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Short-term outcomes of small-incision lenticule extraction (SMILE) for low, medium, and high myopia

Abstract

Purpose

To determine the safety, efficacy, and predictability of small-incision lenticule extraction at 6-month follow-up, depending on the level of the myopic refractive error. The surgeries were performed by a surgeon new to this technique.

Methods

Seventy-one subjects with a mean age of 31.86 ± 5.57 years were included in this retrospective observational study. Subjects were divided into 3 groups depending on the preoperative spherical equivalent (SE): low group from -1.00 D to -3.00 D, medium from -3.25 D to -5.00 D, and high from -5.25 D to -7.00 D. Manifest refraction, corrected distance visual acuity (CDVA), and uncorrected distance visual acuity (UDVA) were measured before surgery and at 6 months after the treatment.

Results

In total, 1.4% of the eyes lost 1 line of CDVA after the procedure, whereas 95.8% remained unchanged and 2.8% gained 1 line. A significant undercorrection (p = 0.031) was found in the high myopia group (median -0.50 D), whereas the low and medium groups remained near to emmetropia. In terms of efficacy, no statistically significant intergroup differences for postoperative UDVA (p = 0.282) were found. The vector analysis also showed undercorrection of the preoperative cylinder, even though the standard deviations decreased from 0.9 D in the x axis and 0.7 D in the y axis to 0.24 D and 0.27 D, respectively.

Conclusions

Small-incision lenticule extraction might be a safe, effective, and predictable procedure even for inexperienced surgeons. No differences in efficacy were found among myopia levels even though undercorrections were found for SE and cylinder in high myopia.

Eur J Ophthalmol 2017; 27(2): 153 - 159

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/ejo.5000849

Authors

Joaquín Fernández, Almudena Valero, Javier Martínez, David P. Piñero, Manuel Rodríguez-Vallejo

Article History

Disclosures

Financial support: Supported by the Sociedad Española de Cirugía Implanto Refractiva (SECOIR) PUBLIbeCA 2014 grant.
Conflict of interest: Dr. Fernández is a consultant for Carl Zeiss Meditec AG (Jena, Germany). The remaining authors have no financial or proprietary interest in the materials presented herein.

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Authors

Affiliations

  •  Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, Almería - Spain
  •  Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante - Spain
  •  Department of Ophthalmology (OFTALMAR), Vithas Medimar International Hospital, Alicante - Spain

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