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refractive surgery: the most cost-saving technique in refractive errors correction

International Journal of Ophthalmology(English edition) 2018年第6期11卷 1013-1019页

作者： Seyed-Farzad Mohammadi Cyrus Alinia Maryam Tavakkoli Alireza Lashay Hormoz Chams Eye Research Center Farabi Eye Hospital Tehran University of Medical Sciences Department of Public Health School of Public Health Urmia University of Medical Sciences Hormoz Chams Research Chair in Public Health Ophthalmology Farabi Eye Center of Excellence Tehran University of Medical Sciences Department of Health Management and Economics School of Public Health Tehran University of Medical Sciences

AIM： To compare the lifetime and annual economic burden of spectacles, contact lenses, and refractive surgery in correction of refractive ***： This is a cross-sectional study with convenience sampling which 120 patients were interviewed in a tertiary referral hospital in the Iranian health care system. The bottom-up based cost of illness approach was estimated using a face-to-face interview to assess the direct and indirect cost of different refractive errors correction of any correction technologies. RESULTS： Correction with spectacle imposes a total direct cost of US dollar （US$） 342.5 （±8.41） per year and US$9373.5 （±230.1） per lifetime to each patient. These figures for the contact lenses were obtained US$198.3 （±0.12） and US$5203.1 （±256.3） and for refractive surgery were obtained US$19.1 （±1.2） and US$568.1 （±64.6）, respectively. Overall, based on age-adjusted prevalence rates, astigmatism had the highest share of refractive errors economic burden with a lifetime direct cost of slightly less than US$5.49 billion, while hyperopia and myopia imposed less than US$5.24 and 4.2 billion on patients, respectively. The annually imposed cost on each individual Iranian patient with refractive errors is US$308.5. CONCLUSION： Based on 18mo post refractive surgery course observation, which is generalized to whole life, refractive surgery significantly imposed much less cost compared with spectacles and contact lenses. refractive errors among Iranians result in considerable economic burden. Using the refractive surgery instead of other two correction methods has the ability to reduce this economic loss in the future.

关键词： refractive error economic burden refractive surgery spectacle contact lenses

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Iris recognition:a biometric method after refractive surgery

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Journal of Zhejiang University-Science A(Applied Physics & Engineering) 2007年第8期8卷 1227-1231页

作者： YUAN Xiao-yan ZHOU Hao SHI Peng-fei Institute of lmage Processing and Pattern Recognition Shanghai Jiao Tong University Shanghai 200240 China Department of Ophthalmology EENT Hospital of Fudan University Shanghai 200031 China

Iris recognition,as a biometric method,outperforms others because of its high accuracy. Iris is the visible internal organ of human,so it is stable and very difficult to be altered. But if an eye surgery must be made to some individuals,it may be rejected by iris recognition system as imposters after the surgery,because the iris pattern was altered or damaged somewhat during surgery and cannot match the iris template stored before the surgery. In this paper,we originally discuss whether refractive surgery for vision correction(LASIK surgery) would influence the performance of iris recognition. And experiments are designed and tested on iris images captured especially for this research from patients before and after refractive surgery. Experiments showed that refractive surgery has little influence on iris recognition.

关键词： Biometric Iris recognition refractive surgery LASIK Myopia

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Corneal neuromediator profiles following laser refractive surgery

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Neural Regeneration Research 2021年第11期16卷 2177-2183页

作者： Lily Wei Yun Yang Jodhbir S.Mehta Yu-Chi Liu Yong Loo Lin School of Medicine National University of SingaporeSingapore Tissue Engineering and Cell Therapy Group Singapore Eye Research InstituteSingapore Department of Cornea and External Eye Disease Singapore National Eye CentreSingapore Ophthalmology and Visual Sciences Academic Clinical Program Duke-NUS Medical SchoolSingapore

Laser refractive surgery is one of the most commonly performed procedures *** laser refractive surgery,Femtosecond Laser in Situ Keratomileusis and refractive Lenticule Extraction have emerged as promising alternatives to microkeratome Laser in Situ Keratomileusis and Photorefractive *** laser refractive surgery,the corneal nerves,epithelial and stromal cells release neuromediators,including neurotrophins,neuropeptides and ***,nerve growth factor,substance P,calcitonin gene-related peptide and various cytokines are important mediators of neurogenic inflammation and corneal nerve *** in neuromediator profiles and ocular surface parameters following laser refractive surgery are attributed to the surgical techniques and the severity of tissue insult *** this review,we will discuss the(1)Functions of neuromediators and their physiological and clinical significance;(2)Changes in the neuromediators following various laser refractive surgeries;(3)Correlation between neuromediators,ocular surface health and corneal nerve status;and(4)Future directions,including the use of neuromediators as potential biomarkers for ocular surface health following laser refractive surgery,and as adjuncts to aid in corneal regeneration after laser refractive surgery.

