PMID- 30203530
OWN - NLM
STAT- MEDLINE
DCOM- 20190412
LR  - 20190412
IS  - 1755-3768 (Electronic)
IS  - 1755-375X (Linking)
VI  - 97
IP  - 2
DP  - 2019 Mar
TI  - Comparison of corneal biomechanical changes after refractive surgery by 
      noncontact tonometry: small-incision lenticule extraction versus flap-based 
      refractive surgery - a systematic review.
PG  - 127-136
LID - 10.1111/aos.13906 [doi]
AB  - Corneal refractive surgery disrupts corneal integrity and reduces biomechanical 
      stability in consequence of the beneficial refractive alteration. The minimal 
      invasive cap-based refractive procedure, small-incision lenticule extraction 
      (SMILE), has been proposed to affect corneal integrity less than flap-based 
      procedures, due to the fibre-sparing incision of the strong anterior corneal 
      lamellae. Flap-based procedures include laser-assisted in situ keratomileusis 
      (LASIK), femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and 
      femtosecond lenticule extraction (FLEx). The purpose of this systematic review 
      was to evaluate corneal biomechanical changes by noncontact air pulse tonometry 
      after treatment of myopia/myopic astigmatism with SMILE compared to flap-based 
      refractive surgery. A total of 220 publications were identified through a 
      systematic search in PubMed and Embase. Two levels of screening identified nine 
      studies (three randomised controlled trials (RCT) and six nonrandomised clinical 
      trials) eligible for the review. All the nonrandomised clinical trials were 
      graded to have an overall serious risk of bias. Measurements with the Corvis ST 
      were not included in any of the eligible studies. The RCTs found no statistical 
      significant differences between SMILE or flap-based procedures concerning corneal 
      hysteresis (CH) or corneal resistance factor (CRF), as measured with the Ocular 
      Response Analyzer. However, a greater reduction in CRF and CH was found in the 
      flap-based group in five and two of the nonrandomised studies, respectively. The 
      findings in this review illustrate that the presumed biomechanical advantages of 
      a cap-based small incision could not be demonstrated in existing studies and by 
      commercially available technology. However, studies with lower levels of evidence 
      suggest less affection of corneal viscoelastic properties after SMILE when 
      evaluating corneal stability by noncontact tonometry.
CI  - (c) 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & 
      Sons Ltd.
FAU - Raevdal, Pernille
AU  - Raevdal P
AD  - Department of Ophthalmology, Odense University Hospital, Odense, Denmark.
AD  - Research Unit of Ophthalmology, University of Southern Denmark, Odense, Denmark.
FAU - Grauslund, Jakob
AU  - Grauslund J
AUID- ORCID: 0000-0001-5019-0736
AD  - Department of Ophthalmology, Odense University Hospital, Odense, Denmark.
AD  - Research Unit of Ophthalmology, University of Southern Denmark, Odense, Denmark.
FAU - Vestergaard, Anders Hojslet
AU  - Vestergaard AH
AUID- ORCID: 0000-0003-1687-4899
AD  - Department of Ophthalmology, Odense University Hospital, Odense, Denmark.
AD  - Research Unit of Ophthalmology, University of Southern Denmark, Odense, Denmark.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
DEP - 20180910
PL  - England
TA  - Acta Ophthalmol
JT  - Acta ophthalmologica
JID - 101468102
SB  - IM
MH  - Biomechanical Phenomena
MH  - Cornea/pathology/*physiopathology/surgery
MH  - Corneal Topography
MH  - Humans
MH  - Keratomileusis, Laser In Situ/*methods
MH  - Myopia/physiopathology/*surgery
MH  - *Surgical Flaps
MH  - Visual Acuity
OTO - NOTNLM
OT  - air pulse tonometry, myopia
OT  - corneal biomechanics
OT  - femtosecond laser
OT  - femtosecond lenticule extraction
OT  - laser in situ keratomileusis
OT  - small-incision lenticule extraction
OT  - systematic review
EDAT- 2018/09/12 06:00
MHDA- 2019/04/13 06:00
CRDT- 2018/09/12 06:00
PHST- 2018/05/02 00:00 [received]
PHST- 2018/08/04 00:00 [accepted]
PHST- 2018/09/12 06:00 [pubmed]
PHST- 2019/04/13 06:00 [medline]
PHST- 2018/09/12 06:00 [entrez]
AID - 10.1111/aos.13906 [doi]
PST - ppublish
SO  - Acta Ophthalmol. 2019 Mar;97(2):127-136. doi: 10.1111/aos.13906. Epub 2018 Sep 
      10.