Posters

Comparative analysis of clinical and functional results of FemtoLASIK and ReLEx SMILE in myopic patients with corneal neovascularization (CN) induced by contact lenses (CL)

Poster Details

First Author: N.Maychuk RUSSIA

Co Author(s):    I. Mushkova                    

Abstract Details

Purpose:

To evaluate the ocular surface (OS) condition in patients with CN induced by CL and compare clinical and functional results of refractive errors correction by FemtoLASIK and ReLEx SMILE in long term CL wearers.

Setting:

Sv. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia

Methods:

178 patients (178 eyes) with mean SE -5.21±0.77D, mean central corneal thickness (CCT) – 547.4±11.2μm, CN more than 2 mm from the limbus were examined with UCVA, BSCVA, SE, OSDI, BUTT, tear osmolarity, confocal microscopy of the cornea. Patients were treated with lubricants, local steroids, ciclosporin A, regenerative agents etc. for 1 to 3 months before achieving normalization of the initially disturbed parameters. 88 eyes were corrected with FemtoLASIK (Group1) and 90 eyes with ReLEx SMILE (Group2). Examination before and after OS treatment, 1 day, 1 week and 1 month after surgery included efficacy, safety, accuracy was performed.

Results:

Mean SE decreased after OS treatment to -4.94±0.43D, 1 month after surgery to -0,09±0.07D in Group1, to 0.08±0.06D in Group2; UCVA increased to 0,98±0,08 in Group1, to 1.02±0.06 in Group2; no lost lines of BSCVA was noticed in both groups. Intraoperative bleeding from damaged corneal vessels: 92.0% (Group1), 8.9% (Group2), sub-flap hem at 1st day post-op: 39.8% (Group1), 0 (Group2). In 8.9% in Group2 – local epithelial damage at the incision area with resulted in 1 case of epithelial ingrowth. Neurotrophic epitheliopathy: 1 day/1 month post-op.: 75.0%/19.3% (Group1) and 15.6%/4.44% (Group2). OSDI: 1 week/1 month post-op.: 36.3±9.5/19.6±7.9 (Group1) and 16.2±6.6/6.1±3.2 (Group2).

Conclusions:

OS condition normalisation resulted in slight SE decrease (not significant), but maximal difference was 1.25D, which requires repeated refraction measurement after OS pharmaceutical normalisation. Both technologies of myopia correction in patients with CN seem to be safe and effective methods of refractive rehabilitation, providing highly predictable, stable results and low complication rate. Refractive results in ReLEx SMILE group were slightly higher probably due to the better OS condition and less corneal dryness (subjective and objective). ReLEx SMILE demonstrates significantly less risk of corneal vessels damage, but a risk of epithelial damage at the incision area with possibility of epithelial ingrowth

Financial Disclosure:

None