{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:40:58Z","timestamp":1791250858065,"version":"4.1.0"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T00:00:00Z","timestamp":1699401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Purpose<\/jats:title><jats:p>To evaluate the changes of the corneal epithelial thickness (ET) profile induced by combined small incision lenticule extraction and accelerated corneal collagen crosslinking (SMILE-xtra) for myopia compared with the standard small incision lenticule extraction (SMILE).<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Setting<\/jats:title><jats:p>Nuri Eye Hospital, 61, Dunsan-ro, Seo-gu, Daejeon, 35233, Korea.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Design<\/jats:title><jats:p>Retrospective cross-sectional study.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Methods<\/jats:title><jats:p>Thirty-one myopic eye undergoing SMILE-xtra and control group of 36 myopic eyes undergoing SMILE were retrospectively analyzed. Spectral-domain optical coherence tomography (CIRRUS\u2122 HD-OCT 5000, ZEISS, Dublin, CA) was used to measure corneal ET of 17 zones within the central 7-mm zone at preoperative, postoperative 1 month, 3 months and 6 months. Postoperative ET alterations were analyzed for correlation with treatment parameters.<\/jats:p><\/jats:sec><jats:sec id=\"sec005\"><jats:title>Results<\/jats:title><jats:p>There was no difference in preoperative mean age, postoperative MRSE, visual acuity, and ablation depth between the two groups, and there was a significant difference in preoperative central corneal thickness. Both groups showed the greatest increase in corneal ET in the paracentral area on the inferotemporal area, respectively, for 6 months. The preoperative MRSE and the ablation depth showed significant correlation with the postoperative epithelial thickening in mid-peripheral sectors in both groups, and significant negative correlations in paracentral sectors only in SMILE-xtra group.<\/jats:p><\/jats:sec><jats:sec id=\"sec006\"><jats:title>Conclusions<\/jats:title><jats:p>It is significant as the first study to compare corneal epithelial remodeling between SMILE and SMILE with accelerated corneal collagen crosslinking. The SMILE-xtra with the relatively large corneal ablation did not show a significant difference in the pattern of corneal epithelial remodeling compared to the SMILE group.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0294121","type":"journal-article","created":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T18:36:37Z","timestamp":1699468597000},"page":"e0294121","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Corneal epithelial remodeling induced by combined small incision lenticule extraction and accelerated corneal collagen crosslinking for myopia"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4752-3098","authenticated-orcid":true,"given":"Kook Young","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinwoo","family":"Bae","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seongjun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1642-0248","authenticated-orcid":true,"given":"Yongwoo","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,11,8]]},"reference":[{"issue":"3","key":"pone.0294121.ref001","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1016\/S0161-6420(99)90105-7","article-title":"Very high-frequency ultrasound corneal analysis identifies anatomic correlates of optical complications of lamellar refractive surgery: anatomic diagnosis in lamellar surgery","volume":"106","author":"DZ Reinstein","year":"1999","journal-title":"Ophthalmology"},{"issue":"3","key":"pone.0294121.ref002","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/S0002-9394(02)01942-6","article-title":"Mathematical model of corneal surface smoothing after laser refractive surgery","volume":"135","author":"D Huang","year":"2003","journal-title":"American journal of ophthalmology"},{"issue":"12","key":"pone.0294121.ref003","doi-asserted-by":"crossref","first-page":"2744","DOI":"10.4103\/ijo.IJO_1709_20","article-title":"Refractive surgery with simultaneous collagen cross-linking for borderline corneas-a review of different techniques, their protocols and clinical outcomes.","volume":"68","author":"S Brar","year":"2020","journal-title":"Indian Journal of Ophthalmology."},{"issue":"1","key":"pone.0294121.ref004","doi-asserted-by":"crossref","first-page":"73","DOI":"10.4103\/ijo.IJO_810_21","article-title":"Prophylactic corneal crosslinking in myopic small-incision lenticule extraction-Long-term visual and refractive outcomes","volume":"70","author":"J-M Sanchez-Gonzalez","year":"2022","journal-title":"Indian Journal of Ophthalmology"},{"issue":"7","key":"pone.0294121.ref005","doi-asserted-by":"crossref","first-page":"446","DOI":"10.3928\/1081597X-20150623-02","article-title":"Postoperative changes in corneal epithelial and stromal thickness profiles after photorefractive keratectomy in treatment of myopia","volume":"31","author":"X Chen","year":"2015","journal-title":"Journal of Refractive Surgery"},{"issue":"4","key":"pone.0294121.ref006","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1097\/ICO.0000000000002521","article-title":"Longitudinal