Site of clear corneal incision in cataract surgery and its effects on surgically induced astigmatism

Piao, Junjie; Joo, Choun‐Ki

doi:10.1038/s41598-020-60985-5

Cited by 19 publications

(7 citation statements)

References 43 publications

(52 reference statements)

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“…A meta-analysis study reported that SMILE procedures did not have obvious superiority over femtosecond-assisted laser in situ keratomileusis, after revealing similar and acceptable objective parameters with SMILE, potentially resulting in milder subjective symptoms [13]. Further, we used the AKP analysis method [12] to evaluate the SIA changes and found that AKP(+ 0) showed statistically signi cant changes in both groups, and uctuation in corneal surface irregularity outcomes masked changes of polar SIA values after SMILE surgery. This meant that the corneal wound healing processes in uenced corneal surface irregularity and corneal polar SIA values during various postoperative visits.…”

Section: Discussionmentioning

confidence: 97%

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Corneal Surface Irregularity and Surgically Induced Astigmatism Changes in the Small Incision Versus Microincision After SMILE

Piao¹,

Y²,

Wang³

2020

Preprint

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Background: To evaluate the corneal surface irregularity and surgically induced astigmatism changes in the small incision versus microincision after small incision lenticule extraction (SMILE) surgery.Methods: A total of 70 eyes of 35 patients with myopia who underwent SMILE surgery were enrolled in this retrospective study. Patients were divided into two groups according to the incision size (small incision, 4.0 mm or microincision, <2.5 mm) and subjected to a standard ophthalmologic examination preoperatively. The changes in corneal topographic and surface irregularities were evaluated using a TMS-4N topographer during a 6-month follow-up period.Results: According to Friedman’s ANOVA test, there were statistically significant changed in SRI, SAI, and IOP between two groups during a 6-month follow-up (all p < 0.001). At last follow-up, SRI values less than 0.50 D were shown 27 eyes (75%) in the small incision group and 28 eyes (82%) in the microincision group; SAI values less than 0.50 D were shown 22 eyes (61%) in the small incision group and 18 eyes (53%) in the microincision group (all p<0.001).Conclusions: SMILE procedures, using both small incisions and microincisions, are safe and effective surgical options for patients with low to high myopia and provide stable postoperative biomechanical properties and superior postoperative visual outcomes.

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Section: Discussionmentioning

confidence: 97%

“…All postoperative follow-up visits included the assessment of UDVA, IOP and corneal topography (TMS-4N, TOMEY, Erlangen, Germany). Polar SIA was analysed by the polar value analysis method [12].…”

Section: Postoperative Evaluationmentioning

confidence: 99%

Corneal Surface Irregularity and Surgically Induced Astigmatism Changes in the Small Incision Versus Microincision After SMILE

Piao¹,

Y²,

Wang³

2020

Preprint

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“…With an effective sealant, corneal surgery would not be restricted to complex incisional architecture. 37 , 38 The availability of pectin film may permit larger or secondary incisions when necessary without the increased risk of perioperative morbidity. Although pectin's biodurability on the cornea and compatibility with tears is unknown, previous studies of the pleural surface of the murine lung suggest a pectin half-life of 7 days.…”

Section: Discussionmentioning

confidence: 99%

Biomechanics of a Plant-Derived Sealant for Corneal Injuries

Liu

Liao

Wagner

et al. 2023

Trans. Vis. Sci. Tech.

