scholarly journals Comparison of the Early Clinical Outcomes between Combined Small-Incision Lenticule Extraction and Collagen Cross-Linking versus SMILE for Myopia

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Alex L. K. Ng ◽  
Tommy C. Y. Chan ◽  
George P. M. Cheng ◽  
Vishal Jhanji ◽  
Cong Ye ◽  
...  
Keyword(s):  
Corneal Thickness ◽  
Early Postoperative Period ◽  
Safety Index ◽  
Corrected Distance Visual Acuity ◽  
Spherical Equivalent Refraction ◽  
Lenticule Extraction ◽  
Efficacy Index ◽  
Bed Thickness ◽  
The Mean ◽  
And Control

Background. To compare the early outcome of combined SMILE and collagen crosslinking (SMILE Xtra) with SMILE.Method. Prospective, comparative interventional study of 21 eyes receiving SMILE Xtra using a low energy protocol and 32 control eyes receiving SMILE only. The outcomes were compared at 1, 3, and 6 months postoperatively.Results. Both groups had myopia with spherical equivalent refraction (SEQ) > 4.00 D. The SMILE Xtra group had thinner preoperative central corneal thickness and residual stromal bed thickness (p<0.021). At 6 months, no eyes lost more than 1 line in corrected distance visual acuity. The safety index was0.96±0.06and1.00±0.00in SMILE Xtra and control, respectively (p<0.001). 89% and 94% of eyes were within ±0.50 D of target refraction, respectively, with the mean error in SEQ correction being-0.17±0.26 D for SMILE Xtra and+0.03±0.25 D for control (p=0.021). The efficacy index was0.88±0.13and0.97±0.06, respectively (p=0.005).Conclusion. SMILE Xtra had good overall safety profile and predictability at 6 months. However, when compared with control, the safety index and efficacy index were statistically significantly lower in the early postoperative period.

Comparing a new hydroexpression technique with conventional forceps method for SMILE lenticule removal

2017 ◽  
Vol 102 (8) ◽  
pp. 1122-1126 ◽  
Author(s):  
Alex L K Ng ◽  
George P M Cheng ◽  
Victor C P Woo ◽  
Vishal Jhanji ◽  
Tommy C Y Chan
Keyword(s):  
Visual Acuity ◽  
Safety Index ◽  
Distance Visual Acuity ◽  
Early Results ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity ◽  
Spherical Equivalent Refraction ◽  
Lenticule Extraction ◽  
Efficacy Index ◽  
Retrospective Comparative Study

BackgroundWe described a modified ‘hydroexpression’ technique for the lenticule removal during small-incision lenticule extraction (SMILE) surgery and compared the results with conventional forceps method.MethodsThis was a retrospective, comparative study of 50 patients who underwent SMILE surgery by the same surgeon. We compared the 1-week and 3-months postoperative results after SMILE using the hydroexpression technique with the conventional forceps technique. Main outcome measures included uncorrected distance visual acuity, corrected distance visual acuity, refractive accuracy, safety index and efficacy index.ResultsThe baseline characteristics were comparable between both groups. At postoperative 1 week, the safety index in forceps and hydroexpression group was 0.93±0.11 and 0.97±0.10, respectively (P=0.246). At 3 months, they were 1.00±0.06 and 0.99±0.09 (P=0.850). For efficacy indices, at 1 week they were 0.84±0.17 and 0.91±0.17 (P=0.158). At 3 months, they were 0.92±0.13 and 0.94±0.19 (P=0.624). All eyes aimed for a plano target. 96% in forceps group and 90% in hydroexpression group were within ±0.50 dioptre (D) in spherical equivalent refraction (SEQ) correction at postoperative 3 months (P=0.567). The mean errors of SEQ correction were −0.10±0.21 D in forceps group and −0.08±0.30 D in hydroexpression group (P=0.705).ConclusionHydroexpression was simple and safe and had early results comparable to the conventional forceps technique. This technique was particularly useful for cases with more adhesions between lenticule and anterior cap, thin lenticule cases and for the inexperienced SMILE surgeons.

scholarly journals Impact of Treatment Decentration on Higher-Order Aberrations after SMILE

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Ying Yu ◽  
Wenwen Zhang ◽  
Xinliang Cheng ◽  
Jianru Cai ◽  
Hui Chen
Keyword(s):  
Visual Acuity ◽  
Spherical Aberration ◽  
Higher Order ◽  
Safety Index ◽  
Higher Order Aberrations ◽  
Wavefront Aberrations ◽  
Corrected Distance Visual Acuity ◽  
Lenticule Extraction ◽  
Efficacy Index ◽  
The Mean

