Lenticule extraction treatment using SmartSight (Schwind eye-tech solutions, Germany) is safe and efficacious on day one post-surgery, according to a study published in BMC Ophthalmology.1 The procedure was found to achieve excellent uncorrected distance visual acuity in myopic eyes (with or without astigmatism).
Researchers completed a retrospective case series to investigate immediate and short-term (at post-operative day 1, (POD1)) visual recovery in myopic eyes (with or without astigmatism) treated with the SmartSight procedure.
The advanced myopic ablation pattern of the low energy asymmetric spacings… results in a smoother extraction and thus a more rapid visual recovery for patients
Additionally, they compared the impact of low energy asymmetric spacings vs. conventional high energy symmetric spacings on the immediate/ early POD1 outcomes of SmartSight lenticule extraction for myopic astigmatism with a new femtosecond laser system.
Two groups of 112 eyes of 56 patients from Matrika Eye Center, Kathmandu, Nepal were consecutively treated. Group A (Study group) was treated with low energy asymmetric spacings. Group S (Controls) was treated using high energy symmetric spacings. Patients’ mean age was 28 ± 5 years with a mean spherical equivalent of -4.41 ± 1.76 diopters (D) and a mean magnitude of refractive astigmatism of 0.89 ± 0.82D.
Laser Energy was -25 ± 1nJ lower for asymmetric treatments (p < .0001); Spot and Track distances were + 0.7 ± 0.1μm larger and -0.8 ± 0.1μm tighter for asymmetric treatments, respectively (p < .0001 for both). At uncorrected and corrected distance visual acuities (UDVA and CDVA, respectively) were -0.03 ± 0.01logMAR better for asymmetric treatments (p < .0007); differences between postop UDVA and preop CDVA along with change in CDVA were + 0.3 ± 0.1lines better for asymmetric treatments (p < .0003).
The authors reported that in Group A, very early visual recovery (at POD1) after SmartSight was rapid, providing excellent UDVA immediately after the surgery.
“We postulate that it is the advanced myopic ablation pattern of the low energy asymmetric spacings… (that) results in a smoother extraction and thus a more rapid visual recovery for patients. This work may help improving the laser energy and spot spacings design to achieved better outcomes in laser driven lenticule extraction procedures,” they wrote.
Reference
1. Pradhan, K.R., Arba Mosquera, S., Comparing high and low energy outcomes on day one for SmartSight myopic-astigmatism treatments with the Schwind ATOS: a retrospective case series. BMC Ophthalmol 23, 328 (2023). doi.org/10.1186/s12886-023-03076-z.
This work may help improving the laser energy and spot spacings design.
