scholarly journals Two-year outcome of a patient after LASIK following SMILE lenticule in situ implantation to treat a rare complication

2019 ◽  
Author(s):  
Jing Zhao ◽  
Jianmin Shang ◽  
Lingling Niu ◽  
Haipeng Xu ◽  
Dong Yang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Rare Complication ◽  
Small Incision Lenticule Extraction ◽  
Case Presentation ◽  
Small Incision ◽  
Corrected Distance Visual Acuity ◽  
Lenticule Extraction ◽  
Myopic Astigmatism ◽  
Corneal Tomography

Abstract Background: To report a case of femtosecond laser-assisted in situ keratomileusis (FS-LASIK) following small incision lenticule extraction (SMILE) lenticule in situ implantation to treat a rare complication. Case presentation: The hyperopic left eye of a 46-year-old patient with refraction of +7.75 diopters sphere (DS)/-1.25 diopters cylinder (DC)×5°and corrected distance visual acuity (CDVA) of 20/50 mistakenly underwent SMILE procedure for myopic astigmatism (-8.50DS/-1.50DC×175°) due to medical record error. The extracted lenticule was subsequently re-implanted in situ. After 8 months, the left eye underwent FS-LASIK to correct hyperopia and astigmatism （+5.0DS/-0.75DC×100°. Two years after FS-LASIK, corneal tomography showed no ectasia and microscopy revealed transparent cornea. The left eye obtained CDVA of 20/50 and the refraction was -0.75DS/-0.25DC×165°. Conclusion: SMILE lenticule in situ implantation offers a solution for rare complications and correction of refractive error following lenticule re-implantation with FS-LASIK is feasible and effective. Keywords: SMILE, Lenticule, Re-implantation, Complication

scholarly journals Two-year outcome of an eye that underwent hyperopic LASIK following inadvertent myopic SMILE lenticule in situ implantation

2019 ◽  
Author(s):  
Jing Zhao ◽  
Jianmin Shang ◽  
Lingling Niu ◽  
Haipeng Xu ◽  
Dong Yang ◽  
...  
Keyword(s):  
Medical Negligence ◽  
Small Incision Lenticule Extraction ◽  
Case Presentation ◽  
Future Studies ◽  
Small Incision ◽  
Corrected Distance Visual Acuity ◽  
Lenticule Extraction ◽  
Myopic Astigmatism ◽  
Corneal Tomography

Abstract Background: This report describes a case in which hyperopic femtosecond laser-assisted in situ keratomileusis (FS-LASIK) was performed following small incision lenticule extraction (SMILE) lenticule in situ implantation. Case presentation: The hyperopic left eye of a 46-year-old patient with refraction of +7.75 diopters sphere (DS)/-1.25 diopters cylinder (DC)  5° and corrected distance visual acuity (CDVA) of 20/50 mistakenly underwent the SMILE procedure for myopic astigmatism (-8.50 DS/-1.50 DC  175°) due to medical negligence. The extracted lenticule was subsequently re-implanted in situ. After 8 months, the left eye underwent FS-LASIK to correct hyperopia and astigmatism (+5.0 DS/-0.75 DC × 100°). Two years after FS-LASIK, corneal tomography showed no ectasia and microscopy revealed transparent cornea. The left eye exhibited CDVA of 20/50 with refraction of -0.75 DS/-0.25 DC × 165°. Conclusions: SMILE lenticule in situ implantation offers a solution for corneal volume and thickness restoration. FS-LASIK provides feasible correction of refractive error following lenticule re-implantation. Future studies are needed for determining the effectiveness of the treatment.

scholarly journals Two-year outcome of an eye that underwent hyperopic LASIK following inadvertent myopic SMILE lenticule in situ implantation

2019 ◽  
Author(s):  
Jing Zhao ◽  
Jianmin Shang ◽  
Lingling Niu ◽  
Haipeng Xu ◽  
Dong Yang ◽  
...  
Keyword(s):  
Medical Negligence ◽  
Small Incision Lenticule Extraction ◽  
Case Presentation ◽  
Small Incision ◽  
Corrected Distance Visual Acuity ◽  
Corneal Volume ◽  
Lenticule Extraction ◽  
Myopic Astigmatism ◽  
Corneal Tomography

Abstract Background: This report describes a case in which hyperopic femtosecond laser-assisted in situ keratomileusis (FS-LASIK) was performed following small incision lenticule extraction (SMILE) lenticule in situ implantation. Case presentation: The hyperopic left eye of a 46-year-old patient with refraction of +7.75 diopters sphere (DS)/-1.25 diopters cylinder (DC)  5° and corrected distance visual acuity (CDVA) of 20/50 mistakenly underwent the SMILE procedure for myopic astigmatism (-8.50 DS/-1.50 DC  175°) due to medical negligence. The extracted lenticule was subsequently re-implanted in situ. After 8 months, the left eye underwent FS-LASIK to correct hyperopia and astigmatism (+5.0 DS/-0.75 DC × 100°). Two years after FS-LASIK, corneal tomography showed no ectasia and microscopy revealed transparent cornea. The left eye exhibited CDVA of 20/50 with refraction of -0.75 DS/-0.25 DC × 165°. Conclusions: SMILE lenticule in situ implantation offers a solution for corneal volume and thickness restoration. In addition, FS-LASIK provides feasible and effective correction of refractive error following lenticule re-implantation.

