One year Results of Refractive Lenticule Extraction ( ReLEx) for Myopia and
astigmatism using Visumax Femto second laser.

Osama Ibrahim M.D. Ph.D. Moones abdalla M.D. ,Ibrahim Sayed Ahmed

Background and Purpose : A new refractive surgery Technique ReLEx ,using femtosecond lenticule extraction w as introduced in our clinic. The report summarizes one year results of both FLEx and SMILE in our clinical setting and the comparison with our established standard
LASIK procedure.

Methods : All treatments were carried out by the same surgeon( OI) w ith the VisuMax femtosecond system (Carl Zeiss Meditec) as part of a pre- market clinical study.
The VisuMax laser is cutting an intrastromal lenticule inside the intact cornea with a sphero-cylindrical contour according to the desir ed correction. The incision is extended to the anterior corneal surface to form an access for manual extraction of the lenticule either through a flap- like opening (FLEx) or microincision (SMILE). Patients were examined post operatively up to one year.

Results: 168 eyes with pre-operative refraction up to - 14 D of myopia including myopic
astigmatis m underwent FLEx and SMILE procedure. At one year , the mean SER w as -0.41 D ± 0.63 D ( range : +0.5 to – 2.0 )and mean astigmatism was -0.41 D ± 0.63 D ( zero to -2.0) w ith 72% w ithin +/- 0.5 and 89% within +/- 1.0 D. The best corrected visual acuity did not change or gained 1 to 2 lines in 82% of eyes. For eyes intended for plano correction , 83% of eyes showed uncorrected VA of 20/20 or better and 94 % of cases 20/25 or better. Corneal topography showed excellent centration and flattening larger than the lenticule diameter . Wave front measurments showed less induced high order aberration than conventional LASIK .
No vision threatening complications were reported in this series.

Conclusions: The new ReLEx procedure both as FLEx and SMILE were successfully established in our refractive clinic with good refractive predictability . Clinical results show that the tr eatment is safe, effective and stable up to one year.