|
Identifier |
000377736 |
Title |
Μελέτη της ασφάλειας και αποτελεσματικότητας ενδοκερατοειδικών διαθλαστικών ενθεμάτων για την διόρθωση της πρεσβυωπίας |
Alternative Title |
Safety and efficacy of intracorneal refractive inlays of presbyopia |
Author
|
Μπουζούκης, Δημήτριος Η
|
Thesis advisor
|
Παλλήκαρης, Ιωάννης
|
Reviewer
|
Τσιλιμπάρης, Μιλτιάδης
Σιγανός, Χαράλαμπος
Βελεγράκης, Γεώργιος
Ζώρας, Οδυσσέας
Χατζηδάκης, Αδάμ
Κυμιωνής, Γεώργιος
|
Abstract |
Purpose: To investigate the visual outcomes and safety of intracorneal refractive inlays
for the surgical treatment of presbyopia and to optimize the intracorneal pocket creation,
using femtosecond laser technology.
Setting: University Hospital of Crete/Institute of Vision and Optics, Greece.
Design: Prospective non comparative interventional clinical study.
Participants: Forty-five emmetropic presbiopian patients with a mean age of 52.3 years
old ± 3.3 (range: from 47 to 58) were enrolled.
Methods: An intrastromal corneal pocket was created using a mechanical
microkeratome. The refractive inlay was inserted within the corneal tunnel in 25-300
microns depth inside the non-dominant eye. Follow-up was one year in all patients and
visits were scheduled at one week, one, three, six and twelve months after surgery.
Mean Outcome Measurements: Near and distant visual acuity, refraction, contrast
sensitivity, wavefront analysis, confocal analysis.
Results: Mean uncorrected visual acuity for near (UNVA) in the operated eye improved
from 20/50 to 20/32 after one week and 20/25 after one month and remained stable
during the 12 follow-up months. The mean add power needed for near vision, was
decreased in the operated eye from 1.87 ± 0.29 diopters (D) (range: from 1.25 to 2.25 D)
to 0.48 ± 0.19 D (range: from plano to 0.75 D). Mean uncorrected visual acuity for
distance (UDVA) was 20/32 in the operated eye and 20/20 binocularly twelve months
postoperatively from 20/20 in the operated eye and binocularly preoperatively. Three
patients lost one line of best spectacle corrected visual acuity for distance (CDVA) and
no patient lost two or more lines. None of these patients wished to remove the inlay as
they were completely satisfied with their binocular far and near vision. All patients
returned to the preoperative refraction with no loss of CDVA for near or distance.
No tissue alterations of the cornea were found using corneal confocal microscopy.
No intra or late-operative complications were demonstrated up to twelve months after
surgery.
The creation of the intracorneal pocket has been achieved with the femtosecond
laser, using a customize PVC mask to limit the tissue separation only to the desired area.
The inlay was successfully, uneventfully and safely implanted into the cornea..
Conclusions: Intracorneal refractive inlays seem to provide a safe, effective and
reversible surgical treatment for presbyopia. . The use of femtosecond laser for the
creation of the intrastromal pocket, seems to improve the procedure, by optimizing and
customizing the pocket formation and simplifying the implantation of the inlay.
|
Language |
Greek |
Subject |
Cornea |
|
Femtosecond laser |
|
Inlays |
|
Microkeratome |
|
Ophthalmologic Surgical Procedures |
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Presbyopia therapy |
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Refractive Surgical Procedures |
|
Ενθέματα |
|
Κερατοειδής |
|
Μικροκερατομος |
|
Πρεσβυωπία Θεραπεία |
Issue date |
2012-12-11 |
Collection
|
School/Department--School of Medicine--Department of Medicine--Doctoral theses
|
|
Type of Work--Doctoral theses
|
Views |
311 |