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    Corneal sensitivity and ocular surface health in patients undergoing femtosecond LASIK retreatment for residual refraction
    (Lippincott Williams and Wilkins, 2024) Çinar, Esat; Yüce, Berna; Aslan, Fatih
    Purpose:To assess corneal sensitivity and the ocular surface in patients undergoing primary femtosecond laser in situ keratomileusis (FS-LASIK) and those undergoing FS-LASIK retreatment under the same flap due to residual refractive error.Setting:Ekol Eye Hospital, Izmir, Turkey.Design:Prospective case series.Methods:19 patients with previous FS-LASIK who had myopic and astigmatic refractive error were included in the study group, and 19 age-matched and sex-matched patients undergoing FS-LASIK for the first time as the control group. Corneal sensitivity, Schirmer test, tear film break-up time (TBUT), Oxford grading scheme for ocular surface staining, and Ocular Surface Disease Index (OSDI) were measured preoperatively and at postoperative 1 week and 1, 3, and 6 months.Results:The mean refractive correction in the study and control groups, respectively, was 2.18 ± 0.78 diopters (D) (range: 1.00 to 3.50) and 2.76 ± 1.20 D (range: 1.00 to 4.50; P =.07). Corneal esthesiometry results in the study and control groups, respectively, were 6.10 ± 12.55 vs 9.90 ± 11.50 mm at 1 week (P =.001), 41.95 ± 6.98 vs 45.09 ± 5.88 mm at 1 month (P =.004), 56.09 ± 3.37 vs 56.19 ± 2.52 mm at 3 months (P =.8), and 58.60 ± 2.01 vs 58.80 ± 1.39 mm at 6 months (P =.5). Significant difference between the 2 groups in Schirmer test score that disappeared at postoperative 3 months and in TBUT and ocular surface staining that disappeared at 6 months, whereas the statistically significant difference in OSDI score persisted at 6 months (P =.03) was detected.Conclusions:Corneal surface sensitivity and ocular surface health are more impaired in patients undergoing FS-LASIK retreatment due to residual refractive error. ©2024 Published by Wolters Kluwer on behalf of ASCRS and ESCRS. Unauthorized reproduction of this article is prohibited.
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    Influence of Nd:YAG laser capsulotomy on toric intraocular lens rotation and change in cylinder power
    (Lippincott Williams and Wilkins, 2024) Çinar, Esat; Yüce, Berna; Aslan, Fatih; Erbakan, Gökhan
    Purpose:To investigate toric monofocal intraocular lens (TIOL) rotation and associated changes in cylinder power caused by Nd:YAG laser capsulotomy performed due to posterior capsule opacification (PCO).Setting:Ekol Eye Hospital, Izmir, Turkey.Design:Prospective case series.Methods:41 eyes of 20 women and 21 men were included in the study. Before and 1 month after Nd:YAG laser capsulotomy, TIOL tilt and decentration were determined with Scheimpflug camera, and TIOL axial rotation and the change in cylinder power induced by this rotation were measured by ray tracing aberrometry. The time interval between cataract surgery and Nd:YAG laser capsulotomy was noted.Results:Rotational misalignment of the TIOL was measured as 4.65 ± 2.75 degrees (range 0 to 11 degrees) before vs 6.97 ± 2.92 degrees (range 0 to 13 degrees) after capsulotomy, and absolute rotation was 2.75 ± 1.94 degrees (range 0 to 7 degrees, P =.028). Before and after Nd:YAG laser capsulotomy, cylinder power was 0.24 ± 0.70 diopter (D) (range 0.00 to 0.63 D) vs 0.56 ± 0.77 D (range 0.02 to 0.91 D), respectively, with an absolute change in cylinder power of 0.34 ± 0.22 D (range 0.01 to 0.90 D, P =.001). After capsulotomy, there was a significant decrease in IOL tilt in the horizontal and vertical planes and an increase in decentration (P <.05). Time interval (33.02 ± 12.9 months) and IOL horizontal decentration were independent factors affecting IOL rotation after capsulotomy (P <.05).Conclusions:Nd:YAG laser capsulotomy may cause TIOL rotation as well as tilt and decentration, resulting in a change in the TIOL's corrective effect on corneal astigmatism. Although this change was clinically insignificant, it may be beneficial to consider that TIOL rotational misalignment may occur in patients undergoing early capsulotomy. © 2024 Elsevier Inc.. All rights reserved.