Small incision lenticule extraction (SMILE), which has not yet been approved for refractive correction in the United States, may be less accurate and produce more irregular astigmatism than LASIK or PRK because of the imprecision resulting from the two incisions needed to create the lenticule. In addition, the technique for potential enhancements needs improvement. However, the treatment is promising and may stand the test of time as the technology advances.
Techniques for performing corneal collagen crosslink (CXL) are being evaluated and adapted, and at the same time, new applications are being developed.
The back layer of the cornea is made up of endothelial cells that keep the cornea clear. All cataract surgery does some damage to these cells, although due to the number of extra cells available in most corneas this damage doesn’t cause any problems. However, occasionally, post-cataract surgery endothelial cells don’t function well enough to keep the cornea clear, which can commonly cause corneal oedema. Here, Prof. Feinbaum describes a new treatment modality that has been designed to reduce and in most cases stop the oedema in 24–48 hours.
Immunomodulatory therapy for ocular inflammatory disease can be potent and effective, but physicians should be patient while awaiting results—and watch carefully for complications.
The rationale for epithelium-on crosslinking procedures is strong, and may ultimately make customized treatment of topographic abnormalities more attractive for therapeutic and refractive indications.