{"corpus_id":1928939,"paper_sha":"bcc61484c010f2ebd303c3a11cccef6923eddf87","doi":"10.2147/OPTH.S51313","arxiv_id":null,"pmid":27143849,"pmcid":"4844427","mag_id":2337968695,"dblp_id":null,"acl_id":null,"title":"Ectasia risk factors in refractive surgery","year":2016,"publication_date":"2016-04-20","venue":"Clinical Ophthalmology","journal":{"name":"Clinical Ophthalmology (Auckland, N.Z.)","pages":"713 - 720","volume":"10"},"journal_issn":null,"journal_title":null,"publication_types":["Review","JournalArticle"],"pubmed_pub_types":["Journal Article","Review"],"s2_fields_of_study":["Medicine"],"reference_count":66,"citation_count":120,"influential_citation_count":10,"is_open_access":true,"arxiv_categories":null,"arxiv_license":null,"arxiv_journal_ref":null,"mesh_headings":null,"chemicals":null,"comments_corrections":null,"source_flags":5,"s2_open_access_pdf_url":"https://www.dovepress.com/getfile.php?fileID=29987","s2_open_access_landing_url":"https://www.semanticscholar.org/paper/bcc61484c010f2ebd303c3a11cccef6923eddf87","s2_open_access_license":"CCBYNC","s2_open_access_status":"GOLD","pmc_open_access_pdf_url":null,"pmc_open_access_landing_url":null,"pmc_open_access_license":null,"pmc_open_access_status":null,"unpaywall_open_access_pdf_url":null,"unpaywall_open_access_landing_url":null,"unpaywall_open_access_license":null,"unpaywall_open_access_status":null,"abstract":"This review outlines risk factors of post-laser in situ keratomileusis (LASIK) ectasia that can be detected preoperatively and presents a new metric to be considered in the detection of ectasia risk. Relevant factors in refractive surgery screening include the analysis of intrinsic biomechanical properties (information obtained from corneal topography/tomography and patient’s age), as well as the analysis of alterable biomechanical properties (information obtained from the amount of tissue altered by surgery and the remaining load-bearing tissue). Corneal topography patterns of placido disk seem to play a pivotal role as a surrogate of corneal strength, and abnormal corneal topography remains to be the most important identifiable risk factor for ectasia. Information derived from tomography, such as pachymetric and epithelial maps as well as computational strategies, to help in the detection of keratoconus is additional and relevant. High percentage of tissue altered (PTA) is the most robust risk factor for ectasia after LASIK in patients with normal preoperative corneal topography. Compared to specific residual stromal bed (RSB) or central corneal thickness values, percentage of tissue altered likely provides a more individualized measure of biomechanical alteration because it considers the relationship between thickness, tissue altered through ablation and flap creation, and ultimate RSB thickness. Other recognized risk factors include low RSB, thin cornea, and high myopia. Age is also a very important risk factor and still remains as one of the most overlooked ones. A comprehensive screening approach with the Ectasia Risk Score System, which evaluates multiple risk factors simultaneously, is also a helpful tool in the screening strategy.","claims":[{"public_id":"cl_3e3cf7d1aead4cba1a357910c6a095bd","status":"active","text":"Abnormal corneal topography remains the most important identifiable risk factor for post-LASIK ectasia.","confidence":0.98,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_3e3cf7d1aead4cba1a357910c6a095bd"},{"public_id":"cl_7238dd20541b1cba21f93f556036ea91","status":"active","text":"High percentage of tissue altered is the most robust risk factor for ectasia after LASIK in patients with normal preoperative corneal topography.","confidence":0.97,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_7238dd20541b1cba21f93f556036ea91"},{"public_id":"cl_8c4dfa1906dd99ad5cbeea8dbeb3badd","status":"active","text":"Percentage of tissue altered likely provides a more individualized measure of biomechanical alteration than specific residual stromal bed or central corneal thickness values.","confidence":0.92,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_8c4dfa1906dd99ad5cbeea8dbeb3badd"},{"public_id":"cl_d132f236c4c9cb010d785f86143325e2","status":"active","text":"The Ectasia Risk Score System is a helpful comprehensive screening tool because it evaluates multiple risk factors simultaneously.","confidence":0.9,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_d132f236c4c9cb010d785f86143325e2"}],"concepts":[{"public_id":"co_32590d2b8687eca97cc98ca03ee9998c","status":"active","name":"multiple risk factors","description":"More than one ectasia-related preoperative factor considered together in screening.","types":["risk profile"],"aliases":[],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_32590d2b8687eca97cc98ca03ee9998c"},{"public_id":"co_5142a3c6f280ca48b2e15c26dbc2546c","status":"active","name":"central corneal thickness","description":"Thickness of the cornea at its center, used as a preoperative corneal measurement.","types":["anatomical measurement"],"aliases":["CCT"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_5142a3c6f280ca48b2e15c26dbc2546c"},{"public_id":"co_58a8a2535b14f14d9b891fbc199d20ae","status":"active","name":"low