June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Corneal Biomechanical and Biometric changes after Femtosecond Small Incision Lenticule Extraction (SMILE) refractive procedure at different treatment depths.
Author Affiliations & Notes
  • Arturo Ramirez-Miranda
    cornea and refractive surgery, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Simran Mangwani-Mordani
    cornea and refractive surgery, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • José Y Arteaga-Rivera
    cornea and refractive surgery, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Alejandro Navas
    cornea and refractive surgery, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Enrique O Graue-Hernandez
    cornea and refractive surgery, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico City, Mexico
  • Jorge Eugenio Valdez-Garcia
    Ophthalmology, Instituto Tecnologico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico
  • Footnotes
    Commercial Relationships   Arturo Ramirez-Miranda None; Simran Mangwani-Mordani None; José Arteaga-Rivera None; Alejandro Navas None; Enrique Graue-Hernandez None; Jorge Eugenio Valdez-Garcia None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 4376 – A0313. doi:
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      Arturo Ramirez-Miranda, Simran Mangwani-Mordani, José Y Arteaga-Rivera, Alejandro Navas, Enrique O Graue-Hernandez, Jorge Eugenio Valdez-Garcia; Corneal Biomechanical and Biometric changes after Femtosecond Small Incision Lenticule Extraction (SMILE) refractive procedure at different treatment depths.. Invest. Ophthalmol. Vis. Sci. 2022;63(7):4376 – A0313.

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

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Abstract

Purpose : To compare the changes of biomechanical properties, endothelial cell density (ECD), higher-order aberrations, and posterior corneal elevation (PCE) of Femtosecond Small Incision Lenticule Extraction (SMILE) at depths of 100 um, 120um, 140um and 160um

Methods : This retrospective, comparative case series was designed to assess outcomes following SMILE procedures performed at a large surgical center by cornea specialists between May 1, 2020 and September 30, 2021. Four cap depth settings were compared: 100 um, 120um, 140um and 160um. Preoperative corneal biomechanical properties, posterior corneal elevation (PCE), total high-order aberrations (THOA), and endothelial cell density (ECD) by Scheimpflug Tomography (Pentacam AXL) , Dynamic Scheimpflug analyzer (Corvis ST) and specular microscopy (Konan SP 9000-LC) respectively, were measured preoperatively and on days 1, 7, 30 and 90 postoperative.
PCE changes by Pentacam were calculated at the corneal apex. Three parameters including deformation amplitude (DA), first applanation time (A1T), and second applanation time (A2T) were chosen for analysis, and then the ECD was automatically calculated by the computer software.

Results : A total of 140 patients (280 eyes) met the inclusion criteria: 70 eyes in 100nm cap depth SMILE group, 700 eyes in 120nm cap depth SMILE group, 70 eyes in 140nm cap depth SMILE group and 700 eyes in 160nm cap depth SMILE group.
Neither deformation amplitude (DA) nor the first applanation time (A1T) were significantly different between the groups. The second applanation time (A2T) was similar between the groups on days 1, 7, 30 with the exception of 90 days after surgery (22.52±0.18 ms in the 160-cap group versus 22.02 ±0.23 ms in the 140-cap group versus 21.84 ±0.24 ms in the 120-cap group versus 21.34 ±0.34 ms in the 100-cap group, p = 0.004). DA curve depth(µm) was steeper in the 100um depth cap, and the curve will be reduced as the SMILE has a deeper cap. AT2 will be significantly shorter in the 100um depth cap SMILE than in the 160um depth cap. No statistically significant differences were found between the different depth groups regarding THOA, ECD, CV and HEX.

Conclusions : A deeper cap while performing SMILE (140-160um) has less biomechanical effect in the cornea than SMILE with a cap created at 100-120 um.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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