Cause and Clinical Effect of Strengthen Surgery After Femtosecond Laser Small Incision Lenticule Extraction
SUN Hongyan
ZHOU Yuanpei
MA Xiaoqian
LIU Subing
WANG Peipei
TIAN Yuan
LI Qing
Abstract：Objective To analyze the causes of transepithelial photo refractive keratectomy(T-PRK)strengthen surgery after femtosecond laser small incision lenticule extraction(SMILE),and observe its surgery efficacy.Methods A retrospective study was conducted.A total of 19 patients(29 eyes)who underwent corneal strengthen surgery after SMILE in Zhengzhou Huaxia Vision Eye Hospital were selected from June 2016 to December 2022.The causes were analyzed in terms of diopter,axial,curvature,adjustment amplitude,postoperative dry eye,occurrence time,and medication,and the clinical effect of corneal strengthen surgery was observed.Results The occurrence time of enhanced surgery was 7-48(26.59±16.02)months after SMILE surgery.Spherical equivalent was-0.75--3.65(-1.43±0.54)D,all patients were refractive regression.Strengthening surgery mostly occured in the early stages of SMILE surgery.Among them,7 eyes were moderate myopia and 22 eyes were high myopia.Two eyes had corneal curvature＞45 D,and the rest of the patients had corneal curvature＜42 D.The diopter after mydriasis pupil was lower than the diopter under the normal pupil about the changes of adjusting tension(P=0.005).The axial length of 18 year old patients before undergoing enhanced surgery was higher than that before SMILE surgery,while others were lower than before SMILE surgery.All patients had different degrees of dry eye after SMILE,and they were treated with tear drops and OPT intense pulsed light treatment.The height of the lacrimal canal after treatment was larger than before treatment,the tear film rupture time was longer than before treatment(P＜0.05).Visual acuity improved by 5 eyes in 2 rows,15 eyes in 3 rows,and 9 eyes in 4 rows.After treatment of timolol eye dropst,the naked eye vision was higher than before treatment(P=0.023),which can delay visual impairment.After 3 months of enhanced surgery,the naked eye visual acuity of patients was higher than the best corrected visual acuity before surgery.Conclusion SMILE surgery is safe and stable,however,patients with moderate to high myopia,corneal flattening,progressive axial growth,high adjusting tension and postoperative dry eyes are more likely to undergo strengthen surgery.The incidence of strengthen surgery is low,and T-PRK is safe and effective.
Keywords：femtosecond laser small incision lenticule extractionrefractive errorrefractive regressioncorneal strengthen surgerycause analysis
Publication Date：2024-06-30
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：5( 2196-2200 )