Long-Term Visual Outcomes And Quality Of Life After Smile In Myopia

The evaluate the long-term visual outcomes and patient satisfaction after Small Incision lenticule extraction (SMILE) in myopia.

Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi.

Ambispective study included 115 eyes of 58 patients who underwent SMILE for correction of myopia and completed 5 years follow-up. Primary outcomes measures were uncorrected distance visual acuity (UDVA) and refractive predictability at 5 years. Secondary outcomes measures were quality of life ascertained using Quality of Life Impact of Refractive Correction (QIRC) questionnaire and safety.

The preoperative mean refractive spherical equivalent (MRSE) was 4.89±1.91 D. At 5 years follow-up, mean UDVA was 0.06 ± 0.13 and 82% of eyes were within 0.5D of intended correction. There was a mean regression of -0.18 ± 0.41 D over 5 years. Significant improvement was observed in the total QIRC score (53.09 ± 3.99 vs 41.58 ± 3.59, P < 0.001). No eyes lost 2 or more lines of corrected distance visual acuity. Incidence of retreatment was 2.6%. A significantly better efficacy (83.9% vs 57.1%, p value=0.003) and refractive predictability (87% vs 64%; p=0.006) was observed in the low-moderate myopic eyes (n=83) as compared to high myopic eyes (n=32).

SMILE is a safe and efficacious modality for treatment of myopia that provides excellent patient satisfaction and quality of life over long-term follow-up. Efficacy and predictability were better in the low-moderate myopic eyes as compared to high myopic eyes.