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Topography-guided photorefractive keratectomy for irregular astigmatism after small incision lenticule extraction

Poster Details

First Author: A.Ivarsen DENMARK

Co Author(s):    J. Hjortdal              

Abstract Details



Purpose:

Small incision lenticule extraction (SMILE) is a new keratorefractive treatment for myopia or myopic astigmatism. In SMILE a femtosecond laser is used to create an intrastromal refractive lenticule that is removed through a small peripheral incision. Clinical studies have shown results on par with LASIK with high efficacy and safety, and with few complications. However, complications during extraction of the refractive lenticule may lead to development of visually significant postoperative irregular astigmatism. The present study reports the outcome of topography-guided photorefractive keratectomy (PRK) after complicated SMILE.

Setting:

University hospital clinic.

Methods:

Five eyes with irregular topography and subjective complaints of ghost images after complicated SMILE were treated with transepithelial topography-guided PRK. In two eyes, 0.02% Mitomycin C was applied during surgery. Patients were examined after a minimum of 3 months with evaluation of uncorrected (UDVA) and corrected (CDVA) distance visual acuity, Pentacam tomography, and whole-eye aberrometry.

Results:

In three eyes, the subjective symptoms were reduced and UDVA, CDVA, tomography, and corneal wavefront aberrations were improved. However, in the remaining two eyes, significant haze developed with worsening of tomography and wavefront aberrations. A two-line reduction in CDVA was observed in one of these eyes. The two eyes with haze development had not received treatment with perioperative Mitomycin C.

Conclusions:

Transepithelial topography-guided PRK may be used to ameliorate significant visual symptoms due to irregular astigmatism after complicated SMILE. To reduce the risk of haze development, perioperative application of Mitomycin C should be considered. FINANCIAL INTEREST: NONE

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