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Purpose The corneal epithelium has a glycocalyx composed of membrane-associated glycoproteins, mucins, and galactin-3. Similar to the glycocalyx in visceral tissues, the corneal glycocalyx functions to limit fluid loss and minimize frictional forces. Recently, the plant-derived heteropolysaccharide pectin has been shown to physically entangle with the visceral organ glycocalyx. The ability of pectin to entangle with the corneal epithelium is unknown. Methods To explore the potential role of pectin as a corneal bioadhesive, we assessed the adhesive characteristics of pectin films in a bovine globe model. Results Pectin film was flexible, translucent, and low profile (80 µm thick). Molded in tape form, pectin films were significantly more adherent to the bovine cornea than control biopolymers of nanocellulose fibers, sodium hyaluronate, and carboxymethyl cellulose ( P < 0.05). Adhesion strength was near maximal within seconds of contact. Compatible with wound closure under tension, the relative adhesion strength was greatest at a peel angle less than 45 degrees. The corneal incisions sealed with pectin film were resistant to anterior chamber pressure fluctuations ranging from negative 51.3 ± 8.9 mm Hg to positive 214 ± 68.6 mm Hg. Consistent with these findings, scanning electron microscopy demonstrated a low-profile film densely adherent to the bovine cornea. Finally, the adhesion of the pectin films facilitated the en face harvest of the corneal epithelium without physical dissection or enzymatic digestion. Conclusions We conclude that pectin films strongly adhere to the corneal glycocalyx. Translational Relevance The plant-derived pectin biopolymer provides potential utility for corneal wound healing as well as targeted drug delivery.

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“…Astigmatic polar value of net astigmatism (AKP) analysis methods [19] were used to analyze astigmatism changes after surgery. All keratometric values were converted to a plus power (@) net cylinder format with the magnitude of keratometric astigmatism in diopters, and the direction in degrees following the steepest keratometric meridian axis.…”

Section: Analysis Of Surgically Induced Astigmatismmentioning

confidence: 99%

Comparative Evaluation of the Visual and Refractive Outcomes Following SMILE, FS-LASIK, and T-PRK Surgery: A Retrospective, Non-Blinded Clinical Study

Piao

2021

Preprint

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Background: To comparatively evaluate of the visual and refractive outcomes after small-incision lenticule extraction (SMILE), femtosecond laser-assisted in situ keratomileusis (FS-LASIK), and transepithelial photorefractive keratectomy (T-PRK) surgery.Methods: This was a retrospective, case-series, non-blinded clinical study. Consecutive eligible patients underwent SMILE, FS-LASIK, and T-PRK at the Department of Ophthalmology of Peking Union Medical Hospital, a tertiary referral center. All myopic patients were treated with corneal refractive surgery (SMILE, FS-LASIK, and T-PRK) using the VisuMax (Carl Zeiss Meditec AG, Jena, Germany) 500-kHz femtosecond laser system and the Amaris 750S excimer laser platform (SCHWIND eye-tech solutions, Kleinostheim, Germany). Visual and topographic astigmatism changes at 6 months were the main outcome measure. Secondary outcomes were the efficacy index at 1, 3, and 6 months postoperatively.Results: We recruited 75 consecutive patients (mean age, 27.88 ± 5.76 years; 68% women; all Asian) with no significant differences between groups in terms of preoperative demographic data, except in preoperative spherical equivalent (SE) (-5.54 ± 1.86 D, -5.64 ± 1.66 D, and -3.78 ± 1.30 D, respectively; P<0.001), astigmatism (1.24 ± 1.62 D, 1.16 ± 0.75 D, and 0.72 ± 0.42 D, respectively; P=0.008), and residual bed thickness (313.08 ± 32.18 μm, 427.59 ± 30.69 μm, and 427.09 ± 41.07 μm, respectively; P<0.001). A superior efficacy index was shown in SMILE and FS-LASIK compared to T-PRK 1 month after surgery.Conclusions: The results from this retrospective, non-blind, case-series clinical study suggest that all of the corneal refractive surgery options are safe and effective. However, while SMILE and FS-LASIK procedures have equal visual outcomes, they have superior efficacy index values in the early postsurgical period.

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Site of clear corneal incision in cataract surgery and its effects on surgically induced astigmatism

Cited by 19 publications

References 43 publications

Corneal Surface Irregularity and Surgically Induced Astigmatism Changes in the Small Incision Versus Microincision After SMILE

Corneal Surface Irregularity and Surgically Induced Astigmatism Changes in the Small Incision Versus Microincision After SMILE

Biomechanics of a Plant-Derived Sealant for Corneal Injuries

Comparative Evaluation of the Visual and Refractive Outcomes Following SMILE, FS-LASIK, and T-PRK Surgery: A Retrospective, Non-Blinded Clinical Study

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