Longitudinal and Regional Non-uniform Remodeling of Corneal Epithelium After Topography-Guided FS-LASIK

Fan, Limin; Xiong, Lu; Zhang, Bo; Wang, Zheng

doi:10.3928/1081597x-20190104-01

Cited by 23 publications

(24 citation statements)

References 35 publications

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“…Our analyzed area was 1 mm larger than that of the previous studies [ 10 , 16 , 24 ], which was from 5 mm to 6 mm in diameter. Nevertheless, in line with the previous studies [ 8 , 19 ], the epithelial thickening and horizontal asymmetry of ET were lower in the mid-peripheral zone than in the paracentral zone. Meanwhile, the vertical asymmetry of ET, which was considered as the influence of tear film [ 25 , 26 ], was simultaneously observed in paracentral and mid-peripheral zones.…”

Section: Discussionsupporting

confidence: 92%

“…This asymmetric profile is similar to that reported by Luft et al [ 15 ]. Reinstein et al and Fan et al also reported a corresponding nonuniform epithelial thickening pattern after LASIK [ 8 , 19 ]. It was assumed that this horizontal asymmetrical epithelial thickness change might result from the correction of astigmatism and the mechanical force exerted by blinking.…”

Section: Discussionmentioning

confidence: 99%

“…Using the VHFS, Reinstein et al found that the epithelial thinning occurred in an annular area from 5.6 to 8 mm in diameter of the cornea, with no significant change from 8 mm to 10 mm diameter after myopic LASIK [ 23 ]. Fan et al reported a significant decrease of ET in the peripheral cornea with OCT [ 19 ]. The present result was consistent with previous findings; we found that the average ET of the peripheral zone continued to decrease from the first 24 hours to one week after SMILE.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Wide Corneal Epithelial Remodeling after Small Incision Lenticule Extraction (SMILE) with Wide-Field Optical Coherence Tomography

Chen

et al. 2022

Journal of Ophthalmology

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Purpose. This study aims to assess the corneal epithelial remodeling within a 9 mm diameter zone induced by small incision lenticule extraction (SMILE) and evaluate its relationship with the refractive outcomes. Methods. A total of 64 eyes of 64 patients were included. Wide-field optical coherence tomography (OCT) was used to measure the epithelial thickness (ET) across a 9 mm diameter area, preoperatively, and after one day, one week, one month, three months, and six months postoperatively. The ET changes were compared among the different time points and analyzed zones. Results. The ET increases from one week to three months and stabilized from three months to six months. Compared to the preoperative values, the mean ET changes at six months in central (2 mm), paracentral (2–5 mm), mid-peripheral (5–7 mm), and peripheral (7–9 mm) zones were 4.37, 4.36, 1.61, and −1.59 μm, respectively. The correlation between the epithelial thickening and the amount of myopia correction was positive in central ( P = 0.001) and paracentral zones ( P < 0.001) and negative in peripheral zone ( P = 0.006). The intended diameter of the optical zone was negatively related to epithelial hyperplasia in the central ( P = 0.020) and paracentral zone ( P = 0.006), and the correlation was positive in the mid-peripheral zone ( P = 0.001). The epithelial thickening of central zone ( P = 0.012) and the difference of mean ET between central and paracentral zone ( P = 0.020) were negatively related to the spherical equivalent at six months. Conclusion. An asymmetric lenticule-like pattern of epithelial remodeling occurred in 9 mm diameter cornea at six months after myopic SMILE. The epithelial remodeling may affect the refractive outcomes of SMILE.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Evaluation of Wide Corneal Epithelial Remodeling after Small Incision Lenticule Extraction (SMILE) with Wide-Field Optical Coherence Tomography

Chen

et al. 2022

Journal of Ophthalmology

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“…In order to effectively evaluate the effect after the refractive surgery, different kinds of examination methods and evaluating indicators were used in previous work [ 7 – 9 ]. Thereinto, the optical quality is believed to be the most important indicator [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the optical quality after SMILE and FS-LASIK for high myopia by OQAS and iTrace analyzer: a one-year retrospective study

