Original article
Corneal epithelial thickness one year after myopic LASIK surgery, measured by anterior segment optical coherence tomography combined with Placido disk
Grosor epitelial corneal un año después de la cirugía de LASIK miópico, medido mediante tomografía de coherencia óptica de segmento anterior combinado con disco de Plácido
Read
8
Timeswas read the article
1
Total PDF
7
Total HTML
Share statistics
array:24 [ "pii" => "S2173579420300864" "issn" => "21735794" "doi" => "10.1016/j.oftale.2020.03.006" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "1660" "copyright" => "Sociedad Española de Oftalmología" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2020;95:544-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0365669120300988" "issn" => "03656691" "doi" => "10.1016/j.oftal.2020.03.004" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "1660" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2020;95:544-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artículo original</span>" "titulo" => "Grosor epitelial corneal un año después de la cirugía de LASIK miópico, medido mediante tomografía de coherencia óptica de segmento anterior combinado con disco de Plácido" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "544" "paginaFinal" => "549" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Corneal epithelial thickness one year after myopic LASIK surgery, measured by anterior segment optical coherence tomography combined with Placido disk" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1432 "Ancho" => 2376 "Tamanyo" => 526816 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Mapas de grosor estromal (arriba) y epitelial (abajo) en paciente no operado (a), post-LASIK 1<span class="elsevierStyleHsp" style=""></span>año (b) y post-LASIK 10<span class="elsevierStyleHsp" style=""></span>años (c).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Díaz-Bernal, I. García-Basterra, J. Mora-Castilla, A. Moreno Guerrero" "autores" => array:4 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Díaz-Bernal" ] 1 => array:2 [ "nombre" => "I." "apellidos" => "García-Basterra" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Mora-Castilla" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Moreno Guerrero" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173579420300864" "doi" => "10.1016/j.oftale.2020.03.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579420300864?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669120300988?idApp=UINPBA00004N" "url" => "/03656691/0000009500000011/v2_202108180554/S0365669120300988/v2_202108180554/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173579420301730" "issn" => "21735794" "doi" => "10.1016/j.oftale.2020.06.007" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "1761" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2020;95:550-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Ocular involvement in a patient with Sweet syndrome: report of a case and review of the literature" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "550" "paginaFinal" => "554" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Afectación oftalmológica en el contexto de un síndrome de Sweet: comunicación de un caso y revisión de la literatura" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 837 "Ancho" => 1250 "Tamanyo" => 344554 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Skin biopsy. A) Skin biopsy including epidermis, dermis and hypodermis. At the level of the superficial dermis (see arrows) an inflammatory sheet infiltrate that condenses around the vessels (#) and some sweat ducts (*) can be observed, without vasculitis. Hematoxylin-eosin,4 x. B) The inflammatory infiltrate of the superficial dermis is composed predominantly of neutrophils with the presence of leukocytoclastia and occasional macrophages. There is no alteration of the epidermis. Hematoxylin-eosin, 20x.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E. Guzmán-Almagro, A. Fernández-Hortelano, A. Díaz-Menéndez, J. González-Martín-Moro" "autores" => array:4 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "Guzmán-Almagro" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Fernández-Hortelano" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Díaz-Menéndez" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "González-Martín-Moro" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669120302471" "doi" => "10.1016/j.oftal.2020.06.012" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669120302471?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579420301730?idApp=UINPBA00004N" "url" => "/21735794/0000009500000011/v1_202011010626/S2173579420301730/v1_202011010626/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2173579420301547" "issn" => "21735794" "doi" => "10.1016/j.oftale.2020.05.015" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "1723" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2020;95:538-43" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Effects and safety of perfluorohexyloctane on the eye surface and corneal endothelium" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "538" "paginaFinal" => "543" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Efectos y seguridad del perfluorohexiloctano en la superficie ocular y el endotelio corneal" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1051 "Ancho" => 2166 "Tamanyo" => 86182 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Subjective evaluations. DED: dry eye disease; EDE: evaporative dry eye.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A.J. Mateo Orobia, A. Blasco-Martinez, P. Rodríguez-Ausín, L.E. Pablo Júlvez, N. Güemes Villahoz, E. del Prado Sanz, M. Satué Palacián, J.M. Benítez-del-Castillo" "autores" => array:8 [ 0 => array:2 [ "nombre" => "A.J." "apellidos" => "Mateo Orobia" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Blasco-Martinez" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Rodríguez-Ausín" ] 3 => array:2 [ "nombre" => "L.E." "apellidos" => "Pablo Júlvez" ] 4 => array:2 [ "nombre" => "N." "apellidos" => "Güemes Villahoz" ] 5 => array:2 [ "nombre" => "E." "apellidos" => "del Prado Sanz" ] 6 => array:2 [ "nombre" => "M." "apellidos" => "Satué Palacián" ] 7 => array:2 [ "nombre" => "J.M." "apellidos" => "Benítez-del-Castillo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669120301945" "doi" => "10.1016/j.oftal.2020.05.016" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669120301945?