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Liu X, Liu Q, Yu LH, Xiong R, Liu ST, You ZP. Three-year results of central corneal stromal thickness reduction in small-incision lenticule extraction for high myopia correction. Photodiagnosis Photodyn Ther 2024; 48:104278. [PMID: 39002832 DOI: 10.1016/j.pdpdt.2024.104278] [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: 05/16/2024] [Revised: 06/23/2024] [Accepted: 07/10/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND To investigate the long-term corneal stromal remodeling and central stromal thickness (CST) reduction accuracy after small-incision lenticule extraction (SMILE) for high myopia correction. METHODS This prospective study included 30 patients (50 eyes) who had undergone SMILE. Measurements of CST reduction using optical coherence tomography were performed at 1 month, 6 months, 1 year, and 3 years after surgery. Correlations were performed between planned and achieved CST reductions. RESULTS The study enrolled 50 eyes of 30 patients. The mean spherical equivalent was -9.25±1.52 D(diopters). The postoperative CST increased in the first month after surgery and remained stable for a year. Thereafter, it remained stable during follow-up from 1 to 3 years postoperatively. The predicted CST reduction was 146.4 ± 10.3 μm. The achieved CST reductions at 1 month, 6 months, 1 year, and 3 years after surgery were 135.3 ± 12.1 μm, 130.8 ± 10.6 μm, 125.9 ± 9.4 μm, and 122.2 ± 10.6 μm, respectively. An overestimation of CST reduction was observed three years after surgery. Correlation analysis revealed a strong correlation between planned and achieved CST reductions; however, no correlation was found between CST reductions predicted error and the planned CST reductions. CONCLUSION During long-term follow-up, our findings revealed a significant stromal remodeling following SMILE in patients with high myopia. Therefore, clinicians should consider it when screening patients with high myopia for SMILE.
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Affiliation(s)
- Xian Liu
- The Affiliated Eye Hospital, Jiangxi Medical College, Nanchang University, No. 463 Bayi Avenue, Nanchang City, Nanchang, Jiangxi 330000, China
| | - Qiang Liu
- The Affiliated Eye Hospital, Jiangxi Medical College, Nanchang University, No. 463 Bayi Avenue, Nanchang City, Nanchang, Jiangxi 330000, China
| | - Lan-Hui Yu
- The Affiliated Eye Hospital, Jiangxi Medical College, Nanchang University, No. 463 Bayi Avenue, Nanchang City, Nanchang, Jiangxi 330000, China
| | - Rui Xiong
- The Affiliated Eye Hospital, Jiangxi Medical College, Nanchang University, No. 463 Bayi Avenue, Nanchang City, Nanchang, Jiangxi 330000, China
| | - Sheng-Tao Liu
- Department of Ophthalmology and Optometry, Eye and ENT Hospital, Key Lab of Myopia, Ministry of Health, Fudan University, No. 83 Fenyang Road, Shanghai 200031, China.
| | - Zhi-Peng You
- The Affiliated Eye Hospital, Jiangxi Medical College, Nanchang University, No. 463 Bayi Avenue, Nanchang City, Nanchang, Jiangxi 330000, China.
