Endokeratophakia appears to be a viable procedure for correcting hyperopia on the cornea by implantation of an extracted myopic SMILE lenticule from a donor patient. However, posterior surface changes and epithelial remodeling resulted in only 50% of the intended correction. No adverse side effects were observed following implantation of donor tissue for 1 year.

Impact of refractive error on people's QoL is multifaceted. Significance of the identified themes varies by refractive error subgroups. Refractive correction may not always address QoL impact of URE but often add unique QoL issues. This study findings also provide content for developing an item-bank for quantitatively measuring refractive error-specific QoL in developing country setting.

The mean achieved optical zone diameter of hyperopic SMILE was found to be larger than the mean achieved optical zone diameter of hyperopic LASIK. Consequently, spherical aberration induction was similar for 6.37-mm SMILE and 7-mm LASIK. [J Refract Surg. 2017;33(6):370-376.].

PURPOSE: To describe a femtosecond laser–assisted small incision sutureless intrastromal lamellar keratoplasty in an eye with severe keratoconus and report on the outcome with a 1-year follow-up. METHODS: A 20-year-old man with a history of keratoconus presented for evaluation at the Tilganga Institute of Ophthalmology, Kathmandu, Nepal. The patient had previously undergone a deep anterior lamellar keratoplasty in the left eye. Examination of the right eye revealed an uncorrected distance visual acuity (UDVA) of counting fingers with a manifest refraction of −5.00 −3.50 × 170, giving a corrected distance visual acuity (CDVA) of 20/80. Thinnest pachymetry was 425 µm and progression of both anterior and posterior corneal elevation tomography and maximum keratometry was noted compared to examination 2 years prior. The VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany) was used to prepare the donor and recipient cornea. The donor graft was inserted into the recipient through the 3-mm small incision. No sutures were applied. RESULTS: At 2 weeks postoperatively, UDVA was 20/50 with a manifest refraction of −1.00 −5.00 × 145 (20/32). One year postoperatively, UDVA was 20/80 with a manifest refraction of −2.50 −3.50 × 125 (20/40 −2 ), with the maximum keratometry decreasing from 64.08 to 56.74 diopters. CONCLUSIONS: This femtosecond laser–assisted sutureless intrastromal corneal transplantation technique may provide an option to improve the quality of vision for some patients with keratoconus, affording a simpler postoperative follow-up course compared to traditional anterior lamellar or full-thickness corneal transplantation. [ J Refract Surg. 2019;35(10):663–671.]

Dr. Reinstein is a consultant to Carl Zeiss Meditec AG and has a proprietary interest in the Artemis technology (Arcscan, Inc.) through patents administered by the Center for Technology Licensing at Cornell University, Ithaca, New York, USA. Drs. Pradhan and Carp have travel expenses to conferences paid by Carl Zeiss Meditec AG. No other author has a financial or proprietary interest in any material or method mentioned.