Comparison of Corneal Sensation Between Small Incision Lenticule Extraction (SMILE) and Femtosecond Laser-Assisted LASIK for Myopia

Li, Meiyan; Zhou, Zimei; Shen, Yang; Knorz, Michael C.; Gong, Lan; Zhou, Xingtao

doi:10.3928/1081597x-20140120-04

Cited by 50 publications

(45 citation statements)

References 20 publications

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“…39,81,82 Postoperative corneal sensitivity in small-incision lenticule extraction-treated eyes appears to be superior to that in femtosecond laser-assisted LASIK eyes as well. 83,84 The interrelation of corneal denervation and development of dry eye 85 has prompted investigation of dry-eye symptoms associated with small-incision lenticule extraction.…”

Section: Corneal Nerve Integritymentioning

confidence: 99%

“…Conventional parameters used during small-incision lenticule extraction are as follows: repetition rate 500 kHz, pulse energy 120 to 170 nJ, spot distance 2 to 5 mm, lenticule side-cut angle 70 degrees, lenticule diameter 5.75 to 7.00 mm, cap diameter 7.0 to 7.9 mm (typically 0.5 to 1.0 mm greater than the lenticule diameter), cap thickness 100 to 140 mm, side-cut circumferential length 3.0 to 5.0 mm, and minimum lenticule side-cut thickness 15 mm. [12][13][14][15]33,[35][36][37][38][39] The optical zone diameter is typically equivalent to the lenticule diameter when only spherical error is being corrected; a transitional zone is added for cylindrical corrections, altering the lenticular shape from ovoid to circular, with subsequent modification of the lenticule diameter. 36 The total time for all femtosecond laser-generated incisions is between 20 seconds and 35 seconds regardless of the refractive error magnitude.…”

Section: Procedural Featuresmentioning

confidence: 99%

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Small-incision lenticule extraction

Moshirfar¹,

McCaughey²,

Reinstein³

et al. 2015

Journal of Cataract and Refractive Surgery

177

116

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Section: Corneal Nerve Integritymentioning

confidence: 99%

Section: Procedural Featuresmentioning

confidence: 99%

Small-incision lenticule extraction

Moshirfar¹,

McCaughey²,

Reinstein³

et al. 2015

Journal of Cataract and Refractive Surgery

177

116

View full text Add to dashboard Cite

show abstract

“…Currently, femtosecond laser has found an increasingly wide utilization in refractive surgeries including femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) [1], femtosecond lenticule extraction (FLEx) [2] and small incision lenticule extraction (SMILE) [3] procedures. However, the safety of corneal refractive surgeries has attracted more and more attention, not only because of the importance in predicting outcomes but also the necessity of assessing operation risks.…”

Section: Introductionmentioning

confidence: 99%

Changes in Corneal Deformation Parameters after Lenticule Creation and Extraction during Small Incision Lenticule Extraction (SMILE) Procedure

et al. 2014

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PurposeTo investigate the effects of lenticule creation and subsequent corneal lenticule extraction on corneal deformation parameters during small incision lenticule extraction (SMILE) procedure.Materials and MethodsIn this prospective study, 18 eyes of 10 patients (27.90±7.11 years, −5.64±2.45 diopters) scheduled for SMILE procedure were enrolled. Changes in the corneal deformation parameters, including deformation amplitude (DA), applanation time(AT1 and AT2), applanation length(AL1 and AL2), corneal velocity(CV1 and CV2), peak distance(P.Dist.), radius and intraocular pressure values were measured preoperatively, immediately after lenticule creation and subsequent to corneal lenticule extraction in all eyes with the Corvis Scheimpflug Technology (Corvis ST, OCULUS, Wetzlar, Germany). Repeated measures analysis of variance (ANOVA) with bonferroni-adjusted post hoc comparisons was performed to investigate changes following each step of the procedure.ResultsAll surgical procedures were uneventful. A significant difference was detected among the three time points (pre-operation, post-lenticule creation and post lenticule extraction) for AT1 (P<0.001), AT2 (P = 0.001), DA(P<0.001), and IOP(P = 0.002). Bonferroni-adjusted post hoc comparisons indicated that there was no significant change in AT1, AT2, DA, or IOP after lenticule creation (post hoc P>0.05), but there was a significant change in these parameters following subsequent corneal lenticule extraction (post hoc P<0.01), when compared to values obtained pre-operatively. The scheimpflug camera of the Corvis ST demonstrated the intralamellar small gas bubbles formed from the vaporisation of tissue after lenticule creation and a gray zone was observed between the cap and the residual stromal bed after lenticule extraction.ConclusionsThere is a significant change in corneal deformation parameters following SMILE procedure. The changes may be caused predominantly by stromal lenticule extraction, while lenticule creation with femtosecond laser may not have an obvious effect on corneal deformation properties.

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“…Although small incisions in SMILE surgeries provide patients with the advantages of greater biomechanical strength and less severe denervation of the cornea, the SMILE procedure requires greater surgical skill compared with other refractive surgeries, because the lenticule is manually removed through the small incision [6–8]. Surgeons may have difficulty separating the lenticule; thus, the separation procedure may require several attempts.…”

Section: Discussionmentioning

confidence: 99%

Chung’s swing technique: a new technique for small-incision lenticule extraction

et al. 2016

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BackgroundTo introduce the Chung’s swing technique for small-incision lenticule extraction (SMILE).MethodsA total of 112 eyes of 56 patients were included in this study. Patients were divided into two groups: 52 eyes of 26 patients were treated with SMILE using a traditional method (traditional group) and 60 eyes of 30 patients were treated with SMILE using the Chung’s swing technique (swing group).ResultsAt 1 month postoperatively, all eyes in both groups had an uncorrected distance visual acuity of 20/20 or better. The efficacy indices were 1.09 ± 0.17 and 1.02 ± 0.11 (p = 0.492), and the safety indices were 1.12 ± 0.14 and 1.09 ± 0.15 (p = 0.537), for the traditional and swing group, respectively. All eyes in both groups underwent successful lenticule extraction; all lenticules were intact and complete. The mean lenticule extraction times were 48.67 ± 4.9 and 39.8 ± 5.53 s, for the traditional and swing group, respectively (p < 0.001).ConclusionsThe Chung’s swing technique is efficient for lenticule separation and extraction. Our study results showed good clinical outcomes.Trial registrationTrial registration number: KCT0001978. Registered 22 July 2016. Retrospectively registered.Electronic supplementary materialThe online version of this article (doi:10.1186/s12886-016-0321-2) contains supplementary material, which is available to authorized users.

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Comparison of Corneal Sensation Between Small Incision Lenticule Extraction (SMILE) and Femtosecond Laser-Assisted LASIK for Myopia

Abstract: 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.

Cited by 50 publications

References 20 publications

Small-incision lenticule extraction

Small-incision lenticule extraction

Changes in Corneal Deformation Parameters after Lenticule Creation and Extraction during Small Incision Lenticule Extraction (SMILE) Procedure

Chung’s swing technique: a new technique for small-incision lenticule extraction

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