Prevalence of Pigment Dispersion Syndrome in Patients Seeking Refractive Surgery.

PURPOSE: To determine the prevalence of pigment dispersion syndrome (PDS) in patients presenting for vision correcting refractive surgery. SETTING: Discover Vision Centers, Kansas City, MO. DESIGN: This is a prospective case series. MATERIALS AND METHODS: A total of 637 eyes of 319 serial patients who presented seeking refractive surgery were included in this prospective, observational study. Patients underwent routine ophthalmologic examination before refractive surgery. PDS was diagnosed by the presence of a deep anterior chamber, posterior bowing of the irides, Krukenberg spindles, and/or presence of mid-peripheral iris transillumination defects by the same experienced ophthalmologist. The prevalence of PDS and its associated ophthalmic and demographic characteristics were evaluated in those diagnosed. RESULTS: Of the 637 eyes, 165 (25.9%) eyes were diagnosed with PDS. Krukenberg spindles were present in 53 (8.3%) of the total eyes and in 47 (28.5%) eyes that were diagnosed with PDS. Transillumination defects were present in 153 (95%) eyes diagnosed with PDS and 161 (25.2%) total eyes. There was equal distribution between sex in those diagnosed with PDS (male vs. female: 26 vs. 25.8%; P=0.942). Blue colored eyes were most likely to have PDS (35.8% of patients). CONCLUSIONS: The prevalence of PDS within the population of patients seeking refractive surgery is likely greater than the general population as a whole. This is most likely the result of self-selection and high association between myopia and PDS. Given that not infrequent sequela can occur from untreated PDS, it is prudent that refractive surgeons be aware of this increased prevalence and perform thorough examinations to properly identify the condition.

Small Incision Lenticule Extraction SMILE - The Future of Refractive Surgery is Here.

Small Incision Lenticule Extraction (SMILE) is a relatively new one-step refractive procedure that has recently been approved by the FDA for the treatment of myopia. It is anticipated myopic astigmatism will be FDA-approved in 2019. The SMILE procedure is shown to have similar efficacy, safety, predictability, and stability as current surgical options, such as LASIK, but has been gaining popularity due to fewer potential complications, such as dry eye incidence and greater biomechanical stability, and faster recovery time. This article discusses the SMILE procedure, its benefits, risks, uncertainties, and potential future in the world of refractive surgery.