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Genes Jun 2024The identification of new biomarkers of ocular diseases is nowadays of outmost importance both for early diagnosis and treatment. Epigenetics is a rapidly growing...
Extensive Contact Lens Wear Modulates Expression of miRNA-320 and miRNA-423-5p in the Human Corneal Epithelium: Possible Biomarkers of Corneal Health and Environmental Impact.
The identification of new biomarkers of ocular diseases is nowadays of outmost importance both for early diagnosis and treatment. Epigenetics is a rapidly growing emerging area of research and its involvement in the pathophysiology of ocular disease and regulatory mechanisms is of undisputable importance for diagnostic purposes. Environmental changes may impact the ocular surface, and the knowledge of induced epigenetic changes might help to elucidate the mechanisms of ocular surface disorders. In this pilot study, we investigated the impact of extensive contact lens (CL) wearing on human corneal epithelium epigenetics. We performed ex vivo analysis of the expression of the miR-320 and miR-423-5p involved in the processes of cellular apoptosis and chronic inflammation. The human corneal epithelium was harvested from healthy patients before the photorefractive keratectomy (PRK). The patients were divided into two age- and sex-matched groups accordingly to CL wearing history with no CL wearers used as a control. The epithelium was stored frozen in dry ice at -80 °C and forwarded for miRNA extraction; afterwards, miRNA levels were detected using real-time PCR. Both miRNAs were highly expressed in CL wearers ( < 0.001), suggesting epigenetic modifications occurring in chronic ocular surface stress. These preliminary results show the relationships between selected miRNA expression and the chronic ocular surface stress associated with extensive CL use. MicroRNAs might be considered as biomarkers for the diagnosis of ocular surface conditions and the impact of environmental factors on ocular surface epigenetic. Furthermore, they might be considered as new therapeutic targets in ocular surface diseases.
Topics: Humans; MicroRNAs; Epithelium, Corneal; Female; Male; Adult; Biomarkers; Contact Lenses; Pilot Projects; Epigenesis, Genetic; Gene Expression Regulation
PubMed: 38927751
DOI: 10.3390/genes15060816 -
Ceska a Slovenska Oftalmologie :... 2024To investigate the concordance between the corneal power determined by various approaches with two tomographers (MS-39® and Galilei G6®) and the clinical history...
AIMS
To investigate the concordance between the corneal power determined by various approaches with two tomographers (MS-39® and Galilei G6®) and the clinical history method (CHM) in patients undergoing photorefractive surgery with excimer laser for myopic errors.
MATERIAL AND METHODS
Prospective cohort study. Patients undergoing keratorefractive surgery, and having pre- and postoperative keratometries, and tomographies, were included.
RESULTS
In 90 eyes, the differences in the power estimated by the CHM and the one determined by four approaches with the corneal tomographers, which included measurements of the posterior cornea, did not show statistically significant differences in their averages. However, the 95% limits of agreement were very wide. After obtaining regression formulas to adjust the values of these four variables, the results of the agreement analysis were similar.
CONCLUSION
Although certain values either directly determined or derived from measurements with the Galilei® and MS-39®corneal tomographers, approximated the estimated value of postoperative corneal power according to the CHM, due to the amplitude of their limits of agreement, these calculations must be taken with care, because they may not be accurate in a given eye.
Topics: Humans; Cornea; Myopia; Adult; Prospective Studies; Male; Female; Photorefractive Keratectomy; Young Adult; Corneal Topography; Lasers, Excimer; Refraction, Ocular
PubMed: 38925892
DOI: 10.31348/2024/23 -
International Ophthalmology Jun 2024To evaluate the intraoperative central corneal epithelial thickness (ET) as measured by optical coherence pachymetry (OCP) in myopic eyes undergoing alcohol-assisted...
PURPOSE
To evaluate the intraoperative central corneal epithelial thickness (ET) as measured by optical coherence pachymetry (OCP) in myopic eyes undergoing alcohol-assisted photorefractive keratectomy (PRK).
METHODS
A retrospective review of patients who underwent alcohol-assisted PRK was performed. Data were abstracted on age, gender, contact lens (CL) wear, preoperative refractive errors, keratometry, topographic and ultrasonic pachymetry, and intraoperative OCP measurements before and after epithelium removal. The central ET was calculated by subtracting OCP measurement after epithelium removal from the OCP measurement prior to epithelium removal.
RESULTS
The study comprised of 162 consecutive eyes from 81 patients. Mean age was 26.73 ± 6.47 years, 50.6% were males. CL was used in 92 eyes (56.8%). The mean sphere and spherical equivalent were -3.60 ± 1.84 D and -3.26 ± 1.85D, respectively. The mean intraoperative ET was 58.22 ± 17.53 µm (range, 15-121µm). Fifty-five percent of the eyes had an ET measurement above or below the range of 40-60µm. ET was significantly higher in the second operated eye compared to the first operated eye (p = 0.006), and an association was found to CL-wear (p = 0.03). There was no significant difference in thickness between genders (p = 0.62), and no correlation to patient age (p = 0.45, r = 0.06), refractive errors (p > 0.30,r-0.07-0.08), nor keratometry(p > 0.80, r-0.01- (-0.02)).
