Purpose: To evaluate the clinical outcome of laser-assisted surgical correction of high hyperopic or mixed astigmatism using small incision intrastromal lenticule rotation (SMILERO) alone or combined with photorefractive keratectomy (PRK).
Methods: This retrospective case series enrolled 25 eyes with high astigmatism that underwent SMILERO surgery. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), manifest refraction, central corneal thickness, and corneal higher order aberrations were analyzed before surgery and after 3, 6, and 12 months of follow-up. The postoperative residual refractive errors were fine-tuned using PRK.
Results: The median absolute preoperative cylinder of 4.50 diopters (D) decreased to 1.25 D at 3 months postoperatively. The lenticule rotation improved UDVA (0.80 vs 0.45 logMAR) due to a noticeable myopic shift. Regarding UNVA, 14 of 24 eyes were capable of reading Jaeger number 1 chart postoperatively in comparison to one eye preoperatively. The lenticule rotation led to successful correction of both astigmatic and spherical components in 13 of 25 eyes. The residual refractive errors in 12 of 25 eyes were fine-tuned postoperatively by PRK. The SMILERO and PRK combination led to a satisfactory refractive outcome with median absolute cylinder of 0.75 D, median spherical equivalent of -0.25 D, and median UDVA of 20/40 Snellen equivalent at 12 months postoperatively.
Conclusions: This study demonstrates that SMILERO is capable of correcting both corneal and refractive astigmatism with mid-term corneal stability. The residual refractive errors were further minimized with subsequent PRK fine-tuning. .
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Purpose: To evaluate the clinical outcome of laser-assisted surgical correction of high hyperopic or mixed astigmatism using small incision intrastromal lenticule rotation (SMILERO) alone or combined with photorefractive keratectomy (PRK).
Methods: This retrospective case series enrolled 25 eyes with high astigmatism that underwent SMILERO surgery. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), manifest refraction, central corneal thickness, and corneal higher order aberrations were analyzed before surgery and after 3, 6, and 12 months of follow-up.
Article Synopsis
- The study investigates a new surgical method that combines autologous astigmatic lenticule reshaping and rotation with excimer laser technology to treat high astigmatism.
- Six patients with severe astigmatism participated, undergoing customized lens cutting, corneal flap manipulation, and lenticule rotation to address residual refractive errors.
- Results showed that the technique is effective and safe, significantly improving vision quality while being tissue-sparing, though further research is needed to enhance predictability.
Clinical outcomes of stromal lenticule rotation to correct mixed astigmatism.
Eur J Ophthalmol
March 2024
Department of Ophthalmology, The First Affiliated Hospital of Northwest University, Xi'an, Shaanxi, China.
Purpose: To describe a stromal lenticule rotation surgical technique to correct mixed astigmatism and evaluate the initial clinical outcomes of this innovative approach.
Methods: This retrospective case series included five eyes from five patients with mixed astigmatism that underwent intrastromal lenticule rotation surgery. The eyes were evaluated for uncorrected visual acuity, corrected distance visual acuity, manifest refraction, central corneal thickness, corneal volume, anterior and posterior K readings, and corneal higher order aberrations (HOAs) (including total HOAs, spherical aberrations, coma, and trefoil) using the Scheimpflug-Placido topographer before and 3 months after surgery.
Corneal Ectasia after Laser-Assisted Small-Incision Lenticule Extraction: The Case for an Enhanced Ectasia Risk Assessment.
J Curr Ophthalmol
November 2022
Instituto de Olhos Renato Ambrósio/Visare Personal Laser, and Department of Ophthalmology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
Purpose: To present a case of asymmetric progressive corneal ectasia following femtosecond laser-assisted small-incision lenticule extraction.
Methods: After obtaining a patient's consent, preoperative and postoperative findings were represented in this case report.
Results: A 29-year-old woman presented with normal preoperative Placido disk-based corneal topography and tomographic findings.
Purpose: To comparatively investigate the changes in corneal thickness and curvature between small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK).
Methods: Data were collected preoperatively and postoperatively at 1 week, 1 month, and 3 months, including central corneal thickness (CCT), midperipheral corneal thickness (MPCT), peripheral corneal thickness (PCT), central keratometry (CK), midperipheral keratometry (MPK), and peripheral keratometry (PK), using a dual rotating Scheimpflug analyzer.
Results: At 1 week postoperatively, changes in CCT, MPCT, PCT, and PK were significantly greater in the SMILE group than in the FS-LASIK group ( = .
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