Corneal regeneration after femtosecond laser small-incision lenticule extraction: a prospective study.
OBJECTIVE
To evaluate the morphologic changes of corneal after small incision lenticule extraction (SMILE) using the Heidelberg Retina Tomograph III (HRT III)/Rostock Cornea Module confocal microscope and three-dimensional optical coherence tomography (3D-OCT).


METHODS
Thirty eyes of 30 patients who underwent SMILE for the correction of myopia and myopic astigmatism in this study. Morphologic modifications of corneal architecture and the density of corneal subbasal nerve were evaluated prior to SMILE and 7 days, 1, 3, and 6 months after SMILE by in-vivo confocal microscopy (IVCM) and 3D-OCT.


RESULTS
The corneal epithelium morphology showed no particular changes during the entire 6-month examination period. Subbasal nerve density recovered to preoperative levels within 3 months after SMILE (P > 0.05). On the interface layer, intense keratocyte activity was noted in all eyes after SMILE. The corneal fibrotic tissues on the interface layer diminished with time, but the persistence of brightly reflective particles still existed. No particular change between preoperative and postoperative corneal endothelium. The incision margin of SMILE had the appearance of a less clearly identified fibrotic scar with epithelial plug.


CONCLUSIONS
IVCM and 3D-OCT analysis showed that there is a low-level corneal wound-healing response after SMILE procedure in the early postoperative period. Subbasal nerve regeneration is recovered at the third month, but the reflective particles elevated up to the sixth month.
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 S. Xianlie Road, Guangzhou, 510060, China.
Manli
M
Liu
Ting
T
Zhang
Yugui
Y
Zhou
Yuan
Y
Sun
Danyang
D
Wang
Hua
H
Zheng
Quan
Q
Liu
D000328:Adult; D001251:Astigmatism / Q000503:physiopathology / Q000601:surgery; D003315:Cornea / Q000294:innervation / Q000502:physiology*; D003319:Corneal Stroma / Q000601:surgery*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D018613:Microscopy, Confocal; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D009412:Nerve Fibers / Q000502:physiology; D009416:Nerve Regeneration / Q000502:physiology; D011446:Prospective Studies; D012038:Regeneration / Q000502:physiology*; D041623:Tomography, Optical Coherence; D014276:Trigeminal Nerve / Q000033:anatomy & histology / Q000502:physiology; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult