Enhancement after small-incision lenticule extraction
Purpose:To report the incidence, risk factors, and outcomes of enhancement after small-incision lenticule extraction (SMILE). Design:Retrospective cohort study.Participants:Five hundred twenty-four eyes of 307 patients who underwent SMILE at Singapore National Eye Center between February 2012 and Ma...
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| Other Authors: | |
| Format: | Journal Article |
| Language: | English |
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2019
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| Online Access: | https://hdl.handle.net/10356/82619 http://hdl.handle.net/10220/49083 |
| _version_ | 1826114062080016384 |
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| author | Liu, Yu-Chi Mohamad Rosman Mehta, Jodhbir Singh |
| author2 | School of Materials Science & Engineering |
| author_facet | School of Materials Science & Engineering Liu, Yu-Chi Mohamad Rosman Mehta, Jodhbir Singh |
| author_sort | Liu, Yu-Chi |
| collection | NTU |
| description | Purpose:To report the incidence, risk factors, and outcomes of enhancement after small-incision lenticule extraction (SMILE). Design:Retrospective cohort study.Participants:Five hundred twenty-four eyes of 307 patients who underwent SMILE at Singapore National Eye Center between February 2012 and March 2016. Methods:The data collected included patient age at primary SMILE, gender, race, preoperative and postoperative manifest refraction spherical equivalent (MRSE), preoperative and postoperative uncorrected distance visual acuity and corrected distance visual acuity, the occurrence of suction loss during the procedure, and the need for enhancement. All enhancements were carried out by performing an alcohol-assisted photorefractive keratectomy (PRK) procedure with application of mitomycin C (MMC).Main Outcome Measures:Incidence, prevalence, preoperative and intraoperative risk factors for enhancement, and outcomes after enhancement. Results:The prevalence of enhancement was 2.7%, and 71.4% eyes had enhancement within 1 year of primary SMILE. The incidence of enhancement was 2.1% and 2.9% at 1 and 2 years, respectively. Age older than 35 years, preoperative MRSE more than −6.00 diopters (D), preoperative myopia more than 6.00 D, preoperative astigmatism more than 3.00 D, and intraoperative suction loss were significant risk factors for enhancement after SMILE after adjusting for all other covariates (odds ratios, 5.58, 4.80, 1.41, 3.06, and 2.14, respectively; P = 0.004, 0.021, 0.022, 0.002, and 0.020, respectively). In the patients who underwent bilateral SMILE, the first-operated eye had a marginal trend toward significance for enhancement (P = 0.054). There was no gender or racial difference. In the 14 eyes requiring enhancement, the uncorrected distance visual acuity before enhancement ranged from 20/80 to 20/25, and the mean attempted enhancement spherical equivalent was −0.50±0.86 D. The uncorrected distance visual acuity improved in most patients (92.9%) after enhancement. Conclusions:The 2-year incidence of enhancement after SMILE was 2.9%. Risk factors associated with enhancement included older age at SMILE procedure, greater preoperative MRSE, greater preoperative myopia, greater preoperative astigmatism, and the occurrence of intraoperative suction loss. Clinical outcomes of using PRK with application of MMC for enhancement were good. |
| first_indexed | 2024-10-01T03:33:21Z |
| format | Journal Article |
| id | ntu-10356/82619 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2024-10-01T03:33:21Z |
| publishDate | 2019 |
| record_format | dspace |
| spelling | ntu-10356/826192020-06-01T10:01:59Z Enhancement after small-incision lenticule extraction Liu, Yu-Chi Mohamad Rosman Mehta, Jodhbir Singh School of Materials Science & Engineering School of Mechanical and Aerospace Engineering MRSE Engineering::Mechanical engineering SMILE Purpose:To report the incidence, risk factors, and outcomes of enhancement after small-incision lenticule extraction (SMILE). Design:Retrospective cohort study.Participants:Five hundred twenty-four eyes of 307 patients who underwent SMILE at Singapore National Eye Center between February 2012 and March 2016. Methods:The data collected included patient age at primary SMILE, gender, race, preoperative and postoperative manifest refraction spherical equivalent (MRSE), preoperative and postoperative uncorrected distance visual acuity and corrected distance visual acuity, the occurrence of suction loss during the procedure, and the need for enhancement. All enhancements were carried out by performing an alcohol-assisted photorefractive keratectomy (PRK) procedure with application of mitomycin C (MMC).Main Outcome Measures:Incidence, prevalence, preoperative and intraoperative risk factors for enhancement, and outcomes after enhancement. Results:The prevalence of enhancement was 2.7%, and 71.4% eyes had enhancement within 1 year of primary SMILE. The incidence of enhancement was 2.1% and 2.9% at 1 and 2 years, respectively. Age older than 35 years, preoperative MRSE more than −6.00 diopters (D), preoperative myopia more than 6.00 D, preoperative astigmatism more than 3.00 D, and intraoperative suction loss were significant risk factors for enhancement after SMILE after adjusting for all other covariates (odds ratios, 5.58, 4.80, 1.41, 3.06, and 2.14, respectively; P = 0.004, 0.021, 0.022, 0.002, and 0.020, respectively). In the patients who underwent bilateral SMILE, the first-operated eye had a marginal trend toward significance for enhancement (P = 0.054). There was no gender or racial difference. In the 14 eyes requiring enhancement, the uncorrected distance visual acuity before enhancement ranged from 20/80 to 20/25, and the mean attempted enhancement spherical equivalent was −0.50±0.86 D. The uncorrected distance visual acuity improved in most patients (92.9%) after enhancement. Conclusions:The 2-year incidence of enhancement after SMILE was 2.9%. Risk factors associated with enhancement included older age at SMILE procedure, greater preoperative MRSE, greater preoperative myopia, greater preoperative astigmatism, and the occurrence of intraoperative suction loss. Clinical outcomes of using PRK with application of MMC for enhancement were good. 2019-07-02T07:50:18Z 2019-12-06T14:59:05Z 2019-07-02T07:50:18Z 2019-12-06T14:59:05Z 2017 Journal Article Liu, Y.-C., Mohamad Rosman., & Mehta, J. S. (2017). Enhancement after Small-Incision Lenticule Extraction. Ophthalmology, 124(6), 813-821. doi:10.1016/j.ophtha.2017.01.053 0161-6420 https://hdl.handle.net/10356/82619 http://hdl.handle.net/10220/49083 10.1016/j.ophtha.2017.01.053 en Ophthalmology © 2017 American Academy of Ophthalmology. All rights reserved. |
| spellingShingle | MRSE Engineering::Mechanical engineering SMILE Liu, Yu-Chi Mohamad Rosman Mehta, Jodhbir Singh Enhancement after small-incision lenticule extraction |
| title | Enhancement after small-incision lenticule extraction |
| title_full | Enhancement after small-incision lenticule extraction |
| title_fullStr | Enhancement after small-incision lenticule extraction |
| title_full_unstemmed | Enhancement after small-incision lenticule extraction |
| title_short | Enhancement after small-incision lenticule extraction |
| title_sort | enhancement after small incision lenticule extraction |
| topic | MRSE Engineering::Mechanical engineering SMILE |
| url | https://hdl.handle.net/10356/82619 http://hdl.handle.net/10220/49083 |
| work_keys_str_mv | AT liuyuchi enhancementaftersmallincisionlenticuleextraction AT mohamadrosman enhancementaftersmallincisionlenticuleextraction AT mehtajodhbirsingh enhancementaftersmallincisionlenticuleextraction |