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- Title
Photorefractive Keratectomy Enhancement (PRK) After Small-Incision Lenticule Extraction (SMILE).
- Authors
Moshirfar, Majid; Parsons, Mark T; Chartrand, Nicholas A; Lau, Chap-Kay; Stapley, Seth; Bundogji, Nour; Ronquillo, Yasmyne C; Hoopes, Phillip C
- Abstract
Purpose: To determine rates of enhancement and visual prognosis following photorefractive keratectomy (PRK) enhancement of small-incision lenticule extraction (SMILE). Patients and Methods: This retrospective, single-site study reviewed all cases of primary SMILE at Hoopes Vision in Draper, Utah between March 14, 2017 and April 8, 2022 to identify any cases that required follow-up enhancement. Primary SMILE was performed using Visumax 500 kHz femtosecond laser (Carl Zeiss Meditec, Jena, Germany). All enhancements were performed with alcohol-assisted PRK, using a WaveLight EX500 excimer laser (Alcon Laboratories, Inc., Fort Worth, TX). Results: Four hundred and five eyes underwent primary SMILE, of which 15 later underwent PRK enhancement (enhancement rate of 3.7%). No significant difference in pre-SMILE data was identified between the enhancement and non-enhancement groups. The average age of those who underwent PRK enhancement was 33.8± 6.3 years old and ranged from 25 to 45. Following primary SMILE, 13 eyes (87%) had an uncorrected distance visual acuity (UDVA) of 20/40 or better, and none had a UDVA of 20/20 or better. After one year of post-enhancement follow-up, all eyes had a UDVA of 20/40 or better, and 13 eyes (87%) had a UDVA of 20/20 or better (Figure 1). All were within one diopter of target spherical equivalent (SEQ), 13 (87%) were within 0.50 D, and 10 (67%) were within 0.25 D. Of those with 12-month follow-up data, none had UDVA worse than corrected distance visual acuity (CDVA), and none had lost lines of CDVA. Efficacy and safety indices were 1.03 and 0.99, respectively. Conclusion: Following SMILE, ophthalmologists may anticipate an enhancement rate of one to seven percent. In these cases, PRK is a safe and effective procedure for enhancement of SMILE.
- Subjects
DRAPER (Utah); JENA (Germany); FORT Worth (Tex.); SMILING; PHOTOREFRACTIVE keratectomy; CARL Zeiss AG; EXCIMER lasers; FEMTOSECOND lasers; VISUAL acuity
- Publication
Clinical Ophthalmology, 2022, Vol 16, p3033
- ISSN
1177-5467
- Publication type
Article
- DOI
10.2147/OPTH.S381319