Post Smile And Ipcl – A Postoperative Comparison
Published 2023 - 41st Congress of the ESCRS
Reference: PO0962 | DOI: 10.82333/3cpt-c962
Authors: Machteld Devenijn* 1 , Ann-Isabel Mattern 1 , Detlev Breyer 1 , Markus Pölzl 2 , Kai Neller 3 , Hakan Kaymak 4
1Internationale Innovative Ophthalmochirurgie GbR,Duesseldorf,Germany, 2Nordblick Eye Clinic Bellevue,Kiel,Germany, 3Internationale Innovative Ophthalmochirurgie GbR,Duesseldorf,Germany;Saarland University,Institute of Experimental Ophthalmology,Homburg/Saar,Germany, 4Internationale Innovative Ophthalmochirurgie GbR,Duesseldorf,Germany;Institute of Experimental Ophthalmology,Homburg/Saar,Germany
Refractive surgery makes it possible to obtain clear vision in the distance without spectacle lenses or contact lenses. Small-incision lenticule extraction (SMILE) and implantable phakic collamer lens (IPCL) are popular methods among young myopic adults for long-term correction of their myopia. IPCL is particularly used in highly myopic patients (<-6 dpt). The question arises whether postoperative biometrical changes can be observed between SMILE and IPCL patients or whether axial length growth in myopic patients stopped after the age of 18.
A multicentric examination at Breyer Kaymak Klabe Augenchirurgie, Düsseldorf, Germany and nordBLICK Augenklinik Bellevue, Kiel, Germany.
Myopic young adults who underwent binocular SMILE or IPCL were given the opportunity to have their eyes examined at a follow-up visit (biometry using Zeiss IOL-Master 700, subjective refraction, examination of the anterior and posterior segment of the eye using the slit lamp).
54 SMILE-patients (age 30,70 ± 3,90 years) appeared at the visit; the SMILE was 2,78 ± 1,12 years ago. The preoperative spherical equivalent was -4,03 ± 1,85 dpt and changed to -0,09 ± 0,23 dpt. A decrease in central corneal thickness due to surgery of 0,650 ± 0.025 mm (p<0.001) as well as a decrese in axial length without considering central corneal thickness from 24.63 ± 1.09 mm to 24.58 ± 1.08 mm (p<0.01) were found. 13 IPCL patients (age 32,0 ± 4,10 years) came to the visit. The surgery was 2,97 ± 1,75 ago and the preoperative spherical equivalent was -7,93 ± 2,85 dpt. Postoperatively, this was -0.33 ± 0.48 dpt. The axial length increased from 26,25 ± 1,70 mm to 26,48 ± 1,83 mm postoperatively (p<0,001).
The collected axial lengths and refractions show no relevant change in the eyes regarding progression of myopia in the SMILE group. The altered corneal profile after SMILE surgery appears to cause a peripheral positive defocus, which may lead to the inhibition of myopia progression. A significant increase of axial length was found in the IPCL group. This suggests that in highly myopic patients after the age of 18, axial length growth is not complete.