{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:37:32Z","timestamp":1780447052726,"version":"3.54.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T00:00:00Z","timestamp":1661299200000},"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>This research aims to study the corneal morphological changes in adult patients with myopic anisometropia after small incision lenticule extraction (SMILE) and the safety, efficacy, and predictability of clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective cohort study. Patients with myopic anisometropia [refractive difference &amp;gt;2.0 diopters (D)] were included in this study who underwent SMILE at our hospital from September 2019 to March 2021. For the two eyes of each patient, the one with higher myopia was defined as group A, and the fellow eye was group B. The follow-up time points were set as 1 week, 1 month, 3 months, and 6 months after the surgery. The data collected were uncorrected and best-corrected distance visual acuity (UDVA and CDVA), spherical equivalent (SE), efficacy and safety indexes, posterior corneal elevation (PCE), anterior and posterior corneal radius of curvature in the 3 mm area at the center of the thinnest point of the cornea (ARC and PRC), and higher-order aberrations (HOAs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 36 patients (72 eyes), and the mean age was 25.2 \u00b1 6.4 years. The preoperative SEs were \u22126.45 \u00b1 1.25 D in group A and \u22123.76 \u00b1 1.29 D in group B. Six months after surgery, the SEs in groups A and B were \u22120.09 \u00b1 0.50 D and 0.07 \u00b1 0.47 (<jats:italic>P<\/jats:italic> = 0.059), respectively. The efficacy indexes were 1.06 \u00b1 0.16 in group A and 1.07 \u00b1 0.14 in group B (<jats:italic>P<\/jats:italic> = 0.750). The safety indexes were 1.08 \u00b1 0.14 in group A and 1.12 \u00b1 0.15 in group B (<jats:italic>P<\/jats:italic> = 0.173). The PCE was significantly reduced at 6 months after surgery in pagebreak both groups (<jats:italic>P<\/jats:italic> &amp;lt; 0.05). The ARC was significantly higher than before the surgery (<jats:italic>P<\/jats:italic> &amp;lt; 0.05) in the two groups. The two groups showed significant increases in total HOAs, coma 90\u00b0, and spherical aberrations (<jats:italic>P<\/jats:italic> &amp;lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SMILE is predictable, effective, and safe in correcting myopic anisometropia. The postoperative changes in HOAs are characteristic.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.977586","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T06:12:45Z","timestamp":1661321565000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Corneal morphological changes after small incision lenticule extraction for myopic anisometropia"],"prefix":"10.3389","volume":"9","author":[{"given":"Lu","family":"Zhu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Ji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaorong","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiong","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiuyi","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjuan","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/j.visres.2017.03.004","article-title":"Observations on the relationship between anisometropia, amblyopia and strabismus.","volume":"134","author":"Smith","year":"2017","journal-title":"Vision Res."},{"key":"B2","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1159\/000067040","article-title":"On the age-related prevalence of anisometropia.","volume":"34","author":"Weale","year":"2002","journal-title":"Ophthalmic Res."},{"key":"B3","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.jcrs.2010.10.045","article-title":"Visual function and patient satisfaction: comparison between bilateral diffractive multifocal intraocular lenses and monovision pseudophakia.","volume":"37","author":"Zhang","year":"2011","journal-title":"J Cataract Refract Surg."},{"key":"B4","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/S0886-3350(03)00417-6","article-title":"Laser-assisted subepithelial keratectomy and photorefractive keratectomy versus conventional treatment of myopic anisometropic amblyopia in children.","volume":"30","author":"Autrata","year":"2004","journal-title":"J Cataract Refract Surg."},{"key":"B5","first-page":"12","article-title":"[Refractive Surgery in Children with Myopic Anisometropia and Amblyopia in Comparison with Conventional Treatment by Contact Lenses].","volume":"72","author":"Autrata","year":"2016","journal-title":"Cesk Slov Oftalmol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1016\/j.ophtha.2005.06.010","article-title":"Long-term outcomes of photorefractive keratectomy for anisometropic amblyopia in children.","volume":"113","author":"Paysse","year":"2006","journal-title":"Ophthalmology."},{"key":"B7","first-page":"813","article-title":"Long-term efficacy of excimer laser in situ keratomileusis in the management of children with high anisometropic amblyopia.","volume":"122","author":"Lin","year":"2009","journal-title":"Chin Med J."},{"key":"B8","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1067\/mpa.2001.119787","article-title":"Refractive surgery for unilateral high myopia in children.","volume":"5","author":"Nucci","year":"2001","journal-title":"J AAPOS."},{"key":"B9","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1177\/112067210601600204","article-title":"Visual outcome after excimer laser refractive surgery in adult patients with amblyopia.","volume":"16","author":"Roszkowska","year":"2006","journal-title":"Eur J Ophthalmol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1159\/000187686","article-title":"Effect of basic fibroblast growth factor in transgenic mice: corneal epithelial healing process after excimer laser photoablation.","volume":"223","author":"Meduri","year":"2009","journal-title":"Ophthalmologica."},{"key":"B11","doi-asserted-by":"publisher","first-page":"424","DOI":"10.4103\/0301-4738.119420","article-title":"Effect of the combination of basic fibroblast growth factor and cysteine on corneal epithelial healing after photorefractive keratectomy in patients affected by myopia.","volume":"62","author":"Meduri","year":"2014","journal-title":"Indian J Ophthalmol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"2085","DOI":"10.1016\/S0140-6736(18)33209-4","article-title":"Refractive surgery.","volume":"393","author":"Kim","year":"2019","journal-title":"Lancet."},{"key":"B13","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1097\/ICO.0000000000000707","article-title":"Clinical outcomes after SMILE and femtosecond laser-assisted LASIK for myopia and myopic astigmatism: a prospective randomized comparative study.","volume":"35","author":"Liu","year":"2016","journal-title":"Cornea."},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1167\/tvst.11.2.13","article-title":"Prospective, randomized, contralateral eye comparison of functional optical zone, and visual quality after SMILE and FS-LASIK for high myopia.","volume":"11","author":"He","year":"2022","journal-title":"Transl Vis Sci Technol."},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-019-1096-z","article-title":"Visual and optical quality outcomes of SMILE and FS-LASIK for myopia in the very early phase after surgery.","volume":"19","author":"Liu","year":"2019","journal-title":"BMC Ophthalmol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"510","DOI":"10.3928\/1081597X-20210506-02","article-title":"Small incision lenticule extraction for correction of pediatric unilateral anisometropic myopia.","volume":"37","author":"Samir","year":"2021","journal-title":"J Refract Surg."},{"key":"B17","doi-asserted-by":"publisher","first-page":"654","DOI":"10.3928\/1081597X-20210712-02","article-title":"7-year results of SMILE for high myopia: visual and refractive outcomes and aberrations.","volume":"37","author":"Damgaard","year":"2021","journal-title":"J Refract Surg."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1064","DOI":"10.1097\/OPX.0000000000001298","article-title":"Unwanted astigmatism and high-order aberrations one year after excimer and femtosecond corneal surgery.","volume":"95","author":"Bohac","year":"2018","journal-title":"Optom Vis Sci."},{"key":"B19","doi-asserted-by":"publisher","first-page":"719","DOI":"10.3928\/1081597X-20150923-11","article-title":"Three-year results of small incision lenticule extraction for high myopia: refractive outcomes and aberrations.","volume":"31","author":"Pedersen","year":"2015","journal-title":"J Refract Surg."},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-017-0507-2","article-title":"Comparison of visual results and higher-order aberrations after small incision lenticule extraction (SMILE): high myopia vs. mild to moderate myopia.","volume":"17","author":"Jin","year":"2017","journal-title":"BMC Ophthalmol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1007\/s10103-019-02854-w","article-title":"Changes in corneal biomechanics during small-incision lenticule extraction (SMILE) and femtosecond-assisted laser in situ keratomileusis (FS-LASIK).","volume":"35","author":"Cao","year":"2020","journal-title":"Lasers Med Sci."},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-015-0051-x","article-title":"One-year outcomes of small-incision lenticule extraction (SMILE): mild to moderate myopia vs. high myopia.","volume":"15","author":"Kim","year":"2015","journal-title":"BMC Ophthalmol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1016\/j.jcrs.2017.01.015","article-title":"Visual and refractive outcomes of small-incision lenticule extraction in mild, moderate, and high myopia: six-month results.","volume":"43","author":"Torky","year":"2017","journal-title":"J Cataract Refract Surg."