An ANCOVA analysis of the results of planned and actually obtained hypocorrection after excimer laser surgery in middle-aged patients with myopia
https://doi.org/10.21516/2072-0076-2021-14-2-50-54
Abstract
Purpose: a covariance analysis of the planned and actually obtained refraction after excimer laser myopia correction surgery in middle-aged patients. Material and methods. 85 patients (170 eyes) aged 35 to 50 underwent excimer laser myopia correction surgery by FemtoLASIK. The patients were divided into 3 groups according to the degree of myopia: group 1 included 13 patients (26 eyes) with myopia from -1.25 to -3.0 D, group 2 had 42 patients (84 myopic eyes) from -3.25 to -6.0 D and group 3 had 30 patients (60 eyes) with myopia of -6.25 D or higher. Results. The patients with low myopia, independently of the age, revealed a postoperative refraction effect closer to that planned than the patients with moderate and high myopia. The difference (delta) between the planned and the obtained results was -0.35 ± 0.08 D (41%) in group 1, -0.58 ± 0.04 D (51.3%) in group 2 and -0.64 ± 0.05 D (46%) in group 3. The divergence between the respective indicators for figures for low and high myopic groups is statistically significant. Conclusion.Patients with low myopia over 35 years old can be recommended a symmetric hypocorrection in binocular format irrespective of the objective data regarding the initial corneal hydration, which affects the ablation volume. To achieve a better agreement between the planned and the actual hypoeffect (and, accordingly, a more precise dosage of the surgery) in patients with moderate and high myopia, it is important to introduce into clinical practice the technology of contactless measurement of corneal hydration.
About the Authors
N. V. KhodzhabekyanRussian Federation
Narine V. Khodzhabekyan— Cand. of Med. Sci., leading researcher
of the department of refraction pathology, binocular vision and
ophthalmoergonomics
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
E. P. Tarutta
Russian Federation
Elena P. Tarutta — Dr. of Med. Sci., professor, head of the department of refraction pathology, binocular vision and ophthalmoergonomics
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
A. T. Khandzhyan
Russian Federation
Anush T. Khandzhyan— Cand. of Med. Sci., senior researcher, department of retinal and optic nerve pathology
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
M. D. Sengaeva
Russian Federation
Maria D. Sengaeva — PhD student of the department of retinal and optic nerve pathology
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
A. V. Ivanova
Russian Federation
Anastasia V. Ivanova— Cand. of Med. Sci., researcher of the department of refractive pathology, binocular vision and ophthalmoergonomics
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
K. B. Letnikova
Russian Federation
Ksenia B. Letnikova — Cand. of Med. Sci., researcher of the department of retinal and optic nerve pathology
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
A. S. Sklyarova
Russian Federation
Anna S. Sklyarova — Cand. of Med. Sci., ophthalmologist, department of retinal and optic nerve patholog
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
References
1. Artola A., Patel S., Schimchak P., et al. Evidence for delayed presbyopia after photorefractive keratectomy for myopia. Ophthalmology. 2006; 113 (5): 735–41. doi: 10.1016/j.ophtha.2006.01.054
2. Uthoff D., Polzl M., Hepper D., Holland D.A new method of cornea modulation with excimer laser for simultaneous correction of presbyopia and ametropia. Graefes Arch. Clin. Exp. Opthalmol. 2012; 250 (11): 1649–61. doi: 10.1007/s00417-012-1948-1
3. Naidoo K.S., Holden B.A. The global burden of potential productivity loss from uncorrected presbyopia. Ophthalmology. 2015; 122 (8): 1706–10. https://doi.org/10.1016/j.ophtha.2015.04.014
4. Charman W.N. Developments in the correction of presbyopia: surgical approaches. Ophthalmic Physiol. Opt. 2014; 34 (4): 397–426. https://doi.org/10.1111/opo.12129
5. Khodzhabekyan N.V., Khandzhyan A.T., Tarutta E.P. Asymmetric hypocorrection of myopia by FemtoLASIK in patients with presbyopia. Russian ophthalmological journal. 2018; 11 (4): 43–8 (in Russian)]. doi: 10.21516/2072-0076-2018-11-4-43-48
6. Artola A., Patel S., Schimchak P., et al.Evidence for delayed presbyopia after photorefractive keratectomy for myopia. Ophthalmology. 2006; 113 (5): 735–41. https://doi.org/10.1016/j.ophtha.2006.01.054
7. Kim W.S., Jo J.M. Corneal hydration affects ablation during laser in situ keratomileusis surgery. Cornea. 2001 May; 20 (4): 394–7. doi: 10.1097/00003226-200105000-00011
8. Rumjantseva O.А., Spivak I.A.Aging change of corneal morphological structure. RMZH. Klinicheskaja oftal’mologija. 2004; 4: 158–61 (in Russian).
9. Polse K.A., Brand R., Mandell R., et al.Age differences in corneal hydration control. Invest Ophthalmol Vis Sci. 1989 Mar; 30 (3): 392–9. PMID: 2925313
10. Fisher B.T., Masiello K.A., Goldstein M.H., Hahn D.W. Assessment of transient changes in corneal hydration using confocal Raman spectroscopy. Cornea. 2003; 22 (4 May): 363–70. doi:10.1097/00003226-200305000-00016
11. Kim Y.L., Walsh Jr J.T., Goldstick T.K., Glucksberg M.R. Variation of corneal refractive index with hydration. Physics in Medicine and Biology. 2004; 49 (5): 859–68. https://doi.org/10.1088/0031-9155/49/5/015
12. Iomdina E., Goltsman G., Seliverstov S., et al.Study of transmittance and reflectance spectra of the cornea and the sclera in the THz frequency range. Journal of Biomedical Optics. 2016; 21 (9), 097002. https://doi.org/10.1117/1.JBO.21.9.097002
13. Iomdina E.N., Seliverstov S.V.,Sianosyan A.A., et al. Terahertz scanning for evaluation of corneal and scleral hydration. Sovremennye tehnologii v medicine. 2018; 10 (4): 143–50 (In Russian)]. https://doi.org/10.17691/ stm2018.10.4.17
Review
For citations:
Khodzhabekyan N.V., Tarutta E.P., Khandzhyan A.T., Sengaeva M.D., Ivanova A.V., Letnikova K.B., Sklyarova A.S. An ANCOVA analysis of the results of planned and actually obtained hypocorrection after excimer laser surgery in middle-aged patients with myopia. Russian Ophthalmological Journal. 2021;14(2):50-54. (In Russ.) https://doi.org/10.21516/2072-0076-2021-14-2-50-54