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Active, not recruitingNCT04692012ReLex-SmileUpdated Jul 29, 2026

Treatment of Residual Hypermetropic Refraction on Pseudophakic Patients Using Allogenic Fresh Myopic Lenticule

An interventional study of FRESH CORNEAL MYOPIC LENTICULE IMPLANTATION in Pseudophakia, Hypermetropia and Myopia, sponsored by Eye Hospital Pristina Kosovo. Active, not recruiting at 1 site in Kosovo. Open to participants aged 19 Years to 50 Years. Per ClinicalTrials.gov, last updated 2026-07-29.

Sponsored by Eye Hospital Pristina Kosovo · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
34
Allocation
Not applicable
Ages
19 Years to 50 Years
Sex
All
01

Study summary

The residual hypermetropic refraction on pseudophakic(Trifocal IOL) patients is difficult to treat surgically. In addition, there are not many suitable options to offer such patients presenting with this condition.

Two current common surgeries to treat residual hyperopic refraction are refractive lens exchange (RLE) and excimer laser ablation (LASIK or PRK).

Laser procedures: Photorefractive keratectomy (PRK); Laser assisted in situ keratomileusis (LASIK); Risks of LASIK include abnormalities of the corneal flap, epithelial ingrowth, corneal ectasia, refractive surprises, irregular astigmatism, decentration, visual aberrations, a loss of BCVA, infectious keratitis, symptoms, and diffuse lamellar keratitis.

Refractive lens exchange (RLE); The risks of RLE are similar to those of cataract surgery and include endophthalmitis, a loss of accommodation, vitreous loss with posterior capsular rupture, and retinal detachment.

The method used at the EYE Hospital Pristina using fresh lenticule implantation by ReLex-SMILE is safe and effective method, since there is no flap this prevents invasive damage to the anterior surface of the cornea contrary to the LASIK where flap is present posing risk for epithelial ingrowth.

Before SMILE,YAG-laser capsulotomy should be performed on all patients, regardless of posterior capsule ossification, in pseudophakic patients with residual refraction. When the YAG-laser is applied after the SMILE,there will be a diopter change.

Read the detailed description

This study is to investigate the effect of fresh myopic corneal lenticule implantation as allogenic implant that will be taken from myopic patients to implant on pseudophakic patients(Trifocal IOL) with residual hypermetropic refraction(over +0.50Dsph) using VisuMax Femtosecond laser - Smile module surgery with primary objective to assess (increase) visual acuity . In pseudophakic patients with hyperopic astigmatism residual refraction, corneal topography-guided intrastromal fresh lenticule implantation should be performed and the lenticule was placed according to the low K value.

02

Conditions studied

  • Pseudophakia
  • Hypermetropia
  • Myopia
03

Who can participate

Ages eligible
19 Years to 50 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • residual hypermetropic refraction on pseudophakic patients
  • low visual acuity

Exclusion criteria

Exclusion Criteria:

  • active anterior segment pathologic features,
  • previous corneal or anterior segment surgery,
  • glaucoma,
  • retinal detachment
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
34 participants (actual)

Study arms

  • Other
    FRESH CORNEAL LENTICULE IMPLANTATION

    The aim of this study is to investigate the effect of fresh corneal myopic lenticule implantation as allogenic implant that will be taken from myopic patients to implant on pseudophakic patients with residual hypermetropic refraction using VisuMax Femtosecond Laser-Smile module surgery with primary objective to assess(increase) visual acuity.

    Other: FRESH CORNEAL MYOPIC LENTICULE IMPLANTATION

Interventions

  • OtherFRESH CORNEAL MYOPIC LENTICULE IMPLANTATION

    VisuMax femtosecond laser performed flap-cut procedure with an energy cut index of 30 nJ (150nJ), spot and track spacing surface cut of 4.5 μm, side cut 2.0 μm were used to create an intrastromal pocket into the patient's cornea to receive the donor lenticule. The stromal pocket diameter was set 7.6 to 8.0 mm (1 mm larger than the optical zone of the donor lenticule) and cap thickness was set to 130 μm from corneal surface and a 4 mm superior incision. Hinge position flap was set at 90°, angle 50° and width 4 mm, side cut angle 90°. The pocket was dissected using a blunt spatula washed with normal saline. The lenticule was held with lenticule forceps and gently inserted into the pocket through the 4 mm superior incision. Incision position changed according to the position of the highest K values. Current orientation was marked with a sterile skin marker. The lenticule was positioned around the marked center of the cone and flattened out from the surface using a blunt spatula.

    Also known as: Relex smile surgery

05

What researchers measure

Primary outcomes

  1. increasing of visual acuity

    using fresh myopic corneal lenticule for treatment of residual hypermetropic refraction on pseudophakic patients

    Time frame: 12 months

06

Study locations

1 site
  • Eye Hospital Pristina
    Pristina, 10000, Kosovo
07

Registry details

Key details

Study ID
NCT04692012
Lead sponsor
Eye Hospital Pristina Kosovo
Responsible party
Dr. Faruk Semiz (Head of Ophthalmology Department, Eye Hospital Pristina Kosovo) — Principal investigator
First posted
Dec 31, 2020
Start date
Apr 1, 2018
Primary completion
Apr 1, 2020
Completion
Feb 1, 2027 (estimated)
Last update
Jul 29, 2026

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is active, not recruiting, as verified in Jul 2026. You cannot join it, but the record below documents what was studied.

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