1
|
Liu Y, He Y, Deng Y, Wang L. Lenticule addition keratoplasty for the treatment of keratoconus: A systematic review and critical considerations. Indian J Ophthalmol 2024; 72:S167-S175. [PMID: 38271413 DOI: 10.4103/ijo.ijo_695_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 09/09/2023] [Indexed: 01/27/2024] Open
Abstract
Keratoconus is a corneal disorder characterized by the progressive thinning and bulging of the cornea. Currently, the major goal of management is to halt its progression, restore normal corneal strength, prevent acute complications, and save vision. Penetrating keratoplasty and deep anterior lamellar keratoplasty as conventional surgical methods for advanced keratoconus are limited by relatively high rates of immune intolerance, slow post-operational recovery, high costs, and shortage of donor corneas. Recently, the development of lenticule addition keratoplasty enables the restoration of corneal thickness simply by implanting a lenticule into the stromal pocket created with the femtosecond laser, which can originate from cadaver corneas or more appealing, be extracted from patients via a small-incision lenticule extraction (SMILE) surgery. As the first systematic review in this field, we critically review publications on lenticule addition keratoplasty and provide our perspectives on its clinical application and the focus of future research.
Collapse
Affiliation(s)
- Yanling Liu
- Operating Room, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Yan He
- Operating Room, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Lixiang Wang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| |
Collapse
|
2
|
Tian G, Chen T, Liu X, Lin Y, Li N, Gao H, Liu M. Comparison of central corneal thickness treated with small incision lenticule extraction, femtosecond laser-assisted in situ keratomileusis, or laser-assisted subepithelial keratomileusis for myopia. Lasers Med Sci 2023; 38:198. [PMID: 37656340 DOI: 10.1007/s10103-023-03862-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023]
Abstract
To compare the central corneal thickness (CCT) treated with small incision lenticule extraction (SMILE), femtosecond laser-assisted in situ keratomileusis (FS-LASIK), or laser-assisted subepithelial keratomileusis (LASEK) for myopia correction. This was a retrospective case series study. Patients who had completed 1-year follow-up after receiving SMILE, FS-LASIK, or LASEK at our hospital from January 2019 to July 2021 were included. Pentacam pachymetry was performed to measure the CCT. The predicted CCT reduction was obtained through laser platform. The measured CCT reduction was defined as the difference between the preoperative and postoperative CCT using Pentacam pachymetry. There were 100 eyes treated by SMILE, 100 eyes by FS-LASIK, and 100 eyes by LASEK. There was a significant difference in predicted CCT reduction among the three surgeries (P < 0.001), but no significant difference in measured CCT reduction postoperatively (PGroup = 0.373). At 1 year postoperatively, the CCT reduction was overestimated by 17.85 ± 5.36 µm in the SMILE group, underestimated by 4.31 ± 7.08 µm in the FS-LASIK group, and underestimated by 7.60 ± 8.28 µm in the LASEK group (PGroup < 0.001, PTime < 0.001). In the FS-LASIK group, the difference between predicted and measured CCT reduction was not related to the predicted CCT reduction (P = 0.095). The laser platform may overestimate the CCT reduction for SMILE and underestimate it for FS-LASIK and LASEK. FS-LASIK has a much higher level of accuracy in CCT reduction, which is not influenced by refractive correction.
Collapse
Affiliation(s)
- Ge Tian
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, 372 Jingsi Road, Jinan, 250021, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Tong Chen
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, 372 Jingsi Road, Jinan, 250021, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Xin Liu
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, 372 Jingsi Road, Jinan, 250021, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Yue Lin
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, 372 Jingsi Road, Jinan, 250021, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Na Li
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, 372 Jingsi Road, Jinan, 250021, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Hua Gao
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, 372 Jingsi Road, Jinan, 250021, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Mingna Liu
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Eye Institute of Shandong First Medical University, 372 Jingsi Road, Jinan, 250021, China.
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China.
