Posters

Comparative analysis of long-term results in extra-high myopia correction with sub-Bowman’s femto-keratomileusis and tissue-saving ablation (SBFK&TSA) and phakic IOL implantation

Poster Details

First Author: N.Maychuk RUSSIA

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

Abstract Details

Purpose:

To evaluate and compare the five-year clinical results of optical rehabilitation of patients with extra-high myopia, corrected by Sub-Bowman’s Femto-Keratomileusis & Tissue Saving Ablation (SBFK&TSA) and Phakic IOL implantation

Setting:

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

Methods:

Group 1- 57 eyes with mean SE -12.21±1.77D, mean central corneal thickness (CCT) – 587.4±11.2μm were operated with SBFK&TSA: 90 μm corneal flaps were created with FS-laser Femto LDV Z6 (Ziemer SIE AG Surgical Instrument Engineering, Switzerland), TSA was performed at excimer laser MicroScan-Visum 500 Hz (OptoSystems, Russia). Minimal calculated residual stromal thickness was 300 μm. Group 2- 44 eyes with mean SE -11.12±1.56D, mean CCT 497.8±11.2 μm were operated with ICL V4 (STAAR Surgical, Switzerland) phakic IOL implantation. Examination before and 5 years post-operatively included UCVA, BSCVA, efficacy, safety, accuracy, SE, corneal topography, Scheimpflug tomography were performed.

Results:

Mean SE decreased from -12.21±1.11 to -1.24±0.43D in Group1, from -11.12±1.56D to -0.89±0.66D in Group2. UCVA increased from 0,02±0,01 to 0,74±0,28 in Group1, from 0.03±0.01 to 0.84±0.16 in Group2; BSCVA from 0,86±0,15 to 0,97±0,06 in Group1, from 0.84±0.16 to 0.96±0.07 in Group2. No lost lines of BSCVA was noticed, in 59.6% in Group1 and in 68.2% in Group2 eyes gained ≥1 lines. 84.2% in Group1 and 86.4% in Group2 were ±0.5D of intended SE. No corneal ectasia, clinically significant cataract or glaucoma was detected. 70.2% in Group1 and 54.5% in Group2 complained on unwanted visual effects in mesopic condition.

Conclusions:

Both technologies of extra-high myopia correction seem to be safe and effective methods of refractive rehabilitation, providing highly predictable, stable results and low complication rate in long-term follow-up. Both technologies require a thorough preoperative examination with exception of patients with contraindications and in each case should choose the most appropriate technology. Both technologies induce undesirable visual effects in mesopic condition (more often SBFK&TSA), which requires requires prior patient information. Despite the absence of a clinically significant cataract, 38.7% of the eye had native lens-IOL contact with the detection of its local opacity, which requires further monitoring of these patients.

Financial Disclosure:

None