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. 2020 Apr 22:2020:3825864.
doi: 10.1155/2020/3825864. eCollection 2020.

Small Incision Lenticule Extraction (SMILE) for Moderate and High Myopia: Seven-Year Outcomes of Refraction, Corneal Tomography, and Wavefront Aberrations

Fei Xia  1   2   3 , Yang Shen  1   2   3 , Tian Han  1   2   3 , Jing Zhao  1   2   3 , Haipeng Xu  1   2   3 , Xingtao Zhou  1   2   3
Affiliations

Small Incision Lenticule Extraction (SMILE) for Moderate and High Myopia: Seven-Year Outcomes of Refraction, Corneal Tomography, and Wavefront Aberrations

Fei Xia et al. J Ophthalmol. .

Abstract

Purpose: To investigate the long-term outcomes of refraction, corneal tomography, and wavefront aberrations after small incision lenticule extraction (SMILE) for moderate and high myopia.

Methods: Prospective, nonconsecutive case series. A total of 26 patients (26 eyes) who underwent SMILE from May 2010 to March 2013 at the Fudan University Eye and ENT Hospital (Shanghai, China) were enrolled. The periods of follow-up were 1 month, 1 year, 5 years, and 7 years after surgery. The routine eye examinations included uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), manifest refraction, and corneal tomography.

Results: All surgeries were executed without any complications. At the final visit, an UDVA of 20/20 or better was achieved in 26 eyes (100%) and 11 eyes (42%) exhibited no change in CDVA. 9 eyes (35%) gained one line, 6 eyes (23%) gained two lines, and no eyes lost CDVA. 24 eyes (92%) and 26 eyes (100%) were within ±0.5 D and ±1.00 D of the target refraction, respectively. A mean refractive regression of -0.17 D was observed between 1 month and 7 years postoperatively. Mean corneal front curvature (MCFC) was significantly decreased between pre- and post-SMILE surgery (P < 0.0001). Higher-order aberrations (HOAs) and vertical coma were significantly increased after SMILE compared to those measured before surgery (all P < 0.001). There were no significant differences in trefoil and spherical aberration between pre- and post-SMILE surgery (all P > 0.05).

Conclusion: SMILE is an effective, safe, and stable procedure for moderate and high myopia, with relatively constant corneal stability and wavefront aberrations. This trial is registered with ChiCTR-ONRC-13003114.

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Conflict of interest statement

The authors declare that there are no conflicts of interest regarding the publication of this article.

Figures

Figure 1
Figure 1
Refractive outcomes at 7 years postoperatively for 26 eyes for moderate and high myopia (UDVA = uncorrected distance visual acuity, CDVA = corrected distance visual acuity, D = diopters, Preop = preoperative, and Postop = postoperative). Uncorrected distance visual acuity (a); change in corrected distance visual acuity (b); spherical equivalent attempted vs achieved (c); spherical equivalent refractive accuracy (d); refractive astigmatism (e); stability of spherical equivalent refraction (f).
Figure 2
Figure 2
Comparison of posterior corneal surface maps obtained by corneal topography preoperatively (a), 1 month (b), 1 year (c), 5 years (d), and 7 years (e) after small incision lenticule extraction (SMILE).
See this image and copyright information in PMC

References

    1. Sekundo W., Kunert K. S., Blum M. Small incision corneal refractive surgery using the small incision lenticule extraction (SMILE) procedure for the correction of myopia and myopic astigmatism: results of a 6 month prospective study. British Journal of Ophthalmology. 2011;95(3):335–339. doi: 10.1136/bjo.2009.174284. - DOI - PubMed
    1. Zhou X. T., Dong Z. X., Yao P. J., Huang J., Xu Y., Xu H. P. The clinical study of femtosecond lenticule extraction for myopia. Zhonghua Yan Ke Za Zhi. 2011;47(7):584–588. - PubMed
    1. Kamiya K., Shimizu K., Igarashi A., Kobashi H. Visual and refractive outcomes of femtosecond lenticule extraction and small-incision lenticule extraction for myopia. American Journal of Ophthalmology. 2014;157(1):128–134.e2. doi: 10.1016/j.ajo.2013.08.011. - DOI - PubMed
    1. Pedersen I. B., Ivarsen A., Hjortdal J. Three-year results of small incision lenticule extraction for high myopia: refractive outcomes and aberrations. Journal of Refractive Surgery. 2015;31(11):719–724. doi: 10.3928/1081597x-20150923-11. - DOI - PubMed
    1. Hansen R. S., Lyhne N., Grauslund J., Vestergaard A. H. Small-incision lenticule extraction (SMILE): outcomes of 722 eyes treated for myopia and myopic astigmatism. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2016;254(2):399–405. doi: 10.1007/s00417-015-3226-5. - DOI - PubMed