Jennifer B Eaddy

Effects of lotrafilcon A and omafilcon A bandage contact lenses on visual outcomes after photorefractive keratectomy

PURPOSE: To evaluate postoperative healing between bandage contact lenses with high and low oxygen permeability in patients having photorefractive keratectomy (PRK). SETTING: Center for Refractive Surgery, Walter Reed Army Medical Center, Washington, DC, USA. METHODS: This retrospective study compared patients receiving a high‐oxygen‐transmission bandage contact lens (Focus Night & Day [N&D], Ciba Vision; n = 92) and those receiving a low‐oxygen‐transmission lens (Proclear, Cooper Vision; n = 114) after PRK. Visual outcomes, safety, and efficacy were assessed postoperatively at 1, 4, and 7 days and 1, 3, 6, and 12 months. RESULTS: Overall pain scores were higher in the Proclear group at 1 day (P = .000) and 4 days (P = .027). The N&D group had an increase in corneal infiltrates at 4 days (P = .025) and 1 week (P = .017). At 1 month, 40.4% of patients in the Proclear group and 18.6% in the N&D group had a 1 or more line decrease in best spectacle‐corrected visual acuity (BSCVA) (P = .002). Although there was a trend toward a higher haze rate in the Proclear group, it was not statistically significant (P = .064). There was no statistically significant difference in uncorrected visual acuity, goal of emmetropia, contrast sensitivity, or reepithelialization. CONCLUSIONS: The N&D lens produced less pain and better postoperative results in terms of haze and BSCVA at 1 month. However, it led to a higher incidence of corneal infiltrates. There was no difference between the lenses in the end result at 12 months.

Contrast Sensitivity After Wavefront-Guided and Wavefront-Optimized PRK and LASIK for Myopia and Myopic Astigmatism

PURPOSE To compare contrast sensitivity among participants undergoing wavefront-guided or wavefront-optimized photorefractive keratectomy (PRK) or LASIK for the treatment of myopia or myopic astigmatism 12 months after surgery. METHODS In a prospective, randomized clinical trial, 215 participants with myopia ranging from -0.50 to -7.25 diopters (D) and less than -3.50 D of manifest astigmatism electing to undergo either LASIK or PRK were randomized to receive wavefront-guided or wavefront-optimized treatment. Corrected Super Vision Test (Precision Vision, La Salle, IL) high contrast and small letter contrast sensitivity, uncorrected postoperative contrast sensitivity function, and uncorrected and corrected distance visual acuity were measured preoperatively and at 1, 3, 6, and 12 months postoperatively. RESULTS There was a significant difference within each of the four groups over time when measuring high contrast visual acuity (P < .001) and small letter contrast sensitivity (P < .001), with the most significant decrease occurring 1 month postoperatively. However, there were no significant differences when comparing the four groups for high contrast sensitivity (P = .22) or small letter contrast sensitivity (P = .06). The area under the logarithm of contrast sensitivity function did not differ significantly over time (P = .09) or between groups (P = .16). A pairwise comparison of preoperative to 12-month CDVA showed a significant improvement in all groups (P < .017). The change in CDVA was also significantly different between groups as determined by one-way analysis of variance (P = .003). CONCLUSIONS Wavefront-guided and wavefront-optimized PRK and LASIK procedures maintained high contrast, small letter contrast sensitivity, and contrast sensitivity function 12 months postoperatively. Although the recovery period for visual performance was longer for PRK versus LASIK, there was no significant difference in treatment type or treatment profile at 12 months postoperatively. [J Refract Surg. 2018;34(9):590-596.].

Vision-Related Quality of Life and Perception of Military Readiness and Capabilities Following Refractive Surgery Among Active Duty U.S. Military Service Members

PURPOSE To assess vision-related quality of life and military readiness and capabilities among active duty U.S. military service members undergoing refractive surgery. METHODS In this prospective, single-center, observational study, active duty U.S. military service members electing to undergo refractive surgery were asked to complete a military performance questionnaire and the National Eye Institute Refractive Error Quality of Life Instrument (NEI RQL-42) preoperatively and at 6 months postoperatively. On the military performance questionnaire, participants rated (1 = very bad to 5 = very good) how they felt their vision affected their military readiness and capabilities after refractive surgery. RESULTS Among 360 participants at 6 months postoperatively, the overall mean military performance score increased from 3.6 ± 0.8 to 4.8 ± 0.3, a change of 1.2, with 91.7% of the participants indicating an overall improvement in readiness and capability (P < .001). Scores measuring overall individual readiness, contribution to units mission, use of night vision goggles, function at night, weapons sighting ability, employment of personal masks, weather extreme environmental conditions, and optical support were significantly higher postoperatively (P < .001). For the NEI RQL-42, scores were significantly higher postoperatively for the subscales clarity of vision, expectations, near vision, far vision, diurnal fluctuations, activity limit, glare, dependence on correction, worry, appearance, and satisfaction with correction (all P < .001), but not for symptoms after refractive surgery (P = .403). CONCLUSIONS Refractive surgery significantly improves military readiness and capabilities and vision-related quality of life of active duty U.S. military service members with refractive error. [J Refract Surg. 2018;34(9):597-603.].