Patient and surgeon experience during laser in situ keratomileusis using 2 femtosecond laser systems

Abstract

Patients preferred surgery with the 500 kHz laser with no loss of light perception, less pain, less fear, and less subconjunctival hemorrhage. Surgeons preferred the 60 kHz laser.

Intraoperative Patient Experience and Postoperative Visual Quality After SMILE and LASIK in a Randomized, Paired-Eye, Controlled Study

“…13 However, a contralateral eye study of LASIK with the Intralase 60-kHz laser and VisuMax 500-kHz laser reported that patients experienced docking and suction as more frightening with the 60-kHz laser. 10 The reported fear scores for the LASIK 500-kHz group were comparable to our current findings. Because the intraoperative intraocular pressure during suction is higher with the 60-kHz laser than with the 500-kHz laser, it may cause more fear in the patients, whereas the intraoperative intraocular pressure is the same in LASIK and SMILE.…”

“…This prospective, randomized, paired-eye study aimed to evaluate the intraoperative and postoperative patient experience in LASIK and SMILE by a standardized validated questionnaire. 2,10 Patients experienced more discomfort during tissue manipulation in SMILE than flap lifting in LASIK, whereas docking and laser application seemed equally uncomfortable for the patients. Interestingly, the patients still feared the initial docking and suction more in LASIK than SMILE, although the level of discomfort was similar for the two refractive procedures.…”

“…Previous studies have described the intraoperative patient experience of LASIK where the corneal flap was created with either a microkeratome 13,14 or femtosecond laser. 2,10,13 A contralateral eye study of LASIK using the Zyoptix XP microkeratome (Bausch & Lomb, Rochester, NY) and the Intralase 60-kHz laser found no significant differences in levels of fear between the two surgical procedures. 13 However, a contralateral eye study of LASIK with the Intralase 60-kHz laser and VisuMax 500-kHz laser reported that patients experienced docking and suction as more frightening with the 60-kHz laser.…”

“…Intraoperative and postoperative questionnaires were developed from a standardized questionnaire that had previously been used to evaluate patient experience after laser refractive procedures. 2,10 The intraoperative questionnaire included light perception, ability to fixate, and level of anxiety, discomfort, and fear at various stages during surgery. The questionnaire consisted of dichotomous yes/no questions combined with Likert scale grading to describe level of anxiety (1 = none, 5 = extreme), discomfort (1 = none, 5 = very severe), and fear (1 = none, 6 = extreme).…”

“…We also compared the postoperative subjective visual symptoms after 1 and 3 months, using a previously validated questionnaire. 2,10 PATIENTS AND METHODS This study was a prospective, randomized, singlemasked, paired-eye, controlled study that included 70 patients between May 2012 and May 2016 at Singapore National Eye Centre. 11 Each patient was randomized to undergo SMILE in one eye and LASIK in the other eye on the same day, determined by a computer-generated allocation sequence.…”