To compare the influence of the LASIK and ReLEx SMILE refractive method on tear osmolarity Methods: Prospective non-randomized comparative study. We evaluated the results in two groups of patients who underwent binocular refractive surgery to remove myopia and possibly astigmatism in the eye clinic of Horní Počernice. In each group were 15 patients (30 eyes), patients of one group undergoing FS-LASIK refractive surgery, in the second group a ReLEx SMILE procedure. Bilateral measurement of the tear film osmolarity using the TearLab instrument on the day of surgery, the first day after surgery, one month and 3 months after surgery was performed on each patient. Results: The mean preoperative value of the osmolarity of the tear film was practically the same in both groups, in the ReLEx SMILE group 294.9 ± 13.4 mOsm/l and in the FS-LASIK group 296.4 ± 13.1. One and three months after the surgery in the ReLEx SMILE group, these values increased to 301.4 and 296.4 ± 13.3 mOsm/l respectively, the elevation of values one month after surgery was statistically significant. In the FS-LASIK group, one month after surgery, the osmolarity was 320.1 ± 14.7, three months postoperatively 306.5 ± 13.1 mOsm / l. Both of these values compared to the preoperative value were statistically significantly higher. The increase of the mean osmolarity was statistically significantly higher in the FS-LA-SIK group compared to the ReLEx SMILE. Three months after surgery, the difference between groups was not statistically significant. Conclusion: In our group of patients, after the FS-LASIK refraction procedure, we noted a higher mean osmolarity of tear film in comparison with patients after the ReLEx SMILE in all evaluated timepoints (1 day, 1 month and 3 months after surgery). We consider ReLEx SMILE as a method with less impact on the quality of tear film, with a faster return to original osmolarity and potentially higher patient comfort.
Background and Aims. Refractive eye surgery is a rapidly expanding field of ophthalmology and corneal surgery is undergoing constant development leading to less invasive technologies. The goal of this study was to compare the most common femtoLASIK surgery with the newer ReLEx SMILE surgery which is gentler to the cornea. The comparison was made in terms of dioptric error reduction. Methods. The studied cohort of patients consisted of two major groups: 30 patients who underwent femtoLASIK surgery and 30 who underwent ReLEx SMILE surgery. -30 patients, 60 eyes. All patients were aged 18-45 years with moderate myopia or astigmatism ranging from -3.25 to -6.0 spherical diopters and from 0 to -1.0 cylindrical diopters. In all, the best corrected visual acuity measured prior to surgery was 1.0. Pachymetry was not comparable because each surgical method was performed at a different time point and the introduction of an innovative method into practice led to a change in selection criteria. Results. During postsurgical check-ups, the ReLEx SMILE method (0.74) led to lower values of non-corrected visual acuity compared to the femtoLASIK method (0.88), (P<0.001). However, the results changed at the one-year post-surgery check-up, when ReLEX SMILE patients achieved non-corrected visual acuity of 0.97 compared to femtoLASIK patients, who scored 0.83, (P=0.007). Based on data analysis from the automatic refractometer, the average spherical diopters of the femtoLASIK (-0.32 D) were higher than those of the ReLEx SMILE (-0.07 D), (P<0.001). The results for the cylindrical diopters were also significant, (P=0.021). When we compared the spherical equivalent one year after surgery, the difference between methods was significant. The FemtoLASIK method resulted in an average SE -0.55 D compared to -0.09 D for the ReLEx SMILE method, (P<0.001). Conclusion. This study showed that there was a significant difference in results between the two surgical methods of treatment of moderate myopia and astigmatism, in terms of regression of dioptric error, as well as in achievement and maintenance of visual acuity during the observed period. The ReLEx SMILE had better results.
Purpose. To evaluate the safety and efficacy of using corneal stromal lenticules (CSLs) obtained during refractive surgery Refractive Lenticule Extraction (ReLEx) with the Small Incision Lenticule Extraction (SMILE) procedure for the treatment of corneal ulcers. Methods. This retrospective study included 12 eyes of 12 patients, 7 men and 5 women with varying degrees of corneal ulcer. The mean age was 64 ± 18 (range 34 to 95 years). The monitoring included corrected distance visual acuity (CDVA), slit-lamp biomicroscopy examination, a Seidel test, stability of the graft and anterior segment optical coherence tomography (AS-OCT) inspection. Patients were closely monitored for possible postoperative complications for at least 6 months. Results. In 7/12 (58%) eyes, the corneal ulcer was successfully sealed with CSL and amniotic membrane (AM) without the need for any additional surgical intervention. In 3 eyes, penetrating keratoplasty (PK) was needed in addition to CSL transplantation and in 2 eyes the scleral patch was used to fully seal after CSL transplantation. During the followup period no signs of rejection or infection were detected in any patient. Conclusion. The use of CSLs from ReLEx SMILE may be considered as an alternative method for the treatment of corneal ulcers before a more extensive and definitive solution -PK -is used. Our preliminary findings suggest that properly performed CSL transplantation using cryopreserved lenticules is a safe and effective method to temporarily cover the corneal partial-thickness defect or even perforation.
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