Diamond burr superficial keratectomy with mitomycin C for corneal scarring and high corneal astigmatism after pterygium excision

Engin Bilge Ozgurhan,1 Necip Kara,1 Aydin Yildirim,2 Zeynep Alkin,1 Ercument Bozkurt,1 Ahmet Demirok1,31Beyoglu Eye Research and Training Hospital, 2Department of Ophthalmology, Sema Research and Treatment Hospital, Fatih University, 3Department of Ophthalmology, Istanbul Medeniyet University Medical School, Istanbul, TurkeyBackground: The purpose of this paper is to report the successful treatment of corneal scarring and high corneal astigmatism secondary to previous pterygium surgery with diamond burr superficial keratectomy using mitomycin C.Methods: Four patients with corneal scarring and high corneal astigmatism related to previous pterygium surgery underwent diamond burr superficial keratectomy with application of mitomycin C. Anterior segment photography and corneal topographic analysis were obtained preoperatively and postoperatively in all patients.Results: Six months after surgery, corneal astigmatism and corneal aberrations were reduced in all patients. A clear cornea was achieved in all cases. No complications were noted during the follow-up period.Conclusion: Diamond burr superficial keratectomy with application of mitomycin C is a potentially effective and simple procedure for treating patients with corneal scarring and high corneal astigmatism secondary to previous pterygium surgery.Keywords: diamond burr superficial keratectomy, astigmatism, pterygium surger

Accuracy and precision of cap thickness in small incision lenticule extraction

Engin Bilge Ozgurhan,1 Alper Agca,1 Ercument Bozkurt,1 Baran Gencer,2 Ugur Celik,1 Kadir İlker Cankaya,1 Ahmet Demirok,1,3 Omer Faruk Yilmaz41Beyoglu Eye Training and Research Hospital, Istanbul, Turkey; 2Ophthalmology Department, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey; 3Department of Ophthalmology, Medeniyet University, Istanbul, Turkey; 4Private practice, Istanbul, TurkeyAims: To report and compare the cap thickness predictability of small incision lenticule extraction (SMILE) and flap thickness of femtosecond laser-assisted in situ keratomileusis (femto-LASIK).Settings and design: Beyoglu Eye Training and Research Hospital, Refractive Surgery Department, Istanbul, Turkey. Retrospective pilot study.Materials and methods: Medical records of patients who had SMILE in one eye and femto-LASIK in the other eye were reviewed. Visante corneal Optical Coherence Tomography (OCT) images at 1 week and 1 month post-surgery were analyzed. Both cap and flap thickness at the temporal edge and the nasal edge were measured and compared to each other.Statistical analyses used: PAWS Statistics 18 and unpaired student t-test were used to compare the groups.Results: The study included 66 eyes of 33 patients (24.7 ± 3.8 years, 20 females and 13 males). Mean flap thickness was 114.88 µm ± 4.96 µm, and mean cap thickness was 114.63 µm ± 5.18 µm. In group 1 (SMILE), cap thickness values were 115.84 µm ± 6.84 µm, 114.75 µm ± 7.36 µm, 113.66 µm ± 6.88 µm, and 114.27 µm ± 6.90 µm in measurement zones 1, 2, 3, and 4, respectively. In group 2 (FemtoLASIK), flap corneal thickness values were 115.96 mmHg ± 7.01 mmHg, 114.72 mmHg ± 7.17 mmHg, 113.54 mmHg ± 6.45 mmHg, and 115.30 mmHg ± 6.64 mmHg in measurement zones 1, 2, 3, and 4, respectively. In both groups, no statistically significant change within the measurement zones was observed.Conclusion: The predictability of cap thickness in SMILE surgery does not differ from the femto-LASIK flaps created using the same femtosecond laser platform.Keywords: SMILE, small incision lenticule extractio

Femtosecond lenticule extraction for correction of myopia: a 6 month follow-up study

Ahmet Demirok,1 Alper Agca,2 Engin Bilge Ozgurhan,2 Ercument Bozkurt,2 Ugur Celik,2 Ali Demircan,2 Nimet Burcu Guleryuz,2 Kadir Ilker Cankaya,2 Omer Faruk Yilmaz3 1Department of Ophthalmology, Medeniyet University, Istanbul, Turkey; 2Beyoglu Eye Training and Research Hospital, Istanbul, Turkey, 3Private Practice, Istanbul, Turkey Aims: To report our initial experience with femtosecond lenticule extraction (FLEX) compared with femtosecond laser-assisted in situ keratomileusis (LASIK). Settings and design: This was a prospective pilot study carried out at the Refractive Surgery Department of the Beyoglu Eye Training and Research Hospital, Istanbul, Turkey. Materials and methods: Surgery was performed on both eyes of 14 consecutive patients with myopia or myopic astigmatism. Patients underwent FLEX in one eye and femtosecond LASIK (FemtoLASIK) in the other eye. The primary outcome was based on uncorrected distance visual acuity, corrected distance visual acuity, and spherical equivalent of the subjective manifest refraction, at 1 week, 1 month, and 6 months postsurgery. Statistical analyses were performed using PAWS Statistics 18. Unpaired Student&rsquo;s t-test was used to compare the groups. Results: During the last follow-up visit (6 months postsurgery), the mean spherical was &minus;0.37 &plusmn; 0.60 diopters (D) (range &minus;1.00 to 0.50) (P < 0.001) and &minus;0.25 &plusmn; 0.41 D (range &minus;0.88 to 0.12 D) (P < 0.001) in the FLEX and FemtoLASIK eyes, respectively. The spherical was within &plusmn; 0.50 D of the intended correction in ten (72%) of the FLEX eyes and 12 (86%) of the FemtoLASIK eyes (P > 0.05). No complications occurred during surgery or the postoperative period. Conclusion: FLEX is a safe, effective, and predictable procedure for surgical correction of myopia. Refractive results were stabilized within the first postoperative week, and visual acuities were stabilized within the first month, comparable to FemtoLASIK. Keywords: FLEX, femtosecond laser-assisted in situ keratomileusi