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AIM: To compare the changes in corneal densitometry after small incision lenticule extraction(SMILE)and femtosecond laser in situ keratomileusis(FS-LASIK)and investigate the effect of corneal interface haze on vision after SMILE.METHODS: Prospective cohort study. A total of 93 patients(186 eyes)who were scheduled to undergo refractive surgery at the Ophthalmic Refractive Surgery Center of the Affiliated Hospital of Nantong University from May 2020 to October 2021 were included in the study, and there were 48 patients(96 eyes)in the SMILE group and 45 patients(90 eyes)in the FS-LASIK group. The changes in corneal densitometry, spherical equivalent(SE), and uncorrected visual acuity(UCVA)were observed and compared between the two groups before and at 1d, 1wk, 1, 3 and 6mo after surgery.RESULTS: The 93 patients all successfully completed the surgery, and there were no related complications during and after the surgery, and there were no lost cases. The UCVA of FS-LASIK group was 0.044±0.064 and -0.001±0.065 respectively at 1d and 1wk after surgery, which was better than that of SMILE group(0.102±0.077 and 0.023±0.064; all P<0.05). There was no statistical difference in the SE between the two groups at the postoperative follow-ups(P>0.05). The corneal densitometry values at 0-2 and 2-6 mm from corneal vertex and total corneal densitometry at 1d postoperatively in the FS-LASIK group were 18.0(17.5, 18.6), 16.2(15.6, 16.7)and 16.7(16.1, 17.3), which were lower than those of SMILE group [18.6(18.1, 19.3), 16.8(16.4, 17.4), 17.2(16.6, 17.8)](all P<0.05); The corneal densitometry values at 0-2 and 2-6 mm from corneal vertex and total corneal densitometry at 1wk postoperatively in the FS-LASIK group were 17.2(16.7, 17.6), 15.5(15.0, 15.9)and 15.9(15.3, 16.7), which were lower than those of SMILE group [17.6(17.1, 18.3), 16.0(15.6, 16.5), 16.6(15.9, 17.1)](all P<0.05).CONCLUSIONS: The transient interface haze after SMILE is responsible for the early higher corneal densitometry than FS-LASIK. The presence of interface haze is probably a factor for the quality of vision.
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AIM: To explore the clinical efficacy of the myopic with moderate to high astigmatism correction between corneal topography-guided femtosecond laser in situ keratomileusis(FS-LAISK)and Toric implantable collamer lens(TICL).METHODS: A total of 60 patients(115 eyes)with moderate to high astigmatism in myopia(115 eyes)from June 2019 to June 2021 and treated in the refractive center of Heyuan Aier Eye Hospital were enrolled in the study, then were divided into Group A and Group B according to the operations they would accept. There were 32 patients(62 eyes)in the Group A treated with corneal topography-guided FS-LASIK and 28 patients(53 eyes)in the Group B treated with TICL implantation. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), spherical diopter and residual astigmatism were recorded preoperatively and postoperatively at 3mo, surgical safety and efficacy were evaluated, and the Alpins vector analysis was used to evaluate the astigmatism.RESULTS: The postoperative at 3mo, there were no differences in the safety index(1.163±0.167 vs 1.136±0.194)and the efficacy index(1.145±0.159 vs 1.123±0.196)between the patients of the two groups(P>0.05). However, the astigmatism vector analysis showed that there were statistically differences in the index of success index [0.125(0.091, 0.200)vs 0.200(0.167, 0.250)], the correction index [1.000(0.902, 1.066)vs 0.834(0.783, 0.869)] and the flattening index [1.000(0.922, 1.079)vs 0.835(0.795, 0.870)](P<0.01).CONCLUSION:Corneal topography-guided FS-LASIK and TICL implantation were effective and safe in correcting myopia with moderate to high astigmatism, and corneal topography-guided FS-LASIK perform better than TICL implantation for the astigmatism correction.