et al. 2021

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Background To compare the correction effect and optical quality after small-incision lenticule extraction (SMILE) and femtosecond laser assisted laser in situ keratomileusis (FS-LASIK) for high myopia. Methods 51 high myopia eyes after SMILE and 49 high myopia eyes after FS-LASIK were enrolled and divided into two groups retrospectively. The OQAS and iTrace analyzer were used for optical quality inspection. Between the two groups the spherical equivalent (SE), astigmatism, uncorrected distant visual acuity (UDVA), strehl ratio (SR), modulation transfer function cutoff frequency (MTF cutoff), objective scatter index (OSI) and wavefront aberrations were analyzed and compared before surgery and at 1, 6 and 12 months after surgery. Results After the operation: (1) SE and astigmatism declined and UDVA increased significantly in both groups, and UDVA was better after SMILE than FS-LASIK. (2) SR and MTF cutoff reduced and OSI increased significantly after SMILE and FS-LASIK. SR and MTF cutoff were significantly higher after SMILE than FS-LASIK. OSI was significantly lower after SMILE than FS-LASIK. (3) The total wavefront aberration, total low-order wavefront aberration, defocus and astigmatism aberration as well as trefoil aberration reduced significantly in both groups. The total high-order wavefront aberration increased significantly after FS-LASIK. The spherical and coma aberration increased significantly in both groups. The total high-order wavefront aberration and coma aberration at 1 month were higher after FS-LASIK than SMILE. Conclusion The optical quality descended after SMILE and FS-LASIK. SMILE was superior to FS-LASIK at the correction effect and optical quality for high myopia. The combination of OQAS and iTrace analyzer is a valuable complementary measurement in evaluating the optical quality after the refractive surgery. Trial registration This is a retrospective study. This research was approved by the ethics committee of Xiangya Hospital and the IRB approval number is 201612074.

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“…This change may be associated with non-uniform proliferation of the corneal epithelium. Two recent studies reported remodeling of the corneal epithelium following corneal refractive surgery [27,28]. The LYRA protocol also mentions the effect of the epithelium on HOA.…”

Section: Discussionmentioning

confidence: 99%

Mutual comparative analysis: a new topography-guided custom ablation protocol referencing subjective refraction to modify corneal topographic data

Cao¹,

Liu²,

Zhang³

et al. 2020

Eye and Vis

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Background: Several planning algorithms have been developed for topography-guided custom ablation treatment (T-CAT), but each has its own deficiencies. The purpose of this study is to demonstrate the potential of a novel mutual comparative analysis (MCA) informed by manifest refraction and corneal topographic data and the patient's subjective perception in correcting ametropia. Methods: This retrospective review included patients with significant preoperative differences in the power or axis of astigmatism according to the manifest refraction and corneal topographic data (power > 0.75 D and/or axis > 10°). T-CAT planning was designed using MCA. Follow-ups were conducted for at least 6 months. Results: Seventy-nine patients (121 eyes) were included. The mean preoperative deviation in the astigmatic power and axis were 0.72 ± 0.43 D and 20.18 ± 23.68°, respectively. The average oculus residual astigmatism (ORA) was 0.81 ± 0.32 D (range: 0.08-1.66 D). Six months postoperatively, the mean spherical equivalent refraction was 0.04 ± 0.42 D, and the mean cylinder was − 0.27 ± 0.24 D. The mean efficacy and safety indices were 1.10 and 1.15, respectively. The uncorrected distance visual acuity in 92% of the eyes was the same or better than the corrected distance visual acuity. The angle of error was ±5°in 61% of eyes and ± 15°in 84% of eyes. Residual astigmatism was ≤0.5 D in 91% of eyes. Optical quality and photopic contrast sensitivity did not change significantly (p > 0.05), and the scotopic contrast sensitivity decreased at 3, 6, and 12 cpd (p < 0.05). The vertical coma and horizontal coma of the anterior corneal surface significantly decreased postoperatively but increased during follow-up. Conclusions: The MCA demonstrated safety, efficacy, accuracy, predictability, and stability and can be used as a complementary and feasible method for T-CAT.

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Longitudinal and Regional Non-uniform Remodeling of Corneal Epithelium After Topography-Guided FS-LASIK

Cited by 23 publications

References 35 publications

Evaluation of Wide Corneal Epithelial Remodeling after Small Incision Lenticule Extraction (SMILE) with Wide-Field Optical Coherence Tomography

Evaluation of Wide Corneal Epithelial Remodeling after Small Incision Lenticule Extraction (SMILE) with Wide-Field Optical Coherence Tomography

Comparison of the optical quality after SMILE and FS-LASIK for high myopia by OQAS and iTrace analyzer: a one-year retrospective study

Mutual comparative analysis: a new topography-guided custom ablation protocol referencing subjective refraction to modify corneal topographic data

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