Deeper small-incision lenticule extraction allows for use of same technique in secondary surgery
MILAN — Performing small-incision lenticule extraction deeper in the corneal stroma enables the surgeon to use the same technique a second time in case enhancement is needed, a presenter here said.
“Small-incision lenticule extraction (smile, Carl Zeiss Meditec) holds several advantages in comparison with LASIK. We have the same visual and refractive results, but less dry eye and better preservation of corneal biomechanics,” José Güell, MD, said at the annual joint meeting of Ocular Surgery News and the Italian Society of Ophthalmology.
When secondary procedures are needed, however, the options have traditionally been limited to surface ablation or standard LASIK. In such cases, the advantages of smile are lost.
The standard depth at which smile is performed and extracted is 120 µ. In a study, Güell compared the results and stability for five different depths, ranging from 120 µ to 180 µ.
“At 3 months, there was no statistically significant difference in uncorrected vision, spherical equivalent and astigmatism between the five groups; however, surprisingly, the best was the deepest,” he said.
Because it was equally safe and potentially better to perform smile deeper, Güell decided to use the 160 µ depth in his patients, thus allowing for secondary smile if needed.
“Our study showed that we can cut deeper, which leaves us enough stromal depth to perform secondary, more superficial smile, at 120 µ. Secondary laser dissection is safe and easy as in the primary procedure, and it allows maintaining the advantages of smile,” he said.
Disclosure: Güell is a consultant for Carl Zeiss Meditec.