Comparative study of functional optical zone: small incision lenticule extraction versus femtosecond laser assisted excimer laser keratomileusis

Song, Yaowen; Feng, Yong; Qu, Min; Gao, Yan; He, Rui

doi:10.18240/ijo.2023.02.10

Cited by 3 publications

(1 citation statement)

References 27 publications

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“…7 The small incision through the corneal epithelium used for lenticule removal during LALEX procedures leads to fewer epithelial defects, less postoperative pain and dryness, faster wound healing, and larger postoperative achieved functional optical zones compared to other corneal refractive surgery procedures. 6,[8][9][10] However, visual recovery can be impacted by femtosecond laser energy levels, 9,11 scanning patterns, 12 and surgical technique, 13 and there is a longer learning curve for surgeons compared to conventional LASIK procedures. 2,13 In procedures such as SMILE, tissue bridges are present between the cornea and the lenticule at the two lenticular interfaces after the femtosecond laser cuts are completed, requiring surgeon manipulation to separate the lenticule prior to extraction.…”

Section: Introductionmentioning

confidence: 99%

Safety and Effectiveness of Smooth Incision Lenticular Keratomileusis (SILKTM) Using the ELITA(TM) Femtosecond Laser System for Correction of Myopic and Astigmatic Refractive Errors

Sachdev,

Shetty,

Khamar

et al. 2023

OPTH

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Purpose To evaluate visual outcomes following the Smooth Incision Lenticular Keratomileusis (SILK TM ) procedure for correction of myopic refractive errors with and without astigmatism, using the ELITA TM Femtosecond Laser System. Patients and Methods A prospective, multicenter, single-arm, open-label clinical study was conducted. Eighty-five myopic subjects (n = 170 eyes), aged 18 years or older, with manifest refractive spherical equivalent (MRSE) up to −12.00 D and astigmatism up to −6.00 D, were treated binocularly using the ELITA femtosecond laser and followed up for 6 months. Intended correction was emmetropia for all eyes. The primary outcome measures included post-operative uncorrected and corrected distance visual acuity (UDVA and CDVA). Secondary outcome measures included surgeon’s rating for ease of lenticule extraction, predictability, safety, and stability. Results A total of 170 eyes of 85 patients underwent SILK. Preoperative mean MRSE was −4.14 D ± 1.32 D (range −1.38 D to −8.88 D) and the mean cylinder was −0.77 D ± 0.62 D. Intraoperative surgeon ease of lenticule dissection was rated as grade 0 or 1 in 85.3% of eyes (no/only mild dissection needed). UDVA at 1 day, 1 week, 1 month, and 6 months was 20/20 or better in 65.9%, 85.4%, 91.5%, and 96% of eyes, respectively. No eyes lost any lines of CDVA at 6 months compared to the preoperative. The postoperative MRSE was stable over time, ranging from −0.34 D ± 0.24 D at 1 month to −0.33 D ± 0.23 D at 6 months. MRSE predictability (± 0.50 D) was 93.5% (129/138) at 3 months and 91.1% (113/124) at 6 months. No serious adverse events were noted. Conclusion The SILK procedure with the ELITA Femtosecond Laser System is safe and effective for the treatment of myopic refractive errors with and without astigmatism. Fast visual recovery was demonstrated, with stability achieved by 3 months.

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Section: Introductionmentioning

confidence: 99%

Safety and Effectiveness of Smooth Incision Lenticular Keratomileusis (SILKTM) Using the ELITA(TM) Femtosecond Laser System for Correction of Myopic and Astigmatic Refractive Errors

Sachdev,

Shetty,

Khamar

et al. 2023

OPTH

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Characterization of Disrupted Tissue Interface Thickness for Keratorefractive Lenticule Extraction Procedure With ELITA Femtosecond Laser

Minoguchi,

Umar,

2024

Trans. Vis. Sci. Tech.

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Effective optical zone after corneal lenticule extraction with the CLEAR femtosecond laser application

Leccisotti,

Fields,

De Bartolo

et al. 2023

Laser Ther J

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Laser vision correction of myopia induces an effective optical zone (EOZ) smaller than the programmed optical zone (POZ) by 16 to 26%. We evaluated the EOZ after corneal lenticule extraction for myopia with astigmatism ≤1 diopter (D) with a new femtosecond laser application (CLEAR), compared to POZ in a retrospective, consecutive, comparative case series study. Forty eyes of 40 patients underwent lenticule extraction with the Ziemer CLEAR® application; the control group was composed of 40 eyes of 40 patients receiving myopic femtosecond laser in situ keratomileusis (LASIK); EOZ was calculated on difference tangential maps at 6 months. For lenticule extraction, mean preoperative spherical equivalent (SE) was -6.03±2.48 D; mean POZ was 6.43±0.27 mm; EOZ 5.55±0.45 mm; mean difference between POZ and EOZ was 0.88 ± 0.28 mm (p=0.00); the mean reduction of EOZ compared to POZ was 13.60%±4.75; a positive correlation between preoperative SE and percent reduction of EOZ was found (r=0.63). For LASIK, mean preoperative SE was -5.89±2.14 D; mean POZ was 6.57±0.34 mm; EOZ 5.16±0.53 mm; the mean difference between POZ and EOZ was 1.41±0.35 mm (p=0.00); the mean reduction of EOZ compared to POZ was 21.46%±5.20. The mean difference between EOZ of the 2 procedures was 0.39 mm (p=0.0008). The mean difference between the reduction in optical zone (POZ-EOZ) of the 2 procedures was -0.53 (p=0.00). In conclusion, in myopia with low astigmatism, the CLEAR application for lenticule extraction provided a limited reduction in EOZ, compared with existing platforms. A positive correlation exists between corrected SE and reduction of the EOZ.

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Comparative study of functional optical zone: small incision lenticule extraction versus femtosecond laser assisted excimer laser keratomileusis

Cited by 3 publications

References 27 publications

Safety and Effectiveness of Smooth Incision Lenticular Keratomileusis (SILKTM) Using the ELITA(TM) Femtosecond Laser System for Correction of Myopic and Astigmatic Refractive Errors

Safety and Effectiveness of Smooth Incision Lenticular Keratomileusis (SILKTM) Using the ELITA(TM) Femtosecond Laser System for Correction of Myopic and Astigmatic Refractive Errors

Characterization of Disrupted Tissue Interface Thickness for Keratorefractive Lenticule Extraction Procedure With ELITA Femtosecond Laser

Effective optical zone after corneal lenticule extraction with the CLEAR femtosecond laser application

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