1
|
Lee CY, Jeng YT, Yang SF, Huang CT, Chao CC, Lian IB, Huang JY, Chang CK. Topographic and Surgical Risk Factors for Early Myopic Regression between Small Incision Lenticule Extraction and Laser In Situ Keratomileusis. Diagnostics (Basel) 2024; 14:1275. [PMID: 38928690 PMCID: PMC11202549 DOI: 10.3390/diagnostics14121275] [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: 05/08/2024] [Revised: 06/06/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
Our objective was to evaluate the topographic and surgical factors of early myopic regression between laser in situ keratomileusis (LASIK) and small-incision lenticule extraction (SMILE). A retrospective case-control study was conducted, and 368 and 92 eyes were enrolled in the LASIK and SMILE groups via propensity score matching (PSM). Visual acuity, refractive status, axial length, and topographic/surgical parameters were collected. Multiple linear regression was applied to the yield coefficient and the 95% confidence interval (CI) of the parameters. The cumulative incidence of early myopic regression was higher in the LASIK group (p < 0.001). In the SMILE group, a lower central corneal thickness (CCT) thinnest value and a higher corneal cylinder associated with early myopic regression were observed; meanwhile, in the LASIK group, a lower CCT thinnest value, a higher steep corneal curvature, a larger optic zone, and a lower flap thickness related to early myopic regression were observed (all p < 0.05). In the SMILE group, a higher CCT difference correlated with early myopic regression was observed compared to the LASIK group (p = 0.030), and higher steep corneal curvature and lower cap/flap thickness (both p < 0.05) correlated with early myopic regression were observed in the LASIK group compared to the SMILE group. In conclusion, CCT differences significantly influence early myopic regression in the SMILE group; meanwhile, corneal curvature and flap thickness affect early myopic regression principally in the LASIK group.
Collapse
Affiliation(s)
- Chia-Yi Lee
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Nobel Eye Institute, Taipei 115, Taiwan
- Department of Ophthalmology, Jen-Ai Hospital Dali Branch, Taichung 412, Taiwan
| | - Yu-Ting Jeng
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Chin-Te Huang
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung 402, Taiwan
- Department of Ophthalmology, School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
| | - Chen-Cheng Chao
- Nobel Eye Institute, Taipei 115, Taiwan
- Department of Optometry, MacKay Junior College of Medicine, Nursing, and Management, Taipei 112, Taiwan
| | - Ie-Bin Lian
- Institute of Statistical and Information Science, National Changhua University of Education, Changhua 500, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Chao-Kai Chang
- Nobel Eye Institute, Taipei 115, Taiwan
- Department of Optometry, Da-Yeh University, Chunghua 515, Taiwan
| |
Collapse
|
2
|
Lee CY, Jeng YT, Chao CC, Lian IB, Huang JY, Yang SF, Chang CK. Refraction and topographic risk factors for early myopic regression after small-incision lenticule extraction surgery. Sci Rep 2024; 14:8732. [PMID: 38627567 PMCID: PMC11021515 DOI: 10.1038/s41598-024-59327-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
We sought to evaluate the topographic risk factors for early myopic regression after small-incision lenticule extraction (SMILE). A retrospective case‒control study was conducted, and individuals who underwent SMILE surgery were enrolled. Among them, 406 and 14 eyes were categorized into the nonregression and regression groups, respectively. The preoperative and postoperative parameters in the two groups were collected, including spherical refraction (SE), axial length (AXL) and topographic data. A generalized linear model was adopted to analyze the difference in each parameter between the two groups. After 6 months, UCVA decreased in the regression group, and SE increased in the regression group (both P < 0.05). The increase in the CCT at the thinnest point (P = 0.044), flat corneal curvature (P = 0.012) and TCRP (P = 0.001) were significantly greater in the regression group. Regarding the risk factors for myopic regression, preoperative SE, preoperative sphere power, preoperative AXL, preoperative flat corneal curvature, preoperative SA, early postoperative SE, early postoperative sphere power, early postoperative AXL and early postoperative CCT difference were significantly greater in the regression group (all P < 0.05). The SE, sphere power, AXL, preoperative flat corneal curvature, preoperative SA, and postoperative CCT difference correlate with early myopic regression after SMILE.
