ISTANBUL escrs

To evaluate the safety and initial outcomes of SMILE Xtra (ReLEx SMILE with accelerated cross linking) in patients with high myopia and borderline topography.

Session Details

Session Title: Cornea
Session Date/Time: Sunday 22/02/2015 | 08:30-11:00
Paper Time: 10:18
Venue: Hall 2
First Author: : S.Ganesh INDIA
Co Author(s): :    S. Brar              

Abstract Details

Purpose:

To describe a new technique, SMILE Xtra, which may safely allow laser refractive correction in patients with higher refractive errors ie spherical equivalent (SE) upto -10D) and borderline corneas for thickness (<480µ) and suspicious topography without increasing risk of ectasia in future.

Setting:

Nethradhama Super Speciality Eye Hospital, Bangalore, India.

Methods:

Eligible candidates first underwent ReLEx SMILE surgery for correction of myopic refractive error. Following removal of lenticule through 2mm superior incision, 0.1-0.2ml riboflavin(0.25% riboflavin in saline ) was applied to the interface and allowed to diffuse for 60 seconds. Interface was washed and exposed to UV-A radiation at 45 mW/ cm2 to facilitate cross-linking for 75 seconds. Total energy delivered was 3.4 J/cm2. Mean follow up was at least 12 months.

Results:

SMILE Xtra was performed in 40 eyes of 20 patients, with pre op mean spherical equivalent -5.026 ± 2.06 D, mean pachymetry 501.3 ±10.06 µ , mean keratometry 45.46 ± 1.40 D and average endothelial cell density (ECD) 2872 cells/mm². At 12 months post op, mean residual SE was -0.32 ± 0.22 D, mean pachymetry 414.8 ±15.36 µm , K mean 41.28 ± 2.20 and mean ECD 2764.3 cells/mm² . Stromal line of demarcation was seen at mean depth of 225.7 ±18.4 µm . There were no intraoperative complications or postoperative haze .None of the eyes had loss of BCVA.

Conclusions:

SMILE Xtra may to be a safe and promising modality to prevent corneal ectasia in thinner corneas / borderline topography and higher refractive errors. However, longer follow-up is required to evaluate the efficacy and refractive stability of the cornea.

Financial Disclosure:

NONE

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