Lenticule intrastromal keratoplasty (LIKE) for hyperopia correction: 1 year follow-up

Session Details

Session Title: SMILE

Session Date/Time: Sunday 23/09/2018 | 16:30-18:00

Paper Time: 17:42

Venue: Room A3, Podium 2

First Author: : T.Seiler SWITZERLAND

Co Author(s): :    P. Krishna   G. Bhavatharini   T. Seiler              

Abstract Details

Purpose:

Current surgical hyperopia correction includes hyperopic LASIK (≤3.0 D) and phakic IOLs (anterior chamber depth, ACD ≥3.0mm). Hyperopic corrections of more than 3D in eyes with shallow anterior chamber are currently problematic. Here, we document the 1 year-results of lenticule intrastromal keratoplasty (LIKE) for hyperopia correction of more than 3 diopters.

Setting:

Institut für Refraktive und Ophthalmo-Chirugie (IROC), Zürich, Switzerland and LV Prasad Eye Institute, Hyderabad, India

Methods:

Ten eyes of 10 patients were treated and followed for at least 1 year. Intended correction ranged from +3.0 to +9.0 diopters, all eyes had an ACD ≤3.0mm. The lenticules (Ø=7.5mm) were produced using a special mechanical microkeratome (Gebauer Medizintechnik, Germany) from human donor corneas not suitable for transplantation containing an intact Bowman´s layer at the anterior surface. The lenticules were positioned under a LASIK-flap with a diameter of 9.5mm and centered on the middle between first Purkinje-image and center of the mesopic pupil. The eyes received postoperatively a bandage lens for 24 hours loaded with dexamethasone and antibiotic.

Results:

Surgery and early post-operative follow-up were uneventful. Repositioning of the lenticule was necessary in 2 eyes at day 1 after surgery, in one eye the lenticule was replaced because of haze 2+. Four eyes showed DLK II which resolved after steroid therapy. At 1 month, 6 eyes (60%) received a re-lift for topography-guided correction of residual refractive error on the lenticule using an excimer laser (Amaris 1050RS, Schwind, Germany). At 12 months, 9 eyes (90%) were within ±1.0D from target refraction. Two eyes had discrete non-progressive epithelium ingrowth. Corneal topography showed an OZ of 7.0mm without a significant gradient.

Conclusions:

This first prospective series of hyperopic correction using LIKE serves as a pilot study to prove the concept regarding refractive success and absence of serious complications. Advantages of LIKE include easy reversibility and the option of refractive fine tuning by means of topography-guided photoablation on the lenticule. These currently good results encourage us to go forward with a phase II-study.

Financial Disclosure:

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