Early postoperative changes in corneal densitometry after SMILE with 120-μm and 130-μm cap thickness: a comparative study

IF 3.4

Advances in ophthalmology practice and research Pub Date : 2025-04-16 DOI:10.1016/j.aopr.2025.04.003

Shirou Wu , Hongying Jin , Ting Wan

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Abstract

Objective

To compare early postoperative changes in corneal densitometry after small incision lenticule extraction using 120-μm and 130-μm cap thicknesses.

Methods

69 eyes of 39 patients who underwent small incision lenticule extraction (SMILE) with cap thicknesses of 120-μm (n = 34) and 130-μm (n = 35) were included in this study. The corneal densitometry (CD) of three zones (0–2 mm, 2–6 mm, and 6–10 mm) of the anterior, central, and posterior corneal layers was evaluated before, one week, and one month after surgery. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical degree, cylinder degree, and spherical equivalent (SE) were also analyzed and compared between the two groups before and after surgery.

Results

Little difference was detected between the two groups in postoperative UCVA, BCVA, SE, and cylinder degree at one month. No statistically significant differences were found between the preoperative and postoperative CD values for the overall (0–12 mm) cornea and the 6–10 mm zone in either group. A significant increase in CD was observed in the 0–2 mm and 2–6 mm zones of the anterior layer in the 120-μm group, and the 0–2 mm zone of the central layer in the 130-μm group, one week postoperatively. These changes persisted for one month after surgery (P < 0.05). The CD in the central layer (0–2 mm and 2–6 mm) in the 120-μm group, as well as the total layer (0–2 mm and 2–6 mm) in both groups, significantly increased at the first postoperative week but returned to preoperative levels by one month after surgery. Additionally, the CD of the anterior layer (0–2 mm and 2–6 mm) increased significantly in the first week postoperatively, decreased significantly one month postoperatively, but remained significantly higher than baseline in the 130-μm group. In both groups, the CD of the posterior 0–2 mm zone decreased. Moreover, the increase in CD in the anterior 2–6 mm zone one week postoperatively was significantly higher in the 120-μm group compared to the 130-μm group (ΔCD 2.4 ± 1.55 vs. 1.64 ± 0.87, P = 0.014). Postoperative corneal wavefront aberrations were significantly higher in the 120-μm group than in the 130-μm group.

Conclusions

CD increased mainly in the 0–6 mm zone of the anterior layer in the early phase after the SMILE procedure with both the 120-μm and 130-μm groups. The increase in CD in the anterior 2–6 mm zone one week postoperatively was higher in the 120-μm group than in the 130-μm group. SMILE with 120-μm and 130-μm cap thickness were both efficient and safe, but eyes with a 120-μm cap thickness showed higher postoperative corneal wavefront aberrations.

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帽厚为120 μm和130 μm的SMILE术后早期角膜密度变化的比较研究

目的比较120 μm和130 μm帽厚小切口晶状体摘除术后早期角膜密度测定的变化。方法采用小切口晶状体摘除术（SMILE），术者39例69眼，帽厚分别为120-μm （n = 34）和130-μm （n = 35）。术前、术后1周和1个月分别测定角膜前、中、后3个区域（0 - 2mm、2 - 6mm和6 - 10mm）的角膜密度。分析比较两组患者术前、术后未矫正距离视力（UDVA）、矫正距离视力（CDVA）、球形度、圆柱体度、球形等效度（SE）。结果两组术后1个月UCVA、BCVA、SE、椎体度差异无统计学意义。两组术前和术后整体（0-12 mm）角膜和6-10 mm区域的CD值均无统计学差异。术后1周，120-μm组前层0- 2mm、2 - 6mm区CD明显增高，130-μm组中央层0- 2mm区CD明显增高。这些变化在手术后持续了一个月(P <；0.05)。120 μm组中心层（0 - 2mm和2 - 6mm）和总层（0 - 2mm和2 - 6mm）的CD在术后第一周显著增加，但在术后1个月恢复到术前水平。此外，前层（0-2 mm和2-6 mm）的CD在术后第1周显著增加，术后1个月显著降低，但在130 μm组仍显著高于基线。两组后0 - 2mm区CD均降低。此外，术后1周，120 μm组2-6 mm前区CD的增加明显高于130 μm组（ΔCD 2.4±1.55 vs. 1.64±0.87,P = 0.014）。120-μm组术后角膜波前像差明显高于130-μm组。结论120-μm组和130-μm组术后早期scd主要在前层0-6 mm区增加。术后1周，120 μm组前路2 ~ 6mm区CD增加明显高于130 μm组。帽厚为120 μm和130 μm的SMILE均有效且安全，但帽厚为120 μm的眼睛术后角膜波前像差较高。

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