title: Safety and efficacy of VisuMax® circle patterns for flap creation and enhancement following small incision lenticule extraction.
abstract: BACKGROUND
  The purpose of this case series is to evaluate the safety and efficacy of VisuMax® Circle patterns in eyes that have undergone small incision lenticule extraction, thus creating a flap to perform an enhancement procedure or residual lenticule extraction.
  
  
  METHODS
  This prospective, single center, case study series evaluated the use of a VisuMax® Circle pattern to create a corneal flap following small incision lenticule extraction. Patients were treated and followed at TRSC International LASIK Center (Bangkok, Thailand) for 3 months to assess the efficacy and safety of the procedure. Efficacy was determined by the surgeon's ability to lift the created corneal flap.
  
  
  RESULTS
  The study enrolled 28 eyes. Twenty-seven underwent the VisuMax® Circle pattern procedure for refractive enhancement, and one for residual lenticule extraction. In 100 % of cases (28 eyes) the lifting of the flap was possible, as planned. In all cases of refractive enhancement (27 eyes) by laser in situ keratomileusis (LASIK), the exposure of the stromal bed was sufficient for the necessary excimer laser ablation. No eyes lost two or more Snellen lines of corrected distance visual acuity (CDVA) and no procedure or flap-related complications or serious adverse events occurred.
  
  
  CONCLUSIONS
  This initial case series demonstrates that VisuMax® Circle pattern is efficacious and a suitable method to create a corneal flap for enhancement, following small incision lenticule extraction.
authors.affiliation: TRSC International LASIK Center, 6th Floor, U Chu Liang Boulevard, 968 Rama 4 Road, Bangkok, Thailand.
authors.forename: Ekktet
authors.initials: E
authors.lastname: Chansue
authors.affiliation: TRSC International LASIK Center, 6th Floor, U Chu Liang Boulevard, 968 Rama 4 Road, Bangkok, Thailand.
authors.forename: Morakot
authors.initials: M
authors.lastname: Tanehsakdi
authors.affiliation: TRSC International LASIK Center, 6th Floor, U Chu Liang Boulevard, 968 Rama 4 Road, Bangkok, Thailand.
authors.forename: Sukanda
authors.initials: S
authors.lastname: Swasdibutra
authors.affiliation: Flinders University, Bedford Park, Adelaide, South Australia Australia ; Wenzhou Medical College, Wenzhou, Zhejiang China.
authors.forename: Colm
authors.initials: C
authors.lastname: McAlinden
keywords: Circle pattern; Femtosecond laser; Flap creation; Lenticule; Refractive enhancement; Refractive surgery; Residual lenticule extraction; SMILE; Small incision lenticule extraction