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Comparison of ReLEx SMILE and PRK in terms of visual and refractive outcomes for the correction of low myopia

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Abstract

Purpose

To compare the objective and subjective quality of vision after femtosecond laser-assisted small incision lenticule extraction (SMILE) and photorefractive keratectomy (PRK) for low myopia.

Methods

One hundred and twenty eyes from 60 patients (34 females, 26 males) undergoing bilateral correction of low myopia (≤−4 D SE) with either ReLEx SMILE or PRK were included. Visual acuity, contrast sensitivity and higher-order aberrations were recorded preoperatively and compared postoperatively. A quality of vision questionnaire was scored and analyzed 3 months postoperatively.

Results

At 3 months, the SMILE group had significantly better uncorrected and corrected distant visual acuity (CDVA), compared to PRK group (p = 0.01). Post-op spherical equivalent (SE) was comparable in both groups (SMILE = −0.15 ± 0.19 D, PRK = −0.14 ± 0.23 D, p = 0.72). However, SE predictability was better in SMILE group with 97% eyes within ±0.05 D compared to 93% eyes in the PRK group. Total higher-order aberrations (HOAs) were significantly higher in PRK compared to the SMILE group (p = 0.022). The SMILE group demonstrated slightly better contrast sensitivity, which was significant at spatial frequency of 12 cpd (p = 0.03). Four eyes in the PRK group had loss of CDVA by one line due to mild haze.

Conclusions

Both SMILE and PRK were effective procedures for correction of low myopia. However, SMILE offered superior quality of vision and patient satisfaction due to better postoperative comfort and lower induction of aberrations at 3 months.

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References

  1. Bailey MD, Zadnik K (2007) Outcomes of LASIK for myopia with FDA-approved lasers. Cornea 26(3):246–254

    Article  PubMed  Google Scholar 

  2. Bailey MD, Mitchell GL, Dhaliwal DK, Boxer Wachler BS, Zadnik K (2003) Patient satisfaction and visual symptoms after laser in situ keratomileusis. Ophthalmology 110(7):1371–1378

    Article  PubMed  Google Scholar 

  3. Sridhar MS, Rao SK, Vajpayee RB, Aasuri MK, Hannush S, Sinha R (2002) Complications of laser-in situ-keratomileusis. Indian J Ophthalmol 50(4):265–282

    PubMed  Google Scholar 

  4. Khoueir Z, Haddad NM, Saad A, Chelala E, Warrak E (2013) Traumatic flap dislocation 10 years after LASIK. Case report and literature review. J Fr d’ophtalmol 36(1):82–86

    Article  CAS  Google Scholar 

  5. Mohammadi SF, Nabovati P, Mirzajani A, Ashrafi E, Vakilian B (2015) Risk factors of regression and undercorrection in photorefractive keratectomy: a case-control study. Int J Ophthalmol 18;8(5): 933–937

  6. Sher NA, Barak M, Daya S (1992) Excimer laser photorefractive keratectomy in high myopia: a multicenter study. Arch Ophthalmol 110:935–943

    Article  CAS  PubMed  Google Scholar 

  7. Diakonis VF, Kankariya VP, Kymionis GD, Kounis G, Kontadakis G, Gkenos E, Grentzelos MA, Hajithanasis G, Yoo SH, Pallikaris IG (2014) Long term followup of photorefractive keratectomy with adjuvant use of mitomycin C. J Ophthalmol 2014:821920. doi:10.1155/2014/821920

    Article  PubMed Central  PubMed  Google Scholar 

  8. 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 95:335–339

    Article  Google Scholar 

  9. Shah R, Shah S, Sengupta S (2011) Results of small incision lenticule extraction: all-in-one femtosecond laser refractive surgery. J Cataract Refract Surg 37(1):127–137

    Article  Google Scholar 

  10. Ghadhfan F, Al-Rajhi A, Wagoner MD (2007) Laser in situ keratomileusis versus surface ablation: visual outcomes and complications. J Cataract Refract Surg 33(12):2041–2048

