Clinical Outcomes of SMILE and FS-LASIK Used to Treat Myopia: A Meta-analysis

Zhang, Yingjie; Shen, Qin; Jia, Yan; Zhou, Dan; Zhou, Jibo

doi:10.3928/1081597x-20151111-06

Cited by 160 publications

(115 citation statements)

References 42 publications

(104 reference statements)

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“…Since both the former procedures involve minimal disruption of the corneal nerve fibers, postoperative dryness was practically non-existent compared to FS-LASIK. These observations corroborate with the results of previous studies on FS-LASIK and post-operative dry eye 9,10…”

Section: Discussionsupporting

confidence: 92%

“…Data from various studies suggest that this modality is a safe and effective method to correct varying degrees of myopia, with the advantages of minimum postoperative discomfort and restrictions, less dry eye, and probably better biomechanics compared to LASIK 9,10. Studies comparing the results of astigmatism correction with ReLEx SMILE and LASIK, however, showed better outcomes with LASIK, most likely due to non-availability of iris registration and eye tracker in the current version of the femtosecond laser used for the ReLEx SMILE procedure 11,12.…”

Section: Introductionmentioning

confidence: 99%

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Matched population comparison of visual outcomes and patient satisfaction between 3 modalities for the correction of low to moderate myopic astigmatism

Ganesh¹,

Brar²,

Pawar³

2017

OPTH

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PurposeTo compare toric implantable collamer lens (T-ICL), femto-LASIK, and ReLEx SMILE for the treatment of low to moderate myopic astigmatism in terms of long-term visual and refractive outcomes and predictability of astigmatic correction.Materials and methodsThe study included 30 eyes from 30 patients between the age groups of 21 and 40 years, undergoing bilateral surgery with any of the three procedures – T-ICL, femto-LASIK, or ReLEx SMILE – for correction of myopic astigmatism within the range of −3 to −8 D spherical equivalent (SE), with a minimum astigmatism of −0.75 D. Patients were followed up at day 1, 1 month, 6 months, and 1 year.ResultsAt 1 year, the mean cylinder reduced to −0.21±0.28, −0.17±0.36, and −0.22±0.28 D in the T-ICL, femto-LASIK, and ReLEx SMILE group, respectively. The predictability of astigmatism correction was comparable, with no statistically significant difference between the 3 groups (P>0.05). A total of 97% of eyes in ReLEx SMILE achieved a uncorrected distance visual acuity of 20/20 or better, compared to T-ICL (93%) and FS-LASIK (90%). However, gain in lines of corrected distant visual acuity (CDVA) was maximum in T-ICL group (60%). Four eyes in the femto-LASIK group had loss of CDVA by one line. Three eyes required exchange due to high vault and rotation of the T-ICL, which did not affect the final outcome.ConclusionAll 3 modalities were effective for myopic astigmatism at the end of 1 year. Quality of vision and patient satisfaction with T-ICL and ReLEx SMILE were similar and better than FS-LASIK. However, slight chances of postoperative rotation and exchange exist with T-ICL, which warrant thorough preoperative planning.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Matched population comparison of visual outcomes and patient satisfaction between 3 modalities for the correction of low to moderate myopic astigmatism

Ganesh¹,

Brar²,

Pawar³

2017

OPTH

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“…Previous meta-analyses suggested that SMILE shows obvious superiority over FS-LASIK by exhibiting a lower risk of postoperative dry eye [3–5]. However, a different conclusion has been drawn in our study.…”

Section: Discussioncontrasting

confidence: 75%

“…The maximum NOS score is nine, based on assessing three areas: selection quality (maximum four points), comparability (maximum two points), and outcome measures (maximum three points). Studies scoring five or fewer points were considered to be of low quality [3]. …”

