. Stimulated Scattering and Phase Conjugation in Photorefractive Materials

    Science.gov (United States)

    1992-01-31

    part of this article on the beaches of that store three-dimensional images. tive materials, light beams as weak as Hawaii and simultaneously...closer look at current- promises Britain account imbalances 59 THIS WEEK 61 Worries about the trade deficit s " -a . hu bl m. h fr.d. Hoq q im . 0 1251...Big-Bang cosmology receptor tailore, to a spe- thinks that the fam:ls, could and has risen through working on basic re- cific odorant. then the

  14. Temporal accommodation response measured by photorefractive accommodation measurement device

    Science.gov (United States)

    Song, Byoungsub; Leportier, Thibault; Park, Min-Chul

    2017-02-01

    Although accommodation response plays an important role in the human vision system for perception of distance, some three-dimensional (3D) displays offer depth stimuli regardless of the accommodation response. The consequence is that most observers watching 3D displays have complained about visual fatigue. The measurement of the accommodation response is therefore necessary to develop human-friendly 3D displays. However, only few studies about accommodation measurement have been reported. Most of the investigations have been focused on the measurement and analysis of monocular accommodation responses only because the accommodation response works individually in each eye. Moreover, a main eye perceives dominantly the object distance. However, the binocular accommodation response should be examined because both eyes are used to watch the 3D display in natural conditions. The ophthalmic instrument that we developed enabled to measure changes in the accommodation response of the two eyes simultaneously. Two cameras acquired separately the infrared images reflected from each eyes after the reflected beams passed through a cylindrical lens. The changes in the accommodation response could then be estimated from the changes in the astigmatism ratio of the infrared images that were acquired in real time. In this paper, we compared the accommodation responses of main eye between the monocular and the binocular conditions. The two eyes were measured one by one, with only one eye opened, during measurement for monocular condition. Then the two eyes were examined simultaneously for binocular condition. The results showed similar tendencies for main eye accommodation response in both cases.

  15. Development of a new photorefractive and photovoltaic potassium niobate crystal

    Science.gov (United States)

    Evans, D. R.; Basun, S. A.; Seim, J. M.

    2005-03-01

    Photovoltaic measurements have been made on a new doped potassium niobate crystal that yields significantly larger photovoltaic fields than other doped potassium niobate crystals. Contra-directional two-beam coupling efficiencies and Raman spectroscopy measurements have also been conducted, which show major differences with respect to the published results for other doped potassium niobate materials.

  16. Crosstalk in dynamic optical interconnects in photorefractive crystals

    DEFF Research Database (Denmark)

    Andersen, Peter E.; Petersen, Paul Michael; Buchhave, Preben

    1994-01-01

    switch off one of the gratings. The crosstalk between the two gratings is experimentally determined from the diffraction efficiency in the remaining grating before and after applying the phase shift. The magnitude of the crosstalk is determined by the intensity ratio between the reference beam intensity...

  17. Transfer of temporal fluctuations in photorefractive two-beam coupling

    DEFF Research Database (Denmark)

    Juul Jensen, S.; Saffman, M.

    1997-01-01

    of perturbations is frequency dependent at low frequencies, and becomes constant at frequencies large compared to the inverse material time constant. Vde discuss the possibility of pump noise suppression when amplifying weak signals. (C) 1997 American Institute of Physics....

  18. Diffusion-trapped Airy beams in photorefractive media.

    Science.gov (United States)

    Jia, Shu; Lee, Joyce; Fleischer, Jason W; Siviloglou, Georgios A; Christodoulides, Demetrios N

    2010-06-25

    We report the first experimental observation of self-trapped Airy beams in a nonlinear medium. As opposed to screening or photovoltaic spatial solitons, this new class of self-localized beams owes its existence to carrier diffusion effects. The asymmetric action of two-wave mixing supports the asymmetric intensity profile of the Airy states, with a balance that is independent of the beam intensity (unlike solitons). Further, the self-trapped wave packets self-bend during propagation at an acceleration rate that is independent of the thermal energy associated with the diffusive nonlinearity.

  19. A Comparison of the American Society of Cataract and Refractive Surgery post-myopic LASIK/PRK Intraocular Lens (IOL calculator and the Ocular MD IOL calculator

    Directory of Open Access Journals (Sweden)

    Hsu M

    2011-09-01

    Full Text Available David L DeMill1, Majid Moshirfar1, Marcus C Neuffer1, Maylon Hsu1, Shameema Sikder21John A Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 2Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USABackground: To compare the average values of the American Society of Cataract and Refractive Surgery (ASCRS and Ocular MD intraocular lens (IOL calculators to assess their accuracy in predicting IOL power in patients with prior laser-in-situ keratomileusis (LASIK or photorefractive keratectomy.Methods: In this retrospective study, data from 21 eyes with previous LASIK or photorefractive keratectomy for myopia and subsequent cataract surgery was used in an IOL calculator comparison. The predicted IOL powers of the Ocular MD SRK/T, Ocular MD Haigis, and ASCRS averages were compared. The Ocular MD average (composed of an average of Ocular MD SRK/T and Ocular MD Haigis and the all calculator average (composed of an average of Ocular MD SRK/T, Ocular MD Haigis, and ASCRS were also compared. Primary outcome measures were mean arithmetic and absolute IOL prediction error, variance in mean arithmetic IOL prediction error, and the percentage of eyes within ±0.50 and ±1.00 D.Results: The Ocular MD SRK/T and Ocular MD Haigis averages produced mean arithmetic IOL prediction errors of 0.57 and –0.61 diopters (D, respectively, which were significantly larger than errors from the ASCRS, Ocular MD, and all calculator averages (0.11, –0.02, and 0.02 D, respectively, all P < 0.05. There was no statistically significant difference between the methods in absolute IOL prediction error, variance, or the percentage of eyes with outcomes within ±0.50 and ±1.00 D.Conclusion: The ASCRS average was more accurate in predicting IOL power than the Ocular MD SRK/T and Ocular MD Haigis averages alone. Our methods using combinations of these averages which, when compared with the individual averages, showed a trend of decreased mean arithmetic IOL

  20. Validade da topografia de córnea na cirurgia refrativa com excimer laser Validity of corneal topography in refractive surgery with excimer laser

    Directory of Open Access Journals (Sweden)

    Orlando da Silva Filho

    2003-12-01

    Full Text Available OBJETIVO: Avaliar os resultados refracionais e a segurança do procedimento cirúrgico PRK (ceratectomia fotorrefrativa com base na topografia de córnea no pré-operatório. MÉTODOS: Participantes - 44 sujeitos que tinham realizado cirurgia refrativa, com o procedimento ceratectomia fotorrefrativa, os quais apresentaram topografias irregulares pré-operatórias. O grupo controle consistiu de 44 sujeitos com topografia regular pré-operatória. Os 88 olhos foram submetidos a ceratectomia fotorrefrativa utilizando-se o "Summit Apex plus Excimer Laser". As topografias irregulares e regulares foram obtidas pelo "Corneal Analysis System"(EyeSys, sendo consideradas como topografias irregulares os seguintes achados: ápice deslocado acima de 1,5 D (AD, asfericidade maior que 0,25 D/mm (AS, obliquidade maior que 15 graus (OB, assimetria inferior-superior igual ou maior que 1,5 D (IS, curvatura maior que 47 D (CU e combinação de 2 critérios (CB. Principal efeito medido: perda de uma ou mais linhas que foram definidas com segurança para o prognóstico. RESULTADOS: Todos os pacientes foram acompanhados por 6 meses. Verificou-se perda significativa de acuidade visual corrigida em pacientes submetidos ao procedimento PRK-AD (pPURPOSE: To evaluate the refractive results and safety of PRK (photorefractive keratectomy based on the preoperative corneal topography. METHODS: 44 operated eyes, using the photorefractive keratectomy process, and which presented preoperative topographical abnormalities. The control group consisted of 44 eyes with preoperative normal corneal topography. Eighty-eight eyes were submitted to the photorefractive keratectomy process using the Summit Apex plus Excimer Laser. Corneal topographies were accessed by the EyeSys Analysis system; the topographic abnormalities which were considered are the following: apex displacement above 1.5D (AD, asphericity above 0.25D/mm (AS, obliquity above 15 degrees (OB, inferior-superior asymmetry

  1. Managing residual refractive error after cataract surgery.

    Science.gov (United States)

    Sáles, Christopher S; Manche, Edward E

    2015-06-01

    We present a review of keratorefractive and intraocular approaches to managing residual astigmatic and spherical refractive error after cataract surgery, including laser in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), arcuate keratotomy, intraocular lens (IOL) exchange, piggyback IOLs, and light-adjustable IOLs. Currently available literature suggests that laser vision correction, whether LASIK or PRK, yields more effective and predictable outcomes than intraocular surgery. Piggyback IOLs with a rounded-edge profile implanted in the sulcus may be superior to IOL exchange, but both options present potential risks that likely outweigh the refractive benefits except in cases with large residual spherical errors. The light-adjustable IOL may provide an ideal treatment to pseudophakic ametropia by obviating the need for secondary invasive procedures after cataract surgery, but it is not widely available nor has it been sufficiently studied. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  2. Advances in Refractive Surgery.

    Science.gov (United States)

    Wang, Li; Moss, Hart; Ventura, Bruna V; Padilha, Henrique; Hester, Christian; Koch, Douglas D

    2013-01-01

    The objective of this study was to review advances in the field of refractive surgery as reported in the peer-reviewed literature over the previous year. This was a literature review. We conducted a PubMed search for terms related to refractive surgery and reviewed prominent international ophthalmic journals published from May 2012 through April 2013. All pertinent articles were reviewed, and selected articles with the greatest relevance were included. Many studies over the previous year have highlighted progress in the field of refractive surgery; topics included keratoconus screening, photorefractive keratectomy and laser in situ keratomileusis, corneal cross-linking, small-incision lenticule extraction, phakic intraocular lenses, corneal inlays, presbyopic corneal treatments, and femtosecond laser-assisted astigmatic keratotomy. The field of refractive surgery continues to provide exciting developments. Improvements in established procedures and promising new surgical options make the current climate an appealing one for refractive surgeons and patients.

  3. Pediatric refractive surgery: corneal and intraocular techniques and beyond.

    Science.gov (United States)

    Paysse, Evelyn A; Tychsen, Lawrence; Stahl, Erin

    2012-06-01

    Refractive surgery has now been used successfully to treat severe anisometropia and isoametropia associated with amblyopia in children who cannot wear standard spectacles or contact lenses. Extraocular techniques include photorefractive keratectomy, laser-assisted subepithelial keratomileusis, and laser-assisted in situ keratomileusis. Intraocular techniques include refractive lensectomy and phakic intraocular lenses and are still being investigated in children for refractive errors outside the treatment dose capabilities of the excimer laser. This workshop discusses the various techniques, how and when to use each, and their risks and benefits. Newer techniques currently being used in adults that may someday be used in children are also introduced. Copyright © 2012 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  4. The effect of 193 nm excimer laser radiation on the human corneal endothelial cell density

    Energy Technology Data Exchange (ETDEWEB)

    Isager, P.; Hjortdal, J.Oe.; Ehlers, N. [Aarhus Univ. Hospital, Dept. of Ophthalmology, Aarhus (Denmark)

    1996-06-01

    The effect of 193 nm excimer laser radiation on human corneal endothelial cell density was examined. Fifty-five eyes from 35 patients underwent photorefractive keratectomy for myopia. Photomicrographs of the endothelium were taken a short time before the operation and on an average of 7 months postoperatively with a specular microscope. The average endothelial cell densities were preoperatively 3375 {+-} 266 cells/mm{sup 2} (means {+-} SD) and postoperatively 3348 {+-} 287 cells/mm{sup 2}, corresponding to a fall of 27 cells/mm{sup 2} (N = 55). This fall in endothelial cell density was not statistically significant. A significant correlation between the change in cell density and age of the patient was found, with older patients losing more cells (N = 35, 2p < 0.05). The magnification of the specular microscope was found to change with corneal thickness. The importance of correcting the endothelial cell densities for corneal thickness is discussed. (au) 14 refs.

  5. Keratoconus: current perspectives

    Science.gov (United States)

    Vazirani, Jayesh; Basu, Sayan

    2013-01-01

    Keratoconus is characterized by progressive corneal protrusion and thinning, leading to irregular astigmatism and impairment in visual function. The etiology and pathogenesis of the condition are not fully understood. However, significant strides have been made in early clinical detection of the disease, as well as towards providing optimal optical and surgical correction for improving the quality of vision in affected patients. The past two decades, in particular, have seen exciting new developments promising to alter the natural history of keratoconus in a favorable way for the first time. This comprehensive review focuses on analyzing the role of advanced imaging techniques in the diagnosis and treatment of keratoconus and evaluating the evidence supporting or refuting the efficacy of therapeutic advances for keratoconus, such as newer contact lens designs, collagen crosslinking, deep anterior lamellar keratoplasty, intracorneal ring segments, photorefractive keratectomy, and phakic intraocular lenses. PMID:24143069

  6. A review of corneal diameter, curvature and thickness values and influencing factors*

    Directory of Open Access Journals (Sweden)

    K. P. Mashige

    2013-12-01

    Full Text Available The cornea is an important ocular structure involved in the mediation of visual perception. It is the principal refractive surface of the eye and vision can be significantly affected by relatively small changes in its structure and parameters. Measurement of corneal parameters is important in the diagnosis and management of ocular diseasessuch as keratoconus and glaucoma, and also in the fitting of contact lenses or with refractive surgery such as Laser-Assisted in situ Keratomileusis(LASIK and photorefractive keratectomy (PRK. The human corneal diameter, anterior curvature and centre thickness as well as factors influencing them are reviewed in this article. This review will be useful to eye care professionals who routinely measure these parameters when fitting contact lenses and assessing, diagnosing as well as managing corneal and other ocular conditions. (S Afr Optom 2013 72(4 185-194

  7. Microbiologic Examination of Bandage Contact Lenses Used after Corneal Collagen Cross-linking Treatment.

    Science.gov (United States)

    Yuksel, Erdem; Yalcin, Nuriye Gokçen; Kilic, Gaye; Cubuk, Mehmet Ozgur; Ozmen, Mehmet Cuneyt; Altay, Aylin; Çağlar, Kayhan; Bilgihan, Kamil

    2016-01-01

    To investigate the agents of bacterial contamination of contact lenses after corneal collagen cross-linking (CCL), and to present the possible changes of ocular flora after riboflavin/ultraviolet A. Seventy-two contact lenses of patients who underwent CCL and 41 contact lenses of patients who underwent photorefractive keratectomy (PRK) as control group were enrolled to the study. After 48 h of incubation, broth culture media was transferred to plates. Samples were accepted as positive if one or more colony-forming units were shown. There were positive cultures in 12 (16.7%) contact lenses in the CCL group and 5 (12.2%) had positive cultures in PRK group. Coagulase-negative staphlycocci (CNS) were the most frequent microorganism. Alpha hemolytic streptococci and Diphteroid spp. were the other isolated microorganisms. Bacterial colonization can occur during and early after the CCL procedure in epithelial healing. To prevent corneal infections after the treatment, prophylactic antibiotics should be prescribed.

  8. Cinemakeratography using computer morphing.

    Science.gov (United States)

    Smolek, M K; Klyce, S D

    1997-11-01

    TMS-1 videokeratography (Tomey Technologies, Inc.) was animated using computer morphing to visualize corneal shape change over time. Morphing was performed using keratoconus (8 examinations/76 months) and postoperative photorefractive keratectomy (PRK) corneas (8 examinations/37 months; LSU PRK Phase IIa). In the keratoconus animation, the inferior cone increased curvature, but not equally in all directions, nor at a constant rate. The cone apex did not drift over time. Periodic flattening and steepening was observed superiorly, as well as cone regression at month 76. The Keratoconus Prediction Index (KPI) at month 0 was 0.18, plateaued at 0.36 at month 46, and dropped to 0.33 at month 76. In the post-PRK animation there was continuous corneal remodeling out to 30 months. Fluctuating steep and flat regions of the ablation zone correlated with the Surface Regularity Index (SRI). Cinemakeratography (Cinema-K) enhanced our appreciation of subtle changes in corneal topography.

  9. Mitomycin C: biological effects and use in refractive surgery.

    Science.gov (United States)

    Santhiago, Marcony R; Netto, Marcelo V; Wilson, Steven E

    2012-03-01

    To provide an overview of the safety and efficacy of mitomycin C (MMC) as adjuvant therapy after refractive surgery procedures. Literature review. Over the past 10 years, MMC has been used by refractive surgeons to prophylactically decrease haze after surface ablation procedures and therapeutically in the treatment of preexisting haze. Development of MMC treatments has had a significant role in the revival of surface ablation techniques. We reviewed the literature regarding mechanism of action of MMC, its role in modulating wound healing after refractive surgery, and its safety and efficacy as adjuvant therapy applied after primary photorefractive keratectomy surgery or after photorefractive keratectomy re-treatment after laser in situ keratomileusis and other corneal surgeries and disorders. The drug is a potent mitotic inhibitor that effectively blocks keratocyte activation, proliferation, and myofibroblast differentiation. Many studies have suggested that MMC is safe and effective in doses used by anterior surface surgeons, although there continue to be concerns regarding long-term safety. After initial depletion of anterior keratocytes, keratocyte density seems to return to normal 6 to 12 months after the use of MMC when corneas are examined with the confocal microscope. Most clinical studies found no difference between preoperative and postoperative corneal endothelial cell densities when MMC 0.02% was applied during refractive surgery, with exposure time of 2 minutes or less. After more than 10 years of use, MMC has been found to be effective when used for prevention and treatment of corneal haze. Questions remain regarding optimal treatment parameters and long-term safety.

  10. Simultaneous topography-guided PRK followed by corneal collagen cross-linking after lamellar keratoplasty for keratoconus

    Directory of Open Access Journals (Sweden)

    Spadea L

    2012-11-01

    Full Text Available Leopoldo Spadea,1 Marino Paroli21University of L’Aquila, Department of Biotechnological and Applied Clinical Sciences, Eye Clinic, L’Aquila, 2La Sapienza University, Department of Biotechnology and Medical-Surgical Sciences, Latina, ItalyBackground: The purpose of this paper is to report the results of using combined treatment of customized excimer laser-assisted photorefractive keratectomy (PRK and prophylactic corneal collagen crosslinking (CXL for residual refractive error in a group of patients who had previously undergone lamellar keratoplasty for keratoconus.Methods: The study included 14 eyes from 14 patients who had originally been treated for keratoconus in one eye by excimer laser-assisted lamellar keratoplasty (ELLK, and subsequently presented with residual ametropia (-6.11 D ± 2.48, range -2.50 to -9.50. After a mean 40.1 ± 12.4 months since ELLK they underwent combined simultaneous corneal regularization treatment with topographically guided transepithelial excimer laser PRK (central corneal regularization and corneal CXL induced by riboflavin-ultraviolet A.Results: After a mean 15 ± 6.5 (range 6–24 months, all eyes gained at least one Snellen line of uncorrected distance visual acuity (range 1–10. No patient lost lines of corrected distance visual acuity, and four patients gained three lines of corrected distance visual acuity. Mean manifest refractive spherical equivalent was -0.79 ± 2.09 (range +1 to -3.0 D, and topographic keratometric astigmatism was 5.02 ± 2.93 (range 0.8–8.9 D. All the corneas remained clear (haze < 1.Conclusion: The combination of customized PRK and corneal CXL provided safe and effective results in the management of corneal regularization for refractive purposes after ELLK for keratoconus.Keywords: corneal collagen crosslinking, excimer laser-assisted lamellar keratoplasty, photorefractive keratectomy

  11. The role of topical vitamin A in promoting healing in surface refractive procedures: a prospective randomized controlled study

    Directory of Open Access Journals (Sweden)

    Chelala E

    2013-09-01

    Full Text Available Elias Chelala,1 Ali Dirani,1 Ali Fadlallah,1 Sharbel Fahd21Saint Joseph University, Faculty of Medicine, Beirut, Lebanon; 2Ophthalmic Consultant of Beirut, Chairman Ophthalmology, Lebanese American University, Beirut, LebanonAim: To evaluate the effect of topical vitamin A supplementation on corneal re-epithelialization time, postoperative pain, visual acuity, and haze following photorefractive keratectomy (PRK.Patients and methods: This prospective study included 32 patients. For each patient, one eye was randomized to the vitamin A group and the fellow eye to the non-vitamin A group (control group. Eyes in the vitamin A group received perioperative topical vitamin A (retinol palmitate, 250 IU/g VitAPOS eye ointment [AFT Pharmaceuticals Pty, Ltd, Sydney, NSW, Australia] in addition to the classic treatment for PRK. Clinical outcomes were evaluated up to 3 months after PRK.Results: There was no difference in the mean time to complete healing between the vitamin A group and the control group (3.36 ± 0.6 days in the control group; 3.42 ± 0.7 days in the vitamin A group; P = 0.854. Mean postoperative pain at the 48-hour visit was 4.35 ± 1.42 over 10 in the control group, and 4.42 ± 1.37 over 10 in the vitamin A group, with no difference between the two groups (P = 0.589. Subepithelial haze evaluated at 3 months postoperatively did not differ between the two groups (P = 0.960. Also, visual and refractive outcomes were not different between the two groups 3 months postoperatively.Conclusion: Topical vitamin A supplementation did not affect re-epithelialization time, postoperative pain, corneal haze formation, or visual outcomes after PRK.Keywords: photorefractive keratectomy, topical vitamin A, corneal re-epithelialization

  12. Comparison of clinical outcomes in PRK with a standard and aspherical optimized profile: a full case analysis of 100 eyes with 1-year follow-up

    Directory of Open Access Journals (Sweden)

    Dausch D

    2014-11-01

    Full Text Available Dieter Dausch,1,2 Burglinde Dausch,2 Matthias Wottke,3 Georg Sluyterman van Langeweyde31Chung-Ang University, Seoul, South Korea; 2Augen-Laser-Klinik Nürnberg, Nuremberg, Germany; 3Carl Zeiss Meditec AG, Jena, Germany Purpose: 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.Methods: Fifty myopic eyes with a manifest refraction spherical equivalent (MRSE between -1.0 diopters (D and -9.75 D were consecutively treated with photorefractive keratectomy 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.Results: 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.Conclusion: 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. Keywords: aberration smart ablation (ASA, manifest refraction spherical equivalent, Triple-A advanced ablation algorithm, uncorrected distance visual acuity, corrected distance visual acuity, excimer laser, PRK, ablation profile

  13. Comparison of Three Epithelial Removal Techniques in PRK: Mechanical, Alcohol-assisted, and Transepithelial Laser.

    Science.gov (United States)

    Shapira, Yinon; Mimouni, Michael; Levartovsky, Shmuel; Varssano, David; Sela, Tzahi; Munzer, Gur; Kaiserman, Igor

    2015-11-01

    To compare the visual and refractive results obtained after photorefractive keratectomy (PRK) in patients who underwent one of three different epithelial removal techniques. The authors reviewed the medical files of consecutive eyes with myopia and myopic astigmatism that were treated during a 10-year period by mechanical PRK, alcohol-assisted PRK, or transepithelial PRK (in the phototherapeutic keratectomy mode), and observed for more than 1 year. A total of 3,417 patients (3,417 eyes) were included in this study. At 3 and 6 months postoperatively, the outcome of alcohol-assisted PRK was superior both in efficacy (P mechanical PRK and transepithelial PRK, which were similar. At more than 1 year postoperatively, the mean efficacy index was still high for alcohol-assisted PRK, but low for the transepithelial PRK, corresponding to a mean uncorrected visual acuity of more than one Snellen line lower than those of the other two techniques (P refractive results of the three epithelial removal techniques. The long-term outcomes were best for alcohol-assisted PRK. Copyright 2015, SLACK Incorporated.

  14. Refractive surgery after Descemet's stripping endothelial keratoplasty.

    Science.gov (United States)

    Prince, Jessica; Chuck, Roy S

    2012-07-01

    Descemet's stripping endothelial keratoplasty (DSEK) has become a preferred surgical correction for endothelial dysfunction. Patient dissatisfaction secondary to refractive error is emerging as a significant complaint after anatomically successful DSEK. This article reviews refractive surgeries after DSEK to address this problem. There are various surgical options available to treat refractive compromise following DSEK. Cataract extraction with intraocular lens (IOL) implantation is a well tolerated option to restore visual acuity after DSEK in cases with significant lens opacities. Laser in-situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) can otherwise successfully correct simple refractive errors. Phototherapeutic keratectomy (PTK) may be employed in cases wherein visually significant subepithelial fibrosis and scarring become evident after DSEK. To obtain maximum visual rehabilitation, patients undergoing DSEK may require further refractive surgeries. Cataract extraction, LASIK, PRK, PTK, and various combination procedures have been shown to optimize corneal clarity and visual acuity in patients who previously had successful DSEK with subsequent refractive errors. Technological advancements and continued research are necessary to perfect optimal timing and outcomes of these secondary refractive surgeries.

  15. Microbiological examination of bandage soft contact lenses used in laser refractive surgery.

    Science.gov (United States)

    Detorakis, E T; Siganos, D S; Houlakis, V M; Kozobolis, V P; Pallikaris, I G

    1998-01-01

    Disposable soft contact lenses are known to be colonized by bacteria and play a key role in bacterial keratitis pathogenesis. Such lenses, commonly used after laser refractive surgery procedures in which postoperative corneal infiltrations are sometimes observed, are potentially a substrate for bacterial inoculation. This study evaluates the extent of such a contamination. Sixty disposable lenses collected from 60 eyes of patients who underwent photorefractive keratectomy (PRK), photoastigmatic refractive keratectomy (PARK), or laser in situ keratomileusis (LASIK) for the treatment of myopia or hyperopia were collected under sterile conditions over 4 months and cultured in various media. Results were statistically analyzed and the correlation with clinical and epidemiological data was examined. Eleven (18.3%) of the examined lenses were contaminated with Staphylococcus epidermidis. No other bacteria or fungi were found. Contamination was significantly more common among female patients (P = .036). Correlation with the other clinical or operative parameters examined was statistically insignificant. Contamination was independent of the surgical procedure and females who were frequent users of eyelid cosmetics displayed higher contamination frequencies, suggesting that bacteria possibly originate from eyelid flora. The isolation of Staphylococcus epidermidis requires close postoperative surveillance, since it is a known cause of keratitis. Prophylactic postoperative treatment with tobramycin, gentamycin, or sulphonamides could be indicated.

  16. Refractive surgery: the future of perfect vision?

    Science.gov (United States)

    Fong, C S

    2007-08-01

    The history of refractive eye surgery is recent, but has seen rapid advancement. Older technologies, such as radial keratectomy, had the problem of overcorrection and epithelial complications. Newer technologies, such as photorefractive keratectomy, laser-assisted in-situ keratomileusis (LASIK) and laser-assisted subepithelial keratomileusis (LASEK), which require the use of laser, has revolutionised eye surgery. However, there are complications, such as corneal hazing, postoperative pain, regression, and poorer correction for high myopes. If not contraindicated, wavefront analysis and femtosecond laser are useful adjuncts to laser photoablation for better visual results. Wavefront analysis improves the precision of laser photoablation by measuring the individual's wavefront aberrations, while femtosecond laser offers an instrument-free means of creating the corneal hinge. Lastly, implantation of intraocular lenses, with or without extraction of the crystalline lens, provides an alternative to laser photoablation for the treatment of high myopia. Clear lens exchange offers refractive correction to presbyopes and people with cataracts. However, complications, such as endothelial cell loss, cataract formation and retinal detachment, exist. In conclusion, refractive eye surgery provides an alternative to wearing spectacles or contact lenses. However, potential patients must be warned of the complications and long-term effects on the eyes.

  17. Clinical findings and treatments of granular corneal dystrophy type 2 (avellino corneal dystrophy): a review of the literature.

    Science.gov (United States)

    Han, Kyung Eun; Kim, Tae-im; Chung, Woo Suk; Choi, Seung-il; Kim, Bong-yoon; Kim, Eung Kweon

    2010-09-01

    To review the literature about clinical findings and treatments of granular corneal dystrophy type 2 (GCD2). Various literatures on clinical findings, exacerbations after refractive corneal surgery, and treatment modalities of GCD2 were reviewed. GCD2 is an autosomal dominant disease. Mutation of transforming growth factor beta-induced gene, TGFBI, or keratoepithelin gene in human chromosome 5 (5q31) is the key pathogenic process in patient with GCD2. Corneal trauma activates TGFBI and then it overproduces transforming growth factor beta-induced gene protein (TGFBIp), which is main component of the corneal opacity. Refractive corneal surgery is a popular procedure to correct refractive error worldwide. However, several cases about exacerbation of GCD2 after corneal refractive surgery such as photorefractive keratectomy, laser in situ keratomileusis, and laser epithelial keratomileusis have been reported. The opacities deteriorate patient's best-corrected visual acuity. Recurrence-free interval varies many factors such as the type of procedure the patient had received and the genotype of the patient. To treat the opacities in GCD2, phototherapeutic keratectomy, lamellar keratoplasty, deep lamellar keratoplasty, and penetrating keratoplasty (PKP) were used. However, the recurrence is still an unsolved problem. Perfect treatment of exacerbation after corneal surface ablation does not exist until now. To prevent exacerbation, refractive surgeons must do a careful preoperative examination of candidates in refractive surgeries.

  18. Microkeratome-assisted superficial anterior lamellar keratoplasty for anterior stromal corneal opacities after penetrating keratoplasty.

    Science.gov (United States)

    Patel, Amit K; Scorcia, Vincenzo; Kadyan, Anju; Lapenna, Lucia; Ponzin, Diego; Busin, Massimo

    2012-01-01

    To describe the surgical technique and report the outcomes of patients treated with microkeratome-assisted superficial anterior lamellar keratoplasty for anterior stromal corneal opacities developing after penetrating keratoplasty (PK). All patients with post-penetrating keratoplasty anterior stromal opacities treated with microkeratome-assisted superficial anterior lamellar keratoplasty between July 2005 and June 2007 were reviewed. A 130-μm superficial keratectomy was performed, followed by the placement of an appropriately sized donor graft, which was secured with overlay sutures. Refraction, corneal topography, and uncorrected and best-corrected visual acuities (UCVA, BCVA, respectively) were noted at each examination. Nine eyes of 8 consecutive patients were identified. Causes of anterior stromal opacities included dystrophy recurrence (n = 3), post-photorefractive keratectomy haze (n = 2), and scarring after stromal melt (n = 4). BCVA improved in all 9 eyes at final follow-up, and 7 of 9 eyes achieved ≥20/40 within the first month. Average follow-up period was 28 ± 3.9 months. Refractive astigmatism also improved by an average of 0.7 diopters. Superficial anterior lamellar keratoplasty is a viable and effective alternative to repeat PK in treating anterior stromal scars. It avoids open-globe surgery and exposure to endothelial rejection associated with repeat PK, and visual rehabilitation is considerably quicker.

