Cargando…
Comparison of Clinical and Biomechanical Outcomes of Small Incision Lenticule Extraction With 120- and 140-µm Cap Thickness
PURPOSE: The purpose of this study was to compare the clinical outcomes and corneal biomechanical changes between 120-µm and 140-µm cap thickness after small incision lenticule extraction (SMILE). METHODS: This prospective study included 150 eyes (150 patients: 91 eyes in the 120-µm group, and 59 ey...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Association for Research in Vision and Ophthalmology
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8288062/ https://www.ncbi.nlm.nih.gov/pubmed/34259803 http://dx.doi.org/10.1167/tvst.10.8.15 |
_version_ | 1783724027341176832 |
---|---|
author | Jun, Ikhyun Kang, David Sung Yong Roberts, Cynthia J. Lee, Hun Jean, Seung Ki Kim, Eung Kweon Seo, Kyoung Yul Kim, Tae-im |
author_facet | Jun, Ikhyun Kang, David Sung Yong Roberts, Cynthia J. Lee, Hun Jean, Seung Ki Kim, Eung Kweon Seo, Kyoung Yul Kim, Tae-im |
author_sort | Jun, Ikhyun |
collection | PubMed |
description | PURPOSE: The purpose of this study was to compare the clinical outcomes and corneal biomechanical changes between 120-µm and 140-µm cap thickness after small incision lenticule extraction (SMILE). METHODS: This prospective study included 150 eyes (150 patients: 91 eyes in the 120-µm group, and 59 eyes in the 140-µm group) who underwent SMILE. Enhanced correction nomograms were applied for patients according to cap thickness. Clinical outcomes, including visual acuity, refraction, and corneal wavefront aberrations, were compared between the two groups. Corneal biomechanics were evaluated using the Corvis ST (Oculus, Wetzlar, Germany). RESULTS: The mean uncorrected-distance visual acuity, safety and efficacy indices, and refractive predictability were comparable in the 120-µm and 140-µm groups after SMILE. The postoperative total corneal root mean square higher-order aberrations (HOAs) and spherical aberrations was 0.48 ± 0.31 and 0.26 ± 0.10 in the 120-µm group, and 0.53 ± 0.16 and 0.34 ± 0.13 in the 140-µm group, which showed significant differences between the two groups (P = 0.027, and <0.001, respectively). Although corneal stiffness decreased after SMILE in both groups, the changes in the deformation amplitude ratio were significantly higher in the 140-µm group than in the 120-µm group (P = 0.022). CONCLUSIONS: SMILE with 120-µm and 140-µm cap thickness provided excellent predictable outcomes according to our enhanced correction nomogram. The amount of tissue removal required to achieve the same amount of refractive correction was greater in the thicker cap group. The induction of corneal HOAs and weakening of corneal biomechanics were less pronounced in the thin-cap group, which may be associated with the thinner cap, lesser lenticule thickness, or thicker residual stromal bed. TRANSLATIONAL RELEVANCE: Although SMILE with different cap thickness was effective, thicker lenticule thickness in the thick-cap group may be associated with induction of HOAs, and corneal stiffness changes. |
format | Online Article Text |
id | pubmed-8288062 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Association for Research in Vision and Ophthalmology |
record_format | MEDLINE/PubMed |
spelling | pubmed-82880622021-07-26 Comparison of Clinical and Biomechanical Outcomes of Small Incision Lenticule Extraction With 120- and 140-µm Cap Thickness Jun, Ikhyun Kang, David Sung Yong Roberts, Cynthia J. Lee, Hun Jean, Seung Ki Kim, Eung Kweon Seo, Kyoung Yul Kim, Tae-im Transl Vis Sci Technol Article PURPOSE: The purpose of this study was to compare the clinical outcomes and corneal biomechanical changes between 120-µm and 140-µm cap thickness after small incision lenticule extraction (SMILE). METHODS: This prospective study included 150 eyes (150 patients: 91 eyes in the 120-µm group, and 59 eyes in the 140-µm group) who underwent SMILE. Enhanced correction nomograms were applied for patients according to cap thickness. Clinical outcomes, including