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Six modes of corneal topography for evaluation of ablation zones after small-incision lenticule extraction and femtosecond laser-assisted in situ keratomileusis
摘要： Purpose To evaluate the ablation zone diameter (AZD) using six modes of corneal topography after small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for myopia and to compare the programmed and postoperative AZDs Methods This retrospective comparative study included 86 right eyes in 86 patients who underwent SMILE or FS-LASIK at the Shandong Eye Institute between June 2016 and August 2017. Data were collected preoperatively and at 1, 3, and 6 months postoperatively using the Pentacam system. The AZD was determined using six modes of corneal topography: postoperative axial curvature topography (PACT), postoperative tangential curvature topography (PTCT), difference-axial curvature topography (DACT), difference-tangential curvature topography (DTCT), postoperative front elevation topography (PFET), and difference-corneal thickness topography (DCTT). The difference between the programmed and postoperative AZDs was compared between the groups of two surgical procedures. Results At 3 months, the AZDs measured by PTCT, DTCT, and PFET after SMILE showed a significant decrease, while the AZD by DACT revealed an increase (P < 0.001), and the AZDs measured by PACT, PTCT, DACT, DTCT, PFET, and DCTT after FS-LASIK were all significantly decreased (P < 0.001), as compared with the programmed ablation zone values. The AZDs measured by DACT and DTCT after 3 months were larger in the SMILE group (P < 0.001); likewise, the differences between the programmed and postoperative AZDs were lower in the SMILE group (P < 0.001). Furthermore, PACT, PTCT, DACT, DTCT, and PFET indicated acceptable inter-observer reliability (ICC > 0.75). Conclusions In the treatment of myopia, the achieved topographic ablation zones after FS-LASIK were smaller than the theoretically designed ones. The AZDs after SMILE were larger than those after FS-LASIK, with an equivalent programmed value. The DACT may be more suitable for measuring postoperative ablation zones in clinic with clearer borders and favorable repeatability. This method may be potential for the measurement of ablation zones and further research on the visual quality after refractive surgery.
关键词： SMILE,FS-LASIK,Corneal topography,Ablation zone
更新于2025-09-23 15:21:01
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Development of low laser energy levels in small-incision lenticule extraction
摘要： Purpose: To evaluate the outcomes of 4 low laser energy levels after small-incision lenticule extraction (SMILE) surgery. Setting: Zhongshan Ophthalmic Center, Guangzhou, China. Design: Prospective randomized clinical trial. Methods: This study evaluated consecutive patients who had SMILE to correct myopia or myopia with astigmatism. Eyes were placed into groups based on the laser energy used during surgery (ie, 105 nJ, 110 nJ, 115 nJ, or 120 nJ). All patients had a thorough ophthalmic examination preoperative and at 4 timepoints over 3 months postoperatively. Black areas and surface regularity of the extracted lenticules were observed and evaluated qualitatively and quantitatively. Results: The study comprised 124 eyes of 62 patients (40 women, 22 men), with 31 eyes in each laser energy group. The incidence of black areas was 45.16% (14 of 31 eyes), 12.90% (4 of 31 eyes), 16.13% (5 of 31 eyes), and 12.90% (4 of 31 eyes) for 105 nJ, 110 nJ, 115 nJ, and 120 nJ, respectively. The mean time for lenticule creation was the longest in the 105 nJ group (P = .015). The greatest increase in corneal thickness postoperatively occurred with 105 nJ (P < .05). Regression was highest in the 105 nJ group at 3 months (P < .01). However, corneal horizontal coma (C8) was lowest in the 105 nJ group at 1 week (P = .032). The lenticular surface in the 110 nJ group was the smoothest (P = .011). All contrast sensitivity values varied with time and recovered to preoperative levels by 1 week or 1 month. In all eyes, the uncorrected distance visual acuity and corrected distance visual acuity were good, with no statistically significant differences between the 4 energy groups. Conclusions: The 105 nJ group, in which the lowest energy was used, had the highest risk for black areas, serious postoperative corneal edema, and a significant healing response.
关键词： small-incision lenticule extraction,laser energy levels,black areas,SMILE,corneal edema
更新于2025-09-23 15:19:57
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Small-incision lenticule extraction in a patient with high astigmatism and nystagmus
摘要： Small-incision lenticule extraction (SMILE) was performed in a patient with high astigmatism and nystagmus. The patient presented for a refractive surgery evaluation with a manifest refraction of -0.50 -6.00 × 137 (20/40-1) in the right eye and -2.25 -2.25 × 30 (20/40-1) in the left eye. The patient was deemed suitable for corneal laser refractive surgery. Consideration was given to SMILE, laser in situ keratomileusis, and photorefractive keratectomy. It was decided SMILE was the best option given that the refractive portion of the procedure is performed while the cornea is immobilized by suction. The treatment was uneventful, and the final manifest refraction was +0.25 -0.25 × 130 (20/40) in the right eye and +0.25 diopter sphere (20/40) in the left eye. Topography was normal, showing a well-centered treatment zone. This case highlights an additional use for SMILE, given its ability to immobilize the cornea during treatment.
关键词： astigmatism,SMILE,refractive surgery,cornea immobilization,nystagmus
更新于2025-09-19 17:15:36
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Five-year outcomes of small-incision lenticule extraction vs femtosecond lasera??assisted laser in situ keratomileusis
摘要： To compare the long-term refractive and visual outcomes and the corneal higher-order aberrations of contralateral eyes of patients who received small-incision lenticule extraction (SMILE) in one eye and femtosecond laser–assisted laser in situ keratomileusis (FS-LASIK) in the other eye.