- School of Ophthalmology, Shandong First Medical University, Jinan, China.
| |
Collapse
|
3
|
Lu X, Fan Y, Liu Z, Qiu X, Shi Q, Gao N, Mi S, Pei C. Comparison of planned versus achieved central corneal stromal thickness reduction in SMILE versus FS-LASIK: a retrospective study. Sci Rep 2023; 13:9956. [PMID: 37340090 DOI: 10.1038/s41598-023-37143-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/16/2023] [Indexed: 06/22/2023] Open
Abstract
Accuracy of planned corneal stromal thickness (CST) reduction is essential to the safety of laser vision correction. This study was to compare the accuracy of the planned central CST reduction in small incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK). A total of 77 patients (43 for SMILE, 34 for FS-LASIK using Custom-Q algorithm) were included in this retrospective study. At postoperative 6-18 months, the central CST reduction was overestimated by 18.49 ± 6.42 μm in the SMILE group (P < 0.001) and underestimated by 2.56 ± 7.79 μm in the FS-LASIK group (P = 0.064). The planned-achieved difference (PAD) of central CST reduction was positively correlated with preoperative manifest refraction spherical equivalent (MRSE) and with planned central CST reduction in both groups. When calculated by manifest refraction (MR) without nomogram adjustment, the central CST reduction was overestimated by 11.14 ± 6.53 μm in the SMILE group and underestimated by 2.83 ± 7.39 μm in the FS-LASIK group. The PAD of central CST reduction without nomogram was significantly narrowed in SMILE and maintained in FS-LASIK, suggesting estimation using MR without nomogram adjustment may be feasible for SMILE and FS-LASIK in clinical practice.
Collapse
Affiliation(s)
- Xueqing Lu
- Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Yimeng Fan
- Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Zhao Liu
- Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China.
| | - Xuanyu Qiu
- Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Qiang Shi
- Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Ning Gao
- Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Shengjian Mi
- Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| | - Cheng Pei
- Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China
| |
Collapse
|
4
|
Liu S, Zhou X, Zhao Y. Comparison of Predictability in Central Corneal Thickness Reduction After SMILE and FS-LASIK for High Myopia Correction. Ophthalmol Ther 2023; 12:549-559. [PMID: 36517698 PMCID: PMC9834448 DOI: 10.1007/s40123-022-00629-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/30/2022] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION To compare central corneal thickness (CCT) reduction after small incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) in eyes with high myopia. METHODS In this prospective, consecutive study, 70 eyes with high myopia undergoing SMILE (n = 35) or FS-LASIK (n = 35) were recruited. Corneal topography images were acquired using the Pentacam HR imaging system preoperatively and at 1 day, 1 month, and 6 months postoperatively. Predicted CCT reduction was extracted directly from the VisuMax femtosecond laser system or MEL 80 excimer laser platform. The achieved CCT reduction was determined using corneal thickness difference maps from the Pentacam. Comparative statistics and linear regression analyses were performed to evaluate the predictability in stromal thickness reduction. RESULTS The mean predicted CCT reductions were 152.9 ± 6.7 μm and 150.9 ± 7.3 μm in the FS-LASIK and SMILE groups, respectively, with no statistical difference. For each follow-up time, no significant difference was noted in the two groups in the achieved CCT reduction. At 6-month follow-up, the CCT reductions were overestimated to be 23.06 ± 6.97 µm and 28.29 ± 13.92 µm in the SMILE and FS-LASIK groups, respectively (P = 0.003), showing statistical difference. Regression analysis revealed that the positive correlation between achieved and predicted CCT reductions was stronger in SMILE (R2 = 0.5065, P < 0.001) than in FS-LASIK (R2 = 0.2237, P = 0.004). Overestimated CCT reduction was not correlated with predicted CCT reduction in either group. CONCLUSIONS Systematically overestimated CCT reduction is found after SMILE and FS-LASIK in high myopia correction. Deviations between planned and achieved CCT reductions are more pronounced in FS-LASIK than in SMILE.
