Correcting myopia with ReLEx SMILE and TransPRK: is it possible to compare?

Session Details

Session Title: LASIK vs SMILE

Session Date/Time: Monday 24/09/2018 | 16:30-18:00

Paper Time: 16:48

Venue: Room A3, Podium 2

First Author: : E.Eskina RUSSIA

Co Author(s): :    V. Parshina   K. Davtian   A. Davydova              

Abstract Details

Purpose:

Nowadays there are two modern approaches in corneal laser refractive surgery available, which minimally affect biomechanics of the cornea: Single Step TransPRK in combination with SmartSurfACE technology and femtosecond based ReLEx SMILE. It is also supposed that SMILE surgery protects the corneal nerve plexus thus preserving the tearfilm. Choosing the optimal approach to correct ametropia is difficult, especially when two fundamentally different approaches are compared. We could not find any publications, which were comparing TransPRK and ReLEx SMILE. We decided to compare these two approaches in terms of efficiency, safety and predictability, vision recovery, HOA and tearfilm production.

Setting:

Laser surgery clinic SPHERE, Moscow, Russia

Methods:

Our study included 160 myopic patients 29±6,7y.o. 50 underwent Transepithelial PRK (99 eyes) and 110 ReLEx SMILE (219 eyes). Mean preoperative spherical equivalent (SE) was −4.25±1.74D (from -1,4 to -8,5D) and −5.11±2.66D respectively (from -1,25 to -11D) (p>0,05) with astigmatism up to 3,5 D in both groups. Refractive results, predictability, safety and efficacy were evaluated during 3 and 6-month follow-up period. We analyzed uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BCVA), mean spherical equivalent (SE), high-order aberrations (HOAs), tear production – Schirmer test (ST) and the accidence of epitheliopathy in both groups.

Results:

UDVA was higher in TransPRK than in ReLExSmile-group (1,04±0,13 and 0,94±0,14 at 6 months respectively, p<0.05). SE closer to target after TransPRK than after ReLExSmile (0,06±0,18D and -0,19±0,42D 6 months postop, p<0.05). 3,2% of eyes in SMILE group lost one and 1,4% two lines BCVA, no loss BCVA after TransPRK. Coma and Spherical aberration postop were higher in SMILE group (p<0,05). The accidence of epitheliopathy 1 month postop after SMILE was 4,8% and 10,2% after TransPRK. ST in TransPRK group was 19,9±10,3 mm and in SMILE group 14,3±10,9 mm, p<0,05

Conclusions:

TransPRK and ReLexSMILE both provide comparable results for patients. The VA recovery is faster after ReLexSMILE: UCVA at 1-st day postop in SMILE group 0,76±0,24D and 0,53±0,22D in TransPRK-group at 1 week postop. But at 3 and 6 months postop the UDVA and predictability are slightly better in TransPRK group. TransPRK with SmartSurfACE technology induces lower HOA than ReLExSmile. It could explain better postop BCVA in TransPRK group. However, the quality of corneal epithelium early postop is better after ReLexSMILE. We assume that both technologies are effective in correction myopia up to 10D.

Financial Disclosure:

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