Clinical Outcomes of ATOS-mediated SmartSight Lenticule Extraction

Purpose@#To evaluate the clinical outcomes of a new refractive corneal lenticule extraction method (SmartSight) using a Schwind ATOS femtosecond laser (Schwind Eye-Tech-Solutions, Kleinostheim, Germany). @*Methods@#The medical records of 338 eyes of 170 patients who underwent SmartSight treatment from April to September 2022 and were followed-up for at least 3 months were retrospectively analyzed. The patients were followed-up at 1 day, 1 week, and 1 and 3 months after operation. Refraction, visual acuity, and intraocular pressure were measured at each visit. @*Results@#Preoperatively, the uncorrected distant visual acuity was 1.26 ± 0.33 logarithm of minimum angle or resolution (logMAR) and the spherical equivalent was -4.52 ± 1.77 diopters. The 3-month, postoperative, uncorrected distant visual acuity was 0.01 ± 0.03 logMAR and the spherical equivalent was -0.12 ± 0.22 diopters. The 3-month data were as follows: efficacy of refractive surgery, 0.99 ± 0.11; safety, 1.00 ± 0.05; predictabilities at ±0.5 and ± 1.0 diopters, 97% and 100%, respectively. @*Conclusions@#Myopic astigmatism correction using the SmartSight method was effective, safe, and predictable in terms of visual outcomes.

Two Cases of Monochromatic Green Argon Laser Photocoagulation for Choroidal Neovascular Membrane in High Myopes

High myopia, often called malignant, pathologic or degenerative myopia, involves a progressive elongation of globe, accompanied by degenerative changes of the retina and choroid. Continued stretching and degeneration of the choroid causes eyes with severe myopia to develop breaks in Bruch's membrane which, called lacquer cracks, and permits neovascular proliferation from the choriocapillaris into the subretinal pigment epithelial space. Neovascularization associated with severe myopia deteriorates central visual acuity due to exudation and/or hemorrhage. Laser photocoagulation therapy is useful in treating neovascular membrane outside the foveal avascular zone or extending to the edge of the perifoveal capillary network. We have evaluated three patients with macular hemorrhage which associated with high myopic choroidal degeneration. Subretinal neovascular membrane was detected by fluorecein angiography and was treated with monochromatic Argon green laser photocoagulation in two patients indicated. The visual acuities were improved. But one patient who had macular hemorrhage involving both foveas could not be treated with laser photocoagulation. Then his visual acuity severly decreased. We give our experiences with the review of other papers in this report.

Three Cases of Simple Ectopia Lentis in One Family

Ectopia lentis, Synonymously with Congenital dislocated lens, is defined as a dislocation of the ocular lens, of greater or less degree, based on a developmental anomaly. It occurs in three conditions, as an isolated anomaly, in association with ocular anomaly, and as a part of a systemic syndrome with other mesodermal, particularly skeletal anomalies. Among these, simple ectopia lentis is a hereditary autosomal dominant disorders without skeletal, connective tissue or metabolic symptomatology. Except for the dislocation of the lens, these eyes are in other respects grossly normal. Regarding its management, there is a continuing debate proponents of active surgical intervention to prevent future problems to those who will not remove the lens and advocates of conservative treatment because lens surgery can be difficult and has a high rate of intraoperative and post operative complication. Recently, the authours have experienced three patients with simple ectopia lentis, which occurred in one family with autosomal dominant inheritance and achieved satisfactory result surgically. Thus these cases are presented with brief review of literatures.