关键词： cornea corneal nerves dry eye femtosecond laser laser in situ keratomileusis neuromediator refractive surgery small incision lenticule extraction

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Progress of corneal collagen cross-linking combined with refractive surgery

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International Journal of Ophthalmology(English edition) 2014年第1期7卷 157-162页

作者： Na Li Xiu-Jun Peng Zheng-Jun Fan Department of Ophthalmology Navy General Hospital of Chinese PLA

As a photochemical reaction that can stiffen the cornea,corneal collagen cross-linking(CXL) is the only promising method of preventing the progress of keratectasia,such as keratoconus and secondary ectasia following refractive surgery. The aim of CXL is to stabilize the underlying condition,with a small chance of visual improvement. Combining CXL with refractive surgery targeting both stabilization and reshaping of the corneal tissue for visual function improvement is a good treatment option. This review aims to provide a comprehensive and unbiased summary of the published research regarding combined CXL and refractive surgery,including measures and results,to help elucidate the future direction of CXL.

关键词： cornea cross-linking refractive surgery keratoconus ectasia

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The European registry of quality outcomes for cataract and refractive surgery(EUREQUO):a database study of trends in volumes,surgical techniques and outcomes of refractive surgery

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Eye and Vision 2015年第1期2卷 76-84页

作者： Mats Lundström Sonia Manning Peter Barry Ulf Stenevi Ype Henry Paul Rosen Department of Clinical Sciences OphthalmologyFaculty of MedicineLund UniversityLundSweden Department of Ophthalmology Mater Misericordiae University HospitalDublinIreland Department of Ophthalmology St.Vincent’s University HospitalDublinIreland Department of Ophthalmology Sahlgren’s University HospitalMolndalSweden Department of Ophthalmology VumcAmsterdamThe Netherlands Oxford Eye Hospital OxfordUK.

Background:A European web-based registry for refractive surgery was established in 2008;The European Registry of Quality Outcomes for Cataract and refractive surgery(EUREQUO).The aim of the registry was to improve treatment and standards of care for refractive *** aims were to offer a tool for benchmarking by establishing a reference database and for surgeons to enter and analyze their own *** purpose of this study was to characterize the registry and analyze the data collected during its first ***:The characteristics of the web-based registry are *** collected from February 4^(th) 2004 until June 30th 2014 are included in the *** database is analyzed in terms of surgical technique,indications for surgery,complications,and refractive and visual ***:Data have been reported from 47 centers in 14 countries until *** 4,000 procedures were reported *** most frequent procedure was laser-assisted in-situ keratomileusis(LASIK)with 11697 reported *** time in the database,LASIK declined(prefractive keratectomy(PRK)and refractive lens exchange(RLE)increased(psurgery,in terms of preoperative refraction and age,were stable over time,for all types of *** complications were reported infrequently and with a well-known relationship to the type of surgical *** reported refractive outcomes were *** visual outcomes indicate a significant increase of visual acuity after high myopia treatment by phakic intraocular lens in the anterior(phakic IOL AC)and the posterior(phakic IOL PC)chamber and a poorer visual outcome,after both myopia and hyperopia treatment,by epithelial LASIK(Epi-LASIK).Conclusions:We describe the establishment of a European registry for refractive *** database increases at a rate of approximately 4000 refractive procedures per *** most frequent procedure is LASIK,but

关键词： refractive surgery Registry European database Outcomes

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Centration axis in refractive surgery

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Eye and Vision 2015年第1期2卷 28-43页

作者： Samuel Arba Mosquera Shwetabh Verma Colm McAlinden SCHWIND eye-tech-solutions KleinostheimGermany Recognized Research Group in Optical Diagnostic Techniques University of ValladolidValladolidSpain Department of Ophthalmology and Sciences of Vision University of OviedoOviedoSpain Flinders University AdelaideSouth AustraliaAustralia Wenzhou Medical University WenzhouZhejiangChina.

The human eye is an asymmetric optical system and the real cornea is not a rotationally symmetrical *** optical element in the eye has its own optical and neural *** the optimum center for laser ablation is difficult with many available *** explain the various centration approaches(based on these reference axes)in refractive surgery and review their clinical *** line-of-sight(LOS)(the line joining the entrance pupil center with the fixation point)is often the recommended reference axis for representing wavefront aberrations of the whole eye(derived from the definition of chief ray in geometrical optics);however pupil centration can be unstable and change with the pupil *** corneal vertex(CV)represents a stable preferable morphologic reference which is the best approximate for alignment to the visual ***,the corneal light reflex can be considered as non-constant,but dependent on the direction of gaze of the eye with respect to the light source.A compromise between the pupil and CV centered ablations is seen in the form of an asymmetric offset where the manifest refraction is referenced to the CV while the higher order aberrations are referenced to the pupil *** is a need for a flexible choice of centration in excimer laser systems to design customized and non-customized treatments optimally.

