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  • SLACK, Inc.  (17)
  • 1
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    Predictive Formula for Refraction of Autologous Lenticule Implantation for Hyperopia Correction
    SLACK, Inc. ; 2017
    In:  Journal of Refractive Surgery Vol. 33, No. 12 ( 2017-12), p. 827-833
    Details
    In: Journal of Refractive Surgery, SLACK, Inc., Vol. 33, No. 12 ( 2017-12), p. 827-833
    Abstract: To create a formula to predict refractive correction of autologous lenticule implantation for correction of hyperopia (with myopia in one eye and hyperopia in the contralateral eye). METHODS: In this prospective study, 10 consecutive patients (20 eyes) who had myopia in one eye and hyperopia in the contralateral eye were included. The preoperative spherical equivalent was −3.31 ± 1.73 diopters (D) for the myopic eyes and +4.46 ± 1.97 D for the hyperopic eyes. For each patient, the myopic eye was treated with small incision lenticule extraction and the lenticule was subsequently implanted into the contralateral hyperopic eye. The average length of follow-up was 17 months. RESULTS: All of the operations were successful without complications. At the last visit, the efficacy index (postoperative uncorrected distance visual acuity/preoperative corrected distance visual acuity [CDVA]) of the hyperopic eyes was 0.94 ± 0.35 and the safety index (postoperative CDVA/preoperative CDVA) was 1.36 ± 0.38. No eyes lost any lines of visual acuity. Six of 10 (60%) of the implanted eyes were within ±1.00 D of the intended refractive target. A predictive formula was derived: Lenticule implantation achieved correction (D) (LAC) = 1.224 Lenticule refractive power (D) (LRP) – 0.063 ( R 2 =0.92, P 〈 .001). On corneal topography, there was a significant increase in the corneal anterior surface keratometry value postoperatively, whereas the posterior surface keratometry value remained stable ( P 〉 .05). CONCLUSIONS: Autologous lenticule implantation could provide a reliable method of correcting hyperopia. The refractive correction formula may require further verification and adjustment. [ J Refract Surg . 2017;33(12):827–833.]
    Type of Medium: Online Resource
    ISSN: 1081-597X
    URL: Article
    DOI: 10.3928/1081597X-20171016-01
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2017
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  • 2
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    Management of Suction Loss During SMILE in 12,057 Eyes: Incidence, Outcomes, Risk Factors, and a Novel Method of Same-Day Recutting of Refractive Lenticules
    SLACK, Inc. ; 2020
    In:  Journal of Refractive Surgery Vol. 36, No. 5 ( 2020-05), p. 308-316
    Details
    In: Journal of Refractive Surgery, SLACK, Inc., Vol. 36, No. 5 ( 2020-05), p. 308-316
    Abstract: To determine the incidence, management, outcomes, and risk factors of suction loss during femtosecond laser small incision lenticule extraction (SMILE) for the treatment of myopia and myopic astigmatism. METHODS: The study reviewed 12,057 consecutive eyes treated with SMILE. Eyes that developed suction loss (study group) or underwent uneventful SMILE (control group) were analyzed. Corneal topography, manifest refractions, and measurements of uncorrected (UDVA) and corrected (CDVA) distance visual acuities were evaluated preoperatively and postoperatively after 1 day and 12 months. Risk factors were determined for suction loss development. RESULTS: Twenty-seven of 12,057 eyes (0.22%) were enrolled in the study group and 50 eyes in the control group. Suction loss occurred in 14 eyes during the cutting of the refractive lenticule, 7 eyes during the cutting of the cap, and 6 eyes during the creation of the cap small incision. There was no statistically significant difference between the two groups in logMAR UDVA ( P = .52) or CDVA ( P = .59). A novel method of increasing cap thickness was applied to 8 eyes when suction loss occurred after more than 10% of the lenticule was cut. The eye being operated on first (the right eye) ( P = .02) and a thinner lenticule ( P = .006) were associated with a significantly higher risk of developing suction loss. CONCLUSIONS: The incidence of suction loss was low. The novel method achieved visual and refractive outcomes as favorable as those of uneventful SMILE procedures. The first eye that was operated on had a higher risk for the development of suction loss. [ J Refract Surg . 2020;36(5):308–316.]
