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Corneal Epithelial Remodeling After Hyperopic SMILE: A 4-Year Study.

Dan Fu1,2,3,4, Luoli Zhang1,2,3,4, Jianmin Shang1,2,3,4

  • 1Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.

Cornea
|October 2, 2024
PubMed
Summary

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Hyperopic small incision lenticule extraction (SMILE) causes significant central corneal epithelial thinning. This corneal epithelial thickness remodeling stabilizes by one month post-surgery and does not correlate with refractive outcomes.

Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Refractive Surgery

Background:

  • Hyperopic small incision lenticule extraction (SMILE) is a refractive surgery procedure.
  • Understanding dynamic changes in corneal epithelial thickness (ET) post-hyperopic SMILE is crucial for assessing long-term outcomes.

Purpose of the Study:

  • To investigate dynamic changes in corneal epithelial thickness (ET) following hyperopic small incision lenticule extraction (SMILE).

Main Methods:

  • Observational study of 18 eyes from 16 patients undergoing hyperopic SMILE.
  • High-resolution spectral-domain optical coherence tomography and custom algorithm used to measure corneal ET.
  • ET analyzed in central, pericentral, and peripheral sectors at baseline and up to 4 years post-surgery.
Keywords:
corneal epitheliumhyperopiarefraction regressionsmall incision lenticule extraction

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Main Results:

  • Average ET decreased by 11.0% at 4 years post-hyperopic SMILE (P<0.001).
  • Central 2 mm ET showed the most significant thinning (14.5%).
  • Corneal epithelial thickness and front corneal curvature stabilized by 1 month post-surgery; no correlation found between ET changes and refractive regression.

Conclusions:

  • Hyperopic SMILE induces significant and lasting central corneal epithelial thinning.
  • Corneal epithelial remodeling in the 6 mm area stabilizes early post-surgery (1 month).
  • Postoperative corneal epithelial thickness changes do not appear to underlie refractive outcomes in hyperopic SMILE.