Comparison of Corneal Optical Quality After SMILE, Wavefront-Optimized LASIK and Topography-Guided LASIK for Myopia and Myopic Astigmatism

Abstract

PurposeTo compare visual outcomes and corneal optical quality after small incision lenticule extraction (SMILE), wavefront-optimized (WFO) FS-LASIK, and topography-guided customized ablation treatment (TCAT) FS-LASIK for myopia.MethodsThis prospective case-series study included 283 eyes of 283 myopic patients who underwent SMILE or FS-LASIK. There were 102, 100, and 81 eyes in the SMILE group, WFO group and TCAT group, respectively. The tomography system (Sirius) was used to measure corneal aberrations and optical quality.ResultsAt postoperative 1 and 6 months, there were no significant differences in uncorrected distance visual acuity and corrected distance visual acuity among the three groups (P > 0.05). Postoperative manifest refractive spherical equivalent was similar among the groups (P > 0.05). There was statistically significant difference in cylinder at 1 month among the three groups, with the highest mean value in TCAT group (P < 0.05). The corneal optical path difference, root mean square of corneal astigmatism and strehl ratio were the most superior in the TCAT group at postoperative 1 and 6 months (P < 0.05).ConclusionSMILE, WFO FS-LASIK, and TCAT FS-LASIK provided similar visual results. The corneal visual quality after TCAT FS-LASIK was the best.

Differences in ocular high order aberrations before and after small incision lenticule extraction for correction of myopia: a systematic review and meta-analysis

“…We evaluated the already identified literature and found 4 new articles from their reference sections and cited articles. Ultimately, 19 articles that satisfied our criteria were included in this meta-analysis (7,8,(10)(11)(12)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Figure 1 displays a flow chart of the literature reviewed in this study.…”

“…The prior occurrence of HOA was eradicated and the development of new HOA was avoided ( 9 ). Despite the technical advantages, there is very conflicting data on whether personalized corneal refractive surgery results in decreased postoperative induction of HOA compared to SMILE procedures ( 10 ). Kwak et al ( 11 ) discovered that SMILE does not cause spherical aberration (SA) in several types of HOA.…”

Three-Month Comprehensive Outcomes of Topography-Guided LASIK Versus Keratorefractive Lenticule Extraction (KLEx): A Prospective Contralateral Study

“…In our study, both groups had excellent safety profiles, with no significant differences. Kang and Zhang et al similarly found no safety differences between TG-LASIK and SMILE, with over 90% of eyes in both groups experiencing no change or improvement in lines of CDVA 6 months postoperatively [ 4 , 11 ].…”

“…In response to this rise, many advancements in excimer laser platforms have been made to make these procedures more accurate, effective, and safer for patients [ 2 ]. WaveLight® Contoura Vision topography-guided LASIK (TG-LASIK), approved by the US Food and Drug Administration (FDA) in 2016, utilizes preoperative corneal topography measurements in its excimer laser platform to create a customized ablation to maintain the aspheric corneal shape and minimize surgically induced corneal irregularities [ 3 , 4 ].…”

“…Several studies have compared visual and refractive outcomes and higher-order aberrations (HOAs) of TG-LASIK and KLEx [ 4 , 10 – 13 ]. One study also assessed epithelial remodeling between these two procedures [ 14 ]; however, to the best of our knowledge, no studies have evaluated corneal biomechanics or extensive corneal topographic parameters between these two procedures.…”