    Article  PubMed  Google Scholar 

  11. Hashemi H, Miraftab M, Ghaffari R, Asgari S (2015) Femtosecond-Assisted LASIK Versus PRK: comparison of 6-Month Visual Acuity and Quality Outcome for High Myopia. Eye Contact Lens. doi:10.1097/ICL.0000000000000216

    Article  PubMed  Google Scholar 

  12. 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 30:590–596

    Article  PubMed  Google Scholar 

  13. Kamiya K, Shimizu K, Igarashi A, Kobashi H (2014) Visual and refractive outcomes of femtosecond lenticule extraction and small-incision lenticule extraction for myopia. Am J Ophthalmol 157(1):128–134

    Article  Google Scholar 

  14. Yu M, Chen M, Wang B (2015) Comparison of Visual Quality After SMILE and LASEK for Mild to Moderate Myopia. J Refract Surg 31(12):795–800

    Article  PubMed  Google Scholar 

  15. Autrata R, Rehurek J (2003) Laser-assisted subepithelial keratectomy for myopia: two-year follow-up. J Cataract Refract Surg 29(4):661–668

    Article  PubMed  Google Scholar 

  16. Ghirlando A, Gambato C, Midena E (2007) LASEK and photorefractive keratectomy for myopia: clinical and confocal microscopy comparison. J Refract Surg 23(7):694–702

    PubMed  Google Scholar 

  17. Li SM1, Zhan S, Li SY, Peng XX, Hu J, Law HA, Wang NL (2016) Laser-assisted subepithelial keratectomy (LASEK) versus photorefractive keratectomy (PRK) for correction of myopia. Cochrane Database Syst Rev. 2016 Feb 22;2:CD009799. doi: 10.1002/14651858.CD009799.pub2

  18. Reinstein DZ, Carp GI, Archer TJ, Gobbe M (2014) Outcomes of small incision lenticule extraction (SMILE) in low myopia. J Refract Surg 30:812–818

    Article  Google Scholar 

  19. Ganesh S, Brar S, Relekar KJ (2016) Epithelial thickness profile changes following small incision refractive lenticule extraction (SMILE) for myopia and myopic astigmatism. J Refract Surg 32:473–482

    Article  PubMed  Google Scholar 

  20. Lazaridis A, Droutsas K, Sekundo W (2014) Topographic analysis of the centration of the treatment zone after SMILE for myopia and comparison to FS-LASIK: subjective versus objective alignment. J Refract Surg 30(10):680–686

    Article  PubMed  Google Scholar 

  21. Arbelaez MC, Vidal C, Mosquera SA (2010) Six-month clinical outcomes in LASIK for high myopia with aspheric aberration neutral ablations using the AMARIS laser system. J Emmetropia 1:111–116

    Google Scholar 

  22. Mok KH (2005) Lee VW (2015) Effect of optical zone ablation diameter on LASIK-induced higher order optical aberrations. J Refract Surg 21(2):141–143

    PubMed  Google Scholar 

  23. Kamiya K, Shimizu K, Igarashi A, Kobashi H, Komatsu M (2013) Comparison of visual acuity, higher-order aberrations and corneal asphericity after refractive lenticule extraction and wavefrontguided laser-assisted in situ keratomileusis for myopia. Br J Ophthalmol 97:968–975

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Nethradhama Superspeciality Eye Hospital, 256/14, Kanakapura Main Road, 7th Block, Jayanagar, Bengaluru, Karnataka, 560070, India

    Sri Ganesh, Sheetal Brar & Utsav Patel

Authors
  1. Sri Ganesh
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  2. Sheetal Brar
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  3. Utsav Patel
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Corresponding author

Correspondence to Sheetal Brar.

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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.

Additional information

Dr. Sri Ganesh is a consultant for Carl Zeiss Meditec, Germany and receives travel grants from the company. Dr. Sheetal Brar and Dr. Utsav Patel do not have any disclosures.

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Ganesh, S., Brar, S. & Patel, U. Comparison of ReLEx SMILE and PRK in terms of visual and refractive outcomes for the correction of low myopia. Int Ophthalmol 38, 1147–1154 (2018). https://doi.org/10.1007/s10792-017-0575-6

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  • DOI: https://doi.org/10.1007/s10792-017-0575-6

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