Refractive surgery: Is the new small-incision lenticule extraction (SMILE) technique equal to or better than the standard flap-and-ablation (FS-LASIK) technique for treating high-degree myopia?

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Resumé

Field:
Ophthalmology
Introduction:
Corneal laser surgery for myopia (nearsightedness) is one of the most performed surgical procedures today. FS-LASIK has been the dominating surgical technique for almost two decades, but a shift to the new less invasive SMILE technique might be underway. However the literature on SMILE is sparse, especially for high-degree myopia (six or more dioptres (D)).
We hypothesize that the accuracy, efficacy, stability and safety after SMILE is equal to or better than FS-LASIK up to three months post-operatively for high-degree myopia.
Methods:
Retrospective study of 1214 eyes treated with SMILE or FS-LASIK for high-degree myopia from 2011-2013 at the Department of Ophthalmology, Odense University Hospital, Denmark. Inclusion criteria: Best spectacle-corrected visual acuity (BSCVA) of 20/25 or better on Snellen chart, and no other ocular condition than high-degree myopia with or without astigmatism of maximum 3 D.
Results:
In total 799 eyes completed the three months follow-up examination, of which 545 eyes were treated with SMILE (mean pre-operative refraction -7.63±1.37 D, range: -6 to -14.75) and 254 with FS-LASIK (mean pre-operative refraction -7.94±1.72 D, range: -6 to -16.50)
Accuracy: After three months 80% of SMILE eyes and 71% of FS-LASIK (P=0.38) were within ±0.5 D of attempted post-operative refraction, whilst 96% of SMILE and 90% of FS-LASIK (P=0.54) were within ±1.0.
Efficacy: In 180 eyes the attempted post-operative refraction was 0 D. Of these, 69% of SMILE and 83% of FS-LASIK (P=0.55) had an uncorrected visual acuity of 20/25 or better one day post-operative. After three months, the results were 95% for SMILE and 81% for FS-LASIK (P=0.73).
Stability: In total 39% of SMILE and 51% of FS-LASIK (P=0.07) changed ≥0.5 D in refraction from one day to three months post-operatively.
Safety: One SMILE eye (0.2%) and no FS-LASIK eyes had lost two or more lines of BSCVA after three months.

Conclusion:
This study is the most extensive of its kind, and our results indicate that the accuracy, efficiency, stability and safety of SMILE is equal to or better than FS-LASIK for high-degree myopia up to 3 months post-operatively.
Keywords:
Refractive surgery, SMILE, FS-LASIK, high-degree myopia
OriginalsprogDansk
Publikationsdato2. jun. 2014
Antal sider2
StatusUdgivet - 2. jun. 2014

Emneord

  • Refractive surgery, femtosecond laser, lenticule extraction

Citer dette

@conference{6da8f2421b0e488cae6c5f1dfc534b67,
title = "Refractive surgery: Is the new small-incision lenticule extraction (SMILE) technique equal to or better than the standard flap-and-ablation (FS-LASIK) technique for treating high-degree myopia?",
abstract = "Field: Ophthalmology Introduction: Corneal laser surgery for myopia (nearsightedness) is one of the most performed surgical procedures today. FS-LASIK has been the dominating surgical technique for almost two decades, but a shift to the new less invasive SMILE technique might be underway. However the literature on SMILE is sparse, especially for high-degree myopia (six or more dioptres (D)). We hypothesize that the accuracy, efficacy, stability and safety after SMILE is equal to or better than FS-LASIK up to three months post-operatively for high-degree myopia. Methods: Retrospective study of 1214 eyes treated with SMILE or FS-LASIK for high-degree myopia from 2011-2013 at the Department of Ophthalmology, Odense University Hospital, Denmark. Inclusion criteria: Best spectacle-corrected visual acuity (BSCVA) of 20/25 or better on Snellen chart, and no other ocular condition than high-degree myopia with or without astigmatism of maximum 3 D. Results: In total 799 eyes completed the three months follow-up examination, of which 545 eyes were treated with SMILE (mean pre-operative refraction -7.63±1.37 D, range: -6 to -14.75) and 254 with FS-LASIK (mean pre-operative refraction -7.94±1.72 D, range: -6 to -16.50) Accuracy: After three months 80{\%} of SMILE eyes and 71{\%} of FS-LASIK (P=0.38) were within ±0.5 D of attempted post-operative refraction, whilst 96{\%} of SMILE and 90{\%} of FS-LASIK (P=0.54) were within ±1.0. Efficacy: In 180 eyes the attempted post-operative refraction was 0 D. Of these, 69{\%} of SMILE and 83{\%} of FS-LASIK (P=0.55) had an uncorrected visual acuity of 20/25 or better one day post-operative. After three months, the results were 95{\%} for SMILE and 81{\%} for FS-LASIK (P=0.73). Stability: In total 39{\%} of SMILE and 51{\%} of FS-LASIK (P=0.07) changed ≥0.5 D in refraction from one day to three months post-operatively. Safety: One SMILE eye (0.2{\%}) and no FS-LASIK eyes had lost two or more lines of BSCVA after three months. Conclusion: This study is the most extensive of its kind, and our results indicate that the accuracy, efficiency, stability and safety of SMILE is equal to or better than FS-LASIK for high-degree myopia up to 3 months post-operatively. Keywords: Refractive surgery, SMILE, FS-LASIK, high-degree myopia",
keywords = "Refractive surgery, femtosecond laser, lenticule extraction",
author = "Hansen, {Rasmus S{\o}gaard} and Niels Lyhne and Jakob Grauslund and Vestergaard, {Anders H{\o}jslet}",
year = "2014",
month = "6",
day = "2",
language = "Dansk",

}

TY - ABST

T1 - Refractive surgery: Is the new small-incision lenticule extraction (SMILE) technique equal to or better than the standard flap-and-ablation (FS-LASIK) technique for treating high-degree myopia?

