Comparison of corneal epithelial response after femtosecond laser-assisted laser in situ keratomileusis (LASIK) and small-incision lenticule extraction (SMILE)

Session Details

Session Title: Corneal Refractive Surgery

Session Date/Time: Tuesday 17/09/2019 | 14:00-16:00

Paper Time: 15:15

Venue: Free Paper Forum: Podium 3

First Author: : I.Toprak SPAIN

Co Author(s): :    M. Canto-Cerdan   J. Alio del Barrio   L. Casanova-Blanquer   J. Alio-Sanz                    

Abstract Details

Purpose:

To compare corneal epithelial response to femtosecond laser-assisted laser in situ keratomileusis (femto-LASIK) and small-incision lenticule extraction (SMILE) surgeries using a high resolution anterior segment optical coherence tomography (AS-OCT).

Setting:

Retrospective case-control study Vissum Innovation, Alicante, Spain

Methods:

The femto-LASIK group included 35 eyes and the SMILE group comprised 38 eyes, which were treated for myopia and/or myopic astigmatism. The two groups were matched in terms of age, gender and preoperative spherical equivalent (SE) value. The AS-OCT measurements were performed by a single experienced optometrist using the MS-39 AS-OCT (CSO, Firenze, Italy) device. The changes in epithelial and stromal measurements (central, 3mm- and 6mm- minimum, maximum and average) between baseline and 1-month after the surgery were compared within and between the two groups.

Results:

Mean SE value was -3.7±2.0 vs. -4.2±1.8 diopters in the femto-LASIK and SMILE groups (p=0.206). The 3mm-average, 3mm-maximum, 6mm-all epithelial thicknesses were significantly increased from baseline at 1-month postoperatively in both groups (p<0.05). However, central epithelial thickness was increased significantly only in the femto-LASIK group (p=0.001). Postoperative increments in 3mm-maximum, 6mm-average and 6mm-maximum epithelial thicknesses were significantly higher in femto-LASIK group than in the SMILE group. Although postoperative decrease in central-stromal thickness was significantly higher in the SMILE group (p<0.05), (change in central epithelial thickness) to (change in central stromal thickness) ratio was similar between two groups (p>0.05).

Conclusions:

Researchers show growing interest on epithelial changes after laser refractive corneal surgery. This study demonstrated significant epithelial thickening after femto-LASIK and SMILE. However, epithelial thickening is more significant following femto-LASIK when compared to the SMILE at 1-month postoperatively. The amount of thickening in central epithelium per decrease in stromal thickness did not differ between the femto-LASIK and SMILE groups in the early postoperative period, although central stromal thickness loss was more prominent after SMILE surgery.

Financial Disclosure:

None