LASIK Eye Research Articles

VAULT: vault accuracy using deep learning technology: new image-based artificial intelligence model for predicting implantable collamer lens postoperative vault.

To develop an accurate deep learning model to predict postoperative vault of phakic implantable collamer lenses (ICLs). Parkhurst NuVision LASIK Eye Surgery, San Antonio, Texas. Retrospective machine learning study. 437 eyes of 221 consecutive patients who underwent ICL implantation were included. A neural network was trained on preoperative very high-frequency digital ultrasound images, patient demographics, and postoperative vault. 3059 images from 437 eyes of 221 patients were used to train the algorithm on individual ICL sizes. The 13.7 mm size was excluded because of insufficient data. A mean absolute error of 66.3 μm, 103 μm, and 91.8 μm were achieved with 100%, 99.0%, and 96.6% of predictions within 500 μm for the 12.1 mm, 12.6 mm, and 13.2 mm sizes, respectively. This deep learning model achieved a high level of accuracy of predicting postoperative ICL vault with the overwhelming majority of predictions successfully within a clinically acceptable margin of vault.

EQIP Quality Assessment of Refractive Surgery Resources on YouTube

ABSTRACT Purpose To evaluate the utility of EQIP as a novel tool for determining the quality of patient information on YouTube regarding refractive eye surgery. Methods Three searches were conducted on YouTube using “PRK eye surgery”, “LASIK eye surgery”, and “SMILE eye surgery”. 110 relevant videos were evaluated using the Ensuring Quality Information for Patients (EQIP) criteria. Results The average EQIP score was 15.1 (moderate quality). On average, physician-authored videos scored significantly higher on questions 17 (p = .01), 18 (p = .001), 26 (p = .008), relating to author transparency and use of graphs/figures. Patient-authored videos scored significantly higher on questions 8 (p < .001), 9 (p < .001), 12 (p = .008), 16 (p = .02), and 21 (p = .0350). These questions addressed risks/benefits, quality of life and alert signs, date and video revisions, and personally addressing viewers. Conclusion EQIP was useful in identifying specific strengths and deficits in online refractive surgery patient education resources that were not evident from other screening tools. The quality of information on YouTube videos on refractive surgeries is average. Physician-authored videos could be improved by clarifying risks and quality of life issues. Quality evaluation of medical information is important for comprehensive online surgical education.

Thin-Flap Laser In Situ Keratomileusis-Associated Dry Eye: A Comparative Study Between Femtosecond Laser and Mechanical Microkeratome-Assisted Laser In Situ Keratomileusis.

To assess and compare postlaser in situ keratomileusis (LASIK) dry eye after LASIK with planned thin flaps created by a femtosecond laser (FS) and mechanical microkeratome (MK). Patients were stratified according to the flap creation technique into FS and MK groups with planned 100 μm flap thickness in all eyes. Dry eye parameters including tear film break-up time (TBUT), Schirmer I test, ocular surface disease index (OSDI), and lower tear meniscus height and area (tear meniscus height [TMH] and tear meniscus area [TMA]) were assessed before surgery and at 3 and 6 months after surgery. The study included 102 eyes of 55 patients (52 eyes underwent FS-LASIK/50 eyes underwent MK-LASIK). The preoperative characteristics including age, gender, and spherical equivalents were similar in both groups (P>0.05). The difference in postoperative flap thickness was statistically significant (P<0.05). In each group, dry eye parameters showed a statistically significant worsening (P value<0.001) at 3 months with later significant improvement at 6 months but did not return to baseline. The mean TBUT, Schirmer I, and lower TMH and TMA were statistically higher, and the mean OSDI was statistically lower in FS-LASIK than the MK-LASIK group at both 3 and 6 months (P value<0.001). The depth of ablation had a statistically significant correlation with Schirmer I at 6 months and OSDI at both 3 and 6 months post-LASIK (P<0.05). The use of femtosecond laser technology in performing thin-Flap LASIK eye surgeries has improved the outcome of post-LASIK dry eye when compared with the mechanical microkeratome.

The effect of music therapy on the anxiety level of patients undergoing LASIK eye surgery before operation

The effect of music therapy on the anxiety level of patients undergoing LASIK eye surgery before operation

Topography-Guided LASIK Versus Small Incision Lenticule Extraction (SMILE) for Myopia and Myopic Astigmatism: A Randomized, Prospective, Contralateral Eye Study.

