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The use of Nd:YAG laser to effect ingrown epithelium after SMILE

Poster Details

First Author: I.Dutchin RUSSIA

Co Author(s):    M. Pshenichnov                    

Abstract Details


to evaluate the effectiveness of the impact on the ingrown epithelium of the ND: YAG laser after the ReLEx Smile operation for myopia. To influence the ingrown epithelium, we used an ND:YAG laser with a double Q-factor "ULTRAQ" (“Ellex Medical”, Australia), a wavelength of 1064 nm. Delivery of laser energy was carried out with the help of a contact operating lens "Abraham capsulotomy". The contact background "Korneregel" was used, after the preliminary epibulbaric anesthesia by Alcain solution.


The work was performed in the State Institution Eye Microsurgery Complex named after academician S.N. Fyodorov, Khabarovsk, Russia.


Patient N., 32 years old, underwent ReLEx Smile surgery to correct myopia of medium degree of both eyes. Operation has passed without features. After 1 month during the follow-up: visual acuity OD = 1.0, OS = 1.0. The indicators of ophthalmometry corresponded to the calculated, with biomicroscopy, at the periphery of the cornea of the left eye, in front of the cut section, a local zone of epithelial growth in the interface was determined. Its dimensions: 1.5 x 2.0 mm. When OCT is performed, additional inclusions are present in the corneal periphery interface.


Intervention technology: impulses of 0.3 mJ were applied in the interface on epithelium grown under "Cap" area till formation of a vapor-gas bubble. We applied the pulses in such a way that single small bubbles merged and at the time of the end of the procedure, a single large bubble formed at the site of exposure under the "Cap" area, occupying entire zone of the ingrown epithelium. 251 impulses were applied. A week after considerable regression of the ingrown epithelium zone was achieved, only its isolated islets remained. They were re-exposed (49 pulses), also till the appearance of the bubble.


Thus, the use of the ND:YAG laser with a double Q-factor "ULTRAQ" is an effective method of controlling the epithelium ingrown under "Cap" area after refractive operations. The advantage of this technique is its sufficient ease of implementation, no need for surgical manipulations in the interface, which is especially important in the ReLEx Smile technology.

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