http://www.pesudovs.com/konrad/Docs/Solomon2009.pdf

LASIK world literature review: quality of life and patient satisfaction.

http://www.brightonvisioncenter.com/Research/Phakic_IOLs_for_Correction_of_Myopia_2009.pdf

Phakic intraocular lens implantation for the correction of myopia: a report by the American Academy of Ophthalmology.

Purpose To review the pathophysiology of LASIK-associated dry eye conditions and provide insights into prophylaxis to decrease the incidence of dry eye after LASIK and to treat the condition when it occurs. Methods A review of the literature was performed on LASIK-associated dry eye and the experience of the authors was summarized. Results LASIK has a neurotrophic effect on the cornea, along with other changes in corneal shape, that affect tear dynamics causing ocular surface desiccation. Dry eye is one of the most common complications of LASIK surgery. Symptoms of dryness may occur in more than 50% of patients, with other complications such as fluctuating vision, decreased best spectacle-corrected visiual acuity, and severe discomfort occurring in approximately 10% of patients. Preoperative dry eye condition is a major risk factor for more severe dry eye after surgery and should be identified prior to surgery. Optimization with artificial tears, nutrition supplementation, punctal occlusion, and topical cyclosporine A in patients with symptoms or signs of dry eye prior to LASIK decreases the incidence of more bothersome symptoms following surgery. Patients with LASIK-induced neurotrophic epitheliopathy often respond to topical cyclosporine A treatment, which treats the underlying inflammation and may benefit nerve regeneration. Conclusions LASIK-induced dry eye and neurotrophic epitheliopathy are common complications of LASIK surgery. Optimization of the ocular surface prior to surgery decreases the incidence and severity of postoperative symptoms of the condition.

LASIK-associated Dry Eye and Neurotrophic Epitheliopathy: Pathophysiology and Strategies for Prevention and Treatment

The second part of a review of phakic intraocular lenses (pIOLs) addresses results and complications with current pIOL models. Phakic IOLs demonstrate reversibility, high optical quality, potential gain in visual acuity in myopic patients due to retinal magnification; correction is not limited by corneal thickness or topography. With proper anatomical conditions, pIOLs also show good results in hyperopic patients. Toric pIOL designs enable spherocylindrical correction. Complications are rare and primarily related to pIOL position and type. The main complications of anglesupported anterior chamber pIOLs are glare and halos, pupil ovalization, and corneal endothelial cell loss; of iris-fixated anterior chamber pIOLs, chronic subclinical inflammation, corneal endothelial cell loss, and dislocation or pupillary block glaucoma; and of posterior chamber pIOLs, anterior subcapsular cataract formation, pigment dispersion, and luxation or pupillary block glaucoma. No causative relationship between pIOL implantation (of any pIOL type) and retinal detachment has been established. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Phakic intraocular lenses: Part 2: Results and complications

https://oogheelkunde.mumc.nl/sites/oogheelkunde/files/long-term_study_of_artisan_phakic_intraocular_lens_implantation.pdf

Long-term study of Artisan phakic intraocular lens implantation for the correction of moderate to high myopia: ten-year follow-up results.

PURPOSE: To determine subjective patient satisfaction and self-perceived quality of vision after laser in situ keratomileusis (LASIK) to correct myopia and myopic astigmatism. SETTING: Department of Ophthalmology, Academic Hospital Maastricht, Maastricht, The Netherlands. METHODS: A validated questionnaire consisting of 66 items was self-administered by 142 consecutive patients. Seven scales covering a specific aspect of quality of vision were formulated. Aspects included global satisfaction, quality of uncorrected and corrected vision, quality of night vision, glare, daytime driving, and night driving. Main outcome measures were responses to individual questions and scale scores, and correlations with clinical parameters including refractive outcome, uncorrected visual acuity, best corrected visual acuity, ablation depth, and scotopic pupil-optical zone disparity were obtained. RESULTS: The mean score for the overall satisfaction was 4.1 +/- 0.71 (SD) (scale 0 to 5.0). A total of 92.2% of patients were satisfied or very satisfied with their surgery, 93.6% considered their main goal of surgery achieved, and 92.3% would choose to have LASIK surgery again. Satisfaction with uncorrected vision was 3.03 +/- 0.71. The mean score for glare was 3.0 +/- 0.9. At night, glare from lights was believed to be more important than before surgery by 47.2%. Glare from oncoming car headlights after surgery was reported by 58.4% and was believed to be more bothersome for night driving than before surgery by 52.8%. Night driving was rated more difficult than before surgery by 39.4%, whereas 59.3% had less difficulty driving at night. There was a significant correlation between the uncorrected vision score and the postoperative spherical equivalent (r = 0.245) and postoperative astigmatism (r = 0.265). There was no correlation between the glare or night vision scores and the degree of correction, the amount of ablation depth, or the disparity between the scotopic pupil and the optical zone. CONCLUSIONS: Self-perceived uncorrected vision after LASIK surgery for the correction of myopia and myopic astigmatism appears to be very good and is related to the postoperative residual error. Although the majority of patients postoperatively experienced glare, particularly with driving at night, this was not related to the pupil-optical zone disparity or degree of correction.