To compare safety and efficacy of topography-guided LASIK and contralateral eye SMILE for myopia and myopic astigmatism correction. This prospective, randomized contralateral eye study included 44 eyes of 22 patients with bilateral myopia or myopic astigmatism. Treated eyes were divided into two groups: 22 eyes were treated with topography-guided LASIK and the fellow eye of each patient was treated with SMILE. The following parameters were evaluated preoperatively and up to 3 months postoperatively: uncorrected distance vision acuity (UDVA), corrected distance vision acuity (CDVA), refractive error, corneal keratometry, contrast sensitivity, and Objective Scatter Index. At 3 months, 86.4% of the LASIK group and 68.2% of the SMILE group had UDVA of 20/20 (P < .002) and 59.1% and 31.8%, respectively, had UDVA of 20/16 (P < .002). Spherical equivalent refraction (±0.50 D) was 95.5% for the LASIK group and 77.3% for the SMILE group (P < .002). Residual refraction cylinder (≤ 0.25 D) was 81.8% for the LASIK group and 50% for the SMILE group (P < .001). Contrast sensitivity (6 cycles/degree) was 7.2 ± 1.01 in the LASIK group and 6.20 ± 1.52 in the SMILE group. Objective Scatter Index measurements at 3 months were 1.35 in the LASIK group and 1.42 in the SMILE group. Topography-guided LASIK was superior in all visual performance parameters studied, both subjective and objective. The main difference between the two techniques likely derives from the eye tracking, cyclorotation compensation, and active centration control in the LASIK technology studied in contrast to the current technology available with SMILE-like procedures. This difference appears to affect refractive and visual aberration performance outcomes. [J Refract Surg. 2017;33(5):306-312.].

Development and significance of automated history-taking software for clinical medicine, clinical research and basic medical science.

Development and significance of automated history-taking software for clinical medicine, clinical research and basic medical science.

Chronic Electromagnetic Exposure at Occupational Safety Level Does Not Affect the Metabolic Profile nor Cornea Healing after LASIK Surgery.

LASIK eye surgery has become a very common practice for myopic people, especially those in the military. Sometimes undertaken by people who need to keep a specific medical aptitude, this surgery could be performed in secret from the hierarchy and from the institute medical staff. However, even though the eyes have been previously described as one of the most sensitive organs to electromagnetic fields in the human body, no data exist on the potential deleterious effects of electromagnetic fields on the healing eye. The consequences of chronic long-lasting radar exposures at power density, in accordance with the occupational safety standards (9.71 GHz, 50 W/m2), were investigated on cornea healing. The metabolic and clinical statuses after experimental LASIK keratotomy were assessed on the different eye segments in a New Zealand rabbit model. The analysis methods were performed after 5 months of exposure (1 hour/day, 3 times/week). Neither clinical or histological examinations, nor experimental data, such as light scattering, 1H-NMR HRMAS metabolomics, 13C-NMR spectra of lipidic extracts, and antioxidant status, evidenced significant modifications. It was concluded that withdrawing the medical aptitude of people working in electromagnetic field environments (i.e., radar operators in the navy) after eye surgery was not justified.

마케팅믹스에 대한 고객만족이 신뢰 및 관계몰입에 미치는 영향

This study classifies the marketing mix of LASIK eye surgery clinics into 7Ps, examines the influence of each factor of 7Ps(product, place, price, promotion, process, people and physical evidence) on customer satisfaction, and investigates the effect of customer satisfaction on trust and relationship commitment. Survey of 500 patients who received surgeries in 3 eye clinics in Busan area was conducted through self-administered questionnaires, and, with this data, path analysis was performed to estimate the study model. Main result showed that, among 7Ps, product, price, promotion, people and physical evidence had significant positive effect on customer satisfaction which, in turn, had significant positive effect on trust and relationship commitment. Also, it was found that trust positively affected relationship commitment. This result would be considered helpful in medical institution's efforts to establish trust on customer satisfaction and maintain relationship commitment. It also implies that, in order to enhance competitiveness in increasingly competitive medical market, establishment of proper marketing strategy is urgently required where the determinants of customer satisfaction are effectively administered and ultimate relationship commitment of customers based on trust can be maintained and enhanced.

