Biomechanical Effects of tPRK, FS-LASIK, and SMILE on the Cornea



Xin, Yue, Lopes, Bernardo T, Wang, JunJie, Wu, Jie, Zhu, ManMan, Jiang, MuChen, Miao, YuanYuan, Lin, HuiNi, Cao, Si, Zheng, XiaoBo
et al (show 6 more authors) (2022) Biomechanical Effects of tPRK, FS-LASIK, and SMILE on the Cornea. FRONTIERS IN BIOENGINEERING AND BIOTECHNOLOGY, 10. 834270-.

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Abstract

<b>Purpose:</b> The objective of this study is to evaluate the <i>in vivo</i> corneal biomechanical response to three laser refractive surgeries. <b>Methods:</b> Two hundred and twenty-seven patients who submitted to transepithelial photorefractive keratectomy (tPRK), femtosecond laser-assisted <i>in-situ</i> keratomileusis (FS-LASIK), or small-incision lenticule extraction (SMILE) were included in this study. All cases were examined with the Corvis ST preoperatively (up to 3 months) and postoperatively at 1, 3, and 6 months, and the differences in the main device parameters were assessed. The three groups were matched in age, gender ratio, corneal thickness, refractive error corrections, optical zone diameter, and intraocular pressure. They were also matched in the preoperative biomechanical metrics provided by the Corvis ST including stiffness parameter at first applanation (SP-A1), integrated inverse radius (IIR), deformation amplitude (DA), and deformation amplitude 2 mm away from apex and the apical deformation (DARatio2mm). <b>Results:</b> The results demonstrated a significant decrease post-operation in SP-A1 and significant increases in IIR, DA, and DARatio2mm (<i>p</i> < 0.05), all of which indicated reductions in overall corneal stiffness. Inter-procedure comparisons provided evidence that the smallest overall stiffness reduction was in the tPRK group, followed by the SMILE, and then the FS-LASIK group (<i>p</i> < 0.05). These results remained valid after correction for the change in CCT between pre and 6 months post-operation and for the percentage tissue altered. In all three surgery groups, higher degrees of refractive correction resulted in larger overall stiffness losses based on most of the biomechanical metrics. <b>Conclusion:</b> The corneal biomechanical response to the three surgery procedures varied significantly. With similar corneal thickness loss, the reductions in overall corneal stiffness were the highest in FS-LASIK and the lowest in tPRK.

Item Type: Article
Uncontrolled Keywords: biomechanical response, in-vivo, tPRK, FS-LASIK, SMILE
Divisions: Faculty of Science and Engineering > School of Engineering
Depositing User: Symplectic Admin
Date Deposited: 16 Feb 2022 09:13
Last Modified: 18 Jan 2023 21:12
DOI: 10.3389/fbioe.2022.834270
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3149009