CONCLUSION
The intraoperative assessment of ET in alcohol-assisted PRK showed a high variability of the central corneal epithelium, with a significant difference between the first and second operated eyes. This difference may have implications when the epithelium is not included in the surgical planning in surface ablation.
Topics: Humans; Photorefractive Keratectomy; Male; Female; Adult; Retrospective Studies; Epithelium, Corneal; Myopia; Young Adult; Corneal Pachymetry; Lasers, Excimer; Intraoperative Period; Tomography, Optical Coherence; Corneal Topography; Adolescent; Refraction, Ocular; Visual Acuity
PubMed: 38916805
DOI: 10.1007/s10792-024-03154-1 -
Korean Journal of Ophthalmology : KJO Jun 2024To evaluate the outcomes of wavefront-optimized (WFO) and topography-guided (TG) transepithelial photorefractive keratectomy (transPRK) in the treatment of myopia and...
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 the WFO transPRK (77 eyes of 36 patients) or TG transPRK (63 eyes of 31 patients) groups in this retrospective, observational cohort study. The pre- and postoperative 3-month refractive and visual outcomes of the two groups were analyzed.
RESULTS
The uncorrected distance visual acuity was 0.0 logMAR or better in 95% of eyes 3 months postoperatively, and the mean manifest refraction spherical equivalent was within ± 1.0 diopter (D) in 90% of eyes. No significant differences were observed between the groups in terms of the UDVA or astigmatism. A significant induction of higher-order aberrations (HOAs) was observed in both groups. However, the induction of total corneal HOAs (P = .014) and spherical aberrations (P = .000) was significantly lower in the TG group than that in the WFO group.
CONCLUSIONS
WFO and TG transPRK effectively improved the visual and refractive outcomes; however, the induction of total corneal HOAs and spherical aberration was lesser following the TG ablation.
PubMed: 38897594
DOI: 10.3341/kjo.2024.0027 -
International Journal of Ophthalmology 2024
PubMed: 38895670
DOI: 10.18240/ijo.2024.06.25 -
Journal of Clinical Medicine May 2024: To evaluate the safety and efficacy of the transepithelial photorefractive keratectomy (TransPRK) performed using smart pulse technology (SPT) in myopic eyes with...
: To evaluate the safety and efficacy of the transepithelial photorefractive keratectomy (TransPRK) performed using smart pulse technology (SPT) in myopic eyes with refractive error ranging from -5.25 D to -9.75 D. : This retrospective study evaluated the outcomes of SPT-assisted TransPRK in 150 eyes performed using a 1050 Hz AMARIS excimer laser. : At 6 months postoperative, 98% of eyes achieved uncorrected distance visual acuity (UDVA) of 20/25 or better, and postoperative UDVA within one line of preoperative corrected distance visual acuity (CDVA). No eyes lost any line of CDVA. Residual spherical equivalent refraction and cylinder within ±0.50 D of intended correction were achieved in 72% and 67% of eyes, respectively. Ninety-seven percent of eyes reported no halos and glare. : TransPRK using a 1050 Hz excimer laser with SPT showed excellent predictability, safety, and efficacy for moderate to high myopia correction.
PubMed: 38892769
DOI: 10.3390/jcm13113058 -
Cureus May 2024The purpose of this clinical report is to describe a 10-year clinical outcome of advanced surface ablation with photorefractive keratectomy (PRK) in a patient who had...
The purpose of this clinical report is to describe a 10-year clinical outcome of advanced surface ablation with photorefractive keratectomy (PRK) in a patient who had been previously incorrectly diagnosed with keratoconus (KC). Corneal ectasia is a rare but extremely relevant complication of laser vision correction, and KC represents a major contraindication for these procedures. Nonetheless, some surface ablation procedures, such as PRK, might be a valid option for particular patients with atypical corneal topography or subclinical or mild forms of KC. Patient education and complete preoperative refractive multimodal imaging are essential for a more conscious therapeutic decision, minimizing iatrogenic ectasia, as well as decreasing the number of patients who are incorrectly denied refractive surgery, as was the patient presented in this study.
PubMed: 38872649
DOI: 10.7759/cureus.60277 -
Beyoglu Eye Journal 2024The objective of this study was to analyze the changes in the effective optical zones (EOZ) using topographic techniques on the tangential curvature difference map at...
OBJECTIVES
The objective of this study was to analyze the changes in the effective optical zones (EOZ) using topographic techniques on the tangential curvature difference map at post-operative 1-year following transepithelial photorefractive keratectomy (T-PRK) and to identify parameters linked to the EOZ alterations.
