O.V. PISAREVSKAYA¹, A.G. SHCHUKO^1-3, T.N. YURYEVA^1-3, T.N. FROLOVA¹, E.M—Z. BALZHIROVA²

¹Irkutsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution, 337 Lermontov Str., Irkutsk, Russian Federation, 664033

²Irkutsk State Medical University, 2 Krasnogo Vosstaniya Str., Irkutsk, Russian Federation, 664033

³Irkutsk State Medical Academy of Postgraduate Education ― Branch Campus of the FSBEI FPE RMACPE MOH Russia, 100 Yubileyniy district, Irkutsk, Russian Federation, 664079

Pisarevskaya O.V. ― Cand. Med. Sc., Head of the 5^th Ophthalmological Department, tel. (3952) 56-41-48, e-mail: lesya_pisarevsk@mail.ru

Shchuko A.G. ― D. Med. Sc., Professor, Director of Irkutsk Branch of the S. Fyodorov Eye Microsurgery Federal State Autonomous Institution; Head of the Eye Diseases Departments of Irkutsk Institute of Postgraduate Medical Education, Irkutsk State Medical University, tel. (3952) 56-41-37, e-mail: shishkinamntk@mail.ru

Yuryeva T.N. ― D. Med. Sc., Professor, Deputy Director on Scientific Work, Professor of the Eye Diseases Departments of Irkutsk Institute of Postgraduate Medical Education, Irkutsk State Medical University, e-mail: tnyurieva@mail.ru

Frolova T.N. ― ophthalmologist of the 5^th Ophthalmological Department, tel. (3952) 56-41-48, e-mail: lesya_pisarevsk@mail.ru

Balzhirova E.M.-Zh. ― ophthalmologist, postgraduate student of the Eye Diseases Department, e-mail: balzhirova.erzhena@mail.ru

 Evaluation was carried out of the effectiveness of the modified Smile operation in 45 patients (90 eyes) with mild degrees of myopia and complex myopic astigmatism. Uncorrected visual acuity before surgery was 0.17±0.21 on average, corrected ― 0.95±0.11, preoperative spherical equivalent as -2.14±0,6 D. It is shown that an increase in the minimum thickness of the lenticle up to 30 mkm and expansion of access to 45 degrees allows to exclude intrastromal complications in the form of rupture of the lenticle with preservation of the predicted refractive effect, and an increase in the cylindrical component on average by 10% of the initial values allows achieving high acuity and visual quality. In all patients on the next day after the operation, uncorrected visual acuity in the distance was significantly higher, but the maximum values were reached after three months. The proposed changes in Smile technology for the correction of myopia of mild degree combined with astigmatism, give a high refractive effect and exclude possible complications, thereby allowing for more widespread introduction of this operation.

Key words: mild myopia, complex myopic astigmatism, femtosecond laser, Smile technology, lenticle, access.

REFERENCES

1. 1.Reinstein D.Z., Carp G.I., Archer T.J., Gobbe M. Outcomes of small incision lenticule extraction (SMILE) in low myopia. J. Refract. Surg., 2014, no. 30(12), pp. 812-818.
2. 2.Netto M.V., Mohan R.R., Sinha S., et al. Stromal haze, myofibroblasts, and surface irregularity after PRK. Exp Eye Res, 2006, no. 82(5), pp. 788-797.
3. 3.Chan J.W., Edwards M.H., Woo G.C., Woo V.C. Contrast sensitivity after laser in situ keratomileusis: one–year follow —up.  J. Cataract Refract. Surg, 2002, no 28 (10). pp. 1774 —1779.
4. 4.Khoueir Z., Haddad N.M., Saad A., et al. Traumatic flap dislocation 10 years after LASIK. Case report and literature review. Journal francais d’ophtalmologie, 2013, no 36(1), pp.82-86.
5. Ivarsen A., Asp S., Hjortdal J. Safety and complications of more than 1500 small-incision lenticule extraction procedures. Ophthalmology, 2014, no. 121 (4), pp. 822–8. doi:10.1016/j.ophtha.2013.11.006. Epub 2013 Dec 21
6. Shchuko A.G., Pisarevskaya O.V., Bukina V.V., Iureva T.N. Femtosecond technologies in correction of myopia. Oftal’mokhirurgiya, 2014, no.2. pp. 85 —91. (in Russ.).
7. Klokova О.А., Sakhnov S.N., Piskunov А.V., et al. Qualitative evaluation of the results of ReLex operations (SMILE technology) based on contrast sensitivity. Materialy XV Mezhdunarodnoy nauchno-prakticheskoy konferentsii «Sovremennyye tekhnologii kataraktal’noy i refraktsionnoy khirurgii», 2014.
8. Pozdeeva N.A., Shkolnik G.S., Pateeva T.Z., Fedotova L.A. Spatial contrast sensitivity and aberrations of higher order after various refractive laser operations in the early postoperative period. Vestnik OGU, 2009, no.12. pp. 115–119. (in Russ.).
9. Perez —Santonja J.J., Sakla H.F., Alio J.L. Contrast sensitivity after laser in situ keratomileusis. J. Cataract Refract. Surg, 1998, no. 24 (2), pp. 183 -189.
10. Li M, Zhao J, Shen Y., Li T., He L., et al. Comparison of Dry Eye and Corneal Sensitivity between Small Incision Lenticule Extraction and Femtosecond LASIK for Myopia. PLoS One, 2013, no.8 (10).