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Yu-Chi Liu, Ericia Pei Wen Teo, Nyein Chan Lwin, Gary Hin-Fai Yam, Jodhbir S Mehta; Effects of Surgical Experience on Corneal Wound Healing and Inflammatory Responses after Small Incision Lenticule Extraction (SMILE). Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3923.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the effect of surgical experience on the early corneal wound healing and inflammatory responses with different power of corrections of small incision lenticule extraction (SMILE).
Twenty-four rabbits were divided into 3 groups and underwent -2.0 D, -4.0 D, and -8.0 D SMILE. One eye of each rabbit was performed by surgeon 1 (experienced), and the contralateral eye was performed by surgeon 2 (less experienced). Slit lamp examination, anterior segment optical coherence tomography (ASOCT), and in vivo confocal microscopy (IVCM) were performed at 1 day and 1 week postoperatively. The corneas were then subjected to immunofluorescent assays for CD11b, fibronectin and HSP47.
All corneas appeared clear throughout the follow-up period. There was a significant difference in the central corneal thickness evaluated by ASOCT between two surgeons at day 1 for -2.0 D treatment (P = 0.049). IVCM showed greater reflectivity after -8.0 D correction than -2.0 D correction at day 1 at the anterior, posterior, and extracted lenticule planes (surgeon 1: P = 0.004, P = 0.041, and P = 0.038; surgeon 2: P = 0.012, P = 0.045 and P = 0.031). Different power of corrections did not significantly affect the amount of CD11b, fibronectin, and HSP47 expression. Eyes performed by surgeon 2 exhibited more CD11b- and HSP47-positive cells at day 1 at the small vertical incision in -2.0 D group (P = 0.039 and P = 0.042). The inflammatory and wound healing response subsided at week 1.
The early inflammatory and wound healing response after SMILE was small, and was independent of power of corrections. In low myopic treatment, the disparity in surgeon experiences lead to different extent of inflammatory process.
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