Table of Contents Author Guidelines Submit a Manuscript
Journal of Ophthalmology
Volume 2015, Article ID 263412, 7 pages
Clinical Study

Clinical Outcomes of Small Incision Lenticule Extraction with Accelerated Cross-Linking (ReLEx SMILE Xtra) in Patients with Thin Corneas and Borderline Topography

Nethradhama Superspeciality Eye Hospital, 256/14 Kanakapura Main Road, 7th Block, Jayanagar, Bangalore 560082, India

Received 3 March 2015; Revised 24 May 2015; Accepted 27 May 2015

Academic Editor: Vasilios F. Diakonis

Copyright © 2015 Sri Ganesh and Sheetal Brar. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To study the safety and clinical outcomes of ReLEx SMILE with accelerated cross-linking in individuals with thinner corneas, borderline topography, and higher refractive errors. Methods. Eligible patients first underwent SMILE procedure for correction of myopic refractive error. Following the removal of lenticule, 0.25% riboflavin in saline was injected into the interface and allowed to diffuse for 60 seconds. Finally, eye was exposed to UV-A radiation of 45 mW/cm2 for 75 seconds through the cap. Total energy delivered was 3.4 J/cm2. Results. 40 eyes of 20 patients with mean age of 26.75 ± 5.99 years were treated. Mean follow-up was 12 months ± 28.12 days. Mean spherical equivalent (SE) was −5.02 ± 2.06 D preoperatively and −0.24 ± 0.18 D postoperatively. The mean central corneal thickness (CCT) and keratometry changed from 501 ± 25.90 µm to 415 ± 42.26 µm and 45.40 ± 1.40 D to 41.2 ± 2.75 D, respectively. Mean uncorrected visual acuity (UCVA) was 20/25 or better in all eyes. No eyes lost lines of corrected distant visual acuity (CDVA). There were no complications like haze, keratitis, ectasia, or regression. Conclusion. Based on the initial clinical outcome it appears that SMILE Xtra may be a safe and feasible modality to prevent corneal ectasia in susceptible individuals.