The long-term effects of interface irrigation on visual outcomes and corneal aberrations in Small Incision Lenticule Extraction (SMILE)

Purpose: To assess the long-term effects on visual outcomes and corneal aberrations of irrigating the interface during the small-incision lenticule extraction (SMILE) surgery for managing myopia and myopic astigmatism. Methods: In 47 patients who underwent bilateral SMILE surgery for myopia and myop...

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Main Authors: Sibel Ahmet, Murat Kocamaz, Cem Sarı, Ahmet Kırgız, Yusuf Yıldırım, Muhittin Taşkapılı
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-07-01
Series:Indian Journal of Ophthalmology
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Online Access:https://journals.lww.com/10.4103/IJO.IJO_1856_24
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author Sibel Ahmet
Murat Kocamaz
Cem Sarı
Ahmet Kırgız
Yusuf Yıldırım
Muhittin Taşkapılı
author_facet Sibel Ahmet
Murat Kocamaz
Cem Sarı
Ahmet Kırgız
Yusuf Yıldırım
Muhittin Taşkapılı
author_sort Sibel Ahmet
collection DOAJ
description Purpose: To assess the long-term effects on visual outcomes and corneal aberrations of irrigating the interface during the small-incision lenticule extraction (SMILE) surgery for managing myopia and myopic astigmatism. Methods: In 47 patients who underwent bilateral SMILE surgery for myopia and myopic astigmatism, one eye was irrigated with 1.0 ml of balanced salt solution via cannula (Group 1) and the other eye was not irrigated (Group 2). Visual and refractive outcomes of 94 eyes were analyzed on the first day, first week, first month, sixth month, and first year. Preoperative and postoperative corneal higher-order aberrations (HOAs) obtained from Sirius corneal tomography (Costruzione Strumenti Oftalmici, Florence, Italy) were evaluated in both groups. Anterior segment optical coherence tomography (Heidelberg Spectralis; Heidelberg Engineering, Heidelberg, Germany) was used for interface evaluation on the first postoperative day. Intraoperative and postoperative complications were recorded. Results: Preoperative spherical, cylindrical, and spherical equivalent values were similar in both groups (P values: 0.913, 0.796, and 0.876, respectively). Statistically significant increases in mean HOAs and coma values were observed in both groups during the postoperative follow-up periods compared to the preoperative period (each P value <0.05). No significant differences were noted between the two groups concerning visual acuity, refractive values, and corneal aberrations throughout all postoperative follow-up periods (each P value >0.05). Epithelial inoculation developed in one eye in the irrigated group, and diffuse lamellar keratitis developed in one eye in the non-irrigated group. Conclusion: This study demonstrated that the visual, refractive, and wavefront aberration outcomes, both in the short and long term, were comparable between cases with and without interface irrigation following lenticule removal from the stromal pocket in SMILE surgery.
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1998-3689
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spelling doaj-art-2fc406c60b6a47e192340ac4dbf5348d2025-08-20T03:31:24ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892025-07-017371005101110.4103/IJO.IJO_1856_24The long-term effects of interface irrigation on visual outcomes and corneal aberrations in Small Incision Lenticule Extraction (SMILE)Sibel AhmetMurat KocamazCem SarıAhmet KırgızYusuf YıldırımMuhittin TaşkapılıPurpose: To assess the long-term effects on visual outcomes and corneal aberrations of irrigating the interface during the small-incision lenticule extraction (SMILE) surgery for managing myopia and myopic astigmatism. Methods: In 47 patients who underwent bilateral SMILE surgery for myopia and myopic astigmatism, one eye was irrigated with 1.0 ml of balanced salt solution via cannula (Group 1) and the other eye was not irrigated (Group 2). Visual and refractive outcomes of 94 eyes were analyzed on the first day, first week, first month, sixth month, and first year. Preoperative and postoperative corneal higher-order aberrations (HOAs) obtained from Sirius corneal tomography (Costruzione Strumenti Oftalmici, Florence, Italy) were evaluated in both groups. Anterior segment optical coherence tomography (Heidelberg Spectralis; Heidelberg Engineering, Heidelberg, Germany) was used for interface evaluation on the first postoperative day. Intraoperative and postoperative complications were recorded. Results: Preoperative spherical, cylindrical, and spherical equivalent values were similar in both groups (P values: 0.913, 0.796, and 0.876, respectively). Statistically significant increases in mean HOAs and coma values were observed in both groups during the postoperative follow-up periods compared to the preoperative period (each P value <0.05). No significant differences were noted between the two groups concerning visual acuity, refractive values, and corneal aberrations throughout all postoperative follow-up periods (each P value >0.05). Epithelial inoculation developed in one eye in the irrigated group, and diffuse lamellar keratitis developed in one eye in the non-irrigated group. Conclusion: This study demonstrated that the visual, refractive, and wavefront aberration outcomes, both in the short and long term, were comparable between cases with and without interface irrigation following lenticule removal from the stromal pocket in SMILE surgery.https://journals.lww.com/10.4103/IJO.IJO_1856_24corneal aberrationscorneal tomographyinterfacemyopiarefractive surgery complicationssmall-incision lenticule extraction (smile)
spellingShingle Sibel Ahmet
Murat Kocamaz
Cem Sarı
Ahmet Kırgız
Yusuf Yıldırım
Muhittin Taşkapılı
The long-term effects of interface irrigation on visual outcomes and corneal aberrations in Small Incision Lenticule Extraction (SMILE)
Indian Journal of Ophthalmology
corneal aberrations
corneal tomography
interface
myopia
refractive surgery complications
small-incision lenticule extraction (smile)
title The long-term effects of interface irrigation on visual outcomes and corneal aberrations in Small Incision Lenticule Extraction (SMILE)
title_full The long-term effects of interface irrigation on visual outcomes and corneal aberrations in Small Incision Lenticule Extraction (SMILE)
title_fullStr The long-term effects of interface irrigation on visual outcomes and corneal aberrations in Small Incision Lenticule Extraction (SMILE)
title_full_unstemmed The long-term effects of interface irrigation on visual outcomes and corneal aberrations in Small Incision Lenticule Extraction (SMILE)
title_short The long-term effects of interface irrigation on visual outcomes and corneal aberrations in Small Incision Lenticule Extraction (SMILE)
title_sort long term effects of interface irrigation on visual outcomes and corneal aberrations in small incision lenticule extraction smile
topic corneal aberrations
corneal tomography
interface
myopia
refractive surgery complications
small-incision lenticule extraction (smile)
url https://journals.lww.com/10.4103/IJO.IJO_1856_24
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