PurposeTo investigate the changes in dry eye symptoms and clinical signs and corneal sensitivity after small incision lenticule extraction (SMILE) and femtosecond LASIK (femto-LASIK).DesignProspective, non-randomized comparative study.MethodsThe study included a total of 71 eyes of 71 patients; the SMILE group comprised 38 eyes of 38 patients, and the femto-LASIK group comprised 33 eyes of 33 patients. Ocular Surface Disease Index (OSDI), Tear film breakup time (TBUT), the Schirmer test without anesthesia (S1T), corneal fluorescein staining, and central corneal sensation were evaluated before surgery and at 1 week, 1 month, 3 months, and 6 months after surgery.ResultsOSDI scores in both groups were increased immediately and returned to preoperative level at 1 month after surgeries. The TBUT values in both groups were reduced after surgeries relative to their preoperative scores. Patients in SMILE group were less likely to have corneal staining compared with those in the femto-LASIK group ([odds ratio] OR = 0.50, 95% [confidence interval] CI 0.28 to 0.93, P = 0.03). Central corneal sensitivity was decreased at all postoperative time points in both groups. However, the central corneal sensation scores in the SMILE group were greater than that in the femto-LASIK group at all of the postoperative time points (all P<0.05).ConclusionsSMILE surgeries resulted in a short-term increase in dry eye symptoms, tear film instability, and loss of corneal sensitivity. Furthermore, SMILE surgeries have superiority over femto-LASIK in lower risk of postoperative corneal staining and less reduction of corneal sensation.

This study suggests that, although mild decentration occurred in the early learning curve, good visual outcomes were achieved after the SMILE surgery. Special efforts to minimize induced vertical coma are necessary.

Applanation time (applanation 1) and deformation amplitude (as measured with the CorVis ST tonometer) may be helpful in assessing corneal biomechanical changes after corneal refractive surgery. The relations between these parameters should be discussed in further studies.

Implanting an autologous lenticule obtained by small incision lenticule extraction for hyperopia might be safe, effective, and stable, but its predictability should be improved in the future.

The breakpoints of seven interstitial de-letions of the long arm of chromosome 16 and two ring chromosomes of this chromosome were mapped by in situ hybridisation or by analysis of mouse/ human somatic cell hybrids containing the deleted chromosome 16. Use of a high resolution cytogenetic based physical map of chromosome 16 enabled breakpoints to be assigned to an average resolution of at least [1][2][3][4][5][6] Mb.In general, interstitial deletions involving q12 or q22.1 have broadly similar phenotypes though there are differences in specific abnormalities. Deletions involving regions more distal, from 16q22.1 to 16q24.1, were associated with relatively mild dysmorphism. One region of the long arm, q24.2 to q24.3, was not involved in any deletion, either in this study or in any previous report. Presumably, monosomy for this region is lethal. In contrast, patients with deletions of 16q21 have a normal phenotype. These results are consistent with the proposed distribution of genes, frequent in telomeric Giesma light band regions but infrequent in G positive bands. (_J Med Genet 1993;30:828-32 The breakpoints of IDI and 1D3-ID5 were mapped by Southern blot or PCR analysis of mouse/human somatic cell hybrids containing the deleted chromosome.'7 The presence (+) or absence (-) of a DNA marker on the chromosome 16 with a deletion was determined by FISH except in cases indicated by an asterisk where this was determined by inheritance of polymorphic (AC)n microsatellite markers. The order of DNA markers is from centromere to qter. showed head circumference and height at the 25th centile for age and weight at the 3rd centile for age. She had a flat occiput and right epicanthic fold but otherwise was not dysmorphic. Re-examination at 71 years showed a short, microcephalic girl with minor dysmorphism consisting of recessed hairline, slightly prominent broad forehead, supernumerary nipple (present in her normal mother), short and broad big toes, and small nails on the fifth toes. She was retarded, not toilet trained, and had general learning difficulties. Patient ID7. This female was delivered spontaneously at 37 weeks' gestation. Birth weight was 3170 g (50th to 75th centile),length 48 cm (50th centile), and head circumference 34 cm (75th centile). During the first few months there was normal feeding and development. At 8 weeks, clinical examination showed trembling, hypertonia, narrow palpebral fissures with antimongoloid slant, broad nasal root, flat forehead, an extremely large anterior fontanelle, long philtrum, high arched palate, and evidence of micrognathia. The two lower incisors were present at birth (both lost spontaneously at 4 weeks), the ears were low set and dysmorphic, there were flexion defects of the middle fingers, and widely spaced nipples. A photograph of the patient is presented in fig 1. DNA markersDeletions and rings

Microdistortions in Bowman's layer after SMILE were associated with the refractive lenticule thickness and surgery order. The microdistortions remained stable after 1 week and had no impact on long-term visual performance.

The impairment of corneal sensation was less significant in the SMILE group than in the femto-LASIK group and was independent of preoperative spherical equivalent or ablation depth.

Purpose To assess the relationship among corneal stiffness, thickness, and biomechanical parameters in keratoconus. Setting The EENT Hospital of Fudan University, Shanghai, China. Design Comparative study. Methods In this cross-sectional prospective study, 75 keratoconic eyes of 44 patients were recruited. Eyes were divided three groups according to the steepest K-readings (Kmax): mild (31 eyes; 42.1–54.5D); moderate (27 eyes, 55.0–61.6D); and severe (17 eyes, 65.2–94.5D). Thirty-one healthy subjects were recruited as the control group. All patients underwent Corvis ST, Pentacam and ORA examinations at the same time. Stiffness parameter A1 (SP-A1) and other dynamic parameters were assessed using the Corvis ST. Kmax and thinnest corneal thickness (TCT) was obtained using the Pentacam. Corneal resistance factor (CRF) and corneal hysteresis (CH) were measured using the ORA. Analysis of correlation was applied to investigate the association between variables. Results There was a decrease in SP-A1 in different stages of keratoconus compared with controls ( P ≤ 0.001): with increasing severity, the value of SP-A1 became smaller ( P < 0.05). A statistically significant linear relationship was noted between SP-A1 and TCT in each subgroup of keratoconus ( P ≤ 0.001). In all three groups, SP-A1 was found to be positively correlated with first applanation time ( P < 0.01), while negatively correlated with deformation amplitude ( P < 0.05). Analysis of SP-A1 with regard to CRF and CH indicated statistically positive correlation in keratoconus ( P < 0.05). Conclusion Significant decreases in corneal stiffness were noted in kerotoconic eyes compared with normal eyes. The stiffness parameter could be a valuable clinical tool enables biomechanically track progression with keratoconus. Synopsis Our study found that corneal thinning and biomechanical decreasing synchronize with one another throughout the progression of the keratoconus, and SP-A1 could be a potential biomarker evaluating disease progression.