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To evaluate three-dimensional epithelial remodeling in patients undergoing myopic LASIK vs. SMILE.
In a prospective randomized contralateral eye study of LASIK vs. SMILE procedures, 21 consecutive patients (42 eyes) were evaluated with corneal epithelial mapping by anterior segment OCT for up to 2-years.
In the LASIK group the central epithelial thickness increased from 52.38 ± 2.57 μm to 57.00 ± 4.23 μm and remained almost stable at this level for up to 24 months. In the SMILE eyes it increased from 52.52 ± 3.01 μm to 57.15 ± 4.57 μm and also remained stable for up to 24 months. Both techniques created the same level of epithelial thickness increase and variation, with significantly higher mid-peripheral epithelial thickness increase. The differences between the preoperative and postoperative changes were found statistically significant, but not different between the two techniques at any given time studied.
Both LASIK and SMILE resulted in significant epithelial thickening. This response appeared to be surprisingly quite similar between the two different techniques. This study suggests that epithelial remodeling may correlate with relative curvature changes resulting after both techniques, rather than the obvious difference of subepithelial corneal denervation changes.