Collapse
Affiliation(s)
- Chia-Yi Lee
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Nobel Eye Institute, No. 13-5, Gongyuan Rd., Zhongzheng Dist., Taipei, 100008, Taiwan
- Department of Ophthalmology, Jen-Ai Hospital Dali Branch, Taichung, Taiwan
| | - Yu-Ting Jeng
- Nobel Eye Institute, No. 13-5, Gongyuan Rd., Zhongzheng Dist., Taipei, 100008, Taiwan
| | - Chen-Cheng Chao
- Nobel Eye Institute, No. 13-5, Gongyuan Rd., Zhongzheng Dist., Taipei, 100008, Taiwan
- Department of Optometry, MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Ie-Bin Lian
- Institute of Statistical and Information Science, National Changhua University of Education, Changhua, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan.
| | - Chao-Kai Chang
- Nobel Eye Institute, No. 13-5, Gongyuan Rd., Zhongzheng Dist., Taipei, 100008, Taiwan.
- Department of Optometry, Da-Yeh University, Chunghua, Taiwan.
| |
Collapse
|
3
|
Li L, Yuan L, Yang K, Wu Y, Alafati S, Hua X, Wang Y, Yuan X. Comparison of the accuracy of 9 intraocular lens power calculation formulas after SMILE in Chinese myopic eyes. Sci Rep 2023; 13:20539. [PMID: 37996736 PMCID: PMC10667341 DOI: 10.1038/s41598-023-47990-0] [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: 06/19/2023] [Accepted: 11/21/2023] [Indexed: 11/25/2023] Open
Abstract
As of 2021, over 2.8 million small-incision lenticule extraction (SMILE) procedures have been performed in China. However, knowledge regarding the selection of intraocular lens (IOL) power calculation formula for post-SMILE cataract patients remains limited. This study included 52 eyes of 26 myopic patients from northern China who underwent SMILE at Tianjin Eye Hospital from September 2022 to February 2023 to investigate the suitability of multiple IOL calculation formulas in post-SMILE patients using a theoretical surgical model. We compared the postoperative results obtained from three artificial intelligence (AI)-based formulas and six conventional formulas provided by the American Society of Cataract and Refractive Surgery (ASCRS). These formulas were applied to calculate IOL power using both total keratometry (TK) and keratometry (K) values, and the results were compared to the preoperative results obtained from the Barrett Universal II (BUII) formula for the SMILE patients. Among the evaluated formulas, the results obtained from the Emmetropia Verifying Optical 2.0 Formula with TK (EVO-TK) (0.40 ± 0.29 D, range 0-1.23 D), Barrett True K with K formula (BTK-K, 0.41 ± 0.26 D, range 0.01-1.19 D), and Masket with K formula (Masket-K, 0.44 ± 0.33 D, range 0.02-1.39 D) demonstrated the closest proximity to BUII. Notably, the highest proportion of prediction errors within 0.5 D was observed with the BTK-K (71.15%), EVO-TK (69.23%), and Masket-K (67.31%), with the BTK-K showing a significantly higher proportion than the Masket-K (p < 0.001). Our research indicates that in post-SMILE patients, the EVO-TK, BTK-K, and Masket-K may yield more accurate calculation results. At their current stage in development, AI-based formulas do not demonstrate significant advantages over conventional formulas. However, the application of historical data can enhance the performance of these formulas.
Collapse
Affiliation(s)
- Liangpin Li
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China
| | - Liyun Yuan
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Kun Yang
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China
| | - Yanan Wu
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China
| | - Simayilijiang Alafati
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China
| | - Xia Hua
- Tianjin Aier Eye Hospital, Tianjin University, Tianjin, 300190, China
| | - Yan Wang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China.
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China.
| | - Xiaoyong Yuan
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China.
