Benzer Kırma Kusuru İçin Uygulanan Farklı Keratorefraktif Cerrahi Yöntemlerinin Keratometrik Değerler Üzerine Etkileri

Abstract

keratorefraktif yöntemlerle düzeltilen benzer büyüklükteki miyopik ve birleşik miyop astigmatik kırma kusurunun, korneal keratometrik güç üzerindeki etkilerinin benzer olup olmadığının araştırılmasıdır. Gereç ve Yöntemler: Bu geriye dönük, randomize olmayan, karşılaştırmalı klinik araştırma Ocak 2018 ve Haziran 2019 tarihleri arasında gerçekleştirilmiştir. Uygulanan cerrahiye göre olgular PRK (n=100) ve LASIK (n=76) olarak 2 gruba ayrılmıştır ve her bir hastanın sağ gözü çalışmaya dahil edilmiştir. Olguların cerrahi öncesi ve cerrahi sonrası 6. aydaki klinik verileri göz önünde bulundurularak sferik eşdeğerindeki (SE) azalma ile SEfark ve ortalama keratometrideki (Km) değişim ile Kfark değerleri hesaplanmıştır. Kfark/SEfark hesaplaması ile birim SE değişiminin Km üzerindeki etkileri araştırılmış ve gruplar arasında karşılaştırma yapılmıştır. Bulgular: PRK ve LASIK grupları arasında cinsiyet (p=0,348) ve yaş (p=0,768) bakımından anlamlı fark yoktu. SEfark değeri PRK grubunda -3,36 ± 1,46 D (-0,88 ile -6,50 D) iken LASIK grubunda -3,26 ± 1,41 D (-1 ile -6,13 D) idi ve gruplar arasında anlamlı fark yoktu (p=0,206). Kfark/SEfark parametresi PRK grubunda -0,87 ± 0,23 (-0,23 ile -1,53) iken LASIK grubunda -0,94 ± 0,46 (-0,32 ile -1,29) idi ve gruplar arasında anlamlı fark yoktu (p=0,169). Sonuç: Benzer büyüklükteki miyopik veya birleşik miyop astigmatik kırma kusuru düzeltmesinde uygulanan PRK ve LASIK cerrahilerinin Km değerindeki cerrahi ile elde edilen değişim üzerine olan etkileri benzerdir.

Keywords

• Keratometri
• LASIK
• PRK
• Refraktif cerrahi
• Sferik eşdeğer

The Effects of Different Keratorefractive Surgical Methods Performed for Similar Refractive Errors on Keratometric Values

Abstract

Objective: To investigate whether the effects of myopic and compound myopic astigmatic refractive errors with similar magnitude corrected by different keratorefractive methods like photorefractive keratectomy (PRK) and laser in-situ keratomileusis (LASIK) on corneal keratometric power are similar. Material and Methods: This retrospective, non-randomized, comparative study was conducted between January 2018 and June 2019. The subjects were separated within two groups as PRK (n=100) and LASIK (n=76) according to performed surgery, and only right eyes of each subjects were included in this study. Considering preoperative and postoperative sixth month clinical values, spherical equivalent (SE) difference (SEdif) and mean keratometry (Km) difference (Kdif) values were calculated. The effects of per each SE change on Km were investigated via calculation of SEdif/Kdif, and the groups were compared. Results: There was no significant difference between PRK and LASIK groups in terms of gender (p=0.348) and age (p=0.768). SEdif values were 3.36 ± 1.46 D (-0.88 to -6.50 D) in PRK group and -3.26 ± 1.41 D (-1 to -6.13 D) in LASIK group, and there was no significant difference between groups (p=0.206). Kdif/SEdif calculation was -0.87 + 0.23 (-0.23 to -1.53) in PRK group and -0.94 + 0.46 (-0.32 to -1.29) in LASIK group, and there was no significant difference between groups (p=0.169). Conclusion: The effects of PRK and LASIK surgeries performed to correct myopic and compound myopic astigmatic refractive errors with similar magnitude, on change in Km value because of surgery, are similar.

