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Journal of Ophthalmology
Volume 2016 (2016), Article ID 3686380, 9 pages
Clinical Study

Small Incision Lenticule Extraction for Postkeratoplasty Myopia and Astigmatism

1Ophthalmology Department, Alexandria University, Alexandria 21511, Egypt
2Roayah Laser Vision Correction Centre, Alexandria, Egypt

Received 10 February 2016; Revised 18 May 2016; Accepted 30 May 2016

Academic Editor: George Kymionis

Copyright © 2016 Tamer H. Massoud et al. 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 evaluate the visual and refractive outcomes after small incision lenticule extraction (SMILE) for treating myopia and myopic astigmatism after penetrating keratoplasty (PKP). Design. Case-series. Methods. Ten eyes of 10 patients with previous PKP and residual myopic astigmatism for whom pentacam imaging and thickness measurements were acceptable for laser vision correction. Manifest refraction (MR), uncorrected distance visual acuity (UDVA), and corrected distance visual acuity (CDVA) were obtained preoperatively and one day, one week, and one, 3, and 6 months postoperatively. Cases were operated on the VisuMax® femtosecond laser platform with 500 kHz repetition rate. Results. The mean correction ratio for spherical errors was  D and for the mean refractive spherical equivalent (MRSE) was  D. Vector analysis showed a mean astigmatism reduction at the intended axis of , a correction index of , and an overall mean percentage of success of astigmatism surgery of . The postoperative MRSE was stable throughout the 6-month follow-up period. The efficacy index was 0.93 and the safety index was 1.12. Conclusion. SMILE for correction of post-PKP myopia and astigmatism is effective, safe, and stable with moderate accuracy and predictability. Centration of the treatment within the grafts was easily performed.