Purpose. To evaluate decentration following femtosecond laser small incision lenticule extraction (SMILE) and sub-Bowman keratomileusis (SBK) and its impact on higher-order aberrations (HOAs). Methods. Prospective, nonrandom, and comparison study. There were 96 eyes of 52 patients who received SMILE and 96 eyes of 49 patients who received SBK in this study. Decentration was calculated 6 months after surgery with Pentacam. HOAs and visual acuity after the surgery were examined for patients in both groups before and 6 months after surgery. Results. The mean decentration displacement in SMILE group was significantly less than SBK group (P=0.020). 89 eyes were decentered within 0.50 mm after SMILE and SBK. The association between vertical decentration and the induced spherical aberration was insignificant in SMILE group (P=0.035). There was an association between decentration and safety index, efficacy index, vertical coma, spherical aberration, and HOAs in root mean square (RMS, μm) after SBK (all P<0.05). No difference was found in uncorrected and corrected distance visual acuity, safety index, efficacy index, and wavefront aberrations between the two subgroups at any delimited value after SMILE (all P>0.05). Decentration exceeding 0.37 mm affected vertical coma and RMSh of SBK eyes (P=0.002, 0.005). Conclusion. SMILE surgery achieved more accurate centration than SBK surgery. Vertical decentration is associated with the induced spherical aberration in SMILE.

scholarly journals Outcomes of Small Incision Lenticule Extraction for Myopic Astigmatic Treatment

2019 ◽  
Vol 7 (24) ◽  
pp. 4272-4277 ◽  
Author(s):  
Nguyen Xuan Hiep ◽  
Pham Thi Minh Khanh ◽  
Do Quyet ◽  
Than Van Thai ◽  
Vu Thi Nga ◽  
...  
Keyword(s):  
Control Function ◽  
Case Series ◽  
Safety Index ◽  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Before And After ◽  
Lenticule Extraction ◽  
Efficacy Index ◽  
The Mean ◽  
Myopic Astigmatism

BACKGROUND: Some studies have shown that there is a certain rotation of the eye in the sitting and lying position of the patient. The Visumax system used for the Refractive Lenticule Extraction-Small Incision Lenticule Extraction (ReLEx SMILE) surgery lacks the rotation of eye control function. So, is the ReLEx SMILE surgery for patients with astigmatism safe and effective? AIM: To evaluate the outcomes of the ReLEx SMILE surgery in cases with myopic astigmatism. METHODS: The case series included 120 eyes with myopic astigmatism undergoing ReLEx SMILE surgery from January 2018 to November 2018. The distribution of patients for two subgroups based on the power of astigmatism, low astigmatic group (≤ 1.50D) and high astigmatic group (> 1.50D). All patients were measured UDVA, CDVA, refractive sphere, astigmatism and sphere equivalent before and after surgery one week, one month and three months carefully. The astigmatic correction was evaluated by the vectorial analysis Alpins. RESULTS: The mean efficacy index of the low and high astigmatic group was 1.035 and 1.082 (respectively); the mean safety index was 1.113 and 1.215 (respectively). 93% of eyes in the low astigmatic group had an angle of error (AE) within ± 15 degrees and 100% in high astigmatic group. There was an undercorrection in astigmatic treatment. No complications during and after surgery were recorded. CONCLUSION: ReLEx SMILE surgery for the myopic astigmatic treatment was safe and effective.

scholarly journals Photorefractive Keratectomy for Residual Myopia after Myopic Laser In Situ Keratomileusis

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Kamal A. M. Solaiman ◽  
Sameh M. Fouda ◽  
Ashraf Bor’i ◽  
Haitham Y. Al-Nashar
Keyword(s):  
Corneal Thickness ◽  
Laser In Situ Keratomileusis ◽  
Photorefractive Keratectomy ◽  
Safety Index ◽  
Corneal Resistance Factor ◽  
Corrected Visual Acuity ◽  
High Predictability ◽  
Efficacy Index ◽  
The Mean