visual acuity, refraction, and corneal wavefront aberrations, were compared between the two groups. Corneal biomechanics were evaluated using the Corvis ST (Oculus, Wetzlar, Germany). RESULTS: The mean uncorrected-distance visual acuity, safety and efficacy indices, and refractive predictability were comparable in the 120-µm and 140-µm groups after SMILE. The postoperative total corneal root mean square higher-order aberrations (HOAs) and spherical aberrations was 0.48 ± 0.31 and 0.26 ± 0.10 in the 120-µm group, and 0.53 ± 0.16 and 0.34 ± 0.13 in the 140-µm group, which showed significant differences between the two groups (P = 0.027, and <0.001, respectively). Although corneal stiffness decreased after SMILE in both groups, the changes in the deformation amplitude ratio were significantly higher in the 140-µm group than in the 120-µm group (P = 0.022). CONCLUSIONS: SMILE with 120-µm and 140-µm cap thickness provided excellent predictable outcomes according to our enhanced correction nomogram. The amount of tissue removal required to achieve the same amount of refractive correction was greater in the thicker cap group. The induction of corneal HOAs and weakening of corneal biomechanics were less pronounced in the thin-cap group, which may be associated with the thinner cap, lesser lenticule thickness, or thicker residual stromal bed. TRANSLATIONAL RELEVANCE: Although SMILE with different cap thickness was effective, thicker lenticule thickness in the thick-cap group may be associated with induction of HOAs, and corneal stiffness changes. The Association for Research in Vision and Ophthalmology 2021-07-14 /pmc/articles/PMC8288062/ /pubmed/34259803 http://dx.doi.org/10.1167/tvst.10.8.15 Text en Copyright 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. |
spellingShingle | Article Jun, Ikhyun Kang, David Sung Yong Roberts, Cynthia J. Lee, Hun Jean, Seung Ki Kim, Eung Kweon Seo, Kyoung Yul Kim, Tae-im Comparison of Clinical and Biomechanical Outcomes of Small Incision Lenticule Extraction With 120- and 140-µm Cap Thickness |
title | Comparison of Clinical and Biomechanical Outcomes of Small Incision Lenticule Extraction With 120- and 140-µm Cap Thickness |
title_full | Comparison of Clinical and Biomechanical Outcomes of Small Incision Lenticule Extraction With 120- and 140-µm Cap Thickness |
title_fullStr | Comparison of Clinical and Biomechanical Outcomes of Small Incision Lenticule Extraction With 120- and 140-µm Cap Thickness |
title_full_unstemmed | Comparison of Clinical and Biomechanical Outcomes of Small Incision Lenticule Extraction With 120- and 140-µm Cap Thickness |
title_short | Comparison of Clinical and Biomechanical Outcomes of Small Incision Lenticule Extraction With 120- and 140-µm Cap Thickness |
title_sort | comparison of clinical and biomechanical outcomes of small incision lenticule extraction with 120- and 140-µm cap thickness |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8288062/ https://www.ncbi.nlm.nih.gov/pubmed/34259803 http://dx.doi.org/10.1167/tvst.10.8.15 |
work_keys_str_mv | AT junikhyun comparisonofclinicalandbiomechanicaloutcomesofsmallincisionlenticuleextractionwith120and140μmcapthickness AT kangdavidsungyong comparisonofclinicalandbiomechanicaloutcomesofsmallincisionlenticuleextractionwith120and140μmcapthickness AT robertscynthiaj comparisonofclinicalandbiomechanicaloutcomesofsmallincisionlenticuleextractionwith120and140μmcapthickness AT leehun comparisonofclinicalandbiomechanicaloutcomesofsmallincisionlenticuleextractionwith120and140μmcapthickness AT jeanseungki comparisonofclinicalandbiomechanicaloutcomesofsmallincisionlenticuleextractionwith120and140μmcapthickness AT kimeungkweon comparisonofclinicalandbiomechanicaloutcomesofsmallincisionlenticuleextractionwith120and140μmcapthickness AT seokyoungyul comparisonofclinicalandbiomechanicaloutcomesofsmallincisionlenticuleextractionwith120and140μmcapthickness AT kimtaeim comparisonofclinicalandbiomechanicaloutcomesofsmallincisionlenticuleextractionwith120and140μmcapthickness |