epithelial thickness profile changes 18 Months after photorefractive keratectomy","volume":"40","author":"G Latifi","year":"2021","journal-title":"Cornea"},{"issue":"5","key":"pone.0294121.ref007","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1097\/ICO.0000000000000087","article-title":"Epithelial remodeling after femtosecond laser-assisted high myopic LASIK: comparison of stand-alone with LASIK combined with prophylactic high-fluence cross-linking","volume":"33","author":"AJ Kanellopoulos","year":"2014","journal-title":"Cornea"},{"issue":"5","key":"pone.0294121.ref008","doi-asserted-by":"crossref","first-page":"304","DOI":"10.3928\/1081597X-20140416-01","article-title":"Lenticule thickness readout for small incision lenticule extraction compared to artemis three-dimensional very high-frequency digital ultrasound stromal measurements","volume":"30","author":"DZ Reinstein","year":"2014","journal-title":"Journal of Refractive Surgery"},{"issue":"9","key":"pone.0294121.ref009","doi-asserted-by":"crossref","DOI":"10.1167\/iovs.15-18879","article-title":"Corneal epithelial remodeling induced by small incision lenticule extraction (SMILE).","volume":"57","author":"N Luft","year":"2016","journal-title":"Investigative Ophthalmology & Visual Science"},{"issue":"7","key":"pone.0294121.ref010","doi-asserted-by":"crossref","first-page":"473","DOI":"10.3928\/1081597X-20160512-01","article-title":"Epithelial thickness profile changes following small incision refractive lenticule extraction (SMILE) for myopia and myopic astigmatism.","volume":"32","author":"S Ganesh","year":"2016","journal-title":"Journal of Refractive Surgery"},{"issue":"4","key":"pone.0294121.ref011","doi-asserted-by":"crossref","first-page":"250","DOI":"10.3928\/1081597X-20170111-01","article-title":"Comparison of corneal epithelial remodeling after femtosecond laser\u2013assisted LASIK and small incision lenticule extraction (SMILE).","volume":"33","author":"I-H Ryu","year":"2017","journal-title":"Journal of refractive surgery"},{"issue":"3","key":"pone.0294121.ref012","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1097\/ICO.0000000000001821","article-title":"Comparison of corneal epithelial remodeling over 2 years in LASIK versus SMILE: a contralateral eye study","volume":"38","author":"AJ Kanellopoulos","year":"2019","journal-title":"Cornea"},{"issue":"4","key":"pone.0294121.ref013","doi-asserted-by":"crossref","first-page":"224","DOI":"10.3928\/1081597X-20210126-01","article-title":"Corneal epithelial thickness changes following SMILE for myopia with high astigmatism","volume":"37","author":"N Yu","year":"2021","journal-title":"Journal of Refractive Surgery"},{"key":"pone.0294121.ref014","first-page":"2022","article-title":"Evaluation of wide corneal epithelial remodeling after small incision lenticule extraction (SMILE) with wide-field optical coherence tomography.","author":"Y Ye","year":"2022","journal-title":"Journal of Ophthalmology"},{"issue":"1","key":"pone.0294121.ref015","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.ophtha.2007.03.073","article-title":"Risk assessment for ectasia after corneal refractive surgery","volume":"115","author":"JB Randleman","year":"2008","journal-title":"Ophthalmology"},{"key":"pone.0294121.ref016","first-page":"2015","article-title":"Clinical outcomes of small incision lenticule extraction with accelerated cross-linking (ReLEx SMILE Xtra) in patients with thin corneas and borderline topography.","author":"S Ganesh","year":"2015","journal-title":"Journal of Ophthalmology"},{"issue":"4","key":"pone.0294121.ref017","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1097\/ICO.0000000000000358","article-title":"Tear film thickness after treatment with artificial tears in patients with moderate dry eye disease","volume":"34","author":"D Schmidl","year":"2015","journal-title":"Cornea"},{"issue":"12","key":"pone.0294121.ref018","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1136\/bjo.80.12.1068","article-title":"Diurnal variations in human corneal thickness","volume":"80","author":"C Harper","year":"1996","journal-title":"British Journal of Ophthalmology"},{"issue":"3","key":"pone.0294121.ref019","first-page":"166","article-title":"Longitudinal postoperative lasik epithelial thickness profile changes in correlation with degree of myopia correction","volume":"30","author":"AJ Kanellopoulos","year":"2014","journal-title":"Journal of refractive surgery"},{"issue":"8","key":"pone.0294121.ref020","doi-asserted-by":"crossref","first-page":"555","DOI":"10.3928\/1081597X-20091105-02","article-title":"Epithelial thickness after hyperopic LASIK: three-dimensional display with Artemis very high-frequency digital ultrasound","volume":"26","author":"DZ Reinstein","year":"2010","journal-title":"Journal of Refractive Surgery"},{"issue":"5","key":"pone.0294121.ref021","doi-asserted-by":"crossref","first-page":"2061","DOI":"10.1167\/iovs.08-2853","article-title":"Three-year changes in epithelial and stromal thickness after PRK or LASIK for high myopia","volume":"50","author":"A Ivarsen","year":"2009","journal-title":"Investigative ophthalmology & visual science"},{"issue":"5","key":"pone.0294121.ref022","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1016\/S0886-3350(99)00014-0","article-title":"Regression and epithelial hyperplasia after myopic photorefractive keratectomy in a human cornea.","volume":"25","author":"CP Lohmann","year":"1999","journal-title":"Journal of Cataract & Refractive Surgery."