![]() ![]() In 2011 we began a research and development project on a laser iris depigmentation technique. For this reason, we planned the development of the cosmetic iridoplasty by laser, the first technique in history able to guarantee all the needed requirements. After several years of basic research on intraocular lenses and intracorneal implants, we finally dismissed their viability. The new procedure had to be reliable in the long term and achieve patient satisfaction. Therefore, Ophthalmology lacked an effective and safe technique that was capable of treating pigmentary disorders of iris, as well as purely cosmetic indications. Furthermore, the aesthetic effect obtained is always artificial (“robot eyes”), with fixed pupils that do not react to light, synthetic colors and parasitic reflections. However, these invasive techniques have caused frequent and serious complications such as glaucoma, uveitis, endothelial or corneal damage, reduction in vision or the visual field, aberrations, etc. Until now, they have been treated conservatively with contact lenses and through surgeries, with cosmetic intraocular lenses or keratopigmentation. Pigmentary disorders of the iris (heterochromia) can be congenital or secondary, due to medical iatrogenesis, metabolic diseases, trauma, or complications from ocular surgeries. PCI is effective, safe, and predictable for the treatment of pigmentary disorders in the iris and for the elective cosmetic indications in eye color change. Only for a week, appropriate pre- and postoperative medication was necessary to guarantee the absence of discomfort, thus confirming security. ConclusionĪfter 9 years of uninterrupted follow-up, PCI has demonstrated a high effectiveness to selectively depigment superficial melanin of iris, with a high predictability and patient satisfaction, without remarkable long-term complications. The patients’ subjective satisfaction at the end of treatment was 95%. In the lightest-colored eyes, turquoise blue colors were obtained as a rule, in varying brightness and in the darkest ones, gray blue tones of varying lightness. The only notable complications (25%) were delayed and brief iritis, which were self-limited with routine topical treatment. There were no significant differences in corrected vision (9 years total follow-up p = 0.78235 last 4 years FU p = 0.99999) and ocular pressure (9 years total FU p = 0.68251 last 4 years FU p = 0.63204) before and after the procedure. The efficacy, as quantified with the Analyzer ® comparison software, was nearly 87–95%. From 9 January 2017 to 28 February 2020, 1176 eyes have been treated in 588 patients, with a mean age of 33.7 years (SD = 9.68 years, range = 18–70 years). Finally, after 5 years, the Crystal Q-switched Nd: Yag at double frequency (532 nm) with 3–4 ns pulses demonstrated the highest efficacy, safety and predictability, so since early 2017 only this equipment has been used. Significant differences were found after 5-year follow-up between 1064, 532, 577 and 532/3–4 ns p = 0.09172, 0.06377 and 0.10183. This study began in 2012, so far 9 years of follow-up, to compare and choose the most suitable among 4 types of lasers to perform cosmetic iridoplasty. The IRÎZ ® (Eyecos ®) scanner was used to evaluate the cases, with photography, optical coherence tomography, and pneumotonography modules, along with the following software programs: Predictor ®, Simulator ® 3D, Analyzer ® and Planner ® (Eyecos ®). The procedures were planned in 2–3 phases of 4 consecutive sessions spaced 4–6 months apart. PCI was performed in 1176 eyes of 588 patients. Excel statistical program was used to perform a general descriptive study, calculation of correlation factors, and statistical significance analysis between quantitative variables (Student T Test). Data were collected independently by assistant optometrists and classified in database. The selection of patients was carried out in healthy individuals, over 18 years of age, with iris heterochromia (congenital-7% or acquired, secondary to topical medication-1%, trauma-0.5% or surgery-0.25%), nevus-0.25% and cosmetic cases-91%. Prospective clinical study on efficacy, safety, predictability, and satisfaction. To evaluate photoablative cosmetic iridoplasty (PCI), and its efficacy, safety, predictability, and satisfaction with the 532 nm Crystal Q-switched Nd: Yag laser, with 3–4 ns pulses, for depigmentation of the anterior epithelium of the iris in cases of heterochromia, nevus, or cosmetic indications (eye color change). ![]()
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