scholarly journals Clinical Observation of Silicon Hydrogel Contact Lens Fitted Immediately after Small Incision Lenticule Extraction (SMILE)

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Jifang Wang ◽  
Shuxin Xi ◽  
Bingjie Wang ◽  
Zhi Chen ◽  
Ke Zheng ◽  
...  
Keyword(s):  
Contact Lenses ◽  
Patient Comfort ◽  
Controlled Study ◽  
Corneal Oedema ◽  
Small Incision Lenticule Extraction ◽  
Blurred Vision ◽  
Small Incision ◽  
Lenticule Extraction ◽  
Group B ◽  
Silicon Hydrogel

Purpose. To examine the immediate use of bandage contact lenses (BCLs) for improving patient comfort after small incision lenticule extraction (SMILE) surgery. Methods. This is a prospective randomized controlled study in which one hundred and seventy-eight patients undergoing SMILE were randomly allocated to three groups: group A wore BCLs for 8 hours postsurgery, group B wore BCLs for 24 hours postsurgery, and group C did not wear any BCLs postsurgery. Eight subjective symptoms including photophobia, tearing, pain, foreign body sensation, burning, blurred vision, sting, and dry eyes were prospectively evaluated at 2 hours, 4 hours, 8 hours, and 24 hours, using a questionnaire with a total score of 24. The scores of symptoms and signs were compared between the three groups. Results. There was a statistically significant time effect on scoring, which implicated a decline in symptoms over time after surgery (P<0.001). There was also a significant interaction between time and the treatment group (P<0.01). The total symptom score of groups A and B (5.85 ± 3.97 and 5.99 ± 4.67, respectively) was significantly lower than that of group C at 2 hours postsurgery (7.35 ± 4.86, P<0.05), especially in tearing and pain (P<0.05). The level of corneal oedema at 24 hours postsurgery was also statistically significantly different between the three groups (P<0.001), and the post hoc test showed that groups A and B were lower than group C (P<0.01). Conclusion. Silicon hydrogel BCLs applied immediately after SMILE surgery can relieve postsurgical symptoms of tearing and pain, improving overall patient comfort, and reduce corneal oedema. This trial is registered with ChiCTR-ONRC-13003114. Precis. The application of silicone hydrogel bandage contact lenses immediately after SMILE surgery has the potential to improve patient comfort, corneal healing, and patient satisfaction following SMILE.

scholarly journals Comparison of early visual quality in patients with moderate myopia using different optical zones in small incision lenticule extraction (SMILE)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan Wu ◽  
Zhenping Huang
Keyword(s):  
Visual Acuity ◽  
Night Vision ◽  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Spatial Frequencies ◽  
Significant Difference ◽  
Group A ◽  
Optical Zone ◽  
Lenticule Extraction ◽  
Group B

Abstract Background The early visual qualities of patients with moderate myopia were evaluated after small incision lenticule extraction (SMILE) using different optical zones. Methods In this retrospective case study, 27 cases (51 eyes) were selected, including 10 cases in Group A (19 eyes), 6.6–6.8 mm in the optical zone, 10 cases in Group B (19 eyes), 6.4–6.5 mm in the optical zone, and 7 cases in Group C (13 eyes),6.1–6.3 mm in the optical zone. The following items were examined preoperatively and 1 month postoperatively: uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), spherical, cylinder, central corneal thickness (CCT), corneal mean curvature (CMC), total ocular aberrations (TA), total low order aberrations (tLOAs), defocus, astigmatism and total high order aberrations (tHOAs), spherical, coma, trefoil, modulation transfer function (MTF), MTFcutoff, SR, objective scatter index (OSI), point scatter function at 50 and 10% (PSF50%, PSF10%), and contrast visual acuity of 100, 20, and 9% (VA100%, VA20%, and VA9%). We compared the three groups by Kruskal-Wallis test. Wilcoxon signed ranks test was used for each group before and 1 month after surgeries. P< 0.05 was considered statistically significant. Results There was no significant difference in UCVA, BCVA, CCT, cylinder, and CMC in three groups preoperatively and 1 month postoperatively (P> 0.05). Comparison of the aberrations of the three groups showed statistically significant difference only in TA, tLOA, defocus, astigmatism and SA preoperatively, and trefoil 1 month postoperatively(P< 0.05). The postoperative TA, tLOAs, defocus, astigmatism and trefoil of the three groups were lower than those before surgeries (P< 0.05). The postoperative tHOAs of Group B and C was lower than those before surgeries (P< 0.05). The MTF results showed that before surgeries, there were significant differences in three groups (P< 0.05) in spatial frequencies 5~15 cycles per degree (cpd), and no differences in 20~30 cpd(P> 0.05), while no difference were observed in all spatial frequencies postoperatively (P> 0.05). Comparing the preoperative and postoperative MTF values for each group, the results showed that there was a significant difference in Group C at 5~20 cpd after surgeries(P< 0.05). There was no significant difference in MTFcutoff, SR, OSI, PSF50%, PSF10%, VA100%, VA20%, and VA9% in the three groups preoperatively (P> 0.05). One month after surgeries, higher VA9% values were measured for Group C compared to Group A and B (P < 0.05). There was no significant difference in each group before and after surgeries (P> 0.05). Conclusion SMILE could improve the visual qualities of patients with moderate myopia. Reducing the surgical optical zone will only affect night vision slightly.