  19. Pain after epithelial removal by ethanol-assisted mechanical versus transepithelial excimer laser debridement.

    Science.gov (United States)

    Kanitkar, K D; Camp, J; Humble, H; Shen, D J; Wang, M X

    2000-01-01

    To compare subjective pain responses between two techniques of epithelial removal prior to photorefractive keratectomy (PRK) treatment: ethanol-soaked pledget with mechanical debridement of the epithelium versus excimer laser transepithelial ablation. Nine patients underwent bilateral PRK. Each had the epithelium in one eye debrided by placing a pledget soaked in 20% ethanol on the cornea for 2 minutes followed by gentle scraping with a blade. The epithelium in the other eye was removed by transepithelial phototherapeutic keratectomy (PTK) treatment. For each eye, PRK was initiated immediately after removal of the epithelium. On postoperative day one, each patient was asked to rate the level of pain suffered over the last 24 hours on a scale of 0 (minimal) to 10 (maximal). Data were analyzed in a masked fashion. Postoperative day one average pain level in the ethanol-assisted mechanically debrided eyes was 3.0 +/- 2.5 and in the transepithelial PTK eyes was 6.8 +/- 1.8. The difference was statistically significant by Student's t-test (P < .01). All epithelial defects healed within 3 days with no clinically significant difference in healing time between the two techniques. In preparation for PRK, ethanol-assisted mechanical debridement of the epithelium caused significantly less postoperative pain than epithelial removal using the excimer laser.

  20. Increased higher-order optical aberrations after laser refractive surgery: a problem of subclinical decentration.

    Science.gov (United States)

    Mrochen, M; Kaemmerer, M; Mierdel, P; Seiler, T

    2001-03-01

    To study the clinical and theoretical effects of subclinical decentrations on the optical performance of the eye after photorefractive laser surgery. Department of Ophthalmology, University of Dresden, Dresden, Germany. Ocular aberrations were determined before and 1 month after uneventful photorefractive keratectomy (PRK) with the Multiscan laser (Schwind) in 10 eyes of 8 patients. The corrections ranged from -2.5 to -6.0 diopters, and ablation zones of 6.0 mm and larger were used. The measured wavefront errors were compared to numerical simulations using the individually determined decentrations and currently used ablation profiles. The PRK-induced aberrations were significantly greater than the preoperative aberrations. The numerically calculated increase in the higher-order optical aberrations correlated with the clinical results, demonstrating a major increase in coma- and spherical-like aberrations. Subclinical decentration (less than 1.0 mm) was found to be a major factor in increased coma-like and spherical-like aberrations after corneal laser surgery. To minimize higher-order optical errors, special efforts to center the ablation zone are necessary; for example, by eye-tracking systems that consider the visual axis.

  1. Near-infrared sensitivity enhancement of photorefractive polymer composites by pre-illumination

    NARCIS (Netherlands)

    Mecher, Erwin; Gallego-Gómez, Francisco; Tillmann, Hartwig; Hörhold, Hans-Heinrich; Hummelen, Jan C.; Meerholz, Klaus; H. Horhold, H.

    2002-01-01

    Among the various applications for reversible holographic storage media, a particularly interesting one is time-gated holographic imaging (TGHI). This technique could provide a noninvasive medical diagnosis tool, related to optical coherence tomography. In this technique, biological samples are

  2. A Comprehensive Study of Photorefractive Properties in Poly(ethylene glycol Dimethacrylate— Ionic Liquid Composites

    Directory of Open Access Journals (Sweden)

    Mostafa A. Ellabban

    2016-12-01

    Full Text Available A detailed investigation of the recording, as well as the readout of transmission gratings in composites of poly(ethylene glycol dimethacrylate (PEGDMA and ionic liquids is presented. Gratings with a period of about 5.8 micrometers were recorded using a two-wave mixing technique with a coherent laser beam of a 355-nm wavelength. A series of samples with grating thicknesses d 0 = 10 … 150 micrometers, each for two different exposure times, was prepared. The recording kinetics, as well as the post-exposure properties of the gratings were monitored by diffracting a low intensity probe beam at a wavelength of 633 nm for Bragg incidence. To obtain a complete characterization, two-beam coupling experiments were conducted to clarify the type and the strength of the recorded gratings. Finally, the diffraction efficiency was measured as a function of the readout angle at different post-exposure times. We found that, depending on the parameters, different grating types (pure phase and/or mixed are generated, and at elevated thicknesses, strong light-induced scattering develops. The measured angular dependence of the diffraction efficiency can be fitted using a five-wave coupling theory assuming an attenuation of the gratings along the thickness. For grating thicknesses larger than 85 microns, light-induced scattering becomes increasingly important. The latter is an obstacle for recording thicker holograms, as it destroys the recording interference pattern with increasing sample depth. The obtained results are valuable in particular when considering PEGDMA-ionic liquid composites in the synthesis of advanced polymer composites for applications, such as biomaterials, conductive polymers and holographic storage materials.

  3. Photorefractive Properties of Doped BaTiO3 and SBN

    Science.gov (United States)

    1991-12-01

    premixed Ar/0i gases and were monitor-I by using a o -0.2- calcia-stabilized zirconia electrochemical oxygeo sensor in 04 4 0 series with the sample...Agency 14-30 Wilson Rlvd Arlington VA 222C9-23G8 Naval Warfare Assessment Center GIDEP Operations Center/Code IA-50 ATTN: E RicharJs Corona CA 41711

  4. Thick plasma gratings using a local photorefractive effect in CdZnTe:In.

    Science.gov (United States)

    Macdonald, R L; Linke, R A; Chadi, J D; Thio, T; Devlin, G E; Becla, P

    1994-12-15

    Diffraction gratings have been encoded in bulk Cd(0.8)Zn(0.2)Te:In samples by near-band-gap excitation. The photoinduced index change is associated with persistent photoconductivity resulting from ionization of DX centers. The gratings have a thickness of 1.7 mm, as evinced by Bragg selectivity during the readout process. Encoded grating are shown to be persistent for sufficiently low temperatures and are not erased by subsequent writing of more gratings.

  5. Coupled electric fields in photorefractive driven liquid crystal hybrid cells - theory and numerical simulation

    Science.gov (United States)

    Moszczyński, P.; Walczak, A.; Marciniak, P.

    2016-12-01

    In cyclic articles previously published we described and analysed self-organized light fibres inside a liquid crystalline (LC) cell contained photosensitive polymer (PP) layer. Such asymmetric LC cell we call a hybrid LC cell. Light fibre arises along a laser beam path directed in plane of an LC cell. It means that a laser beam is parallel to photosensitive layer. We observed the asymmetric LC cell response on an external driving field polarization. Observation has been done for an AC field first. It is the reason we decided to carry out a detailed research for a DC driving field to obtain an LC cell response step by step. The properly prepared LC cell has been built with an isolating layer and garbage ions deletion. We proved by means of a physical model, as well as a numerical simulation that LC asymmetric response strongly depends on junction barriers between PP and LC layers. New parametric model for a junction barrier on PP/LC boundary has been proposed. Such model is very useful because of lack of proper conductivity and charge carriers of band structure data on LC material.

  6. Smart Mirrors for Photorefractive Control of Light with Tim Bunning, RX - Agile Filters Application

    Science.gov (United States)

    2016-11-08

    fabricated from a polymer liquid crystal (LC) polymer slice (POLICRYPS) structure by holographic photopolymerization at high temperature (70 °C) using a...two distinct phases, polymer and LC-rich can be formed whose ultimate local and periodic morphology is related to the chemistry , wavelength of...different orientation states (perpendicular or parallel) depending on chemistry and cure conditions, and can be utilized to produce multi-dimension high

  7. Polythiophene Derivative with a Side Chain Chromophore as Photovoltaic and Photorefractive Materials

    Science.gov (United States)

    1993-11-17

    molecular hole transport agents like diethylamino- benzaldehyde diphenylhydrazone, 27 1,1-bis(4-di-p- tolylaminophenyl)cyclohexane were added into the...using p- toluene sulfonyl chloride in the presence of dry pyridine29 at -20 ’C and was precipitated in ice cold IN hydrochloric acid. The precipitated...tosylate was dried under vacuum and was then recrystallized from petroleum ether, to produce white needle like crystals. The p- toluene sulfonate (tosyl

  8. Photorefractive effects in ferroelectrics as manifestation of structural violations on mesoscales

    CERN Document Server

    Kanaev, I F

    1998-01-01

    The nature of violations in ferroelectric structures that lead to the emergence of direct photocurrents without application of external fields is discussed. We suppose that the main role in transfer processes and photovoltaic effect $9 emergence belongs to macro- and meso-scopic inhomogeneities of the crystal. The boundaries between fairly perfect crystallites have the size of several constants of the crystal lattice and strongly changes the group (pyro-, piezo-, $9 and ferroelectric) properties of the crystal. The presence of inhomogeneities and local electric fields in them determines the charge transfer mechanism: affected by light, the electrons are generated in discretely distributed defect $9 regions and transported from one inhomogeneity to another taking into account the magnitude and sign of the held. In the framework of new concepts, experimental data on recording of the shifted and nonshifted holograms in LiNbO /sub $9 3/ crystals are analyzed. (8 refs).

  9. Aperiodic signals processing via parameter-tuning stochastic resonance in a photorefractive ring cavity

    Directory of Open Access Journals (Sweden)

    Xuefeng Li

    2014-04-01

    Full Text Available Based on solving numerically the generalized nonlinear Langevin equation describing the nonlinear dynamics of stochastic resonance by Fourth-order Runge-Kutta method, an aperiodic stochastic resonance based on an optical bistable system is numerically investigated. The numerical results show that a parameter-tuning stochastic resonance system can be realized by choosing the appropriate optical bistable parameters, which performs well in reconstructing aperiodic signals from a very high level of noise background. The influences of optical bistable parameters on the stochastic resonance effect are numerically analyzed via cross-correlation, and a maximum cross-correlation gain of 8 is obtained by optimizing optical bistable parameters. This provides a prospective method for reconstructing noise-hidden weak signals in all-optical signal processing systems.

  10. All-optically controlled light valve assembled by photorefractive crystal and PDLC hybrid structure

    Science.gov (United States)

    Marinova, Vera; Liu, Ren Chung; Chen, Ming S.; Lin, Shiuan Huei; Lin, Yi Hsin; Hsu, Ken Yuh

    2015-05-01

    A light-valve device, assembled by Ru-doped Bi12SiO20 (BSO) photoconductive substrate and polymer dispersed liquid crystal layer is proposed, in which all the processes are controlled by the near infrared light. Laser beam illumination (Gaussian shape) on BSO:Ru crystal caused charge carriers generation, which migrate and form an inhomogeneous distribution and subsequent space charge field. This surface-localized electromagnetic field penetrates into the PDLC layer and modulate the orientation of the liquid crystals, that caused reverse of the device initial opaque state to the highly transparent one. The proposed structure is simple and easy to fabricate, without requirements of ITO contacts and alignment layers and opens further possibilities for near-infrared applications.

  11. Estesiometria corneana pós cirurgia fotorrefrativa Esthesiometry corneal after surgery photorefractive

    Directory of Open Access Journals (Sweden)

    Alessandro Perussi Garcia

    2009-10-01

    Full Text Available OBJETIVO: Avaliar as alterações que ocorrem na sensibilidade corneanas após as cirurgias de LASIK e PRK MÉTODOS: Estudo prospectivo onde foram avaliados 60 olhos de 30 pacientes submetidos a LASIK bilateral simultaneamente e mais 30 olhos de 15 pacientes submetidos a PRK bilateral simultaneamente. De acordo com a quantidade de ablação intra-operatórias, os olhos foram divididos em dois grupos: Grupo 1 (menor que 40 µm e Grupo 2 (Maior que 40 µm. A sensibilidade corneana foi medida na região central da córnea pelo estesiometro Cochet Bonnet® no pré operatório e após 30, 90 e 180 dias da cirurgias. RESULTADOS: A sensibilidade corneana na LASIK apresentou-se diminuída durante os três primeiros meses retornando as valores pré operatórios aos 6 meses; E de acordo com a quantidade de ablação o Grupo 1 apresentou diferença estatisticamente significante em relação ao Grupo 2 durante os três primeiros meses; No entanto a PRK recuperou seus valores pré operatório aos três meses e de acordo com a quantidade de ablação o Grupo 1 apresentou diferença estatisticamente significante somente no primeiro mês de pós operatório. CONCLUSÃO: A LASIK apresentou sensibilidade menor em relação ao PRK durante os 3 primeiros meses e somente aos 6 meses os valores da sensibilidade corneana foram similares; Os resultados também sugerem que a quantidade de ablação está relacionada com a diminuição da sensibilidade corneana durante os primeiros meses em ambas as técnicas cirúrgicas, principalmente na LASIK.PURPOSE: To evaluate the alterations that occur on the cornea sensitivity after Lasik and PRK surgery. METHODS: Prospective studies have evaluated60 eyes from 30 patients subjected simultaneously to bilateral Lasik and 30 eyes from 15 patients subjected simultaneously to bilateral PRK. According to the amount of inner operatory ablation the eyes were divided into two groups: Group I ( 40µm. The cornea sensitivity was measured in the central region of the cornea on the pre operatory and then again at 30, 90 and 180 days after the surgery with the esthesiometer. RESULTS: The cornea sensitivity in Lasik presented itself in a minor way during the first three months, returning to pre operatory values at six months; and according to the amount of ablation group I presented statistically significant difference in comparison to group II during the first three months; however PRK recovered its pre operatory values at three months and according to the amount of ablation group I presented statistically significant difference only on the first month of pre operatory. CONCLUSION: Lasik showed the least sensitivity in comparison to PRK during the first three months, only at six months the sensitivity values were similar to each other; the results suggest that the result of ablation endangers the cornea sensitivity during the first months on both surgical techniques especially Lasik.

  12. Treatment of corneal defects with delayed re-epithelization with a medical device/drug delivery system for epidermal growth factor.

    Science.gov (United States)

    Holland, Simon; Morck, Douglas; Schultz, Clyde

    2012-01-01

      Human recombinant epidermal growth factor has been shown to be effective in corneal healing when applied topically. The purpose of this preliminary study was to observe whether re-epithelization occurred in patients with non-healing corneal defects treated with a bandage contact lenses impregnated with epidermal growth factor.   Prospective non-comparative interventional case series study. Epidermal growth factor-impregnated bandage contact lenses (created through passive transfer of epidermal growth factor into hydrogel contact lenses of high water content) were used to passively release epidermal growth factor to the corneal surface of the damaged eye.   Nine clinical patients who presented for tertiary care at the University of British Columbia Eye Care Centre at Vancouver General Hospital.   All patients had clinically significant delayed corneal re-epithelization that had not healed despite standard treatments including conventional bandage contact lenses and topical medications. Causes of delayed re-epithelization varied from corneal injuries (e.g. alkali burns, recurrent corneal erosions) to recent corneal surgery (photorefractive keratectomy, phototherapeutic keratectomy, penetrating keratoplasty).   Closure of wounds.   Re-epithelialization was seen in the corneas of seven of the nine patients within 8 days after insertion of the epidermal growth factor-treated bandage contact lens into the damaged eye. The drug delivery system appeared to be most effective in non-inflamed corneas.   Preliminary results indicate that bandage contact lenses impregnated with epidermal growth factor may be helpful in promoting re-epithelization in corneas with delayed healing. Efficacy appears to be reduced for vascularized and significantly inflamed corneas. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.

  13. Application of senofilcon a contact lenses for therapeutic bandage lens indications.

    Science.gov (United States)

    Shafran, Tamar; Gleason, William; Osborn Lorenz, Katherine; Szczotka-Flynn, Loretta B

    2013-09-01

    To conduct a retrospective consecutive chart review of senofilcon A contact lenses when used for therapeutic or bandage lens applications. Indication for use includes corneal protection from exposure or repeated irritation, corneal pain relief, and barrier protection. Outcome assessments included pain relief, improvement in corneal signs, additional complications, and overall treatment success. A total of 43 fully consented patients across 3 different clinical practices in the United States (Georgia, Florida and Ohio) were included in this study. Subjects enrolled in the study were identified by site investigators as their most recent 15 to 20 patients fit in senofilcon A lenses for the listed therapeutic indications. The cases were reviewed to assess the therapeutic success of the lens for the outcomes listed earlier. All lenses fit had an 8.4-mm base curve and 14.0 mm diameter. Patients were fit for pain relief in 26 of the 43 cases of which 81% were judged to be fully effective, 8% partially effective, and 11% ineffective. Improvement in corneal integrity was the treatment goal in 25 cases and was fully effective in 64%, partially effective in 24%, and no change was noted in 12% of the cases. Twelve refractive surgical patients (laser-assisted in situ keratomileusis, epithelial laser-assisted in situ keratomileusis, laser-assisted subepithelial keratectomy, or photorefractive keratectomy) wore the lenses successfully for 4 to 6 days postoperatively for comfort and protection without complications. Investigators judged the overall treatment as fully successful in 68% cases, partially successful in 18% cases, and neutral or unsuccessful in 14% cases. No adverse events were reported in any case. Senofilcon A contact lenses are successful in the majority of cases when used for providing protection of corneal exposure and recurrent damage, pain management, barrier protection, and postsurgical management.

  14. [Retinal detachment after Excimer laser (myopic LASIK or PRK). A retrospective multicentric study: 15 cases].

    Science.gov (United States)

    Feki, J; Trigui, A; Chaabouni, M; Ben Salah, S; Bouacida, B; Chechia, N; Zayani, A; Nouira, F; Daghfous, F; Ayed, S; Kamoun, M

    2005-05-01

    Refractive surgery by LASIK or photorefractive keratectomy (PRK) generaly aims at a myopic population that has a high probability of developing rhegmatogenous retinal detachment (RD). The authors report a multicenter study with 15 cases of RD appearing after refractive surgery by Excimer laser and discuss the role played by the techniques used. Five centers fitted with nine Excimer laser devices took part in this study. Of 22,700 eyes undergoing refractive myopic surgery during the period 1994-2002, 15 eyes developed rhegmatogenous RD. The average age of the patients with RD was 37 years. The average myopia was 13.5 D. RD occurred a mean of 20 months after refractive laser. Fifteen eyes of 13 patients developed a rhegmatogenous RD, two of which were bilateral. Eight of these cases had LASIK surgery and six had photorefractive keratectomy; one of the latter patients was retreated with LASIK because of substantial regression after PRK. RD was total or subtotal in five eyes, partial superior with a temporal tear in six eyes, and nasal in three eyes. One case with inferior RD, two cases with giant retinal tear and one case with posterior tear were also repaired. Fourteen eyes were suitable for operation. The retina was reattached in 12 cases. Mean postoperative visual acuity was 7/10. The occurrence of rhegmatogenous RD in the myopic population is estimated at 2.2%. It is estimated at 0.1% in the emmetropic population. The Excimer laser, through its thermic effects, shock wave, traumatism undergone by the suction ring at the time of LASIK surgery, could increase this risk in myopic patients. A review of the literature cast doubt on the cause and effect hypothesis. Personal and multicenter studies (including ours) show that the frequency rate of rhegmatogenous RD after Excimer laser is equivalent and even lower than that estimated with an emmetropic population. The low percentage of RD after Excimer surgery found in the literature as well as in our study (surgery, the

  15. Medicina regenerativa y superficie ocular Regenerative medicine and ocular surface

    Directory of Open Access Journals (Sweden)

    Taimi Cárdenas Díaz

    2012-06-01

    photorefractive keratectomy, to speed up the curing process and avoid the occurrence of leukomas in patients with persistent epitelial defects, and to decrease the incidence of corneal opacities in patients undergoing photorefractive keratectomy due to different corneal dystrophies.

  16. The management of cornea blindness from severe corneal scarring, with the Athens Protocol (transepithelial topography-guided PRK therapeutic remodeling, combined with same-day, collagen cross-linking

    Directory of Open Access Journals (Sweden)

    Kanellopoulos AJ

    2012-02-01

    Full Text Available Anastasios John KanellopoulosLaservision.gr Institute, Athens, Greece; Manhattan Eye, Ear and Throat Hospital, New York, NY, USA; New York University Medical School, New York, NY, USAPurpose: To evaluate the safety and efficacy of combined transepithelial topography-guided photorefractive keratectomy (PRK therapeutic remodeling, combined with same-day, collagen cross-linking (CXL. This protocol was used for the management of cornea blindness due to severe corneal scarring.Methods: A 57-year-old man had severe corneal blindness in both eyes. Both corneas had significant central scars attributed to a firework explosion 45 years ago, when the patient was 12 years old. Corrected distance visual acuity (CDVA was 20/100 both eyes (OU with refraction: +4.00, –4.50 at 135° in the right eye and +3.50, –1.00 at 55° in the left. Respective keratometries were: 42.3, 60.4 at 17° and 35.8, 39.1 at 151.3°. Cornea transplantation was the recommendation by multiple cornea specialists as the treatment of choice. We decided prior to considering a transplant to employ the Athens Protocol (combined topography-guided partial PRK and CXL in the right eye in February 2010 and in the left eye in September 2010. The treatment plan for both eyes was designed on the topography-guided wavelight excimer laser platform.Results: Fifteen months after the right eye treatment, the right cornea had improved translucency and was topographically stable with uncorrected distance visual acuity (UDVA 20/50 and CDVA 20/40 with refraction +0.50, –2.00 at 5°. We noted a similar outcome after similar treatment applied in the left eye with UDVA 20/50 and CDVA 20/40 with –0.50, –2.00 at 170° at the 8-month follow-up.Conclusion: In this case, the introduction of successful management of severe cornea abnormalities and scarring with the Athens Protocol may provide an effective alternative to other existing surgical or medical options.Keywords: Athens Protocol, collagen cross

  17. Single-step transepithelial ASLA (SCHWIND with mitomycin-C for the correction of high myopia: long term follow-up

    Directory of Open Access Journals (Sweden)

    Aslanides IM

    2014-12-01

    Full Text Available Ioannis M Aslanides, Panagiotis N Georgoudis, Vasilis D Selimis, Achyut N Mukherjee Emmetropia Mediterranean Eye Institute, Heraklion, Crete, Greece Purpose: We wanted to compare the outcomes of single-step modified transepithelial photorefractive keratectomy (tPRK termed a SCHWIND all surface laser ablation (ASLA versus conventional alcohol-assisted photorefractive keratectomy (PRK and laser-assisted in situ keratomileusis (LASIK for the correction of higher myopia of 6.00 diopters (D or more, in an area with high risk of haze due to high intensity of sunlight.Methods: We used a prospective interventional cohort with matched retrospective control groups. Patients with >6 D myopia and <3.5 D of astigmatism were included. All treatments were performed with the SCHWIND Amaris system using aspheric ablation profiles. Mitomycin C was used in all PRK and ASLA cases. Outcomes were postoperative refraction, visual acuity, stability, and complications. The follow-up period was up to 12 months.Results: In total, 101 eyes were included after exclusions. Mean preoperative spherical equivalent refraction was −7.9 D, −8.2 D, and −7.4 D in the ASLA (n=41, PRK (n=29, and LASIK (n=31 groups. Mean postoperative spherical equivalent at 12 months postoperatively was −0.1 (standard deviation [SD]: 0.34, −0.2 (SD: 0.59, and −0.08 (SD: 0.36 in the ASLA, PRK, and LASIK groups, with 91.4%, 85.7%, and 83.9% within 0.5 D of target, respectively. Refractive outcomes and regression at 12 months did not vary among groups (P>0.05. Mean logMAR (logarithm of the minimum angle of resolution uncorrected distance visual acuity at 12 months was 0.00 (SD: 0.05, 0.06 (SD: 0.1, and 0.05 (SD: 0.09 in the ASLA, PRK, and LASIK groups, with significantly better vision in the tPRK group versus LASIK (P=0.01 and PRK (P=0.01 groups.Conclusion: ASLA (SCHWIND tPRK with mitomycin C for high myopia demonstrates comparable refractive outcomes to LASIK and PRK, with relatively

  18. LASIK and PRK in hyperopic astigmatic eyes: is early retreatment advisable?

    Science.gov (United States)

    Frings, Andreas; Richard, Gisbert; Steinberg, Johannes; Druchkiv, Vasyl; Linke, Stephan Johannes; Katz, Toam

    2016-01-01

    To analyze the refractive and keratometric stability in hyperopic astigmatic laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) during the first 6 months after surgery. This retrospective cross-sectional study included 97 hyperopic eyes; 55 were treated with LASIK and 42 with PRK. Excimer ablation for all eyes was performed using the ALLEGRETTO excimer laser platform using a mitomycin C for PRK and a mechanical microkeratome for LASIK. Keratometric and refractive data were analyzed during three consecutive follow-up intervals (6 weeks, 3 months, and 6 months). The corneal topography was obtained using Scheimpflug topography, and subjective refractions were acquired by expert optometrists according to a standardized protocol. After 3 months, mean keratometry and spherical equivalent were stable after LASIK, whereas PRK-treated eyes presented statistically significant (P1 D occurred. The optical zone diameter did not correlate with the development of regression. After corneal laser refractive surgery, keratometric changes are followed by refractive changes and they occur up to 6 months after LASIK and for at least 6 months after PRK, and therefore, caution should be applied when retreatment is planned during the 1st year after surgery because hyperopic refractive regression can lead to suboptimal visual outcome. Keratometric and refractive stability is earlier achieved after LASIK, and therefore, retreatment may be independent of late regression.

  19. Postoperative pain following epi-LASIK, LASEK, and PRK for myopia.

    Science.gov (United States)

    O'Doherty, Maeve; Kirwan, Caitriona; O'Keeffe, Michael; O'Doherty, John

    2007-02-01

    To compare mechanical epithelial separation using the epi-LASIK technique with alcohol assisted separation (LASEK). Patients deemed suitable for surface ablation were randomized to receive epi-LASIK in one eye and LASEK in the other eye. If epi-LASIK failed, the procedure was converted to photorefractive keratectomy (PRK), forming the third comparison group. The outcome measures were postoperative pain, vision, refraction, and haze. Patients were followed for 3 months. Fifty-seven patients (95 eyes) were included in this study (38 epi-LASIK, 19 PRK, and 38 LASEK eyes). There was a 33% rate of conversion from intended epi-LASIK to PRK. Epi-LASIK patients were found to have significantly less pain in the first few hours after surgery but at 4 hours all patients had the same levels of pain, which improved to minimal or no pain at 24 hours. No significant difference was noted among groups for vision, refractive error, and haze; however, epi-LASIK patients had the best day 1 visual acuity. Epi-LASIK offers comparable visual and refractive results to other surface ablation techniques with lower levels of postoperative pain only for the first 2 hours. However, there was a high rate of flap failure and conversion to PRK.

  20. Advances in Refractive Surgery: May 2013 to June 2014.

    Science.gov (United States)

    Mysore, Naveen; Krueger, Ronald

    2015-01-01

    The field of refractive surgery is changing quickly in the areas of screening, treatment, and postoperative management. The objective of this study was to review advances in the field of refractive surgery as reported in the peer-reviewed literature during the previous year. This was a literature review. In this article, we highlight the progression in the field from May 2013 to the end of June 2014. This article is organized as preoperative, intraoperative, and postoperative considerations. The growing use of newer modalities of treatment, such as small-incision lenticule extraction (SmILE) and phakic intraocular lenses, and their safety and efficacy add to the armamentarium in treating refractive error. This past year has seen many studies, which show these procedures to be safe and effective. Also, structurally, SmILE may result in a more biomechanically stable cornea, so that we may be able to safely treat higher refractive errors. While laser-assisted in situ keratomileusis is the predominant surgical procedure, photorefractive keratectomy is still an appropriate choice in certain scenarios (higher risk for ectasia postrefractive surgery and patient choice) with safe, predictable results, and patient satisfaction. Many of the new developments in laser-assisted in situ keratomileusis have focused on flap creation with femtosecond lasers. Histopathology and in vivo optical coherence tomography studies have shown that the stromal bed is smoother, the side cuts are vertical, and the flap has predictable thickness. New surgical modalities, such as femtosecond lenticule extraction and SmILE, are increasingly being used.

  1. Refractive surgery in children: treatment options, outcomes, and controversies.

    Science.gov (United States)

    Daoud, Yassine J; Hutchinson, Amy; Wallace, David K; Song, Jonathan; Kim, Terry

    2009-04-01

    To summarize the evolution of the treatment of pediatric refractive errors, with an emphasis on recent advancements in the use of refractive surgery to treat children. Literature review. We searched MEDLINE (1950 through October 2007), the Cochrane library (December through October 2007), and the Cumulative Index for Nursing and Allied Health Literature (December 1982 through October 2007) for English language articles using the following search strategy with MeSH terms and key words: pediatric refractive errors and amblyopia, anisometropia, hyperopia, myopia, laser in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), laser epithelial keratomileusis (LASEK), excimer laser, refractive intraocular lens (IOL). We also searched the bibliographies of all identified articles. No multicenter, long-term, controlled trial has been published on the use of refractive surgery in children. The current literature shows that LASIK, PRK, and LASEK show promising results in children with refractive amblyopia over the intermediate follow-up period. Corneal haze and myopic regression are the main complications, especially in very high myopia (> 12 diopters). In such patients with extremely high myopia, small studies have reported phakic IOLs or clear lens extraction with or without IOL implantation to be a useful alternative. Refractive surgery is appropriate in children with severe anisometropia or bilateral high ametropia that is resistant to conventional therapy. More information is needed before pediatric refractive surgery can be widely adopted by the ophthalmic community. This could be achieved with a large, prospective, multicenter, randomized, controlled clinical trial.

  2. Reasons For Not Performing Keratorefractive Surgery in Patients Seeking Refractive Surgery in a Hospital-Based Cohort in “Yemen”

    Science.gov (United States)

    Bamashmus, Mahfouth A.; Saleh, Mahmoud F.; Awadalla, Mohamed A.

    2010-01-01

    Background: To determine and analyze the reasons why keratorefractive surgery, laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) were not performed in patients who presented for refractive surgery consultation. Materials and Methods: A retrospective observational study was performed between January 2006 and December 2007 in the Yemen Magrabi Hospital. The case records of 2,091 consecutive new patients who presented for refractive surgery were reviewed. Information from the pre-operative ophthalmic examination, such as refractive error, corneal topography and visual acuity, were analyzed. The reasons for not performing LASIK and PRK in the cases that were rejected were recorded and analyzed. Results: In this cohort, 1,660 (79.4%) patients were advised to have LASIK or PRK from the 2,091 patients examined. LASIK and PRK were not advised in 431 (21%) patients. The most common reasons for not performing the surgery were high myopia >-11.00 Diopters (19%), keratoconus (18%), suboptimal central corneal thickness (15%), cataract (12%) and keratoconus suspect (forme fruste keratoconus) (10%). Conclusion: Patients who requested keratorefractive surgery have a variety of problems and warrant comprehensive attention to selection criteria on the part of the surgeon. Corneal topographies and pachymetry of refractive surgery candidates need to be read cautiously. High-refractive error, keratoconus and insufficient corneal thickness were found to be the leading reasons for not performing keratorefractive surgery in this study. PMID:21180437

  3. Pediatric refractive surgery and its role in the treatment of amblyopia: meta-analysis of the peer-reviewed literature.

