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Comparison of outcomes of wavefront-guided LASIK and small incision lenticule extraction in myopia

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Session Details

Session Title: SMILE, LASIK and Re-treatment

Session Date/Time: Monday 09/10/2017 | 14:30-16:00

Paper Time: 15:27

Venue: Room 2.1

First Author: : A.Shetty INDIA

Co Author(s): :    K. Vunnava   T. Grover   R. Shetty   A. Sinha-Roy           

Abstract Details


To compare efficacy and tomographic outcomes of Small Incision Lenticule Extraction (SMILE) and Wavefront guided LASIK in treatment of myopia and myopic astigmatism


Narayana Nethralaya, Bangalore, India


24 eyes of 12 patients who underwent SMILE and 16 eyes of 8 patients who underwent iDesign Wavefront-guided LASIK which were age, corneal thickness and refractive error matched were included. Central corneal thickness of less than 500 µm, estimated residual stromal bed thickness of less than 250 µm, corneal ectasia, Corrected Distance Visual Acuity (CDVA) less than 20/25, spherical equivalent (SEQ) of more than 10D and astigmatism more than -3D were excluded. Visual acuity, refraction, corneal topography using Pentacam HR and aberrometry using iTrace system were done pre-operatively and 1 month after surgery. Quantitative proteomics was done to tear samples.


No eye showed change in post-operative Uncorrected Distance Visual Acuity(UDVA) as compared to pre-operative CDVA in iDesign group and 92% in SMILE group.Post-Operative residual SEQ was less than ±0.5D in 94% of eyes in iDesign group and 75% in SMILE group.Higher order aberrations increased significantly post-operatively from 0.38 ± 0.02µm to 0.74±0.05µm in SMILE(p<0.001) and 0.42±0.03µm to 0.85±0.16µm in iDesign group.Spherical aberration increased post-operatively in both groups.Quantitative tear proteomic analysis showed raised inflammatory/anti-inflammatory proteins (lysozyme-c,S100A7/A8,galectin-3)in LASIK compared to SMILE.Extracellular matrix remodeling was higher in LASIK compared to SMILE.


Wavefront-guided LASIK showed better safety and accuracy as compared to SMILE. Efficacy of the surgery was comparable in both the groups. Counterintuitively, Wavefront-guided LASIK tended to induce slightly more total higher order aberrations including spherical aberrations than SMILE after the surgery. Wavefront-guided LASIK has been shown to induce higher inflammatory response than SMILE.

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