Corneal ectasia after 10,000 ReLEx SMILE operations

Session Details

Session Title: Keratoconus & Secondary Ectasia

Session Date/Time: Sunday 15/09/2019 | 08:00-10:00

Paper Time: 08:57

Venue: Free Paper Forum: Podium 2

First Author: : A.Kachanov RUSSIA

Co Author(s): :    S. Nikulin   T. Churakov   S. Bauer   V. Kornikov   B. Zimin                 

Abstract Details

Purpose:

To examine the first cases of corneal ectasia after performing 10,000 ReLEx® SMILE operations for myopia correction in one refractive surgery department.

Setting:

1 – St.-Petersburg branch of Sv. Fyodorov “Eye Microsurgery Clinic”, 2 – North-Western State Medical University named after I.I. Mechnikov, ³ – Saint-Petersburg State University, ⁴ – Baltic Technical University; St.-Petersburg, Russia.

Methods:

All cases of corneal ectasia in the eyes of patients who had been operated on ReLEx® SMILE technology in our department of refractive surgery from January 2013 to January 2019 were analyzed. The SMILE was performed on 10,394 eyes of 5,223 patients (~37% of men and ~67% women of them) with low, moderate and high myopia with the spherical component up to -10,0 D and astigmatism up to -5,0 D by using a femtosecond laser VISUMAX (“Carl Zeiss Meditec”). All patients selected for the myopic correction had NO contraindications for ReLEx® SMILE (including corneal topography data).

Results:

Corneal ectasia after SMILE surgery was observed on 6 eyes (0.058% of all operated eyes) of 3 patients (0.057% of all operated patients / 2 men and 1 women). The age of the patients at the time of the SMILE ranged from 29 to 39 years. Cornea ectasia was detected for the first time in periods ranging from 13 months to 47 months ( after SMILE operation. Pre-op sphere-equivalent (SE) of the patients with post-op corneal ectasia was 4,12 ± 1,18 D. The authors used the Randleman scale and Santiago formula to assess the risk of post-SMILE corneal ectasia developing.

Conclusions:

Despite the fact that the ReLEx® SMILE technology refers to flapless operations (as a PRK), after SMILE can be noted such complication as corneal ectasia, which is much more often described after different variants of LASIK operations. Cornea ectasia after SMILE occurred on the eyes without signs of primary keratoconus and without contraindications to SMILE. The incidence of corneal ectasia after SMILE surgery in our study (0,058%) was comparable to that after LASIK surgery.

Financial Disclosure:

None