Comparative analysis of clinical and functional results of sublamellar keratoablation using solid-state and excimer laser devices

Abstract

BACKGROUND: The most popular method of keratorefractive surgery is sublamellar valve technology. It is known that excimer laser systems, which are widely used and are the gold standard in keratorefractive surgery, have a number of disadvantages. Alternative sources of UV radiation generation are solid-state laser systems, in particular the domestic Olimp 2000/213 laser, which previously had no experience in femto-assisted sublamellar surgery.

AIM: To evaluate clinical and functional results of correction of mild, moderate and high myopia using sublamellar keratomileusis technology, performed using the Schwind Amaris 1050 rs excimer laser and the Olimp 2000/213 solid-state ablative laser.

MATERIALS AND METHODS: 190 patients (190 eyes) with stationary myopia were examined and operated on. The follow-up period was 1 year after surgery. The main group consisted of patients who underwent myopia correction using sublamellar keratoablation technology using a solid-state laser Olimp 2000/213 — 92 eyes. The control group consisted of patients after FemtoLASIK, in whom ablation was performed using a Schwind Amaris 1050 rs laser (98 eyes). A comparative analysis was carried out according to modern criteria for refractive surgery.

RESULTS: 190 patients (190 eyes) with stationary myopia were examined and operated on. The follow-up period was 1 year after surgery. The main group patients underwent myopia correction using sublamellar keratoablation technology using a solid-state laser Olimp 2000/213 — 92 eyes. The control group consisted of patients after FemtoLASIK correction, in whom ablation was performed using a Schwind Amaris 1050 rs laser (98 eyes). A comparative analysis was carried out according to modern criteria for refractive surgery.

CONCLUSIONS: The analysis of the clinical and functional results of myopia correction using the technology of sublamellar keratoablation, performed using the Olimp 2000/213 solid-state ablative laser and the Schwind Amaris 1050 rs excimer laser, showed a high comparability of the technologies.

Keywords

keratorefractive surgery / ametropia / FemtoLASIK / solid-state laser / excimer laser / myopia / comparative analysis / vision correction

References

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

[2] Тихов А.В., Суслова А.Ю., Суслов С.И., Страхова Г.Ю. Применение твердотельных лазеров ультрафиолетового диапазона в рефракционной хирургии роговицы. Обзор литературы // Рефракционная хирургия и офтальмология 2010. Т. 10, № 3. С. 11–15. EDN: NCZFUJ

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

[4] Ren QS, Gailitis RP, Tompson KP, Lin JT. Ablation of the cornea and synthetic polymers using a UV (213 nm) solid state laser. IEEE J Quantum Electron. 1990;26(12):2284–2288. doi: 10.1109/3.64366

[5] Ren Q.S., Gailitis R.P., Tompson K.P., Lin J.T. Ablation of the cornea and synthetic polymers using a UV (213 nm) solid state laser // IEEE J Quantum Electron. 1990. Vol. 26, N 12. P. 2284–2288. doi: 10.1109/3.64366

[6] Ren QS, Gailitis RP, Tompson KP, Lin JT. Ablation of the cornea and synthetic polymers using a UV (213 nm) solid state laser. IEEE J Quantum Electron. 1990;26(12):2284–2288. doi: 10.1109/3.64366

[7] Ren Q, Simon G, Parel JM. Ultraviolet solid-state laser (213-nm) photorefractive keratectomy. In vitro study. Ophthalmology. 1993;100(12):1828–1834. doi: 10.1016/s0161-6420(93)31390-4

[8] Ren Q., Simon G., Parel J.M. Ultraviolet solid-state laser (213-nm) photorefractive keratectomy. In vitro study // Ophthalmology. 1993. Vol. 100, N 12. P. 1828–1834. doi: 10.1016/s0161-6420(93)31390-4

[9] Ren Q, Simon G, Parel JM. Ultraviolet solid-state laser (213-nm) photorefractive keratectomy. In vitro study. Ophthalmology. 1993;100(12):1828–1834. doi: 10.1016/s0161-6420(93)31390-4

[10] Swinger C, Lai S, Johnson D, et al. Surface photorefractive keratectomy for correction of hyperopia using the Novatec laser — 3 months follow-up. Investigete Ophthalmol Vis Sci. 1996;37: S55.

[11] Swinger C., Lai S., Johnson D., et al. Surface photorefractive keratectomy for correction of hyperopia using the Novatec laser — 3 months follow-up // Investigete Ophthalmol Vis Sci. 1996. Vol. 37. P. S55.

