Hyperopic Relex Smile

To present the world's first clinical results of laser kerato-lenticule extraction (KLEX) or small incision lenticule extraction (SMILE) for hyperopia correction following the market release. 

Gemini Eye Clinics, Zlin, Czech Republic

36 eyes of 19 patients (11 male, median 27 of years (range 20 to 40), who underwent hyperopia correction by KLEX/SMILE laser refractive surgery. Standard protocol used optical zone of 6.3 mm with a transition zone of 2 mm. Postoperative patients were given antibiotic and steroid eye drops Levofloxacin and combined Tobramycin and Dexamethasone 3 times a day.  Follow ups at 1W, 1M and 3M evaluated subjective and objective refraction, monocular uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), monocular uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA) as well as slit lamp examination were evaluated. All values are presented as median and 25–75% interquartile ranges. 

The subjective spherical equivalent at preop was +4.6 D (3.4; 5.6 IQR) and significantly decreased to 0.0 D (-0.59; 0.0) at 1W after surgery and 0.0 D (-0.09; 0.19) at 3M postoperatively. UDVA improved from 0.48 logMAR (0.30; 0.70) to 0.15 logMAR (0.06; 0.40) at 1W and 0.05 logMAR (0.0; 0.15) at 3M. 95% of eyes achieved 0.2 logMAR and better at 3M. CDVA slightly worsened to 0.04 logMAR (0.02; 0.11) at 3M. However, overall gradual recovery of CDVA was noted as 5 eyes showed a loss of 2 lines at 1W, while at 1M there was only one eye with this loss. UNVA at 3M was J1. Slit lamp examination at 3 months revealed mild debris in 4 eyes (11%), light scatter in mid periphery in 2 eyes (5%) and corneal punctate epitheliopathy in 3 eyes (16%). 

The initial outcomes confirms that hyperopia correction with KLEX / SMILE is effective and safe. Longer follow-up on more patients across various sites is desirable to further evaluate this method.