Flushing versus not flushing the interface during small-incision lenticule extraction

Kind, R.; Kiraly, Laszlo; Taneri, Suphi; Troeber, L.; Wiltfang, Rainer; Bechmann, Martin; Meyer, Bertram; Greene, Brandon; Sekundo, Walter

doi:10.1016/j.jcrs.2018.12.001

Cited by 12 publications

(1 citation statement)

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“…The novel application for lenticule extraction in this study was characterized by good predictability of refractive results, successful extraction of the entire lenticule in all eyes, absence of suction losses, and a slow recovery at day 1, especially after intraoperative difficulties. Despite recent reports of excellent UDVA at day 1, 20 slow visual recovery of SMILE compared with LASIK has been repeatedly observed. 6,21 Prevention of even minor intraoperative complications (as shown in the present series) is determinant in improving visual recovery speed and entails optimization of eye exposure to avoid uncut areas, identification of interfaces, complete separation of the lenticule until its edge to prevent peripheral adhesion, respect of the epithelium.…”

Section: Discussionmentioning

confidence: 85%

Refractive Corneal Lenticule Extraction With the CLEAR Femtosecond Laser Application

Leccisotti

Fields²,

Bartolo³

2022

Cornea

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The aim of this study was to evaluate a new femtosecond laser application for refractive corneal lenticule extraction with suction control and computerized regulation of centration and alignment (Ziemer CLEAR).Methods: This was a retrospective, consecutive, noncomparative case series study. Patients undergoing CLEAR for spherical equivalent (SE) between 23 and 210 D, evaluating SE, defocus equivalent, refractive astigmatism, visual acuity, and centration at 10 months were evaluated in the study.Results: Fifty-three eyes of 42 patients (mean age 40.4 6 8.6 years) were included, with preoperative SE 25.99 6 1.49 D and mean corrected distance visual acuity (CDVA) of 0.05 6 0.07 logMAR. With no suction losses, an intact lenticule was extracted in all eyes. In 6 eyes, peripheral adhesion was resolved by lenticulerrhexis, and in 1 eye, the incision was opened by a crescent blade. Moderate interface inflammation occurred in 3 eyes. At day 1, in the 42 eyes with uneventful surgery, the mean CDVA was 20/27, whereas in the 11 eyes with extra surgical manipulations, it was 20/36 (P= 0.04). At 10 months, for the 53 eyes, the mean uncorrected distance visual acuity was 0.05 6 0.09 logMAR; in 37 eyes (70%), it was 20/25 or better; and the mean CDVA was 0.04 6 0.06 logMAR. Eight eyes (15%) lost 1 logMAR line. The mean SE was 20.13 6 0.15 D. The mean defocus equivalent was 0.33 6 0.32 D, with 46 eyes (87%) #0.50 D and 52 eyes (98%) #1 D. Refractive astigmatism was #0.50 D in 48 eyes (90%). The efficacy index was 1.00, and the safety index was 0.98. The mean decentration from the corneal vertex was 0.28 6 0.07 mm. Conclusions:The application yielded good predictability, efficacy, and safety. Slower visual recovery was observed after extra surgical manipulations.

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Section: Discussionmentioning

confidence: 85%