    Science.gov (United States)

    Alió, Jorge L; Wolter, Nathaly V; Piñero, David P; Amparo, Fransisco; Sari, Esin Sogutlu; Cankaya, Cem; Laria, Carlos

    2011-05-01

    To provide an overview of the visual outcomes after pediatric refractive surgery in anisometropic amblyopia and to analyze the relationship of these outcomes with age and type of refractive surgery. Systematic searches in PubMed, Embase, and Web of Science databases without data restrictions and a search by surveillance of the literature regarding pediatric refractive surgery were performed. Only studies reporting individual data of pediatric cases (age 1 to 17 years) undergoing photorefractive keratectomy (PRK), laser epithelial keratomileusis (LASEK), and LASIK were included. A total of 15 articles including data from a total of 213 amblyopic eyes were considered: LASIK in 95 eyes and surface ablation in 118 eyes. Changes in uncorrected (UDVA) and corrected distance visual acuity (CDVA) were investigated as well as their relation with age and ablation type. A significant increase in logMAR UDVA and CDVA was found in the overall sample of amblyopic eyes after surgery (Psurgery (r=-0.38, Prefractive surgery is an effective option for improving the visual acuity in children with an amblyopic eye in association with anisometropia. Copyright 2011, SLACK Incorporated.

  4. Refractive surgery following corneal graft.

    Science.gov (United States)

    Alió, Jorge L; Abdou, Ahmed A; Abdelghany, Ahmed A; Zein, Ghassam

    2015-07-01

    To review the different surgical procedures for management of postkeratoplasty refractive errors after total suture removal. There are different surgical options to address residual refractive errors that frequently occur after corneal transplantation. The correction can be done on the corneal surface or intraocular with intraocular lens (IOL) implantation which requires complete tectonic and refractive stability after suture removal. The most commonly used procedures are photorefractive keratectomy, laser in-situ keratomileusis and Phakic IOLs. Keratoplasty has been profited by recent advances in refractive surgery. Custom excimer laser ablation is an alternative way to treat irregular errors. New IOL modalities are good practical options for a wide range of errors. Femtosecond laser, as a new option in the toolbox, can modify corneal grafting refractive results and assist corrective refractive procedures. Although being the most successful organ transplantation, keratoplasty is usually followed by significant ametropia. Different corrective modalities exist and the choice should fit ocular conditions, patient requirements, surgeon skills and the available technologies. Recent advances in ophthalmic surgery have improved the outcomes.

  5. Chronic dry eye in PRK and LASIK: manifestations, incidence and predictive factors

    Science.gov (United States)

    Bower, Kraig S.; Sia, Rose K.; Ryan, Denise S.; Mines, Michael J.; Dartt, Darlene A.

    2017-01-01

    Purpose To evaluate dry eye manifestations following photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) and determine the incidence and predictive factors of chronic dry eye using a set of dry eye criteria. Setting Walter Reed Army Medical Center, Washington, DC, USA Methods This is a prospective non-randomized clinical study of 143 active duty U.S. Army personnel aged 29.9±5.2 years with myopia or myopic astigmatism (manifest spherical equivalent −3.83±1.96 diopters) undergoing either PRK or LASIK. Dry eye evaluation was performed pre- and postoperatively. Main outcome measures included dry eye manifestations, incidence, and predictive factors of chronic dry eye. Results Schirmer scores, corneal sensitivity, ocular surface staining, surface regularity index (SRI), and responses to dry eye questionnaire significantly changed over time after PRK. After LASIK, significant changes were observed in tear breakup time, corneal sensitivity, ocular surface staining, and responses to questionnaire. At twelve months postoperatively, 5.0% of PRK and 0.8% of LASIK participants developed chronic dry eye. Regression analysis showed preoperatively lower Schirmer score will significantly influence development of chronic dry eye after PRK whereas preoperatively lower Schirmer score or higher ocular surface staining score will significantly influence the occurrence of chronic dry eye after LASIK. Conclusions Chronic dry eye is uncommon after PRK and LASIK. Ocular surface and tear film characteristics during preoperative examination may help predict chronic dry eye development in PRK and LASIK. PMID:26796443

  6. Refractive surgery after corneal transplantation.

    Science.gov (United States)

    Chang, Daniel H; Hardten, David R

    2005-08-01

    Many patients who have undergone corneal transplantation are unable to achieve satisfactory visual acuity with spectacle and contact lens correction alone. For these patients, refractive surgery becomes a viable option to reduce the post-keratoplasty ametropia. With the many recent advances in refractive surgery for naturally occurring refractive error, new possibilities arise for application to this complicated set of patients. This review discusses key recent developments in refractive surgery after corneal transplantation. The biomechanical effects of incisional keratotomy on post-keratoplasty corneas continue to be studied, and these techniques remain a common and simple method of reducing astigmatism. Photorefractive keratectomy, previously problematic for regression and haze formation, is gaining new prominence as early experience with the adjunctive use of mitomycin C has demonstrated good results. Long-term studies with laser in-situ keratomileusis (LASIK) have continued to show good safety and efficacy. Modern developments in cataract surgery appear to have lower incidences of graft rejection and failure. Developments in lens implantation technology continue to offer expanding options for intraocular refractive surgery. Although visual rehabilitation after corneal transplantation remains a formidable challenge, developments in refractive surgery for naturally occurring ametropias directly translate into an improved ability to help these most challenging refractive cases. Continued research will bring about improved efficacy while maintaining a high level of safety.

  7. VHF digital ultrasound three-dimensional scanning in the diagnosis of myopic regression after corneal refractive surgery.

    Science.gov (United States)

    Reinstein, Dan Z; Ameline, Barbara; Puech, Michel; Montefiore, Guy; Laroche, Laurent

    2005-01-01

    To perform VHF digital ultrasound scanning and analysis of a case of high-myopic undercorrection in an eye that had undergone multiple surgical interventions for the correction of an initial refraction of -12.00 diopters (D). A 49-year-old woman was evaluated after undergoing three surgical interventions for correction of an initial refraction of -12.00 D in the left eye. Automated lamellar keratoplasty (ALK) was followed by arcuate keratotomy (for induced astigmatism) and surface photorefractive keratectomy (PRK). The residual ametropia on presentation was -6.75 -3.50 x 95 degrees. VHF digital ultrasound scanning and analysis was performed. On ultrasound, the ALK interface was clearly visible. Residual stromal thickness beneath the cap was at least 275 microm. The absence of Bowman's layer indicated the region of PRK. New stroma and nascent stromal layers were differentiated within the flap. Neo stromal deposition and central epithelial hyperplasia were determined to be responsible for the myopic shift, as opposed to biomechanical changes. In this case, refraction, slit-lamp examination, and topography were unable to provide a diagnosis for regression following multiple corneal refractive procedures. By providing layered anatomical mapping, VHF digital ultrasound scanning was able to exclude a diagnosis of ectasia and provide anatomical diagnostic information to explain the clinical observations.

  8. Effect of Anisometropia on the Predictability and Accuracy of Refractive Surgery.

    Science.gov (United States)

    Shapira, Yinon; Vainer, Igor; Mimouni, Michael; Levartovsky, Shmuel; Sela, Tzahi; Munzer, Gur; Kaiserman, Igor

    2016-11-01

    To evaluate the predictability and accuracy of refractive surgery among adults with myopic anisometropia. Consecutive cases of myopic eyes that underwent bilateral laser-assisted in situ keratomileusis (LASIK) or bilateral photorefractive keratectomy (PRK) during a 12-year period in a single center were included. Myopic anisometropia was defined as a difference greater than 1.5 D in spherical equivalent between eyes preoperative. A total of 10,046 paired, operated nonamblyopic eyes of 5023 patients were analyzed. Of these, 472 eyes of 236 (4.7%) patients had myopic anisometropia without amblyopia, and 9574 eyes of 4787 patients served as isometropic controls. After refractive surgery, in the anisometropic group the more myopic eye was corrected by +0.47 ± 0.78 (D) more than the contralateral eye (P anisometropia was found to be independent of the magnitude of preoperative myopia or surgeon identity. The more myopic eye of anisometropes undergoing refractive surgery has lower predictability and accuracy and tends to be overcorrected, whereas the less myopic eye has outcome similar to isometropic controls. These results suggest that refractive surgery nomograms should take into account anisometropia.

  9. The U.S. Army Surface Ablation Study: comparison of PRK, MMC-PRK, and LASEK in moderate to high myopia.

    Science.gov (United States)

    Sia, Rose K; Ryan, Denise S; Edwards, Jayson D; Stutzman, Richard D; Bower, Kraig S

    2014-04-01

    To compare visual outcomes following photorefractive keratectomy (PRK), PRK with mitomycin C (MMC-PRK), and LASEK in moderate and high myopia in military personnel. This prospective, randomized contralateral eye study included 167 patients 21 years or older with manifest spherical equivalent -5.99 ± 1.40 diopters (D) (range: -3.88 to -9.38 D) randomized to either MMC-PRK or LASEK treatment in their dominant eye and conventional PRK without MMC in the fellow eye. All procedures were performed using the LADARVision 4000 Excimer Laser System (Alcon Surgical Inc., Ft. Worth, TX). High- and low-contrast visual acuities, manifest refraction, endothelial cell count, and corneal haze were evaluated up to 12 months postoperatively. At 12 months postoperatively, visual outcomes were comparable among the treatment groups. Corneal haze of any grade was less common in MMC-PRK compared to PRK at 1 month (21.4% vs 31.0%; P MMC-PRK compared to LASEK at 1 month (21.4% vs 55.9%; P MMC-PRK. MMC-PRK showed some benefits in minimizing corneal haze formation. One year after surgery, there was no discernible difference in the postoperative refractive outcomes among the three methods. Copyright 2014, SLACK Incorporated.

  10. Oxidative stress induces dysregulated autophagy in corneal epithelium of keratoconus patients

    Science.gov (United States)

    Chevour, Priyanka; Padmajan, Neeraja; Dhamodaran, Kamesh; Jayadev, Chaitra; M. M. A. Nuijts, Rudy; Ghosh, Arkasubhra

    2017-01-01

    Oxidative stress is one of the key factors that contributes to the pathogenesis of keratoconus (KC). Macroautophagy is a vital cellular mechanism that is activated in response to oxidative stress. The aim of this study was to understand the role of the autophagic lysosomal pathway in the oxidative damage of KC corneal epithelium and the human corneal epithelial cell line (HCE).The corneal epithelium was collected from 78 KC patients undergoing corneal cross-linking or topography guided photorefractive keratectomy. We performed microarray, qPCR and western blot analysis for the expression of autophagy markers on this epithelium from patients with different clinical grades of KC. A differential expression pattern of autophagy related markers was observed in the diseased corneal cone-specific epithelium compared to matched peripheral epithelium from KC patients with increasing clinical severity. Human corneal epithelial cells exposed to oxidative stress were analyzed for the expression of key proteins associated with KC pathogenesis and the autophagic pathway. Oxidative stress led to an increase in reactive oxygen species and an imbalanced expression of autophagy markers in the HCE cells. Further, reduced levels of Akt/p70S6 Kinase, which is a known target of the mTOR pathway was observed in HCE cells under oxidative stress as well as in KC epithelium. Our results suggest that an altered expression of proteins suggestive of defective autophagy and is a consequence of oxidative damage. This could play a possible role in the pathogenesis of KC. PMID:28902914

  11. Intraocular lens calculations status after corneal refractive surgery.

    Science.gov (United States)

    Seitz, B; Langenbucher, A

    2000-02-01

    With the increasing number of keratorefractive surgical procedures, an increasing number of cataract surgeries in eyes after keratorefractive surgery is anticipated within a few decades. Although cataract extraction seems to be feasible without major technical obstacles, intraocular lens (IOL) power calculation turned out to be problematic. Insertion of the measured average K-readings (= "central corneal power" = keratometric diopters) after myopic radial keratotomy (RK), photorefractive keratectomy (PRK), or laser in situ keratomileusis (LASIK) into standard IOL power-predictive formulas commonly results in substantial undercorrection and postoperative hyperopic refraction or anisometropia. In this article, the major reasons for IOL power miscalculations (which are different for RK versus RRK/LASIK) are discussed based on model calculations and based on case series of cataract surgeries, methods for improved assessment of keratometric diopters as the major underlying problem are exemplary illustrated, and finally a clinical step-by-step approach to minimize IOL power miscalculations status after corneal refractive surgery is suggested. The "clinical history method" (i.e., subtraction of the spherical equivalent [SEQ] change after refractive surgery from the original K-reading) should be applied whenever refraction and K-reading before the keratorefractive procedure are available to cataract surgeons. In addition, more than one modern third-generation formula (e.g., Haigis, Hoffer Q, Holladay 2, or SRK/T) but not a regression formula (e.g., SRK I or SRK II) should be applied and the highest resulting IOL power should be used for the implant.

  12. [Does refractive surgery really make eyeglasses superfluous?].

    Science.gov (United States)

    Seiler, T

    2001-06-14

    Spectacles have become a problem of life-style in some societies. In the USA, in 1999 approximately 1 million LASIK operations have been performed to correct myopia and astigmatism and in Europe the frequency of refractive surgery stead by increases. However, only 3 to 5% of these operations are medically indicated. Refractive surgery is evaluated regarding safety and efficacy. Modern laser techniques demonstrate excellent refractive results: photorefractive keratectomy (PRK) achieved refractive success rates of 90% and more with complication rates of 0.5% and less. PRK is, therefore, a valuable technique for corrections of myopia up to -6.0 D. Similar efficacy is obtained with LASIK (laser in situ keratomileusis) in corrections up to -10 D, however, the complication rate is somewhat higher. Laser correction of hyperopia is equally successful regarding the refractive success but shows an even higher complication rate and the patient satisfaction is lower. Modern refractive laser surgery may replace spectacles in the majority of the cases, however, none of the techniques is free of complications. Therefore, we understand refractive surgery still to be inferior to the correction of ametropia by means of spectacles and any such operation should be attempted only after thorough discussion.

  13. Laser refractive surgery in diabetic patients: a review of the literature

    Directory of Open Access Journals (Sweden)

    Spadea L

    2012-11-01

    Full Text Available Leopoldo Spadea,1 Maria Pia Paroli21University of L’Aquila, Department of Biotechnological and Applied Clinical Sciences, Eye Clinic, L’Aquila, 2University of Rome “La Sapienza”, Department of Surgical Sciences, Eye Clinic, Rome, ItalyBackground: The purpose of this study was to evaluate the current recommendations regarding laser refractive surgery in patients with diabetes mellitus and to assess whether these patients make appropriate candidates for laser vision correction.Methods: A literature search was conducted to identify current research on the ocular complications of diabetes and original publications on laser refractive surgery in diabetic patients.Results: Diabetes was associated with several ocular complications. Initially the US Food and Drug Administration listed these complications as justification to advise against refractive surgery in patients with diabetes. However, recent studies on laser in situ keratomileusis in diabetic patients indicate that this procedure may be safe in diabetic patients with very well controlled systemic disease and no ocular manifestations.Conclusion: Laser refractive surgery may be performed safely in a very selected group of patients with diabetes.Keywords: diabetes, laser in situ keratomileusis, photorefractive keratectomy, refractive surgery

  14. Irregular Astigmatism After Corneal Transplantation--Efficacy and Safety of Topography-Guided Treatment.

    Science.gov (United States)

    Laíns, Inês; Rosa, Andreia M; Guerra, Marta; Tavares, Cristina; Lobo, Conceição; Silva, Maria F L; Quadrado, Maria J; Murta, Joaquim N

    2016-01-01

    To analyze the efficacy and safety of topography-guided photorefractive keratectomy (TG-PRK) to treat irregular astigmatism after corneal transplantation. This was a retrospective observational case series. Eyes with irregular astigmatism after penetrating keratoplasty treated with TG-PRK (Allegretto Wave Eye-Q) with the topography-guided customized ablation treatment protocol were included. All treatments had been planned to correct the topographic irregularities, as well as to reduce the refractive error after neutralizing the induced refractive change. Clinical records, treatment plan, and the examinations performed were reviewed and the following data were collected: corrected and uncorrected distance visual acuities; manifest refraction; topographic parameters, and corneal endothelial cell count. We included 31 eyes [30 patients; mean age 45.0 ± 13.4 (SD) years]. At the last postoperative follow-up (mean 9.2 ± 8.2 months), we observed a significant improvement in corrected (P = 0.001) and uncorrected distance visual acuities (P transplantation eyes. Our results confirm that TG-PRK is an efficient treatment, associated with significant improvements of both visual acuity and refractive parameters.

  15. Cornea donors who have had prior refractive surgery: data from the Eye Bank Association of America.

    Science.gov (United States)

    Fargione, Robert A; Channa, Prabjot

    2016-07-01

    Millions of Americans have undergone refractive surgeries, including radial keratotomy, photorefractive keratectomy, and laser-assisted in situ keratomileusis. Eye Bank Association of America medical standards do not permit corneas from patients who have undergone refractive procedures to be used in penetrating keratoplasty, anterior lamellar keratoplasty, or tectonic grafting procedures. Such corneas, can, however, be used for endothelial corneal transplantation. The objective of this article is to provide an update on current trends for the screening and usage of corneas that have undergone refractive surgery. Several case reports have highlighted the difficulty in using postrefractive surgery corneas in penetrating keratoplasty. However, tissue with anterior stromal flaws, including a history of refractive surgery, has been used in endothelial keratoplasty with equivalent outcomes in topography, endothelial cell count, and visual acuity. Many modalities for proper identification of postmortem donor corneas that have undergone refractive surgery have been studied. Corneas with a history of refractive surgery have found use in endothelial keratoplasty. Multiple objective methods of tissue identification have been investigated to avoid the use of these corneas in penetrating or anterior keratoplasty surgeries.

  16. Biomechanics and wound healing in the cornea.

    Science.gov (United States)

    Dupps, William J; Wilson, Steven E

    2006-10-01

    The biomechanical and wound healing properties of the cornea undermine the predictability and stability of refractive surgery and contribute to discrepancies between attempted and achieved visual outcomes after LASIK, surface ablation and other keratorefractive procedures. Furthermore, patients predisposed to biomechanical failure or abnormal wound healing can experience serious complications such as keratectasia or clinically significant corneal haze, and more effective means for the identification of such patients prior to surgery are needed. In this review, we describe the cornea as a complex structural composite material with pronounced anisotropy and heterogeneity, summarize current understanding of major biomechanical and reparative pathways that contribute to the corneal response to laser vision correction, and review the role of these processes in ectasia, intraocular pressure measurement artifact, diffuse lamellar keratitis (DLK) and corneal haze. The current understanding of differences in the corneal response after photorefractive keratectomy (PRK), LASIK and femtosecond-assisted LASIK are reviewed. Surgical and disease models that integrate corneal geometric data, substructural anatomy, elastic and viscoelastic material properties and wound healing behavior have the potential to improve clinical outcomes and minimize complications but depend on the identification of preoperative predictors of biomechanical and wound healing responses in individual patients.

  17. Intracorneal Ring Segments Implantation for Corneal Ectasia.

    Science.gov (United States)

    Giacomin, Natalia T; Mello, Glauco R; Medeiros, Carla S; Kiliç, Alyin; Serpe, Cristine C; Almeida, Hirlana G; Kara-Junior, Newton; Santhiago, Marcony R

    2016-12-01

    To provide an overview of the predictability, safety, and efficacy of intrastromal corneal ring segment (ICRS) implantation as a tool to improve visual acuity and its association with other techniques such as corneal collagen cross-linking (CXL), addressing biomechanical outcomes, models, surgical planning and technique, indications, contraindications, and complications in ectatic corneas. Literature review. ICRSs have been used to regularize the corneal shape and reduce corneal astigmatism and higher order aberrations, improve visual acuity to acceptable limits, and delay, or eventually prevent, a corneal keratoplasty in keratoconic eyes. Changes in ICRS thickness and size, combination of techniques, and the addition of femtosecond lasers to dissect more foreseeable channels represent an improvement toward more predictable results. Several studies have shown, over time, the long-term efficacy and safety of ICRS treatment for keratoconus, with variable predictability, maintaining the early satisfactory outcomes regarding visual acuity, keratometry, and corneal thickness. It is just as important to ensure that the disease will not progress as it is to improve the visual acuity. Therefore, many studies have shown combined techniques using ICRS implantation and CXL. Also, further limitations of ICRS implantation can be addressed when associated with phakic intraocular lens implantation and photorefractive keratectomy. ICRS implantation has shown effectiveness and safety in most cases, including combined procedures. In properly selected eyes, it can improve both refraction and vision in patients with keratoconus. [J Refract Surg. 2016;32(12):829-839.]. Copyright 2016, SLACK Incorporated.

  18. Correction of High Astigmatism after Penetrating Keratoplasty with Toric Multifocal Intraocular Lens Implantation

    Directory of Open Access Journals (Sweden)

    Raffaele Nuzzi

    2017-07-01

    Full Text Available After penetrating keratoplasty (PK, high astigmatism is often induced, being frequently about 4–6 dpt. According to the entity and typology of astigmatism, different methods of correction can be used. Selective suture removal, relaxing incisions, wedge resections, compression sutures, photorefractive keratectomy, and laser-assisted in situ keratomileusis can reduce corneal astigmatism and ametropia, but meanwhile they can cause a reduction in the corneal integrity and cause an over- or undercorrection. In case of moderate-to-high regular astigmatisms, the authors propose a toric multifocal intraocular lens (IOL implantation to preserve the corneal integrity (especially in PK after herpetic corneal leukoma keratitis. We evaluated a 45-year-old patient who at the age of 30 was subjected to PK in his left eye due to corneal leukoma herpetic keratitis, which led to high astigmatism (7.50 dpt cyl. 5°. The patient was subjected to phacoemulsification and customized toric multifocal IOL implantation in his left eye. The correction of PK-induced residual astigmatism with a toric IOL implantation is an excellent choice but has to be evaluated in relation to patient age, corneal integrity, longevity graft, and surgical risk. It seems to be a well-tolerated therapeutic choice and with good results.

  19. Automated keratoconus detection using the EyeSys videokeratoscope.

    Science.gov (United States)

    Chastang, P J; Borderie, V M; Carvajal-Gonzalez, S; Rostène, W; Laroche, L

    2000-05-01

    To evaluate the effectiveness of indices derived from the EyeSys System 2000 in detecting keratoconic corneas. Department of Ophthalmology, Hôpital Saint Antoine, Paris VI University, Paris, France. Topographies of 208 corneas were evaluated. The corneas were from 8 groups of patients classified by the following diagnoses: normal, regular astigmatism, cataract, radial keratotomy, photorefractive keratectomy, myopic keratomileusis, penetrating keratoplasty (PKP), and keratoconus. Nine statistical indices derived from EyeSys data, 2 Holladay Diagnosis Summary indices (coefficient of uniformity and coefficient of asphericity [Asph]), and our refractive power symmetry index were studied. A training set of 104 corneas was used to determine the most efficient threshold value of each index based on sensitivity and specificity curves. Decision trees combining 2 indices were generated. Sensitivity and specificity were calculated in a validation set composed of the remaining 104 corneas. Based on the results of the training set, the optimum indices were SDSD (standard deviation of the standard deviations of the radii of curvature of each ring) and Asph. In the validation set, the decision tree using these indices featured 88.5% sensitivity and 94.9% specificity; the 4 false-positive cases were in corneas in the PKP group of patients. Clinically apparent keratoconus can be detected among normal corneas and irregular corneal shape patterns using the EyeSys System 2000 data and a decision tree combining 2 indices.

  20. Giant hepatic hemangioma and cross-fused ectopic kidney in a spaceflight participant.

    Science.gov (United States)

    Jennings, Richard T; Garriott, Owen K; Bogomolov, Valery V; Pochuev, Vladimir I; Morgun, Valery V; Garriott, Richard A

    2010-02-01

    Commercial spaceflight participants are typically older than traditional astronauts and often have medical conditions that make medical certification for flight difficult. This case report considers a 43-yr-old spaceflight participant who planned a short-duration Soyuz flight to the International Space Station (ISS). While he participated in many hazardous activities such as parachuting, hang gliding, scuba diving, Antarctic and jungle exploration, and deep sea submersible operations, he knew that several of his medical conditions precluded serving as a career astronaut. At the time of his initial spaceflight prescreen examination, he was known to have previous bilateral photorefractive keratectomy (PRK) for myopia and a cross-fused left ectopic kidney that would be disqualifying for a career astronaut. During the evaluation for the left single cross-fused ectopic kidney, a giant hepatic hemangioma was also discovered. In order to medically qualify for flight, the giant hepatic hemangioma was surgically removed. This case summary investigat*es the implications of a single cross-fused left ectopic kidney and the decision process and treatment implications for spaceflight medical certification in an individual with an asymptomatic giant hepatic hemangioma.

  1. Evaluation of Corneal Deformation Analyzed with Scheimpflug Based Device in Healthy Eyes and Diseased Ones

    Science.gov (United States)

    Lanza, Michele; Cennamo, Michela; Iaccarino, Stefania; Irregolare, Carlo; Bifani, Mario; Gironi Carnevale, Ugo Antonello

    2014-01-01

    This study was designed to evaluate the correlation between corneal biomechanical and morphological data in healthy eyes, eyes that underwent myopic photorefractive keratectomy (PRK), keratoconus affected eyes, and keratoconus affected eyes that underwent corneal collagen crosslinking (CCC). Complete clinical eye examination of all eyes was followed by tomographic (Pentacam, Oculus, Wetzlar, Germany) and biomechanical (Corvis ST, Oculus, Wetzlar, Germany) evaluation. Differences among Corvis ST (CST) parameters in the different groups have been performed. Linear regression between central corneal thickness (CCT), intraocular pressure (IOP), and anterior corneal curvature measured with Sim'K (KM), versus corneal deformation parameters measured with Corvis ST in the different groups, has been run using SPSS software version 18.0. We evaluated 64 healthy eyes of 64 patients with a mean refractive error of −0.65 ± 1.68 D (measured as spherical equivalent), 17 eyes of 17 patients that underwent myopic PRK for a mean refractive defect of −4.91 ± 2.05 D (measured as spherical equivalent), 16 eyes of 16 patients affected by keratconus (stage 2-3 of Amsler Classification), and 13 eyes of 13 patients affected by keratoconus that underwent CCC. Our data suggest that corneal curvature would have a greater influence on corneal deformation than CCT; in fact KM values are more strongly associated with more CST parameters both about corneal change in shape and both about the corneal ability to come back at original shape. PMID:25054144

  2. Customized Finite Element Modelling of the Human Cornea

    Science.gov (United States)

    Simonini, Irene; Pandolfi, Anna

    2015-01-01

    Aim To construct patient-specific solid models of human cornea from ocular topographer data, to increase the accuracy of the biomechanical and optical estimate of the changes in refractive power and stress caused by photorefractive keratectomy (PRK). Method Corneal elevation maps of five human eyes were taken with a rotating Scheimpflug camera combined with a Placido disk before and after refractive surgery. Patient-specific solid models were created and discretized in finite elements to estimate the corneal strain and stress fields in preoperative and postoperative configurations and derive the refractive parameters of the cornea. Results Patient-specific geometrical models of the cornea allow for the creation of personalized refractive maps at different levels of IOP. Thinned postoperative corneas show a higher stress gradient across the thickness and higher sensitivity of all geometrical and refractive parameters to the fluctuation of the IOP. Conclusion Patient-specific numerical models of the cornea can provide accurate quantitative information on the refractive properties of the cornea under different levels of IOP and describe the change of the stress state of the cornea due to refractive surgery (PRK). Patient-specific models can be used as indicators of feasibility before performing the surgery. PMID:26098104

  3. Correlations between corneal hysteresis, intraocular pressure, and corneal central pachymetry.

    Science.gov (United States)

    Touboul, David; Roberts, Cynthia; Kérautret, Julien; Garra, Caroline; Maurice-Tison, Sylvie; Saubusse, Elodie; Colin, Joseph

    2008-04-01

    To analyze the correlation between corneal hysteresis (CH) measured with the Ocular Response Analyzer (ORA, Reichert) and ultrasonic corneal central thickness (CCT US) and intraocular pressure measured with Goldmann applanation tonometry (IOP GA). Bordeaux 2 University, Ophthalmology Department, Bordeaux, France. This study comprised 498 eyes of 258 patients. Corneal hysteresis, corneal resistance factor (CRF), and IOP corneal-compensated (IOPcc) were provided by the ORA device; CCT US and IOP GA were also measured in each eye. The study population was divided into 5 groups: normal (n = 122), glaucoma (n = 159), keratoconus (n = 88), laser in situ keratomileusis (LASIK) (n = 78), and photorefractive keratectomy (n = 39). The Pearson correlation was used for statistical analysis. Corneal hysteresis was not strongly correlated with IOP or CCT US. The mean CH in the LASIK (8.87 mm Hg) and keratoconus (8.34 mm Hg) groups was lower than in the glaucoma (9.48 mm Hg) and normal (10.26 mm Hg) groups. The lower the CH, the lower its correlation with IOPcc and IOP GA. A CH higher than the CRF was significantly associated with the keratoconus and post-LASIK groups. Corneal hysteresis, a new corneal parameter, had a moderate dependence on IOP and CCT US. Weaker corneas could be screened with ORA parameters, and low CH could be considered a risk factor for underestimation of IOP. The CCT US should continue to be considered a useful parameter.

  4. Corneal Cross-Linking: An Example of Photoinduced Polymerization as a Treatment Modality in Keratoconus.

    Science.gov (United States)

    Kubrak-Kisza, Magdalena; Kisza, Krystian Jerzy; Misiuk-Hojło, Marta

    2016-01-01

    The cornea is one of the principal refractive elements in the human eye and plays a crucial role in the process of vision. Keratoconus is the most common corneal dystrophy, found mostly among young adults. It is characterized by a reduced number of collagen cross-links in the corneal stroma, resulting in reduced biomechanical stability and an abnormal shape of the cornea. These changes lead to progressive myopia, corneal thinning, central scarring and irregular astigmatism, causing severely impaired vision. Hard contact lenses, photorefractive keratectomy or intracorneal rings are the most common treatment options for refractive error caused by keratoconus. However, these techniques do not treat the underlying cause of the corneal ectasia and therefore are not able to stop the progression of the disease. Riboflavin photoinduced polymerization of corneal collagen, also known as corneal cross-linking (CXL), has been introduced as the first therapy which, by stabilizing the structure of the cornea, prevents the progression of keratoconus. It stiffens the cornea using the photo-sensitizer riboflavin in combination with ultraviolet irradiation. This is a current review of the CXL procedure as a therapy for keratoconus, which relies on photoinduced polymerization of human tissue. We have focused on its biomechanical and physiological influences on the human cornea and have reviewed the previous and current biochemical theories behind cross-linking reactions in the cornea.