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579420301547?idApp=UINPBA00004N" "url" => "/21735794/0000009500000011/v1_202011010626/S2173579420301547/v1_202011010626/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Corneal epithelial thickness one year after myopic LASIK surgery, measured by anterior segment optical coherence tomography combined with Placido disk" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "544" "paginaFinal" => "549" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Díaz-Bernal, I. García-Basterra, J. Mora-Castilla, A. Moreno Guerrero" "autores" => array:4 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Díaz-Bernal" "email" => array:1 [ 0 => "Jose.diaz.bernal1@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "I." "apellidos" => "García-Basterra" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J." "apellidos" => "Mora-Castilla" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "A." "apellidos" => "Moreno Guerrero" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Departamento de Oftalmología, Hospital Universitario Virgen de la Victoria, Málaga, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Clínica Oftalmológica Antonio Moreno, Málaga, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Oftalmología, Universidad de Málaga, Málaga, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Grosor epitelial corneal un año después de la cirugía de LASIK miópico, medido mediante tomografía de coherencia óptica de segmento anterior combinado con disco de Plácido" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1432 "Ancho" => 2376 "Tamanyo" => 526970 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Stromal thickness (top) and epithelial thickness (bottom) maps in naïve patient (a), 1-year post-LASIK (b) and 10-year post-LASIK (c).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Corneal epithelium plays an essential role as a natural barrier for the eye in addition to a significant role in corneal refractive power. Recent developments in anterior segment optical coherence tomography (AS-OCT) have enabled <span class="elsevierStyleItalic">in vivo</span> and noninvasive analysis of this corneal layer in a precise and reproducible manner.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Corneal refractive surgery procedures have experienced an important development in recent decades. More specifically, in LASIK refractive surgery<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">2</span></a> changes have been described in the corneal epithelium even though this layer is not actively modified. Even though the majority of these changes take place in the first 3 months,<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">3</span></a> some persist and could originate final refractive changes.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The objective of this study is to analyze the differences between corneal epithelial thickness (CET) of subjects who underwent myopic LASIK surgery over one year before and naïve control subjects. A second objective was to analyze possible CET predictors after myopic LASIK refractive surgery and study its possible consequences as the refractive and visual level.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">A retrospective analysis of a study group comprising 26 subjects (52 eyes) who underwent myopic LASIK surgery and 93 naïve subjects (186 eyes) who were examined in the consulting room between September 2018 and October 2019. The study was approved by the Ethical Committee of Research of the province and conducted in accordance with the Helsinki declaration and the laws of Spain. All the patients were previously informed and signed an informed consent for being included in the study.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The myopic LASIK group comprised subjects who had undergone surgery at least one year before data collection. Only subjects over 18 years of age without any pathology apart from a refractive error up to −6.5 myopia diopters and/or −4.5 astigmatism diopters were included. The study excluded subjects with previous corneal pathology (opacities, dystrophia, keratocone, inflammatory or infectious corneal diseases), users of chronic topical medication, previous ocular surgery other than LASIK and contact lens use during the 2 weeks prior to the measurements.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The control group was made up with normal subjects who visited the clinic to inquire about refractive surgery and finally declined the operation in addition to individuals visiting due to pathologies that did not compromise the anterior pole of the eye. On the basis of a mean central CET of 52.24<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.2<span class="elsevierStyleHsp" style=""></span>μm and a variance of 10.72 on the basis of previous similar studies<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">4,5</span></a> the minimum necessary sample size was calculated to detect a minimum difference of 2<span class="elsevierStyleHsp" style=""></span>μm or more utilizing a double tail test with a confidence level of 95%, statistical power of 90% and expected loss proportion of 10%. Controls were consecutively added until the minimum desired sample size was reached (52 cases).