METHODS
The study comprised 55 eyes of 55 myopic patients who underwent T-PRK. EOZs were measured using the tangential curvature difference map of the Scheimpflug tomography system. Correlations between the EOZ alterations and relevant parameters were assessed.
RESULTS
The EOZ was significantly lower than the programmed optical zone (p<0.001). The decrease in the EOZ was significantly relevant to the decrease in mean keratometry (p=0.01, B/95% confidence interval [CI]: 0.139/0.033 and 0.244, standardized Beta: 0.346) and the increase in maximum keratometry (p=0.003, B/95% CI: 0.072/0.026 and 0.118, standardized Beta: 0.406).
CONCLUSION
The EOZ decreased in the 1 year after T-PRK in eyes with myopia. The decrease in the EOZ was correlated positively with the decrease in mean and maximum keratometry. T-PRK may be an effective and safe surgery for the correction of mild-to-moderate myopia.
PubMed: 38854896
DOI: 10.14744/bej.2024.93075 -
Journal of Refractive Surgery... May 2024To assess the predictive accuracy of new-generation online intraocular lens (IOL) power formulas in eyes with previous myopic laser refractive surgery (LRS) and to...
PURPOSE
To assess the predictive accuracy of new-generation online intraocular lens (IOL) power formulas in eyes with previous myopic laser refractive surgery (LRS) and to evaluate the influence of corneal asphericity on the predictive accuracy.
METHODS
The authors retrospectively evaluated 52 patients (78 eyes) with a history of laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) who subsequently underwent cataract surgery. Refractive prediction errors were calculated for 12 no-history new online formulas: 8 formulas with post-LRS versions (Barrett True-K, EVO 2.0, Hoffer QST, and Pearl DGS) using keratometry and posterior/total keratometry measured by IOLMaster 700 and 4 formulas without post-LRS versions (Cooke K6 and Kane) using keratometry and total keratometry. The refractive prediction error, mean absolute error (MAE), and percentages of eyes with prediction errors of ±0.25, ±0.50, ±0.75, ±1.00, and ±1.50 diopters (D) were compared.
RESULTS
The MAEs of the 12 formulas were significantly different (F = 83.66, < .001). The MAEs ranged from 0.62 to 0.94 D and from 1.07 to 1.84 D in the formulas with and without post-LRS versions, respectively. The EVO formula produced the lowest MAE (0.60) and MedAE (0.47), followed by the Barrett True-K (0.69 and 0.50, respectively). Each percentage of eyes with refractive prediction error was also significantly different among the 12 formulas ( < .001).
CONCLUSIONS
The EVO and Barrett True-K formulas demonstrate comparable performance to the other existing formulas in eyes with a history of myopic LASIK/PRK. Surgeons should use these formulas with post-LRS versions and input keratometric values whenever possible. .
Topics: Humans; Retrospective Studies; Myopia; Lenses, Intraocular; Female; Male; Refraction, Ocular; Middle Aged; Photorefractive Keratectomy; Keratomileusis, Laser In Situ; Lens Implantation, Intraocular; Adult; Optics and Photonics; Visual Acuity; Lasers, Excimer; Cornea; Reproducibility of Results; Biometry; Phacoemulsification; Aged
PubMed: 38848053
DOI: 10.3928/1081597X-20240422-01 -
Indian Journal of Ophthalmology May 2024This study aimed to report the long-term results of combined topography-guided photorefractive keratectomy (PRK) and accelerated corneal collagen cross-linking (CXL) for...
PURPOSE
This study aimed to report the long-term results of combined topography-guided photorefractive keratectomy (PRK) and accelerated corneal collagen cross-linking (CXL) for keratoconus using the Zeiss refractive coordinated system.
METHODS
A prospective interventional study was conducted in a tertiary eye care hospital in South India. Patients with mild-to-moderate progressive keratoconus and corneal pachymetry greater than 450 μm were included. They underwent customized topography-guided PRK followed by CXL. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and keratometry readings and complications were evaluated at 1, 3, 6, 12, and 24 months postoperatively.
RESULTS
Thirty patients (30 eyes) were included in the study. All study parameters showed a statistically significant improvement postoperatively over baseline values. At 24 months, the mean UDVA improved from 0.8 ± 0.180 logarithm of the minimum angle of resolution (logMAR) to 0.38 ± 0.118 logMAR ( P -value <0.001) and CDVA improved from 0.467 ± 0.142 logMAR to 0.227 ± 0.078 logMAR ( P -value <0.001). The mean flat, steep, and maximum keratometry values were significantly reduced by 2.133, 3, and 4.54 diopters, respectively, at the last follow-up examination ( P -value <0.001).
CONCLUSION
The combined topography-guided PRK and accelerated CXL procedure seem to be a promising treatment alternative for early keratoconus. This is the first such study on the Zeiss refractive coordinated system. However, further studies with a larger study population and longer follow-up periods are required to draw final conclusions about the benefits of this procedure in keratoconus.
PubMed: 38767551
DOI: 10.4103/IJO.IJO_791_23