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Chen S, Ma H, Zhao C. Corneal biomechanics after small incision lenticule extraction and femtosecond laser in situ keratomileusis: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e34580. [PMID: 37565903 PMCID: PMC10419641 DOI: 10.1097/md.0000000000034580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/13/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK) have been extensively studied as the main surgical methods for corneal refractive surgery. However, there is no consensus on whether SMILE is superior to FS-LASIK in corneal biomechanics. Therefore, this systematic review and meta-analysis used the results of ocular response analyzer and corvis ST to explore whether SMILE is superior to FS-LASIK in corneal biomechanics. METHODS The literature was searched in PubMed, EMBASE, and Controlled Trials Register databases. The Cochrane Collaboration's "risk of bias" tool was used to evaluate the quality of the included randomized clinical trials, and the Newcastle-Ottawa Scale was used to evaluate the included non-randomized controlled trials. The results were analyzed using Revman 5.3. RESULTS Sixteen studies (3 randomized clinical trials and 13 non-randomized controlled trials) were included in this meta-analysis. There was no statistical difference in corneal biomechanics between SMILE and FS-LASIK in corneal hysteresis [mean difference (MD), 0.20; 95% confidence interval (CI): -0.09, 0.49; P = .18] and corneal resistant factor (MD, 0.31; 95% CI: -0.09, 0.71; P = .13), A1 time (MD, -0.02; 95% CI: -0.11, 0.07; P = .66), A1 length (MD, 0.01; 95% CI: -0.01, 0.03; P = .42), A1 velocity (MD, 0.00; 95% CI: -0.01, 0.01; P = .85), A2 velocity (MD, -0.01; 95% CI: -0.11, 0.09; P = .86), HC time (MD, 0.12; 95% CI: -0.13, 0.38; P = .35), The stiffness parameter at first applanation (MD, -7.91; 95% CI: -17.96, 2.14; P = .12), The ratio between the deformation amplitude 2 mm away from apex and the apical deformation (MD, 0.01; 95% CI: -0.26, 0.27; P = .96). CONCLUSION A comprehensive assessment of the parameters of ocular response analyzer and corvis ST showed that SMILE is not superior to LASIK in corneal biomechanics 3 months post-surgery.
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Affiliation(s)
- Songbai Chen
- Aier Huangpi Eye Hospital, Wuhan, Hubei Province, China
| | - Hongjie Ma
- Zhengzhou Aier Eye Hospital, Zhengzhou, Henan Province, China
| | - Congling Zhao
- Aier Huangpi Eye Hospital, Wuhan, Hubei Province, China
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Boiko EV, Togo ES, Suetov AA, Kachanov AB, Litvin IB. [Direct assessment of changes in biomechanical properties of the cornea after ReLEx SMILE and FemtoLASIK surgeries]. Vestn Oftalmol 2023; 139:41-48. [PMID: 37379108 DOI: 10.17116/oftalma202313903141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
The aim of this study was to evaluate corneal biomechanical properties in myopic patients after ReLEx SMILE and FemtoLASIK surgeries using the Corvis ST analyzer. MATERIAL AND METHODS The SMILE group comprised 23 patients (46 eyes) with spherical refraction -3.8±1.8 diopters (D), the FemtoLASIK group included 18 patients (36 eyes) with spherical refraction -3.5±1.3 D. Analysis of the biomechanical properties of the cornea was carried out using the CORVIS ST device (Oculus, Germany) before and seven days after corneal refractive surgery. RESULTS In the SMILE group, with intraoperative decrease in corneal thickness of 91.43±19.43 µm, a significant increase in the following parameters was observed: deformation coefficient (DA ratio; p=0.0001), peak distance (PD; p=0.02) and inverse concave radius (ICR; p=0.003); a decrease in the stiffness parameter at first applanation (SP-A1; p=0.0001), Corvis biomechanical index (CBI; p=0.0001), intraocular pressure (IOP; p=0.001). In the FemtoLASIK group, with intraoperative decrease in corneal thickness of 75.33±32.3 µm, we observed a significant increase in DA ratio (p=0.0002), PD (p=0.04), ICR (p=0.0002), a decrease in SP-A1 (p<0.0001), IOP values (p=0.0003). In comparison with the FemtoLASIK group, the deformation amplitude DA changed significantly less in the SMILE group (p=0.04). In the FemtoLASIK group, in comparison with the SMILE group, the DA ratio (p=0.0009) and SP-A1 (p=0.0003) significantly increased. Intraoperative corneal thickness change correlates with ICR both in SMILE (R=0.52) and in FemtoLASIK (R=0.65). CONCLUSION Corneal biomechanical properties determined with CORVIS ST in eyes with mild to moderate myopia change to a lesser extent after ReLEx SMILE compared to FemtoLASIK.
