Corneal epithelial remodeling induced by combined small incision lenticule extraction and accelerated corneal collagen crosslinking for myopia

Abstract

To evaluate the changes of the corneal epithelial thickness (ET) profile induced by combined small incision lenticule extraction and accelerated corneal collagen crosslinking (SMILE-xtra) for myopia compared with the standard small incision lenticule extraction (SMILE). Nuri Eye Hospital, 61, Dunsan-ro, Seo-gu, Daejeon, 35233, Korea. Retrospective cross-sectional study. Thirty-one myopic eye undergoing SMILE-xtra and control group of 36 myopic eyes undergoing SMILE were retrospectively analyzed. Spectral-domain optical coherence tomography (CIRRUS™ HD-OCT 5000, ZEISS, Dublin, CA) was used to measure corneal ET of 17 zones within the central 7-mm zone at preoperative, postoperative 1 month, 3 months and 6 months. Postoperative ET alterations were analyzed for correlation with treatment parameters. There was no difference in preoperative mean age, postoperative MRSE, visual acuity, and ablation depth between the two groups, and there was a significant difference in preoperative central corneal thickness. Both groups showed the greatest increase in corneal ET in the paracentral area on the inferotemporal area, respectively, for 6 months. The preoperative MRSE and the ablation depth showed significant correlation with the postoperative epithelial thickening in mid-peripheral sectors in both groups, and significant negative correlations in paracentral sectors only in SMILE-xtra group. It is significant as the first study to compare corneal epithelial remodeling between SMILE and SMILE with accelerated corneal collagen crosslinking. The SMILE-xtra with the relatively large corneal ablation did not show a significant difference in the pattern of corneal epithelial remodeling compared to the SMILE group.