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• W2103857008 abstract "We would like to make several comments about the article by Nishimura et al.1 Forward movements of the cornea measured by slit scan or similar devices after myopic laser in situ keratomileusis (LASIK) or photorefractive keratectomy have been reported by many authors. This phenomenon can be explained by the steepening of the posterior cornea caused by postoperative changes in the magnification ratio.2 Postoperative differences in the corneal thickness measurement by ultrasound and by slit scan or similar devices can be explained by the same hypothesis.3 Nishimura et al. show that in younger and older groups, postoperative curvature of the posterior cornea is slightly steeper than the preoperative state, as described above. If the authors attribute the deepening of the anterior chamber depth to possible backward movements of the cornea, the posterior cornea should become flatter postoperatively. From the standpoint of magnification, performing myopic LASIK is like adding a minus lens on the cornea. Internal structures observed through the postoperative cornea change their apparent sizes, depending on the amount of correction and the distance from the cornea. Assuming that the plane of the anterior surface of the lens is located L (mm) posterior to the anterior surface of the cornea, the refractive power of the cornea is K (D), and the refractive index of the anterior chamber is n, the distance (expressed as minus value by geometrical optics) from the anterior surface of the cornea to the apparent image of the anterior lens surface (L') is expressed as The magnification ratio of the anterior lens surface (M) compared with the real anterior lens surface is expressed as After myopic LASIK, the magnification ratio of the internal structures becomes smaller. Calculation using the above equations discloses that the magnification ratio of the anterior lens decreases by 0.35% per 1.0 diopter (D) correction of myopia. A 10.0 D correction of myopia causes 3.5% reduction of the magnification ratio. If the anterior radius of curvature of the lens is 10.00 mm, it will become 0.35 mm steeper postoperatively. If the amount of steepening is totally or partly converted to the anterior chamber depth in Scheimpflug imaging, a 0.3 to 0.4 mm shallower anterior chamber may well be detected after myopic LASIK. Anterior chamber depth also affects the magnification ratio. Calculation using the above equation reveals that 1.0 mm deepening of the anterior chamber causes a 4.0% larger magnification ratio of the anterior lens. In Nishimura et al.'s study, the anterior chamber depth in the preoperative younger group is about 0.1 mm deeper than that in the older group. The possible impact of the preoperative difference on the result and the discrepancy between postoperative change of the posterior cornea and that of the anterior chamber depth in both groups also deserve further discussion. In conclusion, we recommend to the authors and other researchers that more consideration be given to changes in the magnification ratio when evaluating postoperative changes of parameters measured optically through the cornea." @default.
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• W2103857008 date "2010-05-01" @default.
• W2103857008 modified "2023-09-27" @default.
• W2103857008 title "Decreased anterior chamber depth after myopic LASIK" @default.
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• W2103857008 doi "https://doi.org/10.1016/j.jcrs.2010.03.015" @default.
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