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Three month outcomes including contrast sensitivity of moderate and high myopic small incision lenticule extraction (SMILE) compared to matched LASIK controls

Session Details

Session Title: Refractive Femtosecond

Session Date/Time: Sunday 06/10/2013 | 17:00-18:30

Paper Time: 18:06

Venue: Elicium 2 (First Floor)

First Author: : G.Carp UK

Co Author(s): :    D. Reinstein   T. Archer   M. Gobbe        

Abstract Details

Purpose:

To report the three month visual outcomes of small incision lenticule extraction (SMILE) for myopic eyes using the VisuMax femtosecond laser compared to a control group of LASIK eyes matched for sphere, cylinder, CDVA and age.

Setting:

London Vision Clinic, London, UK

Methods:

This was a retrospective analysis of 96 consecutive myopic SMILE procedures performed using the VisuMax femtosecond laser at the London Vision Clinic. Inclusion criteria were preoperative SEQ up to -12.25 D, cylinder up to 2.50 D and CDVA 20/20 or better. Follow-up was three months. Each eye was matched to three LASIK eyes (i.e. 174 eyes in total) for sphere within ±0.25 D, cylinder within ±0.25 D, age within ±5 years and CDVA. Outcomes analysis was performed according to the Waring Standard Graphs. Eyes not intended for plano were excluded from the UDVA analysis. Analysis was done for moderate myopia (up to -8.00 D, 58 eyes) and high myopia (38 eyes).

Results:

Moderate myopia: mean attempted SEQ was -4.94±1.48D and mean cylinder was 0.54±0.33D (max 1.50D). Median age was 33 years (range: 19-60 years). Postoperative SEQ was -0.02±0.38D (86% ±0.50D) for SMILE and -0.11±0.39D (83% ±0.50D) for LASIK. UDVA was 20/20 or better in 96% for SMILE and 93% for LASIK. One line CDVA was lost in 3% for SMILE and 6% for LASIK. No eyes lost two lines CDVA. Contrast sensitivity was slightly increased at 3, 6, 12 and 18 cpd for SMILE and at 3, 12 and 18 cpd for LASIK (p<0.01). High myopia: mean attempted SEQ was -9.67±1.10D and mean cylinder was 0.76±0.62D (max 2.50D). Median age was 31 years (range: 19-58 years). Postoperative SEQ was -0.18±0.45D (74% ±0.50D) for SMILE and -0.35±0.64D (54% ±0.50D) for LASIK. UDVA was 20/20 or better in 78% for SMILE and 73% for LASIK. One line CDVA was lost in 8% for SMILE and 1% for LASIK. No eyes lost two lines CDVA. Contrast sensitivity was unchanged at all frequencies for SMILE and at 6, 12 and 18 cpd for LASIK, but slightly decreased at 3 cpd (p<0.01).

Conclusions:

Visual outcomes achieved in this consecutive series of myopic SMILE procedures using the VisuMax femtosecond laser were comparable to a matched LASIK control group. Accuracy was better for SMILE in myopia above -8.00 D.

Financial Interest:

... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented