Corneal Biomechanical Changes and Tissue Remodeling After SMILE and LASIK

Rohit Shetty, Mathew Francis, Rushad Shroff, Natasha Pahuja, Pooja Khamar, Molleti Girrish, Rudy M. M. A. Nuijts, Abhijit Sinha Roy*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

54 Citations (Web of Science)

Abstract

PURPOSE. To evaluate transient corneal tissue healing and biomechanical changes between laser in situ keratomileusis (LASIK) and small incision lenticule extraction (SMILE) eyes.

METHODS. In each patient, one eye underwent LASIK and the other underwent SMILE. Optical coherence tomography (OCT) and dynamic Scheimpflug imaging (Corvis-ST) was used to assess tissue healing and biomechanics, respectively. Analyses of OCT scans yielded corneal speckle distribution (CSD) and Bowman's roughness index (BRI). Waveform analyses of deformation amplitude yielded corneal stiffness. Further, corneal force versus corneal deformation data helped compare the two procedures.

RESULTS. BRI increased and then decreased transiently after both treatments (P <0.05). However, SMILE eyes had BRI similar to that of their preoperative state compared to LASIK eyes at 6-month follow-up. CSD indicated a marked increase in the number of bright pixels and a decrease in the number of dark pixels after SMILE (1-month follow-up) and LASIK eyes (3-month follow-up), respectively. CSD returned to near preoperative state thereafter, respectively. Corneal stiffness change from preoperative state was similar between LASIK and SMILE eyes. However, deformation at discrete values of corneal force indicated some recovery of biomechanical strength after SMILE, but not in LASIK eyes.

CONCLUSIONS. BRI and CSD indicated earlier tissue healing in SMILE eyes than in LASIK. CSD results may indicate delayed cell death in LASIK eyes and increased light scatter due to interface fluid in SMILE eyes. Corneal biomechanical strength remodeled better in SMILE. This may indicate some hydration-related recovery.

Original languageEnglish
Pages (from-to)5703-5712
Number of pages10
JournalInvestigative Ophthalmology & Visual Science
Volume58
Issue number13
DOIs
Publication statusPublished - Nov 2017

Keywords

  • corneal biomechanics
  • SMILE
  • LASIK
  • optical coherence tomography
  • INCISION LENTICULE EXTRACTION
  • IN-SITU KERATOMILEUSIS
  • LASER-ASSISTED LASIK
  • OPTICAL COHERENCE TOMOGRAPHY
  • REFRACTIVE SURGERY
  • RESOLUTION OCT
  • FELLOW EYE
  • KERATOCONUS
  • MYOPIA
  • TONOMETRY

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