Ectasia After Corneal Refractive Surgery: A Systematic Review

Moshirfar, Majid; Tukan, Alyson N; Bundogji, Nour; Liu, Harry Y; McCabe, Shannon E; Ronquillo, Yasmyne C; Hoopes, Phillip C

doi:10.1007/s40123-021-00383-w

Cited by 43 publications

(22 citation statements)

References 191 publications

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“…On average, the diagnosis was made 23.2 ± 11.3 (mean ± standard deviation) months after the initial SMILE procedure. In the above-mentioned meta-analysis by Moshirfar et al, the incidence of corneal ectasia after SMILE is given as 0.011 %; this figure is based on an extrapolation of the case reports published to date [5].…”

Section: Discussionmentioning

confidence: 99%

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Korneales Kollagen-Crosslinking (CXL) bei Hornhautektasie nach SMILE (Small Incision Lenticule Extraction)

Feldhaus¹,

Mayer²,

Gerhardt³

et al. 2022

Klin Monbl Augenheilkd

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Zusammenfassung Das SMILE-Verfahren scheint mit einer geschätzten Inzidenz von 0.011% unter allen gängigen keratorefraktiven Verfahren das geringste Risiko für eine postoperative Keratektasie aufzuweisen. Dennoch kann zum jetzigen Zeitpunkt aufgrund der Neuheit des Verfahrens sowie der mangelnden Datenlage diesbezüglich keine eindeutige Überlegenheit gegenüber der Femto-LASIK oder PRK ausgesprochen werden. Insofern sind die identischen, strengen Kriterien zur Indikationsstellung analog zu den Excimer-basierten Verfahren von großer Bedeutung, um das Risiko einer Hornhautektasie zu minimieren. Additiv zur konventionellen Hornhaut-Tomographie sollten neuere bildgebende Modalitäten wie OCT-basiertes Epithelmapping standardmäßig zum präoperativen Screening vor keratorefraktiven Eingriffen eingesetzt werden. Mit dem kornealen Crosslinking steht eine etablierte Behandlungsmethode der post-SMILE Keratektasie zur Verfügung, welche insbesondere in frühen Stadien hohe Erfolgschancen verspricht. Der vorgelegte Fallbericht legt diese Sachverhalte genauer dar. Abstract With an estimated incidence of 0.011%, the SMILE procedure seems to have the lowest risk of postoperative keratectasia among contemporary keratorefractive procedures. Nevertheless, due to the novelty of the procedure as well as the lack of data, no clear superiority over femto-LASIK or PRK can be stated at this time. In this respect, application of the identical tomographic screening criteria previously developed for excimer-based procedures is of paramount importance to minimize the risk of corneal ectasia. Ad an adjunct to conventional corneal tomography, newer imaging modalities such as OCT-based epithelial mapping should be used for preoperative screening before keratorefractive surgery. Corneal crosslinking is an established treatment modality for post-SMILE keratectasia, which promises high success rates especially in early stages. The present case report illustrates these diagnostic and therapeutic considerations.

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Section: Discussionmentioning

confidence: 99%

“…In einer rezenten umfassenden Metaanalyse von Moshirfar et al wird die Inzidenz der Hornhautektasie nach LASIK mit 0,09% und nach PRK mit 0,02% angegeben 5 . Die Hornhautektasie nach SMILE stellt bei mehr als 4 Mio.…”

Section: Diskussionunclassified

Korneales Kollagen-Crosslinking (CXL) bei Hornhautektasie nach SMILE (Small Incision Lenticule Extraction)

Feldhaus¹,

Mayer²,

Gerhardt³

et al. 2022

Klin Monbl Augenheilkd

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“…Nineteen cases of corneal ectasia after SMILE surgery have been reported since 2017, although the previous tomography findings were not normal in some of these cases. Based on the literature review of ectasia, the incidence of post-refractive ectasia in eyes without identifiable preoperative risk factors is 20 per 100,000 eyes for photorefractive keratectomy (PRK), 90 per 100,000 eyes for LASIK, and 11 per 100,000 eyes for SMILE ( 37 ). In addition, it is believed that the combination of Corvis ST and Pentacam can fill the void in preoperative risk prediction and early diagnosis of corneal ectasia and keratoconus; however, the data output by Corvis ST still warrants further discussion.…”

