Visual Outcomes after Small Incision Lenticule Extraction and Femtosecond Laser-Assisted LASIK for High Myopia

Yang, Weiming; Liu, Shengtao; Li, Meiyan; Shen, Yang; Zhou, Xingtao

doi:10.1159/000504304

Cited by 12 publications

(8 citation statements)

References 21 publications

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“…Regardless of the degree of myopia and pupil size, the amount of coma induced by SMILE was equal to or less than that by the other two methods. Similarly, in the study by Yang et al [15], induced coma in the myopic SMILE group (0.22 µm) was not signi cantly different from the femto-LASIK group (0.13 µm).…”

Section: Comasupporting

confidence: 52%

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

Miraftab

Hashemi

Aghamirsalim

et al. 2021

Preprint

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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). Conclusion In correction of moderate myopia, SMILE is preferable to prevent dilated pupil visual problems. In high myopia correction, femto-LASIK and PRK is preferred for normal light activities and SMILE is recommended to avoid dilated pupil visual problems.

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Section: Comasupporting

confidence: 52%

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

Miraftab

Hashemi

Aghamirsalim

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Table 2 Baseline and postoperative 3mm and 6mm higher order aberrations in cases of moderate myopia treated with SMILE, femto-LASIK, and PRK Similarly, in the study by Yang et al [15], induced coma in the myopic SMILE group (0.22 μm) was not significantly different from the femto-LASIK group (0.13 μm).…”

Section: Comamentioning

confidence: 71%

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

et al. 2021

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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.

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“…Hamilton et al ( 23 ) did not detect a difference between the techniques due to the use of a wavefront aberration optimization technique for FS-LASIK, which is slightly different from the WFG technique. Yang et al ( 30 ) conducted research that yielded comparable results, which they attributed to the inclusion of participants with high myopia. The high degree of myopia itself dominated the postoperative HOA changes, leading to the fact that the different surgical modalities did not play a key role in this.…”

Section: Discussionmentioning

confidence: 99%

Differences in ocular high order aberrations before and after small incision lenticule extraction for correction of myopia: a systematic review and meta-analysis

Du,

Di,

Yang

et al. 2024

Front. Med.

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ObjectiveTo examine the causes and factors that lead to high order aberration (HOA) during the treatment of myopia using small incision lenticule extraction (SMILE), as well as the differences between SMILE and other corneal refractive surgeries through a systematic review and meta-analysis.MethodsA systematic search was conducted from January 2015 to February 2023 in Pubmed, Embase, Web of Science, and Google Scholar databases to gather relevant studies on SMILE and HOA. Studies meeting specific criteria were chosen, and clinical data was retrieved for analysis.ResultsThis meta-analysis resulted in the inclusion of 19 studies involving 1,503 eyes. Pooled results showed significant induction of total HOA (tHOA, d = −0.21, p < 0.001), spherical aberration (SA, d = −0.11, p < 0.001) and coma aberration (CA, d = −0.18, p < 0.001) after SMILE compared to pre-SMILE, while no significant change in trefoil aberration (TA) was observed (d = −0.00, p = 0.91). There was a significantly lower induction of tHOA after SMILE compared to femtosecond laser-assisted in situ keratomileusis (FS-LASIK, d = 0.04, p < 0.001), and no significant difference was observed compared to wavefront aberration-guided (WFG) refractive surgery (d = 0.00, p = 0.75). There was also a significant association between different levels of myopia and astigmatism, duration of follow-up, lenticule thickness, and preoperative central corneal thickness (CCT) on the induction of tHOA after SMILE (p < 0.05), while the higher preoperative myopia group (sphere > -5D), lower preoperative astigmatism group (cylinder ≤ -1D), larger lenticule thickness group (lenticule thickness > 100 μm), shorter follow-up group (follow-up 1 month postoperatively) and the thicker CCT group (CCT > 550 μm) brought a significant induction of tHOA compared to the opposite comparison group (p < 0.001).ConclusionWhile SMILE can induce HOA significantly, it induces less HOA than FS-LASIK. Postoperative HOA following SMILE can be affected by factors such as myopia, astigmatism, lenticule thickness, CCT, and duration of follow-up. Future research should continue to explore techniques to decrease the induction of HOA by using this methodology.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/.

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Visual Outcomes after Small Incision Lenticule Extraction and Femtosecond Laser-Assisted LASIK for High Myopia

Cited by 12 publications

References 21 publications

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

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

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

Differences in ocular high order aberrations before and after small incision lenticule extraction for correction of myopia: a systematic review and meta-analysis

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