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Liu M, Li N, Chen T, Tian G, Lin Y, Gao H, Shi W. Comparison of Corneal Biomechanics Treated With Femtosecond Laser-Assisted In Situ Keratomileusis and Small-Incision Lenticule Extraction by New Corneal Biomechanical Parameters of Corvis ST II. Cornea 2023; 42:1384-1390. [PMID: 36729642 DOI: 10.1097/ico.0000000000003191] [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: 07/14/2022] [Accepted: 09/27/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE The aim of this study was to compare corneal biomechanics treated with femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and small-incision lenticule extraction (SMILE) for myopia and astigmatism using the new corneal biomechanical parameters of Corvis ST II. METHODS This was a prospective nonrandomized controlled study. Patients treated with FS-LASIK or SMILE between January 2018 and July 2018 were included. Corvis ST II was performed to measure corneal biomechanical parameters, including deformation amplitude ratio 2.0 mm (DA ratio 2.0 mm), integrated inverse radius (Integr Radius), stiffness parameter at first applanation (SP-A1), and Ambrosio relational thickness through the horizontal meridian (ARTh), preoperatively, 1 month postoperatively, and 6 months postoperatively. Pentacam pachymetry was used to assess the reduction in pachymetry. RESULTS Forty-five eyes underwent FS-LASIK, and 45 eyes underwent SMILE. The new parameters obtained by Corvis ST II between preoperative and postoperative measurements showed significant changes after FS-LASIK or SMILE (all P < 0.001). Postoperative SP-A1 significantly decreased in the 2 groups (108.88 ± 14.47-73.32 ± 13.2 in FS-LASIK and 105.79 ± 17.68-73.91 ± 14.81 in SMILE). Eyes with equal preoperative pachymetry, intraocular pressure, and spherical equivalents showed no significant differences in these new parameters measured using Corvis ST II ( all P > 0.05) between the 2 groups. The prediction of the laser platform overestimated the measured pachymetry reduction in the SMILE group (111.93 ± 15.18 μm vs. 87.16 ± 15.47 μm). CONCLUSIONS New corneal biomechanical parameters measured using Corvis ST II showed no significant differences between FS-LASIK and SMILE in eyes with homogeneous preoperative parameters. The laser software platform may have overestimated the actual corneal reduction in the eyes treated with SMILE.
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Affiliation(s)
- Mingna Liu
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Na Li
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Tong Chen
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Ge Tian
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Yue Lin
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Hua Gao
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Weiyun Shi
- Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Jinan, China ; and
- School of Ophthalmology, Shandong First Medical University, Jinan, China
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Bohač M, Gabrić I, Gabrić K, Jagić M, Arba Mosquera S. Predictability of the Achieved Lenticule Thickness in Keratorefractive Lenticule Extraction for Myopia Correction. J Refract Surg 2023; 39:728-735. [PMID: 37937760 DOI: 10.3928/1081597x-20230925-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
PURPOSE To assess the predictability between the SCHWIND ATOS femtosecond laser (SCHWIND eye-tech-solutions) read-out and achieved lenticule thickness measured using MS-39 anterior segment optical coherence tomography (ASOCT; CSO) at the corneal vertex at postoperative 1 day and 1 and 3 months of follow-up. METHODS This retrospective case series included 130 eyes of 65 consecutive patients who were treated with SmartSight (SCHWIND eye-tech-solutions) lenticule extraction. Sixty-four percent of patients were women with a mean spherical refraction of -4.98 ± 1.19 diopters (D) and mean astigmatism of 0.53 ± 0.64 D. The measurements were performed using AS-OCT with the Phoenix Software v 4.1.1.5. Lenticule thickness was obtained by the subtraction method between preoperative and postoperative total corneal thickness. RESULTS A lower reduction in central corneal thickness (CCT) compared to the laser read-out for all three follow-up visits can be observed. Essentially, the reduction in CCT was identical at 3 months versus 1 month. The reduction in CCT was lowest at postoperative 1 day. Examining the 1- and 3-month data (essentially equivalent), one can see a best fit of y = 0.94 x -7 µm. CONCLUSIONS The reduction in CCT was stable from 1 month of follow-up. The stable reduction in CCT was -6% (-1.5% after accounting for design decisions) and -7 µm lower than the respective laser read-out. The findings are predictable, showing a certain level of the lenticules becoming slightly thinner than their respective laser read-outs. [J Refract Surg. 2023;39(11):728-735.].
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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.
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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.
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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.
