A Pilot Study of SMILE for Hyperopia: Corneal Morphology and Surface Characteristics of Concave Lenticules in Human Donor Eyes

PURPOSE: To evaluate the corneal morphology and surface characteristics of concave lenticules after small incision lenticule extraction (SMILE) for hyperopia. METHODS: SMILE procedures were performed on two human autopsy corneas in vitro to correct +4.00 diopters of hyperopia. Slit-lamp microscopy and anterior optical coherence tomography (OCT) were performed after lenticule creation and extraction. The extracted lenticules and modified corneas were sent for transmission electron microscopy imaging. RESULTS: Interlamellar gas bubbles were detected at 3 minutes and almost burst at 30 minutes after lenticule creation. A few interlamellar bubbles were detected after lenticule extraction. There was an obvious interlamellar concave gap under OCT. Transmission electron microscopy showed the front and back surfaces of the lenticules were smooth, with some tissue bridges, cavities, and grooves. CONCLUSIONS: A good quality concave lenticule can be created via SMILE for hyperopia. The impact of interlamellar gap on visual quality needs further investigation. [ J Refract Surg. 2016;32(10):713–716.]