Comparison Of Very Low Laser Energy Levels In Small-Incision Lenticule Extraction: Short Term Clinical Results, Video Analysis, Histologic Study Of Lenticules
Published 2024 - 42nd Congress of the ESCRS
Reference: FP12.11 | Type: Free paper | DOI: 10.82333/y5sr-5s05
Authors: Sangyoon Hyun* 1 , Taehwan Moon 1 , Moonsun Jung 2
1First eye clinic,Cheongju-si,Korea, Republic Of, 2Ophthalmology,Chungbuk national university college of medicine,Cheongju-si,Korea, Republic Of
Purpose
To investigate the effects of reducing energy levels during Small-Incision Lenticule Extraction (SMILE) surgery using the femtosecond laser ATOS (Schwind, Germany) on short-term surgical outcomes and lenticule surface roughness.
Setting
First eye clinic, Cheongju-si, Republic of Korea
Methods
From November 2023 to January 2024, 55 patients (110 eyes) undergoing myopia correction with SMILE surgery at our clinic using ATOS were included. Patients were divided into an experimental group (80nJ, L-group) and a control group (90nJ, C-group) to compare uncorrected visual acuity (UCVA) and mean spherical equivalent (SE) at 1 day, 1 week, and 1 month post-surgery. Video analysis during surgery was used to compare the incidence of opaque bubble layer (OBL) and black area. The surface regularity of the extracted lenticules were observed using scanning electron microscopic picture and evaluated qualitatively and quantitatively.
Results
Postoperative UCVA (LogMAR) at 1 day and 1 week was better in the experimental group compared to the control group (p<0.05). At 1 month, there was no significant difference in UCVA between the groups (p>0.05). The mean SE at 1 week showed no significant difference between the groups (p>0.05). Black area during surgery did not differ significantly between the groups (p=0.22), but the OBL area was significantly larger in the control group compared to the experimental group (p<0.01). The lenticule surface in experimental group is smoother the control group (P<0.01)
Conclusions
Lowering the energy level to 80nJ in SMILE surgery with ATOS equipment showed differences in initial vision recovery, reduced occurrence of OBL, and improved lenticule surface roughness. This suggests that lower energy levels can achieve stable initial vision recovery and reduce the incidence of surgical complications. Further research is needed to evaluate the long-term surgical outcomes and effects on the cornea, as well as to optimize energy levels.