scholarly journals Detection of Static and Dynamic Stereopsis after Femtosecond Laser Small Incision Lenticule Extraction for High Myopia

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Aiqun Xiang ◽  
Chu Hang ◽  
Xiaoying Wu ◽  
Yewei Yin ◽  
Yanyan Fu ◽  
...  
Keyword(s):  
Femtosecond Laser ◽  
High Myopia ◽  
High Energy ◽  
Low Energy ◽  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Significant Difference ◽  
Manifest Refraction ◽  
Refractive Correction ◽  
Lenticule Extraction

Purpose. The purpose of this study is to test binocular visual function after femtosecond laser small incision lenticule extraction (SMILE) for high myopia. The traditional Titmus stereotest and dynamic stereotest based on the visual perception biological model were used for comparative analysis. Methods. A total of 43 patients were enrolled in this prospective study. At Week 1, Month 1, and Month 3 after surgery, the Titmus stereotest and dynamic stereotest generated by MATLAB were conducted. Dynamic stereopsis consists of randomly flickering Gabor spots and is divided into two models of high energy and low energy according to flicker frequency. Results. The preoperative manifest refraction spherical equivalent was −7.21 ± 0.70 D. The preoperative anisometropia was 0.52 ± 0.54D. The quartiles of static stereoacuity in preoperation and 3 follow-ups were as follows: 50.00 (25.00, 100.00) in preoperation, 63.00 (40.00, 63.00) at Week 1, 40.00 (32.00, 63.00) at Month 1, and 40.00 (25.00, 50.00) at Month 3. Static stereopsis improved at Month 1 and Month 3 compared with preoperation and Week 1 ( P < 0.05 ). There were statistically significant differences in high energy dynamic stereopsis at Week 1 and Month 1 compared to preoperation ( P < 0.05 ). In addition, significant differences in low energy dynamic stereopsis were detected between Month 1 and preoperation and also at Month 3 compared to Month 1 ( P < 0.05 ). Conclusion. Most high myopia patients have a dynamic stereopsis deficiency before refractive correction. SMILE surgery can improve both static and dynamic stereopsis early in the postoperation period. However, in the long term, there is no significant difference or even a decrease in dynamic stereopsis.

scholarly journals Clinical outcomes after small incision lenticule extraction versus femtosecond laser-assisted LASIK for high myopia: a Meta-analysis.

2020 ◽  
Author(s):  
Yanyan Fu ◽  
Yewei Yin ◽  
Yang Zhao ◽  
Aiqun Xiang ◽  
Ying Lu ◽  
...  
Keyword(s):  
Femtosecond Laser ◽  
Clinical Outcomes ◽  
High Myopia ◽  
Spherical Aberration ◽  
Meta Analysis ◽  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Significant Difference ◽  
Lenticule Extraction

Abstract Background To compare postoperative clinical outcomes of high myopia after being treated by Small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK).Methods Comprehensive studies were conducted on the PubMed, MEDLINE, EMBASE, the Cochrane Library, and Chinese databases.Trials meeting the selection criteria were quality appraised, and the data were extracted by 2 independent authors, and the RevMan 5.3 version software were used in analyzing.Result Ten studies involving 637 patients (1093 eyes;575 eyes in the SMILE group and 518 eyes in the FS-LASIK group) were included in this meta-analysis. Pooled result revealed no significant differences in the following outcomes: the logMAR values of postoperative UDVA(WMD = -0.01, 95% CI: -0.02,0.00, I²=0%, P = 0.10 at postoperative 1mo; WMD =-0.01, 95% CI: -0.00 to 0.01, I²=0%,P = 0.35 at postoperative 3mo; WMD = -0.01, 95% CI:-0.02 to 0.01, I²=17%,P = 0.26 at long term), the logMAR values of postoperative CDVA(WMD = -0.02, 95% CI, -0.04 to 0.00, I²=0%, P = 0.11),and the postoperative mean refractive SE (WMD =0.02, 95% CI:0.04 to 0.08, I²=29%, P=0.60) . In the long-term observation, postoperative tHOA (WMD =-0.10, 95% CI:-0.13 to -0.07, I²=15%, P<0.00001)and postoperative spherical aberration (WMD =-0.13, 95% CI:--0.17 to -0.09, I²=38%, P<0.00001) were found to be less in the SMILE group compared with the FS-LASIK group, but no significant difference was found in postoperative coma (WMD =-0.02, 95% CI:-0.04 to 0.00, I²=98%, P=0.40).We also found greater PCE change post FS-LASIK than SMILE at long term follow-ups(WMD =-0.69, 95% CI:-1.36 to -0.01, I²=0%, P<0.05, however, there was no significant difference between the two groups at 3- or 6- months.(WMD =-0.19, 95% CI:-0.41 to 0.03, I²=31%, P=0.09;WMD =-0.20, 95% CI:-0.50 to 0.10, I²=17%, P=0.20)Conclusion For patients with high myopia, both SMILE and FS-LASIK are safe and efficacious. However, SMILE induced less tHOA and spherical aberration compared with FS-LASIK. Besides, FS-LASIK showed a greater increase in PCE than SMILE only at long term follow-ups. It remains to be seen whether the patients can get a better visual quality after SMILE and more comparative studies focused on high myopia is necessary.

