Prospective, Randomized, Contralateral Eye Comparison of Functional Optical Zone, and Visual Quality After SMILE and FS-LASIK for High Myopia

Abstract

Purpose To compare the functional optical zone (FOZ) and visual quality after small-incision lenticule extraction (SMILE) and femtosecond laser–assisted laser in situ keratomileusis (FS-LASIK) in correcting high myopia. Methods Ninety-two eyes of 46 high myopic patients with the same programmed optical zone (POZ) received SMILE in one eye and FS-LASIK in the contralateral eye. FOZ was calculated using a refractive power method. The decentration, visual outcomes, wavefront aberrations, contrast sensitivity, and quality of vision (QoV) questionnaire were analyzed at 6 months postoperatively. Results The postoperative visual and refractive outcomes were comparable between SMILE and FS-LASIK. The FOZ for SMILE (5.62 ± 0.31 mm) was larger than for FS-LASIK (5.35 ± 0.28 mm; P < 0.001). Moreover, the total decentration for SMILE (0.29 ± 0.14 mm) was greater than in FS-LASIK (0.22 ± 0.11 mm; P < 0.001). The induced change in spherical aberration was less for SMILE than for FS-LASIK ( P < 0.001). There was better contrast sensitivity under the mesopic condition with glare for SMILE than for FS-LASIK ( P = 0.024). However, no significant difference was found in QoV scores between the two groups. Conclusions SMILE created a larger FOZ and greater decentration than FS-LASIK when the same POZ was designed in high myopia. Objective and subjective visual symptoms were comparable between SMILE and FS-LASIK. Translational Relevance The differences in FOZ and decentration between SMILE and FS-LASIK have little effect on vision outcomes. Surgeons should consider the FOZ and decentration in surgical options in high myopia.

Patient-reported quality of vision in a prospective randomized contralateral-eye trial comparing LASIK and small-incision lenticule extraction

“…Correspondingly, previously reported data from this study and another prospective contralateral-eye study found no difference in total HOAs between eyes that underwent LASIK or SMILE. 4,23 Our findings with 12month postoperative data are also consistent with other prospective contralateral-eye studies comparing LASIK and SMILE, which reported no difference in quality of vision up to the postoperative 6-month visit. 9,23 The correlation observed between the severity of some visual symptoms and either residual refractive error or UDVA in the SMILE group was not observed in the LASIK group.…”

“…4,23 Our findings with 12month postoperative data are also consistent with other prospective contralateral-eye studies comparing LASIK and SMILE, which reported no difference in quality of vision up to the postoperative 6-month visit. 9,23 The correlation observed between the severity of some visual symptoms and either residual refractive error or UDVA in the SMILE group was not observed in the LASIK group. The reason for the lack of an observed correlation in the LASIK group is likely because there was less variability in residual refractive error, and a greater proportion of eyes had better than 20/20 UDVA with LASIK.…”

Characteristics of Pupil Offset in Young Asian Adults With Mild-Moderate and High Myopia

“…1 C, 1 D). 14 , 15 The Pentacam scanned the anterior and posterior corneal surfaces by 360 degrees rotation within 2 second through a rotating Scheimpflug camera with a short wavelength slit-light, and 25 corneal Scheimpflug images, and a three-dimensional reconstruction of the cornea was obtained.…”

Methods of Corneal Vertex Centration and Evaluation of Effective Optical Zone in Small Incision Lenticule Extraction

“…Centration on the Central 4-mm Area . The EOZ is defined as the outlined area with a difference of 0.5 D from the TCRP of a 4-mm area in the center of the cornea [38, 39]. The method adopted is as follows: in the TCRP map, taking the CV as the center, the EOZ is determined as the maximum ring diameter that is 0.5 D away from the TCRP in the central 4-mm area.…”