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Patterned corneal cross-linking to treat residual refractive errors post SMILE

Poster Details

First Author: A.Bonniard CANADA

Co Author(s):    D. Dejager   C. Kranemann                 

Abstract Details


To determine the effects of patterned corneal crosslinking (PiXL) via either an Epi On with corneal pocket approach vs. an Epi Off approach for residual refractive errors post SMILE>


Clearview Institute


Patients were prospectively randomized to either an Epi On with corneal pocket or and Epi Off approach for the correction of residual refractive errors post SMILE. They underwent a 12 minute soak with Riboflavin 0.25% either into the corneal pocket with the former or onto the ocular surface with the latter. PiXL was applied using a standard protocol and with oxygen supplementation. All patients met the inclusion criteria for laser vision correction. They all underwent a complete ocular examinations, topographies, wavefronts, endothelial cell counts and anterior segment OCT preoperatively and at month 1 and 3 postoperatively.


3 patients were randomized to either group. The preoperative astigmatism range from -.75 to -1.75 with a mean of -1.35 diopters and the sphere from -.75 to .5 with a mean of -.25 diopters. At month 3 the residual astigmatism was -.5 to plano with a mean of -.35 diopters and the sphere -.25 to .25 with a mean of -.1 diopters. All patients improved at least 2 lines of uncorrected distance visual acuity (UDVA) and achieved at least 20/20 UDVA.1/3 patients in the pocket group had grade 2/4 corneal haze at month 1 that resolved by month 3.


Both approaches in this pilot appeared to be effective to reduce the residual refractive error. There was no difference in effectiveness between the two groups. Whether or not corneal haze at month 1 is more frequent in the pocket group would require a larger sample size. At month 3 both approaches appeared equally safe and deserve further study.

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