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Comparison of risk factors for OBL in FS-LASIK and SMILE correction for myopia and myopia astigmatism

  • Refractive Surgery
  • Published:
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Abstract  

Background

To find out the incidence and risk factors of opaque bubble layer (OBL) in eyes with myopia and myopic astigmatism following femtosecond laser–assisted in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE).

Methods

A total of 1076 eyes from 569 patients who had FS-LASIK or SMILE were included in the retrospective research. For each kind of surgery, eyes were separated into two groups: "OBL" groups and "no OBL" groups. In the FS-LASIK group, eyes that developed OBL were split into "hard OBL" and "soft OBL" groups. The incidence and size of OBL were analyzed after watching the surgical procedure videotaped during the operation and taking screenshots. Surgical parameters, including sphere, cylinder, keratometry, corneal thickness, flap thickness, cap thickness, lenticule thickness, and visual acuity, were compared.

Results

In the FS-LASIK surgery, the incidence of OBL was 63.2% (347 eyes). A thicker central corneal thickness (CCT) was the only independent risk factor affecting the OBL area (β = 0.126, P = 0.019). One hundred and thirty of these eyes had hard OBL, and the flap thickness of these eyes was thinner than that of those with soft OBL (P = 0.027). In the SMILE group, 26.6% (140 eyes) developed OBL. A higher flat keratometry (K) and a thicker residual stromal thickness (RST) were risk factors affecting the OBL area (β = 0.195, P = 0.024; β = 0.281, P = 0.001).

Conclusion

The incidence of OBL differs between the FS-LASIK surgery and the SMILE surgery. There are differences in the factors influencing OBL between the two surgeries.

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Acknowledgements

We would like to thank Nantong Science and Technology Project MSZ2022024 and the Science and Technology Development Plan of Jiangsu Provincial Administration of Traditional Chinese Medicine MS2022091 for financial support. The authors thank Ms. Guojuan Jin and Ms. Jing Zhang for skillful technique assistance.

Funding

This project has been funded in part by grants from Nantong Science and Technology Project MSZ2022024 and the Science and Technology Development Plan of Jiangsu Provincial Administration of Traditional Chinese Medicine MS2022091.

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Author notes

  1. Zichen Wang and Mingrui Li contributed equally to this study.

Authors and Affiliations

  1. Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, No. 20, Xisi Road, Nantong City, 226001, Jiangsu Province, China

    Zichen Wang, Mingrui Li, Haixia Ji, Hui Chen, Aimin Sang, Xinliang Cheng & Ying Yu

  2. Department of Dermatology, Nantong First People’s Hospital, Second Affiliated Hospital of Nantong University, Nantong, 226001, China

    Jun Li

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  1. Zichen Wang
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Contributions

Conceptualization: Hui Chen, Ying Yu; Methodology: Mingrui Li, Haixia Ji; Formal analysis and investigation: Xinliang Cheng, Jun Li; Writing—original draft preparation: Zichen Wang; Writing—review and editing: Ying Yu; Supervision: Aimin Sang.

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Correspondence to Ying Yu.

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This retrospective comparative study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of Affiliated Hospital of Nantong University approved this study.

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Wang, Z., Li, M., Ji, H. et al. Comparison of risk factors for OBL in FS-LASIK and SMILE correction for myopia and myopia astigmatism. Graefes Arch Clin Exp Ophthalmol 262, 1925–1931 (2024). https://doi.org/10.1007/s00417-023-06336-2

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