One-year refractive results, contrast sensitivity, high-order aberrations and complications after myopic small-incision lenticule extraction (ReLEx SMILE)

Sekundo, Walter; Gertnere, Jana; Bertelmann, Thomas; Solomatin, Igor

doi:10.1007/s00417-014-2608-4

Cited by 174 publications

(113 citation statements)

References 10 publications

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“…With regard to contrast sensitivity, a study on SMILE by Sekundo et al 16 found no significant decrease in mesopic contrast postoperatively, whereas in another comparative study between SMILE and FS-LASIK, Gertnere et al 17 found better mesopic contrast sensitivity in the SMILE group than in the LASIK group. Montés-Micó et al found a statistically significant reduction (P < .01) in contrast sensitivity at high spatial frequencies (12 and 18 cycles/degree) under mesopic conditions following LASIK.…”

Section: Discussionmentioning

confidence: 96%

Comparison of Visual and Refractive Outcomes Following Femtosecond Laser-Assisted LASIK With SMILE in Patients With Myopia or Myopic Astigmatism

Ganesh¹,

Gupta²

2014

J Refract Surg

187

147

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ASIK is the most popular refractive surgery for myopic laser correction to date. The use of femtosecond laser-assisted LASIK (FS-LASIK) offers the creation of more predictable flaps with regard to flap thickness, diameter, and hinge width. 1,2Even with high success rates, side effects such as increased postoperative dryness, reduced biomechanical corneal strength, induction of higher-order aberrations (HOAs), postoperative glare, halos, and flap-related complications remain. 3-5More recently developed is refractive lenticule extraction, which uses a femtosecond laser to create an intrastromal corneal lenticule (the removal of which alters the shape of the cornea), thereby correcting myopia. It encompasses two different techniques: femtosecond lenticule extraction (FLEX) and small-incision lenticule extraction (SMILE).SMILE is a more recent flapless subtype in which the lenticule is extracted through a small arcuate incision (2 to 4 mm). This allows for greater stability because most of the Bowman's layer remains intact.Studies have shown that SMILE is associated with lower topographic changes and less inflammation and keratocyte apopotosis than FS-LASIK, particularly for higher levels of correction of myopia. 6,7 Because the procedure is flapless, most flap-related complications are not observed with SMILE.The aim of the current study was to evaluate the efficacy and safety of SMILE compared with FS-LASIK. Our primary hypothesis (null hypothesis) states that SMILE is better or comparable to LASIK for correction of myopia in terms of refractive accuracy and quality of vision (ie, postoperative aberrations and contrast sensitivity). Primary outcome measures were refractive efficacy, predictability, and safety, postoperative contrast sensitivity wavefront aberrations, and tear film abnormalities. L ABSTRACT PURPOSE: To compare the visual and refractive outcomes of femtosecond laser-assisted LASIK with smallincision lenticule extraction (SMILE) in terms of visual acuity, contrast sensitivity, aberrations, and dry eye. METHODS:A single-center prospective randomized study in which patients diagnosed as having myopia presenting for refractive correction were allocated to either a LASIK or SMILE group. The primary outcome measures were refractive efficacy, predictability, and safety, postoperative contrast sensitivity, aberrations, and dry eye status. Patients were followed up at days 1 and 15 and 3 months; postoperative uncorrected visual acuity (UCVA), aberrations, dry eye, and contrast sensitivity were recorded and compared to preoperative data. Two postoperative subjective questionnaires were used to assess pain, pricking sensation, redness, glare, and overall patient satisfaction. RESULTS:At day 1 postoperatively, 48 (96%) of 50 eyes in the SMILE group achieved a UCVA of 20/20 compared with 46 (92%) of 50 eyes in the LASIK group. At day 15 postoperatively, contrast sensitivity was similar in the two groups (P = .15), but by 3 months, it was better in the SMILE group than the LASIK group at all spatial frequencies (...

