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SMILE Xtra yields stable outcomes in suboptimal cases

Issue: October 10, 2019

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Hyung-Jin Koo

PARIS — Subgroup characteristics did not affect the clinical outcomes of SMILE Xtra, according to a study presented by Hyung-Jin Koo, MD, of Nunemiso Eye Center, Seoul, at the European Society of Cataract and Refractive Surgeons meeting.

The study evaluated safety, efficacy, stability and predictability of the procedure in eyes with corneal characteristics that were suboptimal for SMILE. These eyes were divided among four groups according to their characteristics: group A, abnormal topography, 36 eyes; group B, low residual stromal bed thickness, 44 eyes; group C, higher refractive error, 21 eyes; and group D, thin preoperative central corneal thickness, 29 eyes.

SMILE Xtra, which adds a cross-linking protocol involving application of 0.25% riboflavin for 90 seconds with 30 mW/cm² UVA applied for 60 seconds, for a total application of 1.8 J/cm², was performed. Overall, at 2 years postoperatively, 97.7% of treated eyes were within 0.5 D error range of targeted spherical equivalent.

“Although group C had a tendency of higher refractive error and lower vision at 2 years postop, no statistical significance was found,” Koo said.

Preoperative and postoperative endothelial cell count change showed no statistical significance, not only in the whole study but also in the four subgroups, he said.

“Except for early postop, SMILE Xtra showed comparable visual outcomes from 1 week to 2 years. Safety, stability and predictability of SMILE Xtra also showed fine and stable results. Subgroup characteristics did not affect the clinical outcomes of SMILE Xtra. Thus, SMILE in combination with 1.8 J/cm² protocol would be an effective, safe and predictable strategy in moderate risk patients,” Koo said. – by Patricia Nale, ELS

Reference:

Koo H. Long-term clinical outcomes of small incision lenticule extraction with accelerated corneal cross-linking (SMILE Xtra): two-year results. Presented at: European Society of Cataract and Refractive Surgeons meeting; Sept. 13-18, 2019; Paris.

Disclosure: Koo reports no relevant financial disclosures.