Two‐years results of small‐incision lenticule extraction and wavefront‐guided laser in situ keratomileusis for Myopia

• Published in: Acta ophthalmologica (Oxford, England) England), 2018-03, Vol.96 (2), p.e119-e126
• Main Authors: Kobashi, Hidenaga, Kamiya, Kazutaka, Igarashi, Akihito, Takahashi, Masahide, Shimizu, Kimiya
• Format: Article
• Language: English
• Subjects: Aberrometry; Adult; Astigmatism - physiopathology; Astigmatism - surgery; Case-Control Studies; Corneal Stroma - surgery; Corneal Wavefront Aberration; Female; Humans; Keratomileusis, Laser In Situ - methods; laser in situ keratomileusis; Lasers, Excimer - therapeutic use; Male; Microsurgery - methods; Middle Aged; myopia; Myopia - physiopathology; Myopia - surgery; Refraction, Ocular - physiology; refractive regression; Retrospective Studies; small‐incision lenticule extraction; Treatment Outcome; Visual Acuity - physiology; Young Adult
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/aos.13470

Purpose To compare the 2‐years visual and refractive outcomes between small‐incision lenticule extraction (SMILE) and wavefront‐guided laser in situ keratomileusis (LASIK) in eyes with myopia and myopic astigmatism. Methods Our retrospective case–control study examined 30 eyes of 30 patients with the manifest refraction spherical equivalent (MRSE) of −3.71 ± 1.83 dioptres (D) who underwent SMILE and 30 eyes of 30 patients with MRSE of −3.81 ± 1.40 D who underwent wavefront‐guided LASIK. We assessed the 2‐years clinical outcomes. Results Logarithm of the minimal angle of resolution (LogMAR)‐corrected distance visual acuity (CDVA) was −0.23 ± 0.07 in the SMILE group and −0.24 ± 0.07 in the wavefront‐guided LASIK group 2 years postoperatively (p = 0.82). Logarithm of the minimal angle of resolution‐uncorrected distance visual acuity (UDVA) was −0.18 ± 0.09 and −0.15 ± 0.11 (p = 0.30, respectively). In the SMILE and wavefront‐guided LASIK groups 2 years postoperatively, 100% and 73% of eyes, respectively, were within 0.5 D of the prompted MRSE correction (p = 0.005). Changes in the MRSE of −0.10 ± 0.30 D and −0.23 ± 0.51 D occurred from 3 months to 2 years (p = 0.40, respectively). We found a significant correlation between myopic regression and the changes in the keratometric readings from 3 months to 2 years after wavefront‐guided LASIK (r = −0.48, p = 0.002), but not after SMILE (r = −0.004, p = 0.90). Conclusion Small‐incision lenticule extraction offers better refractive outcomes than wavefront‐guided LASIK during a 2‐years follow‐up for the correction of myopia and myopic astigmatism.