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Early results with hyperopic SMILE show promise

Issue: March 25, 2018

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Pavel Stodulka

BELGRADE, Serbia — Early results with hyperopic ReLEx small incision lenticule extraction, presented at the European Society of Cataract and Refractive Surgeons winter meeting, seem promising, according to one of the multicenter study investigators.

“Hyperopic correction of the cornea is more challenging than myopia; therefore, it took a few years for SMILE to get ready for this. Results are very promising, though we need to assess stability in the long term because we ablate quite a high amount of tissue,” Pavel Stodulka, MD, said.

A negative lenticule is created, thinner in the center and thicker in the periphery, with a diameter of 7.5 mm or more. After removal, the overlying anterior stroma remodels to create a steeper corneal profile.

A multicenter study supported by Carl Zeiss Meditec is currently ongoing. It involves eight clinics in Europe, India and China, enrolling 374 patients with hyperopia or hyperopic astigmatism, and a follow-up of 12 months. Hyperopic correction is up to 7 D, to reach a corneal steepness with maximum keratometry of 51 D. Postoperative corrected distance visual acuity should be 20/25 or better.

Stodulka said he was cautious at the beginning, treating three patients and then waiting, but he is now confident.

“I have so far treated 25 patients, but the follow-up is still short, with only a few eyes that have achieved 3 months. We need to wait and see how these eyes evolve over time, but what I have experienced is very encouraging,” he said. “What I like is the large, well-centered, regular ablation zones, centered on the visual axis. Patients are very happy about the quality of their vision, even patients with high astigmatism.” – by Michela Cimberle

Reference:

Stodulka P. Correction of hyperopia with hyperopic astigmatism by ReLEx SMILE: case reports. Presented at European Society of Cataract and Refractive Surgeons winter meeting; Feb. 9-11, 2018; Belgrade, Serbia.

Disclosure: Stodulka reports no relevant financial disclosures.