Small-incision lenticule extraction for correction of refractive error after 2 years of follow-up

Abstract

Background: Small-incision lenticule extraction (SMILE) is a relatively novel refractive procedure introduced to correct myopia and myopic astigmatism using femtosecond technology. Aim: The aim of this study was to prospectively assess the predictability, efficacy and safety of SMILE surgery. Setting: The study took place in Alyamama Vision Refractive Center, Baghdad, Iraq. Methods: In this prospective, non-randomised, single-centre clinical study, all patients with myopia or myopic astigmatism underwent the SMILE procedure performed by one surgeon (H.S.S.) with a targeted post-operative refraction of 0 to −0.5 dioptres (D). The procedure was performed using the VisuMax femtosecond platform. Post-operative data, including slit-lamp examination and measurements of uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), objective and subjective refraction, and intraocular pressure (IOP), were recorded. Results: A total of 141 eyes of 76 patients (51 females and 25 males) were included in the study. The mean preoperative spherical equivalent (SE) (−4.37 D ± 1.65 D) ranged from −2.0 D to −10.25 D after 2 years of follow-up, and the mean post-operative SE (−0.06 D ± 0.18 D) ranged from −0.75 D to 0.63 D. A UCVA of 20/40 or better was noted in 98% of the eyes at the 2-year follow-up. Most of the surgical complications, which were seen in 30 eyes, did not result in permanent visual loss. Corneal abrasion was the most common surgical complication, constituting 10.6% of all complications, followed by adherence of the lenticule to the cap (3.5%). Conclusion: The SMILE procedure is effective with high safety and efficacy, and its complication rate will probably decrease with improvement in the surgeon experience level and refinement of the laser parameters.