  5. Biomechanical modeling of refractive corneal surgery.

    Science.gov (United States)

    Alastrué, V; Calvo, B; Peña, E; Doblaré, M

    2006-02-01

    The aim of refractive corneal surgery is to modify the curvature of the cornea to improve its dioptric properties. With that goal, the surgeon has to define the appropriate values of the surgical parameters in order to get the best clinical results, i.e., laser and geometric parameters such as depth and location of the incision, for each specific patient. A biomechanical study before surgery is therefore very convenient to assess quantitatively the effect of each parameter on the optical outcome. A mechanical model of the human cornea is here proposed and implemented under a finite element context to simulate the effects of some usual surgical procedures, such as photorefractive keratectomy (PRK), and limbal relaxing incisions (LRI). This model considers a nonlinear anisotropic hyperelastic behavior of the cornea that strongly depends on the physiological collagen fibril distribution. We evaluate the effect of the incision variables on the change of curvature of the cornea to correct myopia and astigmatism. The obtained results provided reasonable and useful information in the procedures analyzed. We can conclude from those results that this model reasonably approximates the corneal response to increasing pressure. We also show that tonometry measures of the IOP underpredicts its actual value after PRK or LASIK surgery.

  6. Rescue of Primary Incomplete Microkeratome Flap with Secondary Femtosecond Laser Flap in LASIK

    Directory of Open Access Journals (Sweden)

    E. A. Razgulyaeva

    2014-01-01

    Full Text Available For laser-assisted in situ keratomileusis (LASIK retreatments with a previous unsuccessful mechanical microkeratome-assisted surgery, some surgical protocols have been described as feasible, such as relifting of the flap or the creation of a new flap and even the change to a surface ablation procedure (photorefractive keratectomy (PRK. This case shows the use of femtosecond technology for the creation of a secondary flap to perform LASIK in a cornea with a primary incomplete flap obtained with a mechanical microkeratome. As we were unable to characterize the interface of the first partial lamellar cut, a thick flap was planned and created using a femtosecond laser platform. As the primary cut was very thick in the nasal quadrant, a piece of loose corneal tissue appeared during flap lifting which was fitted in its position and not removed. Despite this condition and considering the regularity of the new femtosecond laser cut, the treatment was uneventful. This case report shows the relevance of a detailed corneal analysis with an advanced imaging technique before performing a secondary flap in a cornea with a primary incomplete flap. The femtosecond laser technology seems to be an excellent tool to manage such cases successfully.

  7. Clinical research on high myopia treatments using AMARIS trans-epithelial PRK

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    Wu-Qiang Shan

    2015-12-01

    Full Text Available AIM:To evaluate the efficiency and safety of high myopia treatments using AMARIS trans-epithelial photorefractive keratectomy(PRK.METHODS:One hundred and thirty six eyes in 68 patients with high myopic were treated using Amaris trans-epithelial PRK during December 2012~December 2013. Post-operative pain, haze, visual acuity, refraction and intraocular pressure(IOPwere analyzed during 12mo follow-up post-operatively.RESULTS:One hundred and eight eyes in 54 patients felt no discomfort at all, while 28 eyes in 14 patients reported dry eye, slight pain and foreign body sensation. UCVA between the two groups showed statistically different at 3, 6mo and 1a(t=2.04, P=0.047. UCVA at 3mo was the best compared with those at other time pionts, and became stable at 6mo. UCVA of all patients were above 0.8 at 12mo,and had no difference with that before operations(t=1.508, P=0.1670. Haze were hardly seen, and most of them were between grade 0~1. The patients' satisfaction was over 85% according to the survey about night vision, dry eye and asthenopia.CONCLUSION:Because of the great advantages of no-touch, fast recovery and less side effects, trans-epithelial PRK has great efficiency, safety and satisfaction. It now is the most ideal method of surface ablation for high myopia treatments.

  8. Customized Finite Element Modelling of the Human Cornea.

    Directory of Open Access Journals (Sweden)

    Irene Simonini

    Full Text Available To construct patient-specific solid models of human cornea from ocular topographer data, to increase the accuracy of the biomechanical and optical estimate of the changes in refractive power and stress caused by photorefractive keratectomy (PRK.Corneal elevation maps of five human eyes were taken with a rotating Scheimpflug camera combined with a Placido disk before and after refractive surgery. Patient-specific solid models were created and discretized in finite elements to estimate the corneal strain and stress fields in preoperative and postoperative configurations and derive the refractive parameters of the cornea.Patient-specific geometrical models of the cornea allow for the creation of personalized refractive maps at different levels of IOP. Thinned postoperative corneas show a higher stress gradient across the thickness and higher sensitivity of all geometrical and refractive parameters to the fluctuation of the IOP.Patient-specific numerical models of the cornea can provide accurate quantitative information on the refractive properties of the cornea under different levels of IOP and describe the change of the stress state of the cornea due to refractive surgery (PRK. Patient-specific models can be used as indicators of feasibility before performing the surgery.

  9. Analysis of the direction and degree of static cyclotorsion component and dynamic cyclotorsion component in corneal refractive surgery

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    Bei Huang

    2016-07-01

    Full Text Available AIM: To analyze the direction and degree of static cyclotorsion component(SCCand dynamic cyclotorsion component(DCCin corneal refractive surgery. METHODS:Retrospective analysis. Totally 130 patients(260 eyeswith corneal refractive surgery in our hospital, according to the operation method were divided into femtosecond laser-assisted laser in situ keratomileusis(FS-LASIKgroup and T-photorefractive keratectomy(T-PRKgroup, the differences of the parameters of the two groups were compared; the differences of SCC success rate, SCC, DCC, and the eyeball rotation direction were compared between the two groups; correlation analysis on SCC, DCC and the parameters of postoperative patients were performed. RESULTS:High order aberrations and spherical aberration in the T-PRK group after operation was higher than those of FS-LASIK group, and the difference was statistically significant(PPP>0.05; DCC in T-PRK group(2.86°±1.14°was higher than that of FS-LASIK group(2.17°±1.09°, and the difference was statistically significant(PP>0.05. The SCC of subjects in operation was positively correlated with UCVA, BCVA, spherical equivalent refraction and high order aberrations(PPCONCLUSION:The success rate of SCC in T-PRK surgery is higher than that in LASIK, DCC in T-PRK surgery is higher than that in LASIK, and accurate measurement of SCC and DCC can be effective to compensate for it.

  10. Refractive lenticule extraction (ReLEx through a small incision (SMILE for correction of myopia and myopic astigmatism: current perspectives

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    Ağca A

    2016-10-01

    Full Text Available Alper Ağca,1 Ahmet Demirok,2 Yusuf Yıldırım,1 Ali Demircan,1 Dilek Yaşa,1 Ceren Yeşilkaya,1 İrfan Perente,1 Muhittin Taşkapılı1 1Beyoğlu Eye Research and Training Hospital, 2Department of Ophthalmology, Istanbul Medeniyet University, Istanbul, Turkey Abstract: Small-incision lenticule extraction (SMILE is an alternative to laser-assisted in situ keratomileusis (LASIK and photorefractive keratectomy (PRK for the correction of myopia and myopic astigmatism. SMILE can be performed for the treatment of myopia ≤-12 D and astigmatism ≤5 D. The technology is currently only available in the VisuMax femtosecond laser platform. It offers several advantages over LASIK and PRK; however, hyperopia treatment, topography-guided treatment, and cyclotorsion control are not available in the current platform. The working principles, potential advantages, and disadvantages are discussed in this review. Keywords: SMILE, small-incision lenticule extraction, femtosecond laser, laser in situ keratomileusis, corneal biomechanics

  11. Keratoconus: current perspectives

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    Vazirani J

    2013-10-01

    Full Text Available Jayesh Vazirani, Sayan BasuCornea and Anterior Segment Services, LV Prasad Eye Institute, Hyderabad, IndiaAbstract: Keratoconus is characterized by progressive corneal protrusion and thinning, leading to irregular astigmatism and impairment in visual function. The etiology and pathogenesis of the condition are not fully understood. However, significant strides have been made in early clinical detection of the disease, as well as towards providing optimal optical and surgical correction for improving the quality of vision in affected patients. The past two decades, in particular, have seen exciting new developments promising to alter the natural history of keratoconus in a favorable way for the first time. This comprehensive review focuses on analyzing the role of advanced imaging techniques in the diagnosis and treatment of keratoconus and evaluating the evidence supporting or refuting the efficacy of therapeutic advances for keratoconus, such as newer contact lens designs, collagen crosslinking, deep anterior lamellar keratoplasty, intracorneal ring segments, photorefractive keratectomy, and phakic intraocular lenses.Keywords: keratoconus, corneal topography, hydrops, collagen cross-linking, keratoplasty, contact lenses

  12. Corneal stromal wound healing in refractive surgery: the role of myofibroblasts.

    Science.gov (United States)

    Jester, J V; Petroll, W M; Cavanagh, H D

    1999-05-01

    While laser and incisional refractive surgery offer the promise to correct visual refractive errors permanently and predictably, variability and complications continue to hinder wide-spread acceptance. To explain variations, recent studies have focused on the role of corneal wound healing in modulating refractive outcomes. As our understanding of the corneal response to refractive surgery broadens, it has become apparent that the response of one cell, the corneal stromal keratocyte, plays a pivotal role in defining the results of refractive surgery. Studies reviewed herein demonstrate that injury-induced activation and transformation of keratocytes to myofibroblasts control the deposition and organization of extracellular matrix in corneal wounds. Myofibroblasts establish an interconnected meshwork of cells and extracellular matrix that deposits new matrix and contracts wounds using a novel and unexpected "shoe-string-like" mechanism. Transformation of keratocytes to myofibroblasts is induced in culture by transforming growth factor beta (TGFbeta) and blocked in vivo by antibodies to TGFbeta. Overall, myofibroblast appearance in corneal wounds is associated with wound contraction and regression following incisional keratotomy and the development of "haze" or increased scattered light following laser photorefractive keratectomy (PRK). By contrast, absence of myofibroblasts is associated with continued widening of wound gape and progressive corneal flattening after incisional procedures. Based on these studies, we have arrived at the inescapable conclusion that a better understanding of the cellular and molecular biology of this one cell is required if refractive surgery is ever to achieve predictable and safe refractive results.

  13. Biomechanics and Wound Healing in the Cornea

    Science.gov (United States)

    Dupps, William J.; Wilson, Steven E.

    2009-01-01

    The biomechanical and wound healing properties of the cornea undermine the predictability and stability of refractive surgery and contribute to discrepancies between attempted and achieved visual outcomes after LASIK, surface ablation and other keratorefractive procedures. Furthermore, patients predisposed to biomechanical failure or abnormal wound healing can experience serious complications such as keratectasia or clinically significant corneal haze, and more effective means for the identification of such patients prior to surgery are needed. In this review, we describe the cornea as a complex structural composite material with pronounced anisotropy and heterogeneity, summarize current understanding of major biomechanical and reparative pathways that contribute to the corneal response to laser vision correction, and review the role of these processes in ectasia, intraocular pressure measurement artifact, diffuse lamellar keratitis (DLK) and corneal haze. The current understanding of differences in the corneal response after photorefractive keratectomy (PRK), LASIK and femtosecond-assisted LASIK are reviewed. Surgical and disease models that integrate corneal geometric data, substructural anatomy, elastic and viscoelastic material properties and wound healing behavior have the potential to improve clinical outcomes and minimize complications but depend on the identification of preoperative predictors of biomechanical and wound healing responses in individual patients. PMID:16720023

  14. Presbyopia-correcting intraocular lenses and corneal refractive procedures: a review for retinal surgeons.

    Science.gov (United States)

    Ahmad, Baseer U; Shah, Gaurav K; Hardten, David R

    2014-06-01

    To review the specific challenges and pitfalls that vitreoretinal surgeons may face when operating on eyes with presbyopia-correcting intraocular lenses or previous corneal refractive surgery. In addition, this review aims to familiarize vitreoretinal surgeons with specifications of currently available Food and Drug Administration-approved presbyopia-correcting intraocular lenses. Review of current literature performed with PubMed for search terms "presbyopia," "correction," "IOL," "vitreoretinal," "challenges," and "surgical" both singly and in combination as well as closely related terms. Specific intraoperative issues with presbyopia-correcting intraocular lenses that may be encountered include peripheral visualization, condensation, lens material issues particularly with silicone oil, decentration, Z-syndrome, and foveal image displacement. Every patient undergoing retinal surgery should also be asked about previous laser-assisted in situ keratomileusis/photorefractive keratectomy because those eyes require special attention to surface hydration and care to avoid epithelial removal if possible. Intracorneal ring segments and corneal inlays can cause effects similar to those of a small pupil. However, these can be managed with thorough preoperative evaluation and various intraoperative maneuvers. In addition, retinal physicians should be aware that macular disorders, such as age-related macular degeneration, may be exacerbated by potential loss of contrast sensitivity.

  15. Customized Finite Element Modelling of the Human Cornea.

    Science.gov (United States)

    Simonini, Irene; Pandolfi, Anna

    2015-01-01

    To construct patient-specific solid models of human cornea from ocular topographer data, to increase the accuracy of the biomechanical and optical estimate of the changes in refractive power and stress caused by photorefractive keratectomy (PRK). Corneal elevation maps of five human eyes were taken with a rotating Scheimpflug camera combined with a Placido disk before and after refractive surgery. Patient-specific solid models were created and discretized in finite elements to estimate the corneal strain and stress fields in preoperative and postoperative configurations and derive the refractive parameters of the cornea. Patient-specific geometrical models of the cornea allow for the creation of personalized refractive maps at different levels of IOP. Thinned postoperative corneas show a higher stress gradient across the thickness and higher sensitivity of all geometrical and refractive parameters to the fluctuation of the IOP. Patient-specific numerical models of the cornea can provide accurate quantitative information on the refractive properties of the cornea under different levels of IOP and describe the change of the stress state of the cornea due to refractive surgery (PRK). Patient-specific models can be used as indicators of feasibility before performing the surgery.

  16. Fast dynamic waveguides and waveguide arrays in photorefractive Sn(2)P(2)S(6) induced by visible light.

    Science.gov (United States)

    Juvalta, Flurin; Mosimann, Roger; Jazbinsek, Mojca; Günter, Peter

    2009-01-19

    We report on dynamic waveguides and waveguide arrays induced beneath the surface of electro-optic Sn(2)P(2)S(6) crystals by visible light at 514 nm. The waveguide structures are generated by interband photoexcitation and drift or diffusion charge transport mechanism. These structures are probed nondestructively in the transverse direction with a beam at a longer wavelength. We measured the fastest formation of light induced waveguides in the visible up to now. The recording times are below 200 mus for intensities above 0.1 W/cm2. By interfering two light beams, dynamic waveguide arrays are generated with waveguide spacings of 7 microm. If an electric field is applied to the crystal, these arrays can be spatially shifted by 1.5 mum for an applied field of E(0) = 1 kV/cm.

  17. Synthesis and functionalization of a triaryldiamine-base photoconductive/photorefractive composite, and its application to aberrated image restoration

    Science.gov (United States)

    Liang, Yichen

    Organic phoorefractive (PR) composites have recently emerged as an important class of materials for applications including high-density data storage, optical communication, and biomedical imaging. In an effort to further improve their performance, this study focused on the utilization of functionalized semiconductor nanocrystals to photosensitize triaryamine (TPD)-based PR composites, as well as the application of TPD-based PR composites in the restoration of aberrated optical information. A novel approach to functionalize CdSe quantum dot (QCdSe) was firstly introduced where the sulfonated triarydiamine (STPD) was used as charge-transporting ligand to passivate QCdSe. TPD-based photoconductive and PR composites were photosensitized with the STPD-passivated QCdSe (SQCdSe). Due to the charge-transporting capability of STPD, the composites photosensitized with STPD-capped QCdSe exhibited superior performance relative to composites employing more traditional photosensitizers (such as fullerene C60 and trioctylphosphine-capped QCdSe), with figures-of-merit including photoconductivities in excess of 60 pS/cm, two-beam coupling gain coefficients in excess of 110 cm-1, and PR response time of less than 30 ms. In addition, the ability of TPD-based PR composites to correct aberrations associated with a laser beam was described. Here, a severely aberrated laser beam was able to be restored to a nearly unaberrated condition through the PR process, and the potential of this technique for practical applications was well explained. Based on the current experimental geometry, a PR response time of 0.5 s was observed, which is the fastest PR response time reported for a PR composite operating under experimental conditions designed for the correction of optical aberrations.

  18. Long-term results of femtosecond laser-assisted sutureless anterior lamellar keratoplasty.

    Science.gov (United States)

    Shousha, Mohamed Abou; Yoo, Sonia H; Kymionis, George D; Ide, Takeshi; Feuer, William; Karp, Carol L; O'Brien, Terrence P; Culbertson, William W; Alfonso, Eduardo

    2011-02-01

    To evaluate the long-term results of femtosecond laser-assisted anterior lamellar keratoplasty (FALK) for anterior corneal pathologies. Retrospective, noncomparative, interventional case series. Thirteen consecutive patients who underwent FALK for anterior corneal pathologies. Femtosecond laser-assisted sutureless anterior lamellar keratoplasty. Best spectacle-corrected visual acuity (BSCVA), manifest refraction, need for adjunctive surgery, and complications. Follow-up ranged from 12 to 69 months (mean = 31 months). The BSCVA was significantly improved over preoperative values at the 12-, 18-, 24-, and 36-month visits. A BSCVA greater than 20/30 was achieved in 54% of patients at the 12-month visit when all 13 patients were available for follow-up, in 50% and 33% of patients at the 18- and 24-month visits, respectively, when 12 patients were available, and in 60% and 50% of patients at the 36- and 48-month visits when 5 and 2 patients were available, respectively. The BSCVA of the eye that completed the 60- and 70-month visits was 20/50. Patients achieved a mean gain of 5 lines of BSCVA at the 6-, 12-, 18-, and 24-month visits, 4 lines at the 36-month visit, 5 lines at the 48-month visit, and 6 lines at the 60- and 72-month visits. Two patients lost a mean of 1.5 lines of BSCVA because surface haze developed after photorefractive keratectomy (PRK) and granular dystrophy recurred in the graft. At a mean of 5 weeks postoperatively, 83.3% of patients achieved BSCVA within 2 lines of that recorded at the 24-month visit. At the 12-month visit, mean spherical equivalent and refractive astigmatism were -0.4 diopters (D) and 2.2 D, respectively, with no significant shift from preoperative values or values recorded in different follow-up visits. Adjunctive surgeries included phototherapeutic keratectomy, PRK, cataract extraction, and epithelial ingrowth debridement. Complications included residual corneal pathology, mild interface haze, anisometropia, recurrence of

  19. Análise laboratorial das ceratites infecciosas secundárias à cirurgia refrativa Laboratory analysis of infectious keratitis in patients following refractive surgery

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    Fernando Leal

    2005-06-01

    Full Text Available OBJETIVO: Descrever os resultados laboratoriais de amostras de pacientes com ceratite infecciosa pós-cirurgia refrativa. MÉTODOS: Foram avaliados pacientes do Departamento de Oftalmologia da UNIFESP, que foram submetidos a tratamento para ceratite infecciosa, entre janeiro de 1988 e junho de 2001, e que haviam sido submetidos à ceratomia radial (CR, ceratotomia fotorrefrativa (PRK ou laser in situ keratomileusis (LASIK. Previamente, as infecções foram classificadas como precoces, quando ocorreram até 30 dias após a cirurgia, e tardias quando diagnosticadas após 30 dias. RESULTADOS: Das 93 amostras, 39 eram de (42% pacientes submetidos à ceratotomia radial, sendo 14 (36% infecções precoces e 25 (64% infecções tardias; 38 (41% pacientes submetidos a LASIK, sendo 21 (55% infecções precoces e 17 (45% infecções tardias; 16 (17% eram de pacientes submetidos à ceratotomia fotorrefrativa, sendo 10 (62,5% infecções precoces e 6 (37,5% infecções tardias. Oitenta e seis amostras de córnea coletadas foram submetidas a cultivo e esfregaço para bactérias, 43 cultivos (50% e 43 esfregaços (50% foram positivos. Setenta e duas amostras foram submetidas a cultivo e esfregaço para fungos, 2 cultivos (3% e 4 esfregaços (6% foram positivos. CONCLUSÃO: Os resultados obtidos revelam uma concordância de 80,2% entre cultivo e esfregaço para bactéria. Não houve relação estatisticamente significante entre o tipo de cirurgia e o tempo de manifestação da infecção.PURPOSE: To describe the laboratory findings in patients with infectious keratitis, who underwent refractive surgery, correlating the surgical procedure and the time of infection manifestation, and the results of culture and smears. METHODS: The previous samples were obtained from patients submitted to radial keratotomy (RK, photorefractive keratectomy (PRK and laser in situ keratomileusis (LASIK at the Ophthalmology Department of UNIFESP. The infections were classified as

  20. Astigmatism induced by conventional spherical ablation after PRK and LASIK in myopia with astigmatism < 1.00 D

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    Christiansen SM

    2012-12-01

    Full Text Available Steven M Christiansen,1 Mark D Mifflin,1 Jason N Edmonds,1 Rachel G Simpson,2 Majid Moshirfar11John A Moran Eye Center, University of Utah, Salt Lake City, UT, 2The University of Arizona College of Medicine, Phoenix, AZ, USABackground: The purpose of this study was to evaluate surgically-induced astigmatism after spherical ablation in photorefractive keratectomy (PRK and laser-assisted in situ keratomileusis (LASIK for myopia with astigmatism < 1.00 D.Methods: The charts of patients undergoing spherical PRK or LASIK for the correction of myopia with minimal astigmatism of <1.00 D from 2002 to 2012 at the John A Moran Eye Center in Salt Lake City, UT, were retrospectively reviewed. Astigmatism was measured by manifest refraction. The final astigmatic refractive outcome at 6 months postoperatively was compared with the initial refraction by Alpins vector analysis.Results: For PRK, average cylinder increased from 0.39 ± 0.25 (0.00–0.75 preoperatively to 0.55 ± 0.48 (0.00–1.75 postoperatively (P = 0.014, compared with an increase in LASIK eyes from 0.40 ± 0.27 (0.00–0.75 preoperatively to 0.52 ± 0.45 (0.00–2.00 postoperatively (P = 0.041. PRK eyes experienced an absolute value change in cylinder of 0.41 ± 0.32 (0.00–1.50 and LASIK eyes experienced a change of 0.41 ± 0.31 (0.00–1.50, P = 0.955. Mean surgically-induced astigmatism was 0.59 ± 0.35 (0.00–1.70 in PRK eyes, with an increase in surgically-induced astigmatism of 0.44 D for each additional 1.00 D of preoperative cylinder; in LASIK eyes, mean surgically-induced astigmatism was 0.55 ± 0.32 (0.00–1.80, P = 0.482, with an increase in surgically-induced astigmatism of 0.29 D for each 1.00 D of preoperative cylinder.Conclusion: Spherical ablation can induce substantial astigmatism even in eyes with less than one diopter of preoperative astigmatism in both PRK and LASIK. No significant difference in the magnitude of surgically-induced astigmatism was found between eyes

  1. Effectiveness of an Eyelid Thermal Pulsation Procedure to Treat Recalcitrant Dry Eye Symptoms After Laser Vision Correction.

    Science.gov (United States)

    Schallhorn, Craig S; Schallhorn, Julie M; Hannan, Stephen; Schallhorn, Steven C

    2017-01-01

    To provide an initial retrospective evaluation of the effectiveness of a thermal pulsation system to treat intractable patient-reported dye eye symptoms following laser vision correction. A total of 109 eyes of 57 patients underwent thermal pulsation therapy (LipiFlow; TearScience, Morrisville, NC) for the treatment of dry eye symptoms following laser vision correction. A standardized dry eye questionnaire, the Standard Patient Evaluation of Eye Dryness (SPEED II), was administered to all patients before and after thermal pulsation therapy. The primary outcome was patient-reported dry eye symptoms as measured by this questionnaire. The mean patient age was 49 years (interquartile range [IQR]: 38 to 60), 70% were female, and the primary refractive procedure was LASIK (n = 91, 83%) or photorefractive keratectomy (PRK) (n = 18, 17%). Patients underwent thermal pulsation therapy at a mean of 40.5 months (IQR: 27.6 to 55.0) after the primary procedure. The mean pre-therapy SPEED II questionnaire score was 17.5 (IQR: 14 to 21), with a reduced mean post-therapy score of 10.2 (IQR: 6 to 14; 95% confidence interval [CI]: 8.8 to 11.5, P < .001). Patients with PRK tended to report more improvement. At the follow-up clinical evaluation, objective improvements were noted in tear break-up time (+1.9 sec; 95% CI: 1.3 to 2.5), reduction in grade of meibomian gland dysfunction (-0.69; 95% CI: -0.54 to -0.84), and corneal staining (-0.74; 95% CI: -0.57 to -0.91). In this initial retrospective evaluation, a significant improvement in patient-reported dry eye symptoms was observed following thermal pulsation therapy. This treatment modality may have utility in the management of dry eye symptoms following laser vision correction, but further study is needed to define its role. [J Refract Surg. 2017;33(1):30-36.]. Copyright 2017, SLACK Incorporated.

  2. Clinical use of in vivo confocal microscopy through focusing in corneal refractive surgery.

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    Ying, Li; Xiao, Zhang; Liuxueying, Zhong; Yumei, Jin

    2006-11-01

    To illustrate the use of in vivo confocal microscopy through focusing to observe normal cornea and corneal wound healing after excimer laser refractive surgery. A total of 197 eyes, including both unoperated eyes and eyes that had undergone LASIK, photorefractive keratectomy (PRK), or laser epithelial keratomileusis (LASEK), were examined using in vivo confocal microscopy through focusing. Images of the various corneal layers resolved by confocal microscopy through focusing were recorded and analyzed. Pachymetry of the cornea, epithelium, and stroma was also recorded for all eyes. The t test was used to evaluate the differences between unoperated eyes and postoperative eyes and the change in corneal pachymetry preoperatively to postoperatively with each type of surgery. A P value <.05 was considered statistically significant. Each layer of the cornea could be resolved in unoperated eyes and eyes that had undergone refractive surgery. Wound healing could be followed over time using confocal microscopy through focusing. In eyes that underwent PRK, at 1 month postoperatively, the entire cornea and stroma were thinner than preoperatively, whereas the epithelial layer was statistically significantly thicker (P<.05). Haze after PRK is seen as reflectivity of subepithelial anterior stroma. No clinically significant haze was observed in eyes that underwent LASEK or LASIK. The features of the eyes that underwent LASIK were the same as those of unoperated eyes. Confocal microscopy through focusing was useful in documenting cellular morphology in unoperated corneas and corneas that had undergone refractive surgery. Wound-healing characteristics of eyes that had undergone refractive surgery were also documented using confocal microscopy.

  3. Intrastromal corneal ring segment implantation for ectasia after refractive surgery.

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    Stival, Larissa Rossana Souza; Nassaralla, Belquiz R do Amaral; Figueiredo, Marisa Novaes Falleiro Chaves de; Bicalho, Frederico; Nassaralla Junior, João Jorge

    2015-01-01

    To evaluate the clinical outcomes of intrastromal corneal ring segment (ICRS) implantation to correct ectasia in eyes with prior refractive surgery. Forty-one eyes of 25 patients (13 men, 12 women; mean age, 28.66 years) with ectasia after refractive surgery [photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK)] were included in a nonrandomized, retrospective, observational case series. Corneal tunnels were created by mechanical dissection in all eyes. Main outcome measures included uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BCVA), refraction, keratometry, and computerized analysis of corneal topography. Patients were divided into two groups by the type of refractive surgery (Group A: PRK, Group B: LASIK). The mean preoperative manifest astigmatism decreased from -1.88 to -0.84 D in Group A (p=0.096) and -3.18 to -1.77 D in Group B (p=0.000). The mean keratometric astigmatism decreased from -2.58 to -1.66 D in Group A (p=0.010) and -4.80 to -2.78 D in Group B (p=0.000). The mean spherical equivalent decreased from -2.97 to -2.05 D in Group A (p=0.065) and -3.31 to -2.42 D in Group B (p=0.014). No significant between-group differences were noted on the comparison of preoperative and postoperative results. No intraoperative or postoperative complications were observed. ICRS implantation is a useful treatment option for ectasia following refractive surgery, and it has significantly reduced the refractive cylinder and increased best spectacle-corrected visual acuity.

  4. [Studies of the development of refractive effects in intrastromal refractive corneal surgery with the picosecond laser].

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    Vogel, A; Günther, T; Asiyo-Vogel, M; Birngruber, R

    1997-07-01

    Picosecond laser intrastromal photorefractive keratectomy (ISPRK) aims at achieving a flattening of the central cornea by plasma-mediated tissue evaporation without affecting the anterior or posterior corneal layers. We investigated the laser-induced tissue effects to establish a functional relationship between laser parameters and tissue removal and to assess their influence on the healing process and long-term refractive changes. A modified ISL 2001 System with a cone angle of 30 degrees was used for in vitro investigations of the laser effects in water and porcine cornea. Photographic methods were used to determine the plasma volume and the thickness of the laser-generated intrastromal bubble layer as a function of the pulse energy and the number and separation in which the pulses were applied (216 eyes). Histological evaluation was done by polarization microscopy (9 eyes). Polarization microscopy revealed only minor signs of thermal tissue damage. The maximum amount of tissue that can be evaporated without damaging the outer corneal layers corresponds to a layer about 10 microns thick. With a 6-mm optical zone, this tissue removal yields an immediate refractive effect of only 0.85 dpt. Stronger long-term refractive changes observed in animal experiments and clinical studies must thus be due to the healing response of the cornea. The healing response may be induced by mechanical distortion due to intrastromal bubble formation affecting about one third of the corneal thickness. Since the refractive effects are apparently strongly influenced by corneal healing, they are poorly predictable and can probably not be used for clinical purposes.

  5. Intrastromal corneal ring segment implantation for ectasia after refractive surgery

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    Larissa Rossana Souza Stival

    2015-08-01

    Full Text Available ABSTRACTPurpose:To evaluate the clinical outcomes of intrastromal corneal ring segment (ICRS implantation to correct ectasia in eyes with prior refractive surgery.Methods:Forty-one eyes of 25 patients (13 men, 12 women; mean age, 28.66 years with ectasia after refractive surgery [photorefractive keratectomy (PRK or laser in situ keratomileusis (LASIK] were included in a nonrandomized, retrospective, observational case series. Corneal tunnels were created by mechanical dissection in all eyes. Main outcome measures included uncorrected visual acuity (UCVA, best spectacle-corrected visual acuity (BCVA, refraction, keratometry, and computerized analysis of corneal topography. Patients were divided into two groups by the type of refractive surgery (Group A: PRK, Group B: LASIK.Results:The mean preoperative manifest astigmatism decreased from -1.88 to -0.84 D in Group A (p=0.096 and -3.18 to -1.77 D in Group B (p=0.000. The mean keratometric astigmatism decreased from -2.58 to -1.66 D in Group A (p=0.010 and -4.80 to -2.78 D in Group B (p=0.000. The mean spherical equivalent decreased from -2.97 to -2.05 D in Group A (p=0.065 and -3.31 to -2.42 D in Group B (p=0.014. No significant between-group differences were noted on the comparison of preoperative and postoperative results. No intraoperative or postoperative complications were observed.Conclusion:ICRS implantation is a useful treatment option for ectasia following refractive surgery, and it has significantly reduced the refractive cylinder and increased best spectacle-corrected visual acuity.