scholarly journals Effect of corneal stromal pocket irrigation in small-incision lenticule extraction

Eye ◽  
2020 ◽  
Vol 34 (12) ◽  
pp. 2328-2335 ◽  
Author(s):  
Han Wang ◽  
Hui Ding ◽  
Bo-wen Ouyang ◽  
Zhenduo Yang ◽  
Tan Zhong ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cell Number ◽  
Controlled Study ◽  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Uncorrected Distance Visual Acuity ◽  
Significant Difference ◽  
Lenticule Extraction ◽  
Prospective Controlled Study ◽  
Anterior Oct

Abstract Objectives To investigate the effect of corneal stromal pocket irrigation after small-incision lenticule extraction (SMILE) on visual acuity, intraocular pressure (IOP), corneal parameters and complications after surgery. Methods A total of 242 eyes of 121 patients undergoing SMILE were enrolled in this prospective controlled study, and it was designed for one eye to randomly undergo SMILE with balanced salt solution irrigation of the corneal stromal pocket, while the other eye was not. The uncorrected distance visual acuity (UDVA) and slit lamp examination were recorded at 1 hour, 1 day, 1 week, and 1 month. Postoperative corneal density, corneal biomechanical, corneal endothelial cell number, and anterior OCT images were compared at 1 day, 1 week, and 1 month. Results Compared with the nonirrigation group, the irrigation group showed significantly higher UDVA at 1 day postoperatively (P < 0.05), but there was no significant difference during the rest of the postoperative period (1 hour, 1 week, and 1 month). In addition, no significant differences were found in IOP, corneal density, corneal biomechanics, corneal endothelial cells, and corneal morphology. No visual decline or severe postoperative complications were found in the patients in this study. Conclusions Interlamellar irrigation did not affect IOP, corneal parameters, morphology, complications, or UDVA at 1 hour, 1 week, and 1 month after the operation, but it may promote UDVA 1 day after the operation.

scholarly journals Corneal Cap Thickness and Its Effect on Visual Acuity and Corneal Biomechanics in Eyes Undergoing Small Incision Lenticule Extraction

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Ting Liu ◽  
Ting Yu ◽  
Lina Liu ◽  
Kaijian Chen ◽  
Ji Bai
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Spherical Aberration ◽  
Corneal Thickness ◽  
Cutoff Frequency ◽  
Corneal Biomechanics ◽  
Controlled Study ◽  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Lenticule Extraction

Purpose. To evaluate the effect of corneal cap thickness on visual acuity and corneal biomechanics in small incision lenticule extraction (SMILE) for the treatment of myopia. Methods. Forty eyes of 20 patients undergoing SMILE for the treatment of myopia were enrolled in this prospective controlled study. The patients with 510 μm–560 μm central corneal thickness (CCT) and a refractive spherical equivalent of −3.00 D to −8.00 D were included. It was designed randomly to undergo SMILE with a 110 μm cap thickness in one eye and 150 μm cap thickness in the other. Ophthalmic examinations included best-corrected and uncorrected visual acuity (UCVA); refractive status, contrast sensitivity, and objective visual quality were evaluated at 2 h, 4 h, and 24 h postoperatively; while at 3 months after the procedure, corrected intraocular pressure (IOP), higher order aberrations (HOAs), and morphologic modifications of corneal architecture of both eyes were assessed. Results. Compared with the 150 μm group, the incidence of OBL was significantly higher in the 110 μm cap thickness group (P=0.004), and UCVA, Strehl ratio (SR), objective scatter index (OSI), modulation transfer function (MTF) cutoff frequency, and photopic and scotopic contrast sensitivity at medium spatial frequency were all significantly better in 110 μm group at 2 h and 24 h postoperatively (P<0.05). Corneal spherical aberration and corrected IOP by Corvis ST were significantly higher in the 110 μm group at 3 months postoperatively (P<0.05). No statistically significant differences were found in manifest refraction, UCVA, SR, OSI, MTF cutoff, and mesopic and photopic contrast sensitivity at low frequency, photopic contrast sensitivity at high frequency, endothelial density, corneal coma, and total HOAs at 3 months after the procedure. No visual decline was found in the patients in this study. Conclusions. Both 110 μm and 150 μm cap thickness in SMILE were safe and effective for treatment of myopia. A 110 μm cap thickness demonstrated better visual outcomes during early and late postoperative periods with higher corneal spherical aberration and corrected IOP at 3 months postoperatively. This trial is registered with ChiCTR-IOR-17013369.

