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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 errors.METHODS： 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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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 worldwide.In 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 Keratectomy.Following laser refractive surgery,the corneal nerves,epithelial and stromal cells release neuromediators,including neurotrophins,neuropeptides and neurotransmitters.Notably,nerve growth factor,substance P,calcitonin gene-related peptide and various cytokines are important mediators of neurogenic inflammation and corneal nerve regeneration.Alterations in neuromediator profiles and ocular surface parameters following laser refractive surgery are attributed to the surgical techniques and the severity of tissue insult induced.In 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 surgery.Further aims were to offer a tool for benchmarking by establishing a reference database and for surgeons to enter and analyze their own outcomes.The purpose of this study was to characterize the registry and analyze the data collected during its first decade.Methods:The characteristics of the web-based registry are described.Data collected from February 4^(th) 2004 until June 30th 2014 are included in the analysis.The database is analyzed in terms of surgical technique,indications for surgery,complications,and refractive and visual outcomes.Results:Data have been reported from 47 centers in 14 countries until mid-2014.About 4,000 procedures were reported annually.The most frequent procedure was laser-assisted in-situ keratomileusis(LASIK)with 11697 reported surgeries.Over 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 procedures.Surgical complications were reported infrequently and with a well-known relationship to the type of surgical procedure.The reported refractive outcomes were good.The 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 surgery.The database increases at a rate of approximately 4000 refractive procedures per year.The most frequent procedure is LASIK,but both PRK and RLE are an increasing part of the r

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 volume.Each optical element in the eye has its own optical and neural axes.Defining the optimum center for laser ablation is difficult with many available approaches.We explain the various centration approaches(based on these reference axes)in refractive surgery and review their clinical outcomes.The 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 size.The corneal vertex(CV)represents a stable preferable morphologic reference which is the best approximate for alignment to the visual axis.However,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 center.There 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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Dr.Father 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 today.The 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 surgery.The number of cataract surgeries is expected to continue to rise with the increase of the elderly population.Thus,accurate predictions of intraocular lens(IOL)power and the ability to correct for any postoperative refractive errors are critical.Despite 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 astigmatism.The 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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The 100 most influential articles in myopia:a bibliometric analysis

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International Journal of Ophthalmology(English edition) 2022年第1期15卷 150-156页

作者： Xue-Jiao Wang Di Chen Yang Jiang Yu-Yu Chou Yan Luo Ying Li Jin Ma Yong Zhong Department of Ophthalmology Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China

AIM:To identify and characterize the 100 most influential articles in the field of myopia over the last decades.METHODS:Articles on myopia published between January 1975 and March 2020 were searched through the Web of Science Core Collection database.Two independent authors reviewed and determined the 100 most cited articles.The characteristics of each eligible article were recorded,including authors,institutions,countries,journals,publication date,total citations(TCs),annual citations(ACs),research focus and article type.RESULTS:The top 100 most influential articles were published between 1983 and 2016,with 1999 as the most prolific year.The mean number of TCs was 288(range:193-537)and the mean number of ACs was 19(range:7-109).Treatment and epidemiology of myopia were the most important research focus.These articles were published in 21 journals led by Ophthalmology(29%)followed by Investigative Ophthalmology&Visual Science(23%).The number of ACs for articles published in the last ten years was significantly higher than that for the other most-cited articles(44 vs 16,Mann-Whitney U test P<0.01).There is no difference in the number of TCs between original articles and review articles,while the number of ACs for review articles was significantly higher than that for original articles(22 vs 17,Mann-Whitney U test P<0.05).CONCLUSION:This bibliometric analysis can provide us with concise information about the development trend of research in the field of myopia in the past few decades,and provide an important reference for researchers to guide future research.

关键词： bibliometric analysis myopia citation therapy refractive surgery

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Long-term observation on safety and visual quality of implantable collamer lens V4c implantation for myopia correction:a 5-year follow-up

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International Journal of Ophthalmology(English edition) 2023年第7期16卷 1123-1129页

作者： Xiao Chen Li Li Jing Rao Yue-Xi Chen Yang Gao Rui-Xue Huang Qi-Zhi Zhou Aier Eye Hospital Jinan UniversityGuangzhou 510071Guangdong ProvinceChina Chongqing Aier and Vision Care Hospital Chongqing 400000China Aier Eye Hospital Group Company Limited Changsha 410000Hunan ProvinceChina Jinan University Guangzhou 510000Guangdong ProvinceChina

AIM:To elucidate the safety and visual quality of implantable collamer lens with central hole(ICL V4c)implantation for correcting moderate and high myopia for at least 5y.METHODS:This retrospective study was conducted on 58 patients(114 eyes)who were followed up for at least 5y after ICL V4c implantation.The observation was done before and on 1d,1mo,1 and 5y or more after the surgical procedure.The visual acuity,subjective refraction,intraocular pressure,vault,axial length,central hole position,pupil diameter,visual quality,and adverse events were analyzed.The visual quality includes aberration,the modulation transfer function cutoff frequency(MTF cutoff),objective scattering index(OSI),Stroller's ratio(SR),and visual quality questionnaire.RESULTS:The average follow-up period was 69.25±3.80mo(range 60–82mo)and the preoperative spherical equivalent(SE)was-8.66±1.97 D.At 5y after operation,the safety index was 1.01±0.02 and the efficacy index was 0.99±0.42 and SE was-0.65±0.63 D.The 59.6%of the eyes achieved an uncorrected distance visual acuity of 20/20,76.3%of the eyes had SE within±1.0 D at the last visit.The axial length increased by 0.29±0.71 mm 5y after the surgery(t=-3.843,Psurgery.

关键词： implantable collamer lens with central hole myopia correction refractive surgery visual quality

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