scholarly journals Three-year outcomes of small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for myopia and myopic astigmatism

2018 ◽  
Vol 103 (4) ◽  
pp. 565-568 ◽  
Author(s):  
Tian Han ◽  
Ye Xu ◽  
Xiao Han ◽  
Li Zeng ◽  
Jianmin Shang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Laser In Situ Keratomileusis ◽  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Lenticule Extraction ◽  
Myopic Astigmatism

AimsTo compare long-term clinical outcomes following small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for myopia and myopic astigmatism correction.MethodsIn this retrospective study, we enrolled a total of 101 patients (101 eyes) who underwent SMILE or FS-LASIK 3 years prior. Measured parameters included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction and corneal wavefront aberrations.ResultsNo significant differences in patient characteristics were found between the two groups. At the 3-year follow-up, UDVA was better than or equal to 20/20 in 90% and 85% (p=0.540) of the eyes; the efficacy indexes were 1.05±0.19 and 1.01±0.21 in the SMILE and FS-LASIK groups, respectively (p=0.352). Safety indexes were 1.19±0.17 and 1.15±0.20 in the SMILE and FS-LASIK groups, respectively (p=0.307). Eighty per cent and 65% of eyes were within ±0.50 D of the attempted spherical equivalent correction after SMILE and FS-LASIK, respectively (p=0.164). Vector analysis revealed no significant differences in astigmatic correction between the two groups (p>0.05). Surgically induced spherical aberration was higher in the FS-LASIK group than in the SMILE group (p<0.001).ConclusionLong-term follow-up analysis suggested that both SMILE and FS-LASIK were safe and equally effective for myopic and astigmatic correction.

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 Comparative Study between Femtosecond Laser Assisted in-situ Keratomileusis and Femtosecond Small Incision Lenticule Extraction for Correction of Myopia and Myopic Astigmatism

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A A Abutaleb ◽  
M G Metwally ◽  
T M Elraggal ◽  
O A Salem
Keyword(s):  
Visual Acuity ◽  
Comparative Study ◽  
Dry Eye ◽  
Small Incision Lenticule Extraction ◽  
Schirmer Test ◽  
Corneal Sensation ◽  
Small Incision ◽  
Lenticule Extraction ◽  
Breakup Time ◽  
Myopic Astigmatism

Abstract Purpose This study aimed at comparing femto-LASIK with small incision lenticule extraction (SMILE) as regards the safety, efficacy, accuracy and post-operative complications with special emphasis on the post-operative dry eye, corneal sensation and corneal biomechanics in cases of myopia and myopic astigmatism. Patients and Methods The study was a prospective comparative study that was conducted in a private eye hospital on 60 eyes of 30 patients with myopia or myopic astimgatism. Each patient was fully assessed preoperatively including visual acuity, refraction, tear breakup time, Schirmer test, corneal sensation & Ocular Response Analyzer®. Femto-LASIK was done to 15 patients and SMILE was done to 15 patients. Postoperative visual acuity, refraction, tear breakup time, Schirmer test, corneal sensation at 1 month, 3 months and 6 months and Ocular Response Analyzer® at 6 months were done and data was retrieved and analyzed. Results Cylindrical error was higher in SMILE group at all postoperative points. Tear breakup time was better in SMILE group in 1st month, but no significant difference in later follow ups. Corneal sensation was better in SMILE group in 1 month and 3 months, but this difference disappeared at 6 months. Corneal hysteresis & corneal resistance factor were significantly better in SMILE group. Conclusion Both techniques are safe and efficient. Femto-LASIK is more efficient in correcting cylindrical error. SMILE is better in early postoperative dry eye, corneal sensation and in corneal biomechanics.

Small incision lenticule extraction for the correction of high myopia

2019 ◽  
Vol 30 (5) ◽  
pp. 917-927
Author(s):  
Suphi Taneri ◽  
Saskia Kießler ◽  
Anika Rost ◽  
Tim Schultz ◽  
H Burkhard Dick
Keyword(s):  
Visual Acuity ◽  
High Myopia ◽  
Case Series ◽  
Small Incision Lenticule Extraction ◽  
Distance Visual Acuity ◽  
Small Incision ◽  
Refractive Outcomes ◽  
Uncorrected Distance Visual Acuity ◽  
Corrected Distance Visual Acuity ◽  
Lenticule Extraction

