Tacoma, Wash. With only a small
surface incision and no removal of
the epithelium, SMILE could have
fewer dry eye effects, he said. With
only a single laser platform needed
and all incisions made during one
patient interface, SMILE is a more
streamlined procedure, he added.
John B. Cason, MD, San Diego,
explored whether corneal inlays
could be the "holy grail" of pres-
byopia treatment. The recently ap-
proved KAMRA inlay (AcuFocus, Ir-
vine, Calif.) and 2 others that are in
phase 3 clinical trials show promise,
but there is limited peer-reviewed
literature on the outcomes with
these devices, Dr. Cason said. All 3
inlay designs increase near vision
but sacrifice some distance vision in
the process. Some patients have had
their inlays removed because of sub-
jective vision complaints, he said,
so it is difficult to know what the
future holds for these devices. EW
Editors' note: The physicians have no
financial interests related to this article.
Their comments do not reflect the views
of the U.S. Armed Forces or Department
of Defense.
flap dislocations in the military.
Overall, flap dislocations are rare,
and the majority of them happen
in flaps made by a microkeratome.
Femtosecond flaps are planar with
a reverse bevel, making them more
stable than the lenticular flaps made
by a microkeratome, Dr. Thomas
said.
Surprisingly, Dr. Thomas found
in some cases removing a femto-
second flap after a dislocation can
actually increase visual acuity. She
described one patient whose vision
increased from 20/20 to 20/15 after
she amputated the flap. Remov-
ing a microkeratome flap, on the
other hand, can create significant
corneal astigmatism. Dr. Thomas
recommends that surgeons consider
suturing an amputated microker-
atome flap back in place, as long as
it's feasible.
Future technologies with
potential benefits
Many new refractive technologies
are particularly beneficial for active
duty military members. Small in-
cision lenticule extraction (SMILE)
could be a better option than LASIK
or PRK, said Mark F. Torres, MD,
/attendwoc
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World Ophthalmology Congress
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Dr. Torres highlights the benefits of small incision lenticule extraction (SMILE) over LASIK or
PRK for members of the military.