Retinal nerve fiber layer thickness after laser-assisted subepithelial keratomileusis and femtosecond LASIK: a prospective observational cohort study

Andreas Katsanos,1–3 Esther Arranz-Marquez,1,4 Rafael Cañones,2 Gorka Lauzirika,1 Isabel Rodríguez-Perez,1 Miguel A Teus1,2 1Clínica Novovisión, Madrid, Spain; 2Department of Ophthalmology, University of Alcala, Alcala de Henares, Spain; 3Depart...

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Autores principales:	Katsanos A, Arranz-Marquez E, Cañones R, Lauzirika G, Rodríguez-Perez I, Teus MA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	femtosecond laser glaucoma LASIK LASEK photorefractive keratectomy RNFL Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/61d752d353bf45439a094fdd01fc50ba
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spelling	oai:doaj.org-article:61d752d353bf45439a094fdd01fc50ba2021-12-02T00:12:18ZRetinal nerve fiber layer thickness after laser-assisted subepithelial keratomileusis and femtosecond LASIK: a prospective observational cohort study1177-5483https://doaj.org/article/61d752d353bf45439a094fdd01fc50ba2018-07-01T00:00:00Zhttps://www.dovepress.com/retinal-nerve-fiber-layer-thickness-after-laser-assisted-subepithelial-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Andreas Katsanos,1–3 Esther Arranz-Marquez,1,4 Rafael Cañones,2 Gorka Lauzirika,1 Isabel Rodríguez-Perez,1 Miguel A Teus1,2 1Clínica Novovisión, Madrid, Spain; 2Department of Ophthalmology, University of Alcala, Alcala de Henares, Spain; 3Department of Ophthalmology, University of Ioannina, Ioannina, Greece; 4Ophthalmology Clinic, Rey Juan Carlos Universitary Hospital, Móstoles, Madrid, Spain Purpose: Based on the assumption that high levels of intraocular pressure (IOP) during femtosecond laser-assisted in situ keratomileusis (FS-LASIK) may compromise the retinal nerve fiber layer (RNFL), newer femtosecond platforms that operate without causing significant IOP elevation have been developed in recent years. However, this assumption has not been adequately tested. The aim of the current study was to evaluate possible changes in RFNL thickness in nonglaucomatous myopic patients undergoing FS-LASIK using the 60 KHz IntraLase® device that significantly elevates the IOP for an appreciable period of time vs an advanced surface ablation technique (laser-assisted subepithelial keratomileusis, LASEK) that does not induce any IOP elevation. Methods: This was a prospective, observational, controlled cohort study. One randomly selected eye of 114 consecutive eligible patients was analyzed. Inclusion criteria were myopia up to -6.00 diopters and astigmatism up to -2.00 diopters. As clinically indicated, 50 patients underwent LASEK and 64 underwent FS-LASIK. The RNFL thickness was determined with a spectral-domain optical coherence tomography device preoperatively and 3 months postoperatively by the same masked observer. Results: There was no significant difference in preoperative refractive error, age, or sex between the groups. Preoperatively, central corneal thickness was significantly lower in the LASEK group (529.1±36.1 vs 562.4±31.6 µm, P=0.001). For the LASEK group, there was no significant difference between preoperative and postoperative RNFL thickness in the studied sectors (superior-temporal, temporal, inferior-temporal, average). For the FS-LASIK group, compared to preoperative RNFL measures, statistically significant thicker postoperative values were found for the average RNFL (mean difference: 0.67 µm, 0.7% increase, P=0.008) and the inferior-temporal sector (mean difference: 0.92 µm, 0.6% increase, P=0.02). Conclusion: LASIK with a femtosecond platform that induces high intraoperative IOP did not cause RNFL thinning. The observed differences between preoperative and postoperative values are below the axial resolution limit of optical coherence tomography devices. Keywords: femtosecond laser, glaucoma, surface ablation, LASEK, photorefractive keratectomy, RNFLKatsanos AArranz-Marquez ECañones RLauzirika GRodríguez-Perez ITeus MADove Medical Pressarticlefemtosecond laserglaucomaLASIKLASEKphotorefractive keratectomyRNFLOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 1213-1218 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	femtosecond laser glaucoma LASIK LASEK photorefractive keratectomy RNFL Ophthalmology RE1-994
