{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:27:11Z","timestamp":1781742431677,"version":"3.54.5"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T00:00:00Z","timestamp":1649635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["12072218 11872262 3180078 11802196"],"award-info":[{"award-number":["12072218 11872262 3180078 11802196"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004480","name":"Natural Science Foundation of Shanxi Province","doi-asserted-by":"publisher","award":["20210302123150"],"award-info":[{"award-number":["20210302123150"]}],"id":[{"id":"10.13039\/501100004480","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Bioeng. Biotechnol."],"abstract":"<jats:p>Myopia, which is the result of the uncoordinated development of the eyeball, has become a major public health focus worldwide. Laser <jats:italic>in situ<\/jats:italic> keratomileusis (LASIK) and small-incision lenticule extraction (SMILE) have been successfully used in modern corneal refractive surgery. However, there are still controversies about postoperative results of LASIK and SMILE. In this study, a three-dimensional finite element model of the cornea was constructed based on the elevation and pachymetry data of a female volunteer. Surgical parameters, magnitudes of myopic correction, and intraocular pressure (IOP) were varied. Furthermore, an iterative algorithm was applied to retrieve the free-stress state of the intact corneal model, LASIK model, and SMILE model. To better evaluate the differences between LASIK and SMILE procedures, the displacement and Von Mises stress on the anterior and posterior corneal surface along the <jats:italic>x-<\/jats:italic> and <jats:italic>y<\/jats:italic>-axes were analyzed. Results for the zero-pressure model showed larger displacement compared to the image-based corneal model, suggesting that the initial corneal pre-stress stiffens the response of the cornea, both in the intact cornea and under refractive surgery. In addition, the displacement on the corneal surface in LASIK (both zero-pressure and image-based model) was obviously higher than that of the SMILE model. In contrast, SMILE increased Von Mises stress in the corneal cap and reduced Von Mises stress in the residual stromal bed compared with the LASIK model. However, the maximum Von Mises stress in the SMILE model was still smaller than that of the LASIK model. Moreover, the displacement and Von Mises stress on the residual stromal bed increased linearly with IOP. Overall, LASIK and SMILE refractive surgery could change biomechanical behaviors of the cornea. Compared to LASIK refractive surgery, SMILE may present a lower risk of ectasia. Creating a corneal cap rather than a corneal flap may have an advantage in improving corneal biomechanical stability.<\/jats:p>","DOI":"10.3389\/fbioe.2022.855367","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T04:26:28Z","timestamp":1649651188000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Effects of Laser In Situ Keratomileusis and Small-Incision Lenticule Extraction on Corneal Biomechanical Behavior: A Finite Element Analysis"],"prefix":"10.3389","volume":"10","author":[{"given":"Chenyan","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaona","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongmei","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiyi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.clae.2013.05.003","article-title":"Comparison of Corneal Hysteresis and Corneal Resistance Factor after Small Incision Lenticule Extraction and Femtosecond Laser-Assisted LASIK: A Prospective Fellow Eye Study","volume":"37","author":"Agca","year":"2014","journal-title":"Contact Lens and Anterior Eye"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1647","DOI":"10.1016\/j.jcrs.2013.04.044","article-title":"Visual Outcomes Comparison of 2 Femtosecond Laser Platforms for Laser In Situ Keratomileusis","volume":"39","author":"Ang","year":"2013","journal-title":"J. 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