Three-year clinical outcomes and posterior corneal elevation change after small-incision lenticule extraction in suspicious corneas

Cao, Huazheng; Zhang, Lin; Liang, Shuang; Li, Mengdi; Jhanji, Vishal; Wang, Yan

doi:10.1097/j.jcrs.0000000000000849

Cited by 3 publications

(1 citation statement)

References 29 publications

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“…(21) In eyes with suspicious tomographic features that underwent SMILE, the 3-year change in PCE was − 1.22, indicating no forward displacemen. (22) Interestingly, in another study comparing posterior corneal elevation changes in eyes 10 years after laser in situ keratomileusis (LASIK) to unoperated normal eyes, the results revealed that points in the central 2 mm zone showed backward displacement after LASIK while increasing change in normal eyes. (23) Investigators have attributed this to hyperopic shift after corneal laser surgery: removal of central corneal tissue in corneal refractive surgery leads to relaxation of the peripheral corneal lamella, resulting in redistribution of corneal biomechanical balance.…”

Section: Discussionmentioning

confidence: 99%

Posterior corneal stability after small incision lenticule extraction with different optical zones

Yu,

Cheng,

Zhao

et al. 2023

Preprint

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Background: To assess the changes in the posterior corneal surface following small incision lenticule extraction (SMILE) with different optical zones. Methods: In this retrospective study, 106 eyes of 106 patients who underwent SMILE were recruited 3 years after the procedure. Eyes were divided into two groups according to the size of the surgical optical zone: group A (52 eyes, ≤ 6.2 mm) and group B (54 eyes, ≥ 6.5 mm). Posterior central elevation (PCE) and 12 other points at 45°, 135°, 225° and 315° with distances of 1 mm, 2 mm and 3 mm from the centre were recorded from Pentacam. Results: No iatrogenic keratectasia was identified, and eyes in the two groups showed comparable visual results. The overall trend in posterior corneal elevation changes was consistent for both groups. PCE decreased significantly from 1.33±2.32 to 0.75±2.41 in group A (P=0.024) and from 0.87±2.61 to 0.06±2.74 in group B (P=0.003). All points in the central 2 mm region in both groups were reduced postoperatively. In the 4 mm and 6 mm corneal annulus, almost all points at 225°and 315°showed backward displacement, with the most prominent change occurring at 315°in the 6 mm annulus (P<0.001), indicating no forward protrusion in the inferior area. Conclusions: No forward protrusion in the posterior corneal surface was observed 3 years after SMILE with different optical zones. Comprehensive preoperative measurements are essential for ensuring corneal stability and avoiding iatrogenic keratectasia.

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Section: Discussionmentioning

confidence: 99%

Posterior corneal stability after small incision lenticule extraction with different optical zones

Yu,

Cheng,

Zhao

et al. 2023

Preprint

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Correlation between the ablation ratio and posterior corneal stability after small incision lenticule extraction for high myopia

Yang

Liu

Zhou

et al. 2023

Graefes Arch Clin Exp Ophthalmol

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Purpose The aim of this study is to investigate changes in posterior corneal elevation and their correlations with the ablation ratio 3 years after small incision lenticule extraction (SMILE) for high myopia. Methods Eighty eyes underwent SMILE were enrolled in this study. Eyes were classified into two groups based on the ablation ratio (AR, lenticule thickness from SMILE machine/thinnest corneal thickness): group A (< 25%, 40 eyes) and group B (≥ 25%, 40 eyes). Pentacam was used to measure the posterior corneal elevation at the central point, thinnest point, and posterior maximum elevation (PME) and the mean posterior elevation in the central 2-mm area (MPE-2 mm), 4-mm area, and 6-mm area at the 3-year follow-up. Results More than 85% of the eyes had an AR of less than 27%, and no cases of iatrogenic keratectasia developed. In both groups, for central region, posterior elevation decreased implying backward displacement; for peripheral region, it increased indicating forward trend. There was no significant difference in changes in all determined parameters between the two groups (P ≥ 0.07). Moreover, no significant correlation was noted between AR and posterior elevation changes. In group A, decreasing changes in PME (r = − 0.42, P = 0.01) and MPE-2 mm (r = 0.40, P = 0.01) demonstrated negative correlations with residual bed thickness. Conclusion Region-dependent changes were demonstrated in the eyes that underwent SMILE. The central area showed a subtly declining posterior elevation, and the peripheral area showed a slightly increasing elevation. The limited ablation ratio had no impact on the changes in posterior corneal elevation.

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Posterior corneal stability after small incision lenticule extraction with different optical zones

Cheng,

Zhao,

et al. 2024

Eye

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Background: To assess the changes in the posterior corneal surface following small incision lenticule extraction (SMILE) with different optical zones.Methods: In this retrospective study, 106 eyes of 106 patients who underwent SMILE were recruited 3 years after the procedure. Eyes were divided into two groups according to the size of the surgical optical zone: group A (52 eyes, ≤ 6.2 mm) and group B (54 eyes, ≥ 6.5 mm). Posterior central elevation (PCE) and 12 other points at 45°, 135°, 225° and 315° with distances of 1 mm, 2 mm and 3 mm from the centre were recorded from Pentacam.Results: No iatrogenic keratectasia was identi ed, and eyes in the two groups showed comparable visual results. The overall trend in posterior corneal elevation changes was consistent for both groups. PCE decreased signi cantly from 1.33±2.32 to 0.75±2.41 in group A (P=0.024) and from 0.87±2.61 to 0.06±2.74 in group B (P=0.003). All points in the central 2 mm region in both groups were reduced postoperatively. In the 4 mm and 6 mm corneal annulus, almost all points at 225°and 315°showed backward displacement, with the most prominent change occurring at 315°in the 6 mm annulus (P<0.001), indicating no forward protrusion in the inferior area.Conclusions: No forward protrusion in the posterior corneal surface was observed 3 years after SMILE with different optical zones. Comprehensive preoperative measurements are essential for ensuring corneal stability and avoiding iatrogenic keratectasia.

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Three-year clinical outcomes and posterior corneal elevation change after small-incision lenticule extraction in suspicious corneas

Abstract: This long-term study found that the safety and efficacy outcomes and posterior corneal elevation changes after SMILE is similar in eyes with suspicious tomographic features to that in normal eyes.

Cited by 3 publications

References 29 publications

Posterior corneal stability after small incision lenticule extraction with different optical zones

Posterior corneal stability after small incision lenticule extraction with different optical zones

Correlation between the ablation ratio and posterior corneal stability after small incision lenticule extraction for high myopia

Posterior corneal stability after small incision lenticule extraction with different optical zones

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