Abstract
BackgroundTo compare the refractive results and higher-order aberrations (HOAs) after small incision lenticule extraction (SMILE) in high myopia and mild to moderate myopia patients.MethodsThis prospective study included 165 eyes (86 patients) undergoing SMILE. According to the preoperative spherical equivalent (SE), treated eyes were divided into two groups: the high myopia group (more than -6.0 D, group-H) and the mild to moderate group (less than -6.0 D, group-M). Follow-up intervals were at 1 day, 10 days, 1 month and 3 months postoperatively. We obtained the following parameters: uncorrected (UDVA) and corrected distance visual acuity (CDVA), SE, efficacy and safety index, and HOAs.ResultsPreoperative SE was -7.16 ± 0.93 D in group-H and -4.34 ± 0.97 D in group-M. At 3 months postoperatively, the SE in group-H and group-M was -0.20 ± 0.37 D and 0.01 ± 0.19 D (t = - 4.11, P<0.05), respectively. It was found that 77% and 98% had an UDVA of 20/20, 98% and 99% had a CDVA of 20/20 in group-H and group-M, respectively, while 87% and 95% had a SE within ±0.5 D and ±1.0 D in group-H, and 98% and 100% in group-M. The efficacy indexes were 0.98 ± 0.18 in group-H and 1.05 ± 0.10 in group-M (t = - 3.084, p < 0.05). The safety indexes were 1.06 ± 0.09 and 1.06 ± 0.09 (t = 0.153, p > 0.05), respectively. There were significant increases in total HOAs, 3rd-order coma, and 4th-order spherical aberrations.ConclusionsSMILE is an effective and safe surgery for correcting myopia. But the target correction amount in high myopia patients should be adjusted to avoid undercorrection and acquired more satisfaction. SMILE induced increases of HOAs.Trial registrationChiTrial registration number: ChiCTR-OON-16009164. Retrospectively registered: 06.September.2016
Highlights
To compare the refractive results and higher-order aberrations (HOAs) after small incision lenticule extraction (SMILE) in high myopia and mild to moderate myopia patients
Avoiding the creation of a flap and preserving more corneal nerve fibers, SMILE is expected to remedy the shortcomings of laser-assisted in situ keratomileusis (LASIK) and femtosecond laser-assisted LASIK
The postoperative corneal biomechanical strength is theoretically greater in comparison to LASIK and FS-LASIK [5,6,7]
Summary
To compare the refractive results and higher-order aberrations (HOAs) after small incision lenticule extraction (SMILE) in high myopia and mild to moderate myopia patients. Small incision lenticule extraction (SMILE) has been reported since 2011, for treatment of myopia and astigmatism [1, 2]. SMILE is a novel and less invasive technique because only a small incision is required and without a flap. Studies have reported that SMILE minimizes dry eye, and maintains higher corneal sensitivity [4]. There have been studies on SMILE techniques, but most reported results on visual acuity and refractive outcomes [8,9,10]. It is known that high-order aberrations (HOAs) are always responsible for postoperative symptoms, including halos, glare, monocular diplopia, and decreased contrast sensitivity after successful refractive surgery
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