},{"key":"pone.0294121.ref023","first-page":"133","volume-title":"Role of the corneal epithelium in refractive changes following laser in situ keratomileusis for high myopia","author":"L Spadea","year":"2000"},{"issue":"6","key":"pone.0294121.ref024","doi-asserted-by":"crossref","first-page":"2580","DOI":"10.1167\/iovs.11-8981","article-title":"Reliability and reproducibility of assessment of corneal epithelial thickness by fourier domain optical coherence tomography.","volume":"53","author":"G Prakash","year":"2012","journal-title":"Investigative Ophthalmology & Visual Science."},{"key":"pone.0294121.ref025","first-page":"10","article-title":"Systematic Detection of Keratoconus in Optical Coherence Tomography: Corneal and Epithelial Thickness Maps","author":"B Y\u00fccekul","year":"2022","journal-title":"Journal of Cataract & Refractive Surgery"},{"issue":"6","key":"pone.0294121.ref026","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1016\/j.jcrs.2011.12.038","article-title":"Corneal collagen crosslinking in vitro: Inhibited regeneration of human limbal epithelial cells after riboflavin\u2013ultraviolet-A exposure.","volume":"38","author":"A Thorsrud","year":"2012","journal-title":"Journal of Cataract & Refractive Surgery."},{"issue":"2","key":"pone.0294121.ref027","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1136\/bjophthalmol-2013-303816","article-title":"Protection of corneal epithelial stem cells prevents ultraviolet A damage during corneal collagen cross-linking treatment for keratoconus","volume":"98","author":"JE Moore","year":"2014","journal-title":"British Journal of Ophthalmology"},{"issue":"6","key":"pone.0294121.ref028","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1016\/j.ajo.2012.06.005","article-title":"Persistent corneal edema after collagen cross-linking for keratoconus","volume":"154","author":"A Sharma","year":"2012","journal-title":"American journal of ophthalmology"},{"issue":"11","key":"pone.0294121.ref029","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.3928\/1081597X-20090901-02","article-title":"Collagen cross-linking in early keratoconus with riboflavin in a femtosecond laser-created pocket: initial clinical results","volume":"25","author":"AJ Kanellopoulos","year":"2009","journal-title":"Journal of refractive surgery (Thorofare, NJ: 1995)."},{"key":"pone.0294121.ref030","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2021\/3444083","article-title":"Corneal and epithelial thickness mapping: comparison of swept-source-and spectral-domain-optical coherence tomography","volume":"2021","author":"C Georgeon","year":"2021","journal-title":"Journal of Ophthalmology"},{"issue":"5","key":"pone.0294121.ref031","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.clae.2013.02.006","article-title":"Corneal epithelial permeability: ethnic differences between Asians and non-Asians.","volume":"36","author":"WY Li","year":"2013","journal-title":"Contact Lens and Anterior Eye"},{"issue":"4","key":"pone.0294121.ref032","doi-asserted-by":"crossref","first-page":"240","DOI":"10.3928\/1081597X-20140320-02","article-title":"Correction of myopic astigmatism with small incision lenticule extraction","volume":"30","author":"A Ivarsen","year":"2014","journal-title":"Journal of Refractive Surgery"},{"key":"pone.0294121.ref033","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-319-18530-9","volume-title":"Small incision lenticule extraction (SMILE): principles, techniques, complication management, and future concepts","author":"W. Sekundo","year":"2015"},{"issue":"2","key":"pone.0294121.ref034","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/ICO.0b013e31818a7d61","article-title":"Eyelid pressure: inferences from corneal topographic changes","volume":"28","author":"AJ Shaw","year":"2009","journal-title":"Cornea"},{"issue":"9","key":"pone.0294121.ref035","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1097\/ICO.0b013e31823f8d56","article-title":"Vertical and horizontal corneal epithelial thickness profiles determined by ultra-high resolution optical coherence tomography","volume":"31","author":"C Du","year":"2012","journal-title":"Cornea"}],"updated-by":[{"DOI":"10.1371\/journal.pone.0300941","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000}}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0294121","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T18:00:23Z","timestamp":1730484023000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0294121"}},"subtitle":[],"editor":[{"given":"Deepak","family":"Shukla","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,11,8]]},"references-count":35,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11,8]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0294121","relation":{"correction":[{"id-type":"doi","id":"10.1371\/journal.pone.0300941","asserted-by":"object"}]},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,8]]}}}