Preliminary effects of treating the half of high latent hyperopia on refractive and visual results of femtosecond laser-assisted in situ keratomileusis in subjects with hyperopia

Background: To evaluate the preliminary effects of treating the half of high latent hyperopia on refractive and visual outcomes of femtosecond laser-assisted in situ keratomileusis (LASIK) in young subjects with hyperopia. Methods: This non-randomized comparative study includes 120 eyes of 60 subjects who underwent femtosecond LASIK to correct hyperopia. Group 1 (n = 60) includes subjects with ≤ 1D algebraic difference (DRSE) between cycloplegic (CRSE) and manifest (MRSE) refraction spherical equivalents and was treated by entering manifest refraction values. Group 2 includes subjects with > 1D DRSE and was treated by entering the mean manifest and cycloplegic refraction values. Refractive and subjective outcomes obtained at the 1-, 3-, and 6-month postoperative visits were compared. Results: The mean age of the subjects was 26.2 ± 3.5 and 26.2 ± 5.2 years for Group 1 and Group 2, respectively. The male-to-female ratios were 10/10 in both groups. Demographic values of the groups were similar (p > 0.05). Preoperative MRSE values were similar (p = 0.924), while CRSE and DRSE values were significantly higher in Group 2 (p 0.05). Conclusion: At the 6-month visit after treating the half of > 1D latent hyperopia with femtosecond LASIK, refractive and visual outcomes like MRSE, UDVA, subjective visual parameters, and quality of vision scores become similar to those obtained in ≤ 1D latent hyperopia. © 2020, Springer Nature B.V

Customized corneal cross-linking

3nononePersonalized accelerated crosslinking nomograms for the management of corneal ectasia were conceived after comparative analysis of demarcation lines and cell viability observed after customized accelerated epithelium-off crosslinking CXL treatments by spectral domain corneal OCT and scanning laser in vivo confocal microscopy matching all the clinical and instrumental data with mathematical models. Accelerated high-fluence Topography-guided CXL at 30 mW/cm2 UV-Power and Accelerated epithelium-off CXL with 9 and 15 mW/cm2 UV-A power with standardized Fluence of 5.4 J/cm2 were safe and effective demostrating a keratocytes apoptosis and demarcation line depth between 280 and 340 μm. The 30 mW ACXL showed a penetration with continuous and pulsed light between 150 and 200 μm. No endothelial damage was reported in any case. In vivo morphological studies demonstrated that Accelerated CXL allow a pachymetry-guided cutomization of CXL maintainig the standard Fluence of 5.4 J/cm2 and a total treatment time under 20 min. Moreover a pachymetry-guided ACXL nomogram (M nomogram) developed by Mazzotta C and Friedman M matching the physical and mathematical calculations with the miscostructural IVCM and OCT observations of demarcation lines depths allow an efficacous CXL management of primary and iatrogenic ectatic corneas also allowing a safe management of thin ectatic corneas.noneMazzotta C.; Rechichi M.; Ferrise M.Mazzotta, C.; Rechichi, M.; Ferrise, M