A Study of the Phenomenon of Medical Tourism within the Context of the General Agreement of Trade in Services (GATS)

Cardiac surgery, for example, costs USD 30,000 in the US but USD 8,000 in India; a bone marrow transplant is USD 250,000 in the US but only USD 69,000 in India; a dental filling is priced at USD 400 in the US but only USD 40 in India – and includes round-trip airfare and a brief vacation package. A knee replacement in Thailand with six days of physical therapy costs about one-fifth of what it would in the United States and further, a Lasik eye surgery worth $3,700 in the U.S. is available in many other countries for only $730.Cosmetic surgery savings are even greater: A full facelift that would cost $20,000 in the U.S. runs about $1,250 in South Africa. Why put up with expensive, run-of-the-mill health care at home when you can be treated just as well abroad? Health care generates some USD 3 trillion per year while, in 2009 alone, tourism accounted for USD 3.3 trillion in the GDP of countries throughout the world. From Greeks visiting Epidaurus to Romans immersing themselves in the healing waters of Bath to 19th century Europeans flocking to spa towns and sanatoria, people have travelled long distances hoping to restore their health for millennia. What is new is that, in spite of the existence of excellent local medical care in their countries of origin, many medical tourists residing in richer countries are simply unable to access what is right next door. The sphere of health care has been transformed by private, for-profit interests, where price and private insurance schemes reign and dictate who has access to treatment, surgery and medication and who does not. This paper attempts to understand the phenomenon of medical tourism and how its character has been radically altered with the advent of globalization and the introduction of the General Agreement in Trade in Services (GATS). It would also include a discussion as to what factors of late have encouraged this trend further especially towards the Asian region. It also aims to look at a few case studies in the Asian region to see how health care tourism has been evolved and growing amidst the backdrop of liberalizing trade environments today.

Pricing risky services: preference and quality considerations

PurposeThis study intends to examine effects of price ending and level on preference for a provider of a risky service, LASIK eye surgery, which poses notable health and financial risk. Additionally, the study aims to explore quality concerns thought to intervene between price cues and preference.Design/methodology/approachPrice was manipulated by showing each of three groups an advertisement offering LASIK surgery at one of three prices: US$299, US$300 or US$600. Subjects were asked how likely they were to choose the featured provider if they were to have LASIK surgery; replies were interpreted as indicating the degree to which the featured provider was preferred to all other potential providers. To facilitate exploring the possibility that pricing affects preference via perceived quality, subjects were asked 16 questions about service quality.FindingsLASIK provider preference ratings were significantly lower at US$299 than at US$300 and, thus, contradicted much prior research into the effects of 9 and 0 price endings. Supplemental analyses implied that, in consonance with prior research, US$299 was seen as much less than US$300. However, cognitive price underestimation attenuated preference because it raised stronger concerns about quality and risk. Exploratory analyses revealed three pertinent quality dimensions: outcome expectations, service process expectations, and customer apprehensions.Research limitations/implicationsFindings are based on a small convenience sample not limited to serious LASIK surgery candidates. The depiction of quality within the risky‐service context was rudimentary and requires refinement.Practical implicationsPurveyors of risky services seem ill‐advised to use prices ending in 9. While 9‐endings tend to stimulate sales of common low‐risk goods, they appear to attenuate sales of risky offerings.Originality/valueResults shed light on the generalizability of findings from prior psychological pricing research focused on goods and services quite unlike LASIK surgery. They also provide insights into designing more refined inquiries into quality concerns and the effects of pricing on quality concerns, which seem to affect preference.

Femtosecond laser ablation of the stapes

A femtosecond laser, normally used for LASIK eye surgery, is used to perforate cadaveric human stapes. The thermal side effects of bone ablation are measured with a thermocouple in an inner ear model and are found to be within acceptable limits for inner ear surgery. Stress and acoustic events, recorded with piezoelectric film and a microphone, respectively, are found to be negligible. Optical microscopy, scanning electron microscopy, and optical coherence tomography are used to confirm the precision of the ablation craters and lack of damage to the surrounding tissue. Ablation is compared to that from an Er:YAG laser, the current laser of choice for stapedotomy, and is found to be superior. Ultra-short-pulsed lasers offer a precise and efficient ablation of the stapes, with minimal thermal and negligible mechanical and acoustic damage. They are, therefore, ideal for stapedotomy operations.