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, 300020, China.
| |
Collapse
|
4
|
Zhang D, Tian L, Zhang H, Zheng Y, Fu C, Zhai C, Jie Y, Li L. Differences of Corneal Biomechanics Among Thin Normal Cornea, Forme-Fruste Keratoconus, and Cornea After SMILE. Front Bioeng Biotechnol 2022; 10:861924. [PMID: 35646859 PMCID: PMC9136087 DOI: 10.3389/fbioe.2022.861924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background: To compare the corneal biomechanics of thin normal cornea (TNC) with thinnest corneal thickness (TCT) (≤500 µm), forme-fruste keratoconus (FFKC) and cornea after small incision lenticule extraction (Post-SMILE) had their central corneal thickness (CCT) matched by Corneal Visualization Scheimpflug Technology (Corvis ST).Methods: CCT were matched in 23 eyes with FFKC, 23 eyes by SMILE in 3 months post-operatively, and 23 TNC eyes. The differences in corneal biomechanics by Corvis ST among the three groups were compared.Results: There was no significant difference in CCT among the three groups, and the biomechanically corrected intraocular pressure (bIOP) did not differ significantly among the three groups (all p > 0.05). There were significant differences in most DCR parameters between pre- and post-operatively (all p < 0.05). Compared with TNC, the values of corneal deflection amplitude during the first applanation (A1DA), length at the first applanation (A1L), corneal deflection amplitude during the second applanation (A2DA), and maximum deformation amplitude (DA) decreased in 3 months after SMILE (all p < 0.05), these values increased in the FFKC (all p < 0.05).Conclusion: The majority of the DCR parameters were different among the three groups. The parameters A1DA, A1L, A2DA, and DA may be different between TNC and Post-SMILE, TNC and FFKC, and Post-SMILE and FFKC.
Collapse
Affiliation(s)
- Di Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
- Beijing Advanced Innovation Center for Big Data-based Precision Medicine, Capital Medical University, Beijing, China
| | - Lei Tian
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beijing Tongren Hospital, Beihang University and Capital Medical University, Beijing, China
| | - Haixia Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
- Beijing Advanced Innovation Center for Big Data-based Precision Medicine, Capital Medical University, Beijing, China
| | - Yan Zheng
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Caiyun Fu
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Changbin Zhai
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- *Correspondence: Lin Li, ; Changbin Zhai, ; Ying Jie,
| | - Ying Jie
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- *Correspondence: Lin Li, ; Changbin Zhai, ; Ying Jie,
| | - Lin Li
- School of Biomedical Engineering, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
- Beijing Advanced Innovation Center for Big Data-based Precision Medicine, Capital Medical University, Beijing, China
- *Correspondence: Lin Li, ; Changbin Zhai, ; Ying Jie,
| |
Collapse
|
5
|
Zhou X, Qin B, Han T, Shang J, Chen Z, Zhao J, Yao P, Zhou X. Long-Term Observation of Higher-Order Aberrations and Microdistortions in Bowman’s Layer After Small Incision Lenticule Extraction for the Correcting Myopia With Spherical Equivalent Higher Than −9.0 Diopters. Front Med (Lausanne) 2022; 9:814810. [PMID: 35463029 PMCID: PMC9023804 DOI: 10.3389/fmed.2022.814810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To evaluate the outcomes in corneal higher-order aberrations (HOAs) and microdistortions in the Bowman’s layer after femtosecond laser small incision lenticule extraction (SMILE) for correcting extremely high myopia. Methods This prospective study included patients with myopia with spherical equivalent ≥ -9.0 Diopters (D). SMILE was performed in forty eyes of 40 patients. Pentacam was used to evaluate HOAs before and at 1 day, 3 months, 6 months, and 2 years after surgery. Fourier-domain optical coherence tomography was used to evaluate microdistortions at 2 years postoperatively. Thirty-two eyes of 32 patients receiving femtosecond laser-assisted in situ keratomileusis (FS-LASIK) were enrolled as the control group. HOAs were measured before, at 1 day and at least 1 year postoperatively. Results After SMILE, the long-term safety and effectiveness index was 1.25 and 0.85, respectively. Microdistortions were observed in 73.5% of the eyes at 2 years, with an average number of 1.20 ± 1.22 microdistortions and an average width of 287.37 ± 259.00 μm. We detected more microdistortions in the horizontal meridian than in the vertical meridian (p = 0.035). The average number and width of microdistortions were both higher in the central region (≤4 mm) than in the peripheral region (4–8 mm) (both p < 0.001). With the exception of horizontal trefoil in the SMILE group and vertical trefoil in the FS-LASIK group, significant changes over time were observed in all other HOAs (all p < 0.05). Meanwhile, we detected significant increases in the total corneal HOA, spherical aberration (SA), and coma at all time-points after both surgeries (all p < 0.01). Compared with FS-LASIK, SMILE induced less SA (p < 0.001) and more horizontal coma (p = 0.036). In the SMILE group, the HOA, SA, and trefoil were more in the small optical zone (≤6.0 mm) than in the large optical zone (>6.0 mm) (all p < 0.05). The increase in SA and most trefoil correlated with the mean number of central microdistortions number (all p < 0.05). Conclusion For myopia over −9.0D, the microdistortions in the Bowman’s layer were still detectable in most eyes long-term after SMILE. Both SMILE and FS-LASIK induced more HOAs, mainly HOA, SA, and coma. The small optical zone and microdistortions may affect postoperative aberrations.
