Three-year outcomes of small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for myopia and myopic astigmatism

Han, Tian; Xu, Ye; Han, Xiao; Zeng, Li; Shang, Jianmin; Chen, Xun; Zhou, Xingtao

doi:10.1136/bjophthalmol-2018-312140

Cited by 85 publications

(72 citation statements)

References 23 publications

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“…Sekundo et al [1] first introduced this new procedure in 2011. e first clinical study [2] of femtosecond lenticule extraction in China was also reported in 2011. Numerous clinical studies [3][4][5][6][7][8][9] suggested that SMILE is a safe and effective procedure for myopia correction, and the follow-up periods in these studies mostly spanned from 3 months to 3 years, but rarely up until 4 years [10][11][12][13][14]. In 2019, we [15] have previously compared the 5-year outcomes of SMILE and femtosecond laser-assisted LASIK (FS-LASIK) in patients with myopia.…”

Section: Introductionmentioning

confidence: 99%

Small Incision Lenticule Extraction (SMILE) for Moderate and High Myopia: Seven-Year Outcomes of Refraction, Corneal Tomography, and Wavefront Aberrations

Xia

Shen

Han

et al. 2020

Journal of Ophthalmology

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Purpose. To investigate the long-term outcomes of refraction, corneal tomography, and wavefront aberrations after small incision lenticule extraction (SMILE) for moderate and high myopia. Methods. Prospective, nonconsecutive case series. A total of 26 patients (26 eyes) who underwent SMILE from May 2010 to March 2013 at the Fudan University Eye and ENT Hospital (Shanghai, China) were enrolled. The periods of follow-up were 1 month, 1 year, 5 years, and 7 years after surgery. The routine eye examinations included uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), manifest refraction, and corneal tomography. Results. All surgeries were executed without any complications. At the final visit, an UDVA of 20/20 or better was achieved in 26 eyes (100%) and 11 eyes (42%) exhibited no change in CDVA. 9 eyes (35%) gained one line, 6 eyes (23%) gained two lines, and no eyes lost CDVA. 24 eyes (92%) and 26 eyes (100%) were within ±0.5 D and ±1.00 D of the target refraction, respectively. A mean refractive regression of −0.17 D was observed between 1 month and 7 years postoperatively. Mean corneal front curvature (MCFC) was significantly decreased between pre- and post-SMILE surgery (P<0.0001). Higher-order aberrations (HOAs) and vertical coma were significantly increased after SMILE compared to those measured before surgery (all P<0.001). There were no significant differences in trefoil and spherical aberration between pre- and post-SMILE surgery (all P>0.05). Conclusion. SMILE is an effective, safe, and stable procedure for moderate and high myopia, with relatively constant corneal stability and wavefront aberrations. This trial is registered with ChiCTR-ONRC-13003114.

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Section: Introductionmentioning

confidence: 99%

Small Incision Lenticule Extraction (SMILE) for Moderate and High Myopia: Seven-Year Outcomes of Refraction, Corneal Tomography, and Wavefront Aberrations

Xia

Shen

Han

et al. 2020

Journal of Ophthalmology

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“…Then except for 12 duplicate reports, 67 papers underwent title and abstract screening.33 studies were excluded as a result of following reasons: 11 studies did not have control group, and just made a separate description of SMILE or FS-LASIK; and 7 studies' control groups were not SMILE and FS-LASIK; meanwhile there were 15 Studies whose subjects were not high myopia. Finally, there remained 10 studies [2,3,11,[14][15][16][17][18][19][20] that met our inclusion criteria and they were included in this meta-analysis. Table 1 summarized the main characteristics and the quality assessment of these 10 included studies, which were published from 2014 to 2019.…”

Section: Sensitivity Analysis and Publication Biasmentioning

confidence: 99%

“…The logMAR values of postoperative UDVA. Of these 10 articles, 4 [11,[14][15][16] reported the the logMAR values of postoperative UDVA. And we excluded the study by Likun Xia et al [11] in the first subgroup because its high sensitivity.…”

Section: Primary Outcomesmentioning

confidence: 99%

“…And we excluded the study by Likun Xia et al [11] in the first subgroup because its high sensitivity. An examination of the forest plot showed that, for high myopia, there was no significant statistical difference between the SMILE group and FS-LASIK group in UDVA after 1-and 3-month follow-ups(WMD=-0.01; 95% CI:-0.02,0.00;I²=0%; P=0.10,WMD=-0.00; 95% CI:-0.00 to 0.01;I²=0%; P=0.35; Figure 3A).And 3 [11,14,16] studies were followed up for a longer period of time, and the same results were obtained at long term after surgery(WMD=-0.01; 95% CI:-0.02 to 0.01,I²=17%;P=0.26, Figure 3A).And the same is true for the total results(WMD = -0.00, 95% CI, -0.01 to 0.00, I²=3%,P = 0.38, Figure 3A). And the Funnel plots ( Figure 3B) suggested a slim possibility of publication bias.…”

Section: Primary Outcomesmentioning

confidence: 99%

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Clinical outcomes after small incision lenticule extraction versus femtosecond laser-assisted LASIK for high myopia: a Meta-analysis.