Purpose. To evaluate the safety, efficacy, and predictability of photorefractive keratectomy (PRK) on the corneal flap for correction of residual myopia following myopic laser in situ keratomileusis (LASIK).Patients and Methods. A retrospective study on eyes retreated by PRK on the corneal flap for residual myopia after LASIK. All eyes had no enough stroma after LASIK sufficient for LASIK enhancement. Data included spherical equivalent (SE), uncorrected and best corrected visual acuity (UCVA and BCVA), central pachymetry, corneal higher order aberrations (HOAs), corneal hysteresis (CH), corneal resistance factor (CRF), and corneal haze.Results. The study included 64 eyes. Before PRK, the mean central pachymetry was400.21±7.8 μm, the mean SE was −1.74±0.51 D, and the mean UCVA and BCVA were0.35±0.18and0.91±0.07, respectively. 12 months postoperatively, the mean central corneal thickness was382.41±2.61 μm, the mean SE was −0.18±0.32 D (P<0.01), and the mean UCVA and BCVA were0.78±0.14(P=0.01) and0.92±0.13(P>0.5), respectively. The safety index was 1.01 and the efficacy index was 0.86. No significant change was observed in corneal HOAs.Conclusions. Residual myopia less than 3 D after LASIK could be safely and effectively treated by PRK and mitomycin C with a high predictability. This prevents postoperative ectasia and avoids the flap related complications but has no significant effect on HOAs.

Clinical outcomes of small incision lenticule extraction versus advanced surface ablation in low myopia

2019 ◽  
Vol 30 (6) ◽  
pp. 1278-1286 ◽  
Author(s):  
Suphi Taneri ◽  
Saskia Kießler ◽  
Anika Rost ◽  
Tim Schultz ◽  
H Burkhard Dick
Keyword(s):  
Visual Acuity ◽  
Spherical Equivalent ◽  
Small Incision Lenticule Extraction ◽  
Distance Visual Acuity ◽  
Small Incision ◽  
Surface Ablation ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity ◽  
Spherical Equivalent Refraction ◽  
Lenticule Extraction

Purpose: To compare the visual and refractive outcomes of small incision lenticule extraction and advanced surface ablation for low myopia or myopic astigmatism. Methods: Retrospective, observational case series of our first 50 consecutive small incision lenticule extraction patients compared to refraction-matched 50 advanced surface ablation treatments with attempted spherical equivalent correction ⩽−3.5 D, astigmatism ⩽−1.5 D, and corrected distance visual acuity of 1.0 (decimal scale) or better. Only one eye per patient was included. Results: Small incision lenticule extraction: mean attempted spherical equivalent correction was −2.80 ± 0.63 D. Uncorrected distance visual acuity was 0.85 and 1.0 at days 1 and 5, respectively. At 3 months, mean spherical equivalent refraction was 0.02 ± 0.32 D (range: −0.5 to +0.75 D), mean cylinder was −0.24 ± 0.21 D (range: 0 to −0.75 D), mean uncorrected distance visual acuity was 1.27, mean efficacy index was 0.96, and mean safety index was 1.05. Uncorrected distance visual acuity was same or better than corrected distance visual acuity in 96%, astigmatism ⩽0.5 D in 98% and ⩽1 D in 100% of eyes, respectively. Advanced surface ablation: mean attempted spherical equivalent correction was −2.75 ± 0.5 D. Uncorrected distance visual acuity was 0.72 and 0.61 at days 1 and 5, respectively. At 3 months, mean spherical equivalent refraction was 0.22 ± 0.32 D, mean cylinder was −0.27 ± 0.27 D, mean uncorrected distance visual acuity was 1.21, mean efficacy index was 1.03, and mean safety index was 1.08. Conclusion: Small incision lenticule extraction for low myopia was found to be safe and effective with outcomes at 3 months similar to those obtained with advanced surface ablation while offering a quicker visual recovery.

scholarly journals Clinical Outcomes of Small Incision Lenticule Extraction with Accelerated Cross-Linking (ReLEx SMILE Xtra) in Patients with Thin Corneas and Borderline Topography

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Sri Ganesh ◽  
Sheetal Brar
Keyword(s):  
Visual Acuity ◽  
Clinical Outcomes ◽  
Corneal Thickness ◽  
Cross Linking ◽  
Small Incision Lenticule Extraction ◽  
Uncorrected Visual Acuity ◽  
Distant Visual Acuity ◽  
Lenticule Extraction ◽  
The Mean

Purpose. To study the safety and clinical outcomes of ReLEx SMILE with accelerated cross-linking in individuals with thinner corneas, borderline topography, and higher refractive errors.Methods. Eligible patients first underwent SMILE procedure for correction of myopic refractive error. Following the removal of lenticule, 0.25% riboflavin in saline was injected into the interface and allowed to diffuse for 60 seconds. Finally, eye was exposed to UV-A radiation of 45 mW/cm2for 75 seconds through the cap. Total energy delivered was 3.4 J/cm2.Results. 40 eyes of 20 patients with mean age of 26.75 ± 5.99 years were treated. Mean follow-up was 12 months ± 28.12 days. Mean spherical equivalent (SE) was −5.02 ± 2.06 D preoperatively and −0.24 ± 0.18 D postoperatively. The mean central corneal thickness (CCT) and keratometry changed from 501 ± 25.90 µm to 415 ± 42.26 µm and 45.40 ± 1.40 D to 41.2 ± 2.75 D, respectively. Mean uncorrected visual acuity (UCVA) was 20/25 or better in all eyes. No eyes lost lines of corrected distant visual acuity (CDVA). There were no complications like haze, keratitis, ectasia, or regression.Conclusion. Based on the initial clinical outcome it appears that SMILE Xtra may be a safe and feasible modality to prevent corneal ectasia in susceptible individuals.

