Transepithelial Photorefractive Keratektomy after a Clear Lens Exchange

Ortueta, Diego de

doi:10.3390/vision5010008

Cited by 5 publications

(20 citation statements)

References 27 publications

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“…A potential solution to increase patient satisfaction after cataract surgery is a lens-based procedure (IOL exchange or piggyback IOL implantation) [ 2 , 17 – 25 ], in which the original cataract wound is reopened to repair the residual refractive error immediately after cataract surgery. Subsequently, another IOL can be implanted (IOL replacement), changing the lens immediately after the first surgery, but there is a risk of posterior capsule defect formation, glaucoma, zonular defect formation, endothelial damage, or postoperative pigment dispersion, which occurs when the dorsal lens rubs against the posterior surface of the iris; furthermore, endophthalmitis can occur during these procedures.…”

Section: Discussionmentioning

confidence: 99%

SMILE for the Treatment of Residual Refractive Error After Cataract Surgery

Semiz¹,

Lokaj²,

Musa³

et al. 2022

Ophthalmol Ther

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Introduction In the context of managing patients’ expectations and satisfaction regarding visual acuity after cataract surgery, we aimed to investigate the improvement in visual acuity and patient satisfaction after small-incision lenticule extraction (SMILE) in pseudophakic (trifocal intraocular lens, IOL) patients with residual myopic refraction after cataract surgery. Methods Seventy-six patients (82 eyes) who underwent cataract surgery with ZEISS AT LISA tri 839MP IOL implantation were included in this retrospective study. The included patients were 56–79 years old, wanted spectacle independence, and had preoperative myopic refraction between − 1.0 and − 2.25 diopters (D) and astigmatism between − 0.75 and − 1.75 D. The treatment status of these patients was defined as trifocal IOL ( n = 82). SMILE was performed in patients who were dissatisfied after cataract surgery, and these patients were followed up for 1 year on average. We evaluated visual acuity and satisfaction and further examined laser vision correction and satisfaction levels in patients who were dissatisfied after trifocal IOL implantation. Results The possible reasons for patient dissatisfaction were reading books, using a computer, and driving at night. After SMILE, the residual myopic refractive error (spherical) decreased significantly from − 2.08 ± 0.28 [− 2.25 to − 1.0] preoperatively to − 0.25 ± 0.20 − 0.5 to 0] 1 year postoperatively ( p < 0.001). Additionally, the uncorrected distance visual acuity increased from 0.65 ± 0.08 [0.52–0.7] logMAR preoperatively to 0.09 ± 0.02 [0.05–0.1] logMAR at 1 month postoperatively ( p < 0.001), 0.09 ± 0.02 [0.05–0.1] logMAR at 6 months postoperatively, and 0.06 ± 0.02 [0.05–0.1] logMAR at 12 months postoperatively ( p < 0.001). Patient satisfaction measures after SMILE (reading, night driving, and using a computer) were significantly improved. Conclusion SMILE is a reliable method for treating residual refraction after cataract surgery, as it provides results in the shortest time without complications and increases patient satisfaction. Trial Registration The protocol was registered on clinicaltrials.gov (NCT04693663).

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Section: Discussionmentioning

confidence: 99%

SMILE for the Treatment of Residual Refractive Error After Cataract Surgery

Semiz¹,

Lokaj²,

Musa³

et al. 2022

Ophthalmol Ther

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“…It also produces a smoother and more uniform stromal bed contour than mechanical PRK, which reduces postoperative corneal haze [ 20 ]. SPT is a new Amaris laser platform software that reduces irregularities in the corneal stroma after stromal ablation, allowing for faster re-epithelization and visual recovery, particularly in the first few days after treatment with a lower incidence of postoperative corneal haze [ 17 , 21 ]. MMC is used to reduce the possibility of inflammation, and subsequently, corneal haze, as any change in corneal epithelium could affect the results [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

SmartSurfACE transepithelial photorefractive keratectomy with mitomycin C enhancement after small incision lenticule extraction