Collapse
Affiliation(s)
- Xueyi Zhou
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Bing Qin
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Tian Han
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Jianmin Shang
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Zhuoyi Chen
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Jing Zhao
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Peijun Yao
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye Institute, Eye and ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
- *Correspondence: Xingtao Zhou,
| |
Collapse
|
6
|
Papa-Vettorazzi MR, Güell-Villanueva JL, Cruz-Rodriguez JB, Moura-Coelho N, Artells-de Jorge N, Elies-Amat D. Long-term efficacy and safety profiles following small incision lenticule extraction in eyes with ≥ 5-year follow-up. Eur J Ophthalmol 2022; 32:3333-3339. [PMID: 35102752 DOI: 10.1177/11206721221077541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate long-term efficacy, safety, predictability and stability (refractive and keratometric) of myopic and myopic astigmatism correction with Small Incision Lenticule Extraction (SMILE). METHODS Single center retrospective review of eyes undergoing SMILE from 2012-2015. Forty-two eyes (23 patients) with ≥ 5-year follow-up. Variables analyzed were preoperative, 3-month, 1-year and last follow-up uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, spherical equivalent (SE) and mean keratometry. Descriptive statistics were performed and results reported following the Standard for Reporting Astigmatism Outcomes. RESULTS Mean follow-up of 5.98 ± 0.90 years. Mean preoperative SE was -5.26 ± 1.22D (range -2.50 to -8.12D). Mean preoperative cylinder was -0.66 ± 0.61D (range 0.00 to -2.25D). Efficacy and safety indices were 0.86 and 0.98, respectively. In total, 81% of operated eyes achieved an UDVA of ≥ 0.09 logMar (20/25 Snellen). At the last follow-up, ≥1 line of CDVA was gained in 14% of eyes. Five percent lost 1 line of CDVA, and no eye loss ≥2 lines of CDVA. Sixty-nine percent of eyes were within ± 0.50D and 86% within ± 1.00D of the attempted SE correction. Ninety-one percent of eyes had ≤0.50D of postoperative astigmatism and 71% were within ± 15° from the intended correction axis. At the final follow-up, a statistically significant myopic regression of 0.19 ± 0.50D was observed (p = 0.01). CONCLUSIONS Long-term results demonstrate that SMILE is effective, predictable and safe. SMILE has good stability, low regression compared to LASIK, and no signs of corneal ectasia staging within our standard criteria.
