Comparison of corneal epithelial remodeling over a year in LASIK vs SMILE: a contralateral eye study

Session Details

Session Title: LASIK vs SMILE

Session Date/Time: Monday 24/09/2018 | 16:30-18:00

Paper Time: 16:42

Venue: Room A3, Podium 2

First Author: : I.Kontari GREECE

Co Author(s): :    A. Kanellopoulos                    

Abstract Details

Purpose:

To compare three-dimensional epithelial remodeling in patients undergoing myopic laser vision correction, between two intrastromal techniques.

Setting:

LaserVision.gr Clinical and Research Eye Institute, Athens, Greece

Methods:

In a prospective randomized study of contralateral eye LASIK vs. Smile 21 consecutive patients (42 eyes), were additionally evaluated with 9mm corneal epithelial mapping by anterior segment OCT perioperatively, up to 2-year follow-up. Zonal epithelial thickness and 4 diagnostics variables, including minimum, superior – inferior (S-I), minimum – maximum (MIN-MAX), map standard deviation (MSD) were some of the additional epithelial morphology parameters studied.

Results:

In the LASIK group of eyes the average central epithelium thickness (CET) increased from 52.45±2.76um preoperatively to 57.05±4.17um up to 6months postoperatively and essentially maintained stable up to 1 years, with superior 57.62±4.01um, inferior 58.43±3.46 um, minimum 50.24±4.98um, maximum 63.86±5.11um and topographic thickness variability 2.80±1.00um. The respective values for the group of the contralateral Smile eyes was: central epithelial thickness (+0.09um) and minimum (+2.09um,P<0.05) were thicker, while superior (-1.24um), inferior (-0.67um) and maximum (-1.57um,P<0.05) were thinner, in comparison to the LASIK group, and also essentially stabilized after the first 6-postoperative months.

Conclusions:

Both LASIK and Smile resulted in significant epithelial remodeling in the initial 6 postoperative months consistent with the transient dry-eye symptomatology experienced by the patients during that period. This response appeared to be surprisingly quite similar between the two different intrastromal tissue removing techniques, with LASIK differing only in mid-peripheral greater thickening in relation to the contralateral Smile eyes. Overall this study suggests that epithelial remodeling may correlate with relative curvature changes resulting after LVC with both techniques, rather than the magnitude of sub epithelial corneal denervation changes between the two techniques.

Financial Disclosure:

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