Three-year results of small incision lenticule extraction and wavefront-guided femtosecond laser-assisted laser in situ keratomileusis for correction of high myopia and myopic astigmatism

Xia, Likun; Ma, Jing; Liu, Henan; Shi, Ce; Huang, Qing

doi:10.18240/ijo.2018.03.18

Cited by 21 publications

(26 citation statements)

References 34 publications

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“…We found a trend of regression in our study with achieved SE of −0.26 D, −0.33 D, and 0.43 D at 1, 3, and 5 years, respectively. In line with Xia et al [ 19 ], the difference was not significant at 3 years. However, we found that the regression between 1 and 5 years was statistically significant.…”

Section: Discussionsupporting

confidence: 90%

“…To the best of our knowledge, there is no study reporting 5-year results after SMILE in cases of high myopia. Xia et al [ 19 ] compared 3-year results between SMILE and LASIK. Although they reported a statistically significant regression in the LASIK group, the mean regression in the SMILE group between 1 year and 3-years visits was only 0.14 D, and it was not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…Considering the linear change ( Figure 1(f) ) in mean achieved SE after surgery, it is reasonable to conclude that although regression reaches statistically significant level only after 5 years, it starts in the early postoperative period. Accordingly, studies with a relatively short follow-up may not reveal this mild but statistically significant regression [ 14 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

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Visual and Refractive Outcomes of Small-Incision Lenticule Extraction in High Myopia: 5-Year Results

Ağca

Çakır

Aygün

et al. 2018

Journal of Ophthalmology

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Purpose To report long-term visual and refractive results of small-incision lenticule extraction (SMILE) in treatment of high myopia. Materials and Methods Medical records of patients who underwent SMILE for surgical correction of myopia or myopic astigmatism were retrospectively reviewed. Only patients with a preoperative spherical equivalent of subjective manifest refraction (SE) ≥ 6 D and a postoperative follow-up of 5 years were included in the study. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and SE were analyzed preoperatively and at 1-, 3-, and 5-year postoperative periods. Results Thirty-seven eyes of 37 patients were included in the study. The mean attempted SE was −7.47 ± 1.10 D (range −6.00 to −10.00 D). At the 5-year visit, the mean difference between achieved and attempted SE was −0.43 ± 0.47 (0.50 to −1.25 D). Mean postoperative UDVA and CDVA were 0.20 ± 0.18 and 0.06 ± 0.08 logMAR, respectively. At the 1-year visit, 70% and 97% of the eyes were within ±0.50 D and ±1.00 D of the intended correction. At the 5-year follow-up, 59% and 92% percent of the eyes were within ±0.50 D and ±1.00 D of the intended SE, respectively. At the 5-year visit, the efficacy index was 0.89 ± 0.26 and the safety index was 1.16 ± 0.20. Fifty-four percent of the eyes gained one or more lines of CDVA. Conclusion SMILE with an intended correction of up to a spherical equivalent of 10 D is safe and effective. However, there is regression of the refractive effect over extended follow-up.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Visual and Refractive Outcomes of Small-Incision Lenticule Extraction in High Myopia: 5-Year Results

Ağca

Çakır

Aygün

et al. 2018

Journal of Ophthalmology

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“…There are limited data on the comparative efficacy between procedures with respect to myopia severity. A few studies have investigated SMILE efficacy in patients with high myopia (6.0D myopia or more), which have shown good visual outcomes and safety profiles in treated eyes [16–18]. However, one prospective study including 165 eyes of 86 patients in China reported a trend towards undercorrection by SMILE in eyes with myopia greater than 6.0 D [17].…”

Section: Resultsmentioning

confidence: 99%

Comparison of Visual, Refractive and Ocular Surface Outcomes Between Small Incision Lenticule Extraction and Laser-Assisted In Situ Keratomileusis for Myopia and Myopic Astigmatism

et al. 2019

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Laser-assisted in situ keratomileusis (LASIK) is the most commonly performed laser refractive surgical technique worldwide for the treatment of myopia and myopic astigmatism. In recent years, small incision lenticule extraction (SMILE) has emerged as a promising alternative to LASIK, requiring only a single femtosecond laser to create an intrastromal lenticule, which is then removed via a small incision. The technique obviates the need for a corneal flap. A number of published studies have compared the two techniques in terms of visual, refractive and ocular surface outcomes. This review compares the clinical outcomes between LASIK and SMILE in treating myopia and myopic astigmatism based on studies published in the last 5 years. Twenty-two studies were included, all of which were observational in nature. Results suggest that the two techniques have comparable visual outcomes in terms of safety, efficacy and predictability, although recovery in visual acuity may be slower in SMILE-treated than LASIK-treated eyes. SMILE is found to result in less severe postoperative dry eye symptoms and faster recovery of corneal sensitivity than LASIK. It is important to note, however, that the SMILE technique is limited by the lack of a cyclotorsion-compensation system and option for customized treatment profile. The heterogeneity of results in this review may be attributable to the use of different LASIK platforms in different studies. Few studies compared the outcomes regarding severity of myopia. Future prospective randomized controlled trials with a larger sample size and longer follow-up period will be highly beneficial for progress in this field.

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“…57 The benefits of SMILE over LASIK for patients with high refractive error have not been conclusively established. 64 However, it is possible that the higher laser energy required for LASIK in high myopes results in more inflammation, poorer healing, and hence greater postoperative aberrations. In contrast, the amount of laser energy required in SMILE is comparatively low even when high refractive errors are being corrected.…”

Section: Other Patient-reported Outcome Measuresmentioning

confidence: 99%

Comparing Patient-Reported Outcomes of Laser In Situ Keratomileusis and Small-Incision Lenticule Extraction: A Review

Chiam

2019

Asia-Pacific Journal of Ophthalmology

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Three-year results of small incision lenticule extraction and wavefront-guided femtosecond laser-assisted laser in situ keratomileusis for correction of high myopia and myopic astigmatism

Abstract: Both SMILE and wavefront-guided FS-LASIK procedures provide good visual outcomes. Both procedures are effective and safe, but SMILE surgery achieve more stable long-term refractive outcome and better control of early postoperative dry eye as compared to FS-LASIK.

Cited by 21 publications

References 34 publications

Visual and Refractive Outcomes of Small-Incision Lenticule Extraction in High Myopia: 5-Year Results

Visual and Refractive Outcomes of Small-Incision Lenticule Extraction in High Myopia: 5-Year Results

Comparison of Visual, Refractive and Ocular Surface Outcomes Between Small Incision Lenticule Extraction and Laser-Assisted In Situ Keratomileusis for Myopia and Myopic Astigmatism

Comparing Patient-Reported Outcomes of Laser In Situ Keratomileusis and Small-Incision Lenticule Extraction: A Review

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