Comparison of the visual results after SMILE and femtosecond laser-assisted LASIK for myopia

J Refract Surg. 2014 Apr;30(4):248-54. doi: 10.3928/1081597X-20140320-03.

Abstract

Purpose: To perform a comparative clinical analysis of the safety, efficacy, and predictability of two surgical procedures (ie, small incision lenticule extraction [SMILE] and femtosecond laser-assisted LASIK [FS-LASIK]) to correct myopia.

Methods: Sixty eyes of 31 patients with a mean spherical equivalent of -5.13 ± 1.75 diopters underwent myopia correction with the SMILE procedure. Fifty-one eyes of 27 patients with a mean spherical equivalent of -5.58 ± 2.41 diopters were treated with the FS-LASIK procedure. Postoperative uncorrected and corrected distance visual acuity, manifest refraction, and higher-order aberrations were analyzed statistically at 1 and 3 months postoperatively.

Results: No statistically significant differences were found at 1 and 3 months in parameters that included the percentage of eyes with an uncorrected distance visual acuity of 20/20 or better (P = .556, .920) and mean spherical equivalent refraction (P = .055, .335). At 1 month, 4 SMILE-treated eyes and 1 FS-LASIK-treated eye lost one or more line of visual acuity (P = .214, chi-square test). At 3 months, 2 SMILE-treated eyes lost one or more line of visual acuity, whereas all FS-LASIK-treated eyes had an unchanged or corrected distance visual acuity. Higher-order aberrations and spherical aberration were significantly lower in the SMILE group than the FS-LASIK group at 1 (P = .007, .000) and 3 (P = .006, .000) months of follow-up.

Conclusions: SMILE and FS-LASIK are safe, effective, and predictable surgical procedures to treat myopia. SMILE has a lower induction rate of higher-order aberrations and spherical aberration than the FS-LASIK procedure.

Publication types

  • Comparative Study

MeSH terms

  • Aberrometry
  • Adolescent
  • Adult
  • Corneal Stroma / surgery*
  • Corneal Surgery, Laser / methods
  • Corneal Wavefront Aberration / physiopathology
  • Female
  • Follow-Up Studies
  • Humans
  • Keratomileusis, Laser In Situ / methods*
  • Lasers, Excimer / therapeutic use*
  • Male
  • Myopia / physiopathology
  • Myopia / surgery*
  • Prospective Studies
  • Refraction, Ocular / physiology*
  • Treatment Outcome
  • Visual Acuity / physiology*
  • Young Adult