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small-incision lenticule extraction versus femtosecond lenticule extraction for myopic:a systematic review and Meta-analysis

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International Journal of Ophthalmology(English edition) 2017年第1期10卷 115-121页

作者： Jia-Song Wang Hua-Tao Xie Ye Jia Ming-Chang Zhang Department of Ophthalmology Union HospitalTongji MedicalCollegeHuazhong University of Science and TechnologyWuhan 430022Hubei ProvinceChina

AIM： To examine differences in efficacy, accuracy, safety, aberrations and corneal biomechanical between small incision lenticule extraction （SMILE） and femtosecond lenticule extraction （FLEx） for myopia. METHODS： Comprehensive studies were conducted on the PubMed, MEDLINE, EMBASE, and Cochrane Controlled Trials Register before 31 July, 2015. Meta-analyses were performed on the primary outcomes [loss of ≥2 lines of corrected distance visual acuity （CDVA）, uncorrected distance visual acuity （UDVA） ≥20/20, spherical equivalent （SE） within ±0.50 diopters （D）, final refractive SE], secondary outcomes were high-order aberrations （HOAs） and corneal biomechanical [central corneal thickness （CCT）, corneal hysteresis （CH） and corneal resistance factor （CRF）]. RESULTS： Seven trials describing a total of 320 eyes with myopia were included in this Meta-analysis. No significant differences were found in the efficacy [UDVA weighted mean difference （WMD） -0.01; 95%CI： -0.04 to 0.01; P=0.37, UDVA ≥20/20, OR 1.49; 95%CI： 0.78 to 2.86; P=0.23], accuracy （SE WMD -0.03; 95%CI： -0.12 to 0.07; P=0.58 , SE within ±0.5 D OR 1.25; 95%CI： 0.34 to 4.65; P=0.74）, HOAs （WMD -0.04; 95%CI： -0.09 to 0.01; P=0.14） and CCT WMD 1.83; 95%CI： -7.07 to 10.72; P=0.69, CH WMD -0.01; 95%CI： -0.42 to 0.40; P=0.97, CRF WMD 0.17; 95%CI： -0.33 to 0.67; P=0.50） in the last fellow-up. But for safety, FLEx may achieve fewer CDVA lost two or more two lines （OR 11.11; 95%CI： 1.27 to 96.86; P=0.03） than SMILE, however CDVA （WMD 0.00; 95%CI： -0.03 to 0.02; P=0.77） is similar. CONCLUSION： SMILE and FLEx are comparable in terms of both efficacy, accuracy, aberrations and corneal biomechanical measures in the follow-up,but FLEx seems to be better in safety measures. The results should be interpreted cautiously since relevant evidence is still limited, although it is accumulating. Further large-scale, well-designed randomized controlled trials are urgently needed.

关键词： myopia small-incision lenticule extraction femtosecond lenticule extraction Meta-analysis

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Delayed diffuse lamellar keratitis after small-incision lenticule extraction related to immunoglobulin A nephropathy:A case report

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World Journal of Clinical Cases 2022年第13期10卷 4131-4136页

作者： Ting-Ting Dan Tai-Xiang Liu Yi-Lu Liao Zong-Ze Li Department of Ophthalmology The Affiliated Hospital of Zunyi Medical UniversityZunyi 563003Guizhou ProvinceChina

BACKGROUND Diffuse lamellar keratitis(DLK)is a complication of laser-assisted in situ keratomileusis(LASIK).This condition can also develop after small-incision lenticule extraction(SMILE)with a distinctive *** report the case involving a female patient with delayed onset DLK accompanied by immunoglobulin A(IgA)*** SUMMARY A 22-year-old woman was referred to our department for DLK and a decline in vision 1 mo after undergoing *** initial examination showed grade 2 DLK in the flap involving the central visual axis of the right *** was immediately administered with a large dose of a topical steroid for 30 ***,the treatment was *** vision deteriorated from 10/20 to 6/20,and DLK gradually worsened from grade 2 to ***,interface washout was performed,after which her vision *** completely disappeared 2 mo after *** months after SMILE,the patient was diagnosed with IgA nephropathy due to a 4-year history of interstitial *** DLK is a typical complication of LASIK but can also develop after *** steroid therapy was ineffective in our patient,and interface washout was *** nephropathy could be one of the factors contributing to the development of delayed DLK after SMILE.