</p><p id="par0035" class="elsevierStylePara elsevierViewall">Ophthalmological examination included visual acuity measurement, anterior pole study with slit lamp, intraocular pressure measurements with applanation tonometry, refraction, anterior segment optical coherence tomography study combined with Placido disk topography (MS-39. CSO Italy) and ocular fundus assessments with midriasis. Best corrected visual acuity (BCVA) was determined using a Snellen optotype at 6<span class="elsevierStyleHsp" style=""></span>m converted to the minimum angle resolution logarithm (LogMAR) for statistical analysis. Refraction was taken with an automatic refractometer (KR1-Topcon) and tonometry with a Perkins applanation tonometer.</p><p id="par0040" class="elsevierStylePara elsevierViewall">AS-OCT by means of MS-39 combines spectral domain optical coherence tomography (SD-OCT) and corneal topography with Placido disk corneal topography to obtain epithelial thickness measurements. A standard protocol was used in all eyes included in the study. The scanning process acquires a Placido image and a series of 25 radial SD-OCT sections (1.024 A-scans, each having a length of 16<span class="elsevierStyleHsp" style=""></span>mm) with a wavelength of 840<span class="elsevierStyleHsp" style=""></span>nm, axial resolution of 3.5<span class="elsevierStyleHsp" style=""></span>μm and transversal resolution of 35<span class="elsevierStyleHsp" style=""></span>μm, and a maximum depth of 7.5<span class="elsevierStyleHsp" style=""></span>mm. Each measurement of the epithelium sections has a diameter of 8<span class="elsevierStyleHsp" style=""></span>mm and includes 800<span class="elsevierStyleHsp" style=""></span>A-scans. The device automatically segments the epithelial map in 9 sectors, <span class="elsevierStyleItalic">i.e.</span>, a central sector with a diameter of 3<span class="elsevierStyleHsp" style=""></span>mm, 4 inner sectors (nasal, temporal, superior and inferior) with a ring between 3 and 6<span class="elsevierStyleHsp" style=""></span>mm diameter, and 4 outer areas (nasal, temporal, superior and inferior) with rings between 6 and 8<span class="elsevierStyleHsp" style=""></span>mm diameter. Images obtained with quality indices (image coverage, centered with keratoscopy and section covered by same) below 90% were excluded from the study.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Statistical analyses were carried out with Microsoft Excel 2011 (Microsoft Corp., Redmond, WA, USA) and SPSS statistics (Version 20. IBM-SPSS, Chicago, IL, USA). All data are shown as mean<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>standard deviation. To determine possible significant differences between both groups, Chi square tests were utilized for qualitative variables and <span class="elsevierStyleItalic">T</span> for student for qualitative variables for independent measurements. To calculate the statistical <span class="elsevierStyleItalic">T</span> for student, homocedasticity was previously calculated. Multivariate analysis was utilized to study associations between CET and other ocular and systemic factors, while multiple linear regression was utilized for quantifying the relationships between parameters.</p><p id="par0050" class="elsevierStylePara elsevierViewall">In order to correct possible correlations between eyes of the same individual, the eye variable was added as a fixed factor in univariate models and the eye variable was included in multivariate analysis. The group of patients who underwent LASIK was divided according to ablated diopters and time elapsed since the intervention, carrying out a multivariate analysis and ANOVA test for comparing CET between the groups. Statistical significance was considered when the obtained significance level was below 5% (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05).</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0055" class="elsevierStylePara elsevierViewall">Overall, 238 eyes of 119 patients (57 males and 62 females) were included in the study: 186 eyes of 93 naïve subjects (46 males and 47 females) and 52 eyes of 26 patients (11 males and 15 females) who underwent LASIK more than one year before. The control group had a mean age of 32.80<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9.67<span class="elsevierStyleHsp" style=""></span>years, ages between 18 and 54 and mean spherical equivalent (SE) of −2.90<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.37<span class="elsevierStyleHsp" style=""></span>diopters (D). The +1 year LASIK group had a mean age of 33.68<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9.21<span class="elsevierStyleHsp" style=""></span>years with ages between 21 and 56 with a pre-surgery SE −4.26<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.92<span class="elsevierStyleHsp" style=""></span>D and post-surgery −0.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.70<span class="elsevierStyleHsp" style=""></span>D. No statistically significant differences were found between both groups for age, sex, SE or pachymetry before LASIK (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Both the control and the LASIK group did not produce significant differences between right and left eyes in any of the studied ocular variables (all <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> shows the mean baseline CET values in different sectors and rings. Statistically significant differences (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05) were obtained between both groups (naïve and LASIK >1 year) in all the studied sectors as well as in the inner and outer rings, with CET values being higher in all LASIK >1 year patients. The region with lower CET values was the superior outer region in both groups, with values of 50.82<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.41<span class="elsevierStyleHsp" style=""></span>μm in the control group and 52.78<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.40<span class="elsevierStyleHsp" style=""></span>μm in the LASIK >1 year group. The region with the highest CET values in controls and LASIK >1 year group was the outer nasal with values of 55.21<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.45<span class="elsevierStyleHsp" style=""></span>μm, and