Early recovery of quality of vision and optical performance after refractive surgery: Small-incision lenticule extraction versus laser in situ keratomileusis

Abstract

To assess the early time course of the visual function after small-incision lenticule extraction (SMILE) and laser insitu keratomileusis (LASIK). Quinze-Vingts National Ophthalmology Hospital, Paris, France. Prospective case series. Patients scheduled for bilateral small-incision lenticule extraction or LASIK were consecutively enrolled. In addition to standard refraction and visual acuity, contrast sensitivity, aberrometry, and patient-reported quality of vision and overall satisfaction were measured 1day, 7days, and 1month postoperatively. Each group comprised 23 patients (46 eyes). The postoperative contrast sensitivity was better in the LASIK group at 1day (P=.014) and 7days (P=.001) but not at 1month. No significant differences in visual acuity, efficacy, or safety were found between the 2 groups throughout the follow-up. The objective scatter index assessed by double-pass aberrometry was better after LASIK 1day postoperatively (P=.036) but was not statistically different thereafter. The patient-reported quality of vision was significantly worse in the small-incision lenticule extraction group than in the LASIK group at 7days (P=.010). Global satisfaction did not differ between groups throughout the study. Significant correlations were found between contrast sensitivity and aberrometry in both groups at all examinations. Targeted analysis of early quality of vision through objective and subjective methods suggested that compared with LASIK, a slight delay in corneal optical recovery after small-incision lenticule extraction might lead to reduced contrast sensitivity and specific patient-reported visual disturbance during the first postoperative week with no effect on overall patient satisfaction.