Structure of initial morphometric, optical parameters of cornea in patients with medium degree myopia before refractive surgery. Parity of optimal and possible conditions of surgery
O.Yu. TATANOVA1, E.L.SOROKIN1,2, I.V. DUTCHIN1
1Khabarovsk Branch of the S. Fyodorov Eye Microsurgery Federal State Institution, 211 Tikhookeanskaya Str., Khabarovsk, Russian Federation, 680033
2Дальневосточный государственный медицинский университет МЗ РФ, 680000, г. Хабаровск, ул. Муравьева-Амурского, д. 35
2Far-Eastern State Medical University, 35 Muraviev-Amurskiy Str., Khabarovsk, Russian Federation, 680000
Tatanova O.Yu. — ophthalmologist of the Refractive Surgery Department, tel. (4212) 72-27-92, e-mail: naukakhvmntk@mail.ru
Sorokin E.L. — D. Med. Sc., Professor, Deputy Director for Science, Deputy Head of the Ophthalmology Department, tel. (4212) 72-27-92, e-mail: naukakhvmntk@mail.ru
Dutchin I.V. — Cand. Med. Sc., Head of the Department of Refractive Surgery, tel. (4212) 72-27-92, e-mail: naukakhvmntk@mail.ru
The analysis of the structure of morphometric, anatomical and optical ocular indicators in patients with myopia to 6.0 diopters before performing refractive surgery was made. Clinical material totaled 190 eyes (114 patients) with myopic refractive spheroequivalent of 6.0 diopters and astigmatism of 1.75 diopters. Morphometric and anatomical optic corneal characteristics and optical system of the eye were studied (thickness of the central corneal zone, and its optical power, diameter, width of the pupil in scotopic conditions, the level of higher-order aberrations eye optical system; angle Kappa; codes corneal topography corneal elevation posterior surface of the cornea). In 62.1% of the eyes, the optimal conditions for all investigated indices were determined, in 37.9% only for some of them. In 10.5% of the structure of non-optimal conditions there were deviations in 1-2 features; in 27,4% — on 3 and more indicators. Taking into account the identified baseline indicators, in 37.9% of cases there was a need to make adjustments in the course of operation: to increase the optical zone to perform personalized ablation, to reduce the thickness of valve, shift the ablation zone with the angle kappa. The most common species of deviations from the optimal parameters were: the width of the pupil in scotopic conditions, the optical power of the cornea, the level of higher-order aberrations, SAI index. This created the need to make appropriate adjustments to the course of the operation.
Key words: spheroequivalent of myopic refraction up to 6.0 dpt, morphometric parameters of the cornea, anatomical and optic corneal parameters.
references
- Balashevich L.I. Surgical correction of abnormalities of refraction and accommodation. 2009, pp. 152-153. (in Russ.).
- Guirao A. Theoretical elastic response of the cornea to refractive surgery: Risk factors for keratectasia. Refract. Surg, 2005, vol. 21, no. 2, pp. 176-185.
- Egorov V.V., Dutchin I.V., Smolyakova G.P., Sorokin E.L. Excimer laser surgery and corneal regeneration. Part 1. Clinical types of corneal regeneration at myopia correction with methods PRK and LASIK. Journal cataract and refractive surgery, 2006, 3, pp. 4-9. (in Russ.).
- Egorov V.V., Dutchin I.V., Smolyakova G.P., Sorokin E.L. Excimer laser surgery and corneal regeneration. Part 2. Clinical-immunological features of photorefraction myopia correction and its influence on cornea regeneration. Journal cataract and refractive surgery, 2006, 3, pp. 10-15. (in Russ.).
- Egorov V.V., Posvalyuk V.D., Sorokin E.L., Smoliakova G.P. Searches of possibilities for increase of efficacy in treatment of the heavy induced dystrophies of a cornea by method excimer laser surgery. Ophthalmology, 2008, vol. 5, 3, pp. 35-40. (in Russ.).
- Kachalina G.F., Kishkin Yu.I., Maichuk N.V., Kondakova O.I. Keratoconus and postoperative corneal ectasia: myths and reality. Modern Technologies in Cataract and Refractive Surgery — 2010: abstract book, 2010, pp. 266-272. (in Russ.).
- Kostenev S.V., Chernykh V.V. Clinical and functional study of quality of femtodissection of corneal valve and frequency of occurrence opaque bubble layer at operation Femto-Lasik, depending on anatomical and topographic characteristics of cornea. Modern technologies in ophthalmology, 2014, no. 3, pp. 164. (in Russ.).
- Kachanov A.B., Nikulin S.A., Togo E.S. et al. Relex® SMILE technology in refractive surgery. Modern technologies in ophthalmology, 2014, no. 3, pp. 146. (in Russ.).
- Bogush I.V., Khodjaev N.S. Eccentricity, asphericity and shape factor values of the normal cornea. Ophthalmosurgery, 2011, no. 1, pp. 6-9. (in Russ.).
- Binder P. Flap dimensions created with the IntraLase FS laser. Cataract Refract. Surg, 2004, vol. 30, no. 1, pp. 26-32.
- Zaldivar R., Oscherow S., Bains H.S. Five techniques for improving outcomes of hyperopic LASIK. Refract. Surg, 2005, vol. 21, no. 5, pp. 628-632.
- Chalita M.R., Finkental J., Xu M., Krueger R.R. LADARWave wavefront measurement in normal eyes. Refract. Surg, 2004, vol. 20, no. 2, pp. 132-138.
- Sukhanova E.V. Evaluation of the efficiency of primary optimized LASIK: Abstract of Med.Sc.D. Dissertation, 2007. 24 p. (in Russ.)
- Chan C., Boxer Wachler B. Centration analysis of ablation over the coaxial corneal light reflex for hyperopic LASIK. Refract. Surg, 2006, vol. 22, no. 5, pp. 467-471.
- Lafond G., Bonnet S., Solomon L. Treatment of previous decentered excimer laser ablation with combined myopic and hyperopic ablations. Refract. Surg, 2004, vol. 20, no. 2, pp. 139-148.
- Semenov A.D., Kishkin Y.I., Maichyk N.V. et al. The results of correction of decentration of the ablation zone of the cornea on the technology «Topographically oriented PRK». Practical medicine, 2012, no. 4-1 (59), pp. 49-52. (in Russ.).
- Mrochen M., Krueger R., Bueeler M. et al. Aberration sensing and wave-front guided laser in situ keratomileusis: management of decentered ablation. Refractive surgery, 2002, no. 18, pp. 418-429.
- Makovkin E.M. Signification of ratio of anatomical parameters of eye in excimer laser correction of anomalies of refraction: Abstract of Med.Sc.D. Dissertation, 2008. 28 p. (in Russ.)
- Wang L., Koch D.D. Ocular high order aberrations in individuals screened for refractive surgery. Cataract Refr. Surg, 2003, vol. 29, no.10, pp. 1896-1903.
- Holladay J.T. Detecting forme fruste keratoconus with the Pentacam. Cataract Refract. Surg. Today, 2008, pp. 11-12.