outer temporal with values of 60.71<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7.44<span class="elsevierStyleHsp" style=""></span>μm, respectively. The mean inner ring CET value in the naïve group and the LASIK >1 year group was 53.15<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.29 and 58.97<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.58<span class="elsevierStyleHsp" style=""></span>μm, whereas the outer ring produced mean values of 53.66<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.48 and 57.13<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>4.12<span class="elsevierStyleHsp" style=""></span>μm in the naïve and LASIK >1 year groups, respectively. In the LASIK >1 year group CET values were higher in the inner ring compared to the outer ring. <a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a> shows the epithelial thickness in each period. The univariate model that included the eye as a fixed factor showed significant differences between the epithelial thicknesses of groups, regardless of the eye being studied (group factor: <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05; eye factor: <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Spherical equivalent after LASIK compared to CET changes</span><p id="par0065" class="elsevierStylePara elsevierViewall">Patients with LASIK >1 year were divided in 3 groups according to SE (range between −7.50 and 0.38<span class="elsevierStyleHsp" style=""></span>D). For this purpose, the 33 and 66 percentiles were taken, obtaining a group with SE above −3.33<span class="elsevierStyleHsp" style=""></span>D (17 eyes), a second group with values comprised between −3.33 and −5.41<span class="elsevierStyleHsp" style=""></span>D (18 eyes) and a third group with values below −5.41<span class="elsevierStyleHsp" style=""></span>D (17 eyes). No significant differences were obtained between the groups when comparing previous refraction (SE) and endpoint CET (all <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05).</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Corneal epithelium thickness predictors after LASIK</span><p id="par0070" class="elsevierStylePara elsevierViewall">Multivariate analysis was performed to look for possible correlations between the endpoint CET and other clinic parameters. The variables of age, sex, eye, pachymetry and previous refraction were not correlated with the final epithelial thickness (all <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05). The only related variable was the time elapsed since surgery (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05).</p><p id="par0075" class="elsevierStylePara elsevierViewall">The sample was divided in 3 categories based on the time after surgery variable: 1 year, 2 years and over 2 years, with final mean CET being 58.46<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.35, 59.25<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.41 and 63.60<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.03<span class="elsevierStyleHsp" style=""></span>μm, respectively. ANOVA for comparison of means was utilized to obtain significant differences when comparing the mean values of different groups with each other (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05).</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0080" class="elsevierStylePara elsevierViewall">The present study found that CET, measured with AS-OCT combined with topography with Placido disk is higher in patients who underwent LASIK at least one year before, regardless of age, sex, spherical equivalent and corrected diopters. The only variable related to the endpoint CET was the time elapsed since surgery. Similarly, thicknesses were higher when approaching the center in the group of myopic LASIK patients, with said thickening matching the area of greater ablation.</p><p id="par0085" class="elsevierStylePara elsevierViewall">To date, this is the first study comparing CET values in patients who underwent LASIK over one year before the study compared to a group of control subjects utilizing a device that combines AS-OCT and the Placido ring. This combination seems to improve precision and repeatability to simultaneously evaluate in a single topographic point the anterior curvature and CET, taking into account that both parameters are modified after LASIK. This becomes more important taking into account the line of recent studies that demonstrate the influence of the epithelial profile in post-LASIK refractive results.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">6</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">CET and its clinic use has been studied applying confocal microscopy,<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">7</span></a> very high-frequency ultrasound (VHF-US)<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">3,4</span></a> and AS-OCT.<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">5,8,9</span></a> In comparison with VHF-US and confocal microscopy, AS-OCT constitutes a noninvasive technique that automatically generates epithelial thickness maps without requiring contact. Satisfactory repeatability has been demonstrated for CET measurements in naïve, post-excimer and keratocone patients in recent studies utilizing said device.<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">1,10</span></a> CET study is fundamental in the early diagnostic of subjects with keratocone<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">11,12</span></a> and in results of refractive surgery patients.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">13</span></a> In fact, recent studies emphasize the important role of CET in treatments guided by wave fronts, in which small ablation amounts are utilized for correcting high order aberrations.