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Comparison of the posterior corneal elevation and biomechanics after SMILE and LASEK for myopia: a short- and long-term observation
摘要： Purpose This study compares the posterior corneal elevation and corneal biomechanics after small incision lenticule extraction (SMILE) and laser-assisted subepithelial keratomileusis (LASEK) for myopia correction in a short- and long-term observation. Methods This prospective study included 32 patients in the SMILE group and 32 patients in the LASEK group. Corneal posterior central elevation (PCE), posterior mean elevation (PME), corneal back power (Kb), and anterior chamber depth (ACD) were evaluated with Pentacam, and intraocular pressure (IOP), corneal hysteresis (CH), and corneal resistance factor (CRF) were evaluated with the ORA at pre-operation and 3 months and 3 years post-operation. Results Three months post-operatively, CH, CRF, and IOP decreased significantly and central posterior surface shifted backward in both groups (p < 0.05). CH was lower in the LASEK group (p = 0.03) and change of CH and CRF per unit corneal tissue removed (ΔCH/ablation depth (AD) and ΔCRF/AD) was lower in SMILE than in LASEK (p = 0.01, 0.03). Three years post-operatively, the PME shifted more posteriorly in LASEK (p = 0.04), but was stable in SMILE (p = 0.06). Kb flattened and ACD was shallower in both groups (compared to preoperative data, p < 0.001). CH in the LASEK group increased and is comparable to that in the SMILE group at 3 years post-operative. Conclusion Both SMILE and LASEK can change the posterior surface and corneal biomechanics. SMILE may have less influence on corneal biomechanics than LASEK at an early stage post-operative in terms of per unit corneal tissue removed, but the effect became comparable in a long-term observation.
关键词： Corneal biomechanics,Corneal posterior elevation,Small incision lenticule extraction,Laser-assisted subepithelial keratomileusis
更新于2025-09-23 15:22:29
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Development of low laser energy levels in small-incision lenticule extraction
摘要： Purpose: To evaluate the outcomes of 4 low laser energy levels after small-incision lenticule extraction (SMILE) surgery. Setting: Zhongshan Ophthalmic Center, Guangzhou, China. Design: Prospective randomized clinical trial. Methods: This study evaluated consecutive patients who had SMILE to correct myopia or myopia with astigmatism. Eyes were placed into groups based on the laser energy used during surgery (ie, 105 nJ, 110 nJ, 115 nJ, or 120 nJ). All patients had a thorough ophthalmic examination preoperative and at 4 timepoints over 3 months postoperatively. Black areas and surface regularity of the extracted lenticules were observed and evaluated qualitatively and quantitatively. Results: The study comprised 124 eyes of 62 patients (40 women, 22 men), with 31 eyes in each laser energy group. The incidence of black areas was 45.16% (14 of 31 eyes), 12.90% (4 of 31 eyes), 16.13% (5 of 31 eyes), and 12.90% (4 of 31 eyes) for 105 nJ, 110 nJ, 115 nJ, and 120 nJ, respectively. The mean time for lenticule creation was the longest in the 105 nJ group (P = .015). The greatest increase in corneal thickness postoperatively occurred with 105 nJ (P < .05). Regression was highest in the 105 nJ group at 3 months (P < .01). However, corneal horizontal coma (C8) was lowest in the 105 nJ group at 1 week (P = .032). The lenticular surface in the 110 nJ group was the smoothest (P = .011). All contrast sensitivity values varied with time and recovered to preoperative levels by 1 week or 1 month. In all eyes, the uncorrected distance visual acuity and corrected distance visual acuity were good, with no statistically significant differences between the 4 energy groups. Conclusions: The 105 nJ group, in which the lowest energy was used, had the highest risk for black areas, serious postoperative corneal edema, and a significant healing response.
关键词： small-incision lenticule extraction,laser energy levels,black areas,SMILE,corneal edema
更新于2025-09-23 15:19:57
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Five-year outcomes of small-incision lenticule extraction vs femtosecond lasera??assisted laser in situ keratomileusis
摘要： To compare the long-term refractive and visual outcomes and the corneal higher-order aberrations of contralateral eyes of patients who received small-incision lenticule extraction (SMILE) in one eye and femtosecond laser–assisted laser in situ keratomileusis (FS-LASIK) in the other eye.
关键词： small-incision lenticule extraction,femtosecond laser–assisted laser in situ keratomileusis,myopic astigmatism,corneal higher-order aberrations,SMILE,FS-LASIK,myopia
更新于2025-09-19 17:13:59
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Comparison of anterior segment changes after femtosecond laser LASIK and SMILE using a dual rotating Scheimpflug analyzer
摘要： Background: To compare the changes in the anterior segment after femtosecond laser in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE) using a dual rotating Scheimpflug (DRS) analyzer (Galilei?; Ziemer Ophthalmology, Port, Switzerland). Methods: A total of 218 eyes of 109 patients who underwent FS-LASIK or SMILE for myopic correction were retrospectively studied. Ninety-eight eyes of 49 patients who underwent FS-LASIK were compared to 120 eyes of 60 patients treated with SMILE. A DRS analyzer was used for preoperative and 6-month postoperative anterior segment analyses. Measured variables included the central corneal thickness (CCT), anterior chamber depth (ACD), anterior and posterior keratometry (K), anterior and posterior best-fit sphere radius, and maximum posterior elevation (MPE). Results: After the procedure, the amount of CCT decrease was higher in the SMILE group than in the FS-LASIK group, but it was not statistically significant. The MPE was significantly increased after both procedures (p < 0.001 and p = 0.001 in the FS-LASIK and SMILE groups, respectively), with the amount of elevation being higher after FS-LASIK than after SMILE even though it was not statistically significant. And there was a significant change in the steep and average posterior K in the FS-LASIK group (p = 0.006 and 0.001, respectively), but not in the SMILE group. Conclusions: Regarding changes in the MPE and posterior K, changes in the posterior corneal surface were greater after FS-LASIK than after SMILE.
