Surgical Outcomes of Small Incision Lenticule Extraction and Laser in Situ Keratomileusis at Postoperative One Year

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  • Small incision lenticle extractionとlaser in situ keratomileusis術後1年の経過報告

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[Purpose] To examine and compare the outcomes of small incision lenticule extraction (SMILE) and laser in situ keratomileusis (LASIK) at postoperative one year.<br>[Subjects and Methods] Subjects were 30 eyes of 30 patients with preoperative refractions between -3.00 D and -4.00 D who underwent SMILE between February 2008 and March 2013. To be compared with the SMILE subjects, 30 eyes of 30 patients with the equivalent preoperative refraction who received LASIK during the same period of time at our clinic were randomly selected as the subjects for the LASIK group. Age, preoperative sphere and cylinder of subjective manifest refraction were 30.7±4.3 years, -3.59±1.00 D, and -0.66±0.65 D for the SMILE subjects, and 31.1±4.4 years, -3.76±0.58 D, and -0.68±0.61 D for the LASIK subjects, respectively. The uncorrected, corrected decimal visual acuity (VA), sphere and cylinder of manifest refraction, safety index (postoperative corrected VA divided by preoperative corrected VA), and efficacy index (postoperative uncorrected VA divided by preoperative corrected VA) were compared between both groups. Statistical analysis used the Mann-Whitney test and a significance level was set at 5%. For surgery, SMILE used the VisuMax femtosecond laser (Carl Zeiss Meditec) and LASIK used the MEL80 excimer laser (Carl Zeiss Meditec) and the VisuMax femtosecond laser for flap creation.<br>[Results] The respective uncorrected and corrected VAs at postoperative 1 year were 1.49 and 1.72 for the SMILE group and 1.54 and 1.7 for the LASIK group. The postoperative 1 year sphere and cylinder of manifest refraction were 0.18±0.39 D and -0.33±0.28 D for the SMILE group and 0.31±0.38 D and -0.22±0.25 D for the LASIK group. The average safety and efficacy indices were 1.15±0.17 and 1.04±0.25 for the SMILE group and 1.12±0.2 and 1.03±0.24 for the LASIK group. No significant difference in any of the outcome measures was observed between both groups.<br>[Conclusion] Regarding safety and precision in refractive correction, the outcomes of SMILE surgery at postoperative one year were comparable with those of LASIK. However, the long-term safety and efficacy of SMILE surgery will need to be further evaluated.

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