EyeWorld Asia-Pacific September 2019 Issue

&OLQLFDO 3HDUOV RI )HPWRVHFRQG /DVHU 6XUJHU\ Prof Rohit Shetty )(0726(&21' /$6(5 685*(5< 6XUIDFH $EODWLRQ RQ SRVW 60Ζ/( 3DWLHQWV Prof Chen Yueguo Topography-guided ablation can restore the FRUQHDO UHJXODULW\ DQG LV D VDIH DQG H΍HFWLYH PHWKRG IRU FRPSOLFDWHG 60Ζ/( FDVHV ΖQ SURFHGXUH GHVLJQ EHIRUH HQKDQFHPHQW IRU 60Ζ/( K\SHURSLF VKLIW DQG XQHYHQ HSLWKHOLDO thickness should be considered. Figure4: Post-operative regressionandepithelial thickening 8 Use of small incision lenticule extraction (SMILE) has shown promising results in treatment of refractive errors such as myopia, hyperopia, SUHVE\RSLD DQG DVWLJPDWLVP 60Ζ/( R΍HUV DGYDQWDJHV VXFK DV WKH DELOLW\ WR SHUIRUP ȵDSOHVV LASIK and painless PRK. However, no customized cutting pattern, kappa angle and cyclotorsion compensation, steeper learning curve in lenticule GLVVHFWLRQ DQG GLɝFXOW\ LQ HQKDQFHPHQW procedure decision are some of the disadvantages of SMILE. Ȋ$FFRUGLQJ WR D UHSRUW SXEOLVKHG LQ DERXW RI SDWLHQWV XQGHUJRLQJ 60Ζ/( QHHG DQ enhancement procedure within 1 or 2 years. 4 Post- operative complaints in SMILE patients are due to decentration or small optical zone” explained Prof Chen Yueguo. Prof Chen explained through the case of a 20-year old patient with uneventful bilateral myopic SMILE who presented with glare, halo and double image, since post-operative day one. A topography guided /$6(. HQKDQFHPHQW ZDV SHUIRUPHG PRQWKV post-SMILE, which resulted in reduction of vertical and horizontal coma and spherical aberration within 2-month after the procedure. However, regression was observed over time, and it was believed to be due to epithelial thickening (Figure 4). In addition, post-operative hyperopic shift resulted in over-correction in the dominant eye. Since mitomycin C was not available, a re- enhancement using wavefront optimized (WFO) Wavelight ® EX500 was performed. $ VLJQLȴFDQW LPSURYHPHQW LQ 8&9$ %&9$ DQG refraction (6 month post-operative: 1.0+; plano and 8 month post-operative: 1.0; plano) was seen without any symptoms of glare and halo, thus showing that topography guided WFO ablation was successful in restoring irregularity of cornea. Safety, precision, versatility and patient comfort are the greatest advantages of femtosecond laser (FS) and it has since established its place in high precision ophthalmic surgery. Ȋ(DVH RI OLIWLQJ WKH ȵDS LV RQH RI WKH VWURQJHVW advantages of using FS 200” said Prof. Rohit Shetty. Prof. Shetty shared clinical pearls on femtosecond laser surgery (Table 4).