Corneal biomechanics after small-incision lenticule extraction versus Q-value–guided femtosecond laser-assisted in situ keratomileusis

Zhang, Jun; Li, Zheng; Zhao, Xianxian; Xu, Yang; Shu, Chen

doi:10.1016/j.joco.2016.08.004

Cited by 29 publications

(25 citation statements)

References 22 publications

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“…There were several clinical studies on biomechanical changes in the cornea after LASIK and SMILE. [3][4][5][6][7][8][9][10] A few reported similar biomechanical changes in the cornea after femtosecond LASIK and SMILE. [3][4][5][6] Other studies reported better biomechanical outcomes in SMILE eyes than in LASIK eyes.…”

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confidence: 92%

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Corneal Biomechanical Changes and Tissue Remodeling After SMILE and LASIK

Shetty

Francis

Shroff

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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mentioning

confidence: 92%

“…[3][4][5][6][7][8][9][10] A few reported similar biomechanical changes in the cornea after femtosecond LASIK and SMILE. [3][4][5][6] Other studies reported better biomechanical outcomes in SMILE eyes than in LASIK eyes. [7][8][9][10] Similarly, corneal tissue healing and Scheimpflug densitometry changes indicated a moderately better response in SMILE eyes.…”

mentioning

confidence: 92%

Corneal Biomechanical Changes and Tissue Remodeling After SMILE and LASIK

Shetty

Francis

Shroff

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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“…Many researchers have compared the postoperative CH and CRF between the SMILE and FS-LASIK groups. Two reports by Zhang Jun et al [13,14] showed no significant postoperative differences in CH and CRF between the SMILE group and the FS-LASIK group. However, Wenjing WU et al [15] and Elmohamady et al [16] found that CH and CRF both exhibited postoperative differences between the SMILE group and the FS-LASIK group.…”

Section: Discussionmentioning

confidence: 84%

Meta-analysis of Corneal Biomechanical Effects after SMILE and FS-LASIK

Qin

et al. 2019

Preprint

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Background: To evaluate and compare corneal biomechanics after treatment of myopia using small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK). Methods: We performed a meta-analysis and searched for reports concerning corneal biomechanics after SMILE and FS-LASIK using MEDLINE, EMbase, CNKI and the Cochrane Library. The analysis included corneal hysteresis (CH) and corneal resistance factor (CRF) before and 3 months after the surgery. The quality of the reports was evaluated using the Newcastle-Ottawa scale (NOS). Statistical analysis was performed using RevMan5. Results: Only six studies with a total of 771 eyes were ultimately included in this meta-analysis, and the random effects model was adopted. The preoperative and three-month postoperative CH and CRF of SMILE and FS-LASIK were compared by the meta-analysis. No statistically significant difference was found in CH or CRF between the SMILE group and the FS-LASIK group before the surgery (WMD，-0.12; 95% CI，-0.31～0.06; P，0.19; WMD，-0.05; 95% CI，-0.29～0.19; P，0.69). There was no statistically significant difference in CH between the two surgical methods 3 months after the operation in the foreign group (WMD，0.19; 95% CI，-1.02～1.41; P，0.75) or in the Chinese group (WMD，0.13; 95% CI，-0.16～0.41; P，0.75). Likewise, no statistically significant difference was found in CRF between the two surgical methods in the foreign group 3 months after the operation (WMD，-0.11; 95% CI，-2.53～-2.31; P，0.93). Nevertheless, the difference in CRF between the two surgical methods was statistically significant in the Chinese group (WMD，0.26; 95% CI，0.06～0.47; P，0.01). Concusion: This meta-analysis indicated that SMILE showed no significant postoperative advantage in CH in comparison with FS-LASIK. For CRF, SMILE exhibited no obvious postoperative advantage in comparison with FS-LASIK in the foreign group, whereas SMILE was superior to FS-LASIK in the Chinese group.

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“…The studies by Wu & Wang () and Zhang et al. () did also not state the comparisons of CH and CRF between the groups preoperative or postoperative, which make the interpretation of results uncertain, especially the finding of a statistically significant difference as described by Wu & Wang (). Likewise, Wang et al.…”

Section: Resultsmentioning

confidence: 97%

“…The study by Zhang et al. () did not report the mean age or age range for inclusion and was the only nonrandomised study, which did not find statistical significant differences in the corneal biomechanical changes between the groups.…”

Section: Resultsmentioning

confidence: 99%

Comparison of corneal biomechanical changes after refractive surgery by noncontact tonometry: small‐incision lenticule extraction versus flap‐based refractive surgery – a systematic review

Rævdal

Grauslund

Vestergaard

2018

Acta Ophthalmologica

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Corneal refractive surgery disrupts corneal integrity and reduces biomechanical stability in consequence of the beneficial refractive alteration. The minimal invasive cap-based refractive procedure, small-incision lenticule extraction (SMILE), has been proposed to affect corneal integrity less than flap-based procedures, due to the fibre-sparing incision of the strong anterior corneal lamellae. Flap-based procedures include laser-assisted in situ keratomileusis (LASIK), femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and femtosecond lenticule extraction (FLEx). The purpose of this systematic review was to evaluate corneal biomechanical changes by noncontact air pulse tonometry after treatment of myopia/myopic astigmatism with SMILE compared to flap-based refractive surgery. A total of 220 publications were identified through a systematic search in PubMed and Embase. Two levels of screening identified nine studies (three randomised controlled trials (RCT) and six nonrandomised clinical trials) eligible for the review. All the nonrandomised clinical trials were graded to have an overall serious risk of bias. Measurements with the Corvis ST were not included in any of the eligible studies. The RCTs found no statistical significant differences between SMILE or flap-based procedures concerning corneal hysteresis (CH) or corneal resistance factor (CRF), as measured with the Ocular Response Analyzer. However, a greater reduction in CRF and CH was found in the flap-based group in five and two of the nonrandomised studies, respectively. The findings in this review illustrate that the presumed biomechanical advantages of a cap-based small incision could not be demonstrated in existing studies and by commercially available technology. However, studies with lower levels of evidence suggest less affection of corneal viscoelastic properties after SMILE when evaluating corneal stability by noncontact tonometry.

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Corneal biomechanics after small-incision lenticule extraction versus Q-value–guided femtosecond laser-assisted in situ keratomileusis

Cited by 29 publications

References 22 publications

Corneal Biomechanical Changes and Tissue Remodeling After SMILE and LASIK

Corneal Biomechanical Changes and Tissue Remodeling After SMILE and LASIK

Meta-analysis of Corneal Biomechanical Effects after SMILE and FS-LASIK

Comparison of corneal biomechanical changes after refractive surgery by noncontact tonometry: small‐incision lenticule extraction versus flap‐based refractive surgery – a systematic review

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