Prophylactic corneal crosslinking in myopic small-incision lenticule extraction - Long-term visual and refractive outcomes.

PURPOSE: To analyze the efficacy, safety, predictability, and stability in myopic and astigmatic small-incision lenticule extraction (SMILE) with simultaneous prophylactic corneal crosslinking (CXL) in thin corneas.

METHODS

A total of 48 eyes from 24 patients who underwent myopic and astigmatism SMILE with simultaneous prophylactic CXL were included in this retrospective study. All patients had a 24-month follow-up. A femtosecond laser was performed with VisuMax (Carl Zeiss Meditec). CXL treatment was applied when the predicted stromal thickness was less than 330 μm.

RESULTS

The patients' mean age was 31.58 ± 6.23 years. The previous mean spherical equivalent was - 6.85 ± 1.80 (-9.75 to - 2.00) D. The postoperative mean spherical equivalent was - 0.50 ± 0.26 (-1.00 to + 0.25) D; 60% of the eyes had 20/20 or better; 19% lost one line; 58% were within ± 0.50 D; and 8.3% of the eyes changed 0.50 D or more between 3 and 24 months.

CONCLUSION

Prophylactic CXL with simultaneous SMILE for myopia and astigmatism femtosecond laser surgery technique appears to be partially effective, safe, predictable, and stable after 24 months of follow-up.