A New Successful Approach For Emmetropic Presbyopic Patients Using Intrastromal Pocket With Smile Module - Long Term Follow-Up

Published 2022 - 40th Congress of the ESCRS

Reference: FPT03.02 | Type: Free paper | DOI: 10.82333/xvnq-w423

Authors: Njomza Hima Hima Musa* ¹ , Faruk Semiz ¹ , Anita Syla Lokaj ¹ , Ceren Ece Semiz ¹ , Zekeriya Alp Demirsoy ¹

¹Ophthalmology,Eye Hospital,Pristina,Albania

Purpose

In our study, we have noticed that only cornea, just like a window, is where rays enter the eye and contribute by providing 65-75% of the eye's total refraction, is more flexible in old age, especially from 40-50 years old (mild to moderate presbyopia), offering us the chance to cure presbyopia.

The purpose of our study, was to open an intrastromal pocket in the corneas of presbyopic emmetropic patients by making use of this feature of the cornea by increasing Q corneal values elasticity, shaping the cornea to clarify the near vision without disturbing the far distance.

Setting

Eye Hospital

Department of Ophthalmology

Prishtina

Republic of Kosovo

Methods

This study was carried out in 60 eyes of 30 patients (40-50 years old) with an emmetropic presbyopic complaint at Pristina Eye Hospital between 2018 and 2019.

All surgical procedures were performed by the same surgeon under topical anesthesia.VisuMax femtosecond laser created a stromal pocket with a diameter of 7.60 mm and a cover thickness of 120 µm from the corneal surface and with a 2 mm incision. The pocket was dissected using a blunt spatula. The postoperative therapy included antibiotic eye drops (moxifloxacin hydrochloride) and steroidal eye drops (dexamethasone), administered four times per day for one month

Results

This study was performed on 60 eyes of 30 patients (40-50 years old) with emmetropic presbyopic complaints.

The patients were 16 female (53.3%) and 14 male (46.7%)

Pupil diameters of the patients 5.65 ± 0.82 [4.4 to 7.3] mm

Q value decreased from -0.38 ± 0.07 [-0.52 to -0.26] in pre op to -0.59 ± 0.09 [-0.77 to -0.41]

Post-Op 1 month Q value minimal increaced from -0.59 ± 0.09 [-0.77 to -0.41] to -0.53 ± 0.08 [-0.7 to -0.38]

Post-op 3 month, Q value increaced from -0.53 ± 0.08 [-0.7 to -0.38] to -0.49 ± 0.08 [-0.65 to -0.33]

Post-op 6 month. Little increase between -0.48 ± 0.08 [-0.64 to -0.31]

Post-op 1 year Q value never returned to pre op value from -0.38 ± 0.07 [-0.52 to -0.26] to -0.48 ± 0.08 [-0.64 to -0.31]

All patients reported satisfaction

Conclusions

Our presbyopic treatment shows that intrastromal pocket preparation using the SMILE module by increasing Q corneal values without changing in distance visual acuity for emmetropic patients with presbyopia improves near vision (reading, writing, using electronic devices etc.) which are sufficient to satisfy an individual’s requirements perceiving comfort and convenience in their daily life.

Another advantage of our study is that since we only increase corneal elasticity and we do not impair distance vision, patients will be able to use the lenses they want (trifocal and similar) in their surgeries when they have cataracts in the future.