    Type of Medium: Online Resource
    ISSN: 1081-597X
    URL: Article
    DOI: 10.3928/1081597X-20200323-01
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2020
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  • 3
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    Treatment of Corneal Ectasia by Implantation of an Allogenic Corneal Lenticule
    SLACK, Inc. ; 2018
    In:  Journal of Refractive Surgery Vol. 34, No. 5 ( 2018-05), p. 347-350
    Details
    In: Journal of Refractive Surgery, SLACK, Inc., Vol. 34, No. 5 ( 2018-05), p. 347-350
    Abstract: To describe a case in which post-LASIK corneal ectasia was treated using an allogeneic lenticule implanted into the recipient eye. METHODS: A 29-year-old man presented with bilateral ectasia 10 years after LASIK. Manifest refraction was −1.50 −3.25 × 15° in the right eye and −13.50 −6.00 × 10° in the left eye. Because of contact lens intolerance in the left eye, the authors decided to implant an allogenic corneal lenticule, created by small incision lenticule extraction with the VisuMax laser (Carl Zeiss Meditec, Jena, Germany) in a donor eye with a refraction of +5.75 −0.50 × 15°. The intended peripheral thickness was 116 μm and the central thickness was 20 μm. The lenticule was placed under the original LASIK flap in the left eye. RESULTS: Ten months after surgery, refraction of the left eye had improved to −3.25 −1.50 × 10° with a corrected distance visual acuity of 20/40. The front corneal flat and steep values were decreased by 6.20 and 5.90 diopters (D), respectively, relative to corresponding preoperative values. The cornea remained clear throughout the follow-up. CONCLUSIONS: Implantation of an allogenic lenticule may be an option in the treatment of advanced ectasia. [ J Refract Surg. 2018;34(5):347–350.]
    Type of Medium: Online Resource
    ISSN: 1081-597X
    URL: Article
    DOI: 10.3928/1081597X-20180323-01
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2018
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  • 4
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    Optical Quality and Intraocular Scattering After Femtosecond Laser Small Incision Lenticule Extraction
    SLACK, Inc. ; 2014
    In:  Journal of Refractive Surgery Vol. 30, No. 5 ( 2014-05), p. 296-302
    Details
    In: Journal of Refractive Surgery, SLACK, Inc., Vol. 30, No. 5 ( 2014-05), p. 296-302
    Abstract: To investigate objective optical quality and changes in light scatter after femtosecond laser small incision lenticule extraction (SMILE) for moderate to high myopia correction. METHODS: Prospective clinical study of 66 eyes of 66 patients (23 males, 43 females) with a mean age of 28.67 ± 6.62 years, mean spherical refraction of −6.06 ± 1.57 diopters, and mean cylindrical refraction of −0.68 ± 0.46 diopters. Every patient had a 3-month follow-up after a standard SMILE procedure. An optical quality analysis system was used to measure modulation transfer function cutoff frequency (MTF cutoff ), Strehl2D ratio, and objective scatter index (OSI). RESULTS: At 3 months postoperatively, mean spherical equivalent was 0.03 ± 0.24 diopters and corrected distance visual acuities of all patients were equal to or better than preoperative values, with a mean safety index of 1.12 ± 0.17 (range: 0.80 to 1.50) and mean efficacy index of 1.18 ± 0.21 (range: 0.80 to 1.50). Mean OSI increased from 0.75 preoperatively to 1.09 at 20 days postoperatively ( P 〈 .05), and gradually declined to 0.94 at 40 days and 0.82 at 3 months postoperatively ( P 〉 .05). MTF cutoff and Strehl2D ratio did not change significantly compared with preoperative values ( P 〉 .05). Multiple linear regression analysis revealed that preoperative OSI was significantly correlated with optical quality at 3 months. Patients with less preoperative OSI tended to acquire higher MTF cutoff (b = −8.61) and lower OSI (b = 0.65) ( P 〈 .05). CONCLUSIONS: SMILE had little impact on retinal image quality after myopia correction. Postoperative OSI showed a temporary increase and then returned to normal. [ J Refract Surg. 2014;30(5):296–302.]