Collapse
Affiliation(s)
| | - José Luis Güell-Villanueva
- 427028Department of Cornea and Refractive Surgery, Instituto Microcirugía Ocular (IMO) Barcelona, Spain.,16719Department of Ophthalmology, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
| | | | - Nuno Moura-Coelho
- 427028Department of Cornea and Refractive Surgery, Instituto Microcirugía Ocular (IMO) Barcelona, Spain.,Department of Ophthalmology, Hospital CUF Cascais, Cascais, Portugal.,NOVA Medical School
- Faculdade de Ciências Médicas - Universidade Nova de Lisboa (NMS
- FCM-UNL), Lisbon, Portugal
| | - Nuria Artells-de Jorge
- 427028Department of Cornea and Refractive Surgery, Instituto Microcirugía Ocular (IMO) Barcelona, Spain
| | - Daniel Elies-Amat
- 427028Department of Cornea and Refractive Surgery, Instituto Microcirugía Ocular (IMO) Barcelona, Spain.,Associate professor of European School for advanced Studies in Ophthalmology ESASO, Lugano, Switzerland
| |
Collapse
|
7
|
Cao K, Zhang J, Wang J, Yusufu M, Jin S, Chen S, Wang N, Jin ZB, Wan XH. Implantable collamer lens versus small incision lenticule extraction for high myopia correction: A systematic review and meta-analysis. BMC Ophthalmol 2021; 21:450. [PMID: 34961514 PMCID: PMC8711178 DOI: 10.1186/s12886-021-02206-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/06/2021] [Indexed: 11/10/2022] Open
Abstract
Purpose To compare the efficacy, safety, predictability and visual quality between implantable collamer lens (ICL) implantation and small incision lenticule extraction (SMILE) for high myopia correction in adults. Methods A systematic review and meta-analysis was conducted. A comprehensive literature search was done based on databases including PubMed, Science Direct, Embase, and the Cochrane Central Register of Controlled Trials. The efficacy index, safety index, changes in Snellen lines of corrected distance visual acuity (CDVA), predictability (difference between post-operative and attempted spherical equivalent error, SER), incidence of halos, and change in higher-order aberrations (HOAs) were compared. Mean difference (MD) and 95% confidence interval (CI) was used to estimate continuous outcomes, risk ratio (RR) and 95%CI was used to estimate categorical outcomes. Results Five observational studies involving 555 eyes were included in this review. Studies’ sample sizes (eyes) ranged from 76 to 197. Subjects’ refraction ranged from -6 diopter (D) to -12D. Study duration of most researches were 6 months or 12 months. Compared to SMILE, ICL implantation showed better efficacy index (MD=0.09, 95%CI:0.01 to 0.16) and better safety index (MD=0.08, 95%CI: 0.00 to 0.16). Compared with SMILE, more ICL-treated eyes gained one or more Snellen lines of CDVA (RR=1.54, 95%CI:1.28 to 1.86), more gained two or more lines (RR=2.09, 95%CI:1.40 to 3.13), less lost one or more lines (RR=0.17, 95%CI:0.05 to 0.63). There was no difference in predictability between two treatments, RRs of predictability of within ±0.5D and ±1D were 1.13 (95%CI: 0.94 to 1.36) and 1.00 (95%CI: 0.98 to 1.02). Compared with SMILE, ICL implantation came with a higher risk of halos [RR=1.79, 95%CI: 1.48 to 2.16] and less increase in total HOAs (MD=-0.23, 95%CI: -0.42 to -0.03). Conclusion Compared with SMILE, ICL implantation showed a higher risk of halos, but equal performance on SER control, and better performance on efficacy index, safety index, CDVA improvement and HOAs control. Overall, ICL implantation might be a better choice for high myopia correction in adults.
Collapse
Affiliation(s)
- Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, No17, Hougou ally, Dongcheng district, Beijing, 100005, China
| | - Jingshang Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, No17, Hougou ally, Dongcheng district, Beijing, 100005, China
| | - Jinda Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, No17, Hougou ally, Dongcheng district, Beijing, 100005, China
| | - Mayinuer Yusufu
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, No17, Hougou ally, Dongcheng district, Beijing, 100005, China
| | - Shanshan Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, No17, Hougou ally, Dongcheng district, Beijing, 100005, China
| | - Shuying Chen
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, No17, Hougou ally, Dongcheng district, Beijing, 100005, China
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, No17, Hougou ally, Dongcheng district, Beijing, 100005, China
| | - Zi-Bing Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, No17, Hougou ally, Dongcheng district, Beijing, 100005, China
| | - Xiu Hua Wan
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, No17, Hougou ally, Dongcheng district, Beijing, 100005, China.
| |
Collapse
|