  6. LASIK and PRK in hyperopic astigmatic eyes: is early retreatment advisable?

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    Frings A

    2016-03-01

    Full Text Available Andreas Frings,1 Gisbert Richard,1,2 Johannes Steinberg,1,3,4 Vasyl Druchkiv,1,4 Stephan Johannes Linke,1,3,4 Toam Katz1,4 1Department of Ophthalmology, University Medical Centre Hamburg-Eppendorf, 2Ophthalmologikum an der Alster, 3zentrumsehstärke, 4CARE Vision Germany GmbH, Hamburg, Germany Purpose: To analyze the refractive and keratometric stability in hyperopic astigmatic laser in situ keratomileusis (LASIK or photorefractive keratectomy (PRK during the first 6 months after surgery. Patients and methods: This retrospective cross-sectional study included 97 hyperopic eyes; 55 were treated with LASIK and 42 with PRK. Excimer ablation for all eyes was performed using the ALLEGRETTO excimer laser platform using a mitomycin C for PRK and a mechanical microkeratome for LASIK. Keratometric and refractive data were analyzed during three consecutive follow-up intervals (6 weeks, 3 months, and 6 months. The corneal topography was obtained using Scheimpflug topography, and subjective refractions were acquired by expert optometrists according to a standardized protocol. Results: After 3 months, mean keratometry and spherical equivalent were stable after LASIK, whereas PRK-treated eyes presented statistically significant (P<0.001 regression of hyperopia. In eleven cases, hyperopic regression of >1 D occurred. The optical zone diameter did not correlate with the development of regression. Conclusion: After corneal laser refractive surgery, keratometric changes are followed by refractive changes and they occur up to 6 months after LASIK and for at least 6 months after PRK, and therefore, caution should be applied when retreatment is planned during the 1st year after surgery because hyperopic refractive regression can lead to suboptimal visual outcome. Keratometric and refractive stability is earlier achieved after LASIK, and therefore, retreatment may be independent of late regression. Keywords: hyperopia, astigmatism, regression, keratometry

  7. Calculations of actual corneal astigmatism using total corneal refractive power before and after myopic keratorefractive surgery.

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    Seo, Kyoung Yul; Yang, Hun; Kim, Wook Kyum; Nam, Sang Min

    2017-01-01

    To calculate actual corneal astigmatism using the total corneal refractive astigmatism for the 4-mm apex zone of the Pentacam (TCRP4astig) and keratometric astigmatism (Kastig) before and after photorefractive keratectomy or laser in situ keratomileusis. Uncomplicated 56 eyes after more than 6 months from the surgery were recruited by chart review. Various corneal astigmatisms were measured using the Pentacam and autokeratometer before and after surgery. Three eyes were excluded and 53 eyes of 38 subjects with with-the-rule astigmatism (WTR) were finally included. The astigmatisms were investigated using polar value analysis. When TCRP4astig was set as an actual astigmatism, the efficacy of arithmetic or coefficient adjustment of Kastig was evaluated using bivariate analysis. The difference between the simulated keratometer astigmatism of the Pentacam (SimKastig) and Kastig was strongly correlated with the difference between TCRP4astig and Kastig. TCRP4astig was different from Kastig in magnitude rather than meridian before and after surgery; the preoperative difference was due to the posterior cornea only; however, the postoperative difference was observed in both anterior and posterior parts. For arithmetic adjustment, 0.28 D and 0.27 D were subtracted from the preoperative and postoperative magnitudes of Kastig, respectively. For coefficient adjustment, the preoperative and postoperative magnitudes of Kastig were multiplied by 0.80 and 0.66, respectively. By arithmetic or coefficient adjustment, the difference between TCRP4astig and adjusted Kastig would be less than 0.75 D in magnitude for 95% of cases. Kastig was successfully adjusted to TCPR4astig before and after myopic keratorefractive surgery in cases of WTR. For use of TCRP4astig directly, SimKastig and Kastig should be matched.

  8. Calculations of actual corneal astigmatism using total corneal refractive power before and after myopic keratorefractive surgery.

    Directory of Open Access Journals (Sweden)

    Kyoung Yul Seo

    Full Text Available To calculate actual corneal astigmatism using the total corneal refractive astigmatism for the 4-mm apex zone of the Pentacam (TCRP4astig and keratometric astigmatism (Kastig before and after photorefractive keratectomy or laser in situ keratomileusis.Uncomplicated 56 eyes after more than 6 months from the surgery were recruited by chart review. Various corneal astigmatisms were measured using the Pentacam and autokeratometer before and after surgery. Three eyes were excluded and 53 eyes of 38 subjects with with-the-rule astigmatism (WTR were finally included. The astigmatisms were investigated using polar value analysis. When TCRP4astig was set as an actual astigmatism, the efficacy of arithmetic or coefficient adjustment of Kastig was evaluated using bivariate analysis.The difference between the simulated keratometer astigmatism of the Pentacam (SimKastig and Kastig was strongly correlated with the difference between TCRP4astig and Kastig. TCRP4astig was different from Kastig in magnitude rather than meridian before and after surgery; the preoperative difference was due to the posterior cornea only; however, the postoperative difference was observed in both anterior and posterior parts. For arithmetic adjustment, 0.28 D and 0.27 D were subtracted from the preoperative and postoperative magnitudes of Kastig, respectively. For coefficient adjustment, the preoperative and postoperative magnitudes of Kastig were multiplied by 0.80 and 0.66, respectively. By arithmetic or coefficient adjustment, the difference between TCRP4astig and adjusted Kastig would be less than 0.75 D in magnitude for 95% of cases.Kastig was successfully adjusted to TCPR4astig before and after myopic keratorefractive surgery in cases of WTR. For use of TCRP4astig directly, SimKastig and Kastig should be matched.

  9. Corneal refractive surgery and phakic intraocular lens for treatment of amblyopia caused by high myopia or anisometropia in children.

    Science.gov (United States)

    Tian, Chunyu; Peng, Xiujun; Fan, Zhengjun; Yin, Zhengqin

    2014-01-01

    A systematic review of literature was performed to compare various visual function parameters including the final visual acuity outcome and/or adverse events between corneal refractive surgery (CLRS) and phakic intraocular lens implantation (p-IOLi) in the treatment of refractive amblyopic children. Two reviewers independently searched the PubMed, EMBASE, and Controlled Trials Register databases for publications from 1991 to 2013. There were 25 articles, including 597 patients and 682 eyes, was included in CLRS group. Among them, 21 articles reported the use of CLRS in the treatment of myopic anisometropia for 318 patients (13 photorefractive keratectomy or laser epithelial keratomileusis and eight laser in situ keratomileusis). And 11 articles had the results of CLRS in treating hyperopic anisometropic amblyopia children. Eleven articles reported the effect of p-IOLi for treating high myopia or anisometropic amblyopia, including 61 patients (75 eyes). Age, pre- and postoperation best-corrected vision acuity (BCVA), and spherical equivalent (SE) were compared in CLRS and p-IOLi groups. The average age of CLRS group and p-IOLi group has no statistically significant difference. The SE in CLRS group for myopic anisometropia amblyopia patients was (-10.13 ± 2.73) diopters (D) and for hyperopic anisometropia amblyopia patients was (5.58 ± 1.28) D. In p-IOLi group the SE was (-14.01 ± 1.93) D. BCVA was improved significantly in both groups, and even better in p-IOLi group. Refractive errors were corrected in both groups, but there was no clinically significant difference in final SE between each group. More than one-half of the children had improved binocular fusion and stereopsis function in both groups. Both CLRS group and p-IOLi group showed their advantage in treating refractive amblyopia in children. In comparing p-IOLi with CLRS for treatment of refractive amblyopia, no statistically significant difference in final BCVA was observed.

  10. Effects of mitomycin-C on tear film, corneal biomechanics, and surface irregularity in mild to moderate myopic surface ablation: preliminary results.

    Science.gov (United States)

    Mohammadi, Seyed-Farzad; Ashrafi, Elham; Norouzi, Nima; Abdolahinia, Tahereh; Mir-AbouTalebi, Mohsen; Jabbarvand, Mahmoud

    2014-06-01

    To assess the effect of mitomycin-C (MMC) on the tear film, corneal biomechanics, and surface irregularity in surface ablation (photorefractive keratectomy [PRK]) for low to moderate myopia. Refractive Surgery Unit, Farabi Eye Hospital, Tehran, Iran. Double-masked randomized clinical trial. In patients with spherical equivalent myopia of -0.75 to -3.87 diopters (D) and astigmatism up to -1.75 D, the first eye was randomly assigned to the application of MMC 0.02% or a balanced salt solution for 15 seconds. The fellow eye received the alternate in a masked fashion after excimer photoablation. The study enrolled 60 patients. In fellow eyes, the changes in the tear-film index were comparable 1 month and 6 months postoperatively. There was no significant difference in changes in total higher-order aberrations, spherical aberration, coma, or Q values (Pentacam HR) between fellow eyes at 1 month and 6 months. There was a trend toward a higher asymmetry index at 1 month; however, a statistically significant drop was observed at 6 months in the MMC group (P<.01). It was hypothesized that stromal remodeling was delayed, but better, in MMC-treated eyes. No haze was recorded at 6 months in either group. Use of MMC in PRK did not appear to contribute significantly to surface irregularity, transient tear-film dysfunction, or biomechanical weakening of the cornea compared with PRK without MMC. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  11. Oestrogen-induced changes in biomechanics in the cornea as a possible reason for keratectasia.

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    Spoerl, Eberhard; Zubaty, Viktoria; Raiskup-Wolf, Frederik; Pillunat, Lutz E

    2007-11-01

    The risk of regression after photorefractive keratectomy (PRK) and the tendency to develop keratectasia after laser-assisted in situ keratomileusis (LASIK) procedure is higher in women than men. Currently, interest is focused on the influence of oestrogen on corneal stability after corneal refractive surgery. The aim of this experimental study was to investigate the change in biomechanical properties of the cornea induced by oestrogen. The influence of oestrogen was investigated in 12 fresh porcine corneas incubated in culture medium with 10 micromol/l beta-oestradiol for 7 days. A group of 12 porcine corneas incubated in culture medium without oestradiol for the same time served as a control group. Strips of cornea were cut and the stress-strain was measured in a biomaterial tester. The Young's modulus was calculated. During incubation the thickness of the cornea changed in the control group by only 6.4% and in the oestradiol group by 12%. However, the difference in the biomechanical stress values at 10% strain was significantly larger. In the control group the stress value was 120.18+/-28.93 kPa and in the oestradiol group 76.87+/-34.63 kPa (p = 0.002), representing a reduction of the corneal stiffness by 36% due to the oestradiol treatment. Oestrogen is a modulating factor of the biomechanical properties of the cornea that is not explainable only by an increased swelling. The significance of the hormone status of patients and its influence on the biomechanical stability of the cornea, a determining factor after refractive surgery, have been underestimated and may contribute to the development of keratectasia.

  12. Biomechanical Weakening of Different Re-treatment Options After Small Incision Lenticule Extraction (SMILE).

    Science.gov (United States)

    Kling, Sabine; Spiru, Bogdan; Hafezi, Farhad; Sekundo, Walter

    2017-03-01

    To determine the corneal weakening induced by different re-treatment options after small incision lenticule extraction (SMILE) and investigate the potential of corneal cross-linking (CXL) to reestablish the original corneal stress resistance. A total of 96 freshly enucleated porcine corneas were used. The initial refractive correction was defined to be -11.00 diopters (D) and the required enhancement to be -3.00 D. Three different re-treatment options were analyzed: -3D Re-SMILE, -3D photorefractive keratectomy (PRK) on top of the SMILE cap, and cap-to-flap conversion and -3D excimer ablation on the stromal bed (LASIK). The control condition did not receive any treatment. Subsequently, accelerated CXL (9 mW/cm2, 10 min) was performed in two groups with currently common enhancement techniques: following cap-to-flap conversion (-3D LASIK enhancement) and in controls. Biomechanical properties were measured with stress-strain extensometry ranging from 1.27 to 12.5 N. The Re-SMILE and PRK enhancement did not significantly reduce the overall elastic modulus of the cornea compared to controls (24.7 ± 2.23 and 22.7 ± 2.61 versus 23.8 ± 3.35 MPa, P ≥ .176), whereas LASIK enhancement did (22.2 ± 3.37 MPa, P = .048). CXL treatment significantly increased the elastic modulus compared to all non-cross-linked conditions (P ≤.001). Refractive surgery decreased the overall elastic modulus by 7%, whereas CXL increased it by 20%. In enhancement, the corneal biomechanical integrity is less affected with both Re-SMILE and PRK enhancement. Corneal weakening through laser refractive surgery is small compared to the stiffening effect after CXL. [J Refract Surg. 2017;33(3):193-198.]. Copyright 2017, SLACK Incorporated.

  13. LASIK X PRK após cirurgia de descolamento de retina

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    Rodovalho Adriano Jorge Mattoso

    2003-01-01

    Full Text Available OBJETIVO: Comparar os resultados obtidos pelas técnicas de "laser in situ keratomileusis" (LASIK e "photorefractive keratectomy" (PRK na correção de miopia e astigmatismo em olhos previamente submetidos à cirurgia de descolamento de retina (DR com "buckle" escleral. MÉTODOS: Vinte e cinco olhos de 22 pacientes com alterações refracionais significativas após a cirurgia de DR foram submetidos à cirurgia refrativa. Em 14 olhos de 13 pacientes foi realizado LASIK e em 11 olhos de 9 pacientes, PRK. O intervalo mínimo entre a cirurgia de DR e a cirurgia refrativa foi de 12 meses. O tempo de seguimento foi de, pelo menos, 12 meses. RESULTADOS: Doze meses após a cirurgia, a média do equivalente esférico (EE no grupo submetido ao LASIK diminuiu de -6,49 D antes da cirurgia para -0,17 D e a média do cilindro de -1,10 D para -0,23 D. A média do EE no grupo submetido ao PRK foi reduzida de -5,35 D para +0,02 D e a média do cilindro, de -1,38 D para -0,54D. Em ambos os grupos, 11 olhos apresentaram melhora da acuidade visual sem correção de pelo menos 4 linhas. CONCLUSÃO: Tanto o LASIK quanto o PRK foram seguros e eficazes para a correção do erro refracional induzido após a cirurgia de DR. Nossos resultados não apresentaram diferenças significativas entre os procedimentos. Estudos posteriores envolvendo maior amostragem e seguimento mais prolongado contribuirão para melhor avaliação da cirurgia refrativa em pacientes submetidos à cirurgia com "buckle" escleral.

  14. Corneal ectasia after excimer laser keratorefractive surgery: histopathology, ultrastructure, and pathophysiology.

    Science.gov (United States)

    Dawson, Daniel G; Randleman, J Bradley; Grossniklaus, Hans E; O'Brien, Terrence P; Dubovy, Sander R; Schmack, Ingo; Stulting, R Doyle; Edelhauser, Henry F

    2008-12-01

    To evaluate the histopathology and ultrastructure of corneas developing ectasia after LASIK or photorefractive keratectomy (PRK). Retrospective case series. Thirteen specimens from 12 patients undergoing corneal transplantation for progressive ectasia after LASIK (12 specimens) or PRK (1 specimen) were obtained for histopathologic and ultrastructural evaluation. All 13 ectatic corneas were submitted in formalin for light microscopy. Nine specimens were bisected, and the second half was placed in 2.5% glutaraldehyde for transmission electron microscopy (TEM). Corneal histopathology, ultrastructure, and pathophysiology. Light microscopy of the post-LASIK specimens showed corneal epithelial hypoplasia and occasional foci of epithelial hyperplasia, Bowman's layer breaks, a normal stromal thickness of the LASIK flap, a normal thickness of the hypocellular primitive stromal scar, a thinned residual stromal bed (RSB), and larger than normal artifacteous interlamellar clefts in the RSB of the ectatic region. The post-PRK specimen showed similar findings with the addition of a thinned hypercellular fibrotic stromal scar. TEM showed thinning of the collagen lamellae and loss of lamellar number in the RSB of post-LASIK ectasia corneas or throughout the entire corneal stromal bed in the post-PRK ectasia cornea, with the posterior aspect of the corneal stroma being most affected. Histopathologic and ultrastructural studies suggest that interlamellar and interfibrillar biomechanical slippage occurs when the cornea becomes ectatic after LASIK or PRK in the postoperative stress-bearing regions of the corneal stroma. This 2-phase chronic biomechanical failure process is similar to that seen in keratoconus. Composite sciences classify this chronic biomechanical failure process as interfiber fracture. The authors have no proprietary or commercial interest in any materials discussed in this article.

  15. Biomechanical and wound healing characteristics of corneas after excimer laser keratorefractive surgery: is there a difference between advanced surface ablation and sub-Bowman's keratomileusis?

    Science.gov (United States)

    Dawson, Daniel G; Grossniklaus, Hans E; McCarey, Bernard E; Edelhauser, Henry F

    2008-01-01

    To describe the biomechanical and wound healing characteristics of corneas after excimer laser keratorefractive surgery. Histologic, ultrastructural, and cohesive tensile strength evaluations were performed on 25 normal human corneal specimens, 206 uncomplicated LASIK specimens, 17 uncomplicated sub-Bowman's keratomileusis (SBK) specimens, 4 uncomplicated photorefractive keratectomy (PRK) specimens, 2 uncomplicated advanced surface ablation (ASA) specimens, 5 keratoconus specimens, 12 postoperative LASIK ectasia specimens, and 1 postoperative PRK ectasia specimen and compared to previously published studies. Histologic and ultrastructural studies of normal corneas showed significant differences in the direction of collagen fibrils and/or the degree of lamellar interweaving in Bowman's layer, the anterior third of the corneal stroma, the posterior two-thirds of the corneal stroma, and Descemet's membrane. Cohesive tensile strength testing directly supported these morphologic findings as the stronger, more rigid regions of the cornea were located anteriorly and peripherally. This suggests that PRK and ASA, and secondarily SBK, should be biomechanically safer than conventional LASIK with regard to risk for causing keratectasia after surgery. Because adult human corneal stromal wounds heal slowly and incompletely, all excimer laser keratorefractive surgical techniques still have some distinct disadvantages due to inadequate reparative wound healing. Despite reducing some of the risk for corneal haze compared to conventional PRK, ASA cases still can develop corneal haze or breakthrough haze from the hypercellular fibrotic stromal scarring. In contrast, similar to conventional LASIK, SBK still has the short- and long-term potential for interface wound complications from the hypocellular primitive stromal scar. Ophthalmic pathology and basic science research show that SBK and ASA are improvements in excimer laser keratorefractive surgery compared to conventional LASIK or

  16. Evaluation of donor tissue with a new videokeratoscope: the Keratron Scout.

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    Stoiber, J; Ruckhofer, J; Hitzl, W; Grabner, G

    2001-11-01

    To evaluate the percentage of corneas with an epithelial surface quality sufficient for a reliable screening of donor eyes with keratoconus and after photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK) treatment for refractive errors. The usefulness of the computer-assisted, video-keratography system Keratron Scout in making this determination was evaluated. Forty eyes from 20 donors were screened within 30 minutes after enucleation and within 24 hours postmortem. At first a meticulous slit-lamp evaluation of the corneal surface and stroma was performed; thereafter eight pictures per eye were taken with the Keratron Scout, and an ultrasound pachymetry reading of the corneal center was taken. "True curvature," algorithm-based color maps were used for analysis. Epithelium was not removed, because all corneas were suitable for transplantation. Balanced salt solution was used to keep the corneas moist. The low intraocular pressure regularly found in postmortem eyes was raised to within normal ranges by intravitreal injection. Corneas were classified according to the integrity of their epithelial surface, which influences the regularity of the topography maps. The quality of the images acquired varied, depending mostly on the quality of the epithelium. Regular topography patterns were found in 15 eyes (37.5%); in 14 eyes (35%), minimal epithelial roughness or sloughing in just one quadrant of the cornea was detected. Moderate to severe epithelial irregularities or defects were found in nine eyes (22.5%). Screening for abnormal shape was possible in 90% of the tested eyes, where no changes caused by prior refractive surgery or keratoconus were apparent. The postmortem quality of the epithelial surface allows screening for keratoconus or refractive procedures in the majority of donor eyes. Video-keratography with the Keratron Scout seems to offer a sensitive and quick method for this purpose, thereby adding an additional safety feature to eye banking

  17. Plasma rich in growth factors (PRGF-Endoret) stimulates corneal wound healing and reduces haze formation after PRK surgery.

    Science.gov (United States)

    Anitua, E; Muruzabal, F; Alcalde, I; Merayo-Lloves, J; Orive, G

    2013-10-01

    This study evaluated the efficacy of Plasma rich in growth factors (PRGF-Endoret) on the corneal wound healing process after Photorefractive keratectomy (PRK). To address this, blood from three healthy donors was collected, centrifuged and, the whole plasma column (WP) and the plasma fraction with the highest platelet concentration (F3) were collected. The effects of F3 and WP on the proliferation and migration of human corneal epithelial cells (HCE) were analyzed. PRK was performed on C57BL/6 mice. Animals were divided in three treatment groups: Control, F3, and WP. Corneal wound healing and haze formation were evaluated macroscopically. Eyes were collected at 1, 2, 3, and 7 days after surgery, and were processed for histological studies. Immunofluorescence was used to assess cellular proliferation, apoptosis and myofibroblast transformation in the mouse cornea. Results showed a significant increased on proliferation and wound healing after F3 and WP treatment when compared with control group. In vivo studies showed significant reduction on haze formation in mice treated with both PRGF-Endoret formulations (F3 and WP). Histological studies showed an increase of epithelial cell proliferation in corneas of control group, promoting an epithelial hyperplasia. The number of SMA-positive cells (corresponding to myofibroblast differentiation) was significantly lower in the PRGF-Endoret group than in the control group, correlating with the higher transparence results observed macroscopically in both PRGF-Endoret groups. According to this, it can be concluded that PRGF-Endoret accelerates corneal tissue regeneration after PRK, reducing haze formation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Scattered UV irradiation during VISX excimer laser keratorefractive surgery.

    Science.gov (United States)

    Hope, R J; Weber, E D; Bower, K S; Pasternak, J P; Sliney, D H

    2008-04-01

    To evaluate the potential occupational health hazards associated with scattered ultraviolet (UV) radiation during photorefractive keratectomy (PRK) using the VISX Star S3 excimer laser. The Laser Vision Center, National Naval Medical Center, Bethesda, Maryland, USA. Intraoperative radiometric measurements were made with the Ophir Power/Energy Meter (LaserStar Model PD-10 with silicon detector) during PRK treatments as well as during required calibration procedures at a distance of 20.3 cm from the left cornea. These measurements were evaluated using a worst-case scenario for exposure, and then compared with the American Conference of Governmental Industrial Hygeinists (ACGIH) Threshold Value Limits (TVL) to perform a risk/hazard analysis. During the PRK procedures, the highest measured value was 248.4 nJ/pulse. During the calibration procedures, the highest measured UV scattered radiation level was 149.6 nJ/pulse. The maximum treatment time was 52 seconds. Using a worst-case scenario in which all treatments used the maximum power and time, the total energy per eye treated was 0.132 mJ/cm2 and the total UV radiation at close range (80 cm from the treated eye) was 0.0085 mJ/cm2. With a workload of 20 patients, the total occupational exposure at 80 cm to actinic UV radiation in an 8-hour period would be 0.425 mJ/cm2. The scattered actinic UV laser radiation from the VISX Star S3 excimer laser did not exceed occupational exposure limits during a busy 8-hour workday, provided that operating room personnel were at least 80 cm from the treated eye. While the use of protective eyewear is always prudent, this study demonstrates that the trace amounts of scattered laser emissions produced by this laser do not pose a serious health risk even without the use of protective eyewear.

  19. Bilateral Epithelial Defects after Laser in situ Keratomileusis. Clinical Features, Management and Outcome

    Directory of Open Access Journals (Sweden)

    Rao Srinivas

    2005-03-01

    Full Text Available PURPOSE: To describe the preoperative characteristics, intraoperative details, management, and postoperative in patients with bilateral epithelial defects after laser in situ keratomileusis (LASIK. METHODS: Retrospective non-comparative case series. RESULTS: Six patients with bilateral epithelial defects after LAISK were part of a cohort of 605 patients undergoing bilateral LASIK at our center from December 2001 to April 2003. The mean age of the patients (5M:1F was 28.5 7.9 years, and the average pretreatment myopic spherical equivalent (SE refraction was 7.3 0.7 D (-4, -12.25D. An epithelial flap was present in 6 eyes and an epithelial defect with a mean diameter of 3 mm (2mm, 6mm was seen in 6 eyes. In four patients the epithelial disturbance was bilaterally similar. All defects occurred in the inferior cornea and the epithelial flaps had the hinge positioned superiorly. None of the patients had ocular or systemic risk factors that could have resulted in this complication. A bandage contact lens was used in 6 eyes. At last follow-up of 5.5 9.5 months (0.25, 21 months, unaided visual acuity was 6/9 or better in 10 eyes. Best spectacle-corrected visual acuity (BSCVA was maintained in 8 eyes, while 4 eyes lost one line of BSCVA. Recurrent corneal erosions were not reported in the follow-up period. CONCLUSIONS: These patients represent a hitherto unrecognised group of individuals who appear to have a subclinical weakness of adhesion of the corneal epithelium to the underlying structures, which is not evident on clinical examination. This results in bilateral epithelial disturbances after LASIK. Appropriate management results in satisfactory clinical outcomes. Other options for treatment of the fellow eye of such patients include the use of a different microkeratome, release of suction during the reverse pass of the Hansatome microkeratome, and photorefractive keratectomy if the refractive error is low.

  20. Scattered ultraviolet emissions during refractive surgery using a high-frequency, wavefront-optimized excimer laser platform.

    Science.gov (United States)

    Bower, Kraig S; Edwards, Jayson D; Ryan, Denise Sediq; Coe, Charles D; Hope, Robert J; Sliney, David H

    2010-08-01

    To evaluate occupational ultraviolet (UV) exposure during photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) with the Allegretto Wave Eye-Q 400 Hz excimer laser. Walter Reed Center for Refractive Surgery, Washington, DC, USA. Intraoperative UV measurements were performed during PRK with epithelial removal using an Amoils brush, PRK with epithelial removal using 20% ethanol, or femtosecond LASIK. A LaserStar power/energy meter with a silicone detector (model PD-10) was used for the measurements. The maximum pulse energy 25.4 cm from the corneal surface was recorded for each surgical procedure. Measurements were evaluated using a worst-case scenario for exposure of operating room personnel, and the results were compared with the occupational exposure limit set by the International Commission on Non-Ionizing Radiation Protection. Measurements were taken during 15 cases of each procedure. The mean maximum exposure was 129.38 nJ/pulse +/- 79.48 (SD) during brush PRK, 69.72 +/- 68.80 nJ/pulse during ethanol PRK, and 29.17 +/- 13.82 nJ/pulse during LASIK. The mean maximum exposure per eye was 0.085 mJ/cm(2), 0.046 mJ/cm(2), and 0.01 mJ/cm(2), respectively. The worst-case cumulative exposure during a heavy workday of 20 patients (40 eyes) was calculated at 3.92 mJ/cm(2), 1.51 mJ/cm(2), and 0.79 mJ/cm(2) for brush PRK, ethanol PRK, and LASIK, respectively. Results indicate that the excimer laser platform used in the study may yield greater UV exposure than previous systems; however, the levels did not exceed occupational exposure limits. No author has a financial or proprietary interest in any material or method mentioned. Published by Elsevier Inc.

  1. BMP7 gene transfer via gold nanoparticles into stroma inhibits corneal fibrosis in vivo.

    Directory of Open Access Journals (Sweden)

    Ashish Tandon

    Full Text Available This study examined the effects of BMP7 gene transfer on corneal wound healing and fibrosis inhibition in vivo using a rabbit model. Corneal haze in rabbits was produced with the excimer laser performing -9 diopters photorefractive keratectomy. BMP7 gene was introduced into rabbit keratocytes by polyethylimine-conjugated gold nanoparticles (PEI2-GNPs transfection solution single 5-minute topical application on the eye. Corneal haze and ocular health in live animals was gauged with stereo- and slit-lamp biomicroscopy. The levels of fibrosis [α-smooth muscle actin (αSMA, F-actin and fibronectin], immune reaction (CD11b and F4/80, keratocyte apoptosis (TUNEL, calcification (alizarin red, vonKossa and osteocalcin, and delivered-BMP7 gene expression in corneal tissues were quantified with immunofluorescence, western blotting and/or real-time PCR. Human corneal fibroblasts (HCF and in vitro experiments were used to characterize the molecular mechanism mediating BMP7's anti-fibrosis effects. PEI2-GNPs showed substantial BMP7 gene delivery into rabbit keratocytes in vivo (2×10(4 gene copies/ug DNA. Localized BMP7 gene therapy showed a significant corneal haze decrease (1.68±0.31 compared to 3.2±0.43 in control corneas; p88%; p<0.0001, and immunoblotting of BMP7-transefected HCFs grown in the presence of TGFβ demonstrated significantly enhanced pSmad-1/5/8 (95%; p<0.001 and Smad6 (53%, p<0.001, and decreased αSMA (78%; p<0.001 protein levels. These results suggest that localized BMP7 gene delivery in rabbit cornea modulates wound healing and inhibits fibrosis in vivo by counter balancing TGFβ1-mediated profibrotic Smad signaling.

