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    Advances for refractive laser surgery aim to boost outcomes

    Improvements to treatment planning could enhance efficacy, safety for certain population groups


    Another improvement that could come soon is better precision with the introduction of ultraviolet (UV) femtosecond lasers instead of infrared lasers for small-incision lenticule extraction (SMILE). Although SMILE effectively helps highly myopic patients, Dr. Mrochen said, the procedure’s use of infrared lasers causes some limitations in accuracy. In fact, the accuracy compared with UV lasers is notably lower. By experimenting with ways to use less energy, surgeons can switch to UV light application, he noted.

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    “This will use lower energies and get a more precise cutting element for SMILE,” Dr. Mrochen said.

    In corneal collagen crosslinking for keratoconus, there are efforts under way to use noncutting treatments to correct low refractive errors, especially after cataract lens implantation.

    The use of laser shaped lenticle onlays and an inlay from donor eyes for patients with hyperopia is an approach that is currently under examination, Dr. Mrochen said.

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    Yet, one more advance under assessment is the use of infrared lasers to modify the sclera and increase the ability of the lens to restore accommodation.

    Though there is no one advancement outlined above to address all of the efficacy, safety, or convenience concerns that Dr. Mrochen outlined, they all might play a part in improving refractive surgery in future, he said.


    Michael Mrochen, PhD

    E: [email protected]

    This article was adapted from a presentation by Dr. Mrochen during Refractive Surgery Subspecialty Day at the 2015 meeting of the American Academy of Ophthalmology. Dr. Mrochen is founder of IROC Science, Zurich, Switzerland.


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