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Changes in vision-related quality of life and visual outcomes after small incision lenticule extraction and laser in situ keratomileusis

Poster Details

First Author: M.Ang SINGAPORE

Co Author(s):    E. Lamoureux   D. Tan   J. Mehta              

Abstract Details


To compare clinical and vision-related quality of life (VRQoL) outcomes between Small Incision Lenticule Extraction (SMILE) and laser in situ keratomileusis (LASIK).


A tertiary referral eye center in Singapore


Prospective, single centre, multi-surgeon study of consecutive patients who underwent SMILE or LASIK between 01.03.2010 and 01.11.2012. All patients underwent SMILE (172 eyes) or LASIK (matched cohort of 688 eyes) using the VisuMax (Carl Zeiss Meditec, Germany) 500kHz femtosecond laser system; with LASIK excimer ablation using Wavelight Allegretto 400Hz laser system (Alcon Laboratories Inc., USA). Our primary outcomes were 3-month post-operative refractive measures: Predictability, Efficacy, and Safety. Secondary outcomes measured were intraoperative experience, visual symptoms and VRQoL (validated Quality of Life Impact of Refractive Correction, QIRC questionnaire). Following Rasch analysis, overall QIRC trait was multidimensional and thus, two dimensions: ‘Functional’ and ‘Emotional’, were analysed separately.


At 3 months, SMILE was comparable to LASIK for the predictability (85.3% vs. 82.5%, ±0.5D attempted correction, P=0.453) and safety indices (1.13±0.19 vs. 1.07±0.16, P=0.158); while overall efficacy index was significantly higher in LASIK compared to SMILE at 3 months (0.97± 0.19 vs. 0.91 ± 0.21; P=0.002). Intra-operative experience and visual symptom scores (3-months) were comparable between SMILE and LASIK. There was no significant difference on the ‘Functional’ (66.7±15.7 vs. 55.3±22.2, P=0.064) and ‘Emotional’ (42.7±23.2 vs. 37.9±23.8, P=0.394) QIRC dimensions between LASIK and SMILE at 3 months.


We found relatively comparable predictability and safety profiles, as well as visual functioning and emotional well-being between SMILE and LASIK 3 months post-surgery.

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