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Wound healing profiles of hyperopic-small incision lenticule extraction (SMILE).

Abstract
Refractive surgical treatment of hyperopia still remains a challenge for refractive surgeons. A new nomogram of small incision lenticule extraction (SMILE) procedure has recently been developed for the treatment of hyperopia. In the present study, we aimed to evaluate the wound healing and inflammatory responses of this new nomogram (hyperopic-SMILE), and compared them to those of hyperopic-laser-assisted in situ keratomileusis (LASIK), using a rabbit model. A total of 26 rabbits were used, and slit lamp biomicroscopy, autorefractor/keratometer, intraocular pressure measurement, anterior segment optical coherence tomography, corneal topography, and in vivo confocal microscopy examinations were performed during the study period of 4 weeks. The corneas were then harvested and subject to immunofluorescence of markers for inflammation (CD11b), wound healing (fibronectin) and keratocyte response (HSP47). The lenticule ultrastructual changes were also analyzed by transmission electron microscopy. Out results showed that hyperopic-SMILE effectively steepened the cornea. Compared to hyperopic-LASIK, hyperopic-SMILE had less postoperative wound healing response and stromal interface reaction, especially in higher refractive correction. However, compared to myopic-SMILE, hyperopic-SMILE resulted in more central deranged collagen fibrils. These results provide more perspective into this new treatment option for hyperopia, and evidence for future laser nomogram modification.
AuthorsYu-Chi Liu, Heng Pei Ang, Ericia Pei Wen Teo, Nyein Chan Lwin, Gary Hin Fai Yam, Jodhbir S Mehta
JournalScientific reports (Sci Rep) Vol. 6 Pg. 29802 (07 15 2016) ISSN: 2045-2322 [Electronic] England
PMID27418330 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • CD11b Antigen
  • Fibronectins
  • HSP47 Heat-Shock Proteins
Topics
  • Animals
  • CD11b Antigen (metabolism)
  • Cornea (metabolism, surgery, ultrastructure)
  • Corneal Topography
  • Fibronectins (metabolism)
  • HSP47 Heat-Shock Proteins (metabolism)
  • Hyperopia (diagnostic imaging, physiopathology, surgery)
  • Keratomileusis, Laser In Situ (methods)
  • Microscopy, Confocal
  • Microscopy, Electron, Transmission
  • Ophthalmologic Surgical Procedures (methods)
  • Rabbits
  • Tomography, Optical Coherence
  • Wound Healing

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