关键词： Diffuse lamellar keratitis small-incision lenticule extraction Immunoglobulin A nephropathy Laser-assisted in situ keratomileusis Case report

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Cap morphology after small-incision lenticule extraction and its effects on intraocular scattering

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International Journal of Ophthalmology(English edition) 2018年第3期11卷 456-461页

作者： Dan Fu Lin Wang Xing-Tao Zhou Zhi-Qiang Yu Eye and ENT Hospital of Fudan University Shanghai 200031 China Myopia Key Laboratory of the Health Ministry Shanghai 200031 China

AIM： To investigate cap morphology after small-incision lenticule extraction （SMILE） and its effects on intraocular scattering. METHODS： Sixty-five eyes of 33 patients undergoing SMILE were enrolled. In addition to regular evaluation, Fourier-domain optical coherence tomography was used to investigate cap thickness at ld, lwk, 1 and 3mo postoperatively. The optical quality including modulation transfer function cutoff frequency, Strehl ratio, Optical Quality Analysis System （OQAS） values, and objective scattering index （OSI）, were evaluated using OQASTM. RESULTS： Cap thickness decreased from ld to lwk （P〈0.001）, but remained higher than intended thickness of 120 μm after 3mo （P〈0.001）. Cap thickness in central area was thinner than that of in the paracentral and peripheral areas （P〈0.0001）. Total number of microdistortions decreased from ld to 3mo （P〈0.0001）. Pearson analysis revealed a weak correlation between OSI and standard deviation of cap thickness at ld and lmo, as well as between range of cap thickness and OSI at 1mo. No correlation was found between microdistortion and OSI, but a negative correlation existed between microdistortion and range at ld and lmoafter surgery. CONCLUSION： The corneal cap tends to be more accurate and regular with time lapse. Better cap morphology tends to contribute less intraocular scattering in the eyes undergoing SMILE.

关键词： corneal cap intraocular scattering microdis-tortion small-incision lenticule extraction

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Efficacy, safety, predictability, aberrations and corneal biomechnical parameters after SMILE and FLEx: Metaanalysis

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International Journal of Ophthalmology(English edition) 2016年第5期9卷 757-762页

作者： Jing Ma Nan-Jue Cao Li-Kun Xia Department of Ophthalmology Shengjing Hospital of China Medical University

AIM： To identify possible differences of efficacy, safety predictability, higher-order aberrations and cornea biomechnical parameters after small-incision lenticule extraction（SMILE） and femtosecond lenticule extraction（FLEx）.· METHODS： A systematic literature retrieval was conducted in Medline,Embase and the Cochrane Library up to October, 2015. The included studies were subject to a Meta-analysis. Comparison between SMILE and FLEx was measured as pooled odds ratio（OR） or weighted mean differences（WMD）. Of 95% confidence intervals（CI） were used to analyze data.·RESULTS： A total of seven studies were included Firstly, there were no differences in uncorrected distance visual acuity（UDVA） 20/20 or better（OR, 1.37; 95% CI0.69 to 2.69; P =0.37） and log MAR UDVA（WMD,-0.02;95% CI,-0.05 to 0.01; P =0.17） after SMILE versus FLEx We found no differences in corrected distance visua acuity（CDVA） unchanged（OR, 0.98; 95% CI, 0.46 to 2.11;P =0.97） and log MAR CDVA（WMD,-0.00; 95% CI,-0.01 to 0.01; P =0.90） either. Secondly, we found no differences in refraction within ±1.00 D（OR, 0.98; 95% CI0.13 to 7.28; P =0.99） and ±0.50 D（OR, 1.62; 95% CI0.62 to 4.28; P =0.33） of target postoperatively. Thirdly for higher-order aberrations, we found no differences in the total higher-order aberrations（WMD,-0.04; 95%CI,-0.09 to 0.01;P =0.14）, coma（WMD,-0.04; 95% CI,-0.09 to 0.01; P =0.11）, spherical（WMD, 0.01; 95% CI,-0.02 to0.03; P =0.60） and trefoil（WMD,-0.00; 95% CI,-0.04 to0.03; P =0.76）. Furthermore, for corneal biomechanica parameters, we also found no differences（WMD, 0.08;95% CI,-0.17 to 0.33; P =0.54） after SMILE versus FLEx.·CONCLUSION： There are no statistically differences in efficacy, safety, predictability, higher-order aberrations and corneal biomechnical parameters postoperative between SMILE and FLEx.

关键词： visual quality aberrations corneal biomechnical parameters small-incision lenticule extraction femtosecond lenticule extraction

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