Hyperopic small-incision lenticule extraction (SMILE) performed using a proprietary femtosecond laser (VisuMax, Carl Zeiss Meditec) is feasible and, in early experience, associated with refractive and visual acuity results similar to those achieved with LASIK, said Dan Z. Reinstein, MD.
“Compared with LASIK, SMILE brings potential advantages to hyperopic correction, including maintaining integrity of the corneal nerve plexus, which is particularly important considering that hyperopes tend to be older patients,” said Dr. Reinstein, medical director, London Vision Clinic, London, and adjunct professor of ophthalmology, Columbia University Medical Center, New York.
The original attempt at treating hyperopia using femtosecond lenticule extraction was associated with poor safety and significant regression, but the treatment was performed using a 5.5-mm optical zone and no transition zone. Safety and stability were much better in a subsequent small series treated with a 5.75-mm optical zone and a 2-mm transition zone, he noted.
“The lenticule shape for hyperopic SMILE has been further optimized, and initial results are encouraging,” he said. “We are in the process of treating more patients and analyzing contrast sensitivity and other parameters of quality of vision.”