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Reduced laser energy optimizes results of lenticule extraction procedure
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PARIS — Setting laser energy to a lower level makes visual recovery faster and optimizes results of ReLEx SMILE, according to a study presented here at the meeting of the French Society of Ophthalmology.
“ReLEx SMILE (Zeiss) is a safe and effective procedure, but cases of BCVA loss and slower recovery of vision compared to LASIK were reported,” David Donate, MD, said.
In a study, recovery of vision was evaluated in connection with laser energy. One group of 170 patients was treated with a laser cut energy index of 34 (170 nJ), while in another group of 322 patients, a lower energy index of 20 (100 nJ) was used.
Preoperative data were comparable between the two groups.
“At day 1 we observed better visual recovery in the group treated with lower energy, and the same was at 1 week and 1 month. No patient lost BCVA lines. Those patients also had better contrast sensitivity and fewer high-order aberrations,” Donate said.
“Too much energy leads to the creation of irregular lenticules,” he said.
Donate hypothesized that the gas bubbles produced by high laser energy interfere with the following laser shots. Irregular shots cause distortion in the shape of the lenticule, and irregular lenticules have a slower recovery.
“The epithelium needs time to smoothen up, while regular lenticules recover fast and lead straight to the expected results,” he said
Reduced laser energy may therefore be the answer to optimize ReLEx SMILE results because it maintains corneal transparency and an intact epithelium. – by Michela Cimberle
Reference:
Donate D. SMILE: The role of laser energy. Presented at: French Society of Ophthalmology meeting; May 7-10, 2016; Paris.
Disclosure: Donate reports no relevant financial disclosures.