BMC ophthalmology · 2018
Cap-preserving SMILE Enhancement Surgery.
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Sedky Ahmed N, Wahba Sherine S, Roshdy Maged M, Ayaad Nermeen R
Аннотация
BACKGROUND: Different enhancement procedures have been suggested for reduction of residual refractive errors after SMILE. The aim of this study is to evaluate an improved cap-preserving technique for enhancement after SMILE (Re-SMILE).
METHODS: A retrospective case series was conducted at Eye subspecialty center, Cairo, Egypt on 9 eyes with myopia or myopic astigmatism (spherical equivalent - 8.0 and - 12.0D). undergoing SMILE procedure and needed second interference. This was either because the more myopic meridian was more than - 10.0 D and therefore planned to have two-steps procedure (six eyes) or because of under correction needing enhancement (three eyes). Assessment after the primary SMILE procedure was conducted at 1 day, 1 week, 1 month and 3 months postoperatively. Assessment after Re-SMILE was conducted at 1 day, 1 week, 1 month, 3 months, 6 months and 1 year postoperatively. The assessments included full ophthalmic examination, objective and subjective refraction, and rotating Scheimpflug camera imaging.
RESULTS: Preoperatively, the mean refractive spherical equivalent (MRSE) values were: - 9.36 ± 0. 89. After primary SMILE it was - 2.18 ± 0.71. After Re-SMILE it was - 0.13 ± 0.68. MRSE was significantly improved after both procedures (P < 0.01). The safety index of primary SMILE cases was 1.65 ± 0.62 and for Re-SMILE 1.13 ± 0.34 and the efficacy index was 1.14 ± 0.24 after primary SMILE and 1.11 ± 0.26 after Re-SMILE.
CONCLUSION: Centered cap-preserving Re-SMILE is an effective procedure in reducing residual refractive errors after primary SMILE in high myopes.
METHODS: A retrospective case series was conducted at Eye subspecialty center, Cairo, Egypt on 9 eyes with myopia or myopic astigmatism (spherical equivalent - 8.0 and - 12.0D). undergoing SMILE procedure and needed second interference. This was either because the more myopic meridian was more than - 10.0 D and therefore planned to have two-steps procedure (six eyes) or because of under correction needing enhancement (three eyes). Assessment after the primary SMILE procedure was conducted at 1 day, 1 week, 1 month and 3 months postoperatively. Assessment after Re-SMILE was conducted at 1 day, 1 week, 1 month, 3 months, 6 months and 1 year postoperatively. The assessments included full ophthalmic examination, objective and subjective refraction, and rotating Scheimpflug camera imaging.
RESULTS: Preoperatively, the mean refractive spherical equivalent (MRSE) values were: - 9.36 ± 0. 89. After primary SMILE it was - 2.18 ± 0.71. After Re-SMILE it was - 0.13 ± 0.68. MRSE was significantly improved after both procedures (P < 0.01). The safety index of primary SMILE cases was 1.65 ± 0.62 and for Re-SMILE 1.13 ± 0.34 and the efficacy index was 1.14 ± 0.24 after primary SMILE and 1.11 ± 0.26 after Re-SMILE.
CONCLUSION: Centered cap-preserving Re-SMILE is an effective procedure in reducing residual refractive errors after primary SMILE in high myopes.