Prophylactic corneal crosslinking in myopic small-incision lenticule extraction - Long-term visual and refractive outcomes

ABSTRACT

Purpose: To analyze the efficacy, safety, predictability, and stability in myopic and astigmatic small?incision lenticule extraction (SMILE) with simultaneous prophylactic corneal crosslinking (CXL) in thin corneas. Methods: A total of 48 eyes from 24 patients who underwent myopic and astigmatism SMILE with simultaneous prophylactic CXL were included in this retrospective study. All patients had a 24?month follow?up. A femtosecond laser was performed with VisuMax (Carl Zeiss Meditec). CXL treatment was applied when the predicted stromal thickness was less than 330 ?m. Results: The patients’ mean age was 31.58 ± 6.23 years. The previous mean spherical equivalent was ? 6.85 ± 1.80 (?9.75 to ? 2.00) D. The postoperative mean spherical equivalent was ? 0.50 ± 0.26 (?1.00 to + 0.25) D; 60% of the eyes had 20/20 or better; 19% lost one line; 58% were within ± 0.50 D; and 8.3% of the eyes changed 0.50 D or more between 3 and 24 months. Conclusion: Prophylactic CXL with simultaneous SMILE for myopia and astigmatism femtosecond laser surgery technique appears to be partially effective, safe, predictable, and stable after 24 months of follow?up