Notes from the Editor Emeritus

1. Michael L. Beehner, MD 1. Saratoga Springs, New York ![][1] Whenever I see a newspaper ad for Lasik eye surgeries, it seems it is always accompanied by assurances to the reader that the doctor has performed over 10,000 procedures; and I always wonder: How did he or she ever

Comparison Between LASEK With Mitomycin C and LASIK for the Correction of Myopia of −7.00 to −13.75 D

To compare laser epithelial keratomileusis (LASEK) and LASIK for the correction of high myopia. A prospective, single-masked study was conducted. Patients treated with LASEK to correct myopia > or = -7.00 diopters (D) (spherical equivalent manifest refraction) with a cylinder < or = -3.50 D (LASEK group) were compared to patients treated with LASIK (LASIK group) using the same excimer laser (Technolas 217C). Mitomycin C (MMC) 0.02% was applied for 1 minute in all LASEK-treated eyes. A total of 228 consecutive eyes were included in the study (114 in each group, matched for preoperative refraction). The mean preoperative spherical equivalent manifest refraction was -8.72 +/- 1.20 D in the LASEK group and -8.74 +/- 1.20 D in the LASIK group (range: -7.00 to -13.75 D) (P = .9). Uncorrected visual acuity (UCVA) was significantly lower in LASEK eyes 1, 7, and 30 days postoperatively (P = .0001 for each comparison). No significant differences were found at 3 months postoperatively in UCVA (P = .3), best spectacle-corrected visual acuity (BSCVA) (P = .2), or in the safety (P = .6) and efficacy (P = .8) indices. Uncorrected visual acuity was 1.0 or better in 34.2% of LASEK eyes and 44.7% of LASIK eyes. Spherical refraction was +0.25 +/- 0.6 D after LASEK and -0.06 +/- 0.5 D after LASIK (P = .0001). Sixty-eight percent of LASEK eyes and 79% of LASIK eyes were within +/- 0.50 D of intended refraction. No LASEK eye versus 7 LASIK eyes lost 2 lines of BSCVA. Eight LASEK eyes gained 2 or more lines of BSCVA versus 1 LASIK eye. Visual improvement after LASEK with intraoperative MMC was significantly slower than after LASIK. Visual outcomes (UCVA, BSCVA, and safety and efficacy indices) 3 months after surgery were similar with both techniques for the correction of high myopia. Ten percent more eyes after LASIK were within +/- 0.50 D of intended refraction.

Nine-year Follow-up of a Posterior Chamber Phakic IOL in One Eye and LASIK in the Fellow Eye of the Same Patient

To compare the long-term results (9 years) of LASIK in one eye and phakic intraocular lens (implantable contact lens [ICL]) implantation in the fellow eye of the same patient. A patient with high myopia underwent LASIK with a MEL 60 excimer laser in one eye (spherical equivalent refraction -9.75 diopters [D], 5-mm optical zone with no transition zone) and phakic intraocular lens (STAAR Collamer implantable contact lens [ICL]) implantation (spherical equivalent refraction -9.50 D) in the fellow eye. At 9 years postoperatively, the mean spherical equivalent refraction was -1.00 in the eye with the ICL and -1.75 D in the eye that underwent LASIK. During the first 6 postoperative months in the LASIK eye, refraction regressed, but remained stable during the remainder of follow-up. Uncorrected visual acuity was 20/25 in the eye with the ICL and 20/30 in the LASIK eye, whereas best spectacle-corrected visual acuity was 20/20 in both eyes. Less night vision problems (glare and halos) were experienced in the eye with the ICL compared to the LASIK eye. Although the patient initially preferred the LASIK procedure, at last follow-up 9 years postoperatively, increased overall satisfaction was reported for the eye with the ICL compared to the LASIK eye. Nine years after treatment of high myopia with the ICL and LASIK in the same patient, better quality of vision, stability, and satisfaction score were achieved in the eye with the ICL compared to the eye that had undergone LASIK. No long-term sight-threatening complications were found during followup.

New Developments Concerning Health Care Fitness

In this report we discuss some of the new developments in the health care fitness industry catering to the needs of a healthy lifestyle, and their pros and cons. Such solutions have become very popular among health-conscious people, and these developments help enhance one's appearance, make one feel good, and give more control over one's body and lifestyle. We have also covered various diet solutions available for weight reduction, their advantages and disadvantages, and results. In addition, we throw light on surgical health fitness procedures that help in changing one's appearance and body shape—for example, tummy tucks, gastric bypass surgery, Botox, LASIK eye surgery, hypnosis and stress management. It is found that the results of all these procedures differ for every person depending on their age and lifestyles. They are often expensive and may not have desirable results. Finally the idea behind this report is to emphasise that not all solutions are as good as they are projected in marketing campaigns. Every solution could have a different result on a different body type and, hence, people should be very careful in choosing one that suits them. Also, high expectations only lead to disappointment.

LASIK eye surgery: standard and safety issues

LASIK eye surgery: standard and safety issues