关键词： Dual rotating Scheimpflug analyzer,LASIK,Galilei,Small incision lenticule extraction,FS-LASIK,SMILE
更新于2025-09-12 10:27:22
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Leak in the curved suction contact glass of a femtosecond laser during small-incision lenticule extraction
摘要： We report a case of a leak in the curved suction contact glass of a VisuMax femtosecond laser that occurred during small-incision lenticule extraction (SMILE). As a result, creation of the anterior surface of the lenticule was not complete. One month later, a cap was created using the flap mode; the flap side cut was manually stopped after the flap cut was made. After laser in situ keratomileusis flap creation, the refractive lenticule was manually removed using microforceps, similar to the uneventful SMILE procedure. To our knowledge, this is the first report of a leak in the curved suction contact glass during SMILE that was successfully treated.
关键词： femtosecond laser,small-incision lenticule extraction,leak,suction contact glass,SMILE
更新于2025-09-12 10:27:22
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Comparing Dry Eye Disease After Small Incision Lenticule Extraction and Laser Subepithelial Keratomileusis
摘要： To compare dry eye disease parameters between small incision lenticule extraction (SMILE) and laser subepithelial keratomileusis (LASEK). This prospective, nonrandomized study included 39 eyes of 39 patients who underwent SMILE (n = 19) and LASEK (n = 20). Dry eye disease parameters included Ocular Surface Disease Index (OSDI), tear breakup time, Schirmer I test (SIT) value, corneal esthesiometry result, tear meniscus area, meibomian gland evaluation result, lipid layer thickness, and blink rate. Evaluations were performed before surgery and at 1 and 6 months after surgery. Compared with the LASEK group, the SMILE group showed lower corneal esthesiometry values at 1 month and higher OSDI scores and lower SIT values at 6 months after surgery. The SMILE group showed significantly higher OSDI scores at 1 and 6 months after surgery than before, but significantly lower OSDI scores at 6 months than at 1 month showed significantly decreased after corneal sensitivity at 1 month after surgery, which increased to the preoperative level 6 months after surgery. The change in OSDI scores at 1 month after surgery positively correlated with changes in the total and partial blink rates, whereas the change in corneal sensitivity at 1 month after surgery negatively correlated with the total and partial blink rates. Both SMILE and LASEK groups showed temporary decreases in corneal sensitivity, which recovered to baseline levels. Although subjective symptoms worsened after SMILE, SIT values improved after LASEK. Compared with SMILE, LASEK yielded better results regarding subjective symptoms, tear production, and corneal sensitivity.
关键词： corneal sensitivity,dry eye disease,small incision lenticule extraction,laser subepithelial keratomileusis
更新于2025-09-12 10:27:22
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Clinical outcomes of small incision lenticule extraction versus femtosecond laser-assisted LASIK for myopia: a Meta-analysis
摘要： ● AIM: To evaluate the possible differences in visual quality between small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK) for myopia. ● METHODS: A Meta-analysis was performed. Patients were from previously reported comparative studies treated with SMILE versus FS-LASIK. The PubMed, EMBASE, Cochrane, Web of Science and Chinese databases (i.e. WANFANG and CNKI) were searched in Nov. of 2016 using RevMan 5.1 version software. The differences in visual acuity, aberration and biomechanical effects within six months postoperatively were showed. Twenty-seven studies including 4223 eyes were included. ● RESULTS: No significant differences were observed between SMILE and FS-LASIK in terms of the proportion of eyes that lost one or more lines of corrected distance visual acuity after surgery (P=0.14), the proportion of eyes achieving an uncorrected distance visual acuity of 20/20 or better (P=0.43), the final refractive spherical equivalent (P=0.89), the refractive spherical equivalent within ±1.00 diopter of the target values (P=0.80), vertical coma (P=0.45) and horizontal coma (P=0.06). Compared with the FS-LASIK group, total higher-order aberration (P<0.001) and spherical aberration (P<0.001) were higher and the decrease in corneal hysteresis (P=0.0005) and corneal resistance factor (P=0.02) were lower in the SMILE group. ● CONCLUSION: SMILE and FS-LASIK are comparable in efficacy, safety and predictability for correcting myopia.
关键词： Meta-analysis,small incision lenticule extraction,myopia,femtosecond laser in situ keratomileusis
更新于2025-09-11 14:15:04