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Section: Discussionmentioning

confidence: 96%

Comparison of Visual and Refractive Outcomes Following Femtosecond Laser-Assisted LASIK With SMILE in Patients With Myopia or Myopic Astigmatism

Ganesh¹,

Gupta²

2014

J Refract Surg

187

147

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“…Because of the limited literature on the small-incision lenticule extraction and femtosecond lenticule extraction techniques, all relevant articles were included in the review. Figures 1 to 3 were developed from summation and percentage data in several articles on small-incision lenticule extraction 2,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] and LASIK [26][27][28][29][30][31][32] ; attempts were made to ensure uniformity in the preoperative refractive parameters and other potentially confounding variables. The significant disproportion of available published literature on each technique resulted in a significantly larger portion of LASIK patients (n Z 36 822) than small-incision lenticule extraction patients (n Z 1759).…”

Section: Methodsmentioning

confidence: 99%

“…Information was extracted from several studies. 2,11,12,14,[16][17][18][19][20][21]23 Sample sizes for each time period are as follows: 1 month, n Z 162; 3 months, n Z 958; 6 months, n Z 217; 1 year, n Z 73 (CDVA Z corrected distance visual acuity). a combination of keratectomy with subsequent excimer laser ablation was successfully performed, further refining the keratomileusis procedure.…”

Section: Historical Synopsismentioning

confidence: 99%

Small-incision lenticule extraction

Moshirfar¹,

McCaughey²,

Reinstein³

et al. 2015

Journal of Cataract and Refractive Surgery

177

116

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“…We perform Schirmer's test to establish the quantity of tear film. At the end of the initial examination, the patient is informed about the suggested surgical method, surgical procedure, possible complications and postsurgical regime 11,12,15 . Surgeries were performed by the standard procedure.…”

Section: Presurgical Examination Of Patientmentioning

confidence: 99%

Comparison of the efficiency of femtoLASIK and ReLEx SMILE in terms of dioptric error reduction

Pavkova¹,

Kacerovská²,

Kacerovsky³

2018

BIOMED PAP

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Background and Aims. Refractive eye surgery is a rapidly expanding field of ophthalmology and corneal surgery is undergoing constant development leading to less invasive technologies. The goal of this study was to compare the most common femtoLASIK surgery with the newer ReLEx SMILE surgery which is gentler to the cornea. The comparison was made in terms of dioptric error reduction. Methods. The studied cohort of patients consisted of two major groups: 30 patients who underwent femtoLASIK surgery and 30 who underwent ReLEx SMILE surgery. -30 patients, 60 eyes. All patients were aged 18-45 years with moderate myopia or astigmatism ranging from -3.25 to -6.0 spherical diopters and from 0 to -1.0 cylindrical diopters. In all, the best corrected visual acuity measured prior to surgery was 1.0. Pachymetry was not comparable because each surgical method was performed at a different time point and the introduction of an innovative method into practice led to a change in selection criteria. Results. During postsurgical check-ups, the ReLEx SMILE method (0.74) led to lower values of non-corrected visual acuity compared to the femtoLASIK method (0.88), (P<0.001). However, the results changed at the one-year post-surgery check-up, when ReLEX SMILE patients achieved non-corrected visual acuity of 0.97 compared to femtoLASIK patients, who scored 0.83, (P=0.007). Based on data analysis from the automatic refractometer, the average spherical diopters of the femtoLASIK (-0.32 D) were higher than those of the ReLEx SMILE (-0.07 D), (P<0.001). The results for the cylindrical diopters were also significant, (P=0.021). When we compared the spherical equivalent one year after surgery, the difference between methods was significant. The FemtoLASIK method resulted in an average SE -0.55 D compared to -0.09 D for the ReLEx SMILE method, (P<0.001). Conclusion. This study showed that there was a significant difference in results between the two surgical methods of treatment of moderate myopia and astigmatism, in terms of regression of dioptric error, as well as in achievement and maintenance of visual acuity during the observed period. The ReLEx SMILE had better results.

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One-year refractive results, contrast sensitivity, high-order aberrations and complications after myopic small-incision lenticule extraction (ReLEx SMILE)

Abstract: In this first cohort, ReLEx SMILE produced satisfactory refractive outcomes with moderate induction of HOA and unaffected contrast sensitivity after 1 year.

Cited by 174 publications

References 10 publications

Comparison of Visual and Refractive Outcomes Following Femtosecond Laser-Assisted LASIK With SMILE in Patients With Myopia or Myopic Astigmatism

Comparison of Visual and Refractive Outcomes Following Femtosecond Laser-Assisted LASIK With SMILE in Patients With Myopia or Myopic Astigmatism

Small-incision lenticule extraction

Comparison of the efficiency of femtoLASIK and ReLEx SMILE in terms of dioptric error reduction

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