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Corneal epithelial remodeling induced by femtosecond laser small incision lenticule extraction (SMILE)

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Session Details

Session Title: Interactive Free Paper Session: Femtosecond Small Lenticule Extraction I

Session Date/Time: Monday 07/09/2015 | 09:00-11:00

Paper Time: 09:00

Venue: Room 19

First Author: : N.Luft AUSTRIA

Co Author(s): :    M. Ring   M. Dirisamer   M. Bolz   T. Kreutzer   J. Pretzl   S. Priglinger     

Abstract Details


To assess the changes in central and peripheral corneal epithelial thickness (CET) after refractive small incision lenticule extraction (SMILE).


Ars Ophthalmica Study Center, Department of Ophthalmology, General Hospital (AKH) Linz, Austria


This prospective observational study included patients that underwent uneventful SMILE surgery. Anterior segment SD-OCT (RS-3000 Advance; NIDEK Co. Ltd., Gamagori, Japan) and a custom-built software algorithm for semi-automated quantitative OCT image analysis were used to evaluate corneal epithelial thickness at 17 measurement points within the central 5mm zone in the horizontal, vertical and oblique meridians. Measurements were taken preoperatively, on the first postoperative day, 1 week, 6 weeks as well as 3 months, 6 months and 12 months postoperatively.


Forty eyes of 20 patients were included and mean age was 35±7 years. Mean spherical equivalent of the extracted lenticules was 5.22±1.57 diopters and mean lenticule thickness was 100±21 µm. Preliminary results showed that mean CET in the central 5mm zone was 52.3±3.4µm preoperatively, 52.8±3.3µm on day 1 (p=0.99), 53.4±3.8µm after 1 week (p=0.43), 55.6±3.3µm after 6 weeks (p=0.01) and 56.9±4.5µm after 3 months (p=0.01). The amount of corneal epithelial hyperplasia was strongly correlated with spherical equivalent and thickness of the extracted lenticule (p=0.02).


SMILE seems to induce corneal epithelial remodeling with a delayed onset. The postoperative increase in CET was strongly correlated with the amount of refractive correction and the thickness of the extracted lenticule. A comprehensive analysis of corneal epithelial remodeling in the first 6 postoperative months as well as eventual impact on refractive and visual outcomes will be presented.

Financial Interest:


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