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Affiliation(s)
- E V Boiko
- Saint Petersburg branch of S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", St. Petersburg, Russia
- North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia
| | - E S Togo
- Saint Petersburg branch of S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", St. Petersburg, Russia
- North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia
| | - A A Suetov
- Saint Petersburg branch of S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", St. Petersburg, Russia
| | - A B Kachanov
- Saint Petersburg branch of S.N. Fedorov National Medical Research Center "MNTK "Eye Microsurgery", St. Petersburg, Russia
- North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia
| | - I B Litvin
- North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia
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Ang RET, Bargas NVR, Martinez GHA, Sosuan GMN, Nabor-Umali MI. Comparison of Three Tonometers in Measuring Intraocular Pressure in Eyes That Underwent Myopic Laser in situ Keratomileusis and Photorefractive Keratectomy. Clin Ophthalmol 2022; 16:1623-1637. [PMID: 35656390 PMCID: PMC9153993 DOI: 10.2147/opth.s362344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/16/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Methods Results Conclusion
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Affiliation(s)
- Robert Edward T Ang
- Department of Ophthalmology, Cardinal Santos Medical Center, San Juan City, Metro Manila, Philippines
- Cornea and Refractive Surgery Service, Asian Eye Institute, Makati City, Metro Manila, Philippines
- Glaucoma Service, Asian Eye Institute, Makati City, Metro Manila, Philippines
- Correspondence: Robert Edward T Ang, Cornea and Refractive Surgery and Glaucoma Services, Asian Eye Institute, Makati City, Metro Manila, Philippines, Email
| | - Neiman Vincent R Bargas
- Department of Ophthalmology, Cardinal Santos Medical Center, San Juan City, Metro Manila, Philippines
| | - Gladness Henna A Martinez
- Department of Ophthalmology, Cardinal Santos Medical Center, San Juan City, Metro Manila, Philippines
| | | | - Maria Isabel Nabor-Umali
- Cornea and Refractive Surgery Service, Asian Eye Institute, Makati City, Metro Manila, Philippines
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Ye S, Bao C, Chen Y, Shen M, Lu F, Zhang S, Zhu D. Identification of Peripheral Anterior Synechia by Corneal Deformation Using Air-Puff Dynamic Anterior Segment Optical Coherence Tomography. Front Bioeng Biotechnol 2022; 10:856531. [PMID: 35433648 PMCID: PMC9011042 DOI: 10.3389/fbioe.2022.856531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
Indentation gonioscopy is commonly used in the clinic to evaluate peripheral anterior synechia (PAS) of angle closure glaucoma (ACG). The examination requires contacting with the cornea, resulting in an uncomfortable feeling for patients, and it only provides qualitative outcomes which may be affected by subjective judgment of the clinicians. Previous studies had reported to identify the presence of PAS by measuring the changes of morphological parameters of the anterior chamber angle (ACA) under the pupillary light reflex, by anterior segment optical coherence tomography (AS-OCT). However, this method was invalid for some subjects who had low sensitiveness to light. This article describes an air-puff dynamic anterior segment optical coherence tomography (DAS-OCT) system that can evaluate the presence of PAS in a non-contact approach. The peripheral cornea is deformed by an air puff jetted from the DAS-OCT, causing a transfer of force to the ACA, just as how indentation