Collapse
Affiliation(s)
- Shengtao Liu
- Department of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031 People’s Republic of China ,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China ,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031 People’s Republic of China ,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China ,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Yu Zhao
- Department of Ophthalmology and Optometry, Eye and ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031 People’s Republic of China ,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China ,Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| |
Collapse
|
5
|
Lv X, Zhang F, Song Y, Zhai C, Guo N, Lai L, Xu Y. Corneal biomechanical characteristics following small incision lenticule extraction for myopia and astigmatism with 3 different cap thicknesses. BMC Ophthalmol 2023; 23:42. [PMID: 36717828 PMCID: PMC9885585 DOI: 10.1186/s12886-023-02786-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/16/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The design of cap thickness for small incision lenticule extraction (SMILE) plays a role in post-laser vision correction (post-LVC) corneal biomechanics. This study aimed to compare the corneal biomechanical characteristics following SMILE with different cap thicknesses of 110 μm, 120 μm, and 130 μm for myopia and myopic astigmatism correction. METHODS Seventy-five patients (146 eyes) who underwent SMILE with designed cap thickness of 110 μm, 120 μm, and 130 μm were recruited at the Eye Center of Beijing Tongren Hospital between August 2020 and November 2021. Visual acuity, refraction, and corneal biomechanical parameters were measured preoperatively, 1 week and 1, 3, 6 months postoperatively. One-way analysis of variances (ANOVA) with Bonferroni correction or Kruskal-Wallis test was performed to compare the parameters among different groups. Repeated-measures analysis of variance with Bonferroni correction or Friedman test was applied for comparing the parameters within different follow-up times. RESULTS Uncorrected distance visual acuity of 110-μm group was better only at 1-week and 1-month postoperatively (P = 0.012, 0.037). There were no significant differences in spherical equivalent, nor in Corvis biomechanical index-laser vision correction (CBI-LVC). All the parameters reached stability at 3-month postoperatively. Integrated radius (IR) and deformation amplitude ratio 2 mm (DA ratio 2 mm) in 120-μm and 130-μm groups were higher than 110-μm group at 1-month postoperatively (P = 0.019, 0.002). So was Ambrósio relational thickness (ARTh) at 6-month postoperatively (P = 0.011). Stiffness parameter at applanation A1 (SP-A1), stress-strain index (SSI), biomechanically corrected intraocular pressure (bIOP) and central corneal thickness (CCT) were highest in 130-μm group, followed by 120-μm group, then 110-μm group at 3-month (P<0.001, P = 0.030, P = 0.027, P = 0.008) and 6-month (P<0.001, P = 0.002, P = 0.0023, P = 0.001) postoperatively. CONCLUSIONS The corneal stiffness following SMILE was greatest with 130-μm cap, followed by 120-μm cap, then 110-μm cap. 130-μm cap might have advantages in terms of corneal biomechanics and retreatment option. The SMILE-designed protocol should be customized in practice.
Collapse
Affiliation(s)
- Xiaotong Lv
- grid.414373.60000 0004 1758 1243Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, No 1, Dongjiaominxiang Street, Dongcheng District, Beijing, 100730 China
| | - Fengju Zhang
- grid.414373.60000 0004 1758 1243Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, No 1, Dongjiaominxiang Street, Dongcheng District, Beijing, 100730 China
| | - Yanzheng Song
- grid.414373.60000 0004 1758 1243Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, No 1, Dongjiaominxiang Street, Dongcheng District, Beijing, 100730 China
| | - Changbin Zhai
- grid.414373.60000 0004 1758 1243Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, No 1, Dongjiaominxiang Street, Dongcheng District, Beijing, 100730 China
| | - Ning Guo
- grid.414373.60000 0004 1758 1243Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, No 1, Dongjiaominxiang Street, Dongcheng District, Beijing, 100730 China
| | - Lingbo Lai
- grid.414373.60000 0004 1758 1243Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, No 1, Dongjiaominxiang Street, Dongcheng District, Beijing, 100730 China
| | - Yushan Xu
- grid.414373.60000 0004 1758 1243Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, No 1, Dongjiaominxiang Street, Dongcheng District, Beijing, 100730 China
| |
Collapse
|
6
|
Luo Y, He S, Chen P, Yao H, He A, Li Y, Qiu J, Lan M, Zhuang J, Yu K. Predictability of Central Corneal Stromal Reduction After SMILE and FS-LASIK for High Myopia Correction: A Prospective Randomized Contralateral Eye Study. J Refract Surg 2022; 38:90-97. [DOI: 10.3928/1081597x-20211112-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
7
|
Shang Y, Li Y, Wang Z, Sun X, Zhang F. Risk Evaluation of Human Corneal Stromal Lenticules From SMILE for Reuse. J Refract Surg 2021; 37:32-40. [PMID: 33432993 DOI: 10.3928/1081597x-20201030-03] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 10/30/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the pathogenicity and immunogenicity of human corneal stromal lenticules from small incision lenticule extraction (SMILE). METHODS Serological testing was completed prior to sample collection to rule out infectious diseases. Pathogens herpes simplex viruses (HSV) type 1 and type 2 were screened for by real-time fluorescent quantitative polymerase chain reaction, and bacteria, fungi, and Acanthamoeba from 128 lenticules of 64 patients were cultured. A total of 132 lenticules from 93 patients were randomly assigned to the fresh group, -78 °C anhydrous glycerol preservation group (glycerol group), and 0.1% sodium dodecyl sulfate decellularization group (SDS group) in pairs and detected by immunohistochemistry, Western blot, transmission electron microscopy, transmittance, and nanoindentation. RESULTS The fresh lenticules were all negative for HSV-1, HSV-2, bacteria, fungi, and Acanthamoeba. HLA-I A/B/C and HLA-II DR antigens were all expressed in fresh lenticules but were clearly reduced after preservation at -78 °C in anhydrous glycerol or decellularization in 0.1% SDS. The collagen fibers of the lenticules in the fresh group were regularly arranged, and the keratocytes were intact. The fibers in the glycerol group were regularly arranged, and the integrity of keratocytes was destroyed. The fibers in the SDS group were disordered and had no cellular structure. The transmittance and Young's modulus were highest in the fresh group, lower in the glycerol group, and lowest in the SDS group. CONCLUSIONS Risk of infection is low, but risk of rejection exists on the reuse of fresh human corneal stromal lenticules from SMILE. Anhydrous glycerol preservation at -78 °C is an ideal method for reducing antigens without damaging the structure and function of lenticules. [J Refract Surg. 2021;37(1):32-40.].