关键词： Centration refractive surgery Optical axis Neural axis Corneal vertex Pupil centration Corneal light reflex Line of sight Angle Kappa Alpha Lambda Asymmetric offset

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*** Waclaw Szuniewicz,a forgotten pioneer in refractive surgery and his work in China

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International Journal of Ophthalmology(English edition) 2021年第6期14卷 791-794页

作者： Piotr Kanclerz Andrzej Grzybowski Hygeia Clinic Gdansk 80-286Poland Department of Ophthalmology University of Warmia and MazuryOlsztyn 10-082Poland Institute for Research in Ophthalmology Foundation for Ophthalmology DevelopmentPoznan 60-554Poland

Father Waclaw Szuniewicz(1891-1963) was a skilled ophthalmic surgeon, missionary, and teacher. For several years he worked in China, afterwards in the United States and in Brazil. The aim of the paper is to present the unanalyzed issues of Szuniewicz’s research regarding corneal refractive surgery. Szuniewicz performed experiments on changing the corneal curvature with anterior, posterior and full-thickness incisions. The results of modifying the anterior and posterior corneal curvature were satisfactory, however, diminished significantly within months after surgery. Corneal band resections were superior in terms of efficacy, however, such an intervention commonly led to complications in animal studies. Szuniewicz’s work was not published during his life. Nevertheless, as a result of strong impact of his personality and ideas, he is frequently considered as a pioneer of corneal refractive surgery.

关键词： corneal band resections corneal incisions missionary refractive surgery

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LASIK surgery in patients with residual refractive errors after radial keratotomy

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International Journal of Ophthalmology(English edition) 2010年第2期3卷 172-174页

作者： Abolghasem Rastegar Department of Ophthalmology Sadoughi HospitalYazd Medical Sciences UniversityYazdIran

AIMTo study the results and complications of LASIK surgery after radial keratotomy.

关键词： LASIK radial keratotomy refractive surgery residual myopia

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refractive surgical corrective options after cataract surgery

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Annals of Eye Science 2019年第1期4卷 45-52页

作者： Sierra X.Jin Jimmy K.Lee Montefiore Medical Center/Albert Einstein College of Medicine BronxNYUSA

Cataract surgery is one of the most commonly performed surgeries among the elderly *** volume of cataract surgeries has dramatically increased in the past few decades due to technological advancements leading to decreased morbidity,better overall outcomes,and increased expectation for correction of refractive error and spectacle independence after cataract *** number of cataract surgeries is expected to continue to rise with the increase of the elderly ***,accurate predictions of intraocular lens(IOL)power and the ability to correct for any postoperative refractive errors are *** the improved ability of cataract surgeons to accurately calculate IOL power,postoperative refractive errors still do occur due to various reasons such as imperfect preoperative measurements,toric-lens misalignment,and existing or surgically-induced *** aim of this article is to review the various surgical options,including intraocular and corneal refractive surgical approaches,to correct post-operative refractive errors after cataract surgery.

关键词： refractive surgery cataract surgery intraocular lenses(IOLs) laser refractive surgery

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Biomaterials for refractive correction:corneal onlays and inlays

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Science China Chemistry 2014年第4期57卷 501-509页

作者： WU Jian FUNDERBURGH James L WAGNER William R McGowan Institute for Regenerative Medicine University of Pittsburgh Department of surgery University of Pittsburgh School of Medicine Department of Ophthalmology University of Pittsburgh School of Medicine Department of Bioengineering University of Pittsburgh

Corneal inlays and onlays represent a means of providing patients with permanent refractive error correction. As an alternative to conventional spectacles and contact lens, these techniques are less invasive compared with laser-based refractive surgery and are reversible. In this review, we provide a brief overview of the anatomic microstructure of the human cornea, indicating the primary physiological function for each component. Next, the wide range of biomaterials used as corneal inlays and onlays are considered, from synthetic polymers to biological components derived from the extracellular matrix. The limitations and challenges associated with the most common materials are discussed as is the need to improve their properties to achieve long-term, complication-free intraocular implantation. Finally, the prospect of applying tissue engineering strategies is noted for its potential to generate autologous corneal tissue that could be implanted as the optimal inlay or onlay materials.

关键词： refractive error onlays inlays synthetic polymer biological extracellular matrix refractive surgery

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