SMILE : correction de la myopie par ablation réfractive par laser femtoseconde d’un lenticule intracornéen

Albou-Ganem, C.; Lavaud, Arnold; Amar, Ranawat

doi:10.1016/j.jfo.2014.11.001

“…In FLEx, a corneal flap is created by the FS laser (similar to LASIK) and lifted, allowing lenticule removal [ 1 – 3 ]. For SMILE, a truly flapless procedure, only a small—2–4mm—incision is made, through which the lenticule is removed [ 4 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Early Changes in Ocular Surface and Inflammatory Mediators between Femtosecond Lenticule Extraction and Small-Incision Lenticule Extraction

Zhang

¹

,

Ding

²

,

He

³

et al. 2016

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PurposeTo evaluate the short-term changes in ocular surface measures and tear inflammatory mediators after femtosecond lenticule extraction (FLEx) and small-incision lenticule extraction (SMILE) procedures.MethodsEighteen subjects (18 eyes) underwent FLEx and 23 subjects (23 eyes) underwent SMILE in this single-center and prospective study. Central corneal sensitivity, Schirmer I test (SIT), noninvasive tear breakup time (NI-TBUT), tear meniscus height, corneal fluorescein (FL) staining, and ocular surface disease index (OSDI) were assessed in all patients. Concentrations of interleukin-1α (IL-1α), tumor necrosis factor-α (TNF-α), nerve growth factor (NGF), interferon-γ (IFN-γ), transforming growth factor-β1 (TGF-β1) and matrix metalloproteinase-9 (MMP-9) in collected tears were measured by multiplex antibody microarray.ResultsCentral corneal sensitivity was reduced in both groups, but the scores in the SMILE group were higher than those in the FLEx group at all time points postoperatively (P<0.01). Lower FL scores and longer NI-BUT were observed in the SMILE group 1 week after surgery (P<0.05). OSDI scores in both groups increased rapidly at 1 day and 1 week postoperatively, then returned to their preoperative levels within 1 month (P<0.05). There were no significant differences in SIT or tear meniscus height between the two groups. Lower and faster recovery of tear NGF, TGF-β1 and IL-1α concentration were found in the SMILE group compared to the FLEx group postoperatively. No significant difference was found in tear TNF-α, IFN-γ and MMP-9 for either group before or after surgery. Tear NGF, TGF-β1 and IL-1α show a correlation with ocular surface changes after FLEx or SMILE surgery.ConclusionSMILE has superiority over FLEx in early ocular surface changes and NGF, TGF-β1 and IL-1α may contribute to the process of ocular surface recovery.Trial RegistrationClinicalTrials.gov NCT02540785

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“…However, due to the preciousness of human cornea, it was impossible to carry out experimental studies on fresh corneal materials. A large number of clinical studies have proved that SMILE surgery produces safe, effective, predictable, and stable outcomes in the correction of myopia and astigmatism [19][20][21]. In addition, for the study of corneal biomechanics, this operation provides fresh corneal material; and this has created a new stage in corneal biomechanics research.…”

Section: Discussionmentioning

confidence: 99%

Direct Evidence of Symmetry between Bilateral Human Corneas in Biomechanical Properties: A Comparison Study with Fresh Corneal Tissue

Xue

¹

,

Xiang

²

,

Song

³

et al. 2021

Journal of Ophthalmology

1

0

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Purpose. To investigate the difference between the eyes from the same human with respect to the biomechanical properties of fresh corneal tissues and investigate the assumption of similarity of the corneal biomechanical properties between the eyes. Methods. Strip specimens extracted through a small incision lenticule extraction (SMILE) surgery were tested using a uniaxial tensile test. The specimens were extracted vertically. Low-strain tangent modulus (LSTM), high-strain tangent modulus (HSTM), and tensile strength ( σ b ) were the biomechanical parameters used in the comparison of the eyes from the same human. Results. Ninety corneal specimens from 45 persons were included in this study. The LSTM of the left and right eyes were 1.34 ± 0.52 and 1.37 ± 0.46 MPa, while the HSTM were 50.53 ± 7.51 and 49.41 ± 7.01 MPa, respectively. There was no significant difference between the eyes in terms of LSTM, HSTM, and σ b P = 0.813 , 0.335 , and 0.605 , resp . . The LSTM and HSTM were significantly correlated with the spherical equivalent (SE) ( P ≤ 0.01 , P = 0.001 , resp.). Conclusions. The assumption that the corneal biomechanical properties of the eyes from the same human are similar has been confirmed for the first time using fresh human corneal tissue. This finding may be useful in further biomechanical studies.

