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Lenticule intrastromal keratoplasty (LIKE) for hyperopia correction

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Session Details

Session Title: Moderated Poster Session: What is New and Hot by Great Speakers

Venue: Poster Village: Pod 1

First Author: : T.Seiler SWITZERLAND

Co Author(s): :    P. Krishna   M. Bhavatharini   T.G. Seiler        

Abstract Details

Purpose:

To evaluate refractive outcome and to document absence of serious complications of Lenticule intrastromal keratoplasty (LIKE). Current surgical hyperopia correction includes hyperopic LASIK (≤3.0 D) and phakic IOLs (anterior chamber depth, ACD ≥ 3.0mm). Hyperopia corrections of more than 3D in eyes with shallow anterior chamber are currently highly questionable.

Setting:

Institute of Refractive Surgery (IROC), Zürich, Switzerland and LV Prasad Eye Institute, Hyderabad, India

Methods:

Ten eyes of 8 patients were treated and followed for 6 months. Intended correction ranged from +3.0 to +7.0 diopters and all eyes had an ACD ≤ 3.0mm. The aspheric lenticules (Ø=7.5mm) were created using a mechanical microkeratome with micrometer-precision (Gebauer, Germany) from human donor corneas not elected for transplantation and contained an intact Bowman´s layer at the anterior surface. The lenticules were positioned under a LASIK-flap with a diameter of 9.5mm centered on the middle between Pukinje-image and center of the entrance pupil. The eyes received postoperatively a bandage lens for 24 hours loaded with dexamethasone and antibiotic.

Results:

Surgery and early post-operative follow-up was uneventful, no adverse reactions were seen. Repositioning of the lenticule was necessary in 2 eyes at day 1 after surgery (learning curve). At 1 month, in 5 eyes (50%) a relift was necessary for topography-guided correction of residual astigmatism on the lenticule using an excimer laser (Amaris 1050, Schwind, Germany). At 6 months, 9 eyes (90%) were within ±1.0D from target refraction. Four eyes showed DLK II which resolved after steroid therapy. Two eyes had discrete non-progressive epithelium ingrowth. Corneal topography showed OZ of 7.0mm without any significant gradient.

Conclusions:

This first prospective series of hyperopic correction using LIKE serves as a pilot study to prove the concept regarding refractive success and absence of serious complications. Advantages of LIKE include easy reversibility and the option of refractive fine tuning by means of topography-guided photoablation on the lenticule. These currently good results encourage us to go forward with a phase II-study once we have concluded the 1 year-follow up.

Financial Disclosure:

NONE

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