Sub-Bowman femto-keratomileusis and tissue saving ablation: long-term results in high myopia correction

Session Details

Session Title: Photoablation, Cross-Linking and Intracorneal Ring Segment

Session Date/Time: Monday 07/09/2015 | 08:00-10:30

Paper Time: 09:48

Venue: Room 16

First Author: : N.Maychuk RUSSIA

Co Author(s): :    A. Doga   I. Mushkova   A. Demchinsky              

Abstract Details

Purpose:

To assess the long-term results of Sub-bowman Femto-Keratomileusis & Tissue Saving Ablation (SBFK & TSA) in patients with high myopia and relatively thin corneas.

Setting:

Sv. Fyodorov Eye Microsurgery Federal State Institution, Department of Laser Refractive Surgery, Moscow, Russia.

Methods:

Retrospective, non-comparative analysis of case series included 98 patients (196 eyes) after SBFK&TSA, mean age at the time of surgery was 27.1±0.66 years. Examination before and 5 years after SBFK&TSA included UCVA, BCVA, efficacy, safety, accuracy of the refractive effect, corneal confocal microscopy (KM) (ConfoScan4 (Nidek, Japan)), corneal flap thickness measuring (Visante OCT, Carl Zeiss Meditec, Inc., Germany). 90 μm corneal flaps were created with Femtosecond laser Femto LDV (Ziemer SIE AG Surgical Instrument Engineering, Switzerland). TSA was performed at the excimer laser MicroScan-Visum 500 Hz; (Optosystems, Russia). Minimal calculated residual stromal thickness was 300 μm.

Results:

Mean attempted spherical equivalent (SE) refraction was –9.48±2.79 D. Mean attempted cylinder correction was -2.3±0.92 D. Efficacy of SBFK&TSA in 5 years after surgery: 97.4% of eyes achieved UCVA 20/25 or more. Safety: No eyes have lost lines of BCVA; 41.8% of eyes gained one or more lines. Accuracy: mean deviation from the intended SE was -0.43±0.18 D. 85.7% of eyes were within 0.5D of intended SE. Mean corneal flap thickness was 87.4±3.6 μm; KM of the cornea revealed complete central optical zone reinnervation in 79.6%, local flap edge fibrosis in 49.5%. No cases of postoperative ectasia were detected.

Conclusions:

SBFK and TSA for the high myopia correction - safe and effective method of refractive rehabilitation, providing highly predictable, stable results and a low complication rate.

Financial Interest:

NONE