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Diagnostic Techniques, Ophthalmological |
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Aanbevelingen voor het gebruik van vijf oftalmologische testen in de klinische praktijk / Ann Van den Bruel / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2008)
ISSN : D/2008/10.273/04 : 0 €
Studie nr 2007-01
Languages : Dutch (dut) English (eng)
Descriptors: Indexation
2007-01 ; Diagnostic Techniques, Ophthalmological ; Eye Diseases ; Prognosis ; Quality Assurance, Health Care ; R71
Classification
WW 141 Examination. Diagnosis. Diagnostic methods (General)Link for e-copy: https://doi.org/10.57598/R71A Format of e-copy: .PDF (880 KB) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=1671 Copies
Barcode Call number Media type Location Section Status No copy
€ 0
Languages : Spanish (spa)
Descriptors: Classification
WW 340 Refractive Surgery
Indexation
Diagnostic Techniques, Ophthalmological ; Refractive Errors ; Vision DisordersAbstract: Clinical setting
Approximately one third of the population has a refractive defect requiring correction. Refractive surgery may be defined as those surgical methods used to eliminate or attenuate refractive defects of the eye. The use of excimer laser on the cornea usually aims at correcting spherical, cylindrical or axial defects which are lower order optical aberrations (myopia, hyperopia and astigmatism). For years now, research has been done on the possibility to detect higher-order optical aberrations (coma, spherical aberration, triangular astigmatism, three-leaf clover, etc.) and to try to correct them. These aberrations are usually responsible for 17 to 20% of total refractive defects of the eye. Wave front guided corneal ablation is intended to personalize surgical correction of optical aberrations detected by the use of an aberrometer, a tool used to analyze the wave front.
Technology description
The wave front is a way the light propagates through the optical system. Wave aberration is defined as the difference between perfect (spherical) wave fronts and real wave fronts at each point in the pupil. The aberrometer is a tool used to assess these aberrations. The information obtained with the aberrometer is exported to the excimer laser operating system and is used to guide shooting and therapeutic sculpting. The cost of the procedure in our country is approximately $3,000 (argentine pesos).
Purpose
The purpose of this report is to assess the usefulness of wave front analysis in the diagnosis and management of refractive defects.
Methods
A search was started on the main literature databases (MEDLINE, Cochrane, DARE, LILACS, NHS NICE, EMBASE, Centre for Reviews and Dissemination, York University), on the Internet’s general search engines, health technology assessment agencies and health sponsors as well as in repositories of clinical practice guidelines and several institution coverage policies.
Main results
The simplest and safest way to correct refractive defects is by prescribing eye glasses or contact lenses. Refractive surgery is an alternative method intended to provide better comfort to the patient while avoiding the use of external optical tools, but the correction achieved does not exceed and, in many cases, is lower than that provided by eye glasses and lenses. That is why refractive surgical procedures are not considered medically necessary by many world health organizations. When deciding on refractive surgery, there are several techniques and, basically, there is no evidence coming from prospective randomized trials that one technique is better than the other. The most widely used is LASIK and with the coming up of wave front analysis technology, LASIK may be personalized by using aberrometer guidance. In 2002, Nuijts et al conducted a randomized prospective trial with 12 patients, comparing conventional LASIK versus wave front guided LASIK for the correction of low to moderate myopia after 6 months. Both methods showed an excellent safety rate. With front wave guided LASIK ablation depth was significantly lower, though the efficacy rate was slightly lower as compared to conventional LASIK. In 2003, Phusitphoykai et al compared conventional versus wave front guided LASIK. Twenty short-sighted eyes (10 patients) were randomized to undergo wave front guided ablation in the first eye and conventional ablation in the other. They concluded that the visual result with both procedures was not significantly different. Other studies compared the wave front with the conventional methods as regards induction of post surgical aberrations showing that, in general, a smaller number of higher order aberrations were found with personalized ablation methods. In terms of visual acuity, patient preferences and contrast sensitivity, personalized ablation sometimes resulted in slightly but not statistically significant better results. Several studies showed that the reproducibility of the measurement of higher-order aberrations was low thus restricting result interpretation.