Yin

Zhao

et al. 2020

Preprint

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KEYWORDSsmall-incision lenticule extraction, femotosecond laser in situ keratomileusis, high myopia, visual quality, Meta-analysis 3 Abstract Background To compare postoperative clinical outcomes of high myopia after being treated by Small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK).Methods Comprehensive studies were conducted on the PubMed, MEDLINE, EMBASE, the Cochrane Library, and Chinese databases.Trials meeting the selection criteria were quality appraised, and the data were extracted by 2 independent authors, and the RevMan 5.3 version software were used in analyzing.Result Ten studies involving 637 patients (1093 eyes;575 eyes in the SMILE group and 518 eyes in the FS-LASIK group) were included in this meta-analysis. Pooled result revealed no significant differences in the following outcomes: the logMAR values of postoperative UDVA(WMD = -0.01, 95%CI: -0.02,0.00, I²=0%, P = 0.10 at postoperative 1mo; WMD =-0.01, 95% CI: -0.00 to 0.01, I²=0%,P = 0.35 at postoperative 3mo; WMD = -0.01, 95% CI:-0.02 to 0.01, I²=17%,P = 0.26 at long term), the logMAR values of postoperative CDVA(WMD = -0.02, 95% CI, -0.04 to 0.00, I²=0%, P = 0.11),and the postoperative mean refractive SE (WMD =0.02, 95% CI:0.04 to 0.08, I²=29%, P=0.60) . In the longterm observation, postoperative tHOA (WMD =-0.10, 95% CI:-0.13 to -0.07, I²=15%, P<0.00001)and postoperative spherical aberration (WMD =-0.13, 95% CI:--0.17 to -0.09, I²=38%, P<0.00001) were found to be less in the SMILE group compared with the FS-LASIK group, but no significant difference was found in postoperative coma (WMD =-0.02, 95% CI:-0.04 to 0.00, I²=98%, P=0.40).We also found greater PCE change post FS-LASIK than SMILE at long term follow-ups(WMD =-0.69, 95% CI:-1.36 to -0.01, I²=0%, P<0.05, however, there was no significant difference between the two groups at 3-or 6months.(WMD =-0.19, 95% CI:-0.41 to 0.03, I²=31%, P=0.09;WMD =-0.20, 95% CI:-0.50 to 0.10, I²=17%, P=0.20)Conclusion For patients with high myopia, both SMILE and FS-LASIK are safe and efficacious. However, SMILE induced less tHOA and spherical aberration compared with FS-LASIK. Besides, FS-LASIK showed a greater increase in PCE than SMILE only at long term follow-ups. It remains to be seen whether the patients can get a better visual quality after SMILE and more comparative studies focused on high myopia is necessary. Search strategyIn order to gather records that compare SMILE and LASIK for treating high myopia as many as possible, two reviewers independently searched the electronic database as follows, PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and a Chinese database (CNKI, WANFANG and Weip) from March 2018 to April 2019. The following keywords were used in the search: high myopia (e.g. high myopia, high short-sight, high nearsighted or high correction), LASIK (e.g. LASIK orKeratomileusis, femtosecond laser in situ keratomileusis) and SMILE (e.g. SMILE, lenticule extraction, small incision lenticule extraction). The search proces...

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“…(6) SMILE ve f-LASIK'i hastaların kontralateral gözleri üzerinde refraktif sonuçlar açısından karşılaştırılmıştır. Refraktif sonuçlar açısından bazı yayınlarda SMILE ve f-LASIK'in sonuçlarının benzer olduğu bazılarında ise f-LASIK'in bir miktar daha etkili olduğu belirtilmiştir (3,4,6,7) . Ancak, bildiğimiz kadarıyla bu konuda yapılmış prospektif, kontrol gruplu, çok merkezli, tek/çift kör, kanıt düzeyi yüksek bir çalışma yoktur.…”

Section: Introductionunclassified

Femtosecond Laser Assisted LASIK vs SMILE: Refractive Results, Contrast Sensitivity and Corneal Higher Order Aberrations

Çankaya¹,

Yaşa²,

Ağca³

et al. 2019

IKSST

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ancak daha sonraki kontrollerde istatistiksel olarak anlamlı fark saptanmadı. Ameliyat sonrasında toplam HOA, SA ve koma her iki grupta da istatistiksel olarak anlamlı derecede artmıştı ve gruplar arasında bir fark yoktu (18. ayda ortalama toplam HOA RMS f-LASIK ve SMILE gruplarında sırası ile 0,51±0,10 ve 0,52±0,14, p=0,656). Trefoil ise yalnızca SMILE grubunda artmıştı ve 6. 12. ve 18. ay muayenelerinde f-LASIK grubuna göre anlamlı derecede daha yüksekti. Kontrast duyarlılık iki grupta da ameliyat öncesine göre anlamlı derecede değişmemişti ve gruplar arasında fark saptanmadı. Sonuç: SMILE ve f-LASIK sonrası refraktif sonuçlar ve nihai görme keskinliği benzer olsa da görme rehabilitasyonu f-LASIK sonrası daha hızlıdır. Ayrıca, SMILE cerrahisi bazı yüksek sıralı aberasyonları f-LASIK'e göre daha fazla arttırıyor olabilir.

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Three-year outcomes of small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for myopia and myopic astigmatism

Abstract: Long-term follow-up analysis suggested that both SMILE and FS-LASIK were safe and equally effective for myopic and astigmatic correction.

Cited by 85 publications

References 23 publications

Small Incision Lenticule Extraction (SMILE) for Moderate and High Myopia: Seven-Year Outcomes of Refraction, Corneal Tomography, and Wavefront Aberrations

Small Incision Lenticule Extraction (SMILE) for Moderate and High Myopia: Seven-Year Outcomes of Refraction, Corneal Tomography, and Wavefront Aberrations

Clinical outcomes after small incision lenticule extraction versus femtosecond laser-assisted LASIK for high myopia: a Meta-analysis.

Femtosecond Laser Assisted LASIK vs SMILE: Refractive Results, Contrast Sensitivity and Corneal Higher Order Aberrations

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