[12] Swinger C, Lai S, Johnson D, et al. Surface photorefractive keratectomy for correction of hyperopia using the Novatec laser — 3 months follow-up. Investigete Ophthalmol Vis Sci. 1996;37: S55.

[13] Pajic B, Pajic-Eggspuehler B, Cvejic Z, et al. First clinical results of a new generation of ablative solid-state lasers. J Clin Med. 2023;12(2):731. doi: 10.3390/jcm12020731

[14] Pajic B., Pajic-Eggspuehler B., Cvejic Z., et al. First clinical results of a new generation of ablative solid-state lasers // J Clin Med. 2023. Vol. 12, N 2. P. 731. doi: 10.3390/jcm12020731

[15] Pajic B, Pajic-Eggspuehler B, Cvejic Z, et al. First clinical results of a new generation of ablative solid-state lasers. J Clin Med. 2023;12(2):731. doi: 10.3390/jcm12020731

[16] Tikhov AV, Tikhov AO, Suslova AYu, Suslov SI. Ten-year experience of solid-state laser technology application in refractive surgery. Modern Technologies in Ophthalmology. 2017;(6):206–208. (In Russ.) EDN: ZQTWWP

[17] Тихов А.В., Тихов А.О., Суслова А.Ю., Суслов С.И. Десятилетний опыт применения твердотельной лазерной технологии в рефракционной хирургии // Современные технологии в офтальмологии. 2017. № 6. С. 206–208. EDN: ZQTWWP

[18] Tikhov AV, Tikhov AO, Suslova AYu, Suslov SI. Ten-year experience of solid-state laser technology application in refractive surgery. Modern Technologies in Ophthalmology. 2017;(6):206–208. (In Russ.) EDN: ZQTWWP

[19] Petroll WM, Goldberg D, Lindsey SS, et al. Confocal assessment of the corneal response to intracorneal lens insertion and laser in situ keratomileusis with flap creation using IntraLase. J Cataract Refract Surg. 2006;32(7):1119–1128. doi: 10.1016/j.jcrs.2006.01.093

[20] Petroll W.M., Goldberg D., Lindsey S.S., et al. Confocal assessment of the corneal response to intracorneal lens insertion and laser in situ keratomileusis with flap creation using IntraLase // J Cataract Refract Surg. 2006. Vol. 32, N 7. P. 1119–1128. doi: 10.1016/j.jcrs.2006.01.093

[21] Petroll WM, Goldberg D, Lindsey SS, et al. Confocal assessment of the corneal response to intracorneal lens insertion and laser in situ keratomileusis with flap creation using IntraLase. J Cataract Refract Surg. 2006;32(7):1119–1128. doi: 10.1016/j.jcrs.2006.01.093

[22] Maychuk NV, Mushkova IA, Obraztsova MR. Do we have a place for non-steroidal anti-inflammatory drugs in corneal refractive surgery? Ophthalmology in Russia. 2021;18(3):539–545. EDN: ECQEIM doi: 10.18008/1816-5095-2021-3-539-545

[23] Майчук Н.В., Мушкова И.А., Образцова М.Р. Есть ли место для нестероидных противовоспалительных средств в кераторефракционной хирургии? // Офтальмология. 2021. Т. 18, № 3. С. 539–545. EDN: ECQEIM doi: 10.18008/1816-5095-2021-3-539-545

[24] Maychuk NV, Mushkova IA, Obraztsova MR. Do we have a place for non-steroidal anti-inflammatory drugs in corneal refractive surgery? Ophthalmology in Russia. 2021;18(3):539–545. EDN: ECQEIM doi: 10.18008/1816-5095-2021-3-539-545

[25] Eremenko AI, Yanchenko SV. The epidemiology of “dry eye” syndrome in patients getting on in years. Bulletin of New Medical Technologies. 2009;16(1):150. EDN: LAMVIR

[26] Еременко А.И., Янченко С.В. Эпидемиология синдрома «сухого глаза» у лиц пожилого возраста // Вестник новых медицинских технологий. 2009. Т. 16, № 1. С. 150. EDN: LAMVIR

[27] Eremenko AI, Yanchenko SV. The epidemiology of “dry eye” syndrome in patients getting on in years. Bulletin of New Medical Technologies. 2009;16(1):150. EDN: LAMVIR

[28] Tsubota K, Yokoi N, Shimazaki J, et al. New perspectives on dry eye definition and diagnosis: a consensus report by the Asia dry eye society. Ocul Surf. 2017;15(1):65–76. doi: 10.1016/j.jtos.2016.09.003

