Twelve-month outcomes of a new refractive lenticular extraction procedure

Pradhan, Kishore R; Arba-Mosquera, Samuel

doi:10.1016/j.optom.2021.11.001

Cited by 17 publications

(10 citation statements)

References 58 publications

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“…The ELITA laser system was designed to deliver lower energy per pulse (40–90 nJ) compared to other laser systems on the market, such as the Carl Zeiss Meditec VisuMax (100–180 nJ) 11 , 12 and Schwind ATOS (100–120 nJ), 5 , 22 to produce continuous tissue-bridge-free corneal lenticules that are easy to remove to enable faster visual recovery. Another unique feature of the ELITA system is the biconvex lenticule shape that creates identical surfaces and tissue matching following lenticule removal.…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

“… 27 In a 12-month study of 221 treated with SmartSight lenticule extraction, 1% of eyes lost 1 line of CDVA. 5 …”

Section: Discussionmentioning

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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“…SmartSight treatment (SCHWIND eye-tech solutions GmbH, Kleinostheim, Germany) is a lenticule creation and extraction implemented in the SCHWIND ATOS femtosecond system (SCHWIND eye-tech solutions GmbH, Kleinostheim, Germany) [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Comparing high and low energy outcomes on day one for SmartSight myopic-astigmatism treatments with the SCHWIND ATOS: a retrospective case series

Pradhan

Arba-Mosquera

2023

BMC Ophthalmol

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Background Impact of low energy asymmetric spacings vs. high energy symmetric spacings on the immediate/early (postoperative day 1 (POD1)) outcomes of SmartSight lenticule extraction for myopic astigmatism with a new femtosecond laser system. Methods The first 112 eyes of 56 patients consecutively treated using low energy asymmetric spacings (Group A; Study group) were compared at POD1 to the last 112 eyes of 56 patients consecutively treated using high energy symmetric spacings (Group S; Controls). Mean age of the patients was 28 ± 5 years with a mean spherical equivalent of -4.41 ± 1.76 diopters (D) and a mean magnitude of refractive astigmatism of 0.89 ± 0.82 D. Results Laser Energy was -25 ± 1nJ lower for asymmetric treatments (p < .0001); Spot and Track distances were + 0.7 ± 0.1 µm larger and -0.8 ± 0.1 µm tighter for asymmetric treatments, respectively (p < .0001 for both). At POD1, astigmatism was -0.08 ± 0.02D lower for asymmetric treatments (p < .0003); uncorrected and corrected visual acuities (UDVA and CDVA, respectively) were -0.03 ± 0.01logMAR better for asymmetric treatments (p < .0007); differences between postop UDVA and preop CDVA along with change in CDVA were + 0.3 ± 0.1lines better for asymmetric treatments (p < .0003). Conclusions Lenticule extraction treatment using SmartSight is safe and efficacious already at POD1. Findings suggest that low energy asymmetric spacings may further improve the immediate and short-term outcomes of SmartSight lenticule extraction in the treatment of myopic astigmatism compared to conventional settings (high energy symmetric spacings).

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“…To the best of our knowledge, all reported clinical cases of stromal keratophakia have only been performed with lenticules extracted with SMILE. More recently, other than CLEAR, several other lenticule extraction procedures that use low nJenergy laser systems have become available, such as SmartSight (Schwind, Kleinostheim, Germany) and small incision lenticule keratomileusis (SILK; Johnson & Johnson Vision, Irvine, CA, USA) (32,33). Hence, we sought to compare the differences in performance between two of these lasers, the VisuMax and FEMTO LDV with respect to lenticule extraction.…”

Section: Introductionmentioning

confidence: 99%

Incisional surface quality of electron-beam irradiated cornea-extracted lenticule for stromal keratophakia: high nJ-energy vs. low nJ-energy femtosecond laser

Chan,

Han,

Lim

et al. 2023

Front. Med.

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IntroductionCorneal lenticules can be utilized as an additive material for stromal keratophakia. However, following extraction, they must be reimplanted almost immediately or cryopreserved in lenticule banks. Electron-beam (E-beam) irradiated corneas permit room-temperature storage for up to 2 years, enabling keratophakia to be performed on demand. This study aims to compare the performance of high nano Joule (nJ)-energy (VisuMax) and low nJ-energy (FEMTO LDV) femtosecond laser systems on the thickness consistency and surface quality and collagen morphology of lenticules produced from fresh and E-beamed corneas.MethodsA total of 24 lenticules with −6.00 dioptre power were cut in fresh human donor corneas and E-beamed corneas with VisuMax and FEMTO LDV. Before extraction, the thickness of the lenticules was measured with anterior segment-optical coherence tomography (AS-OCT). The incisional surface roughness of extracted lenticules was analyzed using atomic force microscopy (AFM) and scanning electron microscopy (SEM). Multiphoton microscopy was then used to assess the surface collagen morphometry.ResultsThe E-beamed lenticules that were cut using FEMTO LDV were significantly thicker than the fresh specimens as opposed to those created with VisuMax, which had a similar thickness as the fresh lenticules. On the vertex, they were ∼11% thicker than the fresh lenticules. The surface roughness (Rq) of E-beamed lenticules incised with FEMTO LDV did not differ significantly from the fresh lenticules. This contrasted with the VisuMax-fashioned lenticules, which showed notably smoother surfaces (∼36 and ∼20% lower Rq on anterior and posterior surfaces, respectively) on the E-beamed than the fresh lenticules. The FEMTO LDV induced less cumulative changes to the collagen morphology on the surfaces of both fresh and E-beamed lenticules than the VisuMax.ConclusionIt has been previously demonstrated that the low nJ-energy FEMTO LDV produced a smoother cutting surface compared to high nJ-energy VisuMax in fresh lenticules. Here, we showed that this effect was also seen in the E-beamed lenticules. In addition, lower laser energy conferred fewer changes to the lenticular surface collagen morphology. The smaller disparity in surface cutting quality and collagen disturbances on the E-beamed lenticules could be beneficial for the early visual recovery of patients who undergo stromal keratophakia.

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Twelve-month outcomes of a new refractive lenticular extraction procedure

Cited by 17 publications

References 58 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

Comparing high and low energy outcomes on day one for SmartSight myopic-astigmatism treatments with the SCHWIND ATOS: a retrospective case series

Incisional surface quality of electron-beam irradiated cornea-extracted lenticule for stromal keratophakia: high nJ-energy vs. low nJ-energy femtosecond laser

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