Surgeon presents early results of Schwind platform for lenticule extraction
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Minimally invasive lenticule extraction with the new Schwind ATOS femtosecond laser leads to highly predictable refractive outcomes, good optical quality and slight overestimation of the amount of tissue removed.
“The company is aware of this overestimation, which is programmed on purpose at this early stage as a temporary safety feature,” Ivan Gabri, MD, said at the virtual European Society of Cataract and Refractive Surgeons winter meeting.
The ATOS femtosecond platform has been used in his clinic since September 2020, and during this time, more than 200 lenticule extraction procedures have been performed.
“The device has proven to be an amazing addition to our practice and has performed well above our expectations for a device still early in its development and life cycle,” Gabri said.
Results were analyzed using the MS-39 anterior segment OCT (CSO) and a Placido disc topographer. One hundred thirty eyes of 65 patients were tracked at day 1, day 30 and day 90. The mean attempted refraction was –4.98 D, and the mean attempted cylinder was about –0.5 D. The predicted lenticule thickness was 103 µm.
“Looking at scattergrams, we can see that attempted vs. achieved spherical equivalent is a very tight line. Topography maps show that the expected K values were achieved very early on, and the recovery was very fast. But when we look at the thickness of the lenticule, we see that it is 13.76 µm (10%) less than predicted,” Gabri said.
When these data were reported to Schwind’s R&D department, it responded that the predicted number shown in the software is meant to be 10% greater than the achieved thickness as a temporary safety feature to promote a less aggressive and more conservative approach to residual bed thickness.
“We were assured that in due time this inconsistency will be fixed when more data from other users arrive,” Gabri said.
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Gabrić I. Corneal stroma thickness evolution after myopic lenticular extraction on Schwind ATOS. Presented at: European Society of Cataract and Refractive Surgeons winter meeting; Feb. 18-20, 2022 (virtual meeting).
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