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109 April 2016 EW REFRACTIVE SURGERY Contact information Ganesh: phacomaverick@gmail.com Brar: brar_sheetal@yahoo.co.in a valid and acceptable modality for surgical management of keratoco- nus, Dr. Brar said. In a preliminary study of 6 pa- tients, Wu and colleagues 3 assessed the use of SMILE-extracted lenticules as a surgical alternative for closing wounds in corneal perforation. Using 10-0 nylon interrupted stitches, SMILE-extracted lenticules having a central thickness of >100 mm were fixed over corneal perfo- ration sites. Patient examination included slit lamp microscopy, fluorescein, digital tonometry, and best spectacle corrected visual acuity (BSCVA) measurements and were monitored for a minimum of 1 year. Their findings, demonstrating no evidence of infection, relapse or perforation throughout the 12-month follow-up period, were published in the June 2015 issue of Cornea. "Corneal perforations were successfully sealed in all 6 patients; 3 patients (50%) exhibited improved postoperative BSCVA. Between 3 and 4 weeks after the operation, part of the lenticules became incorpo- rated into the corneal stroma and complete reepithelialization was achieved," they noted. Based on these preliminary find- ings, emphasized the investigators, SMILE-extracted corneal lenticules seem to be a safe and effective surgi- cal alternative in the wound closure of corneal perforation. "The procedure, as potential clinical application, is a relatively simple and inexpensive temporary measure to improve the condition of the cornea for further definitive interventions," they concluded. "Although tissue addition using SMILE-extracted lenticules is a new and evolving field in refractive and corneal surgery, with increasing numbers of refractive surgeons converting from LASIK to SMILE, resulting in increasing accessibility to the corneal lenticules obtained as byproduct, this technique has a way to go," Dr. Brar concluded. EW References 1. Ganesh S, et al. Cryopreservation of ex- tracted corneal lenticules after small incision lenticule extraction for potential use in human subjects. Cornea. 2014;33:1355–1362. 2. Ganesh S, et al. Femtosecond intrastromal lenticular implantation combined with acceler- ated collagen crosslinking for the treatment of keratoconus—initial clinical result in 6 eyes. Cornea. 2015 Oct;34(10):1331–9. 3. Wu F, et al. Treatment of corneal perforation with lenticules from small incision lenticule extraction surgery: a preliminary study of 6 patients. Cornea. 2015;34:658–663. Editors' note: Drs. Ganesh and Brar have no financial interests related to their comments. THE PRESBYOPIA SOLUTION THEY'VE BEEN WAITING FOR. The KAMRA inlay provides a full range of vision and long-term performance, while leaving the natural lens in place. Indications for Use: The KAMRA inlay is indicated for intrastromal corneal implantation to improve near vision by extending the depth of focus in the non-dominant eye of phakic, presbyopic patients between the ages of 45 and 60 years old who have cycloplegic refractive spherical equivalent of +0.50 D to -0.75 D with less than or equal to 0.75 D of refractive cylinder, who do not require glasses or contact lenses for clear distance vision, and who require near correction of +1.00 D to +2.50 D of reading add. KAMRA; the KAMRA logo; Across the page. Across the room. Across the years; and The Presbyopia Solution are trademarks of AcuFocus, Inc. ©2016 AcuFocus, Inc. MKU-157 Rev F Mean near acuity improved about 3 lines to 20/25 at 1 month and was maintained over the 5 year follow-up. The US pivotal clinical study data reported an average gain of about 3 lines of near visual acuity.** *Dexl AK et al. Long-term outcomes after monocular corneal inlay implantation for the surgical compensation of presbyopia. J Cataract Refract Surg. 2015 Mar;41 (3):566-75. **PMA data on file at AcuFocus, Inc. 20/200 20/125 20/80 20/50 20/32 20/20 20/12.5 0 10 20 30 40 50 60 SNELLEN ACUITY MONTH UNCORRECTED NEAR VISUAL ACUITY (INLAY EYE ONLY)* INLAY EYE J2 Across the page. Across the room. Across the years. Visit us at ASCRS Booth #545 ®

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