Long-term Results of Small-incision Lenticule Extraction in High Myopia

Abstract

Objectives:To evaluate two-year results of small-incision lenticule extraction (SMILE) for correction of high myopia.Materials and Methods:Forty-five eyes of 35 patients with mean spherical equivalent (SE) of -7.10±0.95 D who underwent routine SMILE by a single surgeon and were followed for at least 2 years were analyzed by retrospective chart review. SMILE was performed with a Visumax femtosecond laser (Carl Zeiss Meditec, Jena, Germany). Follow-up intervals were at 1, 6, 12, and 24 months after surgery. Uncorrected and best corrected distance visual acuity (CDVA), corneal wavefront measurements, and all complications were recorded.Results:After 2 years, 86% of eyes with plano target had an uncorrected distant visual acuity (VA) of 20/20 or better. Two percent of eyes lost 1 line of CDVA, while 32% gained 1 line. The mean SE after 2 years was -0.30±0.50 D. Corneal total high-order aberrations (HOA) increased from 0.43 to 0.92 μm at postoperative 12 months. There were metallic foreign bodies at the corneal interface in 1 eye of 1 patient which caused no decrease in VA.Conclusion:SMILE for high myopia seems safe and effective in light of two-year follow-up results. The procedure caused a moderate increase in HOA.

Two‐years results of small‐incision lenticule extraction and wavefront‐guided laser in situ keratomileusis for Myopia

“…Our current findings in the SMILE group were comparable with these previous studies in terms of safety, but the efficacy achieved in the current study was better than that of previous studies with a 2‐years follow‐up (Yıldırım et al. ) and with a 3‐years follow‐up (Pedersen et al. ; Messerschmidt‐Roth et al.…”

“…(), one study with a 2‐years follow‐up (Yıldırım et al. ), two with a 3‐years follow‐up (Pedersen et al. ; Messerschmidt‐Roth et al.…”

“…Yıldırım et al. () reported that CDVA decreased by one line in 2% of eyes and increased by one line in 38% at 24 months after SMILE. They also showed that UDVA was 20/20 or better in 86% of eyes at 24 months.…”

“…At 24 months after SMILE, 92% of eyes were within ±0.5 D of the MRSE correction (Yıldırım et al. ). Messerschmidt‐Roth et al.…”

“…Previous studies have demonstrated that SMILE is safe and effective for the correction of myopia and myopic astigmatism (Sekundo et al 2008(Sekundo et al , 2011(Sekundo et al , 2014Blum et al 2010a,b;Shah & Shah 2011b;Shah et al 2011a;Hjortdal et al 2012;Kamiya et al 2012Kamiya et al , 2014Vestergaard et al 2012;Ganesh & Gupta 2014;Lin et al 2014;Xu & Yang 2015). Early visual and refractive outcomes of SMILE are desirable, but the postoperative follow-up period in most studies only spans 3-12 months (Sekundo et al 2008(Sekundo et al , 2011(Sekundo et al , 2014Blum et al 2010a,b;Shah & Shah 2011b;Shah et al 2011a;Hjortdal et al 2012;Kamiya et al 2012Kamiya et al , 2014Kamiya et al , 2015Vestergaard et al 2012;A gca et al 2014;Ganesh & Gupta 2014;Lin et al 2014;Reinstein et al 2014;Kunert et al 2015;Xu & Yang 2015), with the exception of one study with a 2-years follow-up (Yıldırım et al 2016), two with a 3-years follow-up (Pedersen et al 2015;Messerschmidt-Roth et al 2016), and one with a 5-years follow-up (Blum et al 2016). Our primary hypothesis is that SMILE seems to exceed LASIK in terms of its refractive stability and predictability.…”