Right- Left Comparative Study About Techniques Of Smile Derived Lenticule Implantation In Hyperopia

To verify the visual outcomes and complications of the implantation of lenticules (one or two) obtained from myopic Small Incision Lenticule Extraction (SmILE) as an additive refractive procedure for overcoming high hyperopia.

All procedures from patient selection to evaluation were conducted in Negah Eye Hospital.

In a comparative right-left study the visual, refractive, keratometric outcomes, Endothelial cell count, Epithelial Thickness Map, Anterior Chamber Depth, and the level of the  Intraocular Pressure (IOP) were compared. Axial Length, the anterior chamber depth, and Horizontal Corneal Diameter were measured. Safety, stability, efficacy, and predictability for the two methods were compared. SmILE’s Lenticule implantation “SLI’’, as a tissue additive procedure, might become more favorable; in reducing postoperative regression and epithelial compensatory effects and forgiving to mild decentration than tissue ablative procedures. 

At the late postoperative visits, the Uncorrected visual acuity (UCVA) increased from Counting fingers’ baseline preoperative values at two meters to +0.4 logMar. Corneal topography showed a statistically significant decrease in the mean anterior and posterior curvature (6.68 to 5.62; p≤ 0.01), and (5.69 to 6.93; p≤ 0.01) respectively. The visual, refractive, and keratometric outcomes from the third month onwards were stable in two groups. There was no significant change in the visual outcome, Endothelial Cell Density (ECD), Epithelial Thickness Mapping (ETM), Anterior Chamber Depth (ACD), and the level of the IOP postoperatively (P ≥ 0.05).

Altogether, depending on actual preoperative status in small eyes, using a simple and reversible technique called “SLI” instead of more invasive intraocular procedures, may offer a safe and conceivable way for this problematic entity. Small eyes with high hyperopia almost always have two problems entity consisting of high hyperopia for laser refractive surgery and shallow Anterior Chamber Depth for phakic Intraocular Lens implantation.