Comparison Between the Effect of Femtosecond Laser in situ Keratomileusis (FS-LASIK) and Femtosecond Small Incision Lenticule Extraction (FS-SMILE) on the Corneal Endothelium

Yasmine Maher Shaaban,1,2 Tamer Abdel Fattah Badran1,2 1Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt; 2The Eye Subspecialty Center (ESC), Cairo 11402, EgyptCorrespondence: Yasmine Maher ShaabanOphthalmology Department, Faculty of Medicine, Ain Shams Univ...

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Autores principales: Shaaban YM, Badran TAF
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spelling oai:doaj.org-article:5152ea96a1104ec380958ff18a0fed1b2021-12-02T09:13:16ZComparison Between the Effect of Femtosecond Laser in situ Keratomileusis (FS-LASIK) and Femtosecond Small Incision Lenticule Extraction (FS-SMILE) on the Corneal Endothelium1177-5483https://doaj.org/article/5152ea96a1104ec380958ff18a0fed1b2020-09-01T00:00:00Zhttps://www.dovepress.com/comparison-between-the-effect-of-femtosecond-laser-in-situ-keratomileu-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Yasmine Maher Shaaban,1,2 Tamer Abdel Fattah Badran1,2 1Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt; 2The Eye Subspecialty Center (ESC), Cairo 11402, EgyptCorrespondence: Yasmine Maher ShaabanOphthalmology Department, Faculty of Medicine, Ain Shams University, Abbassyia, Cairo 11566, EgyptEmail yasminemaher0@gmail.comPurpose: To compare the effect of FS-LASIK and FS-SMILE on the corneal endothelial cell density (ECD) and morphology.Patients and Methods: This is a prospective, cohort observational study that included 80 eyes of two equal groups of patients. Forty eyes were subjected to the FS-LASIK, and 40 eyes were subjected to the FS-SMILE. In both groups, patients, age ranged between 19 and 37 years with myopia ranges from − 0.75 to − 9.00 diopters (D) and astigmatism up to − 3.00D. The ECD, coefficient of variation (CV), and hexagonality (HEX) in both groups were compared over six months. Specular microscopy was used to evaluate the corneal endothelium throughout the study.Results: In both groups, ECD showed a statistically significant decrease while CV showed a statistically significant increase in the first month postoperatively. The FS-SMILE had more impact on both ECD and CV until the third and six months, respectively. Hexagonality showed a significant decrease in both groups throughout the whole study. In both groups, no vision-threatening complications occurred, and no eyes developed any corneal complications over a six-month follow-up period.Conclusion: Although the ECD, CV, HEX are statistically affected in both FS-LASIK and FS-SMILE groups, both procedures have no significant adverse effects on the ECD and morphology. The impact of the FS-SMILE group may be due to the deeper penetration of the femto laser in the corneal tissue compared to the FS-LASIK. The closer the femto laser to the endothelium, the more exposure to the shock waves and heat energy, although minimal but it can cause collateral damage to this layer. The effects of FS-SMILE surgery on corneal endothelial cells and morphology need further investigations.Keywords: cornea, endothelium, FS-LASIK, FS-SMILEShaaban YMBadran TAFDove Medical Pressarticlecorneaendotheliumfs-lasikfs-smileOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 2543-2550 (2020)
institution DOAJ
collection DOAJ
language EN
topic cornea
endothelium
fs-lasik
fs-smile
Ophthalmology
RE1-994
spellingShingle cornea
endothelium
fs-lasik
fs-smile
Ophthalmology
RE1-994
Shaaban YM
Badran TAF
Comparison Between the Effect of Femtosecond Laser in situ Keratomileusis (FS-LASIK) and Femtosecond Small Incision Lenticule Extraction (FS-SMILE) on the Corneal Endothelium
description Yasmine Maher Shaaban,1,2 Tamer Abdel Fattah Badran1,2 1Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt; 2The Eye Subspecialty Center (ESC), Cairo 11402, EgyptCorrespondence: Yasmine Maher ShaabanOphthalmology Department, Faculty of Medicine, Ain Shams University, Abbassyia, Cairo 11566, EgyptEmail yasminemaher0@gmail.comPurpose: To compare the effect of FS-LASIK and FS-SMILE on the corneal endothelial cell density (ECD) and morphology.Patients and Methods: This is a prospective, cohort observational study that included 80 eyes of two equal groups of patients. Forty eyes were subjected to the FS-LASIK, and 40 eyes were subjected to the FS-SMILE. In both groups, patients, age ranged between 19 and 37 years with myopia ranges from − 0.75 to − 9.00 diopters (D) and astigmatism up to − 3.00D. The ECD, coefficient of variation (CV), and hexagonality (HEX) in both groups were compared over six months. Specular microscopy was used to evaluate the corneal endothelium throughout the study.Results: In both groups, ECD showed a statistically significant decrease while CV showed a statistically significant increase in the first month postoperatively. The FS-SMILE had more impact on both ECD and CV until the third and six months, respectively. Hexagonality showed a significant decrease in both groups throughout the whole study. In both groups, no vision-threatening complications occurred, and no eyes developed any corneal complications over a six-month follow-up period.Conclusion: Although the ECD, CV, HEX are statistically affected in both FS-LASIK and FS-SMILE groups, both procedures have no significant adverse effects on the ECD and morphology. The impact of the FS-SMILE group may be due to the deeper penetration of the femto laser in the corneal tissue compared to the FS-LASIK. The closer the femto laser to the endothelium, the more exposure to the shock waves and heat energy, although minimal but it can cause collateral damage to this layer. The effects of FS-SMILE surgery on corneal endothelial cells and morphology need further investigations.Keywords: cornea, endothelium, FS-LASIK, FS-SMILE
format article
author Shaaban YM
Badran TAF
author_facet Shaaban YM
Badran TAF
author_sort Shaaban YM
title Comparison Between the Effect of Femtosecond Laser in situ Keratomileusis (FS-LASIK) and Femtosecond Small Incision Lenticule Extraction (FS-SMILE) on the Corneal Endothelium
title_short Comparison Between the Effect of Femtosecond Laser in situ Keratomileusis (FS-LASIK) and Femtosecond Small Incision Lenticule Extraction (FS-SMILE) on the Corneal Endothelium
title_full Comparison Between the Effect of Femtosecond Laser in situ Keratomileusis (FS-LASIK) and Femtosecond Small Incision Lenticule Extraction (FS-SMILE) on the Corneal Endothelium
title_fullStr Comparison Between the Effect of Femtosecond Laser in situ Keratomileusis (FS-LASIK) and Femtosecond Small Incision Lenticule Extraction (FS-SMILE) on the Corneal Endothelium
title_full_unstemmed Comparison Between the Effect of Femtosecond Laser in situ Keratomileusis (FS-LASIK) and Femtosecond Small Incision Lenticule Extraction (FS-SMILE) on the Corneal Endothelium
title_sort comparison between the effect of femtosecond laser in situ keratomileusis (fs-lasik) and femtosecond small incision lenticule extraction (fs-smile) on the corneal endothelium
publisher Dove Medical Press
publishDate 2020
url https://doaj.org/article/5152ea96a1104ec380958ff18a0fed1b
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