Abstract
PurposeTo investigate the changes in dry eye symptoms and clinical signs and corneal sensitivity after small incision lenticule extraction (SMILE) and femtosecond LASIK (femto-LASIK).DesignProspective, non-randomized comparative study.MethodsThe study included a total of 71 eyes of 71 patients; the SMILE group comprised 38 eyes of 38 patients, and the femto-LASIK group comprised 33 eyes of 33 patients. Ocular Surface Disease Index (OSDI), Tear film breakup time (TBUT), the Schirmer test without anesthesia (S1T), corneal fluorescein staining, and central corneal sensation were evaluated before surgery and at 1 week, 1 month, 3 months, and 6 months after surgery.ResultsOSDI scores in both groups were increased immediately and returned to preoperative level at 1 month after surgeries. The TBUT values in both groups were reduced after surgeries relative to their preoperative scores. Patients in SMILE group were less likely to have corneal staining compared with those in the femto-LASIK group ([odds ratio] OR = 0.50, 95% [confidence interval] CI 0.28 to 0.93, P = 0.03). Central corneal sensitivity was decreased at all postoperative time points in both groups. However, the central corneal sensation scores in the SMILE group were greater than that in the femto-LASIK group at all of the postoperative time points (all P<0.05).ConclusionsSMILE surgeries resulted in a short-term increase in dry eye symptoms, tear film instability, and loss of corneal sensitivity. Furthermore, SMILE surgeries have superiority over femto-LASIK in lower risk of postoperative corneal staining and less reduction of corneal sensation.
Highlights
Dry eye is a common complaint among patients who have undergone refractive surgeries, including laser in situ keratomileusis (LASIK), photorefractive keratectomy and femtosecond LASIK, and the incidence of dry eye varies among these patients. [1,2,3] It has been reported that patients who develop dry eye after refractive surgery have elevated risks of developing subsequent refractive regression [4] and ocular surface damage. [5] In addition, refractive surgery procedures interrupt the normal organization and regeneration of the corneal nerves, which in turn lead to a prolonged reduction in corneal sensation.Great advances in the techniques used in refractive surgeries to correct myopia have been made from the LASIK technique to that of femtosecond lenticule extraction
Small incision lenticule extraction (SMILE) surgeries resulted in a short-term increase in dry eye symptoms, tear film instability, and loss of corneal sensitivity
We describe a prospective study to investigate the changes in postsurgical dry eye symptoms and clinical signs and corneal sensitivity following SMILE surgery for the treatment of myopia by comparing them with patients who had undergone femto-LASIK
Summary
Dry eye is a common complaint among patients who have undergone refractive surgeries, including laser in situ keratomileusis (LASIK), photorefractive keratectomy and femtosecond LASIK (femto-LASIK), and the incidence of dry eye varies among these patients. [1,2,3] It has been reported that patients who develop dry eye after refractive surgery have elevated risks of developing subsequent refractive regression [4] and ocular surface damage. [5] In addition, refractive surgery procedures interrupt the normal organization and regeneration of the corneal nerves, which in turn lead to a prolonged reduction in corneal sensation.Great advances in the techniques used in refractive surgeries to correct myopia have been made from the LASIK technique to that of femtosecond lenticule extraction. Small incision lenticule extraction (SMILE) is a novel all-in-one procedure that can be used in the surgical correction of myopia without the creation of a corneal flap. This technique makes it possible for SMILE patients to have lower risks of development of dry eye and decreased corneal sensation after surgery. There was no study that reported the changes in dry eye symptoms and dry eye signs before and after SMILE surgery. We describe a prospective study to investigate the changes in postsurgical dry eye symptoms and clinical signs and corneal sensitivity following SMILE surgery for the treatment of myopia by comparing them with patients who had undergone femto-LASIK
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