  2. Reliability of corneal dynamic scheimpflug analyser measurements in virgin and post-PRK eyes.

    Directory of Open Access Journals (Sweden)

    Xiangjun Chen

    Full Text Available PURPOSE: To determine the measurement reliability of CorVis ST, a dynamic Scheimpflug analyser, in virgin and post-photorefractive keratectomy (PRK eyes and compare the results between these two groups. METHODS: Forty virgin eyes and 42 post-PRK eyes underwent CorVis ST measurements performed by two technicians. Repeatability was evaluated by comparing three consecutive measurements by technician A. Reproducibility was determined by comparing the first measurement by technician A with one performed by technician B. Intraobserver and interobserver intraclass correlation coefficients (ICCs were calculated. Univariate analysis of covariance (ANCOVA was used to compare measured parameters between virgin and post-PRK eyes. RESULTS: The intraocular pressure (IOP, central corneal thickness (CCT and 1st applanation time demonstrated good intraobserver repeatability and interobserver reproducibility (ICC ≧ 0.90 in virgin and post-PRK eyes. The deformation amplitude showed a good or close to good repeatability and reproducibility in both groups (ICC ≧ 0.88. The CCT correlated positively with 1st applanation time (r = 0.437 and 0.483, respectively, p<0.05 and negatively with deformation amplitude (r = -0.384 and -0.375, respectively, p<0.05 in both groups. Compared to post-PRK eyes, virgin eyes showed longer 1st applanation time (7.29 ± 0.21 vs. 6.96 ± 0.17 ms, p<0.05 and lower deformation amplitude (1.06 ± 0.07 vs. 1.17 ± 0.08 mm, p < 0.05. CONCLUSIONS: CorVis ST demonstrated reliable measurements for CCT, IOP, and 1st applanation time, as well as relatively reliable measurement for deformation amplitude in both virgin and post-PRK eyes. There were differences in 1st applanation time and deformation amplitude between virgin and post-PRK eyes, which may reflect corneal biomechanical changes occurring after the surgery in the latter.

  3. Refractive lenticule extraction small incision lenticule extraction: A new refractive surgery paradigm

    Directory of Open Access Journals (Sweden)

    Sri Ganesh

    2018-01-01

    Full Text Available Small incision lenticule extraction (SMILE, a variant of refractive lenticule extraction technology is becoming increasingly popular, as a flapless and minimally invasive form of laser vision correction (LVC for the treatment of myopia and myopic astigmatism. This review aims at summarizing the principles, surgical technique, and clinical outcomes in terms of visual and refractive results, safety, efficacy, postoperative dry eye, aberrations, and biomechanics of SMILE and its comparison with other conventional techniques of LVC, such as laser in situ keratomileusis (LASIK and photorefractive keratectomy (PRK. Recent advancements in the laser frequency and energy delivery patterns, instrumentation, and surgical techniques have shown significant improvement in the visual recovery and outcomes after SMILE, compared to the initial results published by Sekundo and Shah et al. Most of the recently published literature on long-term outcomes of SMILE shows excellent stability of the procedure, especially for higher myopia. In terms of the postoperative dry eye, SMILE shows a clear advantage over LASIK as numerous studies have shown significant differences about the Schirmer's, Tear film break up time, corneal sensitivity, and corneal nerve regeneration to be better following SMILE compared to LASIK. There is some evidence that since the Bowman's membrane (BM and the anterior lamellae remain intact after SMILE, this may be a potential advantage for corneal biomechanics over LASIK and PRK where the BM is either severed or ablated, respectively, however, the data on biomechanics are inconclusive at present. Overall, this procedure has proved to be promising, delivering equivalent, or better visual and refractive results to LASIK and providing clear advantage in terms of being a flapless, minimally invasive procedure with minimal pain and postoperative discomfort thus offering high patient satisfaction.

  4. [Subjective visual perception after laser treatment of myopia on two types of lasers].

    Science.gov (United States)

    Kyprianou, G; Machácková, M; Feuermannová, A; Rozsíval, P; Langrová, H

    2010-11-01

    Comparison of subjective evaluation of patients with low and moderate myopia undergoing photorefractive keratectomy (PRK) and Laser in Situ Keratomileusis (LASIK) on two types of excimer lasers: Schwind Esiris and Schwind Amaris. Patients were divided into two groups according to the type of laser that was used. Group A comprised of 23 patients (14 females, 9 males) of average age 33.1 years (range 21-51 years), with an average spherical equivalent before operation of -3.5D. Using the excimer laser Esiris (Schwind, Germany), 10 patients had undergone PRK and 13 LASIK. Group B comprised of 32 patients (21 females, 11 males), of average age 31.9 years (range 22-48 years). Median spherical equivalent before operation was -3.05D. With the excimer laser Amaris (Schwind, Germany) 17 patients had undergone PRK and 15 LASIK. For the subjective evaluation we set up a questioner consisting of 21 questions that were aimed on the quality of vision under various illumination types and intensities, vision under various distances, activities and also questions concerning superficial sensitivity of the anterior segment of the eye. We detected a 100% satisfaction one year after refractive laser treatment with both laser types. Statistical improvement was evident by one month after treatment in both patient groups and upto 12 months it progressively increased. Statistically significant differences were noted one month after treatment, where patients in group B were more satisfied in questions concerning quality of vision, distance vision, while watching TV and driving during daytime and during the night. During further follow-up, results were comparable between both groups. Temporary patient satisfaction treated with laser Amaris is apparently due to the result of a more sparing treatment and thus fewer changes in the corneal stroma.

  5. Subacute effects of rose Bengal/Green light cross linking on rabbit thin corneal stability and safety.

    Science.gov (United States)

    Wang, Ti; Zhu, Lu; Zhu, Jingyin; Peng, Yinbo; Shen, Nianci; Yu, Yan; Yao, Min

    2017-11-02

    The purpose of this study was to investigate the subacute effects of Rose Bengal (RB) and 532 nm green light-induced photochemical crosslinking (RB-PCL) on rabbit thin corneal stability and safety in vivo. Rabbit thin corneal models with 250 μm thickness were created by photorefractive keratectomy surgery. Photochemical crosslinking with green light (wavelength 532 nm) at an illumination intensity of 0.4 W/cm2 for 250 s (100 J/cm2 ) was performed, followed by antibiotic treatment and slit lamp monitoring for four weeks. At the end of week four, corneal biomechanical stiffness, biochemical resistance to collagenase digestion, and corneal cellular morphology were assessed. The penetration depth of RB into the corneal stromal was measured by confocal microscopy. At the end of week 4, RB-PCL had increased corneal tensile strength by an average 2.5-fold and had extended the corneal collagenase digestion time from 10.17 ± 2.93 to 15.83 ± 2.64 days. RB penetrated approximately 90 µm into the corneal stroma. RB-PCL did not alter the corneal endothelial and stromal morphology at the cellular or subcellular levels, according to electron microscopic examination. RB and 532 nm green light irradiation effectively induced crosslinking in rabbit thin cornea, by increasing both the biomechanical stiffness and the biochemical resistance without evidence of morphological damage to the corneal endothelium or stroma. This study demonstrated the efficacy of RB-PCL in strengthening thin cornea at four weeks after the treatment, providing a potential and possibly better option for treating corneal ectasia disorders in cases where corneal thickness is less than 400 µm. Lasers Surg. Med. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  6. Corneal molecular and cellular biology update for the refractive surgeon.

    Science.gov (United States)

    Salomao, Marcella Q; Wilson, Steven E

    2009-05-01

    To review clinically relevant progress in understanding cellular and molecular interactions in the cornea that relate to refractive surgical outcomes in patients. Recent published literature focused on femtosecond LASIK and surface ablation procedures, such as photorefractive keratectomy, was reviewed and correlated with clinical results of surgery. The femtosecond laser has a direct necrotic effect on stromal keratocytes, resulting in the release of cellular components that are chemotactic to bone marrow-derived inflammatory cells. Developments of the femtosecond laser led to lower energy delivery to the stroma and altered laser ablation profiles that decrease epithelial damage during the side-cut, and have markedly improved femtosecond LASIK to the point that the overall early postoperative healing response is indistinguishable from microkeratome LASIK. New studies have directly demonstrated the importance of surface irregularity and resulting structural and functional defects in the epithelial basement membrane, in the generation and persistence of anterior stromal myofibroblasts and haze following surface ablation procedures. These defects augment penetration of epithelium-derived TGF-beta, which is a critical modulator of myofibroblast development in the stroma. Studies on the mechanism of action of mitomycin C treatment to prevent haze have confirmed that the most powerful effect is on stromal cell proliferation and, therefore, decreased population of the anterior stroma with myofibroblast progenitor cells. An undesirable long-term effect of mitomycin C is diminished anterior stromal keratocyte density due to diminished keratocyte re-population. This raises concerns regarding future corneal anomalies in treated corneas. Basic research studies of refractive procedures provide important insights into the effects of wound healing on surgical outcomes.

  7. Effects of new biomimetic regenerating agents on corneal wound healing in an experimental model of post-surgical corneal ulcers.

    Science.gov (United States)

    Alcalde, I; Íñigo-Portugués, A; Carreño, N; Riestra, A C; Merayo-Lloves, J M

    2015-10-01

    The purpose of this study is to assess the effectiveness of the topical application of cacicol regenerating agent (RGTA) in an experimental model of corneal ulcer after photorefractive keratectomy (PRK) in mice. Mice were subjected to PRK surgery with a 2.0mm ablation zone on the central cornea and 45mm of depth on a VISX Star S2 excimer laser. Corneas were treated topically with cacicol drops 1hour and 48hours after injury. Control groups received balanced salt solution (BSS) in the same dosage. Clinical and histopathological events were evaluated at 1, 2, 3 and 7 days after surgery. Sections obtained through the central region of the corneas were used to analyze the histopathological events of injured and healed corneas. αSMA (myofibroblast transformation), E cadherin (assembly of epithelial cells) and neuronal class III β-tubulin (innervation) were performed. Corneas treated topically with cacicol for 7 days showed a greater degree of transparency compared to controls. cacicol treated corneas showed improved epithelial cytoarchitecture. Analysis of αSMA profiles in the stroma showed that cacicol reduced or delayed the presence of myofibroblasts in the stroma compared to BSS (P<0.001). Finally, a putative neuroregenerative effect of cacicol was found in corneas subjected to an experimental PRK lesion. In some cases some interindividual variability could be observed due to the design of the experimental model. This is a limitation to consider, despite the statistical significance of the data. In a model of laser induced surgical lesions in the cornea, topical application of an RGTA (i.e. cacicol) could be involved in avoiding myofibroblast scarring formation and promoting nerve regeneration. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  8. New Meta Nanomaterials Extension II of Optical Enhancement and Photorefractive Two-Beam Coupling - Synthesis and Fabrication of Quantum Dot NLO Polymer Composites

    Science.gov (United States)

    2015-07-09

    formation. A molecular dynamics study carried out by Dr. Heinz group on CdS composites with oligomeric model systems [5] supports the evidence that the...E.; Moggio, I.; Ziolo, R.F.; Heinz , H. Interaction of substituted poly(phenyleneethynylene)s with ligand-stabilized CdS nanoparticles, J. Mater...Hendrik Heinz , J. Mater. Chem. A., 2014, 2,8705-8711. Changes in research objectives (if any): none Change in AFOSR Program Manager, if any: none

  9. Complex investigations of structural and optical homogeneities of low-photorefractivity lithium niobate crystals by the conoscopy and photoinduced and Raman light scattering methods

    Science.gov (United States)

    Sidorov, N. V.; Pikoul, O. Yu.; Kruk, A. A.; Teplyakova, N. A.; Yanichev, A. A.; Palatnikov, M. N.

    2015-02-01

    Using photoinduced light scattering, conoscopy, and Raman spectroscopy methods, we have studied stoichiometric lithium niobate crystals and congruent crystals that were doped with Mg(0.078, 0.89 mas %), Zn(0.03, 0.52, 0.62), Cu(0.015), B(0.12), Gd(0.51), Y(0.46), Gd(0.23):Mg(0.75), Mg(0.86):Fe(0.0036), Ta(1.13):Mg(0.011), and Y(0.24):Mg(0.63) cations. It has been found that, depending on the kind of the pattern of photoinduced light scattering, investigated specimens can be divided into three groups. We have shown that the asymmetry of the indicatrix of photoinduced light scattering of LiNbO3 crystals is caused by birefringence of exciting laser radiation as it propagates perpendicularly to the polar axis of the crystal, whereas the asymmetry of the Raman spectrum arises due to the occurrence of spontaneous polarization, the vector of which is directed along the polar axis, and by birefringence. The pattern of the photoinduced light scattering depends on the difference of the refractive indices Δ n = n o - n e of the ordinary ( n o ) and extraordinary ( n e ) rays and their energies E. If En o {ie259-1} En e , the proportion of the photoinduced light scattering has the shape of a three-layer round spot. For equal energies, the pattern has the shape of a symmetric figure-eight. At En o < En e , the figure-eight is asymmetric. In this case, its large "lobe" is directed in the positive direction of the polar axis of the crystal.

  10. New clinical pathways for keratoconus

    National Research Council Canada - National Science Library

    Gore, D M; Shortt, A J; Allan, B D

    2013-01-01

    .... Over the last decade, outcome data have accumulated for new interventions including corneal collagen crosslinking, intracorneal ring implantation, topographic phototherapeutic keratectomy, and phakic...

  11. Enhancement after Small-Incision Lenticule Extraction: Incidence, Risk Factors, and Outcomes.

    Science.gov (United States)

    Liu, Yu-Chi; Rosman, Mohamad; Mehta, Jodhbir S

    2017-06-01

    To report the incidence, risk factors, and outcomes of enhancement after small-incision lenticule extraction (SMILE). Retrospective cohort study. Five hundred twenty-four eyes of 307 patients who underwent SMILE at Singapore National Eye Center between February 2012 and March 2016. The data collected included patient age at primary SMILE, gender, race, preoperative and postoperative manifest refraction spherical equivalent (MRSE), preoperative and postoperative uncorrected distance visual acuity and corrected distance visual acuity, the occurrence of suction loss during the procedure, and the need for enhancement. All enhancements were carried out by performing an alcohol-assisted photorefractive keratectomy (PRK) procedure with application of mitomycin C (MMC). Incidence, prevalence, preoperative and intraoperative risk factors for enhancement, and outcomes after enhancement. The prevalence of enhancement was 2.7%, and 71.4% eyes had enhancement within 1 year of primary SMILE. The incidence of enhancement was 2.1% and 2.9% at 1 and 2 years, respectively. Age older than 35 years, preoperative MRSE more than -6.00 diopters (D), preoperative myopia more than 6.00 D, preoperative astigmatism more than 3.00 D, and intraoperative suction loss were significant risk factors for enhancement after SMILE after adjusting for all other covariates (odds ratios, 5.58, 4.80, 1.41, 3.06, and 2.14, respectively; P = 0.004, 0.021, 0.022, 0.002, and 0.020, respectively). In the patients who underwent bilateral SMILE, the first-operated eye had a marginal trend toward significance for enhancement (P = 0.054). There was no gender or racial difference. In the 14 eyes requiring enhancement, the uncorrected distance visual acuity before enhancement ranged from 20/80 to 20/25, and the mean attempted enhancement spherical equivalent was -0.50±0.86 D. The uncorrected distance visual acuity improved in most patients (92.9%) after enhancement. The 2-year incidence of enhancement after

  12. Human cornea before and after refractive surgery using a new device: VCH-1.

    Science.gov (United States)

    Patel, Sudi; Alió, Jorge L; Javaloy, Jaime; Perez-Santonja, Juan J; Artola, Alberto; Rodriguez-Prats, Juan

    2008-10-01

    To test and measure the refractive index (RI) and to estimate the equivalent percentage of water content (%WC) of the anterior layers of the human cornea before and after excimer laser photoablation using a novel contact device, the VCH-1. (1) Repeatability was estimated by sequential measurement of the RI of 4 separate hydrogel contact lenses on 2 occasions, 5 and 10 minutes after insertion. (2) Patients preselected for photorefractive keratectomy, laser assisted sub-epithelial keratomileusis, laser assisted in situ keratomileusis, and laser assisted in situ keratomileusis with epithelial flap were enrolled. RI was measured for (a) corneal epithelium after topical anesthesia, (b) Bowman layer where appropriate after either removing epithelium or lifting the epithelial flap and remeasured immediately after excimer laser photoablation, and (c) midstroma after lifting the flap (created using mechanical microkeratome) and immediately after photoablation. (1) Average repeatability of RI measurement was +/-0.001 (range 0.000 to +/-0.002). (2) Mean RI (+/-SD) and estimated mean %WC of (a) epithelium were 1.382 (0.006) and 75% (n = 8, age 28-63 years), (b) Bowman layer 1.380 (0.011) and 77% changing to 1.392 (0.010) and 69% after photoablation (n = 11, age 26-40 years, P = 0.005), and (c) midstroma 1.369 (0.007) and 83% changing to 1.385 (0.006) and 74% after photoablation (n = 30, age 22-56 years, P < 0.0001). RI of corneal epithelium and Bowman layer was significantly greater than that of midstroma before photoablation (P < 0.001). (1) VCH-1 can reliably measure RI to within +/-0.001 units. This is equivalent to an error in water content estimation of +/-0.6%. (2) RI and %WC of the human cornea are not uniform. Intersubject and intracorneal variations in RI and %WC should be considered because these factors will affect optical performance of the eye and photoablation increases RI, presumably by way of tissue dehydration.

  13. Laser in-situ keratomileusis in patients with diabetes mellitus: a review of the literature

    Directory of Open Access Journals (Sweden)

    Simpson RG

    2012-10-01

    Full Text Available Rachel G Simpson,1 Majid Moshirfar,2 Jason N Edmonds,2 Steven M Christiansen21University of Arizona College of Medicine, Phoenix, AZ; 2Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USAPurpose: A growing number of diabetic patients request laser in situ keratomileusis (LASIK for elective vision correction each year. While the United States Food and Drug Administration considers diabetes a relative contraindication to LASIK surgery, there are several reports in the literature of LASIK being performed safely in this patient population. The purpose of this review was to examine whether diabetes should still be considered a contraindication to LASIK surgery by reviewing the ocular and systemic complications of diabetes, and examining the existing data on the outcomes of LASIK in diabetic patients.Methods: A literature review was conducted through PubMed, Medline, and Ovid to identify any study on LASIK surgery in patients with diabetes mellitus. This search was conducted without date restrictions. The search used the Medical Subject Headings (MeSH® term LASIK linked by the word “and” to the following MeSH and natural language terms: diabetes, diabetes mellitus, systemic disease, and contraindications. Abstracts for all studies meeting initial search criteria were reviewed for relevance. There were no prospective clinical studies identified. Three retrospective studies were identified. Key sources from these papers were identified, reviewed, and included as appropriate. An additional literature search was conducted to identify any study of ocular surgery on patients with diabetes using the MeSH terms refractive surgery, photorefractive keratectomy, radial keratotomy, cataract surgery, vitrectomy, and iridectomy linked by the word “and” to the following MeSH terms: diabetes, diabetes mellitus, and systemic disease. This search was conducted without date restrictions. Abstracts of studies meeting the initial

  14. A case report of central toxic keratopathy in a patient post TransPRK (followed by corneal collagen cross-linking

    Directory of Open Access Journals (Sweden)

    Davey N

    2017-04-01

    Full Text Available Nicholas Davey, Ioannis M Aslanides, Vasilis Selimis Emmetropia Mediterranean Eye Institute, Heraklion, Crete, Greece Purpose: The purpose of this article is to report a case of central toxic keratopathy in a patient post transepithelial photorefractive keratectomy (TransPRK, followed immediately by corneal collagen cross-linking.Methods: This article describes the case of a 26-year-old male after bilateral aberration-free, TransPRK laser (Schwind Amaris 750S. The procedure was performed for compound myopic astigmatism in November 2015, followed immediately by accelerated corneal collagen cross-linking for early keratoconus.Results: From day 3 post-op, tear film debris underneath both contact lenses with corneal haze and early, progressive central anterior stromal opacity formation only in the left eye were noted. At 2 weeks post-op, the left eye was noted to have a significant hyperopic shift with central corneal thinning in the anterior stroma. A central anterior stromal dense opacity had formed in the left eye with the surrounding superficial stromal haze. As of month 2, the opacity gradually started to improve in size and density. The hyperopic shift peaked at 2 months and continued to improve, largely due to epithelial compensation with a gradual recovery of stromal thickness.Conclusion: The question remains as to what provokes the typical central corneal necrosis/thinning in central toxic keratopathy. We hypothesize that the space between the contact lens and the corneal surface post TransPRK is prone to a “pseudo-interface pathology” that could mimic diffuse lamellar keratitis-like pathology. Suboptimal lid hygiene, resulting in tear film combinations of bacteria, inflammatory cells, matrix metalloproteinases and other proteolytic enzymes, contributes to the degradation of vulnerable, exposed collagen stromal tissue post TransPRK or any surface corneal ablation. Refractive surgeons should maintain a healthy lid margin and tear

  15. A pharmacological modification of pain and epithelial healing in contemporary transepithelial all-surface laser ablation (ASLA

    Directory of Open Access Journals (Sweden)

    Aslanides IM

    2015-04-01

    regenerating agent, photorefractive keratectomy, PRK, transepithelial

  16. Alterações quantitativas do filme lacrimal após cirurgia refrativa: estudo comparativo entre PRK e LASIK Quantitative changes in tear film after refractive surgery: comparative study between PRK and LASIK

    Directory of Open Access Journals (Sweden)

    Marcelo Galiano Credie

    2007-02-01

    Full Text Available OBJETIVO: Comparar as alterações quantitativas produzidas no filme lacrimal de pacientes submetidos a ceratectomia fotorrefrativa (PRK e ceratomileusis in situ (LASIK ao longo de um ano. MÉTODOS: Desenvolvemos estudo prospectivo, longitudinal, comparativo, pós-intervencional e não-aleatório para detectar diferenças entre a função lacrimal antes e após a correção de ametropias por excimer laser pelos métodos PRK (Grupo 1 = 48 pacientes e LASIK (Grupo 2 = 36 pacientes usando teste de Schirmer 1 no olho direito e do fio de fenol vermelho no olho esquerdo. RESULTADOS: No período compreendido entre o primeiro e o terceiro mês após ambos os procedimentos houve diminuição nos valores das medidas do teste de Schirmer e do fenol vermelho relativos aos valores basais. Um ano após, os valores voltaram a ser iguais aos valores basais précirúrgicos. Não houve diferença entre os grupos estudados. CONCLUSÃO: Apesar da diminuição, dentro dos limites normais, da produção de lágrima reflexa em ambos os grupos, tal alteração parece não trazer problemas maiores em pacientes normais.PURPOSE: To compare quantitative changes induced in the tear film of patients submited to photorefractive keratectomy and LASIK over a year. METHODS: A prospective, longitudinal, comparative, post-interventional study was designed to distinguish tear film changes before and one year after refractive surgery procedures in 48 patients submited to PRK and 36 patients submited to LASIK, using type 1 Schirmer test in the right eye and red phenol thread test in the left eye. RESULTS: Tear film assessment between the first and third postoperative month demonstrated Schirmer and phenol red measurements below basal values for both procedures. One year after the procedures, measurements returned to presurgical values. CONCLUSION: Besides momentary and within normal limit changes in the measurement of tear film, no complications were found in normal patients.

  17. Postoperative Efficacy, Predictability, Safety, and Visual Quality of Laser Corneal Refractive Surgery: A Network Meta-analysis.

    Science.gov (United States)

    Wen, Daizong; McAlinden, Colm; Flitcroft, Ian; Tu, Ruixue; Wang, Qinmei; Alió, Jorge; Marshall, John; Huang, Yingying; Song, Benhao; Hu, Liang; Zhao, Yune; Zhu, Senmiao; Gao, Rongrong; Bao, Fangjun; Yu, Ayong; Yu, Ye; Lian, Hengli; Huang, Jinhai

    2017-06-01

    To compare the postoperative efficacy, predictability, safety, and visual quality of all major forms of laser corneal refractive surgeries for correcting myopia. Systematic review and network meta-analysis. Search of MEDLINE, EMBASE, Cochrane Library, and the US trial registry was conducted up to November 2015. Randomized controlled trials (RCT) reporting in accordance with the eligibility criteria were included in this review. We performed a Bayesian random-effects network meta-analysis. Forty-eight RCTs were identified. For efficacy (uncorrected visual acuity [UCVA]), there were no statistically significant differences between any pair of treatments analyzed. The SUCRA (surface under the cumulative ranking curve) ranking (from best to worst) was femtosecond-based laser in situ keratomileusis (FS-LASIK), LASIK, small-incision lenticule extraction, femtosecond lenticule extraction (FLEx), photorefractive keratectomy (PRK), laser epithelial keratomileusis (LASEK), epipolis (Epi)-LASIK, transepithelial PRK (T-PRK). For predictability (refractive spherical equivalent [SE]), a statistically significant difference was found when FS-LASIK was compared with LASIK (odds ratio [OR] 2.29, 95% credible interval [CrI] 1.20-4.14), PRK (OR 2.16, 95% CrI 1.15-4.03), LASEK (OR 2.09, 95% CrI 1.08-4.55), and Epi-LASIK (OR 2.74, 95% CrI 1.11-6.20). The SUCRA ranking (from best to worst) was FS-LASIK, T-PRK, LASEK, PRK, LASIK, Epi-LASIK. There were no statistically significant differences in the safety (best spectacle-corrected visual acuity) comparisons. For both postoperative higher-order aberrations (HOAs) and contrast sensitivity (CS), there were no statistically significant differences between any pair of treatments analyzed. The SUCRA ranking results show that some corneal surface ablation techniques (PRK and LASEK) rank highest. This network meta-analysis shows that there were no statistically significant differences in either visual outcomes (efficacy and safety) or visual

  18. Efficacious and safe tissue-selective controlled gene therapy approaches for the cornea.

    Directory of Open Access Journals (Sweden)

    Rajiv R Mohan

    2011-04-01

    Full Text Available Untargeted and uncontrolled gene delivery is a major cause of gene therapy failure. This study aimed to define efficient and safe tissue-selective targeted gene therapy approaches for delivering genes into keratocytes of the cornea in vivo using a normal or diseased rabbit model. New Zealand White rabbits, adeno-associated virus serotype 5 (AAV5, and a minimally invasive hair-dryer based vector-delivery technique were used. Fifty microliters of AAV5 titer (6.5×10(12 vg/ml expressing green fluorescent protein gene (GFP was topically applied onto normal or diseased (fibrotic or neovascularized rabbit corneas for 2-minutes with a custom vector-delivery technique. Corneal fibrosis and neovascularization in rabbit eyes were induced with photorefractive keratectomy using excimer laser and VEGF (630 ng using micropocket assay, respectively. Slit-lamp biomicroscopy and immunocytochemistry were used to confirm fibrosis and neovascularization in rabbit corneas. The levels, location and duration of delivered-GFP gene expression in the rabbit stroma were measured with immunocytochemistry and/or western blotting. Slot-blot measured delivered-GFP gene copy number. Confocal microscopy performed in whole-mounts of cornea and thick corneal sections determined geometric and spatial localization of delivered-GFP in three-dimensional arrangement. AAV5 toxicity and safety were evaluated with clinical eye exam, stereomicroscopy, slit-lamp biomicroscopy, and H&E staining. A single 2-minute AAV5 topical application via custom delivery-technique efficiently and selectively transduced keratocytes in the anterior stroma of normal and diseased rabbit corneas as evident from immunocytochemistry and confocal microscopy. Transgene expression was first detected at day 3, peaked at day 7, and was maintained up to 16 weeks (longest tested time point. Clinical and slit-lamp eye examination in live rabbits and H&E staining did not reveal any significant changes between AAV5

  19. Comparison of femtosecond and excimer laser platforms available for corneal refractive surgery.

    Science.gov (United States)

    Chen, Lisa Y; Manche, Edward E

    2016-07-01

    The evolution of laser technology has left today's refractive surgeon with a choice between multiple laser platforms. The purpose of this review is to compare currently available femtosecond and excimer laser platforms, providing a summary of current evidence. Femtosecond lasers create LASIK flaps with better accuracy, uniformity, and predictability than mechanical microkeratomes. Newer higher-frequency femtosecond platforms elicit less inflammation, producing better visual outcomes. SMILE achieved similar safety, efficacy, and predictability as LASIK with greater preservation of corneal nerves and biomechanical strength. The emergence of wavefront technology has resulted in improved excimer laser treatments. Comparisons of wavefront-guided and wavefront-optimized treatments suggest that there is an advantage to using wavefront-guided platforms in terms of visual acuity and quality of vision. Topography-guided ablations are another well tolerated and effective option, especially in eyes with highly irregular corneas. Advances in femtosecond and excimer laser technology have not only improved the safety and efficacy of refractive procedures, but have also led to the development of promising new treatment modalities, such as SMILE and the use of wavefront-guided and topography-guided ablation. Future studies and continued technological progress will help to better define the optimal use of these treatment platforms.

  20. Numerical nonwavefront-guided algorithm for expansion or recentration of the optical zone

    Science.gov (United States)

    Arba Mosquera, Samuel; Verma, Shwetabh

    2014-08-01

    Complications may arise due to the decentered ablations during refractive surgery, resulting from human or mechanical errors. Decentration may cause over-/under-corrections, with patients complaining about seeing glares and halos after the procedure. Customized wavefront-guided treatments are often used to design retreatment procedures. However, due to the limitations of wavefront sensors in precisely measuring very large aberrations, some extreme cases may suffer when retreated with wavefront-guided treatments. We propose a simple and inexpensive numerical (nonwavefront-guided) algorithm to recenter the optical zone (OZ) and to correct the refractive error with minimal tissue removal. Due to its tissue-saving capabilities, this method can benefit patients with critical residual corneal thickness. Based on the reconstruction of ablation achieved in the first surgical procedure, we calculate a target ablation (by manipulating the achieved OZ) with adequate centration and an OZ sufficient enough to envelope the achieved ablation. The net ablation map for the retreatment procedure is calculated from the achieved and target ablations and is suitable to expand, recenter, and modulate the lower-order refractive components in a retreatment procedure. The results of our simulations suggest minimal tissue removal with OZ centration and expansion. Enlarging the OZ implies correcting spherical aberrations, whereas inducing centration implies correcting coma. This method shows the potential to improve visual outcomes in extreme cases of retreatment, possibly serving as an uncomplicated and inexpensive alternative to wavefront-guided retreatments.

  1. Optical vibration detection spectral analysis assembly and method for detecting vibration in an object of interest

    Science.gov (United States)

    Hale, Thomas C.; Telschow, Kenneth L.

    1998-01-01

    A vibration detection assembly is described which includes an emitter of light which has object and reference beams, the object beam reflected off of a vibrating object of interest; and a photorefractive substance having a given response time and which passes the reflected object beam and the reference beam, the reference beam and the object beam interfering within the photorefractive substance to create a space charge field which develops within the response time of the photorefractive substance.

  2. Single-frequency operation of a broad-area laser diode by injection locking of a complex spatial mode via a double phase conjugate mirror

    NARCIS (Netherlands)

    van Voorst, P.D.; Offerhaus, Herman L.; Boller, Klaus J.

    2006-01-01

    We demonstrate what is believed to be the first phase-coherent locking of a high-power broad-area diode to a single-frequency master laser. We use photorefractive double phase conjugation to lock the diode in a selfoptimized complex spatial mode while the photorefractive crystal diffracts that

  3. Optical Pattern Recognition With Self-Amplification

    Science.gov (United States)

    Liu, Hua-Kuang

    1994-01-01

    In optical pattern recognition system with self-amplification, no reference beam used in addressing mode. Polarization of laser beam and orientation of photorefractive crystal chosen to maximize photorefractive effect. Intensity of recognition signal is orders of magnitude greater than other optical correlators. Apparatus regarded as real-time or quasi-real-time optical pattern recognizer with memory and reprogrammability.

