Corneal Ectasia Risk And Percentage Tissue Altered In Myopic Patients Presenting For Refractive Surgery

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorONG, Hon Shing
dc.contributor.authorFAROOK, Mohamed
dc.contributor.authorTAN, Benjamin Boon Chuan
dc.contributor.authorWILLIAMS, Geraint P.
dc.contributor.authorSANTHIAGO, Marcony R.
dc.contributor.authorMEHTA, Jodhbir S.
dc.date.accessioned2019-11-06T18:50:25Z
dc.date.available2019-11-06T18:50:25Z
dc.date.issued2019
dc.description.abstractPurpose: A percentage tissue altered (PTA) score of >= 40% has been advocated as an independent indicator of post-operative ectasia risk following laser in-situ keratomileusis (LASIK). This study was performed to test the hypothesis that refractive procedures, such as laser-assisted subepithelial keratectomy (LASEK) or small incision lenticule extraction (SMILE), may alter the range of PTA, within which refractive corneal surgery can be safely performed. Setting: Refractive department, tertiary ophthalmic hospital. Design: Retrospective observational study. Methods: Review of case notes was performed for patients who presented for refractive surgeries, other than LASIK. To determine the risk of corneal ectasia for each patient prior to refractive surgery, we estimated what each patient's PTA would have been if they had undergone LASIK. The Randleman Ectasia Risk Score System (ERSS) was also calculated. Results: 114 eyes (66 patients) were included. 94 eyes underwent SMILE. 20 eyes underwent LASEK. A significant proportion of eyes had PTA >= 40% - SMILE eyes: up to 31.9%, LASEK eyes: up to 60.0% (at presumed LASIK flap of 120 mu m). The maximum calculated PTA was up to 47.9% in the SMILE group and up to 51.5% in the LASEK group. Using ERSS, 12.8-16% of SMILE eyes and 15.0-80.0% of LASEK eyes would have been considered to have moderate-to-high ectasia risk. No post-surgical ectasia was observed at 3 years. Conclusion: SMILE and LASEK alter the range of PTA, within which corneal refractive surgery may be performed with a lower risk of developing post-operative corneal ectasia; a safe PTA threshold needs to be determined for these procedures before recommendations for clinical practice can be made.eng
dc.description.indexPubMedeng
dc.description.sponsorshipDowager Eleanor Peel Trust Travelling Grant
dc.description.sponsorshipRoyal College of Ophthalmologists/Pfizer Ophthalmic Fellowship
dc.identifier.citationCLINICAL OPHTHALMOLOGY, v.13, p.2003-2015, 2019
dc.identifier.doi10.2147/OPTH.S215144
dc.identifier.issn1177-5483
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/34118
dc.language.isoeng
dc.publisherDOVE MEDICAL PRESS LTDeng
dc.relation.ispartofClinical Ophthalmology
dc.rightsopenAccesseng
dc.rights.holderCopyright DOVE MEDICAL PRESS LTDeng
dc.subjectpercentage tissue alteredeng
dc.subjectectasiaeng
dc.subjectrefractive surgeryeng
dc.subjectlaser in situ keratomileusiseng
dc.subjectlaser-assisted sub-epithelial keratectomyeng
dc.subjectsmall incision lenticule extractioneng
dc.subject.otherin-situ-keratomileusiseng
dc.subject.otherincision lenticule extractioneng
dc.subject.otherforme-fruste keratoconuseng
dc.subject.otherfemtosecond lasereng
dc.subject.othersubclinical keratoconuseng
dc.subject.otherbilateral ectasiaeng
dc.subject.othermechanical microkeratomeeng
dc.subject.otherbiomechanical propertieseng
dc.subject.otheriatrogenic keratectasiaeng
dc.subject.othertensile-strengtheng
dc.subject.wosOphthalmologyeng
dc.titleCorneal Ectasia Risk And Percentage Tissue Altered In Myopic Patients Presenting For Refractive Surgeryeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.affiliation.countrySingapura
hcfmusp.affiliation.countryisosg
hcfmusp.author.externalONG, Hon Shing:Singapore Natl Eye Ctr, Dept Corneal & External Dis, 11 Third Hosp Ave, Singapore 168751, Singapore; Singapore Eye Res Inst, Tissue Engn & Stem Cell Grp, Singapore, Singapore; Duke NUS Grad Med Sch, SingHlth Duke NUS Ophthalmol & Visual Sci Acad Cl, Singapore, Singapore
hcfmusp.author.externalFAROOK, Mohamed:Singapore Natl Eye Ctr, Dept Corneal & External Dis, 11 Third Hosp Ave, Singapore 168751, Singapore
hcfmusp.author.externalTAN, Benjamin Boon Chuan:Singapore Natl Eye Ctr, Dept Corneal & External Dis, 11 Third Hosp Ave, Singapore 168751, Singapore
hcfmusp.author.externalWILLIAMS, Geraint P.:Singapore Natl Eye Ctr, Dept Corneal & External Dis, 11 Third Hosp Ave, Singapore 168751, Singapore; Singapore Eye Res Inst, Tissue Engn & Stem Cell Grp, Singapore, Singapore
hcfmusp.author.externalMEHTA, Jodhbir S.:Singapore Natl Eye Ctr, Dept Corneal & External Dis, 11 Third Hosp Ave, Singapore 168751, Singapore; Singapore Eye Res Inst, Tissue Engn & Stem Cell Grp, Singapore, Singapore; Duke NUS Grad Med Sch, SingHlth Duke NUS Ophthalmol & Visual Sci Acad Cl, Singapore, Singapore; Nanyang Technol Univ, Sch Mat Sci & Engn, Singapore, Singapore
hcfmusp.citation.scopus14
hcfmusp.contributor.author-fmusphcMARCONY RODRIGUES DE SANTHIAGO
hcfmusp.description.beginpage2003
hcfmusp.description.endpage2015
hcfmusp.description.volume13
hcfmusp.origemWOS
hcfmusp.origem.scopus2-s2.0-85073743922
hcfmusp.origem.wosWOS:000490129200001
hcfmusp.publisher.cityALBANYeng
hcfmusp.publisher.countryNEW ZEALANDeng
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