Outcomes of Femtosecond Intrastromal Lenticule Implantation: Tissue Addition Technique for Hyperopia
To study the safety, efficacy and clinical outcomes of FILI for treatment of moderate to high hyperopia.
Seventeen eyes of 11 patients with unilateral or bilateral hyperopia were treated. Femtosecondlaser was used to create a pocket in patients cornea, into which a cryopreserved lenticule (extracted after ReLEx SMILE for myopia) was inserted. The lenticule was matched for refractive error. Mean time for cryopreservation of lenticules was 102.4 days. Preoperatively, mean age was 31.5 years, mean preop SEQ + 5.40 D (range +3.5 to + 6.8 D), mean corrected distance visual acuity 20/32, mean keratometry 44.69 D, mean central corneal thickness 530.26 µm. Postoperatively, topical steroids were prescribed for 3 months.
At 9 month mean follow-up, all patients had clear corneas and well centered lenticules. Postoperatively, mean UCVA, CDVA, residual SE, residual astigmatism was 20/26, 20/23, +0.36 D and +0.60 D (against the rule) respectively. Mean keratometery increased to 46.90 D from 44.69 D and mean central corneal thickness increased to 581.33 µm from 530.26 µm. Change in all parameters was statistically significant from preop values (p<0.05). No adverse reactions or rejection was seen after discontinuation of topical steroids. None of the eyes had loss of CDVA.
FILI is an innovative technique and may be an alternative to LASIK/ PRK for hyperopia. Potential advantages - less chances of regression, less aberrations, no flap complications, no haze, reversibility. Longer follow up studies in larger cohorts are required to establish the technique as valid option to treat hyperopia.