Scanning Electron Microscopy of Variable Corneal Depth Lenticules in Small-Incision Lenticule Extraction Cases

Sunday, April 19, 2015: 1:06 PM
Room 3 (San Diego Convention Center)
Ihab M. Osman, MD, FRCS
Ahmed A. El-Massry, MD

Purpose
Evaluating the surface characters of superficial versus deeper corneal lenticules in SMILE cases at variable magnifications using scanning electron microscopy aiming for future deeper placement of these lenticules to have better corneal biomechanical stability if was comparable to the superficial ones.

Methods
Forty eyes underwent SMILE refractive procedure using femtosecond laser by VisuMax (Zeiss Meditech). 2 groups were used, one with lenticules at 100 µm and the other at 160 µm Lenticules were immediately processed (fixed, dehydrated, dried and mounted with gold coating). JSM-5300 scanning electron microscope was used for observations.

Results
Deeper lenticules had more irregular surfaces and were more difficult to dissect. Comparing the central and peripheral thickness of lenticules to the intended thickness was significantly more accurate in the superficial group.

Conclusion
Energy settings still needs further adjustment to be able to create deeper predictable lenticules in SMILE cases.