Clinical Experience of Small-Incision Lenticule Extraction in More Than 3500 Eyes
To report clinical experience including visual outcome and complications of small incision lenticule extraction to correct myopia and myopic astigmatism more than 3500 eyes.
3544 eyes of 1778 patients underwent small incision lenticule extraction (SMILE) to correct their myopia or myopic astigmatism and were followed up more than 3 months. Mean age of the patients was 30.1 years old and the range of corneal thickness was 470 ~ 643 microns measured with Visante anterior OCT. We made 6.0 ~ 6.5 mm diameter lenticule and it was extracted through 2.0 ~ 4.0 mm side cut incision by using forceps. Postoperative corneal thickness including 100 ~ 120 micron cap thickness was at least 380 microns. We checked uncorrected distance visual acuity (UDVA), manifest refraction and ocular condition after 1 day, 1 week, and 3 months postoperatively.
Preoperative mean spherical equivalent was -5.55±2.22D (-1.0 ~ -10.00D) and preoperative mean astigmatism was 1.01±0.76D (0 ~ 4.25D). Postoperative mean UDVA was 1.03±0.23 (POD 1day), 1.12±0.22(POD 1week), 1.15±0.25(POD 3months). Postop. mean spherical equivalent was -0.56±0.63D, postop. mean astigmatism was -0.52±0.37D. 56% had a refractive outcome between ±0.5D of attempted refraction and 82% between ±1.0D. Suction loss during the surgery occurred in 12 eyes and all eyes could be successfully operated after redocking the treatment package (TP). 15 eyes were retreated with surface ablation technique due to regression or under correction. The incidence of diffuse lamellar keratitis was very low but central toxic keratoplasty was found in 2 eyes. Large extension of side cut incision happened due to intraoperative poor cooperation.
Small incision lenticule extraction is effective and safe vision correction procedure in treating myopia and myopic astigmatism. Visual recovery was quick and there was no vision–threatening postoperative complication.