CLINICAL OUTCOMES OF SMALL INCISION LENTICULE EXTRACTION(SMARTSIGHT) WITH CROSS-LINKING TECHNIQUE

To study the safety and clinical outcomes of refractive lenticule extraction(SmartSight, ATOS, Schwind) with accelerated cross-linking

Patients first underwent SMILE procedure with ATOS(Schwind) for correction of myopic refractive error.

Even if the corneal thickness is thicker than average, the correction criteria for myopia are as follows.
Only patients with a preoperative spherical equivalent  value of -9.0D or less and an estimated residual stromal thickness value of 300 um or more underwent surgery.

In addition, only patients with an expected postoperative K value of 34 or higher were included.

Patients first underwent lenticule extractin procedure with ATOS(Schwind) for correction of myopic refractive error. 0.25% riboflavin in saline was injected into the interface and allowed to diffuse for 30 seconds. Finally, eye was exposed to UV-A radiation of 20 mW/cm(2) for 30 seconds through the cap. 40 eyes of 20 patients with mean age of 29.42± 7.37 years were treated.  Mean spherical equivalent (SE) was -6.83 ± 3.36 D preoperatively and -0.16 ± 0.38 D postoperatively.

The mean central corneal thickness (CCT) and keratometry changed from 542 ± 35.21 µm to 421 ± 41.89 µm and 42.75 ± 2.32 D to 38.12 ± 2.45 D, respectively. Mean uncorrected visual acuity (UCVA) was 20/25 or better in all eyes. No eyes lost lines of corrected distant visual acuity (CDVA). There were no complications like haze, keratitis, ectasia.

Refractive lenticule extraction with crosslinking  may be a safe method to prevent corneal ectasia in susceptible individuals.