Section: Discussionmentioning

confidence: 99%

Twelve-year global publications on small incision lenticule extraction: A bibliometric analysis

et al. 2022

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PurposeTo analyze the development process of small incision lenticule extraction (SMILE) surgery in a 12-year period.MethodsWe conducted a literature search for SMILE research from 2011 to 2022 using the Science Citation Index Expanded (SCIE) of the Web of Science Core Collection (WoSCC). The VOS viewer, and CiteSpace software were used to perform the bibliometric analysis. Publication language, annual growth trend, countries/regions and institutions, journals, keywords, references, and citation bursts were analyzed.ResultsA total of 731 publications from 2011 to 2022 were retrieved. Annual publication records grew from two to more than 100 during this period. China had the highest number of publications (n = 326). Sixty-five keywords that appeared more than four times were classified into six clusters: femtosecond laser technology, dry eye, biomechanics, visual quality, complications, and hyperopia.ConclusionThe number of literatures has been growing rapidly in the past 12 years. Our study provides a deep insight into publications on SMILE for researchers and clinicians with bibliometric analysis for the first time.

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“…Some limitations of our study include that our population of normal, highly astigmatic eyes is based on a population with high astigmatism whom underwent Lasik without developing Post-LASIK ectasia after 3 years (36 months) of follow-up. Moshifar et al 60 in a systematic review evaluating the incidence of ectasia following refractive surgery found that the onset of ectasia ranged from 0.2 to 192 months after laser refractive surgery with a mean of 41 ± 50 months after PRK, 35 ± 24 months in LASIK, and 18 ± 13 months in SMILE. We are aware that post-Lasik ectasia can develop up to 16 years.…”

Section: Discusionmentioning

confidence: 99%

The false positive rates for detecting keratoconus and potential ectatic corneal conditions when evaluating astigmatic eyes with Scheimpflug Technology

Henríquez¹,

Hadid²,

Moctezuma³

et al. 2022

European Journal of Ophthalmology

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Purpose To quantify the false positive rates for keratoconus (KC) and potential ectatic corneal conditions in highly astigmatism eyes when using published parameters/indices obtained from the Pentacam and Galilei units. Setting Oftalmosalud Instituto de Ojos, Lima, Peru. Design Prospective cohort study. Methods 67 consecutive eyes with corneal astigmatism > 1.5 D, with a minimum follow ups of 36 months after an uneventful LASIK procedure were included. Indices for KC and other potential ectatic corneal conditions (subclinical KC, forme fruste KC, suspect KC) were obtained using the Pentacam and Galilei Scheimpflug cameras. Main outcome measures The false positive rates for KC and potential ectatic corneal conditions were measured. Cut off values provided by previous studies and company-based parameters were used to assess the rate of false positivity. Results The range of false positive rates for a KC diagnosis depending on the lowest and highest cutoff values were: index of height decentration (61% - 1%), index of surface variance (76% - 0%), Posterior elevation (55% - 0%), maximum Ambrosio Relational thickness (100% - 13%), Belin Ambrosio enhanced ectasia display total deviation value (100% - 4%), Average pachymetric progression index (69% - 3%), Pachymetry at the thinnest point (58% - 1%), CSI Center Surround Index (100%), Differential sector index (51%). Conclusion The false positive rates for KC and ectatic corneal conditions vary dramatically depending on the cut-off values used. Some indexes used for diagnosis of potential ectatic corneal conditions are inaccurate in normal, highly astigmatic eyes.

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Ectasia After Corneal Refractive Surgery: A Systematic Review

Cited by 43 publications

References 191 publications

Korneales Kollagen-Crosslinking (CXL) bei Hornhautektasie nach SMILE (Small Incision Lenticule Extraction)

Korneales Kollagen-Crosslinking (CXL) bei Hornhautektasie nach SMILE (Small Incision Lenticule Extraction)

Twelve-year global publications on small incision lenticule extraction: A bibliometric analysis

The false positive rates for detecting keratoconus and potential ectatic corneal conditions when evaluating astigmatic eyes with Scheimpflug Technology

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