Small incision lenticule extraction for the correction of high myopia

Abstract

Purpose:Excimer laser-based refractive procedures can have less predictable results when used for correcting high myopia than when used for moderate myopia. Small incision lenticule extraction might overcome this weakness. However, small incision lenticule extraction is only Food and Drug Administration approved for use in myopic eyes up to −8 D with astigmatism of −3 D or less. We report outcomes of small incision lenticule extraction in highly and moderately myopic eyes and compare these to modern laser-assisted in situ keratomileusis.Methods:Retrospective, observational consecutive case series. Inclusion criteria: attempted myopic spherical correction ⩾−8 or−3 to −7.75 D with astigmatism ⩽−3 D, and corrected distance visual acuity of 1.0 (decimal scale) or better.Results:A total of 62 highly myopic and 407 moderately myopic eyes were included. At 3 months postoperatively, the highly myopic eyes had a mean spherical equivalent refraction of −0.28 ± 0.41 D (range: −1.13 to +0.75 D). Mean uncorrected distance visual acuity was 1.0. Mean efficacy index was 0.84. Mean safety index was 1.03. Uncorrected distance visual acuity same or better than corrected distance visual acuity: 61%. Astigmatism was ⩽0.5 D in 90% and ⩽1 D in 100%. The results in the moderately myopic eyes were comparable.Conclusion:We found equally good visual and refractive outcomes after small incision lenticule extraction for the correction of high and of moderate myopia combined with an astigmatic correction of up to 3 D, respectively.

Refraction and topographic risk factors for early myopic regression after small-incision lenticule extraction surgery

“…For refraction, the SE one month postoperatively for the whole study population was -0.01 D in the current study. Previous studies demonstrated postoperative SEs ranging from − 0.28 to − 0.38 D 35 , 36 , similar to the findings of our study. Moreover, excluding those patients with myopic regression, all the patients in the nonregression group had an SE lower than − 0.50 D at 6 months after SMILE surgery.…”

“…In a previous publication, the percentage of patients with a UCVA greater than 20/25 or greater was 100% after 2 years 34 . Another study reported that 82% and 96% of patients achieved a UCVA better than 20/25 three months after SMILE surgery 35 . The efficiency results of the current study are compatible with those of previous studies 34 , 35 .…”

“…Another study reported that 82% and 96% of patients achieved a UCVA better than 20/25 three months after SMILE surgery 35 . The efficiency results of the current study are compatible with those of previous studies 34 , 35 .…”

Topographic and surgical risk factors for high postoperative residual astigmatism after small incision lenticule extraction in patients with different degrees of myopia: a retrospective cohort study

“…For the efficiency and predictability of SMILE surgery in the present study, the mean UCVA of the study population one year after surgery was 0.99, and 95% of patients exhibited a UCVA > 20/25 or better. In previous research, all patients who underwent SMILE surgery exhibited a UCVA > 20/25 at two years post-surgery [ 37 ], and another article described that 82 to 96% of individuals exhibited a UCVA greater than 20/25 at three months post-surgery [ 38 ]. Thus, the satisfactory results of SMILE surgery in the present study are comparable with the findings of previous publications [ 37 , 38 ].…”

Stability of anterior segments in patients with moderate and high myopia one year after SMILE

“…SMILE is a ap-free intrastromal refractive procedure which is currently considered to be less invasive to the corneal biomechanics and with high safety [1][2]. Meanwhile the superiority of SMILE in visual quality and neural repair have been widely reported [3][4][5]. However, whether the structure of eyeball after corneal refractive surgery would be affected remains controversial , especially for changes in the anterior segment.…”