title: Full-Thickness Astigmatic Keratotomy Combined With Small-Incision Lenticule Extraction to Treat High-Level and Mixed Astigmatism.
abstract: OBJECTIVE
  To explore the clinical effects of combined full-thickness astigmatic keratotomy and small-incision lenticule extraction (SMILE) in patients who are inoperable using SMILE alone.
  
  
  METHODS
  We included 13 eyes of 9 patients with high-level or mixed astigmatism who underwent full-thickness astigmatic keratotomy followed by SMILE (secondarily) to correct the residual refractive error.
  
  
  RESULTS
  Six months after SMILE, the spherical equivalent was reduced from -4.83 ± 3.26 D to -0.17 ± 0.38 D (P < 0.001), and the astigmatism was reduced from 5.12 ± 0.96 D to 0.21 ± 0.22 D (P < 0.001). The uncorrected and corrected (CDVA) distance visual acuities improved from 1.07 ± 0.62 to 0.02 ± 0.13 (P < 0.001) and from 0.08 ± 0.14 to -0.01 ± 0.14 (P = 0.002), respectively. The CDVA improved by 1 or 2 Snellen lines in 8 cases (61.5%), and there was no loss in CDVA. All procedures were completed without intraoperative or postoperative complications.
  
  
  CONCLUSIONS
  This combined procedure was effective and safe for the treatment of high-level or mixed astigmatism.
authors.affiliation: *Onnuri Smile Eye Clinic, Hyobong Building, 9F 1, Gangnam-daero 65 gil, Seocho-gu, Seoul, Korea; and †St. Mary's Hospital, Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Bu Ki
authors.initials: BK
authors.lastname: Kim
authors.forename: Su Joung
authors.initials: SJ
authors.lastname: Mun
authors.forename: Dae Gyu
authors.initials: DG
authors.lastname: Lee
authors.forename: Jae Ryun
authors.initials: JR
authors.lastname: Kim
authors.forename: Hyun Seung
authors.initials: HS
authors.lastname: Kim
authors.forename: Young Taek
authors.initials: YT
authors.lastname: Chung
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000503:physiopathology / Q000601:surgery*; D003319:Corneal Stroma / Q000601:surgery*; D048988:Corneal Surgery, Laser / Q000379:methods*; D019781:Corneal Topography; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications; D012029:Refraction, Ocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult