June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
In vivo confocal laser microscopy of morphologic changes after Small Incision Lenticule Extraction with Accelerated Cross-Linking (SMILE Xtra) in Patients with Thin Corneas and high myopia
Author Affiliations & Notes
  • yugui zhou
    zhongshan ophthalmic center, Guangzhou, Guangdong, China
  • quan liu
    zhongshan ophthalmic center, Guangzhou, Guangdong, China
  • Footnotes
    Commercial Relationships   yugui zhou, None; quan liu, None
  • Footnotes
    Support  No
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5288. doi:
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      yugui zhou, quan liu; In vivo confocal laser microscopy of morphologic changes after Small Incision Lenticule Extraction with Accelerated Cross-Linking (SMILE Xtra) in Patients with Thin Corneas and high myopia. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5288.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate the microstructural modifications and safety of small incision lenticule extraction combined with accelerated cross-Linking (SMILE Xtra) in high myopia and thin corneas by means of in-vivo confocal microscopy (IVCM) and 3D-OCT after a 6-month follow-up.

Methods : Forty-three eyes with high myopia and thin corneas were enrolled. All eyes underwent SMILE Xtra. Morphologic modifications of corneal architecture were evaluated prior to SMILE Xtra and 7 days, 1, 3, and 6 months after SMILE by IVCM and 3D-OCT.

Results : The corneal epithelial cells showed slight damage until 3 months postoperatively. The subepithelial nerve plexus decreased but no absence within the treatment zone at the first week after treatment, recolonized at 3 months postoperatively, and had mostly recovered at the 6 months postoperative but remained less than its normal baseline state. Keratocytes were absent in the surgical interface area, and the presence of strong reflective particles and cicatricial reaction in the anterior stroma were observed during the entire 6-month examination period. Increased hyperreflectivity was observed from the cap side at a depth of 60um to stroma bed at a depth of 388 um through 6 months. The depth of the demarcation line in 40 eyes (93.0%)was at a mean depth of 296.12±47.86μm (range 211 to 388μm). No particular change between preoperative and postoperative corneal endothelium was observed.

Conclusions : Confocal microscopy showed increased hyperreflectivity in the SMILE Xtra eyes. We confirmed the safety of the SMILE Xtra but recognize that larger and longer term studies of SMILE Xtra are necessary.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

Endothelial examined at preoperation (A), 1(B), 3(C), and 6(D) months after treatment. No significant differences were found in cell count or cell morphology between preoperative and postoperative corneal endothelium. HRT image; magnification, 400×400μm

Endothelial examined at preoperation (A), 1(B), 3(C), and 6(D) months after treatment. No significant differences were found in cell count or cell morphology between preoperative and postoperative corneal endothelium. HRT image; magnification, 400×400μm

 

Three-dimensional optical coherence tomography (3D- OCT) images showing corneal morphology at preoperative(A), 1 (B), 3(C) and
6 months (D) postoperative.

Three-dimensional optical coherence tomography (3D- OCT) images showing corneal morphology at preoperative(A), 1 (B), 3(C) and
6 months (D) postoperative.

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