Purpose:We aimed to present the visual results obtained in 100 small incision lenticule extraction (SMILE) refractive surgeries; demonstrate whether the technique is effective in the treatment of moderate and high myopia; and observe the follow-up of these patients over 24-month period. Methods: One hundred eyes of 50 consecutive patients were treated with SMILE. The preoperative spherical equivalent refraction was -5.64 ± 1.23 D. During the postoperative period, patients were examined at 3, 6, 12, and 24 months. We analysed the efficacy, safety, predictability, and stability of the technique.
Results:The Snellen visual acuity of 99% of the patients was 20/20 or better after 24 months of follow-up. Two eyes had a loss of two lines of visual acuity; 1% of the patients had a loss of one line of visual acuity. The postoperative spherical refraction was -0.04 ± 0.35 D (-1.00 to 0.50 D). The postoperative spherical equivalent refraction was -0.19 ± 0.38 D (-1.25 to 0.50 D). Eighty-three percent of the eyes were within ± 0.50 D, and 87% obtained a residual astigmatism of 0.50 D or less.
Conclusion:The SMILE technique was demonstrated to be an effective, predictable, safe, and stable technique in the treatment of moderate-to-severe myopia during the 24-month follow-up. Long-term follow-up should be undertaken to observe possible refractive regressions.
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PURPOSE:
To analyze the efficacy, safety, predictability, and stability in hyperopic presbyopic laser in situ keratomileusis (LASIK) surgeries with the TENEO 317 algorithm (Bausch & Lomb Technolas, Munich, Germany).
METHODS:
Eighty eyes from 40 patients who underwent hyperopic and presbyopic LASIK in this retrospective, observational, and longitudinal study were included. All patients had a 24-month follow-up. Excimer laser treatment was performed with TECNOLAS Perfect Vision GmbH TENEO 317 software version 1.25 (Bausch & Lomb) with the PROSCAN platform for the distance dominant eye and the SUPRACOR mild platform for the near dominant eye.
RESULTS:
Mean age was 53.90 ± 4.84 years (range: 42 to 66 years). Postoperative uncorrected distance visual acuity (UDVA) was 0.00 ± 0.04 (20/19.97) for the dominant eye and 0.14 ± 0.05 (20/27.65) for the non-dominant eye. Postoperative uncorrected near visual acuity was 0.51 ± 0.17 (J9) for the dominant eye and 0.09 ± 0.06 (J1.5) for the non-dominant eye, whereas 2.5% of non-dominant eyes lost two lines of corrected distance visual acuity. Half of non-dominant eyes lost one line, and 2.5% of dominant and non-dominant eyes changed 0.50 D or more between 3 and 24 months.
CONCLUSIONS:
PROSCAN surgery in the dominant eye and SUPRACOR surgery in the non-dominant eye using the TENEO 317 algorithm demonstrated that the hyperopic presbyopic excimer laser surgery technique resulted in acceptable and stable outcomes after 24 months of follow-up.
[
J Refract Surg.
2019;35(9):591–598.]
Purpose:
To analyze the efficacy, safety, predictability, and stability in myopic and astigmatic small-incision lenticule extraction (SMILE) with simultaneous prophylactic corneal crosslinking (CXL) in thin corneas.
Methods:
A total of 48 eyes from 24 patients who underwent myopic and astigmatism SMILE with simultaneous prophylactic CXL were included in this retrospective study. All patients had a 24-month follow-up. A femtosecond laser was performed with VisuMax (Carl Zeiss Meditec). CXL treatment was applied when the predicted stromal thickness was less than 330 μm.
Results:
The patients’ mean age was 31.58 ± 6.23 years. The previous mean spherical equivalent was − 6.85 ± 1.80 (−9.75 to − 2.00) D. The postoperative mean spherical equivalent was − 0.50 ± 0.26 (−1.00 to + 0.25) D; 60% of the eyes had 20/20 or better; 19% lost one line; 58% were within ± 0.50 D; and 8.3% of the eyes changed 0.50 D or more between 3 and 24 months.
Conclusion:
Prophylactic CXL with simultaneous SMILE for myopia and astigmatism femtosecond laser surgery technique appears to be partially effective, safe, predictable, and stable after 24 months of follow-up.
Binocular summation along all defocus range after a micro-monovision procedure has scarcely been studied. The aim of this pilot study was to evaluate the efficacy of SMILE combined with different levels of micro-monovision in presbyopic patients and to assess the binocular summation effect on contrast sensitivity defocus curves (CSDC) at the 6-month follow-up. Efficacy was assessed on the basis of visual acuity (VA) and stereopsis at far, intermediate, and near distances. Patient-reported outcomes (PROs) and binocular CSDC were also evaluated. Six patients completed the study with a programmed median anisometropia of 0.81 Diopter. The median binocular uncorrected VA was better than 0 logMAR at the three evaluated distances, and stereopsis was not impaired in any patient, achieving a median of ≤119 arcsec at any distance. CSDC increased binocularly after surgery, significantly in the range of −2 to −3 D (p < 0.05). No clinically relevant changes were observed in PROs compared with the preoperative period, and all patients achieved spectacle independence at intermediate/near distance and were likely or very likely to undergo the same surgery. In conclusion, micro-monovision with SMILE could be an effective procedure, with results that might be comparable to other laser correction techniques specifically designed for presbyopia correction.
The purpose of our study was to evaluate the safety, effectiveness, predictability, and stability of myopic and astigmatic laser-assisted in situ keratomileusis (LASIK) with simultaneous prophylactic corneal cross-linking (CXL) in thin corneas. In total, 100 eyes from 50 patients who were subjected to myopic and astigmatism femtosecond LASIK with simultaneous prophylactic CXL were included. The design of the study was retrospective, longitudinal, and observational. All patients had a 48-month follow-up. The MEL 80 excimer laser was utilized with the Aberration Smart Ablation platform. CXL treatment was applied when the predicted stromal thickness was less than 330 µm. Patients’ mean age was 30.22 ± 5.97 years. Previous mean spherical equivalent was −5.50 ± 1.65 (−9.50 to −1.13) diopters (D). Postoperative mean spherical equivalent was −0.24 ± 0.29 (−0.85 to +0.50) D. Visual acuity (VA) of 20/20 or better was observed in 87% of the eyes and no eyes experienced VA loss. Spherical equivalent within ±0.50 D was observed in 93% of eyes, and 4% of eyes varied by 0.50 D or more between 3 and 48 months. Prophylactic corneal cross-linking with simultaneous femtosecond laser-assisted in situ keratomileusis in thin corneas proved to be effective, safe, and predictable. The results remained stable after 48 months of follow-up.
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