Clinical Outcomes After SMILE and Femtosecond Laser-Assisted LASIK for Myopia and Myopic Astigmatism

Liu, Manli; Chen, Yile; Wang, Danyang; Zhou, Yuefang; Zhang, Xiaoying; He, Jiexu; Zhang, Ting; Sun, Yuan; Liu, Quan

doi:10.1097/ico.0000000000000707

Cited by 115 publications

(86 citation statements)

References 26 publications

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“…The surgical predictability was defined as the percentage of eyes corrected to within ±0.50 D of the intended correction. The present study showed that 97% of eyes after SMILE and 100% of eyes after WFG FS-LASIK met this criterion, this is also comparable to earlier studies [17–20, 22–24]. No eye lost one or more lines of CDVA postoperatively in either group.…”

Section: Discussionsupporting

confidence: 91%

“…Our results show no significant differences in visual outcomes. The surgical efficacy, defined as the percentage of eyes achieving a UDVA of 20/20 or better, was similar for SMILE (90%) and wavefront-guided femtosecond LASIK (88%), consistent with previous reports [7, 8, 13, 17–22]. The surgical predictability was defined as the percentage of eyes corrected to within ±0.50 D of the intended correction.…”

Section: Discussionsupporting

confidence: 83%

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Comparison of ocular higher-order aberrations after SMILE and Wavefront-guided Femtosecond LASIK for myopia

et al. 2017

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BackgroundTo compare changes in higher-order aberrations (HOAs) following small incision lenticule extraction (SMILE) and wavefront-guided femtosecond laser-assisted in situ keratomileusis (WFG FS-LASIK), and to investigate correlations between preoperative spherical equivalence (SE) and components of HOAs affecting visual quality.MethodsSixty-five myopic eyes from 38 patients were enrolled in the study retrospectively, either having undergone SMILE or WFG FS-LASIK. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive error, and individual Zernike coefficients of 3rd- to 6th-order HOAs were measured before and 3 months after the surgeries and were compared using the Mann-Whitney test or Student’s t-test. Additional generalized estimating equation analyses (GEE) were used to control for within-subject biases in individual Zernike coefficients between the right and left eyes of the same patients.ResultsThere was no significant difference in UDVA or CDVA after WFG FS-LASIK (Mean ± SD: −0.02 ± 0.07 and −0.04 ± 0.22 respectively, in logMAR) and after SMILE (−0.01 ± 0.06 and −0.04 ± 0.04 respectively). However, greater vertical coma aberration was found after SMILE (p = 0.036). Preoperative SE was correlated to induced horizontal coma (r = −0.608, p = 0.001) in WFG FS-LASIK, and correlated to induced vertical coma (r = −0.459, p = 0.003) in SMILE.ConclusionsBoth SMILE and WFG FS-LASIK can achieve planned visual outcomes in correcting myopia and myopic astigmatism. However, higher vertical coma was shown in SMILE than WFG FS-LASIK which might be a potentially impact factor for patients’ vision under certain lighting conditions and needs further investigation.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 83%

Comparison of ocular higher-order aberrations after SMILE and Wavefront-guided Femtosecond LASIK for myopia

et al. 2017

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“…As such, there are no comparative studies of different laser platforms for this procedure. However, SMILE has been compared with femtosecond-assisted LASIK in multiple prior studies which show comparable efficacy, safety, and predictability between the two modalities, with induction of fewer HOAs with SMILE [29 & , [30][31][32]. Furthermore, SMILE appears to not only offer a biomechanical advantage to LASIK [33][34][35], but has also been shown to be less detrimental to the ocular surface and corneal innervation, thus resulting in less symptomatic dry eye disease [36][37][38][39]40 && ].…”

Section: Small-incision Lenticule Extractionmentioning

confidence: 97%

Comparison of femtosecond and excimer laser platforms available for corneal refractive surgery

Chen

Manche

2016

Current Opinion in Ophthalmology

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Advances in femtosecond and excimer laser technology have not only improved the safety and efficacy of refractive procedures, but have also led to the development of promising new treatment modalities, such as SMILE and the use of wavefront-guided and topography-guided ablation. Future studies and continued technological progress will help to better define the optimal use of these treatment platforms.

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“…Small-incision lenticular extraction (SMILE) is a new kind of surgical procedure that avoids flap-related complications, 5 and it is gaining more attention. Both procedures have performed well in studies in all measures of safety, efficacy, and predictability 6, 7, 8. Although some previous studies have compared corneal biomechanical properties after SMILE and LASIK, the results have been inconsistent 9, 10.…”

Section: Introductionmentioning

confidence: 99%

Corneal biomechanics after small-incision lenticule extraction versus Q-value–guided femtosecond laser-assisted in situ keratomileusis

Zhang¹,

Li²,

Zhao³

et al. 2016

Journal of Current Ophthalmology

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PurposeThe aim of this study was to compare the changes in corneal biomechanical properties following small-incision lenticule extraction (SMILE) versus Q-value–guided femtosecond laser-assisted in situ keratomileusis (Q-FS-LASIK).MethodsIn this prospective comparative study, patients with a sphere plus cylinder measurement of less than −10.00 D and cylinder measurement of less than −5.00 D were included in the study. A total of 160 patients (160 eyes) with myopia and myopic astigmatism were divided into the two groups, with 80 patients (80 eyes) allocated to SMILE and 80 patients (80 eyes) allocated to Q-FS-LASIK. Corneal hysteresis (CH) and the corneal resistance factor (CRF) were quantitatively assessed using the Ocular Response Analyzer (ORA) preoperatively and at 1 day, 2 weeks, and 1 and 3 months postoperatively.ResultsBoth types of surgery were associated with statistically significant decreases in CH and the CRF at postoperative day 1 (both P < 0.01). In both groups, the decreases subsequently stabilized with no further deteriorations compared to postoperative day 1 (P > 0.05). Both groups showed similar biomechanical changes at each time point (all P > 0.05).ConclusionsBoth SMILE and Q-FS-LASIK resulted in a decrease in CH and the CRF at postoperative 1 day, with the decreases stabilizing after this point. There were no significant differences between the short term effects of SMILE and Q-FS-LASIK on corneal biomechanical properties.

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Clinical Outcomes After SMILE and Femtosecond Laser-Assisted LASIK for Myopia and Myopic Astigmatism

Abstract: Both FS-LASIK and SMILE procedures achieved good visual outcomes in the correction of myopia and myopic astigmatism. SMILE had a lower induction rate of spherical aberration at 6 months postoperatively in the analysis of 6 mm diameter than that of FS-LASIK.

Cited by 115 publications

References 26 publications

Comparison of ocular higher-order aberrations after SMILE and Wavefront-guided Femtosecond LASIK for myopia

Comparison of ocular higher-order aberrations after SMILE and Wavefront-guided Femtosecond LASIK for myopia

Comparison of femtosecond and excimer laser platforms available for corneal refractive surgery

Corneal biomechanics after small-incision lenticule extraction versus Q-value–guided femtosecond laser-assisted in situ keratomileusis

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