{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T22:11:11Z","timestamp":1789683071026,"version":"4.0.1"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T00:00:00Z","timestamp":1632355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Beijing Municipal Administration of Hospitals Clinical medicine Development of special foundation","award":["XMLX201614"],"award-info":[{"award-number":["XMLX201614"]}]},{"DOI":"10.13039\/501100003213","name":"Beijing Municipal Education Commission","doi-asserted-by":"publisher","award":["KZ201710025021"],"award-info":[{"award-number":["KZ201710025021"]}],"id":[{"id":"10.13039\/501100003213","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>To quantitatively evaluate outcomes after small incision lenticule extraction (SMILE) combined with allogeneic intrastromal lenticule inlay for hyperopia with astigmatism.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>It\u2019s a retrospective cohort study. Twenty-four eyes of 15 patients with more than 0.75 diopters (D) of astigmatism in hyperopic eyes were enrolled in this study. The hyperopic eye with astigmatism was first treated with SMILE to correct astigmatism; then a lenticule was extracted from a donor myopic eye and subsequently implanted into the hyperopic eye with astigmatism. Patients were examined preoperatively and 1 day, 1 week, 1,3 months and 1 year after surgery. The main outcome measures were the uncorrected and corrected distance visual acuity (UDVA and CDVA), uncorrected near visual acuity (UNVA), spherical equivalent (SE), corneal topography, anterior segment optical coherence topography (OCT) and ocular response analyzer (ORA) parameters: corneal hysteresis (CH) and corneal resistance factor (CRF). Repeated\u2013measures analyses of variance (ANOVA) and post hoc tests were used to analyze data of different follow-up visits.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The mean preoperative cylinder was 1.95\u00b11.04(D). The UDVA (from 0.37\u00b10.23 to 0.09\u00b10.09), UNVA (from 0.49\u00b10.21 to 0.08\u00b10.06), SE (from +7.42\u00b13.12 to -0.75\u00b10.79) and astigmatism (+1.95\u00b11.04 to -0.65\u00b10.63) postoperatively were obviously better than those before surgery. Five eyes (26.3%) gained one line of CDVA, and 3 eyes (15.8%) gained two lines of CDVA one year after surgery compared with preoperative levels. The average corneal curvature was changed from (43.19\u00b14.37) D to (49.19\u00b13.87) D one year after surgery. The anterior segment OCT images of corneas with lenticule inlays at each follow-up visit showed that the implanted lenticule was shaped like a crescent in the corneal stroma. The CH and CRF didn\u2019t change significantly after surgery (p = 0.189 and p = 0.107respectively).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>SMILE combined with intrastromal lenticule inlay can be used to correct high hyperopia with astigmatism with good safety, efficacy and reproducibility.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0257667","type":"journal-article","created":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T17:53:59Z","timestamp":1632419639000},"page":"e0257667","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":17,"title":["Small incision lenticule extraction (SMILE) combined with allogeneic intrastromal lenticule inlay for hyperopia with astigmatism"],"prefix":"10.1371","volume":"16","author":[{"given":"Jing","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6560-3935","authenticated-orcid":true,"given":"Yuehua","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,9,23]]},"reference":[{"key":"pone.0257667.ref001","first-page":"CD007112","article-title":"Photorefractive keratectomy (PRK) versus laser assisted in situkeratomileusis (LASIK) for hyperopia correction","volume":"6","author":"G Settas","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"pone.0257667.ref002","first-page":"637","article-title":"Adjuvant corneal crosslinking to prevent hyperopic LASIK regression","volume":"7","author":"IM Aslanides","year":"2013","journal-title":"Clin 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