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Comparison of clinical outcomes between small incision lenticule extraction (SMILE) versus corneal wavefront guided transepithelial photorefractive keratectomy for eyes with > 2.5 diopters of refractive astigmatism

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Session Details

Session Title: Presented Poster Session: Keratorefractive Results I

Venue: Poster Village: Pod 2

First Author: : E.Kim SOUTH KOREA

Co Author(s): :    I. Jun   M. Choi   J. Choi   B. Ha   D. Kang   T. Kim

Abstract Details


To evaluate and compare the clinical outcomes, including visual acuity, refractive errors, and corneal aberrations, between small incision lenticule extraction (SMILE), and corneal wavefront guided transepithelial photorefractive keratectomy (trans-PRK) in eyes with more than 2.5 D of refractive astigmatism.


Yonsei University College of Medicine, and Eyereum Eye Clinic, Seoul, Korea


62 eyes of 49 patients, who had refractive astigmatism of more than 2.5 D were treated with either SMILE or trans-PRK (35 eyes in 29 patients, 27 eyes in 20 patients, respectively). Trans-PRK was performed using a 1050 Hz high-repetition excimer laser (SCHWIND Amaris), and SMILE was performed using a femtosecond laser (VisuMax). Safety, efficacy, predictability, and corneal aberrations were compared preoperatively and at 6 months postoperatively.


There were no differences in demographic characters between the two groups. At 6 months after surgery, the mean logMAR UDVA was comparable, at -0.12 ± 0.06 and -0.10 ± 0.07, in the SMILE and trans-PRK groups, respectively. Safety, efficacy, and predictability of refractive and visual outcomes were also comparable in both groups. Corneal total root mean square (RMS) higher-order aberrations (HOAs) were not significantly different between the two groups. However fewer spherical aberration was induced in the SMILE group than in the trans-PRK group. Conversely, more coma was induced in the SMILE group than the trans-PRK group.


SMILE and trans-PRK are safe and effective for correction of high astigmatism without difference in visual acuity and refractive outcomes. However, SMILE induced more corneal coma aberration and less corneal spherical aberration than trans-PRK.

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