Preliminary evaluation of hyperopic SMILE in amblyopic eyes

Session Details

Session Title: Femtosecond Small Lenticule Extraction II

Session Date/Time: Tuesday 08/09/2015 | 16:30-18:30

Paper Time: 17:46

Venue: Room 17

First Author: : T.Yap UK

Co Author(s): :    T. Yap   D. Reinstein   G. Carp   T. Archer   M. Gobbe   R. Khan     

Abstract Details

Purpose:

To evaluate optical quality and centration outcome measures of small incision lenticule extraction (SMILE) for hyperopia.

Setting:

Tilganga Institute of Ophthalmology, Kathmandu, Nepal.

Methods:

Prospective study of vertex-centered hyperopic SMILE using the VisuMax femtosecond laser (Carl Zeiss Meditec). Inclusion criteria were intended sphere ≤+7D, astigmatism ≤6D, age ≥21 years, and CDVA 20/100 or worse. Lenticule parameters were 6.3-mm diameter, 2-mm transition zone, 30-μm minimum thickness, and 120-μm cap thickness. Retinoscopic refraction and Atlas topography were obtained before and 1 month after surgery, available in 11 eyes at time of writing. Refractive predictability, optical zone centration, optical zone diameter, and change in corneal spherical aberration were analyzed and compared to MEL80 LASIK matched control groups for optical zone 6.5-mm and 7-mm (transition 2-mm).

Results:

Mean SEQ was +4.68±1.30D (+3.00 to +6.42D). Mean astigmatism was 1.09±0.65D (0.50 to 2.75D). Mean postop SEQ was +0.10±0.91D (-1.16 to +1.50D); 27% ±0.50D and 82% ±1.00D. Mean spherical aberration change was -0.49-μm in 6.3-mm, SMILE, equivalent to 7-mm LASIK (-0.47-μm, p=0.916), but less than 6.5-mm LASIK (-0.79-μm, p=0.002). Mean optical zone offset was equal for all groups (p>0.73); 0.30±0.18-mm in SMILE, 0.34±0.26-mm in 7-mm LASIK, and 0.29±0.15-mm in 6.5-mm LASIK. Mean achieved optical zone diameter was 5.55±0.35-mm in 6.3-mm SMILE; larger than 6.5-mm LASIK (4.65±0.18-mm, p<0.001) and 7-mm LASIK (4.93±0.32-mm, p<0.001).

Conclusions:

Optical zone centration was equivalent between vertex-centered hyperopic SMILE and LASIK. Less spherical aberration was induced by 6.3-mm SMILE than 6.5-mm LASIK and was equivalent to 7-mm LASIK. Achieved topographic optical zone diameter was larger for 6.3-mm SMILE than 6.5 and 7-mm LASIK. Refraction change by retinoscopy appeared relatively accurate although longer term sighted eye studies will be required to refine nomograms and balance these with observed regression.

Financial Interest:

One of the authors receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented