{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:57:30Z","timestamp":1789588650414,"version":"build-2803163510"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T00:00:00Z","timestamp":1643932800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>To evaluate the changes in posterior corneal elevation in thin corneas after small incision lenticule extraction (SMILE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective study, 97 eyes of 97 patients undergoing SMILE were recruited. Eyes were categorized into the following groups based on the preoperative minimum central corneal thickness (CCT): group A (37 eyes, 480\u2013499 \u03bcm), group B (30 eyes, 500\u2013529 \u03bcm), and group C (30 eyes, 530\u2013560 \u03bcm). The posterior corneal surface was measured with a Pentacam over a 3-year follow-up period. Changes in the posterior corneal elevation at the central point (PCE), thinnest point (PTE), and predetermined area were measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No iatrogenic keratectasia was observed during the follow-up period. The mean changes in PCE, PTE, and the inferior area in group A were 1.14 \u00b1 3.40 \u03bcm, \u22120.11 \u00b1 3.20 \u03bcm, and \u22120.26 \u00b1 1.23 \u03bcm, respectively (<jats:italic>P<\/jats:italic> \u2265 0.125). Although statistically significant change in the central-4 mm area was noted, the value was quite small (0.98 \u00b1 1.67 \u03bcm) and was not higher than that in the other two groups (<jats:italic>P<\/jats:italic> = 0.003). For all three groups, the elevation remained stable or showed a backward change in the central annulus, while there was a small forward displacement in the 6-mm optical zone. In group A, changes in elevation values yielded negative statistical correlations with residual bed thickness and CCT (<jats:italic>P<\/jats:italic> \u2264 0.006) (except for the inferior area, the 4-mm and 6-mm optical zone).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>With a strict preoperative assessment, SMILE achieved good safety and efficacy in correcting myopia in thin corneas and enabled a stable posterior corneal surface over a 3-year follow-up period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Synopsis<\/jats:title><jats:p>Careful preoperative assessment and suitable surgical design should be taken to ensure posterior corneal stability after SMILE in thin corneas.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.758223","type":"journal-article","created":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T07:11:23Z","timestamp":1643958683000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Three-Year Follow-Up of Posterior Corneal Elevation in Thin Corneas After Small Incision Lenticule 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