Changes in anterior chamber dimensions following small incision lenticule extraction (SMILE)

To evaluate the changes in anterior chamber dimensions including horizontal anterior chamber diameter (HACD), anterior chamber depth (ACD), and iridocorneal angle (ICA) following small incision lenticule extraction (SMILE) using Scheimpflug-Placido disk tomographer (Sirius).

The records of the 73 eyes of 47 patients who received SMILE for myopia and myopic astigmatism were retrospectively reviewed. Preoperative and 6-month postoperative measurements of central corneal thickness (CCT), HACD, ACD, ICA, nasal anterior chamber angle (nACA), and temporal anterior chamber angle (tACA) were obtained by tomography, and compared with paired t-tests. Pearson's correlation and linear regression tests were used to evaluate the relationship between these parameters.

The CCT, HACD, and ACD values decreased significantly at 6-month postoperatively (p < 0.05 for all). ICA, nACA, and tACA showed no statistically significant difference postoperatively (p = 0.54, p = 0.118, and p = 0.255, respectively). Pearson's correlation analysis confirms negative relationship between Δ-HACD and Δ-tACA (r = -0.475, p < 0.01), and a loose negative relationship between change in ACD and change in ICA (r = -0.282, p = 0.016). Age and Δ-tACA were found as predictive parameters for Δ-HACD and, Δ-ICA was a predictor for Δ-ACD.

While HACD and ACD decreased significantly, there was no significant change in ICA, nACA and tACA. Changes in HACD and ACD should be considered in terms of subsequent surgeries after SMILE.