ESCRS - FPM03.03 - Enhancements Options After Smile

Purpose

To evaluate the visual and refractive results of 3 enhancements options after SMILE : LASIK, CIRCLE and SUBCAP-LENTICULE EXTRACTION (LE).

Setting

Bellecour Vision Clinic, France

Methods

This retrospective study included 47 eyes of 47 patients which had undergone primary SMILE before an enhancement procedure to correct a residual refraction.

Three techniques of enhancement was evaluated : LASIK (8 eyes) with a mean of spherical equivalent (SE) of -0.75 ± 0.65 Dioptries (D), CIRCLE (20 eyes) with a mean SE of -0.38 ± 0.54 D and SubCap-LE (19 eyes) with a mean SE of -0.85 ± 0.40 D.

Uncorrected Distance Visual acuity (UDVA), Corrected Distance Visual acuity (CDVA), Refraction were measured in preoperative, at 1 day, 1 month and 1 year postoperatively.

Complications after laser enhancement were also evaluated.

Results

Before the primary SMILE, all eyes presented a CDVA of 20/25 Snellen or better. After 1 month of enhancement, all eyes recovered a CDVA of 20/25 Snellen or better.

Before enhancement, the mean UDVA were : 0.58 ± 0.11 logMAR in LASIK, 0.65 ± 0.24 logMAR in CIRCLE and 0.61 ± 0.20 logMAR in SubCap-LE. At 1 year postoperatively, the mean UDVA increased significantly in the 3 groups : 0.00 ± 0.05 logMAR in LASIK, -0.01 ± 0.07 logMAR in CIRCLE and -0.003 ± 0.01 logMAR in SubCap-LE.

At 1 year, 93%, 91% and 100% of eyes had 20/25 of UDVA, respectively in LASIK, CIRCLE ans SubCap – LE groups.

At 1 year, the mean of SE were +0.45 ± 0.20 D in LASIK, +0.18 ± 0.35 D in CIRCLE and +0.24 ± 0.64 D in SubCap-LE.

No complications were observed.

Conclusions

These three options of enhancement were safe and effective to treat a residual refraction after SMILE. Regarding biomechanical cornea, SubCap-LE is the best option. However, CIRCLE is the easiest