Refractive and visual outcomes of small incision lenticule extraction (SMILE) in eyes with thin corneas

Kabakcı, Aslı Kırmacı; Yıldız, Burçin Kepez; Yıldırım, Yusuf; Ağca, Alper; Yilmaz, Fevziye Ondes; Demir, Gökhan; Aygün, Beril Tülü; Demirok, Ahmet

doi:10.1038/s41433-020-01256-5

Cited by 10 publications

(7 citation statements)

References 32 publications

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“…At the same time, at 24 months follow up, higher rates of HOA were reported. It should also be noted that a corneal thickness of < 475 μm is among the contraindications for SMILE surgery [ 17 ]. Ganesh et al (2015) published an efficacy and safety study of SMILE combined with collagen crosslinking in patients with thin corneas (mean central corneal thickness of 501.3 ± 25.9 μm) and borderline corneal topography ( n = 40 eyes).…”

Section: Discussionmentioning

confidence: 99%

Visual Outcomes of Small-Incision Lenticule Extraction (SMILE) in Thin Corneas

Эскина

Klokova

Damashauskas

et al. 2022

JCM

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We aimed to find out whether thin (≤500 μm) or normal (>500 μm, control) corneal thickness would impact efficacy and safety outcomes of small-incision lenticule extraction (SMILE). We retrospectively analyzed medical records of adult patients who had undergone SMILE. A total of 57 eyes were included in the “thin corneas” group and 180 eyes in the “control” group. At one month after surgery, rates of patients with uncorrected distance visual activity (UDVA) ≥ 0.8 were significantly higher in patients from the control group compared to the “thin corneas” group (87 vs. 71%, respectively p < 0.01), though rates were comparable at 3 months (87 vs. 76%, respectively, p > 0.05). SMILE had comparable safety in patients with thin and normal corneas. Procedure result predictability was comparable between groups. Regression analysis demonstrated that cap thickness impacted posterior corneal biomechanics, and the volume of removed tissue had a higher influence in patients with thin corneas. Moreover, an increase in cap thickness was associated with better final BCVA. Further study is needed for the evaluation of the impact of thin corneas on SMILE outcomes and planning. Our study also indicates that patients with thin corneas might require a different approach to nomogram calculation.

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Section: Discussionmentioning

confidence: 99%

Visual Outcomes of Small-Incision Lenticule Extraction (SMILE) in Thin Corneas

Эскина

Klokova

Damashauskas

et al. 2022

JCM

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“…A comparative study between SMILE and LASIK revealed that approximately 90%-95% of patients achieved uncorrected distance visual acuity of 20/20 within the initial day following SMILE surgery [ 21 ]. SMILE's visual recovery process is notably swifter than LASIK [ 21 ]. Studies examining SMILE in patients with thin corneas have demonstrated its safety and efficacy in treating myopia, yielding satisfactory outcomes [ 21 , 22 ].…”

Section: Reviewmentioning

confidence: 99%

“…SMILE's visual recovery process is notably swifter than LASIK [ 21 ]. Studies examining SMILE in patients with thin corneas have demonstrated its safety and efficacy in treating myopia, yielding satisfactory outcomes [ 21 , 22 ]. However, visual outcomes in individuals with thin corneas may lag slightly behind those with average corneal thickness [ 22 ].…”

Section: Reviewmentioning

confidence: 99%

Comparative Analysis of Visual Outcomes and Complications in Intraocular Collamer Lens, Small-Incision Lenticule Extraction, and Laser-Assisted In Situ Keratomileusis Surgeries: A Comprehensive Review

Swaminathan,

Daigavane

2024

Cureus

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This review provides a comparative analysis of visual outcomes and complications associated with three prominent refractive surgical techniques: intraocular collamer lens (ICL) implantation, small-incision lenticule extraction (SMILE), and laser-assisted in situ keratomileusis (LASIK). Refractive surgeries aim to correct myopia, hyperopia, and astigmatism, offering patients an alternative to corrective lenses. The review highlights the importance of comparing these procedures to guide clinical decision-making effectively. Each technique is described, emphasizing its unique advantages and considerations. While LASIK remains widely favored for its rapid visual recovery and high patient satisfaction, ICL is suitable for patients with higher refractive errors or corneal irregularities. Although relatively newer, SMILE shows promise with potential benefits such as corneal biomechanical stability and a reduced risk of dry eye syndrome. However, each procedure carries its distinct complications, reinforcing the need for personalized patient care and informed decision-making. Understanding these techniques' relative efficacy and safety profiles is essential for optimizing outcomes and enhancing patient satisfaction. Continued advancements in technology and surgical techniques promise further improvements in refractive surgery outcomes, underscoring the importance of ongoing research and innovation.