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“…The treatment of pathological myopia aims at improving functional vision, as well as at slowing down the overall progression (Albou-Ganem et al, 2015;Nakagawa et al, 2000;Shen et al, 2015;Qian and Jiang, 2010).…”

Section: Treatmentmentioning

confidence: 99%

Structural and functional macular inter-ocular asymmetry in patients with high myopia

Alzaben

0

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BACKGROUND: Retinal evaluation performed in the optometry clinic allows optometrists to track the prognosis of retinal disease and to assess anatomical and functional changes related to age and pathological and non-pathological conditions. OBJECTIVES: The purpose of this research was to investigate the normal range of inter-ocular asymmetry in retinal and choroidal thickness and in retinal sensitivity high myopia without ocular fundus manifestations and to determine the relationship between inter-ocular asymmetry and refractive error. METHODS: Forty-three patients (35 07 ± 13.31 years) with high myopia, and 45 healthy participants (39.9 ± 14.1 years) were administered an ocular coherence tomography and a microperimetry examination to determine retinal and choroidal thickness and retinal sensitivity at the foveal region and at 1, 2 and 3 mm, nasally, temporally, superiorly and inferiorly. Absolute inter-ocular differences were calculated to determine the normal range of asymmetry, in 95% confidence intervals. RESULTS: The choroid was thinner in the myopic group at all explored locations (all p < 0.05), with larger absolute inter ocular differences in most of the choroidal locations under evaluation (all p < 0.05). Similarly, retinal sensitivity was reduced in the myopic group, although statistically significant differences were only encountered at the subfoveal location (p = 0.001). Retinar sensitivity asymmetry was found to increase with refractive error. CONCLUSION: The expanded range of retinal and choroidal thickness, as well as retinal sensitivity asymmetry found in high myopia in the absence of disease is of relevance when exploring these patients for early signs of ocular pathology. Fundamento y objetivos: La evaluación de la retina que se realiza en la clínica optométrica permite a los optometristas evaluar el estado de la retina y explorar los cambios funcionales y anatómicos asociados a la edad y a condiciones patológicas y no patológicas. El objetivo de la presente tesis era investigar el rango normal de asimetría inter-ocular en espesor retiniano y coroideo y en sensibilidad retiniana en pacientes con miopía alta sin manifestaciones oculares y determinar la posible asociación entre asimetría y error refractivo. Métodos: Cuarenta y tres pacientes (35.07 ± 13.31 años) con miopía alta y 45 participantes sanos (39.9 ± 14.1 años) siguieron un examen con tomografía de coherencia óptica y microperimetría para determinar el espesor de la retina y la coroides y la sensibilidad en retina en la zona foveal y a 1, 2 y 3 mm, en los cuadrantes nasal, temporal, superior e inferior. Se calcularon las diferencias inter-oculares absolutas para determinar el rango normal de asimetría, y los intervalos de confianza al 95%. Resultados: La coroides presento mayor delgadez en el grupo de miopes en todas las zonas sometidas a examen (todas las p < 0.05), con mayores diferencias absolutas en términos de asimetría en la mayoría de las zonas exploradas (p < 0.05). Igualmente, la sensibilidad retiniana se encontró reducida en el grupo miope, si bien sólo se hallaron diferencias estadísticas en la zona subfoveal (p = 0.001). La asimetría en sensibilidad retiniana aumentaba con el error refractivo. Conclusiones: El rango extendido en asimetría en espesor de retina y coroides y en sensibilidad retiniana hallado en miopía alta sin afectación ocular es muy relevante en el momento de explorar estos pacientes para la detección de los primeros signos de patología ocular.

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SMILE : correction de la myopie par ablation réfractive par laser femtoseconde d’un lenticule intracornéen

Cited by 9 publications

References 22 publications

Comparison of Early Changes in Ocular Surface and Inflammatory Mediators between Femtosecond Lenticule Extraction and Small-Incision Lenticule Extraction

Comparison of Early Changes in Ocular Surface and Inflammatory Mediators between Femtosecond Lenticule Extraction and Small-Incision Lenticule Extraction

Direct Evidence of Symmetry between Bilateral Human Corneas in Biomechanical Properties: A Comparison Study with Fresh Corneal Tissue

Structural and functional macular inter-ocular asymmetry in patients with high myopia

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