PURPOSE:
To investigate the potential benefit of keratoconus surgery using customized corneal stromal donor lenticules obtained from myopic small incision lenticule extraction (SMILE) surgery by femtosecond laser.
METHODS:
In this prospective, consecutive, non-comparative series of cases, 22 lenticules were obtained from 22 myopic patients who had SMILE with a lenticule central thickness of greater than 110 µm. The lenticules were implanted in 22 eyes with advanced keratoconus. The lenticules were customized for the purpose of the implantation with either a simple necklace or necklace-with-ring shape (compound form) depending on the corneal thickness and corneal topography configuration of the implanted keratoconic eyes. The lenticules were implanted into a 9.5-mm corneal lamellar pocket created by the femtosecond laser. Changes in densitometry, thickness, confocal microscopy, corrected distance visual acuity (CDVA), and endothelial cell density were investigated.
RESULTS:
Intrastromal lenticule implantation was successfully performed in all cases without any complication. Corneal thickness showed a mean enhancement of 100.4 µm at the thinnest point. On biomicroscopy, all corneas were clear at 1 year postoperatively and there was a significant improvement in corneal densitometry during the entire follow-up period. Confocal biomicroscopy showed collagen reactivation without any inflammatory features caused by the implanted fresh lenticules. CDVA improved from 0.70 to 0.49 logMAR (
P
= .001) and keratometry decreased from 54.68 ± 2.77 to 51.95 ± 2.21 diopters (
P
= .006).
CONCLUSIONS:
Customized SMILE lenticule implantation by femtosecond laser proved to be feasible, resulting in an improvement in vision, topography, and refraction in the implanted eyes.
[
J Refract Surg
. 2020;36(12):786–794.]
Femto-LASIK method with Zyoptic programs after PK was safe, effective, and predictable for correction of spherical and cylindrical components of the refractive error.
Purpose:To compare two phakic intraocular lenses, Artiflex and STAAR® implantable contact lens (ICL), in high myopia.Setting:Isfahan Ophthalmology Clinic, Iran.Materials and Methods:In a randomized, prospective clinical trial study, 40 eyes of 20 patients who came to Isfahan ophthalmology clinic to correct their refractive error were examined. Artiflex was inserted in 20 eyes and ICL in the other 20 eyes. After 1 year, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), contrast sensitivity, intraocular pressure (IOP), and specular microscopy of corneal endothelium were assessed in both the groups.Results:In this study, there was no statistical difference between UCVA, BCVA, IOP, cataract incidence, contrast sensitivity, and specular microscopy, 1 year after surgery. 40% of eyes in the Artiflex group developed anterior chamber cell and flare reaction 1 year postoperatively, but no patient in the ICL group developed the same. So, there is obvious difference in the rate of anterior chamber cell and flare reaction between these two groups.Conclusion:These two lenses have similar outcomes except in the incidence rate of anterior chamber cell and flare reaction that is greater in the Artiflex group. So, these two lenses are safe with predictable outcome in treating high myopia.
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