Refractive outcomes of small lenticule extraction (SMILE) Pro® with a 2 MHz femtosecond laser.

PURPOSE: To evaluate the initial visual outcomes of Small Incision Lenticule Extraction (SMILE) Pro® using a 2 MHz femtosecond laser (VisuMax 800, Carl Zeiss Meditec) and to assess the efficacy, safety, predictability, accuracy, and complication rate. METHODS: This retrospective analysis included eyes which underwent the SMILE Pro® procedure using VisuMax 800 femtosecond laser to correct myopia. All surgeries were performed by one surgeon (DB). Follow-up was conducted 3 months postoperatively to evaluate visual outcomes after neuroadaptation, corrected visual acuity (CDVA) and intra- and postoperative complications. RESULTS: One hundred and fifty-two eyes of 82 patients (mean age 31 ± 6 years) results at 3 months are presented. The mean spherical equivalent (SE) was - 4.44 ± 1.86 D preoperatively while -0.24 ± 0.32 D postoperatively. 99% of eyes achieved SE within ± 1.0 D of attempted correction and 91% were within ± 0.5 D. Efficacy index was 0.93 while the safety index was 1. No complications occurred intra- or postoperatively. No eyes lost more than 1 line of their preoperative CDVA. All highly myopic eyes (- 6.25 to - 10.00 D; n = 18) achieved 20/20 at 3 months postoperatively and were within 0.5 D from the attempted SE and no eyes lost more than 1 line of CDVA. CONCLUSION: The SMILE Pro® is a safe, efficient, and predictable procedure for the treatment of myopia and myopic astigmatism, with comparable results of conventional SMILE surgery. High myopic eyes achieve better results than low and moderate myopia. No complications were recorded in our patients.

[Current Review: Multifocal Intraocular Lenses and Extended Depth of Focus Intraocular Lenses]. / Aktuelle Übersicht: multifokale Linsen und Extended-Depth-of-Focus-Intraokularlinsen.

Presbyopia and cataract patients' wish to be increasingly independent of spectacles after surgery and this is one of the main drivers for the development of multifocal intraocular lenses (MIOL) and extended depth of focus (EDOF) intraocular lenses (IOL). As education, biometry, diagnostics, surgical techniques, and MIOL/EDOF IOL designs have improved over the past decade, an increasing number of cataract surgeons have become cataract refractive surgeons to help address this need. There is not one single MIOL/EDOF IOL, however, that suits all patients' needs. The wide variety of MIOL and EDOF IOL, their optics, and their impact on our patients' quality of vision have to be fully understood if we have to choose the appropriate IOL for each individual; MIOL/EDOF IOL surgery has to be customized. This review article looks at the different optical aspects and clinical consequences of MIOL/EDOF IOL, in order to help surgeons find an appropriate solution for each of their individual patients.

[Comparison of Long-term Results with Small Incision Refractive Lenticule Extraction (ReLEX SMILE) vs. Femto-LASIK]. / Vergleich der Langzeitergebnisse bei Small Incision Refractive Lenticule Extraction (ReLEx SMILE) und Femto-LASIK.

AIM: Our aim was to retrospectively compare ReLEx Smile to femtosecondlaser-assisted LASIK (FsLASIK, femto-LASIK) in terms of safety, efficacy, stability as well as intraoperative complications. Comparable studies only show the results over the course of 3 years, making our data the first to examine longer term results. MATERIALS/METHODS: To accomplish this, we compared 404 eyes after FsLASIK (Mel 80, Carl Zeiss Meditec) and 1192 eyes after ReLEx SMILE (VisuMax, Carl Zeiss Meditec). We collected patients' data at 6 months, 1 year, 2 years and 5 years after refractive surgery. RESULTS: Five years postoperatively, the 2 methods showed equally good results in all investigated parameters. Over the course of these 5 years, the ReLEx SMILE achieved significantly better results for safety (p < 0.05) after 6 months, 1 year and 2 years. The results for visual acuity were significantly better for ReLEx SMILE after 1, 2 and 3 years. The predictability of both methods was consistently good over the entire period of time and intraoperative complications were equally low. CONCLUSION: After retrospective analysis of the visual outcomes of our patients up to 5 years after surgery, the ReLEx SMILE method turned out to be at least as safe and efficient as the FsLASIK. The stability of the refractive outcome was equally good with the 2 methods. Due to the high level of satisfaction experienced by the patients, high patient comfort intra- and postoperatively, absence of dry eyes, and the absence of flap complications, ReLEx SMILE has replaced the FsLASIK in our daily practice and become our method of choice for corneal refractive surgery when it comes to the correction of myopia and myopic astigmatism.

[Clinical Evaluation of a Novel Intraocular Lens with Enhanced Depth of Focus (EDOF) to Increase Visual Acuity for Intermediate Distances]. / Klinische Auswertung einer neuartigen Intraokularlinse mit erweiterter Tiefenschärfe (EDOF) zur Verbesserung der Sehkraft im Intermediärbereich.

BACKGROUND: Modern intraocular lens surgery has made great progress over the last few years towards creating independency of spectacles in daily life. Especially in the areas of distant and near visual acuity, optimisation has been possible. Nevertheless, with new media and requirements in professional life, there is an increasing need for optimisation of the intermediate range. In a prospective, non-randomised clinical study, the functional and refractive results after implantation of a novel intraocular lens with enhanced depth of focus were analysed. PATIENTS/MATERIAL AND METHODS: We have evaluated eleven patients after binocular implantation of the AT LARA 829MP (Carl Zeiss Meditec AG, Germany) 3 months after surgery. We examined refraction, corrected and uncorrected monocular and binocular distant visual acuity (CDVA, UDVA) as well as distance-corrected monocular and binocular visual acuity at different intermediate distances (with DCIVA 90, 80 and 60 cm) and 40 cm (DCNVA). We also performed defocus curve analysis. RESULTS: We found a mean increase of monocular CDVA from 0.35 to - 0.01 logMAR. Binocular DCIVA at 90, 80 and 60 cm was - 0.07, 0.04 and 0.07 logMAR, respectively. Even with a principle focus on intermediate distances, we found a functional DCNVA of 0.33 logMAR. Defocus curve analysis showed a visual acuity of 0.3 logMAR in a range of - 2.5 D to + 1.0 D. CONCLUSION: Binocular implantation of the AT LARA 829MP targeting emmetropia gives stable visual acuity from the distant to the near intermediate range, still with functional vision at the near distance of 40 cm.

Multifocal Intraocular Lenses and Extended Depth of Focus Intraocular Lenses.

Presbyopia and cataract patients' desire for increased spectacle independence after surgery is one of the main drivers for the development of multifocal intraocular lenses (MIOLs) and extended depth of focus (EDOF) intraocular lenses (IOLs). As education, biometry, diagnostics, surgical techniques, and MIOL/EDOF IOL designs have improved over the past decade, an increasing number of cataract surgeons have become cataract-refractive surgeons to help address this need. There is not 1 single MIOL/EDOF IOL, however, that suits all patients' needs. The wide variety of MIOLs and EDOF IOLs, their optics, and their respective impact on our patients' quality of vision have to be fully understood to choose the appropriate IOL for each individual; MIOL/EDOF IOL surgery has to be customized. This review article looks at the different optical aspects and clinical consequences of MIOLs/EDOF IOLs to help surgeons find an appropriate solution for each of their individual patients.