AU - Hansen, Rasmus Søgaard

AU - Lyhne, Niels

AU - Grauslund, Jakob

AU - Vestergaard, Anders Højslet

PY - 2014/6/2

Y1 - 2014/6/2

N2 - Field: Ophthalmology Introduction: Corneal laser surgery for myopia (nearsightedness) is one of the most performed surgical procedures today. FS-LASIK has been the dominating surgical technique for almost two decades, but a shift to the new less invasive SMILE technique might be underway. However the literature on SMILE is sparse, especially for high-degree myopia (six or more dioptres (D)). We hypothesize that the accuracy, efficacy, stability and safety after SMILE is equal to or better than FS-LASIK up to three months post-operatively for high-degree myopia. Methods: Retrospective study of 1214 eyes treated with SMILE or FS-LASIK for high-degree myopia from 2011-2013 at the Department of Ophthalmology, Odense University Hospital, Denmark. Inclusion criteria: Best spectacle-corrected visual acuity (BSCVA) of 20/25 or better on Snellen chart, and no other ocular condition than high-degree myopia with or without astigmatism of maximum 3 D. Results: In total 799 eyes completed the three months follow-up examination, of which 545 eyes were treated with SMILE (mean pre-operative refraction -7.63±1.37 D, range: -6 to -14.75) and 254 with FS-LASIK (mean pre-operative refraction -7.94±1.72 D, range: -6 to -16.50) Accuracy: After three months 80% of SMILE eyes and 71% of FS-LASIK (P=0.38) were within ±0.5 D of attempted post-operative refraction, whilst 96% of SMILE and 90% of FS-LASIK (P=0.54) were within ±1.0. Efficacy: In 180 eyes the attempted post-operative refraction was 0 D. Of these, 69% of SMILE and 83% of FS-LASIK (P=0.55) had an uncorrected visual acuity of 20/25 or better one day post-operative. After three months, the results were 95% for SMILE and 81% for FS-LASIK (P=0.73). Stability: In total 39% of SMILE and 51% of FS-LASIK (P=0.07) changed ≥0.5 D in refraction from one day to three months post-operatively. Safety: One SMILE eye (0.2%) and no FS-LASIK eyes had lost two or more lines of BSCVA after three months. Conclusion: This study is the most extensive of its kind, and our results indicate that the accuracy, efficiency, stability and safety of SMILE is equal to or better than FS-LASIK for high-degree myopia up to 3 months post-operatively. Keywords: Refractive surgery, SMILE, FS-LASIK, high-degree myopia

AB - Field: Ophthalmology Introduction: Corneal laser surgery for myopia (nearsightedness) is one of the most performed surgical procedures today. FS-LASIK has been the dominating surgical technique for almost two decades, but a shift to the new less invasive SMILE technique might be underway. However the literature on SMILE is sparse, especially for high-degree myopia (six or more dioptres (D)). We hypothesize that the accuracy, efficacy, stability and safety after SMILE is equal to or better than FS-LASIK up to three months post-operatively for high-degree myopia. Methods: Retrospective study of 1214 eyes treated with SMILE or FS-LASIK for high-degree myopia from 2011-2013 at the Department of Ophthalmology, Odense University Hospital, Denmark. Inclusion criteria: Best spectacle-corrected visual acuity (BSCVA) of 20/25 or better on Snellen chart, and no other ocular condition than high-degree myopia with or without astigmatism of maximum 3 D. Results: In total 799 eyes completed the three months follow-up examination, of which 545 eyes were treated with SMILE (mean pre-operative refraction -7.63±1.37 D, range: -6 to -14.75) and 254 with FS-LASIK (mean pre-operative refraction -7.94±1.72 D, range: -6 to -16.50) Accuracy: After three months 80% of SMILE eyes and 71% of FS-LASIK (P=0.38) were within ±0.5 D of attempted post-operative refraction, whilst 96% of SMILE and 90% of FS-LASIK (P=0.54) were within ±1.0. Efficacy: In 180 eyes the attempted post-operative refraction was 0 D. Of these, 69% of SMILE and 83% of FS-LASIK (P=0.55) had an uncorrected visual acuity of 20/25 or better one day post-operative. After three months, the results were 95% for SMILE and 81% for FS-LASIK (P=0.73). Stability: In total 39% of SMILE and 51% of FS-LASIK (P=0.07) changed ≥0.5 D in refraction from one day to three months post-operatively. Safety: One SMILE eye (0.2%) and no FS-LASIK eyes had lost two or more lines of BSCVA after three months. Conclusion: This study is the most extensive of its kind, and our results indicate that the accuracy, efficiency, stability and safety of SMILE is equal to or better than FS-LASIK for high-degree myopia up to 3 months post-operatively. Keywords: Refractive surgery, SMILE, FS-LASIK, high-degree myopia

KW - Refractive surgery, femtosecond laser, lenticule extraction

M3 - Konferenceabstrakt til konference

ER -