Conclusions
The added value of higher order aberration correction using wave front guided surgical methods is difficult to assess as regards their clinical impact. Even though it is still necessary to keep doing research on this new technology, it is possible that a selected subgroup of patients had more benefits with this technique: Patients with high rate of refractive defect due to these higher order aberrations, retreatment of already operated patients presenting persisting symptoms attributable to higher order aberrations detected on aberrometry or those patients requiring visual acuities or contrast sensitivity higher than normal, either due to their occupation or to a significant individual sensitivity.Link for e-copy: https://ecommunities.belgium.be/ecomswitch/start/Technology_Evaluation_Center_As [...] Format of e-copy: Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=771 Copies
Barcode Call number Media type Location Section Status No copy
ISSN : D/2008/10.273/06 : 0 €
Study nr 2007-01
Languages : English (eng)
Descriptors: Indexation
2007-01 ; Diagnostic Techniques, Ophthalmological ; Eye Diseases ; Prognosis ; Quality Assurance, Health Care ; R71
Classification
WW 141 Examination. Diagnosis. Diagnostic methods (General)Link for e-copy: https://doi.org/10.57598/R71C Format of e-copy: .PDF (880 KB) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=1673 Copies
Barcode Call number Media type Location Section Status No copy
ISSN : D/2008/10.273/05 : 0 €
Etude nr 2007-01
Languages : English (eng) French (fre)
Descriptors: Indexation
2007-01 ; Diagnostic Techniques, Ophthalmological ; Eye Diseases ; Prognosis ; Quality Assurance, Health Care ; R71
Classification
WW 141 Examination. Diagnosis. Diagnostic methods (General)Link for e-copy: https://doi.org/10.57598/R71B Format of e-copy: .PDF (880 KB) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=1672 Copies
Barcode Call number Media type Location Section Status No copy The protective effect of ophthalmic viscoelastic devices on endothelial cell loss during cataract surgery / Ann Van den Bruel in The British journal of ophthalmology, 95(2011)1 ([01/01/2011])
Languages : English (eng)
in The British journal of ophthalmology > 95(2011)1 [01/01/2011] . - 5-10
Descriptors: Classification
W 1 Serials. Periodicals
Indexation
Diagnosis ; Diagnostic Techniques, Ophthalmological ; Eye Diseases ; Great Britain ; Journal Article ; Meta-Analysis as Topic ; Peer Review ; Review ; TherapeuticsAbstract: Background/Aims To compare ophthalmic viscoelastic devices (OVDs) in protecting the cornea from endothelial cell loss during cataract surgery. Methods A systematic review yielded 21 randomised controlled trials including 1769 patients. OVDs were classified according to the Arshinoff classification. Traditional pairwise meta-analyses were performed for each direct comparison. Mixed treatments comparisons (MTC) analysis was also performed to combine all direct and indirect comparisons. The outcome measure was loss in endothelial cell density 3 months after surgery. Results Direct comparison meta-analysis showed that viscoadaptives lead to a lower loss in cell density compared with very low viscosity dispersives, and compared with super viscous cohesives. The soft shell technique, a combination of viscous cohesives and medium viscosity dispersives, showed a lower loss compared with viscous cohesives, but was not compared with the other treatments. The MTC analysis shows that comparing all treatment options together, all mean differences were =100 cells/mm(2). The probability of being the best treatment option is 80% for viscoadaptives and 18% for the soft shell technique. Conclusion Viscoadaptives may be superior to the other OVDs, but absolute differences in loss in endothelial cell density are <100 cells/mm(2). Link for e-copy: http://vdic.idm.oclc.org/login?url=http://bjo.bmj.com/content/by/year Format of e-copy: VDIC IP recognition (1917 to embargo 1 year) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2292 [article]
