Comparison of Visual Quality Parameters and Complications of the Small-Incision Lenticule Extraction Versus New Excimer Laser for Refractive Surgery
Purpose
To evaluate short-term visual quality parameters in the patients undergoing SMILE (Small Incision Lenticule Extraction) technique and to compare patients undergoing with new excimer laser for LASIK.
Methods
113 patients (237 eyes) underwent SMILE refractive surgery and 22 patients (43 eyes) underwent Excimer laser refractive surgery. The study was performed in accordance with the guidelines of the Declaration of Helsinki. All subjects were over 18 years of age and signed informed consent. All patients were treated according to the same surgical protocol. Flat, steep and mean keratometric radii, asphericity, 4th order spherical aberration, horizontal and vertical coma and trefoil were evaluated before surgery and one month after the procedure. Keratometric and aberrometric parameters were also correlated with refractive changes and visual acuity after surgery.
Results
The spherical equivalent after surgery was −0.22 ± 0.48 diopters for SMILE and −0.03 ± 0.19 diopters for excimer laser. 90.4% SMILE patients achieved UDCVA of at least 0.1 LogMAR (0.8 decimal) meanwhile all patients of excimer laser achieved the same UDCVA. Statistically significant differences were found for steep K, flat K, mean K, asphericity, spherical aberration and vertical coma in both groups to compare pre and postsurgery visit (p < 0.005). Six eyes developed intraoperative complications and nine eyes developed complications after surgery in SMILE group however any complication were found in excimer laser group.
Conclusion
Significant changes in the topographic parameters of the anterior corneal surface, spherical aberration and vertical coma were found after SMILE surgery and excimer laser surgery. In addition, the excimer laser tecnique shows less intra- and postoperative complication than SMILE technique surgery.