Small Incision Lenticule Extraction (SMILE) vs. Femtosecond Laser in Situ Keratomileusis (FS-LASIK) for treatment of myopia

Rasmus Søgaard Hansen, Birgitte Justesen, Niels Lyhne, Jakob Grauslund, Anders Højslet Vestergaard

Publikation: Konferencebidrag uden forlag/tidsskriftPosterForskningpeer review

Resumé

Purpose:LASIK has been the dominating corneal refractive procedure for almost two decades, but the new flap-free SMILE procedure has shown promising results.
The aim of this study was to evaluate and compare refractive predictability, uncorrected and corrected distance visual acuity (UDVA and CDVA), and safety at 1 day, 1 week and 3 months after SMILE and FS-LASIK for all degrees of myopia, but in particular high myopia.
Setting:
Department of Ophthalmology, Odense University Hospital, Odense, Denmark
Methods: Retrospective study of results after SMILE and FS-LASIK for all degrees of myopia.
All treatments were performed at the Department of Ophthalmology, Odense University Hospital from April 2011 to December 2013.
Inclusion criteria: CDVA ≤ 0.10 (logMAR) before surgery and no other ocular conditions than myopia with or without astigmatism of maximum 3 D. Exclusion criteria: Eyes having undergone re-treatment.
The SMILE treatments and FS-LASIK flaps were performed with a VisuMax® femtosecond laser (Carl Zeiss-Meditec, Jena, Germany). The FS-LASIK photoablation was performed with a MEL-80 flying-spot excimer laser with eye-tracker (Carl Zeiss-Meditec, Jena, Germany).
In SMILE, lenticule diameter ranged from 6.00 to 6.60 mm, whereas the FS-LASIK optical zone ranged from 6.00 to 6.25 mm. Maximum attempted spherical correction was -10.00 D in both procedures.
Clinical examinations were performed pre-operatively and at 1 day, 1 week and 3 months post-operatively.
For analysis, high myopia was defined as a spherical equivalent (SE) refraction of -6.00 D or worse.
Results: In total, 612 SMILE eyes and 306 FS-LASIK eyes were included and analyzed.
Before surgery, 88% of SMILE eyes and 85% of FS-LASIK eyes were highly myopic and SE refraction averaged -7.26±1.75 D (range: -0.88 to -14.75) for SMILE and -7.16±2.38 D (range:
-0.88 to -16.50) for FS-LASIK (P=0.42).
After 3 months, 81% of SMILE eyes and 76% of FS-LASIK eyes (P=0.56) were within ±0.5 D of intended refraction, whilst 96% of SMILE eyes and 91% of FS-LASIK eyes (P=0.61) were within ±1.0 D. The mean difference between attempted and achieved SE refraction 3 months after surgery was 0.15±0.49 D in SMILE eyes and -0.13±0.60 D in LASIK eyes (P<0.05).

Emmetropia was the target refraction in 233 eyes; At day 1 after surgery, 33% of SMILE eyes and 48% of FS-LASIK eyes (P=0.24) had an UDVA ≤ 0.00 (logMAR). After 3 months, the results were 86% of SMILE eyes and 68% of FS-LASIK eyes (P=0.48).
After 3 months, 5 SMILE eyes (0.8%) and no FS-LASIK eyes (P=0.18) had lost 2 or more lines of CDVA. All eyes had CDVA ≤ 0.15 (logMAR) 3 months after surgery.
Conclusion: Both FS-LASIK and SMILE were efficient in treating all degrees of myopia and low degrees of astigmatism, and results were overall comparable 3 months after surgery.
Financial disclosures:
None.
OriginalsprogDansk
Publikationsdato13. jun. 2014
Antal sider2
StatusUdgivet - 13. jun. 2014
BegivenhedESCRS - London, Storbritannien
Varighed: 13. sep. 201417. sep. 2014