Functional outcomes and patient satisfaction after laser in situ keratomileusis for correction of myopia

We describe a 54-year old man who developed a severe cell deposition 1 week after implantation of a foldable Artiflex phakic intraocular lens (pIOL) (Ophtec BV) with a silicone optic and poly(methyl methacrylate) (PMMA) haptics in the left eye for the correction of high myopia Nine months after implantation, many cell deposits remained visible on the posterior surface of the IOL, causing severe glare, especially during daylight conditions We explanted the Artiflex pIOL and exchanged it for a PMMA Artisan pIOL One month after the exchange, the uncorrected visual acuity was 20/20 and the patient's glare complaints had disappeared Slitlamp examination showed no signs of inflammation in the anterior segment or cell deposits on the PMMA Artisan pIOL Scanning electron microscopy demonstrated multiple cell deposits on the explanted Artiflex pIOL

Recurrent intraocular inflammation after implantation of the Artiflex phakic intraocular lens for the correction of high myopia.

https://oogheelkunde.mumc.nl/sites/oogheelkunde/files/functional_outcome_and_patient_satisfaction_after_artisan_phakic_intraocular_lens_implantation.pdf

Functional Outcome and Patient Satisfaction After Artisan Phakic Intraocular Lens Implantation for the Correction of Myopia

 Purpose: To evaluate a new, rigid gas permeable contact lens fitting technique following penetrating keratoplasty



Methods: For the correction of postoperative anisometropia or astigmatism, a rigid gas permeable, tetra-curve contact lens with an overall diameter of 120 mm and a back optic zone diameter of 85 mm was fitted in 36 eyes of 33 patients, 7 months after penetrating keratoplasty The contact lens back optic zone radius was selected using the videokeratography values over the elevated edges of the transplant wound (with the sutures in place) Graft clarity, visual outcome, and corneal topography were evaluated up to 3 years after surgery at intervals of 6 months



Results: Throughout the follow-up period (range 6–36, mean 193±sd 118 months), all grafts remained clear Mean contact lens daily wearing time averaged 136 (±sd 47) hours Mean best-corrected visual acuity improved from +036 (±sd 018) LogMAR with spectacles to +011 (±sd 011) LogMAR with contact lenses (p<00001) One patient was excluded from the study due to a lack of motivation and one had an adverse reaction to the stitches



Conclusions: To improve the visual performance following penetrating keratoplasty, the described fitting technique, guided by videokeratography, eased selection of the back optic zone radius of the initial trial lens The large diameter contact lenses with a tetra-curve design were well tolerated in all patients for more than 13 hours daily

A new technique for rigid gas permeable contact lens fitting following penetrating keratoplasty

We report 2 patients who had radial keratotomy (RK) to correct myopia. The first patient developed a postoperative hyperopic shift and cataract. Nine years post RK, she had intracapsular cataract extraction and implantation of an Artisan aphakic intraocular lens (IOL). Twenty years post RK, hyperopia and astigmatism progressed to +7.0 −5.75 × 100 with a best corrected visual acuity (BCVA) of 20/20. Due to contact lens intolerance, the Artisan aphakic IOL was exchanged for an Artisan toric aphakic IOL. Three months later, the BCVA was 20/20 with +1.0 −0.50 × 130. The second patient demonstrated residual myopic astigmatism 6 years after bilateral RK and had become contact-lens intolerant. An Artisan toric phakic IOL was implanted in both eyes. Four months later, the BCVA was 20/25 with a refraction of +0.25 −1.0 × 135 and 20/20 with a refraction of −1.0 × 40. Both patients were satisfied with the visual outcomes.

Fred A.G.J. Eggink

Papers

Functional outcomes and patient satisfaction after laser in situ keratomileusis for correction of myopia

Recurrent intraocular inflammation after implantation of the Artiflex phakic intraocular lens for the correction of high myopia.

Functional Outcome and Patient Satisfaction After Artisan Phakic Intraocular Lens Implantation for the Correction of Myopia

A new technique for rigid gas permeable contact lens fitting following penetrating keratoplasty

Artisan iris-fixated toric phakic and aphakic intraocular lens implantation for the correction of astigmatic refractive error after radial keratotomy.