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">14</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">CET sector measurements described in this paper are similar to others measurements in previous studies utilizing AS-OCT and other devices such as VHF-US. The thickest OCT values in the nasal sector for normal individuals utilizing AS-OCT combined with the Placido ring have also been reported by Vega-Estrada et al.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">10</span></a> Similarly, Reinstein et al.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">4</span></a> described higher values in inferior sectors, supporting the findings of the present study.</p><p id="par0100" class="elsevierStylePara elsevierViewall">Even though there is no direct modification of the epithelial layer, the changes therein after LASIK surgery have been previously documented.<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">2,3,15</span></a> During myopic LASIK, a part of the corneal stromal volume is ablated, with the ablation being deeper at the central level. A compensatory epithelial remodeling is assumed to take place in order to reestablish the uniformity of the optic surface.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">16</span></a> However, the final epithelial profile seems to be independent of the ablated diopters, as reported previously,<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">17</span></a> matching the results of this study. In addition, the present study demonstrates the highest CET in all sectors in the LASIK group compared to the naïve group, with the thickening increasing centripetally and persistently in time, as described by Reinstein et al.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">18</span></a> utilizing VHF-US in myopic LASIK. In addition, significant differences are observed when comparing different LASIK groups with different time periods since surgery, with CET being thicker than in patients who underwent LASIK over 2 years before when compared to those who were intervened 2 and 1 years before (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.02 and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.00 respectively). This study was not designed to identify changes beyond one year since LASIK surgery. Additional studies would be necessary to verify whether these findings are due to other confusing variables or 2 other differences between said subgroups.</p><p id="par0105" class="elsevierStylePara elsevierViewall">The present study involves a number of limitations, the first being that it only includes myopic LASIK patients, which limits the possibility of finding different epithelial growth patterns according to the ablated area. The second is that, even though poor quality measurements have been excluded, it is possible that tears, eyelids or artifacts in the flap measurement could have distorted some values per sectors. This is particularly more likely in peripheral values that have been described as more susceptible to measurement errors and lower reproducibility.<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">19</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">By way of conclusion, the study demonstrates that CET measured with AS-OCT combined with Placido ring is higher in patients who underwent LASIK surgery more than one year before than in normal subjects. These changes should be taken into account when planning surgery due to their implications in endpoint refractive results.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflict of interest</span><p id="par0115" class="elsevierStylePara elsevierViewall">No conflict of interest was declared by the authors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres1407063" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1287293" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1407062" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1287292" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Material and methods" ] 6 => array:3 [ "identificador" => "sec0015" "titulo" => "Results" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Spherical equivalent after LASIK compared to CET changes" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Corneal epithelium thickness predictors after LASIK" ] ] ] 7 => array:2 [ "identificador" => "sec0030" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflict of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-12-24" "fechaAceptado" => "2020-03-24" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1287293" "palabras" => array:5 [ 0 => "Corneal epithelium" 1 => "Epithelial thickness" 2 => "Anterior segment optical coherence tomography" 3 => "Laser <span class="elsevierStyleItalic">in situ</span>" 4 => "Keratomileusis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1287292" "palabras" => array:5 [ 0 => "Epitelio corneal" 1 => "Grosor epitelial" 2 => "Tomografía de segmento anterior" 3 => "Láser <span class="elsevierStyleItalic">in situ</span>" 4 => "Keratomileusis asistida por láser" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To compare corneal epithelial thickness (CET) between patients who underwent LASIK surgery for the correction of myopia at least one year ago and healthy subjects.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A retrospective observational study was conducted that included 93 healthy subjects (186 eyes) and 26 subjects (52 eyes) that underwent myopic LASIK surgery. OCT-SA, combined with Placido disk, was performed on all subjects, and CET maps were measured. Statistical analysis was performed to analyze differences between groups. Multivariate analysis was also performed to look for possible predictors of final CET.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">There was no statistically significant differences between the groups in the demographic (age, sex) or anterior segment parameters (spherical equivalent, pachymetry) (all <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0.05). Statistically significant differences (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05) were obtained between both groups when comparing CET, including central, internal, and external rings (higher in patients that underwent LASIK surgery ≥1 year). With the exception of the time elapsed since surgery (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.00), no correlation was found between the CET and age, sex, ablated dioptres, or other variables studied (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05).