title: Wound healing profiles of hyperopic-small incision lenticule extraction (SMILE).
abstract: Refractive surgical treatment of hyperopia still remains a challenge for refractive surgeons. A new nomogram of small incision lenticule extraction (SMILE) procedure has recently been developed for the treatment of hyperopia. In the present study, we aimed to evaluate the wound healing and inflammatory responses of this new nomogram (hyperopic-SMILE), and compared them to those of hyperopic-laser-assisted in situ keratomileusis (LASIK), using a rabbit model. A total of 26 rabbits were used, and slit lamp biomicroscopy, autorefractor/keratometer, intraocular pressure measurement, anterior segment optical coherence tomography, corneal topography, and in vivo confocal microscopy examinations were performed during the study period of 4 weeks. The corneas were then harvested and subject to immunofluorescence of markers for inflammation (CD11b), wound healing (fibronectin) and keratocyte response (HSP47). The lenticule ultrastructual changes were also analyzed by transmission electron microscopy. Out results showed that hyperopic-SMILE effectively steepened the cornea. Compared to hyperopic-LASIK, hyperopic-SMILE had less postoperative wound healing response and stromal interface reaction, especially in higher refractive correction. However, compared to myopic-SMILE, hyperopic-SMILE resulted in more central deranged collagen fibrils. These results provide more perspective into this new treatment option for hyperopia, and evidence for future laser nomogram modification.
authors.affiliation: Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore.|Singapore National Eye Centre, 11 Third Hospital Ave, Singapore.
authors.forename: Yu-Chi
authors.initials: YC
authors.lastname: Liu
authors.affiliation: Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore.
authors.forename: Heng Pei
authors.initials: HP
authors.lastname: Ang
authors.affiliation: Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore.
authors.forename: Ericia Pei Wen
authors.initials: EP
authors.lastname: Teo
authors.affiliation: Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore.
authors.forename: Nyein Chan
authors.initials: NC
authors.lastname: Lwin
authors.affiliation: Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore.
authors.forename: Gary Hin Fai
authors.initials: GH
authors.lastname: Yam
authors.affiliation: Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore.|Singapore National Eye Centre, 11 Third Hospital Ave, Singapore.|Department of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore.|School of Material Science &Engineering and School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Ave, n3, 639798, Singapore.
authors.forename: Jodhbir S
authors.initials: JS
authors.lastname: Mehta
mesh_terms: D000818:Animals; D039481:CD11b Antigen / Q000378:metabolism; D003315:Cornea / Q000378:metabolism / Q000601:surgery / Q000648:ultrastructure; D019781:Corneal Topography; D005353:Fibronectins / Q000378:metabolism; D050958:HSP47 Heat-Shock Proteins / Q000378:metabolism; D006956:Hyperopia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D018613:Microscopy, Confocal; D046529:Microscopy, Electron, Transmission; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D011817:Rabbits; D041623:Tomography, Optical Coherence; D014945:Wound Healing
chemical_list: D039481:CD11b Antigen; D005353:Fibronectins; D050958:HSP47 Heat-Shock Proteins