Corneal ectasia 6.5 months after small-incision lenticule extraction

Wang, Yumeng; Cui, Chuanbo; Li, Zhiwei; Tao, Xiangchen; Zhang, Chunxiao; Zhang, Xiao; Mu, Guoying

doi:10.1016/j.jcrs.2015.04.001

Cited by 67 publications

(40 citation statements)

References 11 publications

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“…In this case report, the patient appeared to have pre-existing keratoconus. 36 Although this is likely to correspond with the proposed biomechanical benefits of SMILE, it is likely also a consideration of our greater understanding of potential risk factors for ectasia. Longerterm data, with corresponding data sets, will provide confirmation of the potential benefits of SMILE over LASIK surgery in particular.…”

Section: Irregular Astigmatism and Increased Higher-order Aberrationsmentioning

confidence: 95%

“…Through mid‐2015, only one case of ectasia related to a SMILE procedure has been reported in the peer‐reviewed literature. In this case report, the patient appeared to have pre‐existing keratoconus . Although this is likely to correspond with the proposed biomechanical benefits of SMILE, it is likely also a consideration of our greater understanding of potential risk factors for ectasia.…”

Section: Complicationsmentioning

confidence: 99%

“…Reported post-operative complications include; epithelial ingrowth, diffuse lamellar keratitis, corneal haze, irregular astigmatism, increased aberrations, ectasia, punctate corneal staining and mild dry eye. 2,31,32,[36][37][38][39][44][45][46][47][48][49]…”

Section: Post-operative Complicationsmentioning

confidence: 99%

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Small incision lenticule extraction (SMILE) in 2015

Chan

Lawless

Sutton

et al. 2016

Clinical and Experimental Optometry

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Small incision lenticule extraction (SMILE) represents a recent addition to the refractive surgeon's range of procedures. Although there remains a number of similarities to existing techniques in terms of patient selection and treatment parameters, consideration is required to optimise patient outcomes and satisfaction. Here, we review the selection criteria, contraindications, indications and existing published safety and efficacy outcomes.

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Section: Irregular Astigmatism and Increased Higher-order Aberrationsmentioning

confidence: 95%

Section: Complicationsmentioning

confidence: 99%

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Small incision lenticule extraction (SMILE) in 2015

Chan

Lawless

Sutton

et al. 2016

Clinical and Experimental Optometry

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“…In vivo biomechanical studies evaluating the corneal deformation response with noncontact tonometry have been inconsistent, and SMILE has been equal or superior to LASIK. [7][8][9][10][11][12][13][14][15] Furthermore, iatrogenic ectasia has been reported after both LASIK 16 and SMILE, [17][18][19][20] which is characterized by corneal biomechanical weakening, severe protrusion, and decreased visual acuity.…”

mentioning

confidence: 99%

Refractive Correction and Biomechanical Strength Following SMILE With a 110- or 160-μm Cap Thickness, Evaluated Ex Vivo by Inflation Test

Damgaard

Ivarsen

Hjortdal

2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To examine the refractive correction and corneal biomechanical strength after small incision lenticule extraction (SMILE) by using a 110-or 160-lm cap thickness.METHODS. Thirty-two human donor corneas were allocated into 4 groups, combining one of two cap thicknesses (110 and 160 lm) with one of two spherical corrections (À4 D and À8 D). Each cornea was mounted on an artificial anterior chamber. The chamber pressure was adjusted by an attached 8% dextran media column.The anterior and posterior sagittal 3-mm-diameter curvature (r sag3mm ) and the total corneal refractive power (TCRP 4mm,apex,zone ) were obtained before and after SMILE at a chamber pressure of 15 or 40 mm Hg. The average changes after surgery (D ¼ postoperative À preoperative) and at increased chamber pressure (d ¼ 40 mm Hg À 15 mm Hg) were compared. RESULTS. A 110-lm cap thickness caused more anterior flattening (Dr 15,À8D , 1.02 6 0.08 mm versus 0.60 6 0.17 mm), less posterior steepening (Dr 15,À8D , À0.19 6 0.11 mm versus À0.45 6 0.20 mm), and more myopic correction (DTCRP 15,À8D , À6.30 6 0.96 D versus À4.55 6 1.66 D) than a 160-lm cap thickness for À8 D SMILE (P < 0.034), but not for À4 D SMILE (DTCRP 15,À4D,110lm , À3.86 6 1.31 D versus DTCRP 15,À4D,160lm , À3.57 6 1.27 D, P ¼ 0.718). After SMILE, increased chamber pressure caused anterior steepening (P < 0.014), which was similar at cap thicknesses of 110 and 160 lm (dr À4D , À0.13 6 0.14 mm versus À0.09 6 0.05mm, P ¼ 0.431).CONCLUSIONS. For high myopic corrections, a 160-lm cap caused less anterior curvature flattening and more posterior steepening than a 110-lm cap, and consequently less myopic correction. The inflation test revealed a reduction in the biomechanical strength after SMILE; this was similar when using a 110-or 160-lm cap thickness.

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“…Corneal ectasia after refractive surgery is a rare complication (a low incidence rate of 0.04%‐0.6%) . However, many reports describing ectasia after laser‐assisted in situ keratomileusis (LASIK) and small incision lenticule extraction (SMILE) were published in recent years . In some of these reports, subclinical keratoconus was the probable cause of postrefractive surgery .…”

Section: Introductionmentioning

confidence: 99%

Corneal tomographic features of postrefractive surgery ectasia

Khamar

Dalal

Chandapura

et al. 2018

Journal of Biophotonics

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The purpose of this study was to evaluate the tomographic features of postrefractive surgery eyes. This was a retrospective evaluation of clinical data. Three patients with post-LASIK (laser-assisted in situ keratomileusis) and two patients with post-SMILE (small incision lenticule extraction) ectasia were imaged with Scheimpflug imaging (SI, Pentacam) and optical coherence tomography (OCT, RTVue). Curvature and wavefront aberrations of the air-epithelium interface (A-E) and epithelium-Bowman's layer interface (E-B) were derived. OCT of normal and keratoconic eyes from an earlier study were compared with the data of the ectasia eyes. Curvature and aberrometry of the A-E interfaces were statistically similar between SI and OCT. However, OCT revealed a steeper and more aberrated E-B interface than A-E though correlation between them was inferior to the correlation for keratoconic eyes. Furthermore, the magnitude of differences between the A-E and E-B interfaces was greater in the ectasia eyes than the keratoconic eyes. OCT could possibly assist better in selecting appropriate treatment plan for postrefractive surgery ectasia eyes than conventional tomographers.

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Corneal ectasia 6.5 months after small-incision lenticule extraction

Cited by 67 publications

References 11 publications

Small incision lenticule extraction (SMILE) in 2015

Small incision lenticule extraction (SMILE) in 2015

Refractive Correction and Biomechanical Strength Following SMILE With a 110- or 160-μm Cap Thickness, Evaluated Ex Vivo by Inflation Test

Corneal tomographic features of postrefractive surgery ectasia

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