Gab-Alla

2021

Eye and Vis

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Background To evaluate predictability, stability, efficacy, and safety of transepithelial photorefractive keratectomy (TPRK) using smart pulse technology (SPT) (SmartSurface procedure) of Schwind Amaris with mitomycin C for correction of post small incision lenticule extraction (SMILE) myopic residual refractive errors. Method This study is a prospective, non-comparative case series conducted at a private eye centre in Ismailia, Egypt, on eyes with post-SMILE myopic residual refractive errors because of undercorrection or suction loss (suction loss occurred after the posterior lenticular cut and the creation of side-cuts; redocking was attempted, and the treatment was completed in the same session with the same parameters) with myopia or myopic astigmatism. The patients were followed up post-SMILE for six months before the SmartSurface procedure, and then they were followed up for one year after that. TPRK were performed using Amaris excimer laser at 500 kHz. The main outcomes included refractive predictability, stability, efficacy, safety and any reported complications. Results This study included 68 eyes of 40 patients out of 1920 total eyes (3.5%) with post-SMILE technique myopic residual refractive errors. The average duration between the SMILE surgery and TPRK was 6.7 ± 0.4 months (range 6 to 8 months). The mean refractive spherical equivalent (SE) was within ± 0.50 D of plano correction in 100% of the eyes at 12 months post-TPRK. Astigmatism of < 0.50 D was achieved in 100% of the eyes. The mean of the residual SE error showed statistically significant improvement from preoperative − 1.42 ± 0.52 D to 0.23 ± 0.10 D (P < 0.0001). Uncorrected distance visual acuity (UDVA) (measured by Snellen's chart and averaged in logMAR units) was improved significantly to 0.1 ± 0.07 (P < 0.0001). UDVA was 0.2 logMAR or better in 100% of the eyes, 0.1 logMAR or better in 91.2% of the eyes, and 0.0 logMAR in 20.6% of the eyes. Corrected distance visual acuity (CDVA) remained unchanged in 79.4% of eyes. 14.7% of eyes gained one line of CDVA (Snellen). 5.9% of eyes gained two lines of CDVA (Snellen). Conclusion Transepithelial photorefractive keratectomy using smart pulse technology with mitomycin C enhancement after SMILE is a safe, predictable, stable, and effective technique.

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“…The SmartPulse Allocation laser technology with 7D eye tracking system introduced by Schwind is aimed at making the final corneal surface smoother and aberration free. 16 , 17 These innovations are applicable for the correction of myopia, hyperopia, and astigmatism, as claimed by the manufacturers. The iRes excimer laser (iVisTechnologies, Taranto, Italy) is another such technology for Trans PRK using Corneal Interactive Programmed Topographic Ablation software (CIPTA ® 2, iVIS Technologies, Taranto, Italy).…”

Section: Historical Perspectivementioning

confidence: 99%

“…Ortueta et al has mentioned usage of 1050 Hz infrared eye tracker centred on corneal vertex with torsion tracking, which had a response time of 1.7 milliseconds as the patients focused on a green fixation light. 17 …”

Section: Surgical Techniquementioning

confidence: 99%

Transepithelial Photorefractive Keratectomy for Hyperopia Correction: An Uncharted Territory

Sabhapandit,

Abdussamad,

Shaik

et al. 2023

OPTH

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Transepithelial photorefractive keratectomy (Trans PRK) is a relatively new technology for refractive surgery and has shown promising results in myopia correction. The data on hyperopia correction by this method are limited. In this review, we have attempted to understand the outcomes of this technology on hyperopic eyes. There are comparable results with conventional PRK and laser in situ keratomileusis (LASIK) as far as refractive stability, regression rate, predictability, and post-operative complications are concerned. The best results have been obtained in lower hyperopic corrections. In moderate to higher hyperopia, the limited data available show higher regression, unstable visual outcomes, and increased stromal haze. There is a need to evaluate the technology further to understand its success for hyperopic refractive surgery.

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Transepithelial Photorefractive Keratektomy after a Clear Lens Exchange

Cited by 5 publications

References 27 publications

SMILE for the Treatment of Residual Refractive Error After Cataract Surgery

SMILE for the Treatment of Residual Refractive Error After Cataract Surgery

SmartSurfACE transepithelial photorefractive keratectomy with mitomycin C enhancement after small incision lenticule extraction

Transepithelial Photorefractive Keratectomy for Hyperopia Correction: An Uncharted Territory

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