residual stromal bed","description":"A small remaining stromal thickness after surgery, associated with increased ectasia risk.","types":["risk factor"],"aliases":[],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_58a8a2535b14f14d9b891fbc199d20ae"},{"public_id":"co_5fb3a66cdffa11966e410568d4de0420","status":"active","name":"high myopia","description":"A high degree of nearsightedness that is considered in ectasia risk assessment.","types":["risk factor"],"aliases":[],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_5fb3a66cdffa11966e410568d4de0420"},{"public_id":"co_67fafcb9cd2c0f578f4aad94c86855ff","status":"active","name":"residual stromal bed","description":"The remaining stromal thickness left in the cornea after flap creation and laser ablation.","types":["anatomical measurement"],"aliases":["RSB"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_67fafcb9cd2c0f578f4aad94c86855ff"},{"public_id":"co_6d81601aac444b733c4172768aa39a71","status":"active","name":"post-LASIK ectasia","description":"Corneal ectasia occurring after laser in situ keratomileusis, characterized by progressive corneal thinning and steepening.","types":["condition"],"aliases":["ectasia after LASIK"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_6d81601aac444b733c4172768aa39a71"},{"public_id":"co_8c0073afabccce9dedc3e471f21b3541","status":"active","name":"normal preoperative corneal topography","description":"Preoperative corneal topography without obvious abnormal patterns before refractive surgery.","types":["preoperative finding"],"aliases":[],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_8c0073afabccce9dedc3e471f21b3541"},{"public_id":"co_95c003db8f09abd63bc7fe381e1a3f1e","status":"active","name":"percentage of tissue altered","description":"A metric that combines ablation depth, flap thickness, and corneal thickness to estimate the proportion of corneal tissue affected by surgery.","types":["metric","risk factor"],"aliases":["PTA"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_95c003db8f09abd63bc7fe381e1a3f1e"},{"public_id":"co_9ea837b35456dc50131f7bb841c9f8f3","status":"active","name":"thin cornea","description":"A cornea with reduced thickness, considered in ectasia risk assessment.","types":["anatomical feature","risk factor"],"aliases":[],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_9ea837b35456dc50131f7bb841c9f8f3"},{"public_id":"co_bbbcdb61633dc07de199d14564763644","status":"active","name":"Ectasia Risk Score System","description":"A screening system that combines multiple preoperative risk factors to assess ectasia risk.","types":["screening tool"],"aliases":["ERSS"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_bbbcdb61633dc07de199d14564763644"},{"public_id":"co_d8bc3c411430d4cde34225b648d16cca","status":"active","name":"abnormal corneal topography","description":"Irregular corneal surface patterns detected on topographic examination that indicate elevated ectasia risk.","types":["risk factor"],"aliases":["abnormal topography"],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_d8bc3c411430d4cde34225b648d16cca"},{"public_id":"co_e70b81f962cfa4fa0a8a4f50cff8b72d","status":"active","name":"refractive surgery screening","description":"Preoperative assessment used to evaluate patient suitability and identify risk factors before refractive surgery.","types":["clinical process"],"aliases":[],"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/concepts/co_e70b81f962cfa4fa0a8a4f50cff8b72d"}],"external_ids":{"DOI":"10.2147/OPTH.S51313","ArXiv":null,"PubMed":27143849,"PubMedCentral":"4844427","MAG":2337968695,"DBLP":null,"ACL":null},"open_access":{"is_open_access":true,"pdf_url":"https://www.dovepress.com/getfile.php?fileID=29987","landing_url":"https://www.semanticscholar.org/paper/bcc61484c010f2ebd303c3a11cccef6923eddf87","source":"semantic_scholar","pdf_url_source":"semantic_scholar_open_access_pdf","license":"CCBYNC","status":"GOLD","reason":null},"reference_availability":{"status":"available","references_indexed":true,"full_text_available":false,"full_text_source":null,"count_basis":"semantic_scholar_metadata","extraction_status":"not_applicable","reason":null},"source":{"provider":"episteme2","base_corpus":"semantic_scholar_dump","freshness_mode":"unknown","basis":["semantic_scholar_metadata","postgres_metadata"],"limits":["paper metadata is based on indexed upstream scholarly datasets","claims and concepts are available only for extracted papers","absence of claims or concepts means no extracted graph data is available in this response"],"status":"available","degraded":false,"degraded_reasons":[],"diagnostics":{"status":"available","degraded":false,"degraded_reasons":[],"metadata_status":"available","graph_status":"available","abstract_status":"available"},"source_flags":5},"paper_id":637964,"paper_uid":"b6949409-bf2c-403a-8c0d-61f536512374","canonical_identity":{"paper_id":637964,"paper_uid":"b6949409-bf2c-403a-8c0d-61f536512374","identity_status":"available","lookup_basis":"semantic_scholar_external_id","compatibility_path":"corpus_id"},"url":"https://sah.borca.ai/papers/1928939"}