Flap vs flapless surgery: a contralateral study comparing imaging, proteomic, visual and biomechanical outcomes

Session Details

Session Title: Investigations and Complications Management

Session Date/Time: Tuesday 13/09/2016 | 13:30-15:15

Paper Time: 13:42

Venue: Hall C3

First Author: : R.Shroff INDIA

Co Author(s): :    R. Shetty   A. Agrawal   N. Pahuja              

Abstract Details

Purpose:

To compare the outcomes of small incision lenticule extraction (SMILE) and laser in situ keratomileusis (LASIK) in contralateral eyes treated for myopia

Setting:

Narayana Nethralaya, Bangalore

Methods:

80 eyes of 40 patients who underwent SMILE in one eye and LASIK in fellow eye .The FS 200 platform was used to create the flap and Allegretto Wavelight was used for Excimer photoablation in LASIK. The Visumax platform was used to perform SMILE. The biomechanics were studied using Corvis ST. Bowman’s layerroughness index (BRI) was defined using a novel mathematical algorithm. Corneal tomography was assessed with Pentacam .Tears were collected and subjected to proteomic analysis.All tests were performed preoperatively and 1 week, 1 month and 3 months after the surgery.

Results:

BRI was significantly different in the two groups (p=0.04). BRI stabilized in SMILE eyes whereas it kept increasing in LASIK eyes at 3 months postoperatively. Biomechanically SMILE was significantly more stable than LASIK. The Visual acuity was comparable between the two groups (p=0.9). Proteomic analysis revealed an elevation of wound healing markers such as Fetuin and a decrease in inflammatory markers such as MMP-9 in SMILE which was found to be significant (p<0.05).

Conclusions:

Both SMILE and LASIK provide comparable refractive and visual outcomes. SMILE however is a more stable procedure in terms of corneal Biomechanics and Bowman’s layer changes. Proteomic analysis shows better wound healing and less inflammation following SMILE.

Financial Disclosure:

NONE