</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">CET values measured by the OCT-SA were higher in patients that underwent LASIK surgery ≥1 year. The only variable that correlated with the CET after LASIK was the time elapsed since surgery. CET changes should be taken into consideration when planning refractive surgery due to its implications on the final outcome.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Comparar el grosor epitelial corneal (GEC) en pacientes intervenidos de LASIK miópico de más de un año respecto a sujetos no operados.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">En este estudio retrospectivo observacional se incluyeron 93 sujetos no operados (186 ojos) y 26 sujetos (52 ojos) operados de LASIK miópico. Se realizó una tomografía óptica de segmento anterior (OCT-SA) combinada con anillo de Plácido en todos los sujetos y se midió el GEC por sectores. Se hizo análisis estadístico para determinar diferencias entre las variables medidas en ambos grupos, así como análisis multivariante para buscar predictores de GEC.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">No hubo diferencias significativas entre los grupos en términos demográficos (edad, sexo) ni de segmento anterior (equivalente esférico, paquimetría) (todas las <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0,05). Se obtuvieron diferencias estadísticamente significativas (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0,05) entre los dos grupos en todos los sectores estudiados, central, anillos interno y externo, siendo mayores todos los valores de GEC en los pacientes intervenidos de LASIK ≥1 año. A excepción del tiempo transcurrido desde la cirugía (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,00), no se encontró correlación entre el GEC y la edad, el sexo, las dioptrías ablacionadas ni otra variable estudiada (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>0,05).</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El GEC medio y por sectores medido mediante la OCT-SA es mayor en pacientes intervenidos de LASIK hace más de un año. La única variable correlacionada con el GEC tras el LASIK es el tiempo desde la cirugía. Las modificaciones del GEC deben ser tenidas en cuenta al planear la cirugía refractiva por sus implicaciones en el resultado final.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Díaz-Bernal J, García-Basterra I, Mora-Castilla J, Moreno Guerrero A. Grosor epitelial corneal un año después de la cirugía de LASIK miópico, medido mediante tomografía de coherencia óptica de segmento anterior combinado con disco de Plácido. Arch Soc Esp Oftalmol. 2020;95:544–549.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1108 "Ancho" => 2500 "Tamanyo" => 211531 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Corneal epithelial thickness (CET) measurements per sector and rings of controls and >1 year post-LASIK group. Statistically significant differences were found in all sectors (all <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1432 "Ancho" => 2376 "Tamanyo" => 526970 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Stromal thickness (top) and epithelial thickness (bottom) maps in naïve patient (a), 1-year post-LASIK (b) and 10-year post-LASIK (c).</p>" ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Controls (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>186) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Post-LASIK<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>1 year (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>52) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32.80<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9.67 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.68<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9.21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.31 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sex (male/female) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">92/94 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22/30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.22 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Previous refraction (SE, D) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−2.90<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−4.26<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.92 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.36 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Previous pachymetry (μm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">542.42<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>28.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">549.94<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>28.96 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.70 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TCP <span class="elsevierStyleItalic">(total corneal power</span>, D) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43.28<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38.84<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.00 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2413032.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">demographic and clinic characteristics of the control group and the >1-year LASIK group.