Keratorefractive lenticule extraction (KLEx) in patients with cardiac implantable electronic devices

Abstract

Purpose: The use of an excimer laser in corneal refractive surgery generates an electromagnetic field that can interfere with cardiac implantable electronic devices (CIEDs); in addition, CIEDs may disturb the eye-tracking system of the laser machine, leading to potential errors in the surgical refractive correction plan. The recently introduced technique of keratorefractive lenticule extraction (KLEx) does not use an excimer laser, instead based upon the delineation of an intracorneal lenticule by a femtosecond laser, which does not interfere with CIEDs, but the evaluation of KLEx in the presence of a CIED has not been reported before.

Methods: We therefore presented in this study four eyes of two patients with a CIED for atrioventricular block and Wolf-Parkinson-White syndrome that underwent KLEx surgery for myopia and astigmatism correction. Subjects were both 37-year-old males, and the mean spherical equivalent error (SER) was −5.75 ± 0.50 D.

Results: The Surgeries were uneventful, and no interference between the femto-laser and the CIED was observed. At 6 months, both patients had a visual acuity of 6/6 with a mean residual SER of +0.35 ± 0.25 D, and no issues related to their CEID function were detected.

Conclusions: In this pilot study we demonstrated that KLEx can be a good option in patients with CIEDs, as it does not require cardiological care and avoids interferences with an excimer laser