spellingShingle	femtosecond laser glaucoma LASIK LASEK photorefractive keratectomy RNFL Ophthalmology RE1-994 Katsanos A Arranz-Marquez E Cañones R Lauzirika G Rodríguez-Perez I Teus MA Retinal nerve fiber layer thickness after laser-assisted subepithelial keratomileusis and femtosecond LASIK: a prospective observational cohort study
description	Andreas Katsanos,1–3 Esther Arranz-Marquez,1,4 Rafael Cañones,2 Gorka Lauzirika,1 Isabel Rodríguez-Perez,1 Miguel A Teus1,2 1Clínica Novovisión, Madrid, Spain; 2Department of Ophthalmology, University of Alcala, Alcala de Henares, Spain; 3Department of Ophthalmology, University of Ioannina, Ioannina, Greece; 4Ophthalmology Clinic, Rey Juan Carlos Universitary Hospital, Móstoles, Madrid, Spain Purpose: Based on the assumption that high levels of intraocular pressure (IOP) during femtosecond laser-assisted in situ keratomileusis (FS-LASIK) may compromise the retinal nerve fiber layer (RNFL), newer femtosecond platforms that operate without causing significant IOP elevation have been developed in recent years. However, this assumption has not been adequately tested. The aim of the current study was to evaluate possible changes in RFNL thickness in nonglaucomatous myopic patients undergoing FS-LASIK using the 60 KHz IntraLase® device that significantly elevates the IOP for an appreciable period of time vs an advanced surface ablation technique (laser-assisted subepithelial keratomileusis, LASEK) that does not induce any IOP elevation. Methods: This was a prospective, observational, controlled cohort study. One randomly selected eye of 114 consecutive eligible patients was analyzed. Inclusion criteria were myopia up to -6.00 diopters and astigmatism up to -2.00 diopters. As clinically indicated, 50 patients underwent LASEK and 64 underwent FS-LASIK. The RNFL thickness was determined with a spectral-domain optical coherence tomography device preoperatively and 3 months postoperatively by the same masked observer. Results: There was no significant difference in preoperative refractive error, age, or sex between the groups. Preoperatively, central corneal thickness was significantly lower in the LASEK group (529.1±36.1 vs 562.4±31.6 µm, P=0.001). For the LASEK group, there was no significant difference between preoperative and postoperative RNFL thickness in the studied sectors (superior-temporal, temporal, inferior-temporal, average). For the FS-LASIK group, compared to preoperative RNFL measures, statistically significant thicker postoperative values were found for the average RNFL (mean difference: 0.67 µm, 0.7% increase, P=0.008) and the inferior-temporal sector (mean difference: 0.92 µm, 0.6% increase, P=0.02). Conclusion: LASIK with a femtosecond platform that induces high intraoperative IOP did not cause RNFL thinning. The observed differences between preoperative and postoperative values are below the axial resolution limit of optical coherence tomography devices. Keywords: femtosecond laser, glaucoma, surface ablation, LASEK, photorefractive keratectomy, RNFL
format	article
author	Katsanos A Arranz-Marquez E Cañones R Lauzirika G Rodríguez-Perez I Teus MA
author_facet	Katsanos A Arranz-Marquez E Cañones R Lauzirika G Rodríguez-Perez I Teus MA
author_sort	Katsanos A
title	Retinal nerve fiber layer thickness after laser-assisted subepithelial keratomileusis and femtosecond LASIK: a prospective observational cohort study
title_short	Retinal nerve fiber layer thickness after laser-assisted subepithelial keratomileusis and femtosecond LASIK: a prospective observational cohort study
title_full	Retinal nerve fiber layer thickness after laser-assisted subepithelial keratomileusis and femtosecond LASIK: a prospective observational cohort study
title_fullStr	Retinal nerve fiber layer thickness after laser-assisted subepithelial keratomileusis and femtosecond LASIK: a prospective observational cohort study
title_full_unstemmed	Retinal nerve fiber layer thickness after laser-assisted subepithelial keratomileusis and femtosecond LASIK: a prospective observational cohort study
title_sort	retinal nerve fiber layer thickness after laser-assisted subepithelial keratomileusis and femtosecond lasik: a prospective observational cohort study
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/61d752d353bf45439a094fdd01fc50ba
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_version_	1718403869728309248

Retinal nerve fiber layer thickness after laser-assisted subepithelial keratomileusis and femtosecond LASIK: a prospective observational cohort study

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