Comparative Analysis of the Clinical Outcomes of SMILE and Wavefront-Guided LASIK in Low and Moderate Myopia

Khalifa, Mohamed A.; Ghoneim, Ahmed; Shaheen, Mohamed Shafik; Aly, Mahmoud; Piñero, David P.

doi:10.3928/1081597x-20170222-01

Cited by 28 publications

(37 citation statements)

References 25 publications

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“…It has been reported that wavefront-guided LASIK proved the superiority of postoperative CS in comparison to other types of custom ablation [19,20]., and standard LASIK [21,22]. A previous study reported that the CS after wavefront-guided LASIK using the iDESIGN® Refractive Studio was sharper than that produced by small incision lenticule extraction (SMILE) [23,24]. In this present study, wavefrontguided LASIK using a high-resolution aberrometer induced smaller spherical aberration in the 4mm and 6mm pupils.…”

Section: Discussionsupporting

confidence: 46%

Wavefront Guided LASIK with a High-Resolution Aberrometer Induces Less Higher-Order Aberration than Early Custom LASIK

Hieda

Sotozono

Kayukawa

et al. 2020

Preprint

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Background: The use of 'high-resolution' aberrometer wavefront-guided LASIK system offers the theretical advantages. To date there have been a few papers that proved the clinical superiority of the 'high-resolution' wavefront-guided LASIK. The purpose of this present study was to To evaluate the surgical outcomes of wavefront-guided laser in-situ keratomileusis (LASIK) via a high-resolution aberrometer to treat myopic refractive error. Methods: This study involved 51 eyes of 26 consecutive patients (high-resolution group) who underwent wavefront-guided LASIK from 2012 to 2015 via high-resolution aberrometer and excimer laser surgical unit at the Baptist Eye Institute, Kyoto, Japan and who were followed for 6-months postoperative. Postoperative outcomes were compared with our historical control data (early custom group) from 2002 to 2007 (51 eyes of 26 patients) treated with the same correction amount. Measured parameters included Visual acuity (VA), spherical equivalent refractive error (SER), higher-order aberration (HOA), and contrast sensitivity (CS).Results: In the high-resolution group and the early custom group, the mean SER was -5.86±2.57 diopters (D) and -5.99±2.52D, respectively, and the mean patient age was 33.8±9.2 and 34.3±6.9 years, respectively. LogCS of 18 cycles-per-degree (cpd) change was more satisfactory in the high-resolution group than in the early custom group. Postoperative spherical aberration change in the high-resolution group was significantly lower than that in the control group (P<0.05). Decrease of induced spherical aberration produced a positive effect on the post LogCS of 18 cpd.Discussion: The latest wavefront-guided LASIK induced less HOAs than early custom LASIK, and although similar VA and refractive precision findings were observed, the high-resolution group tended to acquire better visual function post surgery.

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Section: Discussionsupporting

confidence: 46%

Wavefront Guided LASIK with a High-Resolution Aberrometer Induces Less Higher-Order Aberration than Early Custom LASIK

Hieda

Sotozono

Kayukawa

et al. 2020

Preprint

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“…Some surgeons prefer Laser-in-situ-Keratomileusis (LASIK) over ASA in moderate and even in low myopia as reported by Khalifa et al 19 They prospectively evaluated SMILE and wavefront-guided LASIK for −6 D or less of myopia and found results favoring wavefront-guided LASIK. However, this is beyond the scope of this article.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of small incision lenticule extraction versus advanced surface ablation in low myopia

