Abstract
BackgroundThe purpose of this study was to compare the refractive outcomes of small incision lenticule extraction (SMILE) in high-myopic patients with those of mild- to moderate-myopic patients.MethodsThis study included 183 eyes of 92 myopic patients treated with SMILE using a VisuMax 500-kHz femtosecond laser. Treated eyes were divided into two groups, according to the preoperative spherical equivalent (SE): mild to moderate myopia (A group, <−6.0 D) and high myopia (B group, ≥ − 6.0 D). Follow-up visits were at 1 day, 1 week, and 1, 3, 6, and 12 months. The outcome measures included uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (BDVA), postoperative SE, efficacy index, safety index, and predictability.ResultsPreoperative SE was −5.05 ± 0.71 D in the A group and −7.67 ± 1.01 D in the B group. No differences were observed between −0.13 ± 0.38 D in the A group and −0.24 ± 0.35 D in the B group 12 months postoperatively (p = 0.18). At 12 months postoperatively, 93.1 % and 76.8 % had an UDVA of 20/20 or better in the A and B groups, respectively. In the A group, 87.9 % and 96.6 % were within ±0.5 D and ±1.0 D, respectively, of the intended correction; in the B group, 88.0 % and 97.6 % were within ±0.5 D and ±1.0 D, respectively. The efficacy index was 1.04 ± 0.19 in the A group and 0.99 ± 0.19 in the B group. The safety index was 1.27 ± 0.17 for the A group and 1.24 ± 0.17 for the B group. The efficacy and safety index were not significantly different between the two groups 12 months postoperatively (p = 0.141 and p = 0.307, respectively).ConclusionsThis study showed that SMILE is effective and safe for correcting high myopia, as well as mild to moderate myopia.
Highlights
The purpose of this study was to compare the refractive outcomes of small incision lenticule extraction (SMILE) in high-myopic patients with those of mild- to moderate-myopic patients
Small incision lenticule extraction (SMILE) is a flap-free refractive surgery, in which the corneal stromal lenticule is cut by a femtosecond laser and removed through a small corneal incision tunnel [1, 2]
SMILE has been proposed as an alternative to Laser-assisted in situ keratomileusis (LASIK) or Photorefractive keratectomy (PRK), which has been a popular refractive surgery technique for a decade because the visual outcome has proved to be generally good and the time to return to normal life after surgery is short[3]
Summary
The purpose of this study was to compare the refractive outcomes of small incision lenticule extraction (SMILE) in high-myopic patients with those of mild- to moderate-myopic patients. SMILE has been proposed as an alternative to LASIK or PRK, which has been a popular refractive surgery technique for a decade because the visual outcome has proved to be generally good and the time to return to normal life after surgery is short[3]. Studies have shown that compared with LASIK, SMILE minimizes dry eye, while maintaining higher corneal sensitivity [8, 9] and cornea tensile strength [10, 11] after surgery. There have been numerous studies [1, 2, 12,13,14] on SMILE outcomes, but most reported short term results based on months or less of follow up with small numbers of samples. Longer-term studies with larger sampling sizes are necessary to establish the full capability of
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