Impact of corneal biomechanical changes on corneal stability and visual quality after small incision lenticule extraction and intervention strategies
10.3980/j.issn.1672-5123.2025.7.13
- VernacularTitle:SMILE术后角膜生物力学变化对角膜稳定性与视觉质量的影响及干预策略
- Author:
Zhuxuan YAN
1
;
Hanrui WANG
1
;
Yang LYU
1
;
Fang CAO
1
;
Zhenguo YAN
1
Author Information
1. Lanzhou Huaxia Eye Hospital, Lanzhou 730000, Gansu Province, China; Department of Ophthalmology, the 940th Hospital of Joint Service Support Forces of the Chinese People's Liberation Army, Lanzhou 730000, Gansu Province, China; First School of Clinical Medical, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China
- Publication Type:Journal Article
- Keywords:
small incision lenticule extraction(SMILE);
corneal biomechanics;
corneal stability;
visual quality
- From:
International Eye Science
2025;25(7):1111-1115
- CountryChina
- Language:Chinese
-
Abstract:
With the rapid advancement of refractive surgery, small incision lenticule extraction(SMILE)has become a mainstream procedure due to its biomechanical advantage in preserving the integrity of the anterior elastic layer and epithelium. However,postoperative stromal tissue removal and stress redistribution may still compromise corneal biomechanical stability, potentially affecting long-term corneal stability and visual quality. This review focuses on the mechanisms underlying biomechanical changes after SMILE, summarizing recent findings on corneal thinning, reduced mechanical strength, and stress remodeling, and their impact on corneal morphology and visual quality. It further explores potential contributors to postoperative ectasia, increased higher-order aberrations(HOAs), and visual fluctuations, highlighting individual variability and current controversies in the literature. Moreover, current evidence on adjunctive strategies such as corneal cross-linking(CXL)in enhancing biomechanical strength, reducing complications, and improving optical quality was analyzed. Finally, optimal timing for CXL, threshold values of biomechanical metrics, and the role of individualized preoperative assessment and postoperative management was discussed, aiming to provide a theoretical and clinical basis for improving safety and visual outcomes following SMILE.