[29] Tsubota K., Yokoi N., Shimazaki J., et al. New perspectives on dry eye definition and diagnosis: a consensus report by the Asia dry eye society // Ocul Surf. 2017. Vol. 15, N 1. P. 65–76. doi: 10.1016/j.jtos.2016.09.003

[30] Tsubota K, Yokoi N, Shimazaki J, et al. New perspectives on dry eye definition and diagnosis: a consensus report by the Asia dry eye society. Ocul Surf. 2017;15(1):65–76. doi: 10.1016/j.jtos.2016.09.003

[31] Eskina EN, Belogurova AV, Parshina VA, Movsesian MKh. Predictability of the refractive effect after laser correction. Determining factors. Review. Ophthalmology in Russia. 2023;20(1):41–52. EDN: BYFHEE doi: 10.18008/1816-5095-2023-1-41-52

[32] Эскина Э.Н., Белогурова А.В., Паршина В.А., Мовсесян М.Х. Предсказуемость рефракционного эффекта при выполнении лазерной коррекции зрения. Определяющие факторы. Обзор литературы // Офтальмология. 2023. Т. 20, № 1. С. 41–52. EDN: BYFHEE doi: 10.18008/1816–5095-2023-1-41-52

[33] Eskina EN, Belogurova AV, Parshina VA, Movsesian MKh. Predictability of the refractive effect after laser correction. Determining factors. Review. Ophthalmology in Russia. 2023;20(1):41–52. EDN: BYFHEE doi: 10.18008/1816-5095-2023-1-41-52

[34] Solodkova EG, Fokin VP, Balalin SV. To the question of stability of refractive result after excimer laser correction of myopia. Journal of Volgograd State Medical University. 2018;(1):78–81. EDN: YUMLOJ doi: 10.19163/1994-9480-2018-1(65)-78-81

[35] Солодкова Е. Г., Фокин В.П., Балалин С.В. К вопросу о стабильности рефракционного результата после эксимерлазерной коррекции миопии // Вестник Волгоградского государственного медицинского университета. 2018. № 1. C. 78–81. EDN: YUMLOJ doi: 10.19163/1994-9480-2018-1(65)-78-81

[36] Solodkova EG, Fokin VP, Balalin SV. To the question of stability of refractive result after excimer laser correction of myopia. Journal of Volgograd State Medical University. 2018;(1):78–81. EDN: YUMLOJ doi: 10.19163/1994-9480-2018-1(65)-78-81

[37] Maychuk NV, Mushkova IA. Screening methods for the hypoxic keratopathy evaluation in the refractive surgery. Ophthalmology in Russia. 2016;13(3):169–177. EDN: XGVNZB doi: 10.18008/1816-5095-2016-3-169-177

[38] Майчук Н.В., Мушкова И.А. Скрининговые методы оценки гипоксической кератопатии в практике рефракционного хирурга // Офтальмология. 2016. Т. 13, № 3. С. 169–177. EDN: XGVNZB doi: 10.18008/1816-5095-2016-3-169-177

[39] Maychuk NV, Mushkova IA. Screening methods for the hypoxic keratopathy evaluation in the refractive surgery. Ophthalmology in Russia. 2016;13(3):169–177. EDN: XGVNZB doi: 10.18008/1816-5095-2016-3-169-177

[40] Maychuk DYu, Tarkhanova AA, Pronkin IA. Ophthalmic products with extracellular matrix components. Their effectiveness in the process of corneal repair in neurotrophic, herpetic, recurrent keratitis and erosions. Fyodorov Journal of Ophthalmic Surgery. 2022; (2):91–100. EDN: UTJFNG doi: 10.25276/0235-4160-2022-2-91-100

[41] Майчук Д.Ю., Тарханова А.А., Пронкин И.А. Офтальмологические средства с компонентами внеклеточного матрикса. Их эффективность в процессе репарации роговицы при нейротрофических, герпетических, рецидивирующих кератитах и эрозиях // Офтальмохирургия. 2022. № 2. С. 91–100. EDN: UTJFNG doi: 10.25276/0235-4160-2022-2-91-100

[42] Maychuk DYu, Tarkhanova AA, Pronkin IA. Ophthalmic products with extracellular matrix components. Their effectiveness in the process of corneal repair in neurotrophic, herpetic, recurrent keratitis and erosions. Fyodorov Journal of Ophthalmic Surgery. 2022; (2):91–100. EDN: UTJFNG doi: 10.25276/0235-4160-2022-2-91-100

RIGHTS & PERMISSIONS

Eco-Vector