scholarly journals Effect of Cap-Lenticule Diameter Difference on the Visual Outcome and Higher-Order Aberrations in SMILE: 0.4 mm versus 1.0 mm

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Banu Torun Acar ◽  
Suphi Acar
Keyword(s):  
Visual Acuity ◽  
Visual Outcome ◽  
Higher Order ◽  
Early Postoperative Period ◽  
Higher Order Aberrations ◽  
Corrected Distance Visual Acuity ◽  
Lenticule Extraction ◽  
Group 2 ◽  
Group 1

Purpose. To evaluate the effect of cap-lenticule diameter difference (CLDD) on the visual outcome and higher-order aberrations (HOAs) of small-incision lenticule extraction (SMILE). Methods. A total of 132 patients who had bilateral SMILE for myopia or myopic astigmatism were included. The CLDD was 0.4 mm in 54 patients (group 1) and 1.0 mm in 78 patients (group 2). The refractive parameters, uncorrected (UDVA) and corrected distance visual acuity (CDVA), and HOAs were determined preoperatively and during six months follow-up. Results. Group 1 had better CDVA (in logMAR) compared to group 2 at day 1 (−0.07 ± 0.07 versus 0.04 ± 0.07, resp.; p<0.001) and week 1 (−0.07 ± 0.07 versus –0.04 ± 0.07, resp.; p=0.001). The visual acuity improved more in group 1 than in group 2. The UDVA (in logMAR) was 0.07 ± 0.07 and 0.29 ± 0.09 at day 1 (p<0.001) and −0.08 ± 0.07 and −0.06 ± 0.06 at six months (p=0.038) in group 1 and group 2, respectively. Group 1 was associated with significantly less induction of HOAs (0.24 ± 0.08 μm and 0.32 ± 0.26 μm, resp.; p=0.002). Conclusions. In SMILE, 0.4 mm CLDD is associated with better visual outcome and less induction of HOAs than 1.0 mm. Narrow CLDD should be considered in SMILE to increase the visual acuity particularly in the early postoperative period.

scholarly journals Transepithelial versus Epithelium off Crosslinking for Treating Keratoconus among Jordanians

2019 ◽  
Vol 13 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Khalid Al Zubi ◽  
Yaser Albakar ◽  
Rana Nasser
Keyword(s):  
Corneal Thickness ◽  
Tertiary Care ◽  
Cross Linking ◽  
Corrected Distance Visual Acuity ◽  
Corneal Collagen Crosslinking ◽  
The Mean ◽  
Group 2 ◽  
Collagen Cross Linking ◽  
Corneal Collagen ◽  
Group 1

Background: The progression of keratoconus is stabilized with the help of corneal collagen cross-linking (CXL) supported through photosynthesized riboflavin. Objective: This study aims to compare the effectiveness of the transepithelial procedure and epithelium off procedure of corneal collagen crosslinking among keratoconus patients in Jordan. Methods: The study recruited 80 patients suffering from progressive keratoconus, from a tertiary care setting in Jordan. These participants were randomly divided into two groups; group 1 with 40 participants subjected to transepithelial (Corneal collagen cross-linking) CXL; and 40 participants in group 2 received conventional epithelium off CXL. Results: Improvement was observed in the mean contact lens, which corrected distance visual acuity (CDVA) from logMAR 0.332 ± 0.09 (group 1), 0.35 ± 0.09 (group 2) to 0.241 ± 0.07 (group 1), 0.21 ± 0.07 (group 2), respectively at the end of follow-up (12 months). The mean pachymetry improved from 429.81 ± 18.96 μm (group 1), 430.08 ± 17.05 μm (group 2) to 436.5 ± 15.49 μm (group 1), 436.44 ± 12.53 μm (group 2), respectively, after twelve months. Additionally, the mean Sim K astigmatism declined from 7.0 ± 2.0 (group 1), 6.73 ± 1.98 (group 2) to 5.97 ± 1.88 (group 1), 5.53 ± 0.08 (group 2) respectively at twelve months post-treatment. Majority of the patients in group 2 experienced more pain as compared to group 1 participants. Conclusion: The effectiveness of a cross-linking procedure related to keratometry readings and corneal thickness showed that conventional (epithelium off) CXL method is more effective than transepithelial CXL.