Konference

KonferenceESCRS
LandStorbritannien
ByLondon
Periode13/09/201417/09/2014

Emneord

  • Refractive surgery, femtosecond laser, lenticule extraction

Citer dette

@conference{eac12e1fdf7048f4ab3a54b9db71f882,
title = "Small Incision Lenticule Extraction (SMILE) vs. Femtosecond Laser in Situ Keratomileusis (FS-LASIK) for treatment of myopia",
abstract = "Purpose:LASIK has been the dominating corneal refractive procedure for almost two decades, but the new flap-free SMILE procedure has shown promising results. The aim of this study was to evaluate and compare refractive predictability, uncorrected and corrected distance visual acuity (UDVA and CDVA), and safety at 1 day, 1 week and 3 months after SMILE and FS-LASIK for all degrees of myopia, but in particular high myopia. Setting: Department of Ophthalmology, Odense University Hospital, Odense, Denmark Methods: Retrospective study of results after SMILE and FS-LASIK for all degrees of myopia. All treatments were performed at the Department of Ophthalmology, Odense University Hospital from April 2011 to December 2013. Inclusion criteria: CDVA ≤ 0.10 (logMAR) before surgery and no other ocular conditions than myopia with or without astigmatism of maximum 3 D. Exclusion criteria: Eyes having undergone re-treatment. The SMILE treatments and FS-LASIK flaps were performed with a VisuMax{\circledR} femtosecond laser (Carl Zeiss-Meditec, Jena, Germany). The FS-LASIK photoablation was performed with a MEL-80 flying-spot excimer laser with eye-tracker (Carl Zeiss-Meditec, Jena, Germany). In SMILE, lenticule diameter ranged from 6.00 to 6.60 mm, whereas the FS-LASIK optical zone ranged from 6.00 to 6.25 mm. Maximum attempted spherical correction was -10.00 D in both procedures. Clinical examinations were performed pre-operatively and at 1 day, 1 week and 3 months post-operatively. For analysis, high myopia was defined as a spherical equivalent (SE) refraction of -6.00 D or worse. Results: In total, 612 SMILE eyes and 306 FS-LASIK eyes were included and analyzed. Before surgery, 88{\%} of SMILE eyes and 85{\%} of FS-LASIK eyes were highly myopic and SE refraction averaged -7.26±1.75 D (range: -0.88 to -14.75) for SMILE and -7.16±2.38 D (range: -0.88 to -16.50) for FS-LASIK (P=0.42). After 3 months, 81{\%} of SMILE eyes and 76{\%} of FS-LASIK eyes (P=0.56) were within ±0.5 D of intended refraction, whilst 96{\%} of SMILE eyes and 91{\%} of FS-LASIK eyes (P=0.61) were within ±1.0 D. The mean difference between attempted and achieved SE refraction 3 months after surgery was 0.15±0.49 D in SMILE eyes and -0.13±0.60 D in LASIK eyes (P<0.05). Emmetropia was the target refraction in 233 eyes; At day 1 after surgery, 33{\%} of SMILE eyes and 48{\%} of FS-LASIK eyes (P=0.24) had an UDVA ≤ 0.00 (logMAR). After 3 months, the results were 86{\%} of SMILE eyes and 68{\%} of FS-LASIK eyes (P=0.48). After 3 months, 5 SMILE eyes (0.8{\%}) and no FS-LASIK eyes (P=0.18) had lost 2 or more lines of CDVA. All eyes had CDVA ≤ 0.15 (logMAR) 3 months after surgery. Conclusion: Both FS-LASIK and SMILE were efficient in treating all degrees of myopia and low degrees of astigmatism, and results were overall comparable 3 months after surgery. Financial disclosures: None.",
keywords = "Refractive surgery, femtosecond laser, lenticule extraction",
author = "Hansen, {Rasmus S{\o}gaard} and Birgitte Justesen and Niels Lyhne and Jakob Grauslund and Vestergaard, {Anders H{\o}jslet}",
year = "2014",
month = "6",
day = "13",
language = "Dansk",
note = "ESCRS ; Conference date: 13-09-2014 Through 17-09-2014",

}

Small Incision Lenticule Extraction (SMILE) vs. Femtosecond Laser in Situ Keratomileusis (FS-LASIK) for treatment of myopia. / Hansen, Rasmus Søgaard; Justesen, Birgitte; Lyhne, Niels; Grauslund, Jakob; Vestergaard, Anders Højslet.

2014. Poster session præsenteret på ESCRS, London, Storbritannien.

Publikation: Konferencebidrag uden forlag/tidsskriftPosterForskningpeer review

TY - CONF

T1 - Small Incision Lenticule Extraction (SMILE) vs. Femtosecond Laser in Situ Keratomileusis (FS-LASIK) for treatment of myopia