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@#AIM: To observe the visual acuity changes within 24h after femtosecond laser small incision lenticule extraction(SMILE)and femtosecond laser <i>in situ </i>keratomileusis(FS-LASIK)for myopia.<p>METHODS: A retrospective analysis was made of 80 myopic patients(160 eyes)who underwent corneal refractive surgery in our hospital from August 2017 to March 2018. They were divided into two groups according to different surgical methods, 40 cases(80 eyes)in SMILE group and 40 cases(80 eyes)in FS-LASIK group. The visual acuity, intraocular pressure, corneal endothelial cells, intraoperative and postoperative complications were observed within 24h.<p>RESULTS: The operation was successfully completed in both groups. The uncorrected visual acuity(UCVA)of SMILE group and FS-LASIK group improved gradually at 2, 4, 6, 8, 12 and 24h after operation. At 2, 4, 6, 8, 12, 24h after operation, the UCVA of FS-LASIK group was better than that of SMILE group, and the difference was statistically significant(<i>P</i><0.05). The UCVA of SMILE group was the best 12 and 24h after operation, and that of FS-LASIK group was the best 6 and 24h after operation. The results of intragroup comparison before and after operation showed that the intraocular pressure(IOP)of the two groups was lower than that before operation, the density of corneal endothelial cells, the coefficient of variation were significantly decreased, the area of corneal endothelial cells and the proportion of hexagonal cells were significantly increased; the difference was statistically significant(<i>P</i><0.01). The results of comparison between groups after operation showed that there was no significant difference in intraocular pressure and corneal endothelial cell related indexes between the two groups(<i>P</i>>0.05). No serious complications occurred during and after operation in both groups.<p>CONCLUSION: Within 24h after SMILE and FS-LASIK, the visual acuity changed greatly, and good visual acuity was obtained.
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@#AIM: To explore the clinical effect of small incision lenticule extraction(SMILE)and femtosecond laser <i>in situ</i> keratomileusis(FS-LASIK)in correcting high myopia and the effect on cornea and tear film stability. <p>METHODS: Totally 120 patients with high myopia treated in the hospital from August 2016 to February 2017 were selected as the research subjects. According to the surgical methods, the patients were divided into SMILE group and FS-LASIK group, 67 cases 134 eyes in SMILE group and, and 53 cases 106 eyes in FS-LASIK group. Group SMILE was treated with SMILE, and group FS-LASIK was treated by FS-LASIK. The influence of normal vision and stability of cornea and tear film. <p>RESULTS: There was no significant difference in uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA)and diopter between two groups after 1mo and 3mo(<i>P</i>>0.05). There was no significant difference in BUT and SⅠt between the two groups of patients before and 1mo after operation(<i>P</i>>0.05). After 3mo between the two groups, BUT and SⅠt in the two groups were statistically different, and the SMILE group was significantly better than the FS-LASIK group(<i>P</i><0.001). There was no significant difference between the two groups of corneal thinning point and posterior vertex height at preoperative and postoperative 1 and 3mo(<i>P</i>>0.05). <p>CONCLUSION: SMILE and FS-LASIK are equally safe and effective and have good predictability and stability. The postoperative tear film stability is superior to FS-LASIK, and there is no significant difference in the biomechanical stability of the two kinds of methods.
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@#AIM: To explore the posterior corneal surface height after femtosecond laser small incision lenticule extraction(SMILE)or femtosecond laser <i>in situ</i> keratomileusis surgery(Fs-LASIK). <p>METHODS: A retrospective analysis of 113 cases of patients(226 eyes)with myopia underwent laser corneal refractive surgery in our hospital from January to December 2016 was taken. There were 51 cases(102 eyes)with SMILE and 62(124 eyes)with Fs-LASIK. Postoperative posterior corneal surface height, uncorrected visual acuity, spherical equivalent change, operation safety were analyzed and compared between the two groups.<p>RESULTS: The preoperative posterior corneal surface height had no statistical difference between the two groups(<i>P</i>>0.05). Corneal surface height at 1, 3 and 6mo after operation were significantly higher than those before operation(<i>P</i><0.05), but the differences between the two groups at different time points after operation were not significant(<i>P</i>>0.05). Preoperative uncorrected visual acuity had no statistical difference between the two groups(<i>P</i>>0.05); postoperative uncorrected visual acuity at 1, 3 and 6mo were significantly better than those before operation(<i>P</i><0.05), but the differences between the two groups at different time points after operation were not significant(<i>P</i>>0.05). Preoperative spherical equivalent had no statistical difference between the two groups(<i>P</i>>0.05); postoperative spherical equivalent at 1wk were significantly better than those before operation(<i>P</i><0.05), but the differences between the two groups after operation were not significant(<i>P</i>>0.05). Postoperative incidence of adverse reactions such as corneal edema, corneal infection, diffuse lamellar keratitis and postoperative glare had no statistical difference between the two groups at 6mo after operation(<i>P</i>>0.05).<p>CONCLUSION: SMILE and Fs-LASIK can be safely and effectively correcting visual acuity, but posterior corneal surface partial forward occurred after either operation.
