PurposeTo study the intraoperative complications of refractive small incision lenticule extraction (ReSMILE push-up technique), and to record the mean intraoperative duration time of all surgeries for the refractive surgeon in his early learning curve.SettingEbsar Eye Center, Benha, Egypt.DesignA prospective, single-center, cohort clinical study.MethodsThis prospective, single-center, cohort clinical study was done on patients with myopia and myopic astigmatism, who were enrolled for SMILE surgeries. All the SMILE operations were performed by a single refractive surgeon (AMH), by using only the ReSMILE push-up technique.ResultsA total of 190 eyes were operated upon, using the (ReSMILE push-up technique), with a mean follow-up period of 2 months. The intraoperative complications have been recorded for all patients. The mean operative duration of all cases was 4.45±1.45 minutes.ConclusionThe ReSMILE: push-up technique seems to facilitate visualization of the edge of the lenticule of the SMILE surgery, especially for the refractive surgeon in his early learning curve.
Aim To evaluate predictability, safety, efficacy, and visual outcome of StreamLight. ™ (SL.), the newly released single-step transepithelial photorefractive keratectomy platform by Alcon WaveLight™ (WL). Methods In this prospective cohort study, photorefractive keratectomy (PRK) was conducted on 500 eyes of 250 patients seeking myopic refractive vision correction. The new single-step transepithelial PRK method was applied, using the SL. platform installed in the WL. Ex 500 excimer laser machine. Patients were followed up to monitor intensity and duration of postoperative pain, as well as speed of epithelial healing in the early post-operative period and visual acuity, postoperative refraction and development of postoperative haze for one year post-operatively. Results Average pain duration was 1.5 days, and the mean pain intensity score on a scale of 0–10 was 3.74 + 1.51. Mean postoperative spherical equivalence was 0.01 ± 0.38 D, and the final postoperative uncorrected distance visual acuity (UCDVA) was 20/20 in 98% of eyes included in this study. None of the eyes lost more than one Snellen chart line or developed visually significant postoperative haze during the follow-up period. Conclusion The new SL. platform for transepithelial PRK is a safe, accurate platform, offering an easier early post-operative recovery, with no compromise in final visual outcome.
The study was conducted as a retrospective non-comparative analysis of the records of 105 eyes of 53 patients treated by the SMILE with a dualincisions technique for a mean spherical myopic error of −5.05 ± 1.93 D (range: −1.38 to −9.0 D) with or without astigmatism and the mean astigmatism of −0.90 ± 0.83 D. The mean LogMAR corrected distance visual acuity (CDVA) was −0.04 ± 0.07. Results: One month after surgery, the mean refractive error was −0.03 ± 0.56 D (range: 0.88 to −1.50 D), and the mean postoperative astigmatism was 0.20 ± 0.31 D. The mean LogMAR UDVA was 0.07 ± 0.18 in the last follow-up visit, 12 months after surgery. At the end of the follow-up period, approximately 91.43% of patients had unchanged CDVA or gained one or more lines, 8.57% lost one line of CDVA, and 0.0% lost 2 lines. Conclusion: SMILE with dual-incisions is effective and safe, with a stable and predictable outcome for correction of myopia and myopic astigmatism.
Purpose To assess the stability, safety, predictability, and efficacy of topography-guided myopic Femto-LASIK with two different treatment protocols. Setting Ebsar Eye center, Benha, Qalyopia, Egypt. Design Single-center, retrospective, COHORT control study. Methods A total of 330 eyes enrolled in the study in group A and 322 eyes enrolled in group B underwent uncomplicated primary bilateral topography-guided Femto-LASIK. Group A was treated with the subjective clinical refraction; however, group B was treated with the modified refraction according to ALCON protocol. Results The mean preoperative refractive spherical equivalent (MRSE) was −4.85±1.90D and −5.0±1.93D in group A and B, respectively (P = 0.86), and a cylinder of −0.95±0.80 D and −0.92±0.81D, respectively. At the 12 months’ postoperatively, the residual manifest SE within ± 0.5D was achieved by 82.86% of eyes in group A compared to 83.93% in group B. Of eyes, 92.06% had ≤0.5 astigmatism dioptre, while 100% of eyes had ≤1.0 astigmatism dioptre in group A (315 eyes); however, 91.80% of eyes had ≤0.5 astigmatism dioptre, while 100% of eyes had ≤1.0 astigmatism dioptre in group B. Conclusion Topographic modification of the magnitude and axis of astigmatism treated using ALCON protocol when different from the clinical refraction may offer good refractive outcomes when we apply the Alcon precalculation considerations.
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