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Effect of Intraoperative Corneal Stromal Pocket Irrigation in Small Incision Lenticule Extraction.

Liu YC, Jayasinghe L, Ang HP, Lwin NC, Yam GH, Mehta JS - Biomed Res Int (2015)

Bottom Line: The results showed that the changes in the total corneal thickness, anterior and posterior lamellar thickness, measured by the anterior segment optical coherence tomography, were comparable between the SMILE with and without irrigation groups, suggesting that the irrigation did not lead to significant changes in the corneal thickness.However, at postoperative 8 hours, in vivo confocal microscopy showed that the interface reflectivity in the SMILE with irrigation group was significantly higher than that in other three groups.Our findings might contribute to the occurrence of post-SMILE delayed immediate visual quality recovery and further clinical study is required.

View Article: PubMed Central - PubMed

Affiliation: Singapore Eye Research Institute, Singapore ; Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751.

ABSTRACT
This study aimed at evaluating the effect of intraoperative corneal pocket irrigation in small incision lenticule extraction (SMILE) and compares it to that in femtosecond laser-assisted in situ keratomileusis (FS-LASIK). Sixteen rabbit eyes underwent a SMILE procedure, with 8 eyes having corneal pocket irrigation, while the other 8 eyes were without irrigation. Another 16 eyes underwent a FS-LASIK procedure for comparison, with 8 eyes having flap irrigation, while the other 8 eyes were without irrigation. The results showed that the changes in the total corneal thickness, anterior and posterior lamellar thickness, measured by the anterior segment optical coherence tomography, were comparable between the SMILE with and without irrigation groups, suggesting that the irrigation did not lead to significant changes in the corneal thickness. However, at postoperative 8 hours, in vivo confocal microscopy showed that the interface reflectivity in the SMILE with irrigation group was significantly higher than that in other three groups. The presence of interface fluid was further confirmed by the identification of fluid pockets with undulated collagen shown on histological section in the post-SMILE with irrigation eyes. Our findings might contribute to the occurrence of post-SMILE delayed immediate visual quality recovery and further clinical study is required.

No MeSH data available.


Representative raster line ASOCT images at 24 hours postoperatively for eyes which underwent (a) SMILE with irrigation, (b) SMILE without irrigation, (c) LASIK with irrigation, and (d) LASIK without irrigation procedure. An increase in the reflectivity could be seen at the cap interface in the post-SMILE eyes (arrowheads) or at the flap interface in the post-FS-LASIK eyes (arrow), and the total corneal thickness and anterior lamellar thickness were accordingly measured. The posterior lamellar thickness was then calculated by subtracting the anterior lamellar thickness from total corneal thickness.
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fig1: Representative raster line ASOCT images at 24 hours postoperatively for eyes which underwent (a) SMILE with irrigation, (b) SMILE without irrigation, (c) LASIK with irrigation, and (d) LASIK without irrigation procedure. An increase in the reflectivity could be seen at the cap interface in the post-SMILE eyes (arrowheads) or at the flap interface in the post-FS-LASIK eyes (arrow), and the total corneal thickness and anterior lamellar thickness were accordingly measured. The posterior lamellar thickness was then calculated by subtracting the anterior lamellar thickness from total corneal thickness.

Mentions: On ASOCT examination, an increase in the reflectivity could be seen at the flap interface in the post-FS-LASIK eyes or cap interface in the post-SMILE eyes (either with or without irrigation) at all the examination time points (Figure 1). The preoperative corneal thickness was 377.8 ± 14.4 μm, 377.5 ± 8.1 μm, 382.0 ± 2.6 μm, and 377.0 ± 15.5 μm for the FS-LASIK with irrigation, FS-LASIK without irrigation, SMILE with irrigation, and SMILE without irrigation groups, respectively (P = 0.883). After surgery, the mean percentage changes in the total corneal thickness, anterior lamellar thickness, and posterior lamellar thickness, at different time points for the four groups, are shown in Figure 2.