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Objective To compare the efficacy,safety and tolerability between bromfenac sodium ophthalmic solution 0.1％ eye drop and loteprednol etabonate 0.5％ eye drop after femtosecond laser in situ keratomileusis (FS-LASIK).Methods A prospective randomized controlled trail was performed.Seventy-six patients who had been undergone FS-LASIK in Daping Hospital were enrolled from December 2013 to December 2014.They were divided into two groups randomly by using the random number table method.The bromfenac sodium group included 38 patients administered 0.1％ bromfenac sodium ophthalmic solution,and the loteprednol etabonate group comprised 38 patients treated with 0.5％ loteprednol etabonate.Patients in both groups initially administered tobramycin-dexamethasone four times a day after FS-LASIK for 1 week.Then the patients in the bromfenac sodium group were treated with bromfenac sodium twice a day until 1 month postoperatively.While the patients from the loteprednol etabonate group were treated with loteprednol etabonate twice a day until 1 month after surgery.Visual acuity,refraction,intraocular pressure and ocular manifestation were examined preoperative and 1 day,1 week,1 month,3 months,6 months after FS-LASIK.This study was approved by the medical ethics Committee of Daping Hospital.Results No significant difference was found in the rate of uncorrected visual acuity (UCVA) which achieved to preoperative best corrected visual acuity (BCVA) between the two groups at each time point after operation (x2 =8.000,P =0.613).There was no difference in spherical equivalent (SE) between the two groups postoperatively (Fgroup =1.137,P =0.288),but a significant difference was found between the different time points (Ftime =29.771,P =0.000).Postoperative SE in the two groups tended to have mild hyperopia in the early days,and then gradually tended to " zero" or mild myopia.There was a significant difference with intraocular pressure among different time points (Ftime =87.519,P =0.000),but no significant difference of intraocular pressure was found between the groups (Fgroup =1.989,P =0.161).One month after surgery,the intraocular pressure were higher than 20 mmHg in two eyes in the loteprednol etabonate group,and two eyes were 5 mmHg higher than preoperative intraocular pressure.In bromfenac group,no one was higher than 5 mmHg compared with the preoperative intraocular pressure,and the pressures of all the eyes were lower than 18 mmHg.All the patients in bromfenac group were no drug withdrawal.But three patients were forced to guide drug withdrawal due to high intraocular pressure in loteprednol group.Conclusions Bromfenac sodium is safe,effective and well tolerated after FS-LASIK.
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AIM: To study the visual quality, dry eye and biomechanical stability of patients with myopia and astigmatism after different corneal refractive surgeries. ·METHODS: A total of 986 patients with myopia and astigmatism were selected as the research object in our hospital from July 2015 to July 2016, according to the operation mode of the selection of the research object, the 986 patients were randomly divided into small incision lenticule extraction ( SMILE) group, femtosecond laser in situ keratomileusis ( FS-LASIK ) group, sub-bowman-keratomileusis ( SBK ) group and laser-assisted in situ keratomileusis ( LASIK ) group. The postoperative visual quality was determined by comparing the diopter, uncorrected visual acuity ( UCVA ) , best corrected visual acuity ( BCVA) and high-order image difference of 25d, 90d. The postoperative dry eye condition was determined by comparing the postoperative tear secretion test ( Schirmer Ⅰ test ) , tear film rupture time ( BUT ) and fluorescence staining ( FS) . The biomechanical stability of the patients was determined by comparing the corneal hysteresis ( CH ) and corneal resistance factor ( CRF ) values of the four groups. ·RESULTS: The diopter, UCVA, BCVA and high-order aberration comparison of FS-LASIK group, SBK group and LASIK group between before and after surgery, showed no significant difference ( P>0. 05 ); on diopter, BCVA, UCVA, there was no significant difference between before and after surgery in SMILE group (P>0. 05), but statistical significance difference on high order aberration (P<0. 05). The BUT and FS value of the four groups decreased obviously after operation, and the difference was statistically significant (P<0. 05). In LASIK group SIt after operation significantly decreased, with statistically significant compared with that before operation ( P <0. 05). After operation, CH and CRF of the four groups decreased with significant differences (P<0. 05). ·CONCLUSION: SMILE, FS-LASIK, SBK and LASIK are equally safe, effective and stable in the treatment of myopia and astigmatism.