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:19 [ 0 => array:3 [ "identificador" => "bib0100" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Repeatability of automatic measurements by a new anterior segment optical coherence tomographer combined with Placido topography and agreement with 2 Scheimpflug cameras" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. Savini" 1 => "D. Schiano-Lomoriello" 2 => "K.J. Hoffer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jcrs.2018.02.015" "Revista" => array:6 [ "tituloSerie" => "J Cataract Refract Surg" "fecha" => "2018" "volumen" => "44" "paginaInicial" => "471" "paginaFinal" => "478" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29705008" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0105" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Arc-scanning very high-frequency digital ultrasound for 3D pachymetric mapping of the corneal epithelium and stroma in laser in situ keratomileusis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.Z. Reinstein" 1 => "R.H. Silverman" 2 => "T. Raevsky" 3 => "G.J. Simon" 4 => "H.O. Lloyd" 5 => "D.J. Najafi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Refract Surg" "fecha" => "2000" "volumen" => "16" "paginaInicial" => "414" "paginaFinal" => "430" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10939721" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0110" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Change in epithelial thickness profile 24<span class="elsevierStyleHsp" style=""></span>hours and longitudinally for 1 year after myopic LASIK: Three-dimensional display with Artemis very high-frequency digital ultrasound" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.Z. Reinstein" 1 => "T.J. Archer" 2 => "M. Gobbe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3928/1081597X-20120127-02" "Revista" => array:6 [ "tituloSerie" => "J Refract Surg" "fecha" => "2012" "volumen" => "28" "paginaInicial" => "195" "paginaFinal" => "201" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22301100" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0115" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epithelial thickness in the normal cornea: three-dimensional display with Artemis very high-frequency digital ultrasound" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D.Z. Reinstein" 1 => "T.J. Archer" 2 => "M. Gobbe" 3 => "R.H. Silverman" 4 => "D.J. Coleman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3928/1081597X-20080601-05" "Revista" => array:6 [ "tituloSerie" => "J Refract Surg" "fecha" => "2008" "volumen" => "24" "paginaInicial" => "571" "paginaFinal" => "581" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18581782" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0120" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "In vivo three-dimensional corneal epithelium imaging in normal eyes by anterior-segment optical coherence tomography: a clinical reference study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.J. Kanellopoulos" 1 => "G. Asimellis" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/ICO.0b013e3182a15cee" "Revista" => array:6 [ "tituloSerie" => "Cornea" "fecha" => "2013" "volumen" => "32" "paginaInicial" => "1493" "paginaFinal" => "1498" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24042485" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0125" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multiple linear regression analysis of the impact of corneal epithelial thickness on refractive error post corneal refractive surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Cho" 1 => "O. Hieda" 2 => "K. Wakimasu" 3 => "K. Yamamura" 4 => "T. Yamasaki" 5 => "Y. Nakamura" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Ophthalmol" "fecha" => "2019" "volumen" => "22" "paginaInicial" => "1" "paginaFinal" => "16" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0130" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epithelial and corneal thickness measurements by in vivo confocal microscopy through focusing (CMTF)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H.F. Li" 1 => "W.M. Petroll" 2 => "T. Møller-Pedersen" 3 => "J.K. Maurer" 4 => "H.D. Cavanagh" 5 => "J.V. Jester" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1076/ceyr.16.3.214.15412" "Revista" => array:6 [ "tituloSerie" => "Curr Eye Res" "fecha" => "1997" "volumen" => "16" "paginaInicial" => "214" "paginaFinal" => "221" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9088737" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0135" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reproducibility and daytime-dependent changes of corneal epithelial thickness and whole corneal thickness measured with Fourier domain optical coherence tomography" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Wasielica-Poslednik" 1 => "W. Lisch" 2 => "K. Bell" 3 => "V. Weyer" 4 => "N. Pfeiffer" 5 => "A. Gericke" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/ICO.0000000000000714" "Revista" => array:6 [ "tituloSerie" => "Cornea" "fecha" => "2016" "volumen" => "35" "paginaInicial" => "342" "paginaFinal" => "349" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26751987" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0140" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Correlation of sex and myopia with corneal epithelial and stromal thicknesses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B.J. Kim" 1 => "I.H. Ryu" 2 => "J.H. Lee" 3 => "S.W. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/ICO.0000000000000850" "Revista" => array:6 [ "tituloSerie" => "Cornea" "fecha" => "2016" "volumen" => "35" "paginaInicial" => "1078" "paginaFinal" => "1083" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27227393" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0145" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Corneal epithelial thickness intrasubject repeatability and its relation with visual limitation in keratoconus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Vega-Estrada" 1 => "M. Mimouni" 2 => "E. Espla" 3 => "J. Alió del Barrio" 4 => "J.L. Alio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ajo.2019.01.015" "Revista" => array:6 [ "tituloSerie" => "Am J Ophthalmol" "fecha" => "2019" "volumen" => "200" "paginaInicial" => "255" "paginaFinal" => "262" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30689987" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0150" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Corneal