Assessing The Effects Of Preoperative Central Epithelial Thickness On The Outcomes Of Lenticule Extraction Procedures: A Retrospective Case Series

Purpose: Impact of preoperative central epithelial thickness on 3-months outcomes of SmartSight lenticule extraction for myopic astigmatism with a new femtosecond laser system.

Private Practice

Methods: 414 treated eyes with preoperative central epithelial thickness of 53µm or more (Group A) were compared a 3-months postoperatively to 346 treated eyes with preoperative central epithelial thickness of 49µm or less (Group S). Mean age of the patients was 29±6 years with a mean spherical equivalent of -4.49±1.91 diopters (D) and a mean magnitude of refractive astigmatism of 0.78±0.68 D.

Preoperative central epithelial thickness was 7±1µm thicker for the group with treatments preoperative central epithelial thickness 53µm or more (p<.0001); patients were -1±1year younger, the SEq was 0.4±0.1D less myopic, there were more males in the thicker epithelium group, respectively (p<.0001 for all). At 3-months postoperatively, SEq was 0.1±0.1D more hyperopic, and astigmatism was -0.02±0.01D lower for the thicker epithelium group (p<.01); postoperatively the epithelium in the thinner epithelium group thickenned by +2±3µm, whereas in the thicker epithelium group thinned by -1±4µm, yet postoperatively the thicker epithelium group remained with a thicker epithelium than the thinner group.

Lenticule extraction treatment using SmartSight is safe and efficacious at 3-months. Findings suggest that preoperative central epithelial thickness has a subtle yet statistically significant impact in the refractive outcomes (with preoperative thicker epithelium leading to relative overcorrections).