First, corneal flaps, with a super-hinge length of 4.0 mm, located at 12 o’clock, were created using the VisuMax femtosecond laser system. Laser settings were similar to those of SMILE. Once the flap scanning was finished, it was manually lifted using a spatula and gently positioned in the upper cornea. Subsequently, stromal ablation was performed using the MEL 80 excimer laser (Carl Zeiss Meditec AG, Germany) system, with parameters programmed as 500 Hz repetition rate. The diameter and thickness of the flap were 7.5 mm and 110 μm, respectively. The optical zone varied from 5.75 to 6.25 due to the corneal thickness and refractive errors. Bandage soft contact lenses were placed to protect each eye for 1 day and removed at the following day. The same surgeon completed all the procedures uneventfully (XZ).
The postoperative medication regimen included the administration of topical levofloxacin (Santen Pharmaceutical, Osaka, Japan) four times per day for 1 week and then 0.1% fluorometholone eye drops (Santen Pharmaceutical, Osaka, Japan) from eight times to one time per day over 24 days in a sequential decreasing order. Lacrimal substitutes were also used four times per day from 1 to 3 months, as required.
The postoperative medication regimen included the administration of topical levofloxacin (Santen Pharmaceutical, Osaka, Japan) four times per day for 1 week and then 0.1% fluorometholone eye drops (Santen Pharmaceutical, Osaka, Japan) from eight times to one time per day over 24 days in a sequential decreasing order. Lacrimal substitutes were also used four times per day from 1 to 3 months, as required.