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      Visual and optical quality outcomes of SMILE and FS-LASIK for myopia in the very early phase after surgery

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          Abstract

          Background

          Small incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) are frequently used to treat myopia. However, little is known about the impact on recovery of these approaches in the very early postsurgical phase (within 24 h).

          Methods

          To compare the efficacy of these two procedures for the treatment of myopia in the early phase after surgery, differences in visual acuity, OSI (objective scattering index), cutoff for modulation transfer function (MTF), and SR (Strehl ratio) between SMILE and FS-LASIK were evaluated at 0, 2, 4 and 24 h postoperatively using two-way analysis of variance (ANOVA).

          Results

          No significant differences between SMILE and FS-LASIK in the MTF cutoff and SR were found ( p > 0.05). However, at 2 h and 4 h after surgery, OSI values in the SMILE group were significantly higher than those in the FS-LASIK group, and visual acuity scores in the SMILE group were significantly poorer than those in the FS-LASIK group ( p < 0.05). Regarding subjective symptoms, the number of patients complaining of eye dryness, blurred vision, foreign body sensation and eye soreness in the SMILE group were lower than the number in the FS-LASIK group.

          Conclusions

          In conclusion, visual and optical quality outcomes of FS-LASIK for myopia were better than those of SMILE in the very early phase after surgery, a difference that is attributable to the formation of interface haze.

          Trial registration

          ChiCTR1900021451.

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          Most cited references 14

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          First efficacy and safety study of femtosecond lenticule extraction for the correction of myopia: six-month results.

          To prospectively study the feasibility of femtosecond lenticule extraction (FLE), a new method of refractive correction. Department of Ophthalmology, Philipps University of Marburg and Helios Clinic, Erfurt, Germany. A flap and a lenticule of intrastromal corneal tissue were simultaneously cut with a VisuMax femtosecond laser system. Next, the lenticule was manually removed and the flap repositioned. The target refraction in all cases was -0.75 diopter (D). All 10 myopic eyes in the initial treatment group completed the final 6-month follow-up. The mean patient age was 39 years. The mean spherical equivalent (SE) was -4.73 +/- 1.48 (SD) preoperatively and -0.33 +/- 0.61 D 6 months postoperatively. Ninety percent of eyes were within +/-1.00 D and 40% were within +/-0.50 D of the intended correction. No eye lost 2 or more Snellen lines. Corneal topography showed large, prolate optical zones. Aberrometry showed no significant induction of higher-order aberrations. On a standardized questionnaire, all patients said they were very satisfied with the results. Preliminary results indicate that FLEx [corrected] is a promising new corneal refractive procedure to correct myopia.
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            Visual and refractive outcomes of femtosecond lenticule extraction and small-incision lenticule extraction for myopia.

            To compare the visual and refractive outcomes of femtosecond lenticule extraction (FLEx) and small-incision lenticule extraction (SMILE) in eyes with myopia. Prospective, randomized, masked clinical trial with intraindividual comparison. This study evaluated 52 eyes of 26 consecutive patients with spherical equivalents of -4.19 ± 1.65 diopters (D) (mean ± standard deviation) who underwent FLEx in 1 eye and SMILE in the other eye by randomized assignment. Before surgery, and 1 week and 1, 3, and 6 months after surgery, we assessed safety, efficacy, predictability, stability, and adverse events of the 2 surgical techniques. LogMAR uncorrected and corrected distance visual acuity was, respectively, -0.17 ± 0.10, -0.20 ± 0.07 in the FLEx group and -0.15 ± 0.10, -0.19 ± 0.07 in the SMILE group 6 months postoperatively. In the FLEx and SMILE groups 6 months postoperatively, 96% and 100% of eyes, respectively, were within 0.5 D of the targeted spherical equivalent correction. Changes of -0.02 ± 0.39 D and 0.00 ± 0.30 D occurred in manifest refraction from 1 week to 6 months in the FLEx and SMILE groups, respectively. No clinically significant complications occurred in the FLEx or the SMILE group. Both FLEx and SMILE performed well in the correction of myopia throughout the 6-month observation period. FLEx may be essentially equivalent to SMILE in terms of safety, efficacy, predictability, and stability, suggesting that the presence or absence of lifting the flap does not significantly affect these visual and refractive outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.
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              Femtosecond lenticule extraction for the correction of myopia: preliminary 6-month results.

              To report the 6-month results of a new method of refractive correction, femtosecond lenticule extraction (FLEx), and the preliminary outcomes in the first 108 eyes. In this prospective study, a flap and a lenticule of intrastromal corneal tissue were cut simultaneously using a femtosecond laser. Thereafter, the lenticule was removed manually and the flap repositioned. One hundred and seven of 108 myopic eyes of 56 patients in the treatment group completed the final 6 months of follow-up. The patients' mean age was 35 years. The preoperative mean spherical equivalent (SE) was -4.59 +/- 1.3 diopters (D). The uncorrected visual acuity and the best spectacle-corrected visual acuity after 6 months, objective and manifest refractions, results of slit-lamp examination, the side effects, and the responses to a questionnaire are reported. Six months postoperatively, the mean SE was -0.19 +/- 0.47 D; 98.1% of treated eyes were within +/-1.0 D, and 74.8% of eyes within +/-0.5 D of the intended correction. Eight (7.4%) of 108 eyes lost one line of Snellen VA, one (0.9%) eye lost two Snellen lines, 46 eyes (43%) gained one line, ten eyes (9.3%) gained two Snellen lines, and the VA remained unchanged in 42 (39.3%) eyes. The patient responses to a standardized questionnaire indicated that 97.1% of patients were satisfied with the obtained results and would undergo the procedure again. FLEx appears to be a safe and promising corneal refractive procedure for correcting myopia.
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                Author and article information

                Contributors
                tingliu1597@126.com
                guantlv@126.com
                chenkaij1981@163.com
                kanqiuxia@163.com
                baiji_liujing@163.com
                Journal
                BMC Ophthalmol
                BMC Ophthalmol
                BMC Ophthalmology
                BioMed Central (London )
                1471-2415
                8 April 2019
                8 April 2019
                2019
                : 19
                Affiliations
                [1 ]ISNI 0000 0004 1799 2720, GRID grid.414048.d, Department of Ophthalmology, , Daping Hospital of Army Medical University of PLA, ; No. 10 Changjiangzhi Road, Yuzhong District, Chongqing, 400042 China
                [2 ]ISNI 0000 0004 1791 6584, GRID grid.460007.5, Department of Blood Transfusion, , Tangdu Hospital, Fourth Military Medical University, ; Xi’an, China
                Article
                1096
                10.1186/s12886-019-1096-z
                6454732
                30961593
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;
                Award ID: 81101490
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Ophthalmology & Optometry

                myopia, smile, fs-lasik, very early phase

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