scholarly journals Research Progress on Morphological Changes and Surgery-related Parameters of Corneal Cap in Small Incision Lenticule Extraction

2021 ◽  
Author(s):  
Chen Liang ◽  
Yan Zhang ◽  
Yuxi He ◽  
Shurong Wang
Keyword(s):  
Morphological Changes ◽  
Visual Quality ◽  
Research Progress ◽  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Operational Design ◽  
Significant Difference ◽  
Refractive Correction ◽  
Lenticule Extraction ◽  
Different Thickness

Small incision lenticule extraction (SMILE) is an "all-in-one" surgical method for refractive correction. An advantage of the SMILE over traditional surgery is that it depends on the corneal cap’s design. This review discusses the morphological evaluation of the corneal cap, selection of the corneal cap with different thickness and diameters, influence of the corneal cap design on retreatment, and management of corneal cap-related complications. The following points should be recognized to define the correct morphology and design of the operation-related parameters of the corneal cap during SMILE: (1) the thickness and diameter of the corneal cap are predictable and influence postoperative visual quality, (2) the change in anterior surface curvature of the corneal cap should be considered in the design of nomogram value, (3) for patients with moderate myopic correction, early visual quality is better with a 6.9-mm than with a 7.5-mm diameter corneal cap, (4) there is no significant difference in visual quality or biomechanics among corneal caps with different thickness; (5) primary corneal cap thickness plays an important role in the SMILE retreatment, (6) a 7.78-mm diameter corneal cap has a greater risk of suction loss than a 7.60-mm diameter corneal cap, (6) if suction loss occurs when lenticular scanning exceeds 10%, then SMILE can be continued by changing corneal cap thickness, (7) preventive collagen cross-linking with SMILE caps are 90–120 μm thick and 7–7.8 mm in diameter, and (8) properly treating SMILE-related complications ensures better postoperative results. The data presented herein shall deepen the understanding of the importance of the corneal cap during SMILE and provide diversified analysis for personalized operational design of corneal cap parameters.

scholarly journals Clinical outcomes after small-incision lenticule extraction versus femtosecond laser-assisted LASIK for high myopia: A meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0242059
Author(s):  
Yanyan Fu ◽  
Yewei Yin ◽  
Xiaoying Wu ◽  
Yuanjun Li ◽  
Aiqun Xiang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Clinical Outcomes ◽  
High Myopia ◽  
Meta Analysis ◽  
Small Incision Lenticule Extraction ◽  
Distance Visual Acuity ◽  
Small Incision ◽  
Lenticule Extraction

Aim To compare postoperative clinical outcomes of high myopia after small-incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK). Methods From March 2018 to July 2020, PubMed, MEDLINE, Embase, the Cochrane Library, and several Chinese databases were comprehensively searched. The studies meeting the criteria were selected and included; the data were extracted by 2 independent authors. The clinical outcome parameters were analyzed with RevMan 5.3. Results This meta-analysis included twelve studies involving 766 patients (1400 eyes: 748 receiving SMILE and 652 receiving FS-LASIK). Pooled results revealed no significant differences in the following outcomes: the logarithm of the mean angle of resolution (logMAR) of postoperative uncorrected distance visual acuity (weighted mean difference (WMD) = -0.01, 95% confidence interval (CI): -0.02 to 0.00, I2 = 0%, P = 0.07 at 1 mo; WMD = -0.00, 95% CI: -0.01 to 0.01, I2 = 0%, P = 0.83 at 3 mo; WMD = -0.00, 95% CI: -0.01 to 0.00, I2 = 32%, P = 0.33 in the long term), and the postoperative mean refractive spherical equivalent (WMD = -0.03, 95% CI: -0.09 to 0.03, I2 = 13%, P = 0.30). However, the SMILE group had significantly better postoperative corrected distance visual acuity (CDVA) than the FS-LASIK group (WMD = -0.04, 95% CI, -0.05 to -0.02, I2 = 0%, P<0.00001). In the long term, postoperative total higher-order aberration (WMD = -0.09, 95% CI: -0.10 to -0.07, I2 = 7%, P<0.00001) and postoperative spherical aberration (WMD = -0.15, 95% CI: -0.19 to -0.11, I2 = 29%, P<0.00001) were lower in the SMILE group than in the FS-LASIK group; a significant difference was also found in postoperative coma (WMD = -0.05, 95% CI: -0.06 to -0.03, I2 = 30%, P<0.00001). Conclusion For patients with high myopia, both SMILE and FS-LASIK are safe, efficacious and predictable. However, the SMILE group demonstrated advantages over the FS-LASIK group in terms of postoperative CDVA, while SMILE induced less aberration than FS-LASIK. It remains to be seen whether SMILE can provide better visual quality than FS-LASIK; further comparative studies focused on high myopia are necessary.

