Lasik/Smile Outcomes In Patients With Preoperative Asymptomatic Anterior Basement Membrane Dystrophy (Abmd)

Published 2024 - 42nd Congress of the ESCRS

Reference: FP12.01 | Type: Free paper | DOI: 10.82333/08nn-ba92

Authors: Glenn Carp* ¹ , Dan Reinstein ² , Timothy Archer ³ , Joseph Potter ³ , Ruchi Gupta ³

¹London Vision Clinic,London,United Kingdom, ²Reinstein Vision,London,United Kingdom;London Vision Clinic,London,United Kingdom;Columbia University Medical Center,New York,United States;Sorbonne Université,Paris,France;Biomedical Science Research Institute, Ulster University,Coleraine,United Kingdom, ³Reinstein Vision,London,United Kingdom;London Vision Clinic,London,United Kingdom

Purpose

To evaluate the incidence of anterior basement membrane dystrophy (ABMD) that required further treatment by PTK in a population of eyes treated by femtosecond LASIK or SMILE

Setting

London Vision Clinic, London, UK

Methods

Retrospective analysis of 25,181 eyes that underwent femtosecond LASIK or SMILE at London Vision Clinic between Feb 2009 to Mar 2019. All eyes underwent full ophthalmological examination before surgery and cases of ABMD were graded. Mild and/or asymptomatic ABMD with no signs of recurrent corneal erosions and no movement on the Epithelial Stress Test underwent LASIK or SMILE. Patients with symptomatic ABMD underwent a surface procedure. These patients were given an additional consent form to highlight the increased risk that a therapeutic treatment for ABMD may be required after surgery. The incidence of an intraoperative epithelial slide and the need for a therapeutic treatment were compared between the ABMD group and no ABMD group.

Results

Of the total population of patients presenting for refractive surgery, the overall incidence of ABMD before surgery was 3.18% (802/25181). Of the 802 eyes diagnosed with ABMD before surgery, 790 eyes (98.5%) underwent a LASIK or SMILE procedure (ABMD group). During surgery an intraoperative slide occurred in 72 eyes (8.98%) in the ABMD group compared to 365 eyes (1.50%) in the no ABMD group. A therapeutic treatment for ABMD such as PTK, PRK or epithelial debridement was performed in 12 eyes (1.50%) in the ABMD group compared to 19 eyes (0.08%) in the no ABMD group. In the ABMD group a second therapeutic treatment was required in 5 eyes (41.7%) compared to 2 (10.5%) eyes in the no ABMD group.

Conclusions

This study has demonstrated that LASIK and SMILE is a safe and effective refractive procedure for patients with asymptomatic ABMD before surgery. In eyes that had clinically visible mild signs of ABMD before surgery, that would have traditionally undergone a surface procedure, 91% had a completely routine LASIK/SMILE procedure and benefitted from the many advantages of undergoing LASIK/SMILE compared with PRK.