Section: Methodsmentioning

confidence: 99%

Dry Eye after Small Incision Lenticule Extraction (SMILE) versus Femtosecond Laser-Assisted in Situ Keratomileusis (FS-LASIK) for Myopia: A Meta-Analysis

et al. 2016

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PurposeTo compare dry eye after small incision lenticule extraction (SMILE) and femtosecond laser-assisted LASIK (FS-LASIK) for correcting myopia.MethodsCENTRAL, Embase and PubMed were searched in November 2016. All randomized controlled trials (RCTs) and prospective cohorts that compared dry eye after SMILE with FS-LASIK were selected.ResultsFive cohorts and one RCT were identified for comparing dry eye after SMILE (291 eyes) and FS-LASIK (277 eyes). The pooled results revealed that the SMILE and FS-LASIK groups did not differ significantly in terms of Schirmer’s I test (SIT) and tear film osmolarity (TFO) at any postoperative visits. By contrast, tear break up time (TBUT; p = 0.04 for one month, p < 0.001 for three months, and p = 0.02 for six months) and ocular surface disease index (OSDI; p < 0.001 for one month and three months, and p = 0.006 for six months) were significantly worse in the FS-LASIK group than in the SMILE group at follow-up. At six months postoperatively, TBUT and TFO values in both the SMILE and FS-LASIK groups and OSDI scores in the SMILE group returned to preoperative levels, but SIT values in both groups (p = 0.02 for the SMILE group and p < 0.001 for the FS-LASIK group) and OSDI in the FS-LASIK group (p < 0.001) were still statistically impaired.ConclusionDry eye after both SMILE and FS-LASIK usually occurs transiently. SMILE does not show obvious superiority over FS-LASIK by exhibiting similar and acceptable objective parameters, and SMILE may have milder subjective symptoms.

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“…Compared to the other nowadays techniques of correcting myopic refractive errors, Femtosecond-LASIK was comparable with Small Incision Lenticule Extraction (SMILE) [ 5 - 7 ] and Transepithelial Photorefractive Keratectomy (Transepithelial-PRK) [ 8 ] in terms of safety, efficacy and predictability. After Femto-LASIK, the corneal sensitivity was lower and the dry eye syndrome was more frequent than after SMILE [ 5 ] but compared to Transepithelial-PRK had a shorter recovery time [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

One year refractive outcomes of Femtosecond-LASIK in mild, moderate and high myopia

Tăbăcaru

Stanca

2017

rjo

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Purpose: To evaluate the safety, efficacy, predictability and stability for a cohort of myopic eyes treated by Femtosecond-LASIK procedure. Methods: 60 eyes (36 patients) with different degrees of myopia that underwent refractive surgery by using the Femtosecond-LASIK technique were prospectively evaluated for 12 months. The mean preoperative spherical equivalent value was -3.827 ± 1.410 diopters (D) (range: -8.125 to -1.375 D). VisuMax  femtosecond laser was used for cutting the corneal flap and then the Mel80  excimer laser for the stromal ablation. Results: Mean age was 30.80 ± 5.745 years (range: 21 to 46 years) with 75% female patients. Postoperative spherical equivalent at 12 months was within ±0.25 D of emmetropia in 90% of the eyes and within ±0.50 D of emmetropia in 100% of the eyes. All the eyes achieved an uncorrected distance visual acuity (UDVA) of 1.0 (decimal scale). No eye lost lines of preoperative corrected distance visual acuity (CDVA). No major intraoperative or postoperative complications were encountered. Conclusions: Femtosecond-LASIK seems to be a suitable option for the correction of mild, moderate, and high myopia, as the procedure showed to be safe, effective, and predictable for the treatment of myopic refractive errors.

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Clinical Outcomes of SMILE and FS-LASIK Used to Treat Myopia: A Meta-analysis

Abstract: SMILE and FS-LASIK were comparable in terms of both safety and efficacy. SMILE may create fewer dry eye symptoms than FS-LASIK. Corneal sensitivity was greater after SMILE than FS-LASIK.

Cited by 160 publications

References 42 publications

Matched population comparison of visual outcomes and patient satisfaction between 3 modalities for the correction of low to moderate myopic astigmatism

Matched population comparison of visual outcomes and patient satisfaction between 3 modalities for the correction of low to moderate myopic astigmatism

Dry Eye after Small Incision Lenticule Extraction (SMILE) versus Femtosecond Laser-Assisted in Situ Keratomileusis (FS-LASIK) for Myopia: A Meta-Analysis

One year refractive outcomes of Femtosecond-LASIK in mild, moderate and high myopia

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