Customized Autologous Small-Incision Lenticule Extraction-Derived Lenticle Implantation For Presbyopia Correction

To explore the feasibility of excimer laser customized autologous small-incision lenticule extraction (SMILE)-derived lenticule implantation for correcting presbyopia.

Three patients aged 52, 43 and 45 years old with myopic presbyopia correcting presbyopia with a small incision lenticule extraction (SMILE)-derived micro-lenticule modified by excimer laser. 

Two patients aged 43 and 45 years old with presbyopia underwent autologous microlenticule implantation after lenticule reshaping using an excimer laser. The non-dominant eye of the two patients was scheduled to undergo femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and femtosecond laser-assisted lenticule intrastromal keratoplasty, respectively. A reshaped autologous microlenticule is implanted in the stromal bed of the non-dominant eye. One 52-year-old patient corrected presbyopia with a small incision lenticule extraction (SMILE)-derived micro-lenticule modified by excimer laser. Visual acuity, manifest refraction, corneal topography, and optical coherence tomography images were examined. One year after microlenticule implantation, the uncorrected near visual acuity (UNVA) in the non-dominant eye of patients with improved significantly. All patients achieved a binocular uncorrected distance visual acuity of 20/20 and a UNVA of 20/25. All microlenticules were transparent and well-centered without haze or rejection. The topography showed a central area of prolateness corresponding to the microlenticules.

This pilot study demonstrated the safety and efficacy of autologous SMILE-derived microlenticules customized with an excimer laser for presbyopia correction; however, its long-term outcomes require further investigation.