Outcome comparison of 2,000 small incision lenticle extractions and 1,900 femtolaser-assisted eximer ablations

Session Details

Session Title: Interactive Free Paper Session: Femtosecond Small Lenticule Extraction I

Session Date/Time: Monday 07/09/2015 | 09:00-11:00

Paper Time: 09:06

Venue: Room 19

First Author: : P.Oksman FINLAND

Co Author(s): :    H. Koskela   A. Viljanen                 

Abstract Details

Purpose:

This study compares stability, refractive outcome and visual outcome of small incision lenticle extraction (SMILE) and femtolaser-assisted LASIK (fLASIK).

Setting:

In this retrospective two-center study, total of 1991 subjects with mean age of 34 years, 59% females, were treated. Baseline spherical equivalent refraction error (SEQ) was selected from -0.75 to -10 diopter. 1981 eyes of SMILE (mean SEQ -4.3 D) and 1895 eyes of fLASIK (mean SEQ -4.0) were compared. Medilaser LCC, Tampere, Finland

Methods:

The lasers were VisuMax (Carl Zeiss, Germany) and Amaris (Schwind, Germany) in both clinics. Parameters are attended refractive change versus achieved refractive change and baseline BCVA compared to UCVA and BCVA after laser. Linear mixed model was used in statistical analysis. Subgroups of SEQ -0.75 - -3, -3.01 - -6 and -6.01 - -10 diopter were analyzed also. Follow-up visits were 1 and 6 months.

Results:

SMILE and fLASIK were equally stable from 1 month to 6 months. The attended vs achieved refractive change was equal in 1 month and 6 months, p=ns for both. In the subgroup of SEQ -0.75D to -3D, SMILE was more accurate in 1 and 6 months, p less than 0.05 for both. The baseline BCVA was better in fLASIK subgroups. UCVA in 1 and 6 months was better after fLASIK in the subgroup of SEQ -0.75D to - 3D. The change of BCVA was 1 to 2 ETDRS better after fLASIK in all of the subgroups in both follow-up visits, p less than 0.05 for all.

Conclusions:

SMILE and fLASIK are equally stable. In this study, refractive outcome of SMILE was statistically better compared to fLASIK in small refractive errors; on the other hand, UCVA was statistically better after fLASIK in small refractive errors. Refractive outcome and UCVA was equal in moderate and high refractive errors. BCVA was 1 to 2 ETDRS letters in favor of fLASIK in addition to baseline BCVA, which was better in fLASIK group. Observed clinical differences were small.

Financial Interest:

NONE