关键词： small-incision lenticule extraction,femtosecond laser–assisted laser in situ keratomileusis,myopic astigmatism,corneal higher-order aberrations,SMILE,FS-LASIK,myopia
更新于2025-09-19 17:13:59
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Refractive outcomes comparing small-incision lenticule extraction and femtosecond lasera??assisted laser in situ keratomileusis for high myopia
摘要： To compare the long-term refractive effects of small-incision lenticule extraction (SMILE) and femtosecond laser–assisted laser in situ keratomileusis (FS-LASIK) on the correction of high myopia and astigmatism.
关键词： refractive surgery,SMILE,FS-LASIK,high myopia,astigmatism
更新于2025-09-19 17:13:59
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Lip Repositioning Surgery Using an Er,Cr:YSGG Laser: A Case Series
摘要： Excessive gingival display (EGD) is a common esthetic concern. Lip repositioning surgery (LRS) was introduced as one of the treatment options to manage EGD. LRS can be used for skeletally and/or muscularly induced EGD. The present case series applied LRS using an Er,Cr:YSGG laser to treat 24 patients with minor vertical maxillary overgrowth or a hypermobile lip. At 6 months, the gingival display had decreased by 3.79 ± 1.59 mm (mean ± standard deviation), and the visible lip body when smiling had increased by 1.23 ± 0.74 mm. A questionnaire revealed that the level of satisfaction with the smile increased among the patients and that they had a positive attitude toward Er,Cr:YSGG laser–assisted LRS.
关键词： Er,excessive gingival display,Lip repositioning surgery,Cr:YSGG laser,smile esthetics
更新于2025-09-19 17:13:59
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Comparing Patient-Reported Outcomes of Laser In Situ Keratomileusis and Small-Incision Lenticule Extraction
摘要： Laser in situ keratomileusis (LASIK) and small-incision lenticule extraction (SMILE) are popular refractive surgeries. The objective refractive outcomes of LASIK and SMILE have been studied extensively; both procedures have comparable safety, efficacy, and predictability. However, owing to various psychosocial factors, refractive patients may report dissatisfaction despite good postoperative vision. Hence the importance of studies on subjective patient-reported outcomes. This review discusses the role of psychometric-technique-based validated questionnaires when evaluating subjective outcomes. It also summarizes the literature on patient-reported outcomes for LASIK and SMILE.
关键词： SMILE,LASIK,patient-reported outcomes
更新于2025-09-16 10:30:52
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Comparison of anterior segment changes after femtosecond laser LASIK and SMILE using a dual rotating Scheimpflug analyzer
摘要： Background: To compare the changes in the anterior segment after femtosecond laser in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE) using a dual rotating Scheimpflug (DRS) analyzer (Galilei?; Ziemer Ophthalmology, Port, Switzerland). Methods: A total of 218 eyes of 109 patients who underwent FS-LASIK or SMILE for myopic correction were retrospectively studied. Ninety-eight eyes of 49 patients who underwent FS-LASIK were compared to 120 eyes of 60 patients treated with SMILE. A DRS analyzer was used for preoperative and 6-month postoperative anterior segment analyses. Measured variables included the central corneal thickness (CCT), anterior chamber depth (ACD), anterior and posterior keratometry (K), anterior and posterior best-fit sphere radius, and maximum posterior elevation (MPE). Results: After the procedure, the amount of CCT decrease was higher in the SMILE group than in the FS-LASIK group, but it was not statistically significant. The MPE was significantly increased after both procedures (p < 0.001 and p = 0.001 in the FS-LASIK and SMILE groups, respectively), with the amount of elevation being higher after FS-LASIK than after SMILE even though it was not statistically significant. And there was a significant change in the steep and average posterior K in the FS-LASIK group (p = 0.006 and 0.001, respectively), but not in the SMILE group. Conclusions: Regarding changes in the MPE and posterior K, changes in the posterior corneal surface were greater after FS-LASIK than after SMILE.
关键词： Dual rotating Scheimpflug analyzer,LASIK,Galilei,Small incision lenticule extraction,FS-LASIK,SMILE
更新于2025-09-12 10:27:22
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Fourier Analysis of Corneal Irregular Astigmatism After Small Incision Lenticule Extraction and Comparison to Femtosecond Laser-Assisted Laser In Situ Keratomileusis
摘要： Evaluation of spherical component (SC), regular astigmatism (RA), and irregular astigmatism (IA, ie, Asymmetry and Irregularities) 3 years after small incision lenticule extraction (SMILE) and comparison to femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK).
关键词： FS-LASIK,SMILE,irregular astigmatism,Fourier analysis
更新于2025-09-12 10:27:22
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Leak in the curved suction contact glass of a femtosecond laser during small-incision lenticule extraction
摘要： We report a case of a leak in the curved suction contact glass of a VisuMax femtosecond laser that occurred during small-incision lenticule extraction (SMILE). As a result, creation of the anterior surface of the lenticule was not complete. One month later, a cap was created using the flap mode; the flap side cut was manually stopped after the flap cut was made. After laser in situ keratomileusis flap creation, the refractive lenticule was manually removed using microforceps, similar to the uneventful SMILE procedure. To our knowledge, this is the first report of a leak in the curved suction contact glass during SMILE that was successfully treated.
关键词： femtosecond laser,small-incision lenticule extraction,leak,suction contact glass,SMILE
更新于2025-09-12 10:27:22