    Type of Medium: Online Resource
    ISSN: 1081-597X
    URL: Article
    DOI: 10.3928/1081597X-20140415-02
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2014
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  • 5
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    Development of the Continuous Curvilinear Lenticulerrhexis Technique for Small Incision Lenticule Extraction
    SLACK, Inc. ; 2015
    In:  Journal of Refractive Surgery Vol. 31, No. 1 ( 2015-01), p. 16-21
    Details
    In: Journal of Refractive Surgery, SLACK, Inc., Vol. 31, No. 1 ( 2015-01), p. 16-21
    Abstract: To develop and evaluate the new continuous curvilinear lenticulerrhexis (CCL) technique for small incision lenticule extraction. METHODS: Thirty-one eyes of 20 patients with myopia were included in the study. The CCL technique for lenticule extraction was developed and used in 16 eyes of 10 patients (CCL group). The traditional technique of lenticule extraction was used in 15 eyes of 10 patients (traditional group). Uncorrected and corrected distance visual acuity, manifest refraction, lenticule quality, the duration of the extraction procedure, microdistorsions in Bowman’s layer under optical coherence tomography (Optovue OCT; Optovue, Inc., Fremont, CA), and adverse events were evaluated at 1 day and 1 month postoperatively. RESULTS: At the first postoperative month, all eyes in both groups had an uncorrected distance visual acuity of 1.0 or better. The safety indices were 1.12 and 1.09 for the CCL and traditional groups, respectively. The efficacy indices were 1.06 and 1.09 for the CCL and traditional groups, respectively. All lenticules in the CCL group had intact, round margins, whereas one lenticule in the traditional group had a microdefect margin. There was no statistically significant difference in duration of lenticule extraction or microdistorsions in Bowman’s layer. No eyes in the CCL group developed diffuse lamellar keratitis, as compared to one eye in the traditional group. CONCLUSIONS: The CCL technique exhibited excellent safety and efficacy for myopia correction, suggesting CCL is a promising technique that merits further development and study. [ J Refract Surg . 2015;31(1):16–21.]
    Type of Medium: Online Resource
    ISSN: 1081-597X
    URL: Article
    DOI: 10.3928/1081597X-20141218-02
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2015
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  • 6
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    Visual Outcomes After Implantation of Allogenic Lenticule in a 100-µm Pocket for Moderate to High Hyperopia: 2-Year Results
    SLACK, Inc. ; 2021
    In:  Journal of Refractive Surgery Vol. 37, No. 11 ( 2021-11), p. 734-740
    Details
    In: Journal of Refractive Surgery, SLACK, Inc., Vol. 37, No. 11 ( 2021-11), p. 734-740
    Abstract: To investigate 2-year visual outcomes, stability, and predictability after allogenic lenticule implantation in a 100-µm pocket for moderate to high hyperopia correction. METHODS: In this prospective case series, 14 eyes of 9 patients with moderate to high hyperopia ranging from +3.00 to +8.00 diopters sphere were included between March and September 2018. Allogenic lenticules extracted from myopic small incision lenticule extraction were implanted into a pocket created by femtosecond laser at a 100-µm depth in recipients with hyperopia. All patients were followed up for 2 years. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity, manifest refraction, corneal topography, Fourier-domain optical coherence tomography, and in vivo confocal microscopy were examined. RESULTS: At postoperative 2 years, 2 eyes (14.3%) gained one line of CDVA, 11 eyes (78.6%) had unchanged CDVA, and 1 eye (7.1%) lost one line of CDVA. No eyes lost two or more lines of CDVA. Twelve of the treated eyes (85.7%) had postoperative uncorrected near visual acuity equal to or better than pre-operative values. The spherical equivalent decreased from +5.53 ± 1.45 D preoperatively to −0.60 ± 1.20 D at postoperative year 2 ( P 〈 .001). The anterior mean keratometric readings increased from 42.41 ± 1.03 D preoperatively to 48.38 ± 1.98 D at postoperative year 2 ( P 〈 .001). Of 14 treated eyes, 10 eyes (71.4%) had spherical equivalent within ±1.00 D. CONCLUSIONS: The findings suggest that allogenic lenticule transplantation may be a promising option for the correction of moderate to high hyperopia. [ J Refract Surg . 2021;37(11):734–740.]