  4. Experimental evidence of photoinduced valence change of Fe 3 in ...

    Indian Academy of Sciences (India)

    Keywords. Photorefraction; electron paramagnetic resonance of Fe3+; BaTiO3; photo-electron paramagnetic resonance. Abstract. With a view to understanding the role of photo-induced valence changes of impurities in BaTiO3 in the phenomena of photorefraction, EPR experiments were conducted under in situ HeNe laser ...

  5. Organization of the Optical Society of America Photonic Science Topical Meeting Series. Volume 14. Photorefractive Materials Effects, and Devices Held in Beverly, Massachusetts on 29-31 July 1991

    Science.gov (United States)

    1991-01-01

    third laser beam. (p. 195) Jean-Pierre Huignard, Thomson-CSF, France, Presider 12:45 pm CLAM BAKE (at Endicott Beach) 10:30 am Food served from 12:45 pm...profile of the form: n(x) = n0 + nisin (Kx) (1) where K= 2-/A is the grating vector and A is the fringe spacing. The reflectance of the filter is given by

  6. Polarization properties of a photorefractive Bi12SiO20 crystal and their application in an optical correlator

    DEFF Research Database (Denmark)

    Edvold, Bent; Andersen, Peter E.; Buchhave, Preben

    1994-01-01

    is based on an extension of the optical beam-propagation (OBP) method to include all the significant optical properties of the BSO crystal when used in a two-wave mixing configuration, i.e., optical activity, field-induced birefringence, and anisotropic diffraction. The model is able to handle multiple...... gratings where the input beams do not have to be symmetric about the axis of propagation. Using the numerical model the polarization properties of the BSO crystal are analyzed and the operation of the correlator is explained. The model is able to take into account self-diffraction effects, and it is shown...... conditions and of the polarization state of the input beams...

  7. Nonlinear excitations and charge transport in lithium niobate crystals investigated using femtosecond-light gratings; Nichtlineare Anregungen und Ladungstransport in Lithiumniobatkristallen untersucht mit Femtosekunden-Lichtgittern

    Energy Technology Data Exchange (ETDEWEB)

    Maxein, Karl Dominik

    2009-12-15

    Lithium niobate (LiNbO{sub 3}) is a widely employed material in nonlinear optics and photonics. Its usage is hampered by the photorefractive effect, which can destroy beam profiles and phase matching conditions. Existing methods to suppress photorefraction fail for the interesting regime of very high intensities and short pulses. Therefore, the photorefractive effect is investigated using femtosecond laser pulses: By utilizing so-called 2K holography, the occupation of energetically shallow traps is observed to occur in less than 100 fs after a two-photon excitation. Writing of photorefractive gratings into oxidized iron-doped LiNbO{sub 3} is much faster with pulses than with cw light. This is explained by the sensitization of the crystal due to charge trapping in photorefractive centers after nonlinear excitations. Finally, light-induced scattering of pulse light is suppressed compared to the scattering of cw light due to the small coherence length of pulses. (orig.)

  8. Glossary of Terms

    Science.gov (United States)

    ... keratectomy, and intrastromal corneal implants (plastics and hydrogels). Cryogenic: The use of very low temperatures; cryotherapy or ... preparation and delivery of work orders for the grinding of lenses and the fabrication of eye wear; ...

  9. A dermoid of the eye in a blue-fronted Amazon parrot (Amazona aestiva).

    Science.gov (United States)

    Leber, A.C.; Bürge, T.

    1999-01-01

    A corneo-conjunctival dermoid is reported in a blue-fronted Amazon parrot (Amazona aestiva). After laminar keratectomy, histology showed the epidermis with feather follicles and dermal connective tissue with lymph follicles and sebaceous glands.

  10. The SCHWIND AMARIS Total-Tech Laser as An All-Rounder in Refractive Surgery

    Science.gov (United States)

    Arbelaez, Maria Clara; Mosquera, Samuel Arba

    2009-01-01

    Purpose: To describe and argument an overview of the main features and unique technical points of AMARIS Total-Tech Laser, coupled with patient outcomes supporting the decision to perform LASIK treatments with maximised outcomes. Settings: Dr. M.C. Arbelaez, Muscat Eye Laser Center, Muscat, Sultanate of Oman. Methods: The findings collected during 18-month experience using SCHWIND AMARIS Total-Tech Laser have been reviewed to provide arguments for supporting the decision to perform LASIK treatments with maximised outcomes. For updated clinical outcomes, the last 100 myopic astigmatism treatments, the last 100 hyperopic astigmatism treatments, the last 30 ocular-wavefront-guided treatments, and the last 30 corneal-wavefront-guided treatments, all with 6-month follow-up, were included. For all those, LDV femtosecond system was used to prepare the flaps, and AMARIS flying spot system was used to perform ablations. Clinical outcomes were evaluated in terms of predictability, refractive outcome, safety, wavefront aberration, and contrast sensitivity. Results: 6-month postoperatively, mean defocus was −0.14±0.31D and astigmatism 0.25±0.37D. 70± eyes were within ±0.25D of emmetropia. 43± eyes gained lines of best spectacle-corrected visual acuity. For Aberration-Free treatments, none of the aberration metrics changed from pre- to postoperative values in a clinically relevant amount. For ocular-wavefront-guided treatments, the surgery did not change coma or spherical aberration, and reduced trefoil (ptotal root-mean-square values of higher order aberration, were significantly reduced (p<.05) when the pre-existing aberrations were greater than the repeatability and the biological noise. Conclusions: Although this review does not allow for evidence-based conclusions, following our strategy, LASIK results were excellent. LASIK surgery with AMARIS system yield excellent outcomes. Refractions were reduced to subclinical values with no induction of High

  11. Retrospective Analysis of the Post-Operative Changes in Higher-Order Aberrations: A Comparison of the WaveLight EX500 to the VISX S4 Laser in Refractive Surgery.

    Science.gov (United States)

    Reed, Donovan S; Apsey, Douglas; Steigleman, Walter; Townley, James; Caldwell, Matthew

    2017-11-01

    In an attempt to maximize treatment outcomes, refractive surgery techniques are being directed toward customized ablations to correct not only lower-order aberrations but also higher-order aberrations specific to the individual eye. Measurement of the entirety of ocular aberrations is the most definitive means to establish the true effect of refractive surgery on image quality and visual performance. Whether or not there is a statistically significant difference in induced higher-order corneal aberrations between the VISX Star S4 (Abbott Medical Optics, Santa Ana, California) and the WaveLight EX500 (Alcon, Fort Worth, Texas) lasers was examined. A retrospective analysis was performed to investigate the difference in root-mean-square (RMS) value of the higher-order corneal aberrations postoperatively between two currently available laser platforms, the VISX Star S4 and the WaveLight EX500 lasers. The RMS is a compilation of higher-order corneal aberrations. Data from 240 total eyes of active duty military or Department of Defense beneficiaries who completed photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK) refractive surgery at the Wilford Hall Ambulatory Surgical Center Joint Warfighter Refractive Surgery Center were examined. Using SPSS statistics software (IBM Corp., Armonk, New York), the mean changes in RMS values between the two lasers and refractive surgery procedures were determined. A Student t test was performed to compare the RMS of the higher-order aberrations of the subjects' corneas from the lasers being studied. A regression analysis was performed to adjust for preoperative spherical equivalent. The study and a waiver of informed consent have been approved by the Clinical Research Division of the 59th Medical Wing Institutional Review Board (Protocol Number: 20150093H). The mean change in RMS value for PRK using the VISX laser was 0.00122, with a standard deviation of 0.02583. The mean change in RMS value for PRK using the

  12. Levels of interleukin-6 in tears before and after excimer laser treatment.

    Science.gov (United States)

    Resan, Mirko; Stanojević, Ivan; Petković, Aleksandra; Pajić, Bojan; Vojvodić, Danilo

    2015-04-01

    Immune response and consequent inflammatory process which originate on ocular surface after a trauma are mediated by cytokines. Photoablation of corneal stroma performed by excimer laser causes surgically induced trauma. Interleukin-6 (IL-6) is mostly known as a proinflammatory cytokine. However, it also has regenerative and anti-inflammatory effects. It is supposed that this cytokine is likely to play a significant role in the process of corneal wound healing response after photoablation of stroma carried out by laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) methods. The aim of this study was to determine and compare the levels of IL-6 in tears before and after treatment with LASIK and PRK methods. The study included 68 shortsighted eyes up to -3.0 diopter sphere, i.e. 198 samples of tears (per three samples taken from each of the eyes), divided into two groups according to the kind of excimer laser intervention performed: the group 1--eyes treated by LASIK method (n=31), and the group 2--eyes treated by the PRK method (n=37). The samples of tears were taken from each eye at the following time points: before excimer laser treatment (0 h, the control group), 1 h after the treatment (1 h) and 24 h after the treatment (24 h). The patients did not use anti-inflammatory therapy 24 h after the intervention. Tear samples were collected using microsurgical sponge. Level of IL-6 in tear fluid was determined by the flow cytometry method, applying a commercial test kit which allowed cytokine detection from a small sample volume. Results. The values of IL-6 were detectable in 16% of samples before LASIK treatment and in 30% of samples before PRK treatment. One h after the treatment IL-6 was detectable in 29% of samples for the LASIK group and 43% of samples for the PRK group, and 24 h after the treatment it was detectable in 19% of samples for the LASIK group and in 57% of samples for the PRK group. When we analyzed the dynamics of IL76 production

  13. Is keratoconus a true ectasia? An evaluation of corneal surface area.

    Science.gov (United States)

    Smolek, M K; Klyce, S D

    2000-09-01

    Keratoconus has long been considered to be an ectasia produced by stromal stretching. Although stretching should result in increased corneal surface area, previous observations of topography during progression of keratoconus have suggested that surface area may actually be conserved. A novel objective surface area measurement based on corneal topography was tested and applied to data from actual corneas under various conditions for comparative analysis. The LSU Eye Center clinic videokeratography archives. TMS-1 videokeratography files (Tomey Corp, Cambridge, Mass) were obtained from 6 groups of corneas: normal (n = 29), keratoconus from mild to severe states (n = 51), topographically judged keratoconus-suspect conditions (n = 10), postoperative photorefractive keratectomy for myopia (n = 39), with-the-rule corneal astigmatism (n = 17), and keratoglobus (n = 1). Additionally, 3 different spherical test surfaces were analyzed to verify the accuracy of the process. Only maps with no missing data out to ring 29 were used. The cumulative surface area from center to periphery was determined by calculating and summing the area of individual patches along consecutive annular rings. Mean surface area with respect to mean chord radius was plotted for each corneal condition, and curve fitting was used to extend each result to a 5. 85-mm limbus. Means, SEs, and 95% confidence intervals were calculated at intervals for statistical comparisons among all groups. Computer-generated surfaces helped to evaluate the relationship between shape and surface area. When videokeratographic test targets were used, surface area error was less than 2%, which was deemed acceptable. Normal corneas had a mean +/- SE surface area of 120.3 +/- 2.2 mm(2), whereas all keratoconus corneas combined had a mean +/- SE surface area of 116.2 +/- 3.4 mm(2). The difference was not significant at any chord radius (analysis of variance, Pcornea was found to have a surface area of 129. 9 mm(2), which was 7

  14. Adaptação de lentes de contato após cirurgia refrativa Contact lens fitting after refractive surgery

    Directory of Open Access Journals (Sweden)

    Adimara da Candelária Renesto

    2005-02-01

    surgery procedure, ametropia after surgery, postoperative spherical equivalent, postoperative keratometry, base curve of fitted contact lens, contact lens design, final visual acuity with spectacles after surgery, final visual acuity with contact lens, complications and the reason for stopping the use. The follow-up of patients ranged from 1 month to 84 months (average of 42,5 months. RESULTS: Of 53 evaluated patients, 19 patients had undergone LASIK (Laser Assisted in Situ Keratomileusis, 29 patients had undergone RK (radial keratotomy, 4 patients had undergone PRK (photorefractive keratectomy and in one patient it was not possible to know which surgery was performed. 61.29% of the patients (57 eyes of a total of 93 eyes were fitted with rigid gas-permeable lenses. There was an improvement of visual acuity in 60.21% of the cases (VA>20/40, with few complications. CONCLUSION: Due to the great number of performed refractive surgery, an increase in the number of patients unhappy with the postoperative result is expected, and for these patients, many times the use of contact lens is the best option. The fitting of contact lenses after refractive surgery demands knowledge, dedication and has good results principally regarding better visual acuity.

  15. Trends in refractive surgery at an academic center: 2007-2009

    Directory of Open Access Journals (Sweden)

    Kuo Irene C

    2011-05-01

    Full Text Available Abstract Background The United States officially entered a recession in December 2007, and it officially exited the recession in December 2009, according to the National Bureau of Economic Research. Since the economy may affect not only the volume of excimer laser refractive surgery, but also the clinical characteristics of patients undergoing surgery, our goal was to compare the characteristics of patients completing excimer laser refractive surgery and the types of procedures performed in the summer quarter in 2007 and the same quarter in 2009 at an academic center. A secondary goal was to determine whether the volume of astigmatism- or presbyopia-correcting intraocular lenses (IOLs has concurrently changed because like laser refractive surgery, these "premium" IOLs involve out-of-pocket costs for patients. Methods Retrospective case series. Medical records were reviewed for all patients completing surgery at the Wilmer Laser Vision Center in the summer quarter of 2007 and the summer quarter of 2009. Outcome measures were the proportions of treated refractive errors, the proportion of photorefractive keratectomy (PRK vs. laser-assisted in-situ keratomileusis (LASIK, and the mean age of patients in each quarter. Chi-square test was used to compare the proportions of treated refractive errors and the proportions of procedures; two-tailed t-test to compare the mean age of patients; and two-tailed z-test to compare proportions of grouped refractive errors in 2007 vs. 2009; alpha = 0.05 for all tests. Refractive errors were grouped by the spherical equivalent of the manifest refraction and were considered "low myopia" for 6 diopters (D of myopia or less, "high myopia" for more than 6 D, and "hyperopia" for any hyperopia. Billing data were reviewed to obtain the volume of premium IOLs. Results Volume of laser refractive procedures decreased by at least 30%. The distribution of proportions of treated refractive errors did not change (p = 0.10. The

  16. Search for new paradigms in organic materials for photonics and electronics

    Science.gov (United States)

    You, Wei

    This dissertation describes detailed synthesis and physical studies of novel organic materials for photorefractive application and molecular electronics. Two organic photorefractive material systems were developed, namely, polymeric materials and monolithic organic materials. For polymeric photorefractive materials, it was found that careful design of energy levels between photosensitizers and transporting moieties leads to optimized PR effect. When an electron-rich photosensitizer is used, the electron deficient charge transporting component enhances photorefractive performance and reduces the response time. By incorporating the efficient non-linear optical chromophore into the fully functionalized polymers, high net optical gain and diffraction efficiency were obtained. A small library of monolithic photorefractive materials with 2-dicyanomethylene-3-cyano-2,5-dihydrofuran as the eletron-withdrawing moieties was prepared and the detailed structure-property correlation was investigated. The PR performance was significantly enhanced by fine-tuning structures of these materials It was found that the photorefractive properties were affected by doping a small amount of electron trapping moiety into two monolithic materials. The trapping molecule plays different roles in the two closely related photorefractive materials. Results from different measurements on photorefractive properties, charge mobility and charge transport activation energy confirmed that the trapping molelcule acts as an effective electron-trapping center in one of the materials but traps both electron and hole in the other material. These results shed light into the PR mechanisms and indicate that the PR performance of organic photorefractive materials can be further improved by the deliberate addition of suitable charge trapping center. A series of switch molecules was synthesized based on the novel design rationale to achieve switching behavior at molecular level. The monolayers were prepared from

  17. Improving near vision in presbyopic eyes by selective treatment of high-order aberrations

    Directory of Open Access Journals (Sweden)

    Khalifa MA

    2011-10-01

    Full Text Available Mounir A Khalifa1,2, Waleed A Allam1,2, Ahmed M Khalifa21Tanta University Eye Hospital, Tanta, Egypt; 2Horus Vision Correction Center, Alexandria, EgyptPurpose: Evaluation of improving near vision in presbyopic patients with low to moderate myopia with selective treatment of high-order aberrations (HOAs using the ORK-CAM software aberrometer and a SCHWIND ESIRIS excimer laser. In this study, all HOAs except vertical coma were treated and the effect on near visual function was evaluated.Setting: Horus Vision Correction Center, Alexandria, Egypt.Methods: Twenty-six presbyopic patients (52 eyes with low to moderate myopia were divided into two groups, A and B. The ORK-CAM software aberrometer was used in both groups to measure HOAs and design wavefront-guided treatment. All included eyes had total coma >0.2 µm. The Moria M2 mechanical microkeratome was used for flap making in both groups. Wavefront-guided laser-assisted in situ keratomileusis using ESIRIS laser was done for all eyes. In Group A (30 eyes all HOAs were treated. In Group B (22 eyes vertical coma was left untreated. Postoperative uncorrected distance visual acuity (UCVA, best corrected distance visual acuity (BCVA, uncorrected near acuity (UCNA, distance corrected near acuity (DCNA, best corrected near acuity with addition for near vision (BCNA, manifest refractive spherical equivalent (MRSE, HOAs, and contrast sensitivity for both groups were done preoperatively and at 3 months postoperatively.Results: Mean age was 47.46 and 45.2 years for groups A and B, respectively. Mean preoperative MRSE was -2.37 and -2.87 D and mean preoperative total HOAs was 0.35 and 0.38 µm in groups A and B, respectively. There was no significant difference between groups regarding age, sex, preoperative MRSE, and preoperative total HOAs. After 3 months, there was no significant difference between groups in terms of UCVA, BCVA, MRSE, and contrast sensitivity. Analysis of postoperative HOAs showed

  18. Surgical management and immunohistochemical study of corneal plaques in vernal keratoconjunctivitis

    Directory of Open Access Journals (Sweden)

    Hsiu-Yi Lin

    2013-09-01

    Full Text Available Two children with shield ulcer in vernal keratoconjunctivitis unresponsive to steroid therapy received plaque removal by superficial keratectomy, followed by amniotic membrane transplantation (AMT. Hematoxylin and eosin staining of the excised corneal specimen revealed a thick layer of eosinophilic material attached to the Bowman's layer. These deposits were positive for eosinophil granule major basic protein, as confirmed by an immunohistochemical study. The shield ulcer healed after the amniotic membrane was removed. No recurrent corneal plaque developed, although corneal opacity complicated in both cases. Lamellar keratectomy with AMT offers an effective management by removing the cytotoxic plaques and protecting the denuded stroma from deposition of inflammatory debris.

  19. Qualidade visual após retratamento de LASIK personalizado versus convencional Visual quality after custom versus standard LASIK retreatment

    Directory of Open Access Journals (Sweden)

    Andréia Peltier Urbano

    2008-12-01

    Full Text Available OBJETIVO: Avaliar a qualidade visual após retratamento personalizado e retratamento convencional em olhos submetidos a LASIK primário convencional. MÉTODOS: Foi realizado estudo prospectivo de 74 olhos submetidos ao retratamento de LASIK para correção de miopia e astigmatismo. Cada paciente foi submetido ao retratamento de LASIK com ablação personalizada (Zyoptix, Bausch & Lomb em um olho e ablação convencional (Planoscan, Bausch & Lomb no olho contralateral. Foram comparados os resultados do teste de ofuscamento e da sensibilidade ao contraste durante o acompanhamento de seis meses. RESULTADOS: Os olhos do grupo Zyoptix apresentaram melhores resultados no teste de ofuscamento e na sensibilidade ao contraste do que o olho contralateral, quando se compararam os resultados. CONCLUSÕES: O retratamento personalizado resultou em melhor qualidade visual pós-operatória do que o retratamento convencional de LASIK primário convencional.PURPOSE: To evaluate visual quality after wavefront-guided LASIK versus standard LASIK in retreatment of primary LASIK for myopia and myopic astigmatism. METHODS: A prospective study was performed with paired eye control of 74 eyes with LASIK retreatment. Each patient underwent retreatment using custom ablation (Zyoptix, Bausch & Lomb in 1 eye and standard ablation LASIK (PlanoScan, Bausch & Lomb in the contralateral eye. A complete ophthalmologic examination was performed, including evaluation of glare test and contrast sensitivity test, with a follow-up of 6 months. RESULTS: Zyoptix eyes showed better results of glare test and contrast sensitivity test than the contralateral eyes. CONCLUSIONS: Wavefront-guided LASIK produces better visual quality than standard LASIK in the retreatment of refractive errors after primary LASIK.

  20. [Influence of mydriatic eye drops on the aberrometer predicted phoropter refraction].

    Science.gov (United States)

    Taneri, S; Stottmeister, S; Krause, K

    2010-01-01

    Wavefront-guided ablations are based on wavefront sensing in a pupil dilated under mesopic conditions, or in patients with insufficient natural pupil dilation, after the application of mydriatic eye drops. The aim of this study was to investigate a potential influence of mydriatic eye drops on wavefront-sensing in terms of the predicted phoropter refraction (PPR). In this prospective study 70 myopic eyes were measured in miosis and pharmacologically induced mydriasis with the Zywave aberrometer and automated refraction (Canon R-F10). 52 eyes were dilated with eye drops containing tropicamide 0.5 % and phenylephrine 2.5 %, in the remaining 18 eyes tropicamide 0.5 % was used. The PPR for a pupil diameter of 3.5 mm in miosis and in mydriasis, respectively, were compared and correlated to the corresponding values of the automated refraction. PPR values obtained in mydriasis were less myopic than in miosis. The sphere of PPR differed by an average of + 0.19 +/- 0.3 diopters (range: -1.07 to + 0.37 diopters) when using tropicamide 0.5 % and phenylephrine 2.5 %. With tropicamide 0.5 % eye drops the difference was + 0.25 +/- 0.4 diopters (range: -1.12 diopters to + 0.27 diopters). Cylinder values were not affected. Automated refraction yielded a smaller difference of + 0.16 +/- 0.33 diopters (tropicamide 0.5 % and phenylephrine 2.5 %) and + 0.1 +/- 0.19 diopters (tropicamide 0.5 %). Cylinder values changed significantly. The cycloplegic effect of mydriatic eye drops should be taken into account when interpreting aberration measurements and planning a wavefront-guided laser ablation. (c) Georg Thieme Verlag KG Stuttgart New York.

  1. FREE CONJUNCTIVAL AUTOGRAFT IN THE MANAGEMENT OF ...

    African Journals Online (AJOL)

    hi-tech

    2000-11-11

    Nov 11, 2000 ... Intervention: A superficial Keratectomy extending beyond the corneal lesion all around and sufficiently deep to Bowman's layer to produce a perfectly clear cornea in the excised area followed by suture a free ..... autograft transplantation for advanced and recurrent pterygium. Ophthalmology. 1985 ...

  2. Clinical experience in managing Fusarium solani keratitis.

    Science.gov (United States)

    Lin, H-C; Chu, P-H; Kuo, Y-H; Shen, S-C

    2005-05-01

    Fusarium solani keratitis is a rare ocular infectious disease. The clinical characteristics and treatment methods of 18 patients with culture proven F. solani keratitis between July 1997 and December 2003 and with a follow-up period of more than 4 months were analysed retrospectively. The patients were divided into two groups based on the severity of keratitis. Group A (n = 13) displayed non-severe keratitis and were treated with debridement, lamellar keratectomy and antifungal medication. Group B (n = 5) displayed severe keratomycosis and were treated with lamellar keratectomy combined with amniotic membrane transplantation (AMT) and antifungal medication. In group A, wound healing did not interfere with the integrity of the anterior chamber. The mean re-epithelialisation time was 12.67 days (range: 5-21 days). All patients were free of major immediate postoperative complications. In group B, AMT preserved the anterior chamber integrity in two cases, but failed to do so in the other three cases. Therapeutic patch grafts were required in these three cases. Non-severe F. solani keratitis is best treated with superficial keratectomy. Timely AMT combined with lamellar keratectomy appears to be an adjuvant therapy for severe keratomycosis and avoiding emergent therapeutic penetrating keratoplasty. However, AMT was effective in cases involving non-suppurative Fusarium keratitis.

  3. CORNEA AND ANTERIOR SEGMENT

    African Journals Online (AJOL)

    2016-11-04

    Nov 4, 2016 ... Surgery and Phacoemulsification in Eye Foundation Hospital. Lagos Nigeria. Oderinlo O. O., Hassan ... phacoemulsification between January 2012 and December 2013 in Eye. Foundation Hospital Lagos .... topical diclofenac use after laser-assisted subepithelial keratectomy. J Cataract Refract Surg 2006 ...

  4. Experimental color encryption in a joint transform correlator architecture

    Energy Technology Data Exchange (ETDEWEB)

    Tebaldi, Myrian; Amaya, Dafne; Torroba, Roberto [Centro de Investigaciones Opticas (CONICET La Plata-CIC) and UID OPTIMO, Facultad Ingenieria, Universidad Nacional de La Plata (Argentina); Horrillo, Sergi; Perez-Cabre, Elisabet; Millan, Maria S [Departamento de Optica y Optometria de la Universidad Politecnica de Cataluna, Terrasa (Spain); Bolognini, Nestor, E-mail: myrianc@ciop.unlp.edu.ar

    2011-01-01

    We present an experimental color image encryption by using a photorefractive crystal and a joint transform correlator (JTC) architecture. We achieve the color storing by changing the illumination wavelength. One JTC aperture has the input image information corresponding to a determined color channel bonded to a random phase mask (object aperture), and the other JTC aperture contains the key code mask. The joint power spectrum is stored in a photorefractive crystal. Each color data is stored as a modulation of birefringence in this photosensitive medium. The adequate wavelength change produces a corresponding power spectrum modification that avoids image encryption cross talk in the read out step. An analysis in terms of the sensitivity of the photorefractive silenite crystal for different recording wavelengths is carried out. It should be highlighted that the multiplexed power spectrum shows neither the multiplexing operation nor the amount of stored information increasing the system security. We present experimental results that support our approach

  5. EDITORIAL: Controlling light with light

    Science.gov (United States)

    Hesselink, Lambertus; Feinberg, Jack; Roosen, Gerald

    2008-11-01

    The field of photorefractive physics and optics is mature and, although there is no significant commercial activity using photorefractive media, researchers in the field have had an extraordinary impact on many related areas of research and development. For example, in the late 1990s many of the telecom innovations and products were based on the interaction between light and matter. Examples include optical switches, filters, gratings, routers and light sources. The theory of multiple interacting beams of light inside a photosensitive medium, many of which were developed or further explored in photorefractive media, has found application in medicine, engineering, communication systems, displays and other photonics devices. On the occasions of the 30th anniversary of the theory of coupled wave analysis and the 10th anniversary of the meetings on Photorefractive Effects and Devices, it seemed appropriate to the meeting organizers of PR'07 to broaden the scope to include other related fields. The name of the meeting was changed to Controlling Light with Light: Photorefractive Effects, Photosensitivity, Fiber Gratings, Photonic Materials and More to attract a larger audience than traditionally would attend the more narrowly focused photorefractive meeting. To further disseminate the results of the 2007 meeting, Gerald Roosen proposed a special publication of original full research articles arising from key presentations at the meeting. The selection of papers in this Cluster Issue of Journal of Physics D: Applied Physics is the result of that initiative. We would like to thank all the authors for their contributions, the committee members for their valuable insight and efforts in helping to organize the meeting, and the Optical Society of America for their professional assistance throughout the preparation period of the meeting as well as during the three beautiful days in Lake Tahoe, CA.

  6. Surface plasmon polariton excitation by electrostatic modulation and phase grating in indium-tin-oxide coated lithium niobate slabs

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Hao; Zhang, Jingwen; Zhao, Hua, E-mail: zhaohuaz@hit.edu.cn [Institute of Modern Optics, Department of Physics, Harbin Institute of Technology, Harbin 150001 (China); Key Laboratory of Micro-Optics and Photonics Technology of Heilongjiang Province, Harbin 150001 (China)

    2015-08-14

    Excitation of surface plasmon polaritons (SPPs) in a non-metal system in visible regime is discussed. With the assistance of phase grating resulted from photorefractive effect and electrostatic modulation of ITO induced by strong photovoltaic effect in iron-doped LiNbO{sub 3}, phase matching condition could be satisfied for SPP excitation in this semiconductor/dielectric system. Both the phase grating instead of metal grating and electrostatic modulation of semiconductor could be used for the design of tunable plasmonic devices based on nonlinear photorefractive crystals.

  7. Linear and nonlinear discrete light propagation in weakly modulated large-area two-dimensional photonic lattice slab in LiNbO3:Fe crystal.

    Science.gov (United States)

    Qi, Xinyuan; Zhang, Guoquan; Xu, Ningning; Qi, Yiling; Han, Bin; Fu, Yulan; Duan, Changsha; Xu, Jingjun

    2009-12-07

    A weakly modulated large-area two-dimensional square photonic lattice slab was fabricated through optical induction technique in a photorefractive photovoltaic LiNbO(3):Fe crystal. Bragg-matched diffraction technique was used to characterize the square photonic lattice slab. Interestingly, linear discrete diffraction typical for waveguide arrays was observed in such a square photonic lattice slab, indicating that the lattice slab can be viewed effectively as a one-dimensional waveguide array. Furthermore, discrete soliton was demonstrated in the photonic lattice slab due to a saturable self-defocusing nonlinearity arising from the bulk photorefractive photovoltaic effect of LiNbO(3):Fe.

  8. Writing and probing light-induced waveguides thanks to an endlessly single-mode photonic crystal fiber.

    Science.gov (United States)

    Huy, Kien Phan; Safioui, Jassem; Guichardaz, Blandine; Devaux, Fabrice; Chauvet, Mathieu

    2012-07-01

    We demonstrate writing and probing of light-induced waveguides in photorefractive bulk LiNbO3 crystal using an endlessly single-mode photonic crystal fiber. The optical waveguides are written at visible wavelengths by slightly raising the ferroelectric crystal temperature to benefit from the pyroelectric-driven photorefractive effect and the guiding properties are investigated at telecom wavelengths using the same photonic crystal fiber. End butt coupling with this photonic crystal fiber enables writing and probing of optical waveguides due to the self-alignment properties of spatial solitons.

