Early clinical outcomes, including efficacy and endothelial cell loss, of refractive lenticule extraction using a 500 kHz femtosecond laser to correct myopia

J Cataract Refract Surg. 2012 Nov;38(11):1996-2002. doi: 10.1016/j.jcrs.2012.06.052. Epub 2012 Sep 14.

Abstract

Purpose: To assess the early clinical outcomes, including the efficacy and the endothelial cell loss, of femtosecond lenticule extraction using a 500 kHz femtosecond laser system to correct myopia.

Setting: Department of Ophthalmology, Kitasato University, Kanagawa, Japan.

Design: Case series.

Methods: This study evaluated eyes with a spherical equivalent of -4.26 diopters (D) ± 1.39 (SD) that had femtosecond lenticule extraction for myopia. Before surgery and 1 week and 1, 3, and 6 months after surgery, the safety, efficacy, predictability, stability, and adverse events of the surgery were assessed.

Results: The study enrolled 38 eyes of 20 patients. The uncorrected distance visual acuity and corrected distance visual acuity 6 months after surgery were -0.14 ± 0.10 logMAR and -0.21 ± 0.09 logMAR, respectively. The safety index was 0.96 ± 0.19 and the efficacy index, 0.82 ± 0.17. At 6 months, all eyes were within ±0.50 D of the targeted correction. The mean manifest refraction change from 1 week to 6 months was 0.02 ± 0.28 D. The endothelial cell density was 2814 ± 199 cells/mm(2) preoperatively and 2762 ± 213 cells/mm(2) postoperatively; the change was not significant (P = .32, Wilcoxon signed-rank test). No vision-threatening complications occurred during the observation period.

Conclusions: Femtosecond lenticule extraction performed well in the correction of myopia. Neither significant endothelial cell loss nor serious complications occurred throughout the 6-month follow-up, suggesting femtosecond lenticule extraction is a viable surgical option to treat myopic eyes.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

MeSH terms

  • Adult
  • Astigmatism / physiopathology
  • Astigmatism / surgery
  • Cell Count
  • Corneal Endothelial Cell Loss / diagnosis
  • Corneal Endothelial Cell Loss / etiology*
  • Corneal Pachymetry
  • Corneal Stroma / surgery*
  • Endothelium, Corneal / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Intraocular Pressure / physiology
  • Laser Therapy / methods*
  • Male
  • Middle Aged
  • Myopia / physiopathology
  • Myopia / surgery*
  • Postoperative Complications*
  • Prospective Studies
  • Refraction, Ocular / physiology
  • Surgical Flaps
  • Treatment Outcome
  • Visual Acuity / physiology
  • Young Adult