Small Incision Lenticule Extraction (SMILE) for Hyperopia: Optical Zone Centration

2017 ◽  
Vol 33 (3) ◽  
pp. 150-156 ◽  
Author(s):  
Dan Z. Reinstein ◽  
Kishore R. Pradhan ◽  
Glenn I. Carp ◽  
Timothy J. Archer ◽  
Marine Gobbe ◽  
...  
2021 ◽  
Author(s):  
Ke Zheng ◽  
Yinan Han ◽  
Jing Wang ◽  
Tian Han ◽  
Xingtao Zhou

Abstract Background: To study the impact of unintended initial dissection of the posterior plane (UIDPP) on operation time and surgical outcomes during small incision lenticule extraction (SMILE) surgery.Methods: Based on the SMILE procedure video, the operating eyes were assigned to the normal and UIDPP groups according to the presence or absence of UIDPP signals during surgery. The UIDPP group was further separated into early and late detection. Patient's demographic data, preoperative evaluation data, operation time and postoperative outcomes were collected.Results: Sixty-six patients who underwent SMILE were included, with 24 patients with UIDPP (13 in the early detection group and 11 in the late group). The optical zone was smaller (median 6.5 vs. 6.6, P=0.007), and the operation time was longer (median, 189.5 vs. 91.0 s, P<0.001) in the UIDPP group compared with controls. There were significant differences in operation time between the late detection group and early detection group (median, 489.0 vs. 139.0 s, P<0.05) and between the late detection group and normal group (489.0 vs. 91.0 s, P<0.05), while the optical zone was different only between the late detection and normal groups (median, 6.6 vs. 6.5, P<0.05). Conclusion: The occurrence of UIDPP will increase the surgery time of SMILE. Detecting IUDPP earlier could help shorten the operation time.


2017 ◽  
Vol 33 (6) ◽  
pp. 370-376 ◽  
Author(s):  
Dan Z. Reinstein ◽  
Kishore R. Pradhan ◽  
Glenn I. Carp ◽  
Timothy J. Archer ◽  
Marine Gobbe ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yan Wu ◽  
Zhenping Huang

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.


2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jia-Hao Zhang ◽  
Shu-Rong Wang ◽  
Yu-Xi He ◽  
Bo-Yuan Yao ◽  
Yan Zhang

2021 ◽  
Author(s):  
Jiao Peng ◽  
Ding-Juan Zhong ◽  
Jia Liu ◽  
Li-Yuan Zhang ◽  
Hao Wu ◽  
...  

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.


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