Collapse
|
8
|
[Regression and ablation profiles in corneal refractive surgery]. J Fr Ophtalmol 2021; 44:1059-1075. [PMID: 34148702 DOI: 10.1016/j.jfo.2020.08.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/16/2020] [Accepted: 08/24/2020] [Indexed: 11/21/2022]
Abstract
Regression after corneal refractive surgery is a complex phenomenon which seems inevitable. The choice of surgical technique has very little influence on regression for low myopia or myopic astigmatism. However, LASIK and SMILE are the two techniques of choice in the correction of high myopia. LASIK is also better for the correction of hyperopia, hyperopic astigmatism and mixed astigmatism. Intraoperatively, the choice of a wide optical zone and adherence to a thick residual stromal bed provide stability. Regression may also be reduced by modulating anti-inflammatory therapy, treating dry eye, and using mitomycin C in PKR. In all cases, obtaining keratometry during patient follow-up helps to identify the cause of the regression. The objective of this review is to synthesize recent data from the literature on regression in refractive surgery as a function of the ablation profiles used.
Collapse
|
9
|
Wu F, Yin H, Yang Y. Evaluation of the Difference between Predicted and Measured Central Corneal Thickness Reduction after SMILE and Femtosecond Laser-assisted LASIK for Myopia. Curr Eye Res 2021; 46:1089-1095. [PMID: 33494622 DOI: 10.1080/02713683.2021.1877310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the agreement between the predicted and measured central corneal thickness (CCT) reduction after the small incision lenticule extraction (SMILE) surgery and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) surgery. METHODS A total 165 patients were enrolled in this prospective study. Eighty patients with a mean spherical equivalent (SE) of -4.72 ± 1.80 Diopters (D) were treated with the FS-LASIK procedure and Eighty-five patients with a mean SE of -4.78 ± 1.63 D were treated with SMILE procedure. One eye for each patient was randomly selected and included for statistical analysis. Ultrasound pachymetry measurement and Scheimpflug camera corneal topography were performed preoperatively and 3 months postoperatively. The measured CCT reduction was calculated by comparing the preoperative examinations with postoperative examinations. Comparative statistics and linear regression analyses were performed. RESULTS The mean predicted CCT reduction was 95.02 ± 21.39 μm in FS-LASIK group and 103.49 ± 22.87 μm in SMILE group (P = .015). The prediction of laser platform was found to overestimate the measured CCT reduction for both FS-LASIK group (ultrasound 13.20 ± 9.34 μm) and SMILE group (ultrasound 13.12 ± 8.68 μm). The prediction of laser platform was found to systematically overestimate the measured CCT reduction in FS-LASIK group. In SMILE group, the difference between predicted and measured CCT reduction were found significantly related with the predicted CCT reduction (P < .001 for ultrasound; and P = .004 for Pentacam). CONCLUSION A systematic overestimation of measured CCT reduction in FS-LASIK group did not influence the refractive precision of FS-LASIK. Due to the different biomechanical distributions in post-SMILE cornea, the measured CCT reduction was influenced as the changes in refractive correction. Nomogram adjustment for high myopic correction needs further research.
Collapse
Affiliation(s)
- Fang Wu
- Eye Center, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Houfa Yin
- Eye Center, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Yabo Yang
- Eye Center, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| |
Collapse
|
10
|
Romito N, Trinh L, Goemaere I, Borderie V, Laroche L, Bouheraoua N. Corneal Remodeling After Myopic SMILE: An Optical Coherence Tomography and In Vivo Confocal Microscopy Study. J Refract Surg 2020; 36:597-605. [DOI: 10.3928/1081597x-20200713-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/12/2020] [Indexed: 11/20/2022]
|
11
|
Chong JK, Hamilton DR. SMILE for Myopic Astigmatism: Early Experience in the USA and International Advances. CURRENT OPHTHALMOLOGY REPORTS 2020. [DOI: 10.1007/s40135-020-00250-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|