gonioscopy works. The dynamic changes of the ACA before and after the air puff are recorded by OCT. Ten eyes of normal subjects were enrolled in this study to validate the repeatability and availability of the measurements. Then, ten samples of the ACA from five subjects with ACG were recruited and were assigned into two groups, the non PAS group (NPAS) and PAS group, according to the results of gonioscopy. The ACA structural parameters including the angle opening distance at 750 μm to the scleral spur (AOD750) and the trabecular-iris space area at 750 μm anterior to the scleral spur (TISA750) were then calculated automatically by a custom-written algorithm. The intraclass correlation coefficient (ICC) of measured parameters was all above 0.85 for normal subjects, exhibiting good repeatability. For patients, both parameters showed significant differences between the two groups after the air puff, while no differences were observed before the air puff. AOD750dif and TISA750dif between two groups showed more significant differences, indicating that they could be used as indicators to identify the presence of PAS. In conclusion, the DAS-OCT system proposed in this study is demonstrated effective to identify the presence of PAS by measuring the changes of the ACA via a noncontact approach. It shows great potential for applications in guidance for diagnosis of angle closure glaucoma.
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Affiliation(s)
- Shuling Ye
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | | | - Yulei Chen
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Meixiao Shen
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Fan Lu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Shaodan Zhang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Shaodan Zhang, ; Dexi Zhu,
| | - Dexi Zhu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Shaodan Zhang, ; Dexi Zhu,
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Vinciguerra R, Herber R, Wang Y, Zhang F, Zhou X, Bai J, Yu K, Chen S, Fang X, Raiskup F, Vinciguerra P. Corneal Biomechanics Differences Between Chinese and Caucasian Healthy Subjects. Front Med (Lausanne) 2022; 9:834663. [PMID: 35280913 PMCID: PMC8914014 DOI: 10.3389/fmed.2022.834663] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 01/31/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose The aim of this study was to evaluate the difference between Caucasian and Chinese healthy subjects with regards to Corvis ST dynamic corneal response parameters (DCRs). Methods Two thousand eight hundred and eighty-nine healthy Caucasian and Chinese subjects were included in this multicenter retrospective study. Subsequently, Chinese eyes were matched to Caucasians by age, intraocular pressure (IOP), and Corneal Thickness (CCT) using a case-control matching algorithm. The DCRs assessed were Deformation Amplitude (DA) Applanation 1 velocity (A1v), integrated radius (1/R), deformation amplitude ratio (DAratio), stiffness parameter at applanation 1 (SPA1), ARTh (Ambrósio's Relational Thickness to the horizontal profile), and the novel Stress Strain Index (SSI). Results After age-, CCT-, and IOP- matching, 503 Chinese were assigned to 452 Caucasians participants. Statistical analysis showed a statistical significant difference between Chinese and Caucasian Healthy subjects in the values of SPA1 (p = 0.008), Arth (p = 0.008), and SSI (p < 0.001). Conversely, DA, A1v, DAratio, and 1/R were not significantly different between the two ethnical groups (p > 0.05). Conclusion We found significant differences in the values of the DCRs provided by the Corvis ST between Chinese and Caucasian healthy subjects.