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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
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Hashemi H, Roberts CJ, Elsheikh A, Mehravaran S, Panahi P, Asgari S. Corneal Biomechanics After SMILE, Femtosecond-Assisted LASIK, and Photorefractive Keratectomy: A Matched Comparison Study. Transl Vis Sci Technol 2023; 12:12. [PMID: 36928130 PMCID: PMC10029763 DOI: 10.1167/tvst.12.3.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Purpose To evaluate the change in corneal stiffness after small incision lenticule extraction (SMILE), femtosecond laser-assisted in situ keratomileusis (FS-LASIK), and photorefractive keratectomy (PRK). Methods Age, gender, spherical equivalent, and central corneal thickness (CCT)-matched cases undergoing SMILE with a 120-µ cap, FS-LASIK with a 110-µ flap, and PRK were enrolled. One-year change in the stress-strain index, stiffness parameter at first applanation, integrated inverse radius, deformation amplitude ratio at 2 mm, and deformation amplitude ratio at 1 mm were compared between the surgical groups by linear mixed-effect models. Results Within each surgical group, 120 eyes completed 1 year of follow-up. The residual stromal bed (RSB) thickness and (RSB/CCTpostop) were 348.1 ± 35.0 (0.74), 375.4 ± 31.0 (0.77) and 426.7 ± 2 µm (0.88) after SMILE, FS-LASIK, and PRK, respectively. The 1-year change in all biomechanical indices was significant, except the stress-strain index with PRK (P = 0.884). The change in all indices with SMILE were significantly greater than with FS-LASIK and with PRK (all P < 0.01), except the deformation amplitude ratio at 1 mm change between SMILE and FS-LASIK (P = 0.075). The changes in all indices with FS-LASIK were significantly greater than with PRK (all P < 0.05). Conclusions Although SMILE preserves the greatest amount of anterior cornea with a cap thickness of 120 µ, this also produces the smallest RSB and the greatest decrease in stiffness. Thus, the RSB is shown to be the predominant determinant of stiffness decreases, rather than the preserved anterior cornea. We recommend using a thinner cap to achieve a thicker RSB and a lesser decrease in the corneal stiffness in the SMILE procedure. Translational Relevance After refractive surgery, RSB is predominant determinant of stiffness decreases, rather than the preserved anterior cornea.
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Affiliation(s)
- Hassan Hashemi
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Cynthia J Roberts
- Department of Ophthalmology & Visual Sciences, Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Ahmed Elsheikh
- School of Engineering, University of Liverpool, Liverpool, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China
| | - Shiva Mehravaran
- School of Computer, Mathematical, and Natural Sciences, Morgan State University, Baltimore, MD, USA
| | - Parsa Panahi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Soheila Asgari
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
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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.
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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
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Lwowski C, Voigt A, Van Keer K, Kohnen T. Corneal Lenticule Creation Using a New Solid-State Femtosecond Laser Measured by Spectral Domain OCT in a Porcine Eye Model. Transl Vis Sci Technol 2022; 11:20. [PMID: 35731540 PMCID: PMC9233285 DOI: 10.1167/tvst.11.6.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine the accuracy and precision of corneal lenticule creation with a new solid-state femtosecond laser in a porcine eye model. Methods Corneal lenticule creation was performed using a new solid-state femtosecond laser on 60 porcine eyes with 10 subgroups. Optical coherence tomography images were acquired immediately after laser treatment. Cap thickness (CT), cap diameter (CD), and lenticule thickness (LT) were measured manually by three independent readers. Additionally, CT and LT were measured by an automated algorithm (aLT, aCT). Results Measured LT was significantly greater than the intended LT (average difference 14.3 ± 5.6 µm, P < 0.001). aLT was closer but still significantly different from the intended LT (-2.9 ± 5.8 µm, P < 0.001). Measured CT showed no significant difference from the intended CT (2.6 ± 13.3, P = 0.145). aCT was significantly smaller compared to the intended CT (-9.6 ± 13.6, P < 0.001). Measured CD was significantly smaller compared to the intended CD (-0.21 ± 0.20 mm, P < 0.001). All lenticules were cut as planned with no laser-related complications. Conclusions This new solid-state femtosecond laser used in our trial provides corneal lenticule creation in a porcine eye model comparable to other established systems. However, measuring those lenticules in the provided setting seems too challenging even when using semiautomated algorithms, which seems to be due to the experimental setting of the trial. Translational Relevance This trial shows the precision and repeatability of corneal cuts performed by a new femtosecond laser that could translate to refractive corneal lenticule surgery.
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Affiliation(s)
- Christoph Lwowski
- Department of Ophthalmology, Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
| | - Anna Voigt
- Department of Ophthalmology, Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
| | - Karel Van Keer
- Department of Ophthalmology, Goethe-University Frankfurt am Main, Frankfurt am Main, Germany.,Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
| | - Thomas Kohnen
- Department of Ophthalmology, Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
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