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“…There was no difference between the 1, 3, and 6mo results in the right and left eyes (P=0.15, P=0.16, respectively). DISCUSSION Since SMILE was first announced, it has opened a new horizon of refractive surgery [6,[15][16][17] . It is known that the visual acuity results are comparable to those of conventional surgery, but there have been studies showing that astigmatism and highorder aberration results are inferior [18][19] .…”

Section: Measuring Cyclotorsion In Smilementioning

confidence: 99%

Simple method of measuring ocular rotation in supine position during small incision lenticule extraction

Song¹,

Jung²,

Kim³

2022

Int J Ophthalmol

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AIM: To introduce a novel measurement method of static cyclotorsion in small incision lenticule extraction (SMILE) and to investigate the effect of preoperative parameters on cyclotorsion and the effect of cyclotorsion on postoperative outcomes. METHODS: The medical records of 242 patients and 484 eyes who underwent SMILE surgery were retrospectively reviewed. Preoperative intraocular pressure, refractive error, and corneal thickness were investigated. Refractive values and visual acuity were measured at 1d, 1, 3, and 6mo. Ocular cyclotorsion in the supine position was measured by calculating the location and angle of the incision site of the cornea in the anterior slit photograph taken after surgery. RESULTS: Of the total 484 eyes in 242 patients, preoperative mean spherical equivalent (SE) was -4.10±1.64 D, and the mean astigmatism was -0.82±0.74 D. Uncorrected distance visual acuity (UCVA) and SE improved significantly after the surgery. Moreover, 219 (45.2%) eyes had excyclotorsion, 235 (48.6%) eyes had incyclotorsion, and 30 (6.2%) eyes had no torsion. The right eyes tended to be excyclotorted, and the left eyes tended to be incyclotorted (P<0.01). The mean cyclotorsion was 1.18°±3.69°, and the mean absolute value of cyclotorsion was 3.14°±2.26°. The range of cyclotorsion was 0.5°–11.4°. It was found that the smaller the preoperative sphere, the higher the amount of cyclotorsion (r=0.11, P=0.016). There was no significant association between the amount of cyclotorsion and preoperative astigmatism. There was no correlation between sex, preoperative corneal thickness, preoperative intraocular pressure, amount of cyclotorsion, and direction of cyclotorsion. The ratio of right eye excyclotorsion and left eye incyclotorsion on 1d was higher than that at 1, 3, and 6mo (all P<0.01). There was no difference between the 1, 3, and 6mo results in the right and left eyes (P=0.15, P=0.16, respectively). CONCLUSION: The newly devised ocular cyclotorsion measurement method can be used to evaluate ocular cyclotorsion after SMILE. Preoperative SE is associated with the amount of cyclotorsion, however, cyclotorsion doesn’t have a significant effect on the results of SMILE surgery.

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Refractive and visual outcomes of small incision lenticule extraction (SMILE) in eyes with thin corneas

Abstract: Objectives To report the refractive and visual outcomes of small incision lenticule extraction (SMILE) with the thinnest corneal thickness (CCT) of less than 500 µm and evaluate it in terms of safety and efficacy.

Cited by 10 publications

References 32 publications

Visual Outcomes of Small-Incision Lenticule Extraction (SMILE) in Thin Corneas

Visual Outcomes of Small-Incision Lenticule Extraction (SMILE) in Thin Corneas

Comparative Analysis of Visual Outcomes and Complications in Intraocular Collamer Lens, Small-Incision Lenticule Extraction, and Laser-Assisted In Situ Keratomileusis Surgeries: A Comprehensive Review

Simple method of measuring ocular rotation in supine position during small incision lenticule extraction

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