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Comparison of Clinical and Biomechanical Outcomes of Small Incision Lenticule Extraction With 120- and 140-µm Cap Thickness

Authors
 Ikhyun Jun  ;  David Sung Yong Kang  ;  Cynthia J Roberts  ;  Hun Lee  ;  Seung Ki Jean  ;  Eung Kweon Kim  ;  Kyoung Yul Seo  ;  Tae-Im Kim 
Citation
 TRANSLATIONAL VISION SCIENCE & TECHNOLOGY, Vol.10(8) : 15, 2021-07 
Journal Title
TRANSLATIONAL VISION SCIENCE & TECHNOLOGY
Issue Date
2021-07
MeSH
Cornea / surgery ; Germany ; Humans ; Lasers, Excimer* ; Myopia* / surgery ; Prospective Studies ; Refraction, Ocular
Abstract
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.
Files in This Item:
T202103289.pdf Download
DOI
10.1167/tvst.10.8.15
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Eung Kweon(김응권) ORCID logo https://orcid.org/0000-0002-1453-8042
Kim, Tae-Im(김태임) ORCID logo https://orcid.org/0000-0001-6414-3842
Seo, Kyoung Yul(서경률) ORCID logo https://orcid.org/0000-0002-9855-1980
Jun, Ik Hyun(전익현) ORCID logo https://orcid.org/0000-0002-2160-1679
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/184618
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