Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Long-term Results of Refractive Lenticule Extraction
ReLEx SMILE compared to Femto-LASIK
P. Hagen, D. Breyer, H. Kaymak, K...
Financial Disclosure
Breyer, Kaymak & Klabe Eye Surgery and Premium Eyes are Consulting, Study Center & MAB for:
Abott, Al...
Theoretical Background:
ReLEx SMILE & Femto-LASIK
© by Premium Eyes Laser Eye Surgery · premiumeyes.de · · Slide17-06-04 3...
Materials and Methods: Preoperative Patient Data
© by Premium Eyes Laser Eye Surgery · premiumeyes.de · · Slide17-06-04 4
...
Materials and Methods: Postoperative Examinations
Examinations
(up to 3 year postop.):
• Manifest refraction
(Phoropter)
•...
-1
-0.75
-0.5
-0.25
0
0.25
0.5
0.75
1
Sphere Cylinder SE
RefractivePower[D]
Manifest Refraction
Smile 6M (n=138)
Smile 1Y ...
0%
25%
50%
75%
100%
loss3
ormore
loss2
loss1
unchanged
gain1
gain2
gain3
ormore
Percentageofeyes[%]
∆CDVA [Snellen Lines]
...
Results: Predictability 1 Year after Surgery
• 1 year after surgery:
No significant differences
for predictability of SE
o...
Results: Predictability 2 Years after Surgery
• 2 years after surgery:
No significant differences
for predictability of SE...
Results: Predictability 3 Years after Surgery
• 3 years after surgery:
No significant differences
for predictability of SE...
-0.4
-0.2
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
pre 3M 6M 1Y 2Y
UDVA[logMAR]
Visual recovery
Lasik
Smile
Results: Visual Recover...
-2.0
-1.5
-1.0
-0.5
0.0
0.5
1.0
1.5
Astigmatism (RMS) Total HOA (RMS) Coma (RMS) Spherical
Aberration
OcularAberrations[µm...
Conclusion and Outlook
© by Premium Eyes Laser Eye Surgery · premiumeyes.de · · Slide17-06-04 13
Comparison of long-term r...
Thank you very much for your attention!
You’ve finished this document.
Upcoming SlideShare
What to Upload to SlideShare
Next
Upcoming SlideShare
What to Upload to SlideShare
Next

Share

Long-term Results of Refractive Lenticule Extraction ReLEx SMILE compared to Femto-LASIK

Presentation by Detlev Breyer (MD) at the ASCRS 2017 in Los Angeles. Title: Long-term Results of Refractive Lenticule Extraction ReLEx SMILE compared to Femto-LASIK.

Related Books

Free with a 30 day trial from Scribd

See all

Related Audiobooks

Free with a 30 day trial from Scribd

See all

Long-term Results of Refractive Lenticule Extraction ReLEx SMILE compared to Femto-LASIK

