Comparison of Vision Correction and Corneal Thickness at 180-Day Follow-Up After Femtosecond Laser-Assisted In-Situ Keratomileusis (FS-LASIK), Photorefractive Keratectomy (PRK), and Small Incision Lenticule Extraction (SMILE): A Study from a Single Center in Poland of 120 Patients with Myopia

Abstract

Background This study from a single center in Poland included 120 patients with myopia, and the aim was to compare vision correction and corneal thickness at the 180-day follow-up after femtosecond laser-assisted in-situ keratomileusis (FS-LASIK), photorefractive keratectomy (PRK), or small incision lenticule extraction (SMILE). Material/Methods The effectiveness and safety of laser vision correction (LVC) procedures were evaluated by determining pre- and post-procedure uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) values on the Snell chart. Twenty patients with diagnosed mild myopia (sphere maximum −3.0 diopters D; cylinder maximum 0.5 D) were qualified for PRK surgery. Fifty patients with diagnosed intolerance (sphere maximum −6.0 D; cylinder maximum 5.0 D) were eligible for the FS-LASIK procedure. Fifty patients with diagnosed myopia (sphere maximum −6.0 D cylinder 3.5 D) were qualified for the SMILE procedure. Results Regardless of which procedure was performed, both UDVA and CDVA improved significantly postoperatively ( P <0.05). In addition, the UDVA and CDVA values were similar in the postoperative period ( P >0.05). For each procedure, the EI was no less than 0.94. Regardless of which type of LVC procedure was performed, CET at the center and 1.5 mm from the center in 4 meridians thickened, and this change was not statistically significant over the observation period ( P >0.05). Conclusions Our analysis demonstrated similar effectiveness of the 3 methods – PRK, FS-LASIK, and SMILE – in patients with mild and moderate myopia.

Comparison of early visual outcomes after SMILE using VISUMAX 800 and VISUMAX 500 for myopia: a retrospective matched case–control study

“…SMILE has similar or superior vision improvement effects and predictive power to LASIK 19 , 20 . VISUMAX 800 began to be used in Europe in the second half of 2021 after the Conformité Européenne (CE) certification.…”

Safety and Effectiveness of Smooth Incision Lenticular Keratomileusis (SILKTM) Using the ELITA(TM) Femtosecond Laser System for Correction of Myopic and Astigmatic Refractive Errors

“…1,2 This alteration of corneal curvature is the foundation of all plano-convex tissue removal techniques, including laser in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), small incision lenticule extraction (SMILE, VisuMax 500 and 800, Carl Zeiss Meditec AG Germany), SmartSight (ATOS, Schwind eye-tech-solutions, Germany), and CLEAR (Z8, Ziemer, Switzerland). [1][2][3][4][5][6] Femtosecond lasers generate ultrashort laser pulses, which induce micron-scale incisions in target tissues by photodisruption. 7 The small incision through the corneal epithelium used for lenticule removal during LALEX procedures leads to fewer epithelial defects, less postoperative pain and dryness, faster wound healing, and larger postoperative achieved functional optical zones compared to other corneal refractive surgery procedures.…”

“…7 The small incision through the corneal epithelium used for lenticule removal during LALEX procedures leads to fewer epithelial defects, less postoperative pain and dryness, faster wound healing, and larger postoperative achieved functional optical zones compared to other corneal refractive surgery procedures. 6,[8][9][10] However, visual recovery can be impacted by femtosecond laser energy levels, 9,11 scanning patterns, 12 and surgical technique, 13 and there is a longer learning curve for surgeons compared to conventional LASIK procedures. 2,13 In procedures such as SMILE, tissue bridges are present between the cornea and the lenticule at the two lenticular interfaces after the femtosecond laser cuts are completed, requiring surgeon manipulation to separate the lenticule prior to extraction.…”