Keywords

• Keratometry
• LASIK
• PRK
• Refractive surgery
• Spherical equivalent

References

1. 1. Hürmeriç V, Erdem H, Dağlı O, Dağlı S. LASEK ve PRK cerrahisi uygulana hastalarda görsel ve refraktif sonuçlar: Çift göz çalışması. Turk J Ophthalmol 2009; 39: 365-371.
2. 2. Ozulken K, Ilhan C. Effects of cyclotorsion orientation and magnitude in eyes with compound myopic astigmatism on the compensation capacity of WaveLight EX500 photorefractive keratectomy. Korean J Ophthalmol 2019; 33(5): 458-466.
3. 3. Lume M, Salgado R, Vaz F, Pinto MC, Furtado MJ, Reimao P. RNFL thickness after LASIK, LASEK and PRK. Ophthalmology Times Europe 2009;5:40-41.
4. 4. Vossmerbaeumer U, Jonas JB. Structure of intracorneal femtosecond laser pulse effects in conical incision profiles. Graefes Arch Clin Exp Ophthalmol 2008; 246: 1017– 1020.
5. 5. Choi SK, Kim JH, Lee D. The effect of femtosecond laser lamellar dissection at various depths on corneal endothelium in the recipient bed of the porcine eye. Ophthalmic Surg Lasers Imaging 2010; 41: 255–260.
6. 6. Ozulken K, Ilhan C. Comparison of 9.0 and 9.2 mm flap diameter options of femtosecond laser in-situ keratomileusis for hypermetropia and hypermetropic astigmatism. J Ophthalmol 2019: 5907645. doi: 10.1155/2019/5907645.
7. 7. YuenLH, ChanWK, KohJ, MehtaJS, TanDT, SingLasik Research Group. A 10-year prospective audit of LASIK outcomes for myopia in 37,932 eyes at a single institution in Asia. Ophthalmology 2010; 117: 1236–1244.
8. 8. Alio JL, Muftuoglu O, Ortiz D, Perez-Santonja JJ, Artola A, Ayala MJ, Garcia MJ, Castro de Luna G. Ten-year follow-up of laser in situ keratomileusis for myopia of up to 10 diopters. Am J Ophthalmol 2008; 145: 46–54.

9. 9. Kaiserman I, Sadi N, Mimouni M, Sela T, Munzer G, Levartovsky S. Corneal breakthrough haze after photorefractive keratectomy with mitomycin C. Cornea 2017; 36(8): 961-966.
10. 10. Ladas JG, Boxer Wachler BS, Hunkeler JD, Durrie DS. Intraocular lens power calculations using corneal topography after photorefractive keratectomy. Am J Ophthalmol 2001; 132: 254–255.
11. 11. Feiz V, Mannis MJ, Garcia-Ferrer F, Kandavel G, Darlington JK, Kim E, Caspar J, Wang JL, Wang W. Intraocular lens power calculation after laser in situ keratomileusis for myopia and hyperopia: a standardized approach. Cornea 2001; 20: 792–797.
12. 12. Wang L, Spektor T, de Souza RG, Koch DD. Evaluation of total keratometry and its accuracy for intraocular lens power calculation in eyes after corneal refractive surgery. J Cataract Refract Surg 2019; 45(10): 1416-1421.
13. 13. Wang L, Hill WE, Koch DD. Evaluation of intraocular lens power prediction methods using the American Society of Cataract and Refractive Surgeons post-keratorefractive intraocular lens power calculator. J Cataract Refract Surg 2010; 36: 1466–1473.
14. 14. Randleman JB, Woodward M, Lynn MJ, Stulting RD. Risk assessment for ectasia after corneal refractive surgery. Ophthalmology 2008; 115(7): 37-50.
15. 15. Fabian E, Wehner W. Prediction accuracy of total keratometry compared to standard keratometry using different ıntraocular lens power formulas. J Refract Surg 2019; 35(6): 362-368.