  1. 1. Long-term Results of Refractive Lenticule Extraction ReLEx SMILE compared to Femto-LASIK P. Hagen, D. Breyer, H. Kaymak, K. Klabe, F. Kretz, G. Auffarth
  2. 2. Financial Disclosure Breyer, Kaymak & Klabe Eye Surgery and Premium Eyes are Consulting, Study Center & MAB for: Abott, Alcon, AlimeraSciences, Allergan, AMO, Bayer, Carl Zeiss Meditec, Ellex, Fluoron, Geuder, iOptics, LensAR, Novartis, Oculentis, Oertli, Revision Optics, Santen, Staar Surgical, Thea, Topcon, Visufarma, Ziemer
  3. 3. Theoretical Background: ReLEx SMILE & Femto-LASIK © by Premium Eyes Laser Eye Surgery · premiumeyes.de · · Slide17-06-04 3 CZM Mel 80 • Excimer laser • Femto-LASIK:  Flap creation using VisuMax®  Tissue ablation through laser vaporization of corneal stroma CZM VisuMax • Femtosecond laser • Low laser pulse energies • Corneal suction • ReLEx SMILE:  Intracorneal lenticule is created by a pattern of laser induced cavitation bubbles  Mechanical removal of lenticule through small peripheral incision Pictures are used with the kind permission of CZM Idea: Retrospectively compare long-term results of both groups: 1. Femto-LASIK (flap thickness 100-120µm) 2. ReLEx SMILE (cap thickness 120-150µm) Target refraction: emmetropia
  4. 4. Materials and Methods: Preoperative Patient Data © by Premium Eyes Laser Eye Surgery · premiumeyes.de · · Slide17-06-04 4 Treatment Femto-LASIK targ. refr.: emmetropia ReLEx SMILE targ. refr.: emmetropia Number of eyes 366 653 Age [years] 36 ± 9 34 ± 8 Central thickness [µm] 550 ± 29 545 ± 31 Sphere [D] -2.32 ± 2.11 -3.87 ± 1.88 Cylinder [D] -0.87 ± 0.88 -0.70 ± 0.70 Spherical Equivalent [D] -2.76 ± 2.02 -4.22 ± 1.89
  5. 5. Materials and Methods: Postoperative Examinations Examinations (up to 3 year postop.): • Manifest refraction (Phoropter) • Visual acuity measurement at far (ETDRS-chart) • Wave front analysis (KR-1W Topcon) • Patient questionnaire © by Premium Eyes Laser Eye Surgery · premiumeyes.de · · Slide17-06-04 5
  6. 6. -1 -0.75 -0.5 -0.25 0 0.25 0.5 0.75 1 Sphere Cylinder SE RefractivePower[D] Manifest Refraction Smile 6M (n=138) Smile 1Y (n=129) Smile 2Y (n=43) Smile 3Y (n=17) -1 -0.75 -0.5 -0.25 0 0.25 0.5 0.75 1 Sphere Cylinder SE RefractivePower[D] Manifest Refraction Lasik 6M (n=44) Lasik 1Y (n=41) Lasik 2Y (n=23) Lasik 3Y (n=27) Results: Manifest Refraction © by Premium Eyes Laser Eye Surgery · premiumeyes.de · · Slide17-06-04 6 Differences in manifest refraction: • 1 year after surgery: Mean values for sphere and SE significantly (p<0.05) better in SMILE group • Tendentially slightly narrower standard deviations for sphere in case of SMILE
  7. 7. 0% 25% 50% 75% 100% loss3 ormore loss2 loss1 unchanged gain1 gain2 gain3 ormore Percentageofeyes[%] ∆CDVA [Snellen Lines] Safety: Change in CDVA (post. - pre.) Lasik 6M (n=44) Lasik 1Y (n=39) Lasik 2Y (n=22) Lasik 3Y (n=26) Smile 6M (n=140) Smile 1Y (n=129) Smile 2Y (n=86) Smile 3Y (n=34) Results: Safety © by Premium Eyes Laser Eye Surgery · premiumeyes.de · · Slide17-06-04 7 Significant (p<0.05) differences: • At 6 months and 1 year: SMILE with slightly better results.  Slight advantages for ReLEx SMILE in terms of safety
  8. 8. Results: Predictability 1 Year after Surgery • 1 year after surgery: No significant differences for predictability of SE outcome in Femto-LASIK and ReLEx SMILE group • Slight undercorrection of roughly 10%  Compensate for in planning phase of OP © by Premium Eyes Laser Eye Surgery · premiumeyes.de · · Slide17-06-04 8
  9. 9. Results: Predictability 2 Years after Surgery • 2 years after surgery: No significant differences for predictability of SE outcome in Femto-LASIK and ReLEx SMILE group • Slight undercorrection of roughly 10%  Compensate for in planning phase of OP © by Premium Eyes Laser Eye Surgery · premiumeyes.de · · Slide17-06-04 9
  10. 10. Results: Predictability 3 Years after Surgery • 3 years after surgery: No significant differences for predictability of SE outcome in Femto-LASIK and ReLEx SMILE group • Slight undercorrection of roughly 10%  Compensate for in planning phase of OP • More data needed for ReLEx SMILE group © by Premium Eyes Laser Eye Surgery · premiumeyes.de · · Slide17-06-04 10
  11. 11. -0.4 -0.2 0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 pre 3M 6M 1Y 2Y UDVA[logMAR] Visual recovery Lasik Smile Results: Visual Recovery © by Premium Eyes Laser Eye Surgery · premiumeyes.de · · Slide17-06-04 11 n = number of eyes preop. 3M 6M 1Y 2Y LASIK 348 43 47 34 9 SMILE 614 149 128 128 37 Differences in UDVA: • Preop.: LASIK has significantly better UDVA than SMILE (eyes are less myopic) • Postop.: In total, slightly better mean values for SMILE, however, differences not significant 3-year data needed
  12. 12. -2.0 -1.5 -1.0 -0.5 0.0 0.5 1.0 1.5 Astigmatism (RMS) Total HOA (RMS) Coma (RMS) Spherical Aberration OcularAberrations[µm] Ocular Aberrations (6mm) Lasik preop. (n=255) Lasik post (n=157) Smile preop. (n=631) Smile post (n=524) Results: Wave Front Analysis © by Premium Eyes Laser Eye Surgery · premiumeyes.de · · Slide17-06-04 12 Significant (p<0.05) differences: • Astigmatism is reduced by Femto-LASIK and ReLEx SMILE • Higher order aberrations slightly increased by both treatments No significant differences between both groups post: 3M to 2Y
  13. 13. Conclusion and Outlook © by Premium Eyes Laser Eye Surgery · premiumeyes.de · · Slide17-06-04 13 Comparison of long-term results (up to 3 years): • Safety: - Slight advantages for ReLEx SMILE compared to Femto-LASIK • Predictability: - No significant differences between SMILE and LASIK - Compensation of undercorrection of roughly 10% has to be considered in planning phase of the surgery - More 3-year data for ReLEx SMILE needed • Visual recovery: - Tendentially slightly better UDVA-values for ReLEx SMILE compared to Femto-LASIK (not significant) • Wave front analysis: - No significant differences between both groups • Patient questionnaire: - Less dry eyes, less pain sensation and better patient comfort were observed in ReLEx SMILE groups  ReLEx SMILE is the treatment of choice
  14. 14. Thank you very much for your attention!
  • BostjanDrev

    Jan. 5, 2019
  • ashwinisonkamble1

    Aug. 30, 2017

Presentation by Detlev Breyer (MD) at the ASCRS 2017 in Los Angeles. Title: Long-term Results of Refractive Lenticule Extraction ReLEx SMILE compared to Femto-LASIK.

Views

Total views

6,580

On Slideshare

0

From embeds

0

Number of embeds

1,048

Actions

Downloads

0

Shares

0

Comments

0

Likes

2

×