    Type of Medium: Online Resource
    ISSN: 1081-597X
    URL: Article
    DOI: 10.3928/1081597X-20210730-02
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2021
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  • 7
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    Comparison of Optical Zone Decentration Following FS-LIKE and SMI-LIKE for Correcting Hyperopia
    SLACK, Inc. ; 2022
    In:  Journal of Refractive Surgery Vol. 38, No. 3 ( 2022-03), p. 184-190
    Details
    In: Journal of Refractive Surgery, SLACK, Inc., Vol. 38, No. 3 ( 2022-03), p. 184-190
    Abstract: To investigate optical zone decentration following femtosecond laser–assisted lenticule intrastromal keratoplasty (FS-LIKE) or small incision lenticule intrastromal keratoplasty (SMI-LIKE) for correcting hyperopia. METHODS: This study analyzed decentration values obtained from optical coherence tomography (OCT) and tangential topography difference maps of 23 eyes (18 patients) undergoing FS-LIKE (n = 12) or SMI-LIKE (n = 11) via the concentric centration method. Total higher order aberrations (HOAs) and component aberrations were measured preoperatively and 6 months postoperatively. RESULTS: The mean optical zone decentration was 0.27 ± 0.08 and 0.39 ± 0.16 mm for the FS-LIKE and SMI-LIKE groups, respectively ( P = .039). A significant difference was noted in lenticule decentration between the two groups (0.18 vs 0.37 mm), whereas no significant difference was observed in stromal bed (pocket) decentration between the two groups (0.10 vs 0.12 mm). Six months after surgery, the spherical equivalent showed a reduction of 6.14 ± 2.44 and 6.10 ± 1.79 diopters (D) for the two groups, respectively ( P = .971), whereas the surgically induced astigmatism was 0.68 ± 0.49 and 1.56 ± 0.78 D for the two groups, respectively ( P = .004). Furthermore, induction of HOAs in the SMI-LIKE group was significantly larger than that in the FS-LIKE group ( P = .013). CONCLUSIONS: FS-LIKE can yield improved treatment centration and less induction of total HOAs. [ J Refract Surg . 2022;38(3):184–190.]
    Type of Medium: Online Resource
    ISSN: 1081-597X
    URL: Article
    DOI: 10.3928/1081597X-20211213-03
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2022
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  • 8
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    Quantitative Analysis of Microdistortions in Bowman’s Layer Using Optical Coherence Tomography After SMILE Among Different Myopic Corrections
    SLACK, Inc. ; 2015
    In:  Journal of Refractive Surgery Vol. 31, No. 2 ( 2015-02), p. 104-109
    Details
    In: Journal of Refractive Surgery, SLACK, Inc., Vol. 31, No. 2 ( 2015-02), p. 104-109
    Abstract: To quantitatively analyze the characteristics of Bowman’s layer microdistortions after femtosecond laser small incision lenticule extraction (SMILE) among different myopic corrections, and their correlations with stromal lenticule thickness. METHODS: In this nonrandomized, prospective, controlled study, 63 eyes of 32 consecutive patients undergoing SMILE were divided into three groups according to the preoperative spherical equivalent (SE): greater than −6.00 D (20 eyes), −3.00 to −6.00 D (26 eyes), and −3.00 D or less (17 eyes). Measurement by slit-lamp microscope, uncorrected distance visual acuity (UDVA), manifest refraction, and Fourier-domain optical coherence tomography (FD-OCT) were conducted preoperatively and 1 day and 1 month postoperatively. Index M was calculated according to the OCT images to indicate the quantity of microdistortions in Bowman’s layer. RESULTS: Microdistortions in Bowman’s layer were observed in 65.0% (13 of 20 eyes) and 30.8% (8 of 26 eyes) in the greater than −6.00 D and −3.00 to −6.00 D groups, respectively, 1 day postoperatively, and in 60% (12 of 20 eyes) and 23.1% (6 of 26 eyes) 1 month later. No Bowman’s layer microdistortion was detected in the −3.00 D or less group postoperatively. The quantitative index M of microdistortions was higher in the greater than −6.00 D group than in the −3.00 to −6.00 D group at 1 day and 1 month ( P 〈 .05). There was no statistically significant difference between the indexes M on 1 day compared to 1 month. Index M was correlated with the preoperative SE and lenticule thickness ( P 〈 .05). CONCLUSION: The incidence and range of microdistortions in Bowman’s layer detected after SMILE are positively correlated with the myopic correction. High myopia tends to develop more microdistortions in Bowman’s layer after SMILE. [ J Refract Surg. 2015;31(2):104–109.]
