Visual and refractive outcomes of 100 small incision lenticule extractions (SMILE) in moderate and high myopia: a 24-month follow-up study

Sánchez‐González, José‐María; Alonso-Aliste, Federico

doi:10.1007/s00417-019-04349-4

Cited by 21 publications

(15 citation statements)

References 32 publications

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“…These results are similar to those demonstrated in a previous study after SMILE surgery for high myopia [15]. Superior e cacy index is shown in present study, and similar results (0.97) were reported by Sánchez-González et al [16] Schallhorn et al [17] found that the CCT, ablation volume, and ap creation were in uenced by the postoperative IOP. In the current study, a high steroid-induced IOP was observed (> 20 mmHg) in 8.57% of cases.…”

Section: Discussionsupporting

confidence: 93%

Corneal Surface Irregularity and Surgically Induced Astigmatism Changes in the Small Incision Versus Microincision After SMILE

Piao¹,

Y²,

Wang³

2020

Preprint

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Background: To evaluate the corneal surface irregularity and surgically induced astigmatism changes in the small incision versus microincision after small incision lenticule extraction (SMILE) surgery.Methods: A total of 70 eyes of 35 patients with myopia who underwent SMILE surgery were enrolled in this retrospective study. Patients were divided into two groups according to the incision size (small incision, 4.0 mm or microincision, <2.5 mm) and subjected to a standard ophthalmologic examination preoperatively. The changes in corneal topographic and surface irregularities were evaluated using a TMS-4N topographer during a 6-month follow-up period.Results: According to Friedman’s ANOVA test, there were statistically significant changed in SRI, SAI, and IOP between two groups during a 6-month follow-up (all p < 0.001). At last follow-up, SRI values less than 0.50 D were shown 27 eyes (75%) in the small incision group and 28 eyes (82%) in the microincision group; SAI values less than 0.50 D were shown 22 eyes (61%) in the small incision group and 18 eyes (53%) in the microincision group (all p<0.001).Conclusions: SMILE procedures, using both small incisions and microincisions, are safe and effective surgical options for patients with low to high myopia and provide stable postoperative biomechanical properties and superior postoperative visual outcomes.

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Section: Discussionsupporting

confidence: 93%

Corneal Surface Irregularity and Surgically Induced Astigmatism Changes in the Small Incision Versus Microincision After SMILE

Piao¹,

Y²,

Wang³

2020

Preprint

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“…A different study reported visual acuity of -0.05 logarithm of the minimum angle of resolution and mean SE of -0.01 D at 3 years after SMILE [11]. Another group reported Snellen visual acuity of 99% and SE of -0.19 D at 2 years after SMILE [12]. The efficacy and safety indices were also comparable to those in previous studies [7,13,14].…”

Section: Discussionsupporting

confidence: 72%

Clinical Outcomes of Small Incision Lenticule Extraction in Myopia: Study of Vector Parameters and Corneal Aberrations

Kwak

Jun

Kim

et al. 2020

Korean J Ophthalmol

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Since Jose Barraquer invented keratomileusis for correction of high myopia in 1949, researchers have combined keratomileusis with excimer laser surface ablation to develop one of the most commonly used laser corneal refractive surgery techniques, laser in situ keratomileusis (LASIK) [1]. Creation of a corneal flap allows early visual recovery, less discomfort, and reduced stromal inflamma-Purpose: To investigate clinical outcomes of small incision lenticule extraction (SMILE) including vector parameters and corneal aberrations in myopic patients. Methods: This retrospective, observational case series included 57 eyes (29 patients) that received treatment for myopia using SMILE. Visual acuity measurement, manifest refraction, slit-lamp examination, autokeratometry, corneal topography, and evaluation of corneal wavefront aberration were performed preoperatively and at 1 and 3 months after surgery. We analyzed the safety, efficacy, vector parameters, and corneal aberrations at 3 months after surgery. Results: Preoperatively, mean manifest refraction spherical equivalent refraction was -4.94 ± 1.94 D (range, -8.25 to 0 diopters [D]), and the cylinder was -1.14 ± 0.82 D (range, -3 to 0 D). Mean manifest refraction spherical equivalent improved to -0.10 ± 0.23 D at 3 months postoperatively, when uncorrected distance visual acuity was 20 / 20 or better in 55 (96%) eyes. The linear regression model of target induced astigmatism vector versus surgically induced astigmatism vector exhibited slopes and coefficients (R 2 ) of 0.9618 and 0.9748, respectively (y = 0.9618x + 0.0006, R 2 = 0.9748). While total corneal root mean square higher order aberrations, coma and trefoil showed statistically significant increase, spherical aberration did not show statistically significant change after SMILE. Conclusions: SMILE has proven to be effective and safe for correcting myopia and astigmatism. We showed that SMILE did not induce spherical aberrations. A small increase in postoperative corneal higher order aberration may be associated with increase in coma and trefoil.

