Predictive Formula for Refraction of Autologous Lenticule Implantation for Hyperopia Correction.

PURPOSE To create a formula to predict refractive correction of autologous lenticule implantation for correction of hyperopia (with myopia in one eye and hyperopia in the contralateral eye). METHODS In this prospective study, 10 consecutive patients (20 eyes) who had myopia in one eye and hyperopia in the contralateral eye were included. The preoperative spherical equivalent was -3.31 ± 1.73 diopters (D) for the myopic eyes and +4.46 ± 1.97 D for the hyperopic eyes. For each patient, the myopic eye was treated with small incision lenticule extraction and the lenticule was subsequently implanted into the contralateral hyperopic eye. The average length of follow-up was 17 months. RESULTS All of the operations were successful without complications. At the last visit, the efficacy index (postoperative uncorrected distance visual acuity/preoperative corrected distance visual acuity [CDVA]) of the hyperopic eyes was 0.94 ± 0.35 and the safety index (postoperative CDVA/preoperative CDVA) was 1.36 ± 0.38. No eyes lost any lines of visual acuity. Six of 10 (60%) of the implanted eyes were within ±1.00 D of the intended refractive target. A predictive formula was derived: Lenticule implantation achieved correction (D) (LAC) = 1.224 Lenticule refractive power (D) (LRP) - 0.063 (R2 =0.92, P < .001). On corneal topography, there was a significant increase in the corneal anterior surface keratometry value postoperatively, whereas the posterior surface keratometry value remained stable (P > .05). CONCLUSIONS Autologous lenticule implantation could provide a reliable method of correcting hyperopia. The refractive correction formula may require further verification and adjustment. [J Refract Surg. 2017;33(12):827-833.].

[1]  A. Frings,et al.  Role of preoperative cycloplegic refraction in LASIK treatment of hyperopia , 2016, Graefe's Archive for Clinical and Experimental Ophthalmology.

[2]  J. Alió,et al.  Three-Year Follow-up of Hyperopic LASIK Using a 500-Hz Excimer Laser System. , 2015, Journal of refractive surgery.

[3]  J. Zhao,et al.  The Safety and Predictability of Implanting Autologous Lenticule Obtained by SMILE for Hyperopia. , 2015, Journal of refractive surgery.

[4]  D. Reinstein,et al.  Small-incision lenticule extraction. , 2015, Journal of cataract and refractive surgery.

[5]  S. Ganesh,et al.  Cryopreservation of Extracted Corneal Lenticules after Small Incision Lenticule Extraction for Potential Use in Human Subjects , 2014, Cornea.

[6]  J. Grauslund,et al.  Efficacy, safety, predictability, contrast sensitivity, and aberrations after femtosecond laser lenticule extraction , 2014, Journal of cataract and refractive surgery.

[7]  J. Mehta,et al.  LASIK following Small Incision Lenticule Extraction (SMILE) Lenticule Re-Implantation: A Feasibility Study of a Novel Method for Treatment of Presbyopia , 2013, PloS one.

[8]  D. Reinstein,et al.  Femtosecond laser-assisted keyhole endokeratophakia: correction of hyperopia by implantation of an allogeneic lenticule obtained by SMILE from a myopic donor. , 2013, Journal of refractive surgery.

[9]  J. Mehta,et al.  Refractive lenticule re-implantation after myopic ReLEx: a feasibility study of stromal restoration after refractive surgery in a rabbit model. , 2012, Investigative ophthalmology & visual science.

[10]  J. Mehta,et al.  Femtosecond lenticule extraction (FLEx): clinical results, interface evaluation, and intraocular pressure variation. , 2012, Investigative ophthalmology & visual science.

[11]  R. Shah,et al.  Results of small incision lenticule extraction: All‐in‐one femtosecond laser refractive surgery , 2011, Journal of cataract and refractive surgery.

[12]  D. Reinstein,et al.  Corneal ablation depth readout of the MEL 80 excimer laser compared to Artemis three-dimensional very high-frequency digital ultrasound stromal measurements. , 2010, Journal of refractive surgery.

[13]  K. Boergen,et al.  Screening for Refractive Errors in Preschool Children with the Vision Screener , 2007, Strabismus.

[14]  J. Marshall,et al.  5-year follow-up of LASIK for hyperopia. , 2005, Ophthalmology (Rochester, Minn.).