Preview

Ophthalmology in Russia

Advanced search

The First Clinical and Functional Results of Myopia Correction Using a Solid-State Laser Unit

https://doi.org/10.18008/1816-5095-2023-3-444-450

Abstract

Relevance. Modern keratorefractive surgery (CRS) is a high-tech field of ophthalmology aimed at solving various problems of correcting a wide range of ametropias. Increasing the security of the RFI is one of the priority areas Purpose. To analyze the clinical and functional results of the use of the “Olimp™-2000” solid-state laser system during CRS using the method of superficial and sublamellar laser keratoablation and formulate recommendations for the therapeutic management of patients. Materials and methods. 53 patients (106 eyes) were examined, the average age was 28.5 ± 2.4 years. The inclusion criterion was moderate myopia and the absence of contraindications to CRC. If sufficient, taking into account safety criteria, CRS was performed by sublamellar keratoablation, if insufficient, superficial keratoablation was performed. In both cases, ablation was performed using a domestic solid-state laser machine. The observation period was 3 months. Pharmacological support in all cases was standard, adopted for the management of patients in FCMMG “YourMed”. Results. An analysis of the clinical and functional results of CRS using a solid-state laser device showed full compliance with the criteria set by the Food and Drug Administration (FDA). The accuracy of hitting the target refraction in the range of ± 0.5 diopters was 99.2 %; in 3 months of observation, no regression of the obtained refractive result was observed in any case. There was no loss of lines in any case, the BCVA after the operation corresponded to or exceeded by 1–2 lines the BCVA before the operation. When performing superficial keratoablation, in two cases, the loss of line 1 of the NCVA was noted due to the development of early subepithelial fibroplasia, which required correction of the pharmacological support. Conclusion. The analysis of the clinical and functional results of the correction of moderate myopia using the “Olimp™-2000” solid-state laser device showed high efficiency in terms of efficiency, safety, and predictability, despite little experience in using solid-state ablation in clinical practice. The use of Floas Mono® did not cause side effects in all cases and contributed to the smooth course of the early postoperative period. Thus, this drug is effective in the postoperative period and can be recommended for use in patients after CRC. The generation of ultraviolet radiation by modern solid-state devices for the purpose of correcting ametropia is a promising direction in CRS.

About the Authors

N. V. Maychuk
YourMed Clinics; Voronezh State Medical University
Russian Federation

Maychuk Natalia V., PhD, Associate Professor of the Department of Ophthalmology, Head “YourMed”, Deputy General Director and Chief Ophthalmologist

Molodyozhnaya str., 7/1, Khimki, Moscow region, 141407

Studencheskaya str., 10, Voronezh, 394036



A. V. Tikhov
Laser Eye Microsurgery Clinic
Russian Federation

Tikhov Alexander V., chief physician, general director

Yakovlevskaya str., 7a, bld. 2, Yaroslavl, 150062



Kh. P. Takhchidi
Pirogov Russian National Research Medical University
Russian Federation

Takhchidi Khristo P., MD, Professor, Academician, Director of the Eye Research Center

Ostrovityanova str., 1, Moscow, 117997



N. Sh. Sarkhadov
YourMed Clinics
Russian Federation

Sarkhadov Nazir S., PhD, General Director

Sovkhoznaya str., 9, Khimki, Moscow region, 141407



I. S. Malyshev
YourMed Clinics; Pirogov Russian National Research Medical University
Russian Federation

Malyshev Ilya S., postgraduate, ophthalmologist

Molodyozhnaya str., 7/1, Khimki, Moscow region, 141407

Ostrovityanova str., 1, Moscow, 117997



References

1. Tikhov AV, Suslova AYu, Suslov SI, Strahova GYu. Application of solid-state ultraviolet lasers in corneal refractive surgery. Literature review. Refractive surgery and ophthalmology. 2010;10(3):11–15 (In Russ.).

2. Anderson I, Sanders DR, van Saarloos P, Ardrey WJ. Treatment of irregular astig matism with a 213 nm solid-state, diode-pumped neodymium: YAG ablative laser. J. Cataract. Refract. Surg. 2004;30:2145–2151. doi: 10.1016/j.jcrs.2004.03.032.

