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Small-incision lenticule extraction (SMILE): outcomes of 722 eyes treated for myopia and myopic astigmatism

  • Refractive Surgery
  • Published:
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Abstract

Purpose

To study the outcomes of small-incision lenticule extraction (SMILE) for treatment of myopia and myopic astigmatism.

Methods

Retrospective study of patients treated for myopia or myopic astigmatism with SMILE, using a VisuMax® femtosecond laser (Carl Zeiss Meditec, Jena, Germany), at the Department of Ophthalmology, Odense University Hospital, Odense, Denmark. Inclusion criteria were corrected distance visual acuity (CDVA) of 20/25 or better before surgery and no ocular conditions other than myopia up to −10.00 diopters (D) with astigmatism up to 3.00 D.

Results

Of the 729 treatments, 722 were included. The spherical equivalent (SE) refraction averaged −6.82 ± 1.66 diopters (D) before surgery. After 3 months, 88 % of eyes were within ±0.50 D of the intended refraction, whilst 98 % were within ±1.00 D. The mean difference between attempted and achieved SE refraction at 3 months after surgery was −0.06 ± 0.01 D (range: −1.25 to 1.25 D). In eyes with emmetropia as target refraction (n = 362), 63 % had uncorrected distance visual acuity (UDVA) of 20/25 or better 1 day after surgery, rising to 83 % at 3 months after surgery. The average gain in CDVA from before surgery to 3 months after surgery was 0.07 ± 0.03 (logMAR). However, 12 eyes (1.6 %) lost 2 or more lines of CDVA from before surgery to 3 months postoperatively. Simultaneous treatment of up to 3.00 D of astigmatism was not associated with less predictable refractive outcomes.

Conclusions

In the short term, SMILE seemed predictable, efficient, and safe for treatment of myopia and myopic astigmatism.

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References

  1. Sekundo W, Kunert KS, Blum M (2011) 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. Br J Ophthalmol 95(3):335–339

    Article  PubMed  Google Scholar 

  2. Reinstein DZ, Archer TJ, Randleman JB (2013) Mathematical model to compare the relative tensile strength of the cornea after PRK, LASIK, and small incision lenticule extraction. J Refract Surg 29(7):454–460

    Article  PubMed  Google Scholar 

  3. Vestergaard AH, Gronbech KT, Grauslund J, Ivarsen AR, Hjortdal JO (2013) Subbasal nerve morphology, corneal sensation, and tear film evaluation after refractive femtosecond laser lenticule extraction. Graefe's Arch Clin Exp Ophthalmol 251(11):2591–2600

    Article  Google Scholar 

  4. Xu Y, Yang Y (2014) Dry eye after small incision lenticule extraction and LASIK for myopia. J Refract Surg 30(3):186–190

    Article  PubMed  CAS  Google Scholar 

  5. Vestergaard A, Ivarsen A, Asp S, Hjortdal JO (2013) Femtosecond (FS) laser vision correction procedure for moderate to high myopia: a prospective study of ReLEx((R)) flex and comparison with a retrospective study of FS-laser in situ keratomileusis. Acta Ophthalmol 91(4):355–362

    Article  PubMed  Google Scholar 

  6. Ganesh S, Gupta R (2014) Comparison of visual and refractive outcomes following femtosecond laser-assisted lasik with smile in patients with myopia or myopic astigmatism. J Refract Surg 30(9):590–596

    Article  PubMed  Google Scholar 

  7. Moshirfar M, McCaughey MV, Reinstein DZ, Shah R, Santiago-Caban L, Fenzl CR (2015) Small-incision lenticule extraction. J Cataract Refract Surg 41(3):652–665

    Article  PubMed  Google Scholar 

  8. Hjortdal JO, Vestergaard AH, Ivarsen A, Ragunathan S, Asp S (2012) Predictors for the outcome of small-incision lenticule extraction for Myopia. J Refract Surg 28(12):865–871

    Article  PubMed  Google Scholar 

  9. Chen YI, Chien KL, Wang IJ, Yen AM, Chen LS, Lin PJ, Chen TH (2007) An interval-censored model for predicting myopic regression after laser in situ keratomileusis. Invest Ophthalmol Vis Sci 48(8):3516–3523

    Article  PubMed  Google Scholar 

  10. Yang CC, Wang IJ, Chang YC, Lin LL, Chen TH (2006) A predictive model for postoperative intraocular pressure among patients undergoing laser in situ keratomileusis (LASIK). Am J Ophthalmol 141(3):530–536

    Article  PubMed  Google Scholar 

  11. Potgieter FJ, Roberts C, Cox IG, Mahmoud AM, Herderick EE, Roetz M, Steenkamp W (2005) Prediction of flap response. J Cataract Refract Surg 31(1):106–114

    Article  PubMed  Google Scholar 

  12. Liyanage SE, Allan BD (2012) Multiple regression analysis in myopic wavefront laser in situ keratomileusis nomogram development. J Cataract Refract Surg 38(7):1232–1239

    Article  PubMed  Google Scholar 

  13. Holladay JT (2004) Visual acuity measurements. J Cataract Refract Surg 30(2):287–290

    Article  PubMed  Google Scholar 

  14. Lin F, Xu Y, Yang Y (2014) Comparison of the visual results after SMILE and femtosecond laser-assisted LASIK for myopia. J Refract Surg 30(4):248–254

    Article  PubMed  Google Scholar 

  15. Shortt AJ, Allan BD, Evans JR (2013) Laser-assisted in-situ keratomileusis (LASIK) versus photorefractive keratectomy (PRK) for myopia. Cochrane Database Syst Rev 1:Cd005135

    PubMed  Google Scholar 

  16. Ivarsen A, Asp S, Hjortdal J (2014) Safety and complications of more than 1500 small-incision lenticule extraction procedures. Ophthalmology 121(1):822–828

    Article  PubMed  Google Scholar 

  17. Ivarsen A, Hjortdal J (2014) Correction of myopic astigmatism with small incision lenticule extraction. J Refract Surg 30(4):240–247

    Article  PubMed  Google Scholar 

  18. Wan-Soo K, Jin-Man J (2001) Corneal hydration affects ablation during laser in situ keratomileusis surgery. Cornea 20(4):394–397

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark

    Rasmus Søgaard Hansen, Niels Lyhne, Jakob Grauslund & Anders Højslet Vestergaard

Authors
  1. Rasmus Søgaard Hansen
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  2. Niels Lyhne
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  3. Jakob Grauslund
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  4. Anders Højslet Vestergaard
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Corresponding author

Correspondence to Rasmus Søgaard Hansen.

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Funding

No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Hansen, R.S., Lyhne, N., Grauslund, J. et al. Small-incision lenticule extraction (SMILE): outcomes of 722 eyes treated for myopia and myopic astigmatism. Graefes Arch Clin Exp Ophthalmol 254, 399–405 (2016). https://doi.org/10.1007/s00417-015-3226-5

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  • DOI: https://doi.org/10.1007/s00417-015-3226-5

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