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Small incision lenticule extraction combined with astigmatic keratotomy to treat high astigmatism or mixed astigmatism

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Session Details

Session Title: Interactive Free Paper Session: Femtosecond Small Lenticule Extraction I

Session Date/Time: Monday 07/09/2015 | 09:00-11:00

Paper Time: 10:12

Venue: Room 19

First Author: : B.Kim SOUTH KOREA

Co Author(s): :    Y. Chung   S. Mun   D. Lee              

Abstract Details


Small-incision lenticule extraction (SMILE) is a relatively new technique for correcting myopia and myopic astigmatism, and recent evidence suggests that this procedure affords excellent clinical outcomes, and is safe, effective, and predictable. But SMILE is limited to refractive correction of up to 10 diopters (D) of myopia, 5 D of astigmatism, and 10 D of the sum of myopia and astigmatism. Astigmatic keratotomy is effective in correcting astigmatism. Using this procedure it is possible to operate on patients with high-level or mixed astigmatism.


Onnuri Eye Clinic, Jeonju, Korea.


We included 13 eyes of nine patients with high-level or mixed astigmatism who underwent astigmatic keratotomy followed by SMILE (thus secondarily) to correct residual refractive error.


Six months after SMILE, the spherical equivalent was reduced from –4.83 ± 3.26 to –0.17 ± 0.38 D (p < 0.001) and astigmatism was reduced from 5.12 ± 0.96 to 0.21 ± 0.22 D (p < 0.001). The uncorrected (UDVA) and corrected (CDVA) distance visual acuities improved from 1.07 ± 0.62 to 0.02 ± 0.13 (p < 0.001) and from 0.08 ± 0.14 to –0.01 ± 0.14 (p = 0.002), respectively. The CDVA improved by one or two Snellen lines in eight cases (61.5%) and there was no loss in CDVA. All procedures were completed without intra- or post-operative complications.


SMILE is effective in correct myopic astigmatism, however it is currently restricted to less than 10 D of myopia, 5 D of astigmatism, and 10 D of the sum of myopia and astigmatism, and cannot correct hyperopia. In our study, the combined procedure of SMILE and astigmatic keratotomy was effective and safe in the treatment of high- level or mixed astigmatism.

Financial Interest:


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