    Type of Medium: Online Resource
    ISSN: 1081-597X
    URL: Article
    DOI: 10.3928/1081597X-20150122-05
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2015
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  • 9
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    Achieved Lenticule Diameter and Functional Optical Zone in Hyperopic Eyes After Lenticule Intrastromal Keratoplasty
    SLACK, Inc. ; 2022
    In:  Journal of Refractive Surgery Vol. 38, No. 12 ( 2022-12), p. 791-796
    Details
    In: Journal of Refractive Surgery, SLACK, Inc., Vol. 38, No. 12 ( 2022-12), p. 791-796
    Abstract: To investigate achieved lenticule diameter (ALD) and functional optical zone (FOZ) following femtosecond laser–assisted lenticule intrastromal keratoplasty (FS-LIKE) or small incision lenticule intrastromal keratoplasty (SMI-LIKE). Methods: Small incision lenticule extraction (SMILE)–derived human lenticules were placed on the surface of a contact glass (CG) and model eye (ME). Ex vivo ALDs were assessed at different hydration times. The ALD and FOZ were obtained using optical coherence tomography and Scheimpflug tomography at 6 months after lenticule implantation. Results: At 1 hour after hydration, lenticules achieved a slightly larger CG-loading ALD (6.63 ± 0.07 mm) and similar ME-loading ALD (6.53 ± 0.07 mm) as compared to a programmed optical zone (POZ) of 6.5 mm ( P 〈 .001). At 6 months after surgery, FS-LIKE with a POZ of 6.5 mm obtained an ALD of 6.20 ± 0.21 mm, which was larger than SMI-LIKE with a POZ of 6.64 mm (5.90 ± 0.14 mm, P = .001). The mean FOZ diameters were 5.33 ± 0.28 and 5.11 ± 0.14 mm for the FS-LIKE and SMI-LIKE groups, respectively ( P = .022). The absence of significant differences in the ALD and FOZ among the different meridians indicated that the achieved lenticule and optical zone shapes were circular. Conclusions: An accurate lenticular size could be obtained from SMILE, and FS-LIKE could achieve a larger FOZ than SMI-LIKE, attributed to attaining a larger ALD. [ J Refract Surg . 2022;38(12):791–796.]
    Type of Medium: Online Resource
    ISSN: 1081-597X
    URL: Article
    DOI: 10.3928/1081597X-20221107-02
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2022
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  • 10
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    Comparison of Corneal Deformation Parameters After SMILE, LASEK, and Femtosecond Laser-Assisted LASIK
    SLACK, Inc. ; 2014
    In:  Journal of Refractive Surgery Vol. 30, No. 5 ( 2014-05), p. 310-318
    Details
    In: Journal of Refractive Surgery, SLACK, Inc., Vol. 30, No. 5 ( 2014-05), p. 310-318
    Abstract: To investigate the differences in corneal deformation parameters after femtosecond laser small incision lenticule extraction (SMILE), laser-assisted subepithelial keratomileusis (LASEK), and femtosecond laser-assisted LASIK (FS-LASIK). METHODS: In this retrospective study, 17 eyes of 17 patients after SMILE, 18 eyes of 18 patients after LASEK, and 17 eyes of 17 patients after FS-LASIK were included. Corneal deformation parameters were measured with the CorVis ST tonometer (Oculus Optikgeräte GmbH, Wetzlar, Germany) 3 months postoperatively. RESULTS: The mean value of deformation amplitude of the FS-LASIK group was significantly higher than that of the LASEK group ( P = .022). The mean value of applanation time (applanation 1) of the LASEK group was significantly higher than that of the FS-LASIK group ( P = .038). No significant difference was detected in the mean values of deformation amplitude and applanation time (applanation 1) ( P 〉 .05) between the LASEK and SMILE groups or between the SMILE and FS-LASIK groups. Multiple linear regression model analysis revealed that after adjustment for age and preoperative central corneal thickness and manifest refraction spherical equivalent, the significance of the difference in the mean values of applanation time (applanation 1) and deformation amplitude between the LASEK and FS-LASIK groups were P = .084 and .059, respectively. In all three groups, the values of applanation 1 negatively correlated to those of applanation time (applanation 2) (SMILE: r = −0.577, P = .015; LASEK: r = −0.833, P 〈 .001; FS-LASIK: r = −0.516, P = .034) and deformation amplitude (SMILE: r = −0. 556, P = .021; LASEK: r = −0.877, P 〈 .001; FS-LASIK: r = −0.509, P = .037). CONCLUSIONS: Applanation time (applanation 1) and deformation amplitude (as measured with the CorVis ST tonometer) may be helpful in assessing corneal biomechanical changes after corneal refractive surgery. The relations between these parameters should be discussed in further studies. [ J Refract Surg. 2014;30(5):310–318. ]
    Type of Medium: Online Resource
    ISSN: 1081-597X
    URL: Article
    DOI: 10.3928/1081597X-20140422-01
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2014
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