epithelial thickness profile in the diagnosis of keratoconus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.Z. Reinstein" 1 => "T.J. Archer" 2 => "M. Gobbe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3928/1081597X-20090610-06" "Revista" => array:6 [ "tituloSerie" => "J Refract Surg" "fecha" => "2009" "volumen" => "25" "paginaInicial" => "604" "paginaFinal" => "610" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19662917" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0155" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Subclinical keratoconus detection by pattern analysis of corneal and epithelial thickness maps with optical coherence tomography" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Y. Li" 1 => "W. Chamberlain" 2 => "O. Tan" 3 => "R. Brass" 4 => "J.L. Weiss" 5 => "D. Huang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jcrs.2015.09.021" "Revista" => array:6 [ "tituloSerie" => "J Cataract Refract Surg" "fecha" => "2016" "volumen" => "42" "paginaInicial" => "284" "paginaFinal" => "295" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27026454" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0160" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Role of the corneal epithelium measurements in keratorefractive surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.Q. Salomão" 1 => "A.L. Hofling-Lima" 2 => "B.T. Lopes" 3 => "A.L.C. Canedo" 4 => "D.G. Dawson" 5 => "R. Carneiro-Freitas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/ICU.0000000000000379" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Ophthalmol" "fecha" => "2017" "volumen" => "28" "paginaInicial" => "326" "paginaFinal" => "336" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28399067" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0165" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Wavefront-optimized ablation profiles" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Mrochen" 1 => "C. Donitzky" 2 => "C. Wüllner" 3 => "J. Löffler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jcrs.2004.01.026" "Revista" => array:6 [ "tituloSerie" => "J Cataract Refract Surg" "fecha" => "2004" "volumen" => "30" "paginaInicial" => "775" "paginaFinal" => "785" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15093638" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0170" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relationship between central epithelial thickness and central corneal thickness in healthy eyes and eyes after laser in situ keratomileusis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D.S. Maltsev" 1 => "E.V. Kudryashova" 2 => "A.N. Kulikov" 3 => "A.Y. Mareichev" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/ICO.0000000000001568" "Revista" => array:6 [ "tituloSerie" => "Cornea" "fecha" => "2018" "volumen" => "37" "paginaInicial" => "1053" "paginaFinal" => "1057" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29543664" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0175" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Refractive and topographic errors in topography-guided ablation produced by epithelial compensation predicted by 3D Artemis VHF digital ultrasound stromal and epithelial thickness mapping" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.Z. Reinstein" 1 => "T.J. Archer" 2 => "M. Gobbe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3928/1081597X-20120815-02" "Revista" => array:6 [ "tituloSerie" => "J Refract Surg" "fecha" => "2012" "volumen" => "28" "paginaInicial" => "657" "paginaFinal" => "663" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22947295" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0180" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Corneal thickness, epithelial thickness and axial length differences in normal and high myopia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "X. Wang" 1 => "J. Dong" 2 => "Q. Wu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12886-015-0039-6" "Revista" => array:6 [ "tituloSerie" => "BMC Ophthalmol" "fecha" => "2015" "volumen" => "15" "paginaInicial" => "49" "paginaFinal" => "53" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25947156" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0185" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epithelial thickness profile changes induced by myopic LASIK as measured by Artemis very high-frequency digital ultrasound" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.Z. Reinstein" 1 => "S. Srivannaboon" 2 => "M. Gobbe" 3 => "T.J. Archer" 4 => "R.H. Silverman" 5 => "H. Sutton" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3928/1081597X-20090422-07" "Revista" => array:6 [ "tituloSerie" => "J Refract Surg" "fecha" => "2009" "volumen" => "25" "paginaInicial" => "444" "paginaFinal" => "450" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19507797" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0190" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of corneal epithelial thickness measurement between Fourier-domain OCT and very high-frequency digital ultrasound" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D.Z. Reinstein" 1 => "T.E. Yap" 2 => "T.J. Archer" 3 => "M. Gobbe" 4 => "R.H. Silverman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3928/1081597X-20150623-01" "Revista" => array:6 [ "tituloSerie" => "J Refract Surg" "fecha" => "2015" "volumen" => "31" "paginaInicial" => "438" "paginaFinal" => "445" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26186562" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000009500000011/v1_202011010626/S2173579420300864/v1_202011010626/en/main.assets" "Apartado" => array:4 [ "identificador" => "5816" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000009500000011/v1_202011010626/S2173579420300864/v1_202011010626/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579420300864?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 5 | 1 | 6 |
| 2021 February | 2 | 0 | 2 |