Comparison of Early Visual Quality in Patients using Different Optical Zones Based on Dark Pupil Diameters in Small Incision Lenticule Extraction (SMILE)

2021 ◽  
Author(s):  
Jiao Peng ◽  
Ding-Juan Zhong ◽  
Jia Liu ◽  
Li-Yuan Zhang ◽  
Hao Wu ◽  
...  
Keyword(s):  
Pupil Diameter ◽  
Visual Quality ◽  
Higher Order ◽  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Group A ◽  
Optical Zone ◽  
Lenticule Extraction ◽  
The Difference ◽  
Group B

Abstract AIM: The early visual qualities of patients were evaluated after small incision lenticule extraction (SMILE) using different optical zones based on dark pupil diameters.METHODS: A case-control study was conducted to include 49 myopic patients (96 eyes) who underwent SMILE surgery. Patients were divided into three groups according to the difference between the diameter of the optical zone and the diameter of the dark pupil: Group A (<0 mm, N=30), Group B (0-1 mm, N=36), and Group C (>1 mm, N=30). In all groups, the dark pupil diameter was measured preoperatively. Subjective visual quality, uncorrected vision acuity (UCVA), spherical equivalent (SE), modulation transfer function cut-off frequency (MTFcutoff), objective scattering index (OSI), simulated contrast visual acuity (VA100%, VA20%, VA9%), total corneal higher-order aberration (tot-HOA), corneal spherical aberration (totZ40) and corneal coma (tot-coma) were measured preoperatively and 3 months postoperatively. P< 0.05 was considered statistically significant.RESULTS: There were no statistically significant differences in age, sex, UCVA, SE, corneal higher-order aberration, OQAS or subjective visual quality among the three groups before surgery (P>0.05). At 3 months postoperatively, there was no significant difference in UCVA, SE, MTFcutoff, OSI, VA100%, VA20%, or VA9% among the three groups (P>0.05). However, the tot-HOA, totZ40 and tot-coma indexes and the changes in corneal higher-order aberrations (Dtot-HOA, DtotZ40, Dtot-coma) at 3 months postoperatively were as follows: Group A > Group B > Group C (P<0.05). At 3 months postoperatively, the difference in subjective visual quality between the three groups was statistically significant (P<0.05). The difference in the amount of change in subjective visual quality between Groups A and C was statistically significant (P<0.05).CONCLUSION: Although the difference between the diameter of the optical zone and the diameter of the dark pupil does not affect the VA or the same diopter of patients after SMILE myopia correction, the optical zone diameter should be greater than the dark pupil diameter as far as possible in the design of SMILE surgery, in order to improve the objective visual quality and subjective satisfaction of patients after surgery.

scholarly journals SMILE and Wavefront-Guided LASIK Out-Compete Other Refractive Surgeries in Ameliorating the Induction of High-Order Aberrations in Anterior Corneal Surface

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Min-jie Ye ◽  
Cai-yuan Liu ◽  
Rong-feng Liao ◽  
Zheng-yu Gu ◽  
Bing-ying Zhao ◽  
...  
Keyword(s):  
Spherical Aberration ◽  
Laser In Situ Keratomileusis ◽  
Small Incision Lenticule Extraction ◽  
Corneal Surface ◽  
Small Incision ◽  
Significant Difference ◽  
Lenticule Extraction ◽  
A Prospective Study ◽  
High Order Aberrations

Purpose. To compare the change of anterior corneal higher-order aberrations (HOAs) after laser in situ keratomileusis (LASIK), wavefront-guided LASIK with iris registration (WF-LASIK), femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK), and small incision lenticule extraction (SMILE).Methods. In a prospective study, 82 eyes underwent LASIK, 119 eyes underwent WF-LASIK, 88 eyes underwent FS-LASIK, and 170 eyes underwent SMILE surgery. HOAs were measured with Pentacam device preoperatively and 6 months after surgery. The aberrations were described as Zernike polynomials, and analysis focused on total HOAs, spherical aberration (SA), horizontal coma, and vertical coma over 6 mm diameter central corneal zone.Results. Six months postoperatively, all procedures result in increase of anterior corneal total HOAs and SA. There were no significant differences in the induced HOAs between LASIK and FS-LASIK, while SMILE induced fewer total HOAs and SA compared with LASIK and FS-LASIK. Similarly, WF-LASIK also induced less total HOAs than LASIK and FS-LASIK, but only fewer SA than FS-LASIK (P<0.05). No significant difference could be detected in the induced total HOAs and SA between SMILE and WF-LASIK, whereas SMILE induced more horizontal coma and vertical coma compared with WF-LASIK (P<0.05).Conclusion. FS-LASIK and LASIK induced comparable anterior corneal HOAs. Compared to LASIK and FS-LASIK, both SMILE and WF-LASIK showed advantages in inducing less total HOAs. In addition, SMILE also possesses better ability to reduce the induction of SA in comparison with LASIK and FS-LASIK. However, SMILE induced more horizontal coma and vertical coma compared with WF-LASIK, indicating that the centration of SMILE procedure is probably less precise than WF-LASIK.

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