Comparison of Visual and Refractive Outcomes of Femto-LASIK Versus Flapless Small-Incision Femtosecond Lenticule Extraction

Ganesh, Sri

Comparison of Visual and Refractive Outcomes of Femto-LASIK Versus Flapless Small-Incision Femtosecond Lenticule Extraction

Saturday, April 26, 2014: 4:02 PM

Room 152 (Boston Convention and Exhibition Center)

Sri Ganesh, MBBS, MS, DNB, Nethradhama Super Speciality Eye Hospital, Bangalore, India

Narrative Responses:

Purpose
To compare visual and refractive outcomes, dry eye status, contrast sensitivity and higher order aberrations in patients who underwent SMILE with those of Femto LASIK.

Methods
In this prospective, randomised study, 100 eyes of 50 patients were randomised to 2 groups: 1) FEMTO LASIK group and 2) SMILE group. All patients satisfying the inclusion criteria underwent thorough pre-op evaluation including refraction, BCVA, contrast sensitivity(F.A.C.T), higher order aberrations(Itrace),dry eye evaluation (schirmer’s 1,2, TBUT and tear osmolarity).Post-op follow ups were done at day 1,15 and 3 months during which refraction, UCVA, contrast sensitivity, aberrometry and dry eye evaluation was done. Data was analysed using EPI 2010 (Epidemiological Information Package). Paired ‘t’ test was used to test the significance of differences between quantitative variables.

Results
50 eyes underwent LASIK with MRSE was -3.88±2.23D and 50 eyes underwent ReLEx SMILE with MRSE-5.47±2.21D. On 1^st postoperative day 96%patients attained 20/20 in SMILE group, as compared to 84%patients in LASIK group. Contrast sensitivity reduced postoperatively in both groups, however by 3months contrast was better in SMILE group (p<0.0001) for lower spatial frequencies (1.5, 3,6cycles/degree).Comparison of Schirmer’s 1, 2, TBUT and tear osmolarity between the 2 groups showed less dry eye in SMILE group than LASIK (p<0.0001). Higher order aberrations in SMILE group increased from 0.206±0.07µ to 0.267±0.07µ, while in LASIK group it increased from 0.266±0.114µ to 0.439±0.102µ (p<0.0001).

Conclusion
In our study we found better refractive results and contrast sensitivity at lower spatial frequencies, and reduced higher order aberrations and dry eyes in SMILE group as compared to Femto LASIK group. Thus SMILE, the flapless all Femtosecond Laser procedure is comparable or better than the currently popular Femto LASIK.