Purpose: Excimer laser-based refractive procedures can have less predictable results when used for correcting high myopia than when used for moderate myopia. Small incision lenticule extraction might overcome this weakness. However, small incision lenticule extraction is only Food and Drug Administration approved for use in myopic eyes up to −8 D with astigmatism of −3 D or less. We report outcomes of small incision lenticule extraction in highly and moderately myopic eyes and compare these to modern laser-assisted in situ keratomileusis. Methods: Retrospective, observational consecutive case series. Inclusion criteria: attempted myopic spherical correction ⩾−8 or−3 to −7.75 D with astigmatism ⩽−3 D, and corrected distance visual acuity of 1.0 (decimal scale) or better. Results: A total of 62 highly myopic and 407 moderately myopic eyes were included. At 3 months postoperatively, the highly myopic eyes had a mean spherical equivalent refraction of −0.28 ± 0.41 D (range: −1.13 to +0.75 D). Mean uncorrected distance visual acuity was 1.0. Mean efficacy index was 0.84. Mean safety index was 1.03. Uncorrected distance visual acuity same or better than corrected distance visual acuity: 61%. Astigmatism was ⩽0.5 D in 90% and ⩽1 D in 100%. The results in the moderately myopic eyes were comparable. Conclusion: We found equally good visual and refractive outcomes after small incision lenticule extraction for the correction of high and of moderate myopia combined with an astigmatic correction of up to 3 D, respectively.

scholarly journals Small Incision Lenticule Extraction for Postkeratoplasty Myopia and Astigmatism

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Tamer H. Massoud ◽  
Osama Ibrahim ◽  
Kitty Shehata ◽  
Moones F. Abdalla
Keyword(s):  
Visual Acuity ◽  
Case Series ◽  
Small Incision Lenticule Extraction ◽  
Distance Visual Acuity ◽  
Small Incision ◽  
Refractive Outcomes ◽  
Laser Vision ◽  
Lenticule Extraction ◽  
The Mean ◽  
Myopic Astigmatism

Purpose. To evaluate the visual and refractive outcomes after small incision lenticule extraction (SMILE) for treating myopia and myopic astigmatism after penetrating keratoplasty (PKP).Design. Case-series.Methods. Ten eyes of 10 patients with previous PKP and residual myopic astigmatism for whom pentacam imaging and thickness measurements were acceptable for laser vision correction. Manifest refraction (MR), uncorrected distance visual acuity (UDVA), and corrected distance visual acuity (CDVA) were obtained preoperatively and one day, one week, and one, 3, and 6 months postoperatively. Cases were operated on the VisuMax® femtosecond laser platform with 500 kHz repetition rate.Results. The mean correction ratio for spherical errors was0.84±0.19 D and for the mean refractive spherical equivalent (MRSE) was0.79±0.13 D. Vector analysis showed a mean astigmatism reduction at the intended axis of67±25.25%, a correction index of0.81±0.21, and an overall mean percentage of success of astigmatism surgery of53±37.9%. The postoperative MRSE was stable throughout the 6-month follow-up period. The efficacy index was 0.93 and the safety index was 1.12.Conclusion. SMILE for correction of post-PKP myopia and astigmatism is effective, safe, and stable with moderate accuracy and predictability. Centration of the treatment within the grafts was easily performed.

scholarly journals Small Incision Lenticule Extraction (SMILE) for Moderate and High Myopia: Seven-Year Outcomes of Refraction, Corneal Tomography, and Wavefront Aberrations

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Fei Xia ◽  
Yang Shen ◽  
Tian Han ◽  
Jing Zhao ◽  
Haipeng Xu ◽  
...  
Keyword(s):  
Visual Acuity ◽  
High Myopia ◽  
Spherical Aberration ◽  
Final Visit ◽  
Small Incision Lenticule Extraction ◽  
Wavefront Aberrations ◽  
Distance Visual Acuity ◽  
Small Incision ◽  
Lenticule Extraction ◽  
Corneal Tomography

Purpose. To investigate the long-term outcomes of refraction, corneal tomography, and wavefront aberrations after small incision lenticule extraction (SMILE) for moderate and high myopia. Methods. Prospective, nonconsecutive case series. A total of 26 patients (26 eyes) who underwent SMILE from May 2010 to March 2013 at the Fudan University Eye and ENT Hospital (Shanghai, China) were enrolled. The periods of follow-up were 1 month, 1 year, 5 years, and 7 years after surgery. The routine eye examinations included uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), manifest refraction, and corneal tomography. Results. All surgeries were executed without any complications. At the final visit, an UDVA of 20/20 or better was achieved in 26 eyes (100%) and 11 eyes (42%) exhibited no change in CDVA. 9 eyes (35%) gained one line, 6 eyes (23%) gained two lines, and no eyes lost CDVA. 24 eyes (92%) and 26 eyes (100%) were within ±0.5 D and ±1.00 D of the target refraction, respectively. A mean refractive regression of −0.17 D was observed between 1 month and 7 years postoperatively. Mean corneal front curvature (MCFC) was significantly decreased between pre- and post-SMILE surgery (P<0.0001). Higher-order aberrations (HOAs) and vertical coma were significantly increased after SMILE compared to those measured before surgery (all P<0.001). There were no significant differences in trefoil and spherical aberration between pre- and post-SMILE surgery (all P>0.05). Conclusion. SMILE is an effective, safe, and stable procedure for moderate and high myopia, with relatively constant corneal stability and wavefront aberrations. This trial is registered with ChiCTR-ONRC-13003114.

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