  9. PRK versus LASIK para correção de miopia baixa e moderada PRK versus LASIK for correction of low and moderate myopia

    Directory of Open Access Journals (Sweden)

    Adriana dos Santos Forseto

    2000-08-01

    Full Text Available Objetivo: Comparar, por meio de um estudo prospectivo e bilateral randomizado, a eficácia, segurança e previsibilidade das técnicas de ceratectomia fotorrefrativa (PRK e "excimer laser in situ keratomileusis" (LASIK para o tratamento da miopia baixa e moderada. Métodos: Foram incluídos dezessete pacientes (34 olhos com equivalente esférico (EE refracional entre -2,00 e -6,00 dioptrias (D. Cada paciente foi submetido a PRK em um olho e LASIK no outro. Ambos os olhos foram tratados no mesmo dia pelo mesmo cirurgião, com o excimer laser VISX 20/20B e o microceratótomo automatizado da Chiron. Resultados: No pré-operatório, a média do EE refracional foi semelhante nos dois grupos (-3,57±1,17D e -3,71±0,98D, para PRK e LASIK, respectivamente. Dor pós-operatória foi referida somente nos casos de PRK (8 olhos: 47,1%. O seguimento pós-operatório médio foi de 14±5 meses (6 a 24 para o grupo de PRK, e 14±6 meses (3 a 24 para o de LASIK. A média do erro refrativo residual foi semelhante nos dois grupos (-0,34±0,45D e -0,29±0,52D, para PRK e LASIK, respectivamente. No primeiro dia pós-tratamento, 15 olhos (100% do grupo de LASIK e 2 (13,3% de PRK apresentavam acuidade visual sem correção (AV s/c ³ 20/40 (n=15. Ao último exame, 15 olhos (88,2% de LASIK contra 11 (64,7% de PRK atingiram AV s/c ³ 20/20 (n=17. Não houve perda da melhor acuidade visual corrigida. Conclusão: Neste estudo, tanto o PRK quanto o LASIK mostraram-se ser tecnicamente seguros, eficazes e previsíveis para a correção da miopia baixa e moderada. A técnica de LASIK foi a preferida na análise subjetiva dos pacientes, pela recuperação visual mais precoce associada a menor dor no pós-operatório.Purpose: To compare, through a prospective, randomized and bilateral study, the effectiveness, safety and predic-tability of photorefractive keratectomy (PRK and excimer laser in situ keratomileusis (LASIK for correction of low and moderate myopia. Methods

  10. Laboratory, clinical, and kindergarten test of a new eccentric infrared photorefractor (PowerRefractor).

    Science.gov (United States)

    Choi, M; Weiss, S; Schaeffel, F; Seidemann, A; Howland, H C; Wilhelm, B; Wilhelm, H

    2000-10-01

    Photorefraction is a convenient way to determine refractive state from a distance. It is, therefore, useful for measuring infants and noncooperative subjects. However, its reliability (or precision) and accuracy (or validity) has been questioned. In a study in subjects without cycloplegia, we have tested whether, after complete automatization, eccentric photorefraction at a 1-m distance can be as reliable as a common autorefractor. In a laboratory study of 15 student subjects without the use of cycloplegia (30 eyes, refractive errors ranging from -6 D to +6 D), age 25 to 31 years, the photorefractive measurements were compared with spectacle prescriptions. In a clinical study, photorefraction, autorefraction, and subjective refraction were performed in 40 patients without cycloplegia (refractive errors ranging from -4 D to +4 D), most of them with various ocular pathologies. Subjective refractions were obtained by an experienced clinical ophthalmologist but were not accessible to the examiner who used the two refractors. Visual acuity was 20/20 or better except for five subjects. Ages ranged from 6 to 75 years. In the kindergarten screening study, 108 children aged 3 to 6 years were screened for refractive errors. In the laboratory study, it was found that the mean difference between spectacle prescription and PowerRefractor measurements was current autorefractors in that it is faster, measures both eyes at once, and gives interpupillary distance, pupil size, and information on the alignment of the eyes at the same time.

  11. Shape changing collisions of optical solitons, universal logic gates ...

    Indian Academy of Sciences (India)

    Coupled nonlinear Schrödinger equations (CNLS) very often represent wave propagation in optical media such as multicore fibers, photorefractive materials and so on. We consider specifically the pulse propagation in integrable CNLS equations (generalized Manakov systems). We point out that these systems possess ...

  12. Tunable Optical Sources.

    Science.gov (United States)

    1980-11-01

    crystals were grown from melts containing excess Li20, interlace partitioning and build-up was expected. To prevent breakdown and constitutional supercooling...1" Journ. Appl. Phys. 43(3), p.1042-1049 (1972). 15. D. von der Linde, A.M. Glass and K.F. Rodgers, "Multi- photon Photo-refractive Processes for

  13. Optical Computing Research.

    Science.gov (United States)

    1985-06-01

    configuration [1] prompted a flurry of investigation into their properties. In addition, several types of optical processing using photorefractive crystals have...Photographic Process ( Mac - entire inversion regime into regions of strict and ap- millan, New York, 1954). proximate inversion, we find that strict

  14. Photocatalysed (Methacrylate Polymerization by (Antimony-Doped Tin Oxide Nanoparticles and Photoconduction of Their Crosslinked Polymer Nanoparticle Composites

    Directory of Open Access Journals (Sweden)

    J. C. M. Brokken-Zijp

    2010-01-01

    Full Text Available In the absence of another (photoradical initiator Sb:SnO2 nanoparticles (0≤Sb≤13 at % photocatalyze during irradiation with UV light the radical polymerization of (methacrylate monomers. When cured hard and transparent (>98% films with a low haze (0 at % nanoparticles can be attractive fillers for other photocatalytic applications photorefractive materials, optoelectronic devices and sensors.

  15. Dependence of gain and phase-shift on crystal parameters and ...

    Indian Academy of Sciences (India)

    The steady-state amplification of light beam during two-wave mixing in photorefractive materials has been analysed in the strong nonlinear regime. The oscillation conditions for unidirectional ring resonator have been studied. The signal beam can be amplified in the presence of material absorption, provided the gain due to ...

  16. X-ray structure, hydrogen bonding and lattice energy analysis of (2E ...

    Indian Academy of Sciences (India)

    erocyclic compounds. Chalcones are an important class of secondary metabolites that are precursors of many naturally occurring plant pigments [1]. These small molecules are also used as starting materials in the synthesis of UV absorption filters in polymers, photorefractive polymers, photosensitiz- ers in colour films, ...

  17. Running gratings in photoconductive materials

    DEFF Research Database (Denmark)

    Kukhtarev, N. V.; Kukhtareva, T.; Lyuksyutov, S. F.

    2005-01-01

    Starting from the three-dimensional version of a standard photorefractive model (STPM), we obtain a reduced compact Set of equations for an electric field based on the assumption of a quasi-steady-state fast recombination. The equations are suitable for evaluation of a current induced by running...

  18. Surgical management and immunohistochemical study of corneal plaques in vernal keratoconjunctivitis.

    Science.gov (United States)

    Lin, Hsiu-Yi; Yeh, Po-Ting; Shiao, Cheng-Shiang; Hu, Fung-Rong

    2013-09-01

    Two children with shield ulcer in vernal keratoconjunctivitis unresponsive to steroid therapy received plaque removal by superficial keratectomy, followed by amniotic membrane transplantation (AMT). Hematoxylin and eosin staining of the excised corneal specimen revealed a thick layer of eosinophilic material attached to the Bowman's layer. These deposits were positive for eosinophil granule major basic protein, as confirmed by an immunohistochemical study. The shield ulcer healed after the amniotic membrane was removed. No recurrent corneal plaque developed, although corneal opacity complicated in both cases. Lamellar keratectomy with AMT offers an effective management by removing the cytotoxic plaques and protecting the denuded stroma from deposition of inflammatory debris. Copyright © 2012. Published by Elsevier B.V.

  19. Comparison between lamellar keratoplasties produced by conjunctival pedicle and free corneal autografts. Experimental study in the dog (Canis familiaris - LINNAEUS, 1758

    Directory of Open Access Journals (Sweden)

    José Luiz Laus

    1996-03-01

    Full Text Available A comparative study of conjunctival pedicle and corneal autografts, for experimental healing of superficial keratectomies in dogs (Canis familiaris was performed. It was carried out by using 24 animals, and the technical procedures were analysed according to clinical, histologic and scanning electron microscopy parameters, in early and late postoperative periods. The obtained results are believed to represent feasible methods of proteresis, applied to the healing ophthalmic surgery. There were few, irrelevant differences between the two tested techniques.

  20. DISTRIBUTION OF REFRACTIVE INDEX AND CHROMATIC DISPERSION OF THE CORNEA

    OpenAIRE

    渡邉, 千博

    1999-01-01

    Many refractive surgeries of the cornea (radial keratotomy RK, photore- fractive keratectomy PRK, laser in situ keratomileusis LASIK) are done routinely in an increasing number of patients in many countries. However, few analyses of the cornea related to the corneal configuration change and refractive index distribution, which affect the postoperative visual outcomes, have been reported. We have analyzed the refractive index and chromatic dispersion of the cornea as a function of the temperat...

  1. Modulation of Ocular Inflammation by Mesenchymal Stem Cells

    Science.gov (United States)

    2017-03-01

    side effects such as infection, cataract and glaucoma. Thus, there is a pressing need for new immunomodulatory strategies that not only inhibit...Examina- tion of the restoration of epithelial barrier function following superficial keratectomy. Exp. Eye Res. 84, 32–38. Jester, J.V. (2008). Corneal...corneal transplantation. Invest424 Ophthalmol Vis Sci. 2014;55:6631-6638.425 23. Takizawa H, Boettcher S, Manz MG. Demand -adapted regulation of early

  2. A selective inhibitor of the Rho kinase pathway, Y-27632, and its influence on wound healing in the corneal stroma.

    Science.gov (United States)

    Yamamoto, Mayumi; Quantock, Andrew J; Young, Robert D; Okumura, Naoki; Ueno, Morio; Sakamoto, Yuji; Kinoshita, Shigeru; Koizumi, Noriko

    2012-01-01

    Our study examined the effect of a selective Rho kinase inhibitor, Y-27632, on corneal wound healing and potential stromal scarring after superficial keratectomy. Rabbit keratocytes were induced into myofibroblasts by transforming growth factor β1 (TGFβ1) either with or without Y-27632. Then α-smooth muscle actin (α-SMA) was examined by immunohistochemistry and western blotting, and the contractility of the seeded collagen gels was measured. Y-27632 eye drops (or vehicle only) were administered to eyes after a superficial keratectomy, and the tissue was examined by immunohistochemistry for α-SMA, collagen types I, II, and III, and keratan sulfate. Electron microscopy was conducted with and without histochemical contrasting of sulfated proteoglycans. Spindle-like cells in culture constituted 99.5±1.1% with TGFβ1 stimulation, but 3.5±1.0% after TGFβ1 and Y-27632 treatment (pcollagen gels. After superficial keratectomies, collagen type I and keratan sulfate were unchanged by Y-27632 application. Collagen type II was not detected in Y-27632 or vehicle-only corneas. With Y-27632 treatment, α-SMA expression increased and the collagen type III signal became in the weaker subepithelial area. Interestingly, bundles of aligned and uniformly spaced collagen fibrils were more prevalent in keratocytes in Y-27632-treated corneas, which is reminiscent of fibripositor-like structures that have been proposed as a mechanism of matrix deposition in embryonic connective tissues. Y-27632 inhibits keratocyte-to-myofibroblast transition, and its topical application after a superficial lamellar keratectomy elicits an altered wound healing response, with evidence of an embryonic-type deposition of collagen fibrils.

  3. Comparison of wavefront aberrations under cycloplegic, scotopic and photopic conditions using WaveScan

    Directory of Open Access Journals (Sweden)

    Rong Fan

    2012-04-01

    Full Text Available PURPOSE: To evaluate the differences of wavefront aberrations under cycloplegic, scotopic and photopic conditions. METHODS: A total of 174 eyes of 105 patients were measured using the wavefront sensor (WaveScan® 3.62 under different pupil conditions: cycloplegic 8.58 ± 0.54 mm (6.4 mm - 9.5 mm, scotopic 7.53 ± 0.69 mm (5.7 mm - 9.1 mm and photopic 6.08 ± 1.14 mm (4.1 mm - 8.8 mm. The pupil diameter, standard Zernike coefficients, root mean square of higher-order aberrations and dominant aberrations were compared between cycloplegic and scotopic conditions, and between scotopic and photopic conditions. RESULTS: The pupil diameter was 7.53 ± 0.69 mm under the scotopic condition, which reached the requirement of about 6.5 mm optical zone design in the wavefront-guided surgery and prevented measurement error due to the pupil centroid shift caused by mydriatics. Pharmacological pupil dilation induced increase of standard Zernike coefficients Z3-3, Z4(0 and Z5-5. The higher-order aberrations, third-order aberration, fourth-order aberration, fifth-order aberration, sixth-order aberration, and spherical aberration increased statistically significantly, compared to the scotopic condition (P<0.010. When the scotopic condition shifted to the photopic condition, the standard Zernike coefficients Z4(0, Z4², Z6-4, Z6-2, Z6² decreased and all the higher-order aberrations decreased statistically significantly (P<0.010, demonstrating that accommodative miosis can significantly improve vision under the photopic condition. Under the three conditions, the vertical coma aberration appears the most frequently within the dominant aberrations without significant effect by pupil size variance, and the proportion of spherical aberrations decreased with the decrease of the pupil size. CONCLUSIONS: The wavefront aberrations are significantly different under cycloplegic, scotopic and photopic conditions. Using the wavefront sensor (VISX WaveScan to measure scotopic

  4. Femtosecond laser versus mechanical microkeratome: a retrospective comparison of visual outcomes at 3 months.

    Science.gov (United States)

    Tanna, Mesha; Schallhorn, Steven C; Hettinger, Keith A

    2009-07-01

    To compare the visual outcomes of LASIK procedures in which flaps were created with a femtosecond laser (IntraLase FS 60Hz, Abbott Medical Optics [AMO]) to procedures in which flaps were created with a mechanical microkeratome (Moria Evo3 One Use-Plus, Moria SA). A retrospective analysis was performed on 2000 eyes treated in 2008 for low myopia and astigmatism (sphere mechanical microkeratome. All eyes received wavefront-guided LASIK treatments performed with a VISX S4 IR Advanced CustomVue excimer laser (AMO). Refractive predictability, change in mean spherical equivalent refraction, postoperative uncorrected visual acuity (UCVA), and loss of best spectacle-corrected visual acuity (BSCVA) were compared at 1 day, 1 week, 1 month, and 3 months following surgery. The refractive accuracy was the same for both groups. At all time points measured, the percentage of eyes that achieved a postoperative UCVA of 20/20 or better was significantly higher in the femtosecond laser group than in the mechanical keratome group. Also, a higher percentage of eyes in the femtosecond laser group achieved a postoperative UCVA of 20/16 at 3 months. Finally, a lower percentage of eyes in the femtosecond laser group lost two or more lines of BSCVA at 1 week and 1 month postoperative. Creating LASIK flaps with the femtosecond laser resulted in faster visual recovery and better UCVA.

  5. [Ablation profiles in refractive surgery. Part 1: in search of excellence].

    Science.gov (United States)

    Smadja, D; Reggiani-Mello, G; Touboul, D; Colin, J

    2012-02-01

    To provide an overview of the clinical results of various ablation profiles and discuss their technical characteristics and limitations. Literature review. With the emergence of wavefront technology, new photoablation profiles have been developed, allowing for customization of refractive treatments and reduction of nocturnal visual symptoms, which adversely affect the reputation of refractive surgery. Over the past decade, several comparative studies have been published in the literature aiming to demonstrate either the superiority of wavefront-guided correction over conventional, or one laser platform over another. However, has an ideal treatment algorithm really emerged from these studies? Does one ablation profile clearly demonstrate superiority over another, in terms of visual performance? Despite technological advances as well as improved visual results for custom versus conventional photoablation, the promise of excellence in visual performance has not been achieved with these various technologies. The concept of an individualized eye model has emerged recently, based on an optical ray tracing algorithm, and could theoretically provide an ideal ablation profile, thus fulfilling the promise of "supernormal vision". Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  6. Fulfilling the promise of laser refractive surgery.

    Science.gov (United States)

    Lawless, Michael A; Potvin, Richard J

    2006-11-01

    To review the characteristics required to perform accurate and precise laser refractive surgery relative to the current state of the art and the technology improvements needed in the future. The general characteristics for laser refractive surgery are identified and their relative contributions to a successful result considered. For each characteristic, the degree to which improvements in technology are likely to improve results is discussed. The environment (surgeon, site), technology (laser, aberrometer), and patient are identified as key factors affecting results. Although aberrometers appear to be clinically sufficient, improvements in laser beam characteristics and delivery should improve system consistency. Current registration technology may be a factor in variability from patient to patient, but the greatest contribution in this regard would appear to be patient biomechanical and healing response factors. Wavefront-guided laser refractive surgery has demonstrated an ability to be better than conventional surgery. Improvements in laser technology, registration technology, and biomechanical diagnostics are expected to further improve results. These potential improvements are expected to reduce variability and suggest that the final potential of this technology has not yet been realized.

  7. Diurnal fluctuation of higher order ocular aberrations: correlation with intraocular pressure and corneal thickness.

    Science.gov (United States)

    Mierdel, Peter; Krinke, Hans-Eberhard; Pollack, Katharina; Spoerl, Eberhard

    2004-01-01

    Optimal wavefront-guided refractive corneal laser surgery requires sufficiently exact data of optical higher order aberrations. We investigated whether these aberrations had a systematic during-the-day variation, studied the range of variation, and changes in intraocular pressure and central corneal thickness. In 22 eyes of 22 young volunteers the optical aberrations of higher order were measured by means of a Tscherning-type ocular aberrometer three times during one day (7 AM, 12 noon, 4 PM). In addition, in 12 of these eyes the intraocular pressure and central corneal thickness were measured. The intraocular wavefront aberration was computed using Zernike polynomials up to the sixth order, and Zernike coefficients of third and fourth order were analyzed. Only the coefficient Z 2/4 (C13) showed a significant increase during the day by a mean 0.016 microm. A significant regression could be detected between changes of coefficients Z3/3, Z-2/4, Z0/4, Z4/4, and changes of intraocular pressure or central corneal thickness during the day. Due to the small values, the measured during-the-day changes of higher order aberrations had no direct practical consequences for the aberrometry-guided corneal laser surgery. Alterations of some Zernike coefficients during the day may be explained by the biomechanical behavior of the cornea.

  8. Clinical outcomes of corneal wavefront customized ablation strategies with SCHWIND CAM in LASIK treatments.

    Science.gov (United States)

    Arbelaez, Maria Clara; Vidal, Camila; Arba-Mosquera, Samuel

    2009-09-01

    To evaluate the clinical outcomes of aspheric corneal wavefront (CW) ablation profiles in LASIK treatments. Thirty eyes treated with CW ablation profiles were included after a follow-up of 6 months. In all cases, standard examinations including preoperative and postoperative wavefront analysis with a CW topographer (Optikon Keratron Scout) were performed. Custom Ablation Manager (CAM) software was used to plan corneal wavefront customized aspheric treatments, and the ESIRIS flying spot excimer laser system was used to perform the ablations (both SCHWIND eye-tech-solutions, Kleinhostheim, Germany). Clinical outcomes were evaluated in terms of predictability, refractive outcome, safety, and wavefront aberration. In general, the postoperative uncorrected visual acuity and the best corrected visual acuity improved (p < 0.001). In particular, the trefoil, coma, and spherical aberrations, as well as the total root-mean-square values of higher order aberrations, were significantly reduced (p < 0.05) when the pre-existing aberrations were greater than the repeatability and the biological noise. The study results indicate that the aspheric corneal wavefront customized CAM approach for planning ablation volumes yields visual, optical, and refractive results comparable to those of other wavefront-guided customized techniques for correction of myopia and myopic astigmatism. The CW customized approach shows its strength in cases where abnormal optical systems are expected. Apart from the risk of additional ablation of corneal tissue, systematic wavefront-customized corneal ablation can be considered as a safe and beneficial method.

  9. Effects of chalazion excision on ocular aberrations.

    Science.gov (United States)

    Sabermoghaddam, Ali A; Zarei-Ghanavati, Siamak; Abrishami, Mojtaba

    2013-06-01

    The goal of this study was to compare higher-order aberrations before and after upper lid chalazion excision. Fourteen eyes from 12 patients (8 females, mean age: 28.7 ± 2.7 years) with upper lid chalazion were enrolled in this prospective interventional case series. Chalazia were excised by standard transconjunctival vertical incision. Ocular aberrations were evaluated by aberrometry (ZyWave) before and 2 months after chalazion excision. Root mean square of total higher-order aberrations decreased from 0.67 ± 0.12 to 0.43 ± 0.15 μm (P = 0.012) after excision. The root mean square of Zernike orders in the vertical and horizontal trefoil and horizontal coma were decreased after excision. Orbscan IIz tomography showed a statistically significant decrease in 5 mm zone irregularity (P = 0.027) and an increase in minimum simulated keratometry after surgery (P = 0.046). Chalazion increases higher-order aberrations, as measured by the Hartmann-Shack aberrometer, which could affect the preoperative evaluation and results of refractive surgery, especially wavefront-guided approaches. Chalazion excision could reduce ocular aberrations and is recommended before refractive surgeries.

  10. [The influence of phenylephrine and tropicamide on higher order monochromatic aberrations].

    Science.gov (United States)

    Jurkutat, S; Loosberg, B; Hemmelmann, C; Dawszynski, J; Strobel, J

    2007-03-01

    For wave-front guided corneal surgery, measuring higher order monochromatic aberrations in mydriasis is needed. However, a potential influence of mydriatic drugs on such aberrations could distort the ablation profile. Wave-front analysis was carried out on 20 (tropicamide) and 19 (phenylephrine) eyes after dark adaptation, followed by measurement after the instillation of the mydriatics one after another. Phenylephrine had no significant influence on the wave-front; neither sphere nor RMS data differed from those taken after dark adaptation. After instilling tropicamide, significant changes in Z(2) (0) and, in parallel, also of the sphere were found. The RMS showed no significant difference, only the spherical aberration Z(4) (0) was reduced by an average of 0.035 microm. The wave-front changes individually through the mydriasis due to phenylephrine and tropicamide. In the case of tropicamide, the deviation is statistically significant. Therefore, abandonment of these mydriatics before refractive surgery can be recommended, as can the use physiological pupil dilatation. Because of its lower influence, phenylephrine should be the first choice if dimout effects no adequate mydriasis.

  11. Multilayer Optical Learning Networks

    Science.gov (United States)

    Wagner, Kelvin; Psaltis, Demetri

    1987-08-01

    In this paper we present a new approach to learning in a multilayer optical neural network which is based on holographically interconnected nonlinear Fabry-Perot etalons. The network can learn the interconnections that form a distributed representation of a desired pattern transformation operation. The interconnections are formed in an adaptive and self aligning fashion, as volume holographic gratings in photorefractive crystals. Parallel arrays of globally space integrated inner products diffracted by the interconnecting hologram illuminate arrays of nonlinear Fabry-Perot etalons for fast thresholding of the transformed patterns. A phase conjugated reference wave interferes with a backwards propagating error signal to form holographic interference patterns which are time integrated in the volume of the photorefractive crystal in order to slowly modify and learn the appropriate self aligning interconnections. A holographic implementation of a single layer perceptron learning procedure is presented that can be extendept ,to a multilayer learning network through an optical implementation of the backward error propagation (BEP) algorithm.

  12. Structure and optical homogeneity of LiNbO{sub 3}:Zn (0.03–4.5 mol.%) crystals

    Energy Technology Data Exchange (ETDEWEB)

    Sidorov, Nikolay, E-mail: sidorov@chemy.kolasc.net.ru, E-mail: tepl-na@chemy.kolasc.net.ru, E-mail: fleischermed@gmail.com, E-mail: Jovial1985@yandex.ru, E-mail: palat-mn@chemy.kolasc.net.ru; Tepljakova, Natalja, E-mail: sidorov@chemy.kolasc.net.ru, E-mail: tepl-na@chemy.kolasc.net.ru, E-mail: fleischermed@gmail.com, E-mail: Jovial1985@yandex.ru, E-mail: palat-mn@chemy.kolasc.net.ru; Gabain, Aleksei, E-mail: sidorov@chemy.kolasc.net.ru, E-mail: tepl-na@chemy.kolasc.net.ru, E-mail: fleischermed@gmail.com, E-mail: Jovial1985@yandex.ru, E-mail: palat-mn@chemy.kolasc.net.ru; Yanichev, Aleksander, E-mail: sidorov@chemy.kolasc.net.ru, E-mail: tepl-na@chemy.kolasc.net.ru, E-mail: fleischermed@gmail.com, E-mail: Jovial1985@yandex.ru, E-mail: palat-mn@chemy.kolasc.net.ru; Palatnikov, Mikhail, E-mail: sidorov@chemy.kolasc.net.ru, E-mail: tepl-na@chemy.kolasc.net.ru, E-mail: fleischermed@gmail.com, E-mail: Jovial1985@yandex.ru, E-mail: palat-mn@chemy.kolasc.net.ru [I.V. Tananaev Institute of Chemistry and Technology of Rare Elements and Mineral Raw Materials of the Kola Science Center RAS, Apatity, Murmansk region, 184209 (Russian Federation)

    2014-11-14

    Structure and optical homogeneity of LiNbO{sub 3}:Zn (0.03–4.5 mol.%) crystals were searched by photoinduced light scattering and by Raman spectroscopy. The photorefractive effect depends on Zn{sup 2+} concentration nonmonotonically. Decrease of photorefractive effect is explained by decrease of structure defects with localized electrons. The Zn{sup 2+} cations replace structure defects Nb{sub Li} and Li{sub Nb}, trapping levels appear near the bottom of the conduction band and photo electrons recombine with emission under laser radiation. By the Raman spectra the area of the high structure order is found. In this area the own alternation, the alternation of impurity cations and the vacancies along the polar axis is almost perfect.

  13. Holographic gratings in pure and Mg-doped near-stoichiometric LiTaO 3 induced by deep-ultraviolet light

    Science.gov (United States)

    Juvalta, F.; Dittrich, Ph.; Montemezzani, G.; Jazbinsek, M.; Günter, P.; Takekawa, S.; Kitamura, K.

    2006-05-01

    Interband photorefractive gratings induced by deep ultraviolet light at λ UV = 257 nm are investigated in pure and Mg-doped near-stoichiometric LiTaO 3. By controlling the stoichiometry, the response time and dynamic range of the interband photorefractive effect can be very much improved. Measured time constants are in the order of a few tens of milliseconds for UV light intensities of about 100 mW/cm2. Further, we report that Mg doping of near-stoichiometric LiTaO 3 increases the grating response rate by a factor of 50 compared with the one in undoped crystals. In Mg-doped near-stoichiometric LiTaO 3, quasi-fixing of holographic gratings with UV light and nondestructive readout in the visible has been observed. These quasi-fixed gratings are written in the deep traps of the crystal.

  14. Self-amplified optical pattern recognition system

    Science.gov (United States)

    Liu, Hua-Kuang (Inventor)

    1994-01-01

    A self amplifying optical pattern recognizer includes a geometric system configuration similar to that of a Vander Lugt holographic matched filter configuration with a photorefractive crystal specifically oriented with respect to the input beams. An extraordinarily polarized, spherically converging object image beam is formed by laser illumination of an input object image and applied through a photorefractive crystal, such as a barium titanite (BaTiO.sub.3) crystal. A volume or thin-film dif ORIGIN OF THE INVENTION The invention described herein was made in the performance of work under a NASA contract, and is subject to the provisions of Public Law 96-517 (35 USC 202) in which the Contractor has elected to retain title.

  15. Optical waveguides in lithium niobate: Recent developments and applications

    Science.gov (United States)

    Bazzan, Marco; Sada, Cinzia

    2015-12-01

    The state of the art of optical waveguide fabrication in lithium niobate is reviewed, with particular emphasis on new technologies and recent applications. The attention is mainly devoted to recently developed fabrication methods, such as femtosecond laser writing, ion implantation, and smart cut waveguides as well as to the realization of waveguides with tailored functionalities, such as photorefractive or domain engineered structures. More exotic systems, such as reconfigurable and photorefractive soliton waveguides, are also considered. Classical techniques, such as Ti in-diffusion and proton exchange, are cited and briefly reviewed as a reference standpoint to highlight the recent developments. In all cases, the application-oriented point of view is preferred, in order to provide the reader with an up-to date panorama of the vast possibilities offered by lithium niobate to integrated photonics.

  16. Activation energy of proton migration in Mn- and Fe-doped lithium niobate obtained by holographic methods

    Science.gov (United States)

    Mandula, G.; Ellabban, M. A.; Rupp, R. A.; Fally, M.; Hartmann, E.; Kovacs, L.; Polgar, K.

    2003-01-01

    The activation energy of thermal fixing of photorefractive gratings is determined in congruent and nearly stoichiometric lithium niobate crystals, both doped with iron or manganese. The novel technique called holographic scattering method is compared with the standard two-wave mixing method. A measurement of the angular distribution of the self scattered intensity and its possible-analytical function is presented. The mathematical problems of the holographic scattering method are discussed applying the angular distribution functions.

  17. Bridgman growth of bismuth tellurite crystals

    Indian Academy of Sciences (India)

    The photorefractive crystal, Bi2TeO5, was grown by the modified Bridgman method for the first time. High purity Bi2O3 and TeO2 were used as starting materials and were mixed thoroughly with molar ratio of Bi2O3/TeO2 = 1 : 1. Platinum crucible was fabricated with a seed well of 10 mm in diameter and several folds were ...

  18. Dependence of gain and phase-shift on crystal parameters and ...

    Indian Academy of Sciences (India)

    pAs exp(j k · r ) + ApA∗ s exp(−j k · r ). (4). The magnitude of the wave vector k is given by 2π/Λ, where Λ is the spatial period of the interference fringe pattern. The intensity expression (4) represents a spatial variation of optical energy inside the photorefractive medium. According to the band transport model [5–7], such an ...

  19. Spatial light modulation in compound semiconductor materials

    Science.gov (United States)

    Cheng, Li-Jen (Inventor); Gheen, Gregory O. (Inventor); Partovi, Afshin (Inventor)

    1990-01-01

    Spatial light modulation (22) in a III-V single crystal (12), e.g., gallium arsenide, is achieved using the photorefractive effect. Polarization rotation created by beam coupling is utilized in one embodiment. In particular, information (16)on a control beam (14) incident on the crystal is transferred to an input beam (10), also incident on the crystal. An output beam (18) modulated in intensity is obtained by passing the polarization-modulated input beam through a polarizer (20).

  20. Light deflection and modulation through dynamic evolution of photoinduced waveguides

    OpenAIRE

    Montemezzani, Germano; Gorram, Mohammed; Fressengeas, Nicolas; Juvalta, Flurin; Jazbinsek, Mojca; Gunter, Peter

    2008-01-01

    International audience; Light induced waveguides produced by lateral illumination of a photorefractive crystal show a complex dynamic evolution upon removal of the sustaining applied electric field. Using this effect, deflection and modulation of the guided light is realized by taking advantage of the screening and counter-screening of the space charge distribution. The spot separation upon deflection can exceed 10 times the original waveguide width. Numerical simulations of the refractive in...