Effect of Intraoperative Corneal Stromal Pocket Irrigation in Small Incision Lenticule Extraction.

Liu YC, Jayasinghe L, Ang HP, Lwin NC, Yam GH, Mehta JS - Biomed Res Int (2015)

Representative raster line ASOCT images at 24 hours postoperatively for eyes which underwent (a) SMILE with irrigation, (b) SMILE without irrigation, (c) LASIK with irrigation, and (d) LASIK without irrigation procedure. An increase in the reflectivity could be seen at the cap interface in the post-SMILE eyes (arrowheads) or at the flap interface in the post-FS-LASIK eyes (arrow), and the total corneal thickness and anterior lamellar thickness were accordingly measured. The posterior lamellar thickness was then calculated by subtracting the anterior lamellar thickness from total corneal thickness.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4530243&req=5

fig1: Representative raster line ASOCT images at 24 hours postoperatively for eyes which underwent (a) SMILE with irrigation, (b) SMILE without irrigation, (c) LASIK with irrigation, and (d) LASIK without irrigation procedure. An increase in the reflectivity could be seen at the cap interface in the post-SMILE eyes (arrowheads) or at the flap interface in the post-FS-LASIK eyes (arrow), and the total corneal thickness and anterior lamellar thickness were accordingly measured. The posterior lamellar thickness was then calculated by subtracting the anterior lamellar thickness from total corneal thickness.
Mentions: On ASOCT examination, an increase in the reflectivity could be seen at the flap interface in the post-FS-LASIK eyes or cap interface in the post-SMILE eyes (either with or without irrigation) at all the examination time points (Figure 1). The preoperative corneal thickness was 377.8 ± 14.4 μm, 377.5 ± 8.1 μm, 382.0 ± 2.6 μm, and 377.0 ± 15.5 μm for the FS-LASIK with irrigation, FS-LASIK without irrigation, SMILE with irrigation, and SMILE without irrigation groups, respectively (P = 0.883). After surgery, the mean percentage changes in the total corneal thickness, anterior lamellar thickness, and posterior lamellar thickness, at different time points for the four groups, are shown in Figure 2.

Bottom Line: The results showed that the changes in the total corneal thickness, anterior and posterior lamellar thickness, measured by the anterior segment optical coherence tomography, were comparable between the SMILE with and without irrigation groups, suggesting that the irrigation did not lead to significant changes in the corneal thickness.However, at postoperative 8 hours, in vivo confocal microscopy showed that the interface reflectivity in the SMILE with irrigation group was significantly higher than that in other three groups.Our findings might contribute to the occurrence of post-SMILE delayed immediate visual quality recovery and further clinical study is required.

View Article: PubMed Central - PubMed

Affiliation: Singapore Eye Research Institute, Singapore ; Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751.

ABSTRACT
This study aimed at evaluating the effect of intraoperative corneal pocket irrigation in small incision lenticule extraction (SMILE) and compares it to that in femtosecond laser-assisted in situ keratomileusis (FS-LASIK). Sixteen rabbit eyes underwent a SMILE procedure, with 8 eyes having corneal pocket irrigation, while the other 8 eyes were without irrigation. Another 16 eyes underwent a FS-LASIK procedure for comparison, with 8 eyes having flap irrigation, while the other 8 eyes were without irrigation. The results showed that the changes in the total corneal thickness, anterior and posterior lamellar thickness, measured by the anterior segment optical coherence tomography, were comparable between the SMILE with and without irrigation groups, suggesting that the irrigation did not lead to significant changes in the corneal thickness. However, at postoperative 8 hours, in vivo confocal microscopy showed that the interface reflectivity in the SMILE with irrigation group was significantly higher than that in other three groups. The presence of interface fluid was further confirmed by the identification of fluid pockets with undulated collagen shown on histological section in the post-SMILE with irrigation eyes. Our findings might contribute to the occurrence of post-SMILE delayed immediate visual quality recovery and further clinical study is required.

No MeSH data available.