AU - Hansen, Rasmus Søgaard

AU - Justesen, Birgitte

AU - Lyhne, Niels

AU - Grauslund, Jakob

AU - Vestergaard, Anders Højslet

PY - 2014/6/13

Y1 - 2014/6/13

N2 - Purpose:LASIK has been the dominating corneal refractive procedure for almost two decades, but the new flap-free SMILE procedure has shown promising results. The aim of this study was to evaluate and compare refractive predictability, uncorrected and corrected distance visual acuity (UDVA and CDVA), and safety at 1 day, 1 week and 3 months after SMILE and FS-LASIK for all degrees of myopia, but in particular high myopia. Setting: Department of Ophthalmology, Odense University Hospital, Odense, Denmark Methods: Retrospective study of results after SMILE and FS-LASIK for all degrees of myopia. All treatments were performed at the Department of Ophthalmology, Odense University Hospital from April 2011 to December 2013. Inclusion criteria: CDVA ≤ 0.10 (logMAR) before surgery and no other ocular conditions than myopia with or without astigmatism of maximum 3 D. Exclusion criteria: Eyes having undergone re-treatment. The SMILE treatments and FS-LASIK flaps were performed with a VisuMax® femtosecond laser (Carl Zeiss-Meditec, Jena, Germany). The FS-LASIK photoablation was performed with a MEL-80 flying-spot excimer laser with eye-tracker (Carl Zeiss-Meditec, Jena, Germany). In SMILE, lenticule diameter ranged from 6.00 to 6.60 mm, whereas the FS-LASIK optical zone ranged from 6.00 to 6.25 mm. Maximum attempted spherical correction was -10.00 D in both procedures. Clinical examinations were performed pre-operatively and at 1 day, 1 week and 3 months post-operatively. For analysis, high myopia was defined as a spherical equivalent (SE) refraction of -6.00 D or worse. Results: In total, 612 SMILE eyes and 306 FS-LASIK eyes were included and analyzed. Before surgery, 88% of SMILE eyes and 85% of FS-LASIK eyes were highly myopic and SE refraction averaged -7.26±1.75 D (range: -0.88 to -14.75) for SMILE and -7.16±2.38 D (range: -0.88 to -16.50) for FS-LASIK (P=0.42). After 3 months, 81% of SMILE eyes and 76% of FS-LASIK eyes (P=0.56) were within ±0.5 D of intended refraction, whilst 96% of SMILE eyes and 91% of FS-LASIK eyes (P=0.61) were within ±1.0 D. The mean difference between attempted and achieved SE refraction 3 months after surgery was 0.15±0.49 D in SMILE eyes and -0.13±0.60 D in LASIK eyes (P<0.05). Emmetropia was the target refraction in 233 eyes; At day 1 after surgery, 33% of SMILE eyes and 48% of FS-LASIK eyes (P=0.24) had an UDVA ≤ 0.00 (logMAR). After 3 months, the results were 86% of SMILE eyes and 68% of FS-LASIK eyes (P=0.48). After 3 months, 5 SMILE eyes (0.8%) and no FS-LASIK eyes (P=0.18) had lost 2 or more lines of CDVA. All eyes had CDVA ≤ 0.15 (logMAR) 3 months after surgery. Conclusion: Both FS-LASIK and SMILE were efficient in treating all degrees of myopia and low degrees of astigmatism, and results were overall comparable 3 months after surgery. Financial disclosures: None.

AB - Purpose:LASIK has been the dominating corneal refractive procedure for almost two decades, but the new flap-free SMILE procedure has shown promising results. The aim of this study was to evaluate and compare refractive predictability, uncorrected and corrected distance visual acuity (UDVA and CDVA), and safety at 1 day, 1 week and 3 months after SMILE and FS-LASIK for all degrees of myopia, but in particular high myopia. Setting: Department of Ophthalmology, Odense University Hospital, Odense, Denmark Methods: Retrospective study of results after SMILE and FS-LASIK for all degrees of myopia. All treatments were performed at the Department of Ophthalmology, Odense University Hospital from April 2011 to December 2013. Inclusion criteria: CDVA ≤ 0.10 (logMAR) before surgery and no other ocular conditions than myopia with or without astigmatism of maximum 3 D. Exclusion criteria: Eyes having undergone re-treatment. The SMILE treatments and FS-LASIK flaps were performed with a VisuMax® femtosecond laser (Carl Zeiss-Meditec, Jena, Germany). The FS-LASIK photoablation was performed with a MEL-80 flying-spot excimer laser with eye-tracker (Carl Zeiss-Meditec, Jena, Germany). In SMILE, lenticule diameter ranged from 6.00 to 6.60 mm, whereas the FS-LASIK optical zone ranged from 6.00 to 6.25 mm. Maximum attempted spherical correction was -10.00 D in both procedures. Clinical examinations were performed pre-operatively and at 1 day, 1 week and 3 months post-operatively. For analysis, high myopia was defined as a spherical equivalent (SE) refraction of -6.00 D or worse. Results: In total, 612 SMILE eyes and 306 FS-LASIK eyes were included and analyzed. Before surgery, 88% of SMILE eyes and 85% of FS-LASIK eyes were highly myopic and SE refraction averaged -7.26±1.75 D (range: -0.88 to -14.75) for SMILE and -7.16±2.38 D (range: -0.88 to -16.50) for FS-LASIK (P=0.42). After 3 months, 81% of SMILE eyes and 76% of FS-LASIK eyes (P=0.56) were within ±0.5 D of intended refraction, whilst 96% of SMILE eyes and 91% of FS-LASIK eyes (P=0.61) were within ±1.0 D. The mean difference between attempted and achieved SE refraction 3 months after surgery was 0.15±0.49 D in SMILE eyes and -0.13±0.60 D in LASIK eyes (P<0.05). Emmetropia was the target refraction in 233 eyes; At day 1 after surgery, 33% of SMILE eyes and 48% of FS-LASIK eyes (P=0.24) had an UDVA ≤ 0.00 (logMAR). After 3 months, the results were 86% of SMILE eyes and 68% of FS-LASIK eyes (P=0.48). After 3 months, 5 SMILE eyes (0.8%) and no FS-LASIK eyes (P=0.18) had lost 2 or more lines of CDVA. All eyes had CDVA ≤ 0.15 (logMAR) 3 months after surgery. Conclusion: Both FS-LASIK and SMILE were efficient in treating all degrees of myopia and low degrees of astigmatism, and results were overall comparable 3 months after surgery. Financial disclosures: None.

KW - Refractive surgery, femtosecond laser, lenticule extraction

M3 - Poster

ER -