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. 2022 Aug 18;22(1):347.
doi: 10.1186/s12886-022-02568-8.

Long-term visual quality after small incision lenticule extraction (SMILE) and laser assisted subepithelial keratomileusis (LASEK) for low myopia

Mengjun Fu #  1   2   3 , Meiyan Li #  4   5   6 , Ruoyan Wei  4   5   6 , Chuanwei Zhang  7 , Yangyi Huang  4   5   6 , Lingling Niu  4   5   6 , Xiaoying Wang  4   5   6 , Haorun Zhang  8 , Xingtao Zhou  9   10   11
Affiliations

Long-term visual quality after small incision lenticule extraction (SMILE) and laser assisted subepithelial keratomileusis (LASEK) for low myopia

Mengjun Fu et al. BMC Ophthalmol. .

Abstract

Background: Few studies have reported the visual outcomes of small-incision lenticule extraction (SMILE) and laser-assisted subepithelial keratomileusis (LASEK) for myopia correction. This study aims to compare the visual quality and corneal wavefront aberrations after SMILE and LASEK for low-myopia correction.

Methods: In this prospective study, we included 29 eyes of 29 patients who received SMILE and 23 eyes of 23 patients who received LASEK between June 2018 and January 2019. The following measurements were assessed: uncorrected (UDVA) and corrected (CDVA) distance visual acuity, manifest refraction, corneal wavefront aberrations, and subjective visual quality. All patients were followed up for two years.

Results: All procedures were uneventful. An efficacy index of 1.19 ± 0.17 was established in the SMILE group and 1.23 ± 0.20 in the LASEK group. No eyes lost more than two lines of CDVA. We found that 93% (27/29) of the treated eyes in the SMILE group and 91% (21/23) in the LASEK group had spherical equivalent (SE) within ± 0.25D. The increases in the total corneal spherical aberration and the corneal front spherical aberration were lower in the SMILE group than in the LASEK group (P < 0.01). In contrast, the increases in the total corneal vertical coma and the corneal front vertical coma in the SMILE group were greater than those in the LASEK group (P < 0.01).

Conclusion: Both SMILE and LASEK have good safety, stability, and patient-reported satisfaction for low myopia. SMILE induced less corneal spherical aberration but greater vertical coma than LASEK.

Keywords: Laser assisted subepithelial keratomileusis (LASEK); Myopia; Small incision lenticule extraction (SMILE); Visual quality.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
A-B Postoperative uncorrected distance visual acuity (UDVA) and preoperative corrected distance visual acuity (CDVA) between the SMILE (A) and LASEK (B) groups. C-D Spherical equivalent in the SMILE (C) group and LASEK (D) groups. E–F Changes in the lines of the CDVA in the SMILE (E) and LASEK (F) groups. Plano: zero diopter; Postop: postoperative; Preop: preoperative; SMILE: small incision lenticule extraction; LASEK: Laser-assisted subepithelial keratomileusis
Fig. 2
Fig. 2
A-B Spherical equivalent (SE) attempted versus achieved in the SMILE (A) and LASEK (B) groups. C-D Postoperative refractive astigmatism and preoperative refractive astigmatism in the SMILE (C) and LASEK (D) groups. Postop: postoperative; Preop: preoperative. SMILE: small incision lenticule extraction; LASEK: Laser-assisted subepithelial keratomileusis
Fig. 3
Fig. 3
Scatter plot of the achieved versus attempted correction of astigmatic vectors after SMILE (A) and LASEK (B). Percentage of eyes according to the angle of error (degrees) after SMILE (C) and LASEK (D). SMILE: small incision lenticule extraction; LASEK: Laser-assisted subepithelial keratomileusis
Fig. 4
Fig. 4
Induced changes in wavefront aberrations (6.0-mm analysis corneal diameter) in the SMILE and LASEK groups. Postop: postoperative; RMS: root mean square; HOAs: higher-order aberrations; Z4,0: spherical aberration; Z3, -3: oblique trefoil; Z3, -1: vertical coma; Z3, 1: horizontal coma; Z3, 3: horizontal trefoil. SMILE: small incision lenticule extraction; LASEK: Laser-assisted subepithelial keratomileusis
Fig. 5
Fig. 5
Visual complaints in the SMILE (A) and LASEK (B) groups. Postop: postoperative; SMILE: small incision lenticule extraction; LASEK: Laser-assisted subepithelial keratomileusis
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