CIRCLE Enhancement After Myopic SMILE

Luft, Nikolaus; Mayer, Wolfgang J.; Siedlecki, Martin; Kook, Daniel; Meyer, Bertram; Bechmann, Martin; Wiltfang, Rainer; Priglinger, Siegfried; Dirisamer, Martin

doi:10.3928/1081597x-20180308-02

Cited by 25 publications

(21 citation statements)

References 22 publications

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“…For these reasons, pattern D is currently recommended by the manufacturer and has been adopted by most surgeons. Chansue et al 14 and Siedlecki et al 5,8 have reported on the clinical efficacy of CIRCLE pattern D and have found excellent results with flap handling very similar to conventional fs-LASIK. To facilitate surgical manipulation, the outer diameter of the CIRCLE procedure is recommended to be programmed to extend beyond the SMILE interface (eg, 8.2 mm over ≥7.9 mm, depending on the white-to-white diameter).…”

Section: Options Of Enhancement After Smilementioning

confidence: 97%

“…71% of retreatments are performed within the first year with a mean latency of 10 to 11 months. 5,7,8 Retreatment is much more likely to be performed for under- (79%) than overcorrection (21%), and 86% represent spherocylindrical retreatments. 7…”

Section: Epidemiology and Risk Factors Of Smile Enhancementmentioning

confidence: 99%

“…The proprietary CIRCLE software of the VisuMax platform (presently not available in the United States) has been specifically developed for enhancements and conversion of the SMILE cap into a full flap for LASIK-like excimer laser enhancement. 5 Presently, 4 CIRCLE patterns with different sequential laser cuts are available. 13 Pattern A represents the simplest one, creating a side cut in the clearance zone of the cap plane between the end of the optical zone and the outer circumference of the cap (Fig.…”

Section: Options Of Enhancement After Smilementioning

confidence: 99%

“…To avoid cross-talk with the SMILE incision, the flap should be orientated in a fashion that the new hinge area does not overlap with the former side cut incision (eg, SMILE incision at 130 degree and CIRCLE flap at 50 degree). 5 After femtosecond laser application, the new flap can be lifted using a blunt spatula like a regular LASIK flap, followed by excimer laser treatment. The use of MMC has been reported in the first few published cases on CIRCLE, 5 however, is now deemed obsolete, as the inflammatory reaction after CIRCLE is much less severe than that after surface ablation, making haze a rare complication.…”

Section: Options Of Enhancement After Smilementioning

confidence: 99%

“…1,2 In contrast to LASIK, which can be retreated by a flap relift, reSMILE retreatment is, however, currently neither approved nor commercially available in the VisuMax platform (Carl Zeiss Meditec AG, Jena, Germany), with sparse data on its safety and efficacy. 3 As a substitute, a multitude of alternative enhancement options have been proposed and established, including surface ablation, 4 cap-to-flap conversion using the CIRCLE program, 5 and thin-flap LASIK. 6 This review will focus on the epidemiology of enhancement after SMILE and elucidate the advantages and disadvantages of each available retreatment method.…”

mentioning

confidence: 99%

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Enhancement Options After Myopic Small-Incision Lenticule Extraction (SMILE): A Review

Luft

Priglinger

Dirisamer

2019

Asia-Pacific Journal of Ophthalmology

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Purpose:To provide an overview of the currently available retreatment methods after myopic small-incision lenticule extraction (SMILE).Design:Systematic literature review.Methods:The PubMed library was searched for articles containing the terms “small-incision lenticule extraction” and “enhancement” or “retreatment”. The last search was performed on May 1, 2019.Results:In contrast to laser in-situ keratomileusis (LASIK), which can be retreated by a flap relift, repeat SMILE retreatment is currently not approved and only seldomly performed. As substitutes, surface ablation, cap-to-flap conversion using the CIRCLE program in the VisuMax platform, and thin-flap LASIK have been recently established. While all options offer safety and efficacy comparable to LASIK retreatments, each has its patient-specific advantages and disadvantages. While surface ablation preserves the flap-free approach of the primary procedure, the aspect of pain and a slow visual recovery might render it less attractive as compared with CIRCLE and thin-flap LASIK which offer quick recovery, however at the price of flap creation. Besides, each retreatment method generates specific tissue responses and has a different impact on corneal biomechanics, which is strongly dependent on the previous SMILE parameters, especially the cap thickness.Conclusions:Refractive enhancement after SMILE is currently mostly performed by surface ablation, CIRCLE cap-to-flap conversion or thin-flap LASIK, which all offer safety and efficacy comparable to LASIK retreatments. In this review, a detailed overview over each method, its technical aspects, and specific advantages and disadvantages is given.

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Section: Options Of Enhancement After Smilementioning

confidence: 97%