scholarly journals Quantification of Ocular Parameters To Create An Anatomical Eye Model for The Japanese Population

2021 ◽  
Author(s):  
Takushi Kawamorita ◽  
Hiroshi Uozato ◽  
Tetsuro Oshika ◽  
Kazuno Negishi ◽  
Takashi Fujikado ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
Anterior Chamber Depth ◽  
Age Related ◽  
Corrected Distance Visual Acuity ◽  
Minimum Angle ◽  
Refractive Correction ◽  
Corneal Asphericity ◽  
The Mean ◽  
Posterior Corneal Curvature

Abstract This prospective observational study aimed to evaluate the eye shape and visual function of Japanese people through a multicenter approach and to create a Japanese model eye. Uncorrected and corrected distance visual acuity (UDVA and CDVA, respectively) in the log minimum angle of resolution (logMAR), subjective and objective spherical equivalent values (SE) of ocular refraction, anterior and posterior corneal curvature (ACC and PCC, respectively), anterior and posterior corneal asphericity (ACA and PCA, respectively), central corneal thickness (CCT), anterior chamber depth (ACD), and ocular axial length (AL) were measured in the eyes of 250 participants (mean age = 46.5 ± 18.0 years, range: 20–90 years) across five institutions in Japan. The mean UDVA, CDVA, subjective SE, objective SE, ACC, PCC, ACA, PCA, CCT, ACD, and AL were 0.68, -0.08, -2.42 D, -2.66 D, 7.77 mm, 6.33 mm, -0.31, -0.39, 0.55 mm, 2.92 mm, and 24.78 mm, respectively. Age-related changes and sex-based differences were observed in the visual acuity, refraction, corneal shape, ACD, and AL. Although the sample size needs to be increased, the results of this study can be applied to the development of refractive correction methods and various vision-related fields.

scholarly journals Implantable collamer lens versus small incision lenticule extraction for high myopia correction: A systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kai Cao ◽  
Jingshang Zhang ◽  
Jinda Wang ◽  
Mayinuer Yusufu ◽  
Shanshan Jin ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Myopia ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Safety Index ◽  
Small Incision Lenticule Extraction ◽  
Implantable Collamer Lens ◽  
Small Incision ◽  
Lenticule Extraction ◽  
Efficacy Index

Abstract Purpose To compare the efficacy, safety, predictability and visual quality between implantable collamer lens (ICL) implantation and small incision lenticule extraction (SMILE) for high myopia correction in adults. Methods A systematic review and meta-analysis was conducted. A comprehensive literature search was done based on databases including PubMed, Science Direct, Embase, and the Cochrane Central Register of Controlled Trials. The efficacy index, safety index, changes in Snellen lines of corrected distance visual acuity (CDVA), predictability (difference between post-operative and attempted spherical equivalent error, SER), incidence of halos, and change in higher-order aberrations (HOAs) were compared. Mean difference (MD) and 95% confidence interval (CI) was used to estimate continuous outcomes, risk ratio (RR) and 95%CI was used to estimate categorical outcomes. Results Five observational studies involving 555 eyes were included in this review. Studies’ sample sizes (eyes) ranged from 76 to 197. Subjects’ refraction ranged from -6 diopter (D) to -12D. Study duration of most researches were 6 months or 12 months. Compared to SMILE, ICL implantation showed better efficacy index (MD=0.09, 95%CI:0.01 to 0.16) and better safety index (MD=0.08, 95%CI: 0.00 to 0.16). Compared with SMILE, more ICL-treated eyes gained one or more Snellen lines of CDVA (RR=1.54, 95%CI:1.28 to 1.86), more gained two or more lines (RR=2.09, 95%CI:1.40 to 3.13), less lost one or more lines (RR=0.17, 95%CI:0.05 to 0.63). There was no difference in predictability between two treatments, RRs of predictability of within ±0.5D and ±1D were 1.13 (95%CI: 0.94 to 1.36) and 1.00 (95%CI: 0.98 to 1.02). Compared with SMILE, ICL implantation came with a higher risk of halos [RR=1.79, 95%CI: 1.48 to 2.16] and less increase in total HOAs (MD=-0.23, 95%CI: -0.42 to -0.03). Conclusion Compared with SMILE, ICL implantation showed a higher risk of halos, but equal performance on SER control, and better performance on efficacy index, safety index, CDVA improvement and HOAs control. Overall, ICL implantation might be a better choice for high myopia correction in adults.

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