Posters

Management of post-SMILE ectasia with tissue addition and simultaneous pocket collagen cross-linking

Poster Details

First Author: S.Brar INDIA

Co Author(s):    S. Ganesh                    

Abstract Details

Purpose:

To describe the outcomes of 2 eyes of post SMILE ectasia managed using tissue addition and accelerated collagen cross-linking in pocket.

Setting:

Nethradhama Super Speciality Eye Hospital, Bangalore

Methods:

Two eyes of two female patients aged 23 and 28 years developed clinical and topographical features of keratectasia, in the left eyes , 2 and 3 years post SMILE procedure for myopia correction. In both cases, there was irregular astigmatism on topography and CDVA dropped to 0.50 and 0.60 logMar respectively. Both cases were managed with heterologous corneal tissue addition, using SMILE lenticules matched for SE, followed by simultaneous accelerated cross linking in the pocket.

Results:

At 2 weeks, the SE reduced from - 6 to -1.75 D in case 1, and from - 5.37 to 0.50 D in case 2, with subsequent improvement in CDVA to 0.20 LogMar in both cases. Post tissue addition, there was a reduction in steep keratometry from 52.3 to 46.3  and 44.8 to 38.4 D in case 1 and 2 respectively. There was also reduction in higher order aberrations in both cases. At 6 months, the refractive and topographic parameters remained stable compared to 2 weeks. No eye developed haze/infection or required explantation of the tissue.

Conclusions:

Tissue addition with simultaneous pocket cross linking may be a safe and feasible approach to manage post SMILE ectasia. However, long term follow-ups are required to establish its effects on corneal stabilization

Financial Disclosure:

... receives consulting fees, retainer, or contract payments from a competing company