3. Roszkowska AM, Korn G, Lenzner M, Kirsch M, Kittelmann O, Zatonski R, Fer reri P, Ferreri G. Experimental and clinical investigation of efficiency and ablation profiles of new solid-state deep-ultraviolet laser for vision correction. J. Cataract. Refract. Surg. 2004;30:2536–2542. doi: 10.1016/j.jcrs.2004.04.071.

4. Carr JD, Hersh PS. Excimer laser technology: Key concepts for the ophthalmologist Semin.Ophthalmol. 1996;11:212–223. doi: 10.3109/08820539609063814.

5. Pajic B, Pajic-Eggspuehler B, Cvejic Z, Rathjen C, Ruff V. First Clinical Results of a New Generation of Ablative Solid-State Lasers. J Clin Med. 2023 Jan 16;12(2):731. doi: 10.3390/jcm12020731.

6. Tikhov AV, Tikhov AO, Suslova AYu, Suslov SI. Ten years of experience in the application of solid state laser technology in refractive surgery. Modern technologies in ophthalmology. 2017;6(19):206–208 (In Russ.).

7. Randleman JB, Dawson DG. Depth-dependent cohesive tensile strength in human donor corneas: implications for refractive surgery. J Refract Surg. 2008;24:S85–S89.

8. Vokhmyakov AV, Okolov IN, Gurchenok PA. The choice of the optimal antibiotic for the prevention of infectious complications in ophthalmic surgery. Clinical Ophthalmology. 2007;8(1):36–40 (In Russ.).

9. Samiy N, Foster CS. The role of non-steroidal anti-inflammatory drugs in ocular inflammation. Int Ophthalmol Clin. 1996;36:195–206.

10. Rajpal RK, Ross B, Rajpal SD, Hoang K. Bromfenac ophthalmic solution for the treatment of postoperative ocular pain and inflammation: safety, efficacy, and patient adherence. Patient Prefer Adherence. 2014 Jun 25;8:925–931. doi: 10.2147/PPA.S46667.

11. Sancilio LF, Nolan JC, Wagner LE, Ward JW. The analgesic and anti-inflammatory activity and pharmacologic properties of bromfenac. Arzneimittelforschung. 1987;37:513–519.

12. Vetrugno M, Maino A, Quaranta GM, Cardia L. The effect of early steroid treatment after PRK on clinical and refractive outcomes. Acta Ophthalmologica Scandinavica. 2001 Feb;79(1):23–27.

13. Eskina N, Parshina VA, Kukleva OY, Maychuk NV. Medicamental correction of pathomorphological changes of the ocular surface in patients with steroid therapy intol erance after photorefractive keratectomy. Vestnik Oftalmologii. 2019;135(3):67–77 (In Russ.).doi: 10.17116/oftalma201913503167.

14. Netto MV, Mohan RR, Ambrósio R Jr, Hutcheon AE, Zieske JD, Wilson SE. Wound healing in the cornea: a review of refractive surgery complications and new prospects for therapy. Cornea. 2005;24(5):509–522.

15. Eskina EN, Parshina VA, Stepanova MA. Results of correction of high myopia by transepithelial PRK using the SCHWIND AMARIS device. Modern technologies in ophthalmology. 2014;3:239–324 (In Russ.).

16. Dougherty PJ, Welish KL, Maloney RK. Excimerlaser ablation rate and corneal hydration. AmJ. Ophthalmol. 1994;18:169–176.


Review

For citations:


Maychuk N.V., Tikhov A.V., Takhchidi Kh.P., Sarkhadov N.Sh., Malyshev I.S. The First Clinical and Functional Results of Myopia Correction Using a Solid-State Laser Unit. Ophthalmology in Russia. 2023;20(3):444-450. (In Russ.) https://doi.org/10.18008/1816-5095-2023-3-444-450

Views: 567


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1816-5095 (Print)
ISSN 2500-0845 (Online)