Abstract
BackgroundTo compare the correction effect and optical quality after small-incision lenticule extraction (SMILE) and femtosecond laser assisted laser in situ keratomileusis (FS-LASIK) for high myopia.Methods51 high myopia eyes after SMILE and 49 high myopia eyes after FS-LASIK were enrolled and divided into two groups retrospectively. The OQAS and iTrace analyzer were used for optical quality inspection. Between the two groups the spherical equivalent (SE), astigmatism, uncorrected distant visual acuity (UDVA), strehl ratio (SR), modulation transfer function cutoff frequency (MTF cutoff), objective scatter index (OSI) and wavefront aberrations were analyzed and compared before surgery and at 1, 6 and 12 months after surgery.ResultsAfter the operation: (1) SE and astigmatism declined and UDVA increased significantly in both groups, and UDVA was better after SMILE than FS-LASIK. (2) SR and MTF cutoff reduced and OSI increased significantly after SMILE and FS-LASIK. SR and MTF cutoff were significantly higher after SMILE than FS-LASIK. OSI was significantly lower after SMILE than FS-LASIK. (3) The total wavefront aberration, total low-order wavefront aberration, defocus and astigmatism aberration as well as trefoil aberration reduced significantly in both groups. The total high-order wavefront aberration increased significantly after FS-LASIK. The spherical and coma aberration increased significantly in both groups. The total high-order wavefront aberration and coma aberration at 1 month were higher after FS-LASIK than SMILE.ConclusionThe optical quality descended after SMILE and FS-LASIK. SMILE was superior to FS-LASIK at the correction effect and optical quality for high myopia. The combination of OQAS and iTrace analyzer is a valuable complementary measurement in evaluating the optical quality after the refractive surgery.Trial registrationThis is a retrospective study. This research was approved by the ethics committee of Xiangya Hospital and the IRB approval number is 201612074.
Highlights
To compare the correction effect and optical quality after small-incision lenticule extraction (SMILE) and femtosecond laser assisted laser in situ keratomileusis (FS-LASIK) for high myopia
The inclusion criteria of enrolling these patients was as follows: (1) the age was 18 years old or older, (2) the spherical refraction was from − 6.00 D to − 10.00 D and the astigmatism was from 0 D to − 2.50 D, (3) there was no history of other eye diseases that might impair the patients’ vision, (4) the follow-up duration was more than one year with regular check at 1, 6 and 12 months postoperatively, (5) both the SMILE and FS-LASIK surgery were performed by the same experienced surgeon and the examinations before and after operation were performed by the same experienced technicians
Both spherical equivalent (SE) and astigmatism significantly decreased after SMILE and FS-LASIK (p < 0.05)
Summary
To compare the correction effect and optical quality after small-incision lenticule extraction (SMILE) and femtosecond laser assisted laser in situ keratomileusis (FS-LASIK) for high myopia. In the field of corneal refractive surgery, both smallincision lenticule extraction (SMILE) and femtosecond laser assisted laser in situ keratomileusis (FS-LASIK) have been extensively applied [3, 4]. When performing the SMILE surgery, a corneal stromal lenticule is firstly made with the femtosecond laser and extracted from a small side incision [5]. According to most of clinical data, the optical quality after SMILE is generally better than that after FS-LASIK [11,12,13] Most of these data are obtained from the patients with low and moderate myopia. It is meaningful to evaluate the optical quality objectively in high myopia correction after SMILE and FS-LASIK
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