Comparison Between Q-Adjusted LASIK and Small-Incision Lenticule Extraction for Correction of Myopia and Myopic Astigmatism

El-Mayah, Esraa; Anis, Mohamed; Salem, Mohsen; Piñero, David P.; Hosny, Mohamed

doi:10.1097/icl.0000000000000532

Cited by 17 publications

(20 citation statements)

References 43 publications

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“…Seventeen studies reported a cap thickness between 100 to 120 μ m [25, 30, 39–41, 45, 47–53, 55, 56, 58, 59]. Only one study reported a 90 μ m thickness cap [36].…”

Section: Resultsmentioning

confidence: 99%

“…Only one study reported a 90 μ m thickness cap [36]. The cap diameter was between 7.2 to 8 mm in 16 studies, [25, 30, 36, 38, 41, 45–51, 53, 58–60] and the diameter of the optical zone was between 6 to 7 mm in 19 studies [25, 30, 36, 38–41, 45, 47–49, 51–56, 58, 59]. Twelve studies were performed with an energy between 115 to 190 nJ [30, 36, 38, 40, 41, 45, 47, 49–51, 53, 54, 58].…”

Section: Resultsmentioning

confidence: 99%

“…All the 14 studies [25, 30, 38–41, 47, 48, 50, 52, 55–57, 59] performed FS-LASIK except for the study of Osman et al and Elmohamady et al, [36, 57] in which microkeratome is used for the flap creation. The flap thickness was between 90 to 110 μm among the 14 studies which performed LASIK [25, 30, 36, 39–41, 47, 48, 50, 52, 55–57, 59].…”

Section: Resultsmentioning

confidence: 99%

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Corneal biomechanical properties after SMILE versus FLEX, LASIK, LASEK, or PRK: a systematic review and meta-analysis

2019

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Background The aim of this study was to compare the postoperative corneal biomechanical properties between small incision lenticule extraction (SMILE) and other corneal refractive surgeries. Methods A systematic review and meta-analysis were conducted. Articles from January 2005, to April 2019, were identified searching PubMed, EMBASE, Web of Science, and International Clinical Trials Registry Platform. Studies that compared SMILE with other corneal refractive surgeries on adult myopia patients and evaluated corneal biomechanics were included. Multiple effect sizes in each study were combined. Random-effects model was conducted in the meta-analysis. Results Twenty-two studies were included: 5 randomized controlled trials (RCTs), 9 prospective and 6 retrospective cohort studies, and 2 cross-sectional studies. Using the combined effect of corneal hysteresis (CH) and corneal resistance factor (CRF), which were obtained from ocular response analyzer (ORA), the pooled Hedges’ g of SMILE versus femtosecond laser-assisted in situ keratomileusis (FS-LASIK) was 0.41 (95% CI, 0.00 to 0.81; p = 0.049; I 2 = 78%), versus LASIK was 1.31 (95% CI, 0.54 to 2.08; p < 0.001; I 2 = 77%), versus femtosecond lenticule extraction (FLEX) was − 0.01 (95% CI, − 0.31 to 0.30; p = 0.972; I 2 = 20%), and versus the group of photorefractive keratectomy (PRK) and laser-assisted sub-epithelial keratectomy (LASEK) was − 0.26 (95% CI, − 0.67 to 0.16; p = 0.230; I 2 = 54%). The summary score of Corvis ST (CST) after SMILE was comparable to FS-LASIK/LASIK with the pooled Hedges’ g = − 0.05 (95% CI, − 0.24 to 0.14; p = 0.612, I 2 = 55%). Conclusions In terms of preserving corneal biomechanical strength after surgeries, SMILE was superior to either FS-LASIK or LASIK, while comparable to FLEX or PRK/LASEK group based on the results from ORA. More studies are needed to apply CST on evaluating corneal biomechanics after refractive surgeries. Electronic supplementary material The online version of this article (10.1186/s12886-019-1165-3) contains supplementary material, which is available to authorized users.

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“…Seventeen studies reported a cap thickness between 100 to 120 μ m [25, 30, 39–41, 45, 47–53, 55, 56, 58, 59]. Only one study reported a 90 μ m thickness cap [36].…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Corneal biomechanical properties after SMILE versus FLEX, LASIK, LASEK, or PRK: a systematic review and meta-analysis

2019

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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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“…However, Wenjing WU et al [15] and Elmohamady et al [16] found that CH and CRF both exhibited postoperative differences between the SMILE group and the FS-LASIK group. Lei Xia et al [17] and El-Mayah E et al [18] concluded that while there was no significant difference in the postoperative CH between the SMILE group and the FS-LASIK group, the postoperative CRF was different between the two groups. Therefore, we performed this meta-analysis to clarify whether CH and CRF were different after the surgery in the SMILE and FS-LASIK groups.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of Corneal Biomechanical Effects after SMILE and FS-LASIK

Qin

et al. 2019

Preprint

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Background: To evaluate and compare corneal biomechanics after treatment of myopia using small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK). Methods: We performed a meta-analysis and searched for reports concerning corneal biomechanics after SMILE and FS-LASIK using MEDLINE, EMbase, CNKI and the Cochrane Library. The analysis included corneal hysteresis (CH) and corneal resistance factor (CRF) before and 3 months after the surgery. The quality of the reports was evaluated using the Newcastle-Ottawa scale (NOS). Statistical analysis was performed using RevMan5. Results: Only six studies with a total of 771 eyes were ultimately included in this meta-analysis, and the random effects model was adopted. The preoperative and three-month postoperative CH and CRF of SMILE and FS-LASIK were compared by the meta-analysis. No statistically significant difference was found in CH or CRF between the SMILE group and the FS-LASIK group before the surgery (WMD，-0.12; 95% CI，-0.31～0.06; P，0.19; WMD，-0.05; 95% CI，-0.29～0.19; P，0.69). There was no statistically significant difference in CH between the two surgical methods 3 months after the operation in the foreign group (WMD，0.19; 95% CI，-1.02～1.41; P，0.75) or in the Chinese group (WMD，0.13; 95% CI，-0.16～0.41; P，0.75). Likewise, no statistically significant difference was found in CRF between the two surgical methods in the foreign group 3 months after the operation (WMD，-0.11; 95% CI，-2.53～-2.31; P，0.93). Nevertheless, the difference in CRF between the two surgical methods was statistically significant in the Chinese group (WMD，0.26; 95% CI，0.06～0.47; P，0.01). Concusion: This meta-analysis indicated that SMILE showed no significant postoperative advantage in CH in comparison with FS-LASIK. For CRF, SMILE exhibited no obvious postoperative advantage in comparison with FS-LASIK in the foreign group, whereas SMILE was superior to FS-LASIK in the Chinese group.

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Comparison Between Q-Adjusted LASIK and Small-Incision Lenticule Extraction for Correction of Myopia and Myopic Astigmatism

Abstract: SMILE is as safe and predictable as FS-LASIK. According to the ORA system, SMILE is not better than FS-LASIK in terms of biomechanical changes. However, SMILE causes less effect on dry eye parameters during the first 3 postoperative months.

Cited by 17 publications

References 43 publications

Corneal biomechanical properties after SMILE versus FLEX, LASIK, LASEK, or PRK: a systematic review and meta-analysis

Corneal biomechanical properties after SMILE versus FLEX, LASIK, LASEK, or PRK: a systematic review and meta-analysis

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

Meta-analysis of Corneal Biomechanical Effects after SMILE and FS-LASIK

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