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AIM:To evaluate the efficacy and stability by comparing acuity and diopter of small incision lenticule extraction ( SMILE) , femtosecond laser in situ keratomileusis ( FS-LASIK ) and laser in situ keratomileusis ( LASIK ) in treating myopia with a follow-up of 6mo. METHODS: A retrospective study, 42 cases ( 84 eyes ) received SMILE, 37 cases ( 74 eyes ) received FS-LASIK and 31cases (62 eyes) undergone LASIK in our hospital during Apr. 2014 to Jun. 2014 were involved. The follow-up data of 6mo was analyzed. The preoperative spherical equivalent was -5. 91±1. 83D, -5. 89±1. 96D, -5. 88±1. 68D in SMILE, FS-LASIK and LASIK group, respectively. The differences of preoperative best corrected visual acuity ( BCVA ) , pupil diameter ( PD ) and central corneal thickness ( CCT ) had no statistically significant between three groups. The postoperative uncorrected visual acuity ( UCVA) , BCVA and diopter were comparative analyzed at 1wk, 1, 3 and 6m after surgery. RESULTS:1) No patients lost to follow-up of 1wk and 1mo. A total of 10 eyes (5 cases), 10 eyes (5 cases) and 8 eyes (4 cases) lost to follow-up of 3m in SMILE、FS-LASIK and LASIK group, respectively, and raised to 18 eyes (9 cases), 12 eyes (6 cases) and 14 eyes (7 cases) in follow-up of 6m. 2) At 1wk follow-up, the differences of UCVA between SMILE group, FS- LASIK group vs LASIK group was statistically significant respectively ( t=4. 098, P=0. 000;t=2. 493, P=0. 004). 3) In LASIK group, the differences of UCVA between 1wk vs 3, 6m follow-up was statistically significant respectively (t=3. 410, P=0. 001;t=3. 771, P=0. 000), the differences of UCVA between 1m and 6m follow-up was statistically significant (t=2. 283, P=0. 026). 4) The differences of diopter were not statistically significant among three groups at 1wk, 1, 3 and 6mo follow-up respectively (χ2=0. 119, P=0. 942;χ2=1. 504, P=0. 471;χ2=0. 949, P=0. 622; χ2=0. 277, P=0. 871). 5) the differences of eyes with UCVA≥5. 0 was statistically significant between SMILE group vs FS-LASIK group, LASIK group at 1wk follow-up (χ2=9. 249, P=0. 002<0. 05/3;χ2=12. 906, P=0. 000<0. 05/3), there was no significant statistical difference between FS-LASIK group and LASIK group (χ2=0. 500, P=0. 604). 6) there was no significant statistical difference of eyes with SE (±0. 50D) at any time post operation among three groups (χ2=0. 809, P=0. 697;χ2=1. 176, P=0. 634;χ2=0. 871, P=0. 736;χ2=0. 683, P=0. 770).CONCLUSION: All of SMILE, FS-LASIK and LASIK are effective and stable on treating myopia according to follow-up of 6mo. However, in this study, SMILE group shows more effective than FS-LASIK and LASIK at 1wk, which could enhance postoperative UCVA more rapidly.
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AIM: To compare the change of visual quality of femtosecond-laser in situ keratomileusis ( FS-LASIK) and laser in situ keratomileusis ( LASIK) for myopia. METHODS: A retrospective case series. A total of 89 cases 178 eyes were chosen from Jan. 2014 to Dec. 2015. There were 46 cases (92 eyes) in FS-LASIK and 43 cases 86 eyes in LASIK. The visual acuity, refraction state, subjective visual quality score, high order aberration were measured at 6mo after surgery. RESULTS: All patients underwent operation smoothly, and no complication was observed during and after surgery; there was no statistically significant difference between two groups at visual acuity (P>0. 05). Postoperative diopter compared with preoperative expectations diopter difference is statistically significant between two groups (P CONCLUSION: Femtosecond laser corneal flap is more accurate and reliable and the discrete degree is smaller. It can make more thin corneal flap. Femtosecond laser disc of LASIK surgery compare with traditional mechanical plate layer knife following LASIK has better visual quality.