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Femtosecond Lasers and Corneal Surgical Procedures
摘要： Our purpose is to present a broad review about the principles, early history, evolution, applications, and complications of femtosecond lasers used in refractive and nonrefractive corneal surgical procedures. Femtosecond laser technology added not only safety, precision, and reproducibility to established corneal surgical procedures such as laser in situ keratomileusis (LASIK) and astigmatic keratotomy, but it also introduced new promising concepts such as the intrastromal lenticule procedures with refractive lenticule extraction (ReLEx). Over time, the refinements in laser optics and the overall design of femtosecond laser platforms led to it becoming an essential tool for corneal surgeons. In conclusion, femtosecond laser is a heavily utilized tool in refractive and nonrefractive corneal surgical procedures, and further technological advances are likely to expand its applications.
关键词： intrastromal corneal ring segments,keratoplasty,femtosecond laser,SMILE,LASIK
更新于2025-09-11 14:15:04
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Corneal higher-order aberrations of the anterior surface, posterior surface, and total cornea after small incision lenticule extraction (SMILE): high myopia versus mild to moderate myopia
摘要： Background: To investigate corneal higher-order aberrations (HOAs) of the anterior surface, posterior surface, and total cornea after small incision lenticule extraction (SMILE) in high myopic and mild to moderate myopic patients. Methods: This retrospective study included 197 eyes (101 patients) undergoing SMILE surgery. According to the preoperative spherical equivalent (SE), treated eyes were divided into two groups: a high myopic group (more than ? 6.0 D, Group H) and a mild to moderate myopic group (less than ? 6.0 D, Group M). Corneal HOAs of the anterior surface, posterior surface, and total cornea were measured using a Scheimpflug camera preoperatively and 3 months postoperatively. Pearson’s correlation analysis was conducted to determine relationships between corneal aberrations and the SE. Results: There were no significant differences in third-order to eight-order aberrations (RMS HOAs) of the anterior surface, posterior surface, and total corneal between the two groups before SMILE surgery. However, after SMILE, anterior and total corneal HOAs, especially vertical coma and spherical aberrations, significantly increased in both groups (p < 0.0167), whereas posterior corneal HOAs remained relatively stable (p > 0.0167). The induction of HOAs was significantly greater in Group H than Group M postoperatively (p < 0.0167). Changes in anterior surface and total corneal HOAs, especially vertical coma and spherical aberrations, were related to the SE (p < 0.05). Conclusions: Anterior and total corneal HOAs, particularly vertical coma and spherical aberrations, significantly increased after SMILE in both groups, whereas posterior corneal HOAs remained stable. Aberration changes were related to SE.
关键词： Posterior cornea,SMILE,Higher-order aberrations
更新于2025-09-10 09:29:36
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Outcomes of Small Incision Lenticule Extraction: Mild to Moderate Myopia versus High Myopia
摘要： Purpose: To evaluate the refractive outcomes of small incision lenticule extraction (SMILE) in high myopia patients compared with mild to moderate myopia patients. Methods: This study included 332 eyes of 166 myopic patients treated with SMILE using Visumax 500 kHz femtosecond laser. Treated eyes were divided into 2 groups according to preoperative spherical equivalent (SE): mild to moderate myopia (A group, <-6.0 D) and high myopia (B group, ≥-6.0 D). Follow-up visits were at 1 day, 1 week, 1 month, 3 months, and 6 months. The outcome measures included uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BDVA), postoperative SE, efficacy index, safety index and predictability. Results: Preoperative SE was -4.85 ± 0.86 D in the A group and -7.70 ± 1.0 D in the B group. No differences were observed between -0.04 ± 0.29 D in the A group and -0.30 ± 0.37 D in the B group at 6 months postoperatively (p = 0.062). At 6 months postoperatively, 98.3% and 97.3% had UDVA of 20/25 or better in the A group and B group, respectively. In the A group, 97.3% and 100% were within ±0.5 D and ±1.0 D of intended correction and in the B group, 91.7% and 96.9% were within ±0.5 D and ±1.0 D, respectively. Efficacy indices were 1.02 ± 0.19 in the A group and 0.99 ± 0.18 in the B group. Safety indices were 1.16 ± 0.16 in the A group and 1.14 ± 0.16 in the B group. The efficacy and safety indices were not significantly different between the A and B groups at 6 months postoperatively (p = 0.09, p = 0.695, respectively). Conclusions: This study showed that SMILE is effective and safe for correcting high myopia as well as mild to moderate myopia.
关键词： Best corrected distance visual acuity,SMILE,High myopia,Uncorrected distance visual acuity
更新于2025-09-09 09:28:46