Corneal Irregular Astigmatism and Curvature Changes After Small Incision Lenticule Extraction: Three-Year Follow-Up

Sideroudi, Haris; Lazaridis, Apostolos; Messerschmidt-Roth, Anke; Labiris, Georgios; Kozobolis, Vassilios; Sekundo, Walter

doi:10.1097/ico.0000000000001532

Cited by 14 publications

(13 citation statements)

References 19 publications

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“…With respect to corneal stability, we observed significant changes in MCFC from 3 months to 4 years post-SMILE, in line with prior findings (25,26). We additionally observed no changes in the posterior corneal surface following SMILE.…”

Section: Discussionsupporting

confidence: 91%

Four-Year Outcomes of Small Incision Lenticule Extraction for Extreme High Myopia and Myopic Astigmatism

et al. 2020

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Purpose: To evaluate the long-term safety, efficacy, predictability, and stability of small incision lenticule extraction (SMILE) for the treatment of high myopia and myopic astigmatism >−10.0 D. Methods: This was a prospective study that incorporated 35 consecutive patients (35 eyes) undergoing SMILE from September 2015 to March 2016. These patients had a mean preoperative spherical equivalent refraction of −10.06 ± 0.64 D. Patients were followed over a 4-year period and assessed for outcomes including uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, and corneal topography. Results: At 4 years post-SMILE, respective efficacy and safety indices were 1.01 ± 0.19 and 1.07 ± 0.15. In total, 97% of operated eyes achieved an UDVA of 20/25 or better. ≥1 line was gained for 9 eyes (26%), with 25 eyes (71%) remaining stable. Twenty-four (69%) and 33 (94%) eyes, respectively, were within ±0.50 D and ±1.0 D of target refraction. From 3 months to 4 years postoperatively, a mean refractive regression of −0.22 D (−0.06 D per year) was detected, whereas no significant changes in mean corneal back curvature or posterior central elevation were detected ( P = 0.617 and 0.754, respectively). We detected significant increases in higher-order aberrations (HOAs) of the anterior and total cornea (all P < 0.001), with spherical aberrations and vertical coma being particularly common, whereas posterior corneal HOA remained fairly stable (all P < 0.05). Conclusion: SMILE is a safe, effective, predictable, and stable means of correcting high myopia and myopic astigmatism over a 4-year postoperative period.

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Section: Discussionsupporting

confidence: 91%

Four-Year Outcomes of Small Incision Lenticule Extraction for Extreme High Myopia and Myopic Astigmatism

et al. 2020

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“…This has been reported in a recent study by Sideroudi et al. 53 It has also been supported by the results presented by Ganesh et al. 54 …”

Section: Discussionsupporting

confidence: 87%

Twelve-month outcomes of a new refractive lenticular extraction procedure

Pradhan

Arba-Mosquera

2023

Journal of Optometry

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“…Moreover, they induce different postoperative biomechanical responses, which may result in different remodeling of the anterior and posterior cornea. [1][2][3][4][5][6][7][8][9][10][11][12] Several in vivo and ex vivo studies as well as mathematical models have shown that LASIK may cause a greater reduction in the biomechanical strength of the cornea compared with SMILE, which is mainly associated with the flap creation in LASIK. A better preservation of the corneal tensile strength may result in a more stable corneal morphology and possibly a more stable refractive outcome in the long term.…”

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confidence: 99%

Corneal Remodeling After Myopic SMILE Versus FS-LASIK: A Spatial Analysis of Short- and Mid-Term Corneal Thickness, Volume, and Shape Changes

Lazaridis

Spiru

Giallouros

et al. 2021

Cornea

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To evaluate the short-and mid-term changes of corneal thickness spatial profile (CTSP), corneal volume distribution (CVD), and corneal asphericity after small-incision lenticule extraction (SMILE) for correction of myopia and astigmatism and compare the results with femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK).Method: Thirty eyes of 18 patients who underwent SMILE were compared with a group of 30 eyes of 16 patients who underwent FS-LASIK. The groups were matched for preoperative central corneal thickness and lenticule thickness/ablation depth. Scheimpflug corneal tomography was performed preoperatively and postoperatively at 2 months and 3 years. The CTSP was evaluated on 4 concentric rings (2, 4, 6, and 8 mm). The CVD was evaluated at 3 concentric zones (3, 5, and 7 mm). Changes in the anterior and posterior asphericity at a 6-mm zone were also evaluated.Results: Between the 2-month and 3-year examination, the CTSP showed a similar increase for both groups at all measured points and rings (P $ 0.168). The CVD also showed a similar increase for both groups at all measured zones (P $ 0.278). The anterior corneal asphericity remained stable after SMILE (2-mo Q = 0.46 6 0.27; 3-yr Q = 0.45 6 0.27; P = 0.711) but decreased significantly after FS-LASIK (2-mo Q = 0.52 6 0.47; 3-yr Q = 0.47 6 0.44; P = 0.028). Similarly, the posterior corneal asphericity remained stable after SMILE (2-mo Q = 20.11 6 0.15; 3-yr Q = 20.11 6 0.13; P = 0.902) but decreased significantly after FS-LASIK (2-mo Q = 20.13 6 0.14; 3-yr Q = 20.16 6 0.15; P = 0.034).Conclusions: CTSP and CVD between the 2-month and 3-year examination showed a similar increase after SMILE and FS-LASIK. During the postoperative course, the anterior and posterior corneal asphericity remained more stable after SMILE compared with FS-LASIK.

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Corneal Irregular Astigmatism and Curvature Changes After Small Incision Lenticule Extraction: Three-Year Follow-Up

Abstract: Three years after SMILE, there was a reduction of posterior astigmatism in high refractive corrections. This could result in undercorrection in high refractive treatments. Total irregularities increased despite the compensatory effect of the posterior corneal surface.

Cited by 14 publications

References 19 publications

Four-Year Outcomes of Small Incision Lenticule Extraction for Extreme High Myopia and Myopic Astigmatism

Four-Year Outcomes of Small Incision Lenticule Extraction for Extreme High Myopia and Myopic Astigmatism

Twelve-month outcomes of a new refractive lenticular extraction procedure

Corneal Remodeling After Myopic SMILE Versus FS-LASIK: A Spatial Analysis of Short- and Mid-Term Corneal Thickness, Volume, and Shape Changes

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