Matched comparison of corneal higher order aberrations induced by SMILE to femtosecond assisted LASIK and to PRK in correcting moderate and high myopia: 3.00mm vs. 6.00mm

Abstract

Background The refractive surgeries induce corneal higher order aberrations (C-HOAs). In this study, change of C-HOAs after small-incision lenticule extraction (SMILE) compared to femtosecond assisted laser in situ keratomileusis (femto-LASIK), and to photorefractive keratectomy with mitomycin-C (PRK) under photopic and mesopic conditions. Methods In this prospective study, age, gender, and apical corneal thickness (ACT) matched cases with moderate myopia [spherical equivalent (SE) 3.00 to 6.00D) to high myopia (SE > 6.00D)] were enrolled. In addition to visual acuity and refraction, total C-HOA, coma, spherical aberration (SA), and trefoil in the 3- and 6-mm zones were measured before and 3 and 6 months after surgery. Results Overall, 372 moderate myopia cases (124 eyes of 124 individuals in each surgical group) and 171 high myopia cases (57 eyes of 57 individuals in each surgical group) were enrolled. At baseline, the differences in age, gender, ACT, uncorrected and corrected visual acuity, and SE were not statistically significant between subgroups of surgical methods within each myopia group (all P > 0.05). At 12 months, in the moderate myopia group, there was less increase in 6-mm zone total C-HOA, coma, and SA with SMILE compared to the other groups (all P < 0.05). In the high myopia group, there was greater increase in photopic total C-HOA and trefoil and less increase in mesopic SA with SMILE (all P < 0.05). Conclusions In correction of moderate myopia, SMILE has better results in mesopic condition. In high myopia correction, femto-LASIK and PRK have better results in photopic and SMILE in mesopic condition.

Prospective Safety Evaluation of the Femtosecond Laser-Assisted Keratomileusis Procedure in Correcting Residual Ametropia in Patients After Deep Anterior Lamellar Keratoplasty

“…These methods account for about 20% of all laser vision correction procedures [ 13 , 14 ]. Deep methods, on the other hand, include laser-assisted in situ keratomileusis (LASIK), femtosecond laser-assisted in situ keratomileusis (Femto-LASIK), and refractive lenticule extraction small incision lenticule extraction (ReLEx Smile) [ 15 – 17 ]. Laser vision correction can be divided into superficial and deep surgical procedures, and the Femto-LASIK procedure is part of the latter [ 18 – 20 ].…”

SMILE after DALK to reduce residual refraction: two-year results

“…HOAs, except trefoil, showed a non-signi cant increase in the current study. HOA changes had a similar trend to normal corneas undergoing SMILE (9). Two points should be kept in mind.…”

Comparison of clinical outcomes of LASIK, Trans-PRK, and SMILE for correction of myopia

“…44,57,62,63 Moreover, FS-LASIK possessed more total HOAs at 3 months 45,59,60 and 1 year postoperatively. 57 Compared with SMILE, FS-LASIK had more wound healing response and inflammatory infiltration, 64 resulting in higher total HOA induction. 60 However, several articles found no significant difference in aberration values between FS-LASIK and SMILE at 3 months, 6,46,65 6 months, 6,66 1 year, 6,41 3 years, and 5 years.…”

“…56 Flap centration, ablation zone area, and the degree of myopia could also affect the amount of aberrations. 57 The pupil diameters alter the contribution of aberrations to visual quality. HOAs under mesopic pupil (5 or 6 mm) in most previous reports are summarized and discussed below.…”