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“…The minimally invasive, flapless small incision lenticule extraction (SMILE) procedure offers a means of retaining superior corneal integrity relative to laser in situ keratomileuses (LASIK) while eliminating flap-related adverse effects. Since it was initially described in 2011 (1,2), SMILE has been confirmed to be safe, efficacious, predictable, and stable in a range of studies (3)(4)(5)(6). Following 2016 updates to the VisuMax femtosecond laser system software (Carl Zeiss Meditec AG, Jena, Germany), surgical indications for this approach were expanded to the treatment of myopia and myopic astigmatism of >-10.0 D, with this approach having been shown to be safe and effective at 6 and 15 months postoperatively by Qin et al (7) and Yang et al (8), respectively.…”

Section: Introductionmentioning

confidence: 99%

Four-Year Outcomes of Small Incision Lenticule Extraction for Extreme High Myopia and Myopic Astigmatism

et al. 2020

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Purpose: To evaluate the long-term safety, efficacy, predictability, and stability of small incision lenticule extraction (SMILE) for the treatment of high myopia and myopic astigmatism >−10.0 D. Methods: This was a prospective study that incorporated 35 consecutive patients (35 eyes) undergoing SMILE from September 2015 to March 2016. These patients had a mean preoperative spherical equivalent refraction of −10.06 ± 0.64 D. Patients were followed over a 4-year period and assessed for outcomes including uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction, and corneal topography. Results: At 4 years post-SMILE, respective efficacy and safety indices were 1.01 ± 0.19 and 1.07 ± 0.15. In total, 97% of operated eyes achieved an UDVA of 20/25 or better. ≥1 line was gained for 9 eyes (26%), with 25 eyes (71%) remaining stable. Twenty-four (69%) and 33 (94%) eyes, respectively, were within ±0.50 D and ±1.0 D of target refraction. From 3 months to 4 years postoperatively, a mean refractive regression of −0.22 D (−0.06 D per year) was detected, whereas no significant changes in mean corneal back curvature or posterior central elevation were detected ( P = 0.617 and 0.754, respectively). We detected significant increases in higher-order aberrations (HOAs) of the anterior and total cornea (all P < 0.001), with spherical aberrations and vertical coma being particularly common, whereas posterior corneal HOA remained fairly stable (all P < 0.05). Conclusion: SMILE is a safe, effective, predictable, and stable means of correcting high myopia and myopic astigmatism over a 4-year postoperative period.

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Visual and refractive outcomes of 100 small incision lenticule extractions (SMILE) in moderate and high myopia: a 24-month follow-up study

Cited by 21 publications

References 32 publications

Corneal Surface Irregularity and Surgically Induced Astigmatism Changes in the Small Incision Versus Microincision After SMILE

Corneal Surface Irregularity and Surgically Induced Astigmatism Changes in the Small Incision Versus Microincision After SMILE

Clinical Outcomes of Small Incision Lenticule Extraction in Myopia: Study of Vector Parameters and Corneal Aberrations

Four-Year Outcomes of Small Incision Lenticule Extraction for Extreme High Myopia and Myopic Astigmatism

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