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Corneal wound healing and inflammatory responses after small incision lenticule extraction (SMILE): comparison of the effects of different refractive corrections and surgical experiences

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Session Details

Session Title: Presented Poster Session: Femtolaser Refractive Applications

Session Date/Time: Saturday 05/09/2015 | 09:30-11:00

Paper Time: 09:40

Venue: Poster Village: Pod 2

First Author: : Y.Liu SINGAPORE

Co Author(s): :    P. Teo   N. Lwin   G. Yam   J. Mehta     

Abstract Details


To investigate the early corneal wound healing and inflammatory responses after small incision lenticule extraction (SMILE) with different power of corrections and surgical experiences.


Singapore Eye Research Institute


Twenty-four rabbits underwent -2.0 D, -4.0 D, and -8.0 D SMILE, respectively. One eye of each rabbit was performed by surgeon 1 (experienced), and the contralateral eye was performed by surgeon 2 (novice). Slit lamp, anterior segment optical coherence tomography (ASOCT) and in vivo confocal microscopy (IVCM) were performed at 1-day and 1-week postoperatively. The corneas were harvested for immunofluorescence of markers for inflammation (CD11b), wound healing (fibronectin) and keratocyte response (HSP47).


All corneas appeared clear throughout the follow-up period. IVCM showed a greater reflectivity after -8.0 D than -2.0 D correction at day 1 at the lenticule 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 refractive corrections did not significantly affect the expression of CD11b, fibronectin and HSP47. In -2.0 D group, eyes performed by surgeon 2 had thicker central corneal thickness evaluated by ASOCT (P=0.049), and exhibited more CD11b and HSP47- positive cells at day 1 at the small vertical incision (P=0.039 and P=0.042).


The early inflammatory and wound healing responses after SMILE were minimal, and the inflammatory response was independent of different refractive corrections. In the early postoperative period, less surgical experience resulted in an increased inflammatory response in low myopic corrections. Greater keratocyte response was seen in high myopic corrections irrespective of surgeon experience. The results provide new perspective on the treatment after SMILE, suggesting that more anti-inflammatory medication in the early postoperative period may be required when less experienced surgeons perform low myopic treatment or when high myopic treatment is performed.

Financial Interest:


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