Purpose: To report the efficacy of postoperative diclofenac eye drops for pain reduction in patients undergoing topography-guided transepithelial surface ablation.
Methods: Retrospective consecutive case series of patients undergoing topography-guided transepithelial surface ablation for refractive myopia treatment using a 1 KHz excimer laser. Patients were divided into three groups. Group 1 did not receive any diclofenac drops, group 2 received one diclofenac drop postoperatively (day 1), and group 3 received one drop of diclofenac postoperatively (day 1) and on the day after treatment (day 2). Postoperative pain was self-assessed by patients per eye daily for the first 4 consecutive days (days 1 to 4) after the treatment using the visual analogue scale (VAS). We compared VAS with respect to the use of additional oral or topical treatment as well as VAS with regards to the total amount of ablated tissue (< 50 µm, 50 - 100 µm, ≥ 100 µm) among the groups.
Results: We enrolled 163 eyes of 163 patients (55.0% female), with a mean age of 31.3 years (SD ± 6.6; range 21 - 68). We excluded 16 patients who applied other additional analgesics. Group 1 comprised 35 eyes (21%), group 2 had 21 eyes (13%), and group 3 consisted of 107 eyes (66%). Median pain score (VAS) was 5 (range 0, 10) in group 1, which was higher than in groups 2 (median 1, range 0 to 7) and 3 (median 1.5, range 0 to 7) on the day of surgery (p < 0.0001). Percentage of patients using an additional oral NSAID on days 1 and 2 was significantly higher in group 1 (69/83%) when compared to groups 2 (24/43%) or 3 (31/49%) (p < 0.001 day 1, p = 0.001 day 2). No correlation was found between pain sensation and maximum ablation depth (Spearman correlation p > 0.05).
Conclusion: The instillation of one drop of diclofenac after topography-guided transepithelial surface ablation reduced subjective pain sensation according to VAS and decreased the need for additional topical anesthetic drops or oral NSAID.
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http://dx.doi.org/10.1055/a-1739-0410 | DOI Listing |
J Clin Med
November 2024
Ophthalmology Department, LaserVision Ambulatory Eye Surgery Unit, 11521 Athens, Greece.
To report a novel application within the USA of excimer ablation for the normalization of central corneal refractive irregularity, combined with higher fluence CXL in the effective management and visual rehabilitation of progressive keratoconus. 17 consecutive cases with progressive keratoconus were treated with corneal surface excimer laser ablation normalization using topography-guided (Contura) myopic ablation for customized corneal re-shaping with a 6 mm optical zone. The epithelial removal was accounted for by adding a -2.
View Article and Find Full Text PDFClin Ophthalmol
October 2024
Cornea Revolution/Motwani LASIK Institute, San Diego, CA, 92121, USA.
Purpose: To present the outcomes of a retrospective study of treatment of radial keratotomy-induced corneal irregularity with topographic guided ablation and a trans-epithelial approach based on epithelial compensation.
Methods: Sixty eyes of 31 patients were treated for radial keratotomy-induced corneal irregularity utilizing a customized trans-epithelial topographic guided ablation photorefractive keratectomy (PRK) for treatment of corneal higher-order aberrations and lower-order astigmatism. Three-month results were analyzed via measurement of vision, refraction, residual higher-order aberrations (HOAs), residual lower-order and higher-order aberrations, as well as for loss or gains of lines of best corrected visual acuity.
Korean J Ophthalmol
August 2024
First Samsung Eye Clinic, Seoul, Korea.
Purpose: To evaluate the outcomes of wavefront-optimized (WFO) and topography-guided (TG) transepithelial photorefractive keratectomy (transPRK) in the treatment of myopia and myopic astigmatism.
Methods: Patients who underwent transPRK using the WaveLight EX500 excimer laser for the correction of myopia and myopic astigmatism between January 2022 and March 2023 were divided into groups of WFO transPRK (77 eyes of 36 patients) or TG transPRK (63 eyes of 31 patients) in this retrospective, observational cohort study. The preoperative and postoperative 3-month refractive and visual outcomes of the two groups were analyzed.
Cornea
September 2024
Section of Ophthalmology, Department of Translational Biomedicine Neuroscience, University of Bari, Bari, Italy.
Purpose: The purpose of this study was to report the first remote telesurgery in a case of epithelial basement membrane disease with recurrent corneal erosions.
Methods: Topography-guided transepithelial photorefractive combined phototherapeutic keratectomy (PRK-PTK) is a surgical option that treats corneal irregularities and prevents the recurrences of erosions while treating the refractive error.
Results: We performed for the first time a remote transepithelial topography-guided combined PRK-PTK using the iRes®2 excimer laser platform (iVIS Technologies, Taranto, Italy), with the surgeon sitting in his own room and controlling the excimer laser in remote with 5G connection through the Remote Control Station and the patient in the operating room.
J Cataract Refract Surg
July 2024
From the Department of Clinical Sciences/Ophthalmology, Umeå University, Umeå, Sweden .
Purpose: To compare clinical outcomes of customized transepithelial (epi-on) corneal crosslinking (CXL) in high oxygen and customized CXL with epithelial removal (epi-off) in room air for keratoconus (KC).
Setting: Umeå University Hospital, Umeå, Sweden.
Design: Prospective, randomized, single-masked, intraindividually comparing study.
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