Taneri

Kießler

Rost

et al. 2019

European Journal of Ophthalmology

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Purpose:To compare the visual and refractive outcomes of small incision lenticule extraction and advanced surface ablation for low myopia or myopic astigmatism.Methods:Retrospective, observational case series of our first 50 consecutive small incision lenticule extraction patients compared to refraction-matched 50 advanced surface ablation treatments with attempted spherical equivalent correction ⩽−3.5 D, astigmatism ⩽−1.5 D, and corrected distance visual acuity of 1.0 (decimal scale) or better. Only one eye per patient was included.Results:Small incision lenticule extraction: mean attempted spherical equivalent correction was −2.80 ± 0.63 D. Uncorrected distance visual acuity was 0.85 and 1.0 at days 1 and 5, respectively. At 3 months, mean spherical equivalent refraction was 0.02 ± 0.32 D (range: −0.5 to +0.75 D), mean cylinder was −0.24 ± 0.21 D (range: 0 to −0.75 D), mean uncorrected distance visual acuity was 1.27, mean efficacy index was 0.96, and mean safety index was 1.05. Uncorrected distance visual acuity was same or better than corrected distance visual acuity in 96%, astigmatism ⩽0.5 D in 98% and ⩽1 D in 100% of eyes, respectively. Advanced surface ablation: mean attempted spherical equivalent correction was −2.75 ± 0.5 D. Uncorrected distance visual acuity was 0.72 and 0.61 at days 1 and 5, respectively. At 3 months, mean spherical equivalent refraction was 0.22 ± 0.32 D, mean cylinder was −0.27 ± 0.27 D, mean uncorrected distance visual acuity was 1.21, mean efficacy index was 1.03, and mean safety index was 1.08.Conclusion:Small incision lenticule extraction for low myopia was found to be safe and effective with outcomes at 3 months similar to those obtained with advanced surface ablation while offering a quicker visual recovery.

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“…Notably, our findings showed that SMILE induced astigmatism in a small subset of our cohort with preoperative cylinder greater than 0.26 D. Although we don’t believe this was the case in our study, a possible and often cited complication of SMILE is an inadvertent lenticule remnant from incidental tearing that can induce irregular astigmatism [ 35 , 36 ]. Other than this complication, there was limited prior literature addressing any induction of astigmatism with SMILE; however, past publications have consistently shown SMILE inferior to LASIK with regards to astigmatic corrections [ 8 , 37 – 39 ]. There are quite a few reasons why SMILE has a tendency to produce these suboptimal outcomes.…”

Section: Discussionmentioning

confidence: 99%

Initial Single-Site Surgical Experience with SMILE: A Comparison of Results to FDA SMILE, and the Earliest and Latest Generation of LASIK

et al. 2018

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IntroductionThe primary objective was to show our initial surgical single-site experience with small incision lenticule extraction (SMILE) after the official enrollment in March 2017 following Food and Drug Administration (FDA) approval for simple myopia in late 2016 in the United States and, subsequently, compare our results to the earliest and most advanced generation of excimer platforms for laser-assisted in situ keratomileusis (LASIK) surgery.MethodsThis was a retrospective single-site study of 68 eyes from 35 patients who had SMILE surgery. The patients’ preoperative and postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest sphere, manifest cylinder, intraoperative complications, and preoperative and postoperative visual symptoms were collected. We compared our findings to the results from the FDA SMILE study, and to the three earliest (1999–2000) and three of the most updated (2013–2016) platforms for LASIK.ResultsThe cumulative UDVA was 20/20 and 20/40 or better in 74% and 100% of patients, respectively. The intended target refraction was within ± 0.5 and ± 1.00 D in 80% and 93% of cases, respectively. The prevalence of dry eyes decreased by nearly half from 1-week to the 6-month postoperative interval. Patients noted improvement in glare (17%), halos (17%), fluctuation (25%), and depth perception (8%) at the 6-month interval compared to preoperative levels.ConclusionsThis study’s findings are consistent with current SMILE reports. Notably, the results are superior to the earliest generation of LASIK, however inferior to the latest excimer platforms. SMILE does meet the efficacy and safety criteria met by FDA; however, there is a definite need for further improvement to reach the superior refractive outcomes produced by the latest generation of LASIK platforms.

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Comparative Analysis of the Clinical Outcomes of SMILE and Wavefront-Guided LASIK in Low and Moderate Myopia

Abstract: SMILE and WFG LASIK are efficacious and safe procedures for the correction of low and moderate myopia, but WFG LASIK allows a more predictable outcome and better aberrometric control. [J Refract Surg. 2017;33(5):298-304.].

Cited by 28 publications

References 25 publications

Wavefront Guided LASIK with a High-Resolution Aberrometer Induces Less Higher-Order Aberration than Early Custom LASIK

Wavefront Guided LASIK with a High-Resolution Aberrometer Induces Less Higher-Order Aberration than Early Custom LASIK

Clinical outcomes of small incision lenticule extraction versus advanced surface ablation in low myopia

Initial Single-Site Surgical Experience with SMILE: A Comparison of Results to FDA SMILE, and the Earliest and Latest Generation of LASIK

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