ESCRS - CC01.10 - Intrastromal Lenticule Rotation To Correct High Hyperopic-Astigmatism

Intrastromal Lenticule Rotation To Correct High Hyperopic-Astigmatism

Published 2024 - 42nd Congress of the ESCRS

Reference: CC01.10 | Type: Case Report | DOI: 10.82333/wks7-0p74

Authors: Suphi Taneri* 1 , Anika Förster 2 , H. Burkhard Dick 3

1Eye center at St. Francis Hospital,Center of Refractive Surgery Muenster,Muenster,Germany;Ruhr-University Bochum,Bochum,Germany, 2Center of Refractive Surgery Muenster,Muenster,Germany, 3Ruhr-University Bochum,Bochum,Germany

Purpose

To report clinical outcomes of this new modality 

Setting

Eye Center at St. Francis Hospital, Münster, Germany

Report of case

Case 1: A 23-year-old male presented with a manifest refraction of OD +6.75 -6.0 X 19° =1.25 and OS +6.5 - 6.5 X 157° = 1.0 (decimal scale).

Case 2: A 19-year-old female presented with a manifest refraction of OD +6.25 -3.75 X11° = 1,25 and OS +7.5 -5.25 X 173° =1.25.

Case 3: A 46-year-old male presented with a manifest refraction of OD +4.75 -6.0 X 178° =1.33 and OS +5.0 - 6.5 X 17° = 1.0.

All corneas had regular astigmatism with orthogonal axes.

A flap and a toric lenticule with half of the refractive cylinder was created inside the corneal stroma using the SMILE software of the Visumax 500 (Carl Zeiss Meditec). After flap lifting, the lenticule was rotated by 90° and the flap repositioned. Thus, a spherical refraction was targeted. Additionally, a subsequent excimer laser ablation of the rotated lenticule for refinement was discussed with the patients.

Case 1 presented 8 months after surgery with a manifest refraction of OD +3.75 -2.0 X33° v=1.25 and OS +2.75 -1.0 X8° v=1.25. The second case had a manifest refraction of OD +4.75 -0.5 X158° v=1.33 and OS +5.25 -2.25 X121° =1.33 3 months after surgery.

Case 3 presented 5 months after surgery with a manifest refraction of OD +0.5 -0.5 X21° = 1.0 and OS +1.0 -1.0 X46° = 0.8.

Uncorrected visual acuity improved in all 6 eyes, but one eye lost one line of corrected visual acuity.

Conclusion/Take home message

Lenticule rotation is a promising new modality to correct high hyperopic-astigmatism outside the Femto-LASIK range. Additional excimer-laser ablation, either on the stromal surface or on the lenticule after flap-lifting, to correct residual manifest ametropia seems feasible.