Small incision lenticule extraction (SMILE) and femtosecond laser LASIK: comparison of corneal wound healing and inflammation

Dong, Zixian; Zhou, Xingtao; Wu, Jihong; Zhang, Zhehuan; Li, Tao; Zhou, Zimei; Zhang, Shenghai; Li, Gang

doi:10.1136/bjophthalmol-2013-303415

Cited by 141 publications

(97 citation statements)

References 24 publications

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“…[48][49][50] Comparative studies of postoperative corneal healing have shown significantly fewer inflammatory cells in corneas treated with femtosecond lenticule extraction/small-incision lenticule extraction than with femtosecond laser-assisted LASIK. 51,52 In the study by Riau et al, 52 a statistically significant increase in inflammatory cells was observed when higher spherical corrections were attempted (À6.00 D to À9.00 D) with femtosecond laser-assisted LASIK than with femtosecond lenticule extraction/small-incision lenticule extraction. A greater proportion of ablated tissue during higher refractive corrections and increased energy absorption from the excimer laser were suggested as probably explanations for the differences.…”

Section: Postoperative Inflammationmentioning

confidence: 93%

Small-incision lenticule extraction

Moshirfar¹,

McCaughey²,

Reinstein³

et al. 2015

Journal of Cataract and Refractive Surgery

177

116

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Section: Postoperative Inflammationmentioning

confidence: 93%

Small-incision lenticule extraction

Moshirfar¹,

McCaughey²,

Reinstein³

et al. 2015

Journal of Cataract and Refractive Surgery

177

116

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“…Similarly, CCT, Kf, Ks, and Km also did not regain its stability at 3 months except in corneal biomechanics. When compared with SMILE, FS-LASIK induced more keratocyte apoptosis, proliferation, and inflammation, 31 so IOP values after FS-LASIK seemed less stable, which may be a result of corneal structure variation.…”

Section: Discussionmentioning

confidence: 99%

Intraocular Pressure Changes and Relationship With Corneal Biomechanics After SMILE and FS-LASIK

Wang

Dou

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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Citation: Li H, Wang Y, Dou R, et al. Intraocular pressure changes and relationship with corneal biomechanics after SMILE and FS-LASIK. Invest Ophthalmol Vis Sci. 2016;57:4180-4186. DOI:10.1167/iovs.16-19615 PURPOSE. The purpose of this article was to evaluate intraocular pressure (IOP) changes and investigate the relationship with corneal biomechanics after small-incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK). METHODS.A total of 193 eyes of 193 patients who underwent SMILE and FS-LASIK procedures were included in this retrospective study. Data were collected preoperatively and postoperatively, including Goldmann-correlated IOP (IOPg), corneal-compensated IOP (IOPcc), corneal hysteresis (CH), and corneal resistance factor (CRF) by ocular response analyzer, noncontact intraocular pressure (IOP NCT ) by noncontact tonometer, and Ehlers, Shah, Dresden, Kohlhaas, Orssengo/Pye by the Pentacam corrected system. Changes in both groups and differences between groups were evaluated. Multiple linear regression models were constructed to explore factors influencing IOP changes.RESULTS. In SMILE, the IOPg, IOPcc, IOP NCT , and Kohlhaas decreased significantly at 1 month postoperatively (P < 0.01), whereas with the Ehlers formula they significantly increased (P < 0.01). IOPs decreased at 3 and 6 months compared with all preoperative values except Ehlers values (P < 0.01), but there was no significant difference between 3 and 6 months (P > 0.05). In FS-LASIK, the IOPg, IOPcc, and IOP NCT decreased significantly at 1 month (P < 0.01), whereas in the Ehlers and Shah formulas they significantly increased (P < 0.01). Compared with preoperative values, the IOPs decreased at 3 and 6 months except in the Ehlers and Shah formulas (P < 0.01). Only IOPg and IOPcc differed between 3 and 6 months (P < 0.05). The Ehlers and Shah formulas were closer to the preoperative IOP for both groups, with variation approximately 1 mm Hg at 6 months postoperatively. Preoperative IOP, postoperative corneal resistance factor, corneal hysteresis, and flat keratometry were enrolled into the regression equations.CONCLUSIONS. IOP underestimation after SMILE or FS-LASIK was related to corneal biomechanics as well as preoperative IOP and flat keratometry. IOP after SMILE seem to remain more stable. Accordingly, the Ehlers and Shah formulas were closer to the preoperative IOP. It may be useful to estimate future IOP with the best-fit models after surgery.

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“…The ReLEx SMILE method leads to a release of energy only during creation of the refractive lenticule and sidecut. In contrast, femto-LASIK surgery has manifold higher energy requirements needed for photoablation of the entire mass of removed stromal surface 30 . Last but not least, ReLEx SMILE saves time, because it is not necessary to transport the patient to another laser during surgery.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the efficiency of femtoLASIK and ReLEx SMILE in terms of dioptric error reduction

Pavkova¹,

Kacerovská²,

Kacerovsky³

2018

BIOMED PAP

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Background and Aims. Refractive eye surgery is a rapidly expanding field of ophthalmology and corneal surgery is undergoing constant development leading to less invasive technologies. The goal of this study was to compare the most common femtoLASIK surgery with the newer ReLEx SMILE surgery which is gentler to the cornea. The comparison was made in terms of dioptric error reduction. Methods. The studied cohort of patients consisted of two major groups: 30 patients who underwent femtoLASIK surgery and 30 who underwent ReLEx SMILE surgery. -30 patients, 60 eyes. All patients were aged 18-45 years with moderate myopia or astigmatism ranging from -3.25 to -6.0 spherical diopters and from 0 to -1.0 cylindrical diopters. In all, the best corrected visual acuity measured prior to surgery was 1.0. Pachymetry was not comparable because each surgical method was performed at a different time point and the introduction of an innovative method into practice led to a change in selection criteria. Results. During postsurgical check-ups, the ReLEx SMILE method (0.74) led to lower values of non-corrected visual acuity compared to the femtoLASIK method (0.88), (P<0.001). However, the results changed at the one-year post-surgery check-up, when ReLEX SMILE patients achieved non-corrected visual acuity of 0.97 compared to femtoLASIK patients, who scored 0.83, (P=0.007). Based on data analysis from the automatic refractometer, the average spherical diopters of the femtoLASIK (-0.32 D) were higher than those of the ReLEx SMILE (-0.07 D), (P<0.001). The results for the cylindrical diopters were also significant, (P=0.021). When we compared the spherical equivalent one year after surgery, the difference between methods was significant. The FemtoLASIK method resulted in an average SE -0.55 D compared to -0.09 D for the ReLEx SMILE method, (P<0.001). Conclusion. This study showed that there was a significant difference in results between the two surgical methods of treatment of moderate myopia and astigmatism, in terms of regression of dioptric error, as well as in achievement and maintenance of visual acuity during the observed period. The ReLEx SMILE had better results.

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Small incision lenticule extraction (SMILE) and femtosecond laser LASIK: comparison of corneal wound healing and inflammation

Cited by 141 publications

References 24 publications

Small-incision lenticule extraction

Small-incision lenticule extraction

Intraocular Pressure Changes and Relationship With Corneal Biomechanics After SMILE and FS-LASIK

Comparison of the efficiency of femtoLASIK and ReLEx SMILE in terms of dioptric error reduction

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