Short-Term Outcomes of Small-Incision Lenticule Extraction (SMILE) for Low, Medium, and High Myopia

2016 ◽  
Vol 27 (2) ◽  
pp. 153-159 ◽  
Author(s):  
Joaquín Fernández ◽  
Almudena Valero ◽  
Javier Martínez ◽  
David P. Piñero ◽  
Manuel Rodríguez-Vallejo
Keyword(s):  
Visual Acuity ◽  
High Myopia ◽  
Small Incision Lenticule Extraction ◽  
Distance Visual Acuity ◽  
Small Incision ◽  
Uncorrected Distance Visual Acuity ◽  
Manifest Refraction ◽  
Corrected Distance Visual Acuity ◽  
Lenticule Extraction

Purpose To determine the safety, efficacy, and predictability of small-incision lenticule extraction at 6-month follow-up, depending on the level of the myopic refractive error. The surgeries were performed by a surgeon new to this technique. Methods Seventy-one subjects with a mean age of 31.86 ± 5.57 years were included in this retrospective observational study. Subjects were divided into 3 groups depending on the preoperative spherical equivalent (SE): low group from -1.00 D to -3.00 D, medium from -3.25 D to -5.00 D, and high from -5.25 D to -7.00 D. Manifest refraction, corrected distance visual acuity (CDVA), and uncorrected distance visual acuity (UDVA) were measured before surgery and at 6 months after the treatment. Results In total, 1.4% of the eyes lost 1 line of CDVA after the procedure, whereas 95.8% remained unchanged and 2.8% gained 1 line. A significant undercorrection (p = 0.031) was found in the high myopia group (median -0.50 D), whereas the low and medium groups remained near to emmetropia. In terms of efficacy, no statistically significant intergroup differences for postoperative UDVA (p = 0.282) were found. The vector analysis also showed undercorrection of the preoperative cylinder, even though the standard deviations decreased from 0.9 D in the x axis and 0.7 D in the y axis to 0.24 D and 0.27 D, respectively. Conclusions Small-incision lenticule extraction might be a safe, effective, and predictable procedure even for inexperienced surgeons. No differences in efficacy were found among myopia levels even though undercorrections were found for SE and cylinder in high myopia.

scholarly journals Artificial Intelligence-Based Nomogram for Small-Incision Lenticule Extraction

2021 ◽  
Author(s):  
Seungbin Park ◽  
Hannah Kim ◽  
Laehyun Kim ◽  
Jin-kuk Kim ◽  
In Sik Lee ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Machine Learning ◽  
Learning Algorithm ◽  
Machine Learning Algorithms ◽  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Manifest Refraction ◽  
Individual Knowledge ◽  
Refractive Correction ◽  
Lenticule Extraction

Abstract Background: Small-incision lenticule extraction (SMILE) is a surgical procedure for the refractive correction of myopia and astigmatism, which has been reported as safe and effective. However, over- and under-correction still occur after SMILE. The necessity of nomograms is emphasized to achieve optimal refractive results. Ophthalmologists diagnose nomograms by analyzing the preoperative refractive data with their individual knowledge which they accumulate over years of experience. Our aim was to predict the nomograms of sphere, cylinder, and astigmatism axis for SMILE accurately by applying machine learning algorithm.Methods: We retrospectively analyzed the data of 3,034 eyes composed of four categorical features and 28 numerical features selected from 46 features. The multiple linear regression, decision tree, AdaBoost, XGBoost, and multi-layer perceptron were employed in developing the nomogram models for sphere, cylinder, and astigmatism axis. The scores of the root mean square error (RMSE) and accuracy were evaluated and compared. Subsequently, the feature importance of the best models was calculated.Results: AdaBoost achieved the highest performance with an RMSE of 0.1378, 0.1166, and 5.17 for the sphere, cylinder, and astigmatism axis, respectively. The accuracies of which error below 0.25 D for the sphere and cylinder nomograms and 25° for the astigmatism axis nomograms were 0.969, 0.976, and 0.994, respectively. The feature with the highest importance was pre-operative manifest refraction for all the cases of nomograms. For the sphere and cylinder nomograms, the following highly important feature was the surgeon.Conclusions: Among the diverse machine learning algorithms, AdaBoost exhibited the highest performance in prediction of the sphere, cylinder, and astigmatism axis nomograms for SMILE. The study proved the feasibility of applying artificial intelligence (AI) to nomograms for SMILE. Also it may enhance the quality of the surgical result of SMILE by providing assistance in nomograms and preventing the misdiagnosis in nomograms.

Visual Outcomes after Small Incision Lenticule Extraction and Femtosecond Laser-Assisted LASIK for High Myopia

2019 ◽  
Vol 63 (4) ◽  
pp. 427-433
Author(s):  
Weiming Yang ◽  
Shengtao Liu ◽  
Meiyan Li ◽  
Yang Shen ◽  
Xingtao Zhou
Keyword(s):  
Femtosecond Laser ◽  
High Myopia ◽  
Small Incision Lenticule Extraction ◽  
Visual Outcomes ◽  
Small Incision ◽  
Lenticule Extraction
Sign in / Sign up

Export Citation Format

Share Document