},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-019-1135-9","article-title":"The comparison of visual outcomes, aberrations, and Bowman\u2019s layer micro-distortions after femtosecond laser small-incision lenticule extraction (SMILE) for the correction of high and moderate myopia and myopic astigmatism.","volume":"19","author":"Qin","year":"2019","journal-title":"BMC Ophthalmol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1136\/bjophthalmol-2013-303415","article-title":"Small incision lenticule extraction (SMILE) and femtosecond laser LASIK: comparison of corneal wound healing and inflammation.","volume":"98","author":"Dong","year":"2014","journal-title":"Br J Ophthalmol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"346","DOI":"10.3928\/1081597X-20160217-05","article-title":"Early corneal wound healing and inflammatory responses after SMILE: comparison of the effects of different refractive corrections and surgical experiences.","volume":"32","author":"Liu","year":"2016","journal-title":"J Refract Surg."},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1186\/s40662-020-00218-y","article-title":"Impact of ablation ratio on 5-year postoperative posterior corneal stability after refractive surgery: SMILE and FS-LASIK.","volume":"7","author":"Li","year":"2020","journal-title":"Eye Vis."},{"key":"B28","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1007\/s00417-018-04227-5","article-title":"Comparison of the posterior corneal elevation and biomechanics after SMILE and LASEK for myopia: a short- and long-term observation.","volume":"257","author":"Yu","year":"2019","journal-title":"Graefes Arch Clin Exp Ophthalmol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/S0161-6420(00)00502-9","article-title":"Factors affecting the forward shift of posterior corneal surface after laser in situ keratomileusis.","volume":"108","author":"Baek","year":"2001","journal-title":"Ophthalmology."},{"key":"B30","doi-asserted-by":"publisher","first-page":"2175","DOI":"10.1016\/j.ophtha.2004.06.027","article-title":"Wavefront-guided LASIK with the Zyoptix 3.1 system for the correction of myopia and compound myopic astigmatism with 1-year follow-up: clinical outcome and change in higher order aberrations.","volume":"111","author":"Kohnen","year":"2004","journal-title":"Ophthalmology."},{"key":"B31","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1097\/j.jcrs.0000000000000067","article-title":"Five-year outcomes of small-incision lenticule extraction vs femtosecond laser-assisted laser in situ keratomileusis: a contralateral eye study.","volume":"46","author":"T\u00fcl\u00fc Ayg\u00fcn","year":"2020","journal-title":"J Cataract Refract Surg."},{"key":"B32","doi-asserted-by":"crossref","first-page":"523","DOI":"10.18240\/ijo.2021.04.07","article-title":"Comparison of correcting myopia and astigmatism with SMILE or FS-LASIK and postoperative higher-order aberrations.","volume":"14","author":"Zhao","year":"2021","journal-title":"Int J Ophthalmol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1097\/ICL.0000000000000225","article-title":"Corneal higher-order aberrations of the anterior surface, posterior surface, and total cornea after SMILE, FS-LASIK, and FLEx surgeries.","volume":"42","author":"Wu","year":"2016","journal-title":"Eye Contact Lens."},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-017-0431-5","article-title":"Comparison of ocular higher-order aberrations after SMILE and Wavefront-guided Femtosecond LASIK for myopia.","volume":"17","author":"Chen","year":"2017","journal-title":"BMC Ophthalmol."},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/758196","article-title":"The correlation analysis between corneal biomechanical properties and the surgically induced corneal high-order aberrations after small incision lenticule extraction and femtosecond laser in situ keratomileusis.","volume":"2015","author":"Wu","year":"2015","journal-title":"J Ophthalmol."},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-019-1084-3","article-title":"Comparative study of wavefront aberration and corneal Asphericity after SMILE and LASEK for myopia: a short and long term study.","volume":"19","author":"Yu","year":"2019","journal-title":"BMC Ophthalmol."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.977586\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T06:12:53Z","timestamp":1661321573000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.977586\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,24]]},"references-count":36,"alternative-id":["10.3389\/fmed.2022.977586"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.977586","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,24]]},"article-number":"977586"}}