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Intraoperative experience and postoperative symptoms after small incision lenticule extraction versus laser in-situ keratomileusis in a randomized trial

Poster Details

First Author: M.Ang SINGAPORE

Co Author(s):    F. Mohd   H. Hla Myint   J. Mehta              

Abstract Details


To compare intraoperative experience and postoperative visual symptoms between Small Incision Lenticule Extraction (SMILE) and laser in situ keratomileusis (LASIK).


Single tertiary center, parallel group, single-masked, paired-eye design, non-inferiority, randomized controlled trial.


Each participant was randomized to receive SMILE or LASIK 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). We analyzed intra-operative experience and post-operative visual symptom scores 3 months after surgery using previously validated questionnaires.


Intra-operative experience was similar between SMILE and LASIK except surgical manipulation, which was significantly more uncomfortable during SMILE compared to LASIK (mean score 1.7�Â�±0.7 vs. 1.3�Â�±0.6, P=0.003). At 3 months after surgery, patients had similar symptom scores between eyes, except more dryness in the eye with LASIK compared to SMILE (2.6�Â�±0.6 vs. 2.0�Â�±0.6, P=0.004) but more haloes in the SMILE than LASIK eye (1.7�Â�±0.7 vs. 1.3�Â�±0.4, P =0.018).


Intra-operative experience was comparable between SMILE and LASIK performed in the same patient, while SMILE requires more surgical manipulation. Subjective dry eye symptoms were significantly higher in the eye with LASIK but haloes with SMILE, which requires further objective assessment to quantify and validate.

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