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Affiliation(s)
| | - Robert Herber
- Department of Ophthalmology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Yan Wang
- Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Visual Science, Nankai University Affiliated Eye Hospital, Tianjin, China
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Fengju Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Sciences Key Lab, Capital Medical University, Beijing, China
| | - Xingtao Zhou
- EYE & ENT Hospital of Fudan University, Shanghai, China
| | - Ji Bai
- BAI JI Ophthalmology, Chongqing, China
| | - Keming Yu
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Shihao Chen
- Eye Hospital, Wenzhou Medical University, Zhejiang, China
| | | | - Frederik Raiskup
- Department of Ophthalmology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Paolo Vinciguerra
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano, Italy
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Association of Corneal Biomechanics Properties with Myopia in a Child and a Parent Cohort: Hong Kong Children Eye Study. Diagnostics (Basel) 2021; 11:diagnostics11122357. [PMID: 34943594 PMCID: PMC8700309 DOI: 10.3390/diagnostics11122357] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/29/2021] [Accepted: 12/07/2021] [Indexed: 11/17/2022] Open
Abstract
Associations between corneal biomechanics, axial elongation and myopia are important but previous results are conflicting. Our population-based study aimed to investigate factors associated with corneal biomechanics, and their relationships with myopia in children and adults. Data from 3643 children and 1994 parents showed that children had smaller deformation amplitudes (DA) than parents (p < 0.001). A larger DA was significantly associated with elongated axial length (AL; children: ß = 0.011; adults: ß = 0.0013), higher corneal curvature (children: ß = 0.0086; adults: ß = 0.0096), older age (children: ß = 0.010; adults: ß = 0.0013), and lower intraocular pressure (IOP; children: ß = −0.029; adults: ß = −0.031) in both cohorts. The coefficient of age for DA in children was larger than in adults (p < 0.001), indicating that the DA change with age in children is faster than in adults. DA was significantly associated with spherical equivalent (p < 0.001) resulting from its correlation with AL and corneal curvature. In conclusion, the cornea is more deformable in adults than in children, whereas corneal deformation amplitude increases faster with age in children than that in adults, along with AL elongation. Longer AL, steeper corneal curvature, older age and smaller IOP correspond to a more deformable cornea. The association between corneal deformation amplitude and refraction was mediated via AL and corneal curvature.
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Baptista PM, Ambrosio R, Oliveira L, Meneres P, Beirao JM. Corneal Biomechanical Assessment with Ultra-High-Speed Scheimpflug Imaging During Non-Contact Tonometry: A Prospective Review. Clin Ophthalmol 2021; 15:1409-1423. [PMID: 33854295 PMCID: PMC8039844 DOI: 10.2147/opth.s301179] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/05/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In recent years, increasing interest has arisen in the application of data from corneal biomechanics in many areas of ophthalmology, particularly to assist in the detection of early corneal ectasia or ectasia susceptibility, to predict corneal response to surgical or therapeutic interventions and in glaucoma management. Technology has evolved and, recently, the Scheimpflug principle was associated with a non-contact air-puff tonometer, allowing a thorough analysis of corneal biomechanics and a biomechanically corrected intraocular pressure assessment, opening up new perspectives both in ophthalmology and in other medical areas. Data from corneal biomechanics assessment are being integrated in artificial intelligence models in order to increase its value in clinical practice. OBJECTIVE To review the state of the art in the field of corneal biomechanics assessment with special emphasis to the technology based on ultra-high-speed Scheimpflug imaging during non-contact tonometry. SUMMARY A meticulous literature review was performed until the present day. We used 136 published manuscripts as our references. Both information from healthy individuals and descriptions of possible associations with systemic diseases are described. Additionally, it exposed information regarding several fields of ocular pathology, from cornea and ocular surface through areas of refractive surgery and glaucoma until vascular and structural diseases of the chorioretinal unit.
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Affiliation(s)
- Pedro Manuel Baptista
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal
| | - Renato Ambrosio
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro, RJ, Brazil
- Department of Cornea and Refractive Surgery, Instituto de Olhos Renato Ambrósio, Rio de Janeiro, Brazil
- Department of Opthalmology, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
- Federal University of São Paulo (UNIFESP), São Paulo, Brazil
- Brazilian Study Group of Artificial Intelligence and Corneal Analysis - BrAIN, Rio de Janeiro & Maceió, Brazil
| | - Luis Oliveira
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Pedro Meneres
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal
| | - Joao Melo Beirao
- Ophthalmology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Porto, Portugal
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