Review of Corneal Biomechanical Properties Following LASIK and SMILE for Myopia and Myopic Astigmatism

Damgaard, Iben Bach; Reffat, Mohamed; Hjortdal, Jesper

doi:10.2174/1874364101812010164

Cited by 37 publications

(31 citation statements)

References 55 publications

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“…Corneal biomechanical property changes can occur before the diagnosis of corneal ectasia, which is characterized by changes in corneal geometric features [17]. To evaluate corneal biomechanics, the most widespread devices at the time of writing are ocular response analyzer (ORA) and Corvis ST system (CST) [18, 19]. Both of them are non-contact tonometry and share some common principle: an air pulse is produced and projects to the cornea, then a set of different variables are generated related to the cornea deformation [20].…”

Section: Introductionmentioning

confidence: 99%

Corneal biomechanical properties after SMILE versus FLEX, LASIK, LASEK, or PRK: a systematic review and meta-analysis

2019

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Background The aim of this study was to compare the postoperative corneal biomechanical properties between small incision lenticule extraction (SMILE) and other corneal refractive surgeries. Methods A systematic review and meta-analysis were conducted. Articles from January 2005, to April 2019, were identified searching PubMed, EMBASE, Web of Science, and International Clinical Trials Registry Platform. Studies that compared SMILE with other corneal refractive surgeries on adult myopia patients and evaluated corneal biomechanics were included. Multiple effect sizes in each study were combined. Random-effects model was conducted in the meta-analysis. Results Twenty-two studies were included: 5 randomized controlled trials (RCTs), 9 prospective and 6 retrospective cohort studies, and 2 cross-sectional studies. Using the combined effect of corneal hysteresis (CH) and corneal resistance factor (CRF), which were obtained from ocular response analyzer (ORA), the pooled Hedges’ g of SMILE versus femtosecond laser-assisted in situ keratomileusis (FS-LASIK) was 0.41 (95% CI, 0.00 to 0.81; p = 0.049; I 2 = 78%), versus LASIK was 1.31 (95% CI, 0.54 to 2.08; p < 0.001; I 2 = 77%), versus femtosecond lenticule extraction (FLEX) was − 0.01 (95% CI, − 0.31 to 0.30; p = 0.972; I 2 = 20%), and versus the group of photorefractive keratectomy (PRK) and laser-assisted sub-epithelial keratectomy (LASEK) was − 0.26 (95% CI, − 0.67 to 0.16; p = 0.230; I 2 = 54%). The summary score of Corvis ST (CST) after SMILE was comparable to FS-LASIK/LASIK with the pooled Hedges’ g = − 0.05 (95% CI, − 0.24 to 0.14; p = 0.612, I 2 = 55%). Conclusions In terms of preserving corneal biomechanical strength after surgeries, SMILE was superior to either FS-LASIK or LASIK, while comparable to FLEX or PRK/LASEK group based on the results from ORA. More studies are needed to apply CST on evaluating corneal biomechanics after refractive surgeries. Electronic supplementary material The online version of this article (10.1186/s12886-019-1165-3) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Corneal biomechanical properties after SMILE versus FLEX, LASIK, LASEK, or PRK: a systematic review and meta-analysis

2019

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“…In SMILE, femtosecond laser is used to cut out a piece of intrastromal lenticule, which is then removed through a small opening created by a minor incision. As SMILE does not involve the creation of corneal flap, it offers better preservation of the corneal biomechanical strength compared to LASIK [ 140 ].…”

Section: Lutein Supplementation and Myopiamentioning

confidence: 99%

Lutein Supplementation for Eye Diseases

Lee

Leung

et al. 2020

Nutrients

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Lutein is one of the few xanthophyll carotenoids that is found in high concentration in the macula of human retina. As de novo synthesis of lutein within the human body is impossible, lutein can only be obtained from diet. It is a natural substance abundant in egg yolk and dark green leafy vegetables. Many basic and clinical studies have reported lutein’s anti-oxidative and anti-inflammatory properties in the eye, suggesting its beneficial effects on protection and alleviation of ocular diseases such as age-related macular degeneration, diabetic retinopathy, retinopathy of prematurity, myopia, and cataract. Most importantly, lutein is categorized as Generally Regarded as Safe (GRAS), posing minimal side-effects upon long term consumption. In this review, we will discuss the chemical structure and properties of lutein as well as its application and safety as a nutritional supplement. Finally, the effects of lutein consumption on the aforementioned eye diseases will be reviewed.

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“…21 Owing to the absence of a flap, SMILE thus results in less biomechanical impact on the cornea than LASIK. 22…”

Section: Enhancement Options From a Tissue Perspectivementioning

confidence: 99%

Enhancement Options After Myopic Small-Incision Lenticule Extraction (SMILE): A Review

Luft

Priglinger

Dirisamer

2019

Asia-Pacific Journal of Ophthalmology

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Purpose:To provide an overview of the currently available retreatment methods after myopic small-incision lenticule extraction (SMILE).Design:Systematic literature review.Methods:The PubMed library was searched for articles containing the terms “small-incision lenticule extraction” and “enhancement” or “retreatment”. The last search was performed on May 1, 2019.Results:In contrast to laser in-situ keratomileusis (LASIK), which can be retreated by a flap relift, repeat SMILE retreatment is currently not approved and only seldomly performed. As substitutes, surface ablation, cap-to-flap conversion using the CIRCLE program in the VisuMax platform, and thin-flap LASIK have been recently established. While all options offer safety and efficacy comparable to LASIK retreatments, each has its patient-specific advantages and disadvantages. While surface ablation preserves the flap-free approach of the primary procedure, the aspect of pain and a slow visual recovery might render it less attractive as compared with CIRCLE and thin-flap LASIK which offer quick recovery, however at the price of flap creation. Besides, each retreatment method generates specific tissue responses and has a different impact on corneal biomechanics, which is strongly dependent on the previous SMILE parameters, especially the cap thickness.Conclusions:Refractive enhancement after SMILE is currently mostly performed by surface ablation, CIRCLE cap-to-flap conversion or thin-flap LASIK, which all offer safety and efficacy comparable to LASIK retreatments. In this review, a detailed overview over each method, its technical aspects, and specific advantages and disadvantages is given.

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Review of Corneal Biomechanical Properties Following LASIK and SMILE for Myopia and Myopic Astigmatism

Cited by 37 publications

References 55 publications

Corneal biomechanical properties after SMILE versus FLEX, LASIK, LASEK, or PRK: a systematic review and meta-analysis

Corneal biomechanical properties after SMILE versus FLEX, LASIK, LASEK, or PRK: a systematic review and meta-analysis

Lutein Supplementation for Eye Diseases

Enhancement Options After Myopic Small-Incision Lenticule Extraction (SMILE): A Review

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