Comparison Of Refractive Outcomes In Femtosecond-Assisted Lasik And Small-Incision Lenticule Extraction For Myopia And Myopic Astigmatism, And Vector Analysis Of Myopic Astigmatism Correction.
Published 2023 - 41st Congress of the ESCRS
Reference: PP27.09 | Type: Free paper | DOI: 10.82333/pss6-ya61
Authors: Magdalena Vokrojova* 1 , Lenka Havlíčková 2 , Martin Filipec 2 , Zuzuna Hlinomazova 2 , Silvie Zapletalová 2
1eye clinic,European Eye clinic Lexum,Prague,Czech Republic;Ophtalmology Clinic,3.rd medical faculty UK,Prague,Czech Republic, 2eye clinic,European Eye clinic Lexum,Prague,Czech Republic
Purpose
To compare refractive outcomes in femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) and small-incision lenticule extraction (SMILE) for myopia and myopic astigmatism, and to evaluate effectiveness of astigmatism correction in eyes with myopic astigmatism using vector analysis.
Setting
Surgeries were performed in 2020 and 2021 at Eye Clinic Lexum, Prague, Czech Republic.
Methods
Our study consisted of 697 patients after refractive laser surgery for myopia and myopic astigmatism, with mean patient age 31 years (range: 18 to 36 years). Only right eyes were included in the study. Within the group, 273 eyes underwent FS-LASIK surgery and 424 eyes were after SMILE surgery. Follow-up was 1 year. Evaluated parameters were preoperative and postoperative uncorrected (UDVA) and corrected (CDVA) distance visual acuity and refraction. In eyes with myopic astigmatism (165 eyes after FS-LASIK and 274 eyes after SMILE), vector analysis of astigmatism using Alpins method was performed.
Results
Postop. UDVA was better than or equal to 20/20 in 90% and 94% of eyes in the FS-LASIK and SMILE group.
In eyes with myopic astigmatism, mean preoper. manifest astigmatism was -1.13±0.76 D (-4.00 to -0.25 D) and -0.90±0.52 D (-3.50 to -0.50 D), mean postop. manifest cylinder was -0.09±0.24 and -0.05±0.20 D, and it was within ±0.25 D in 86% and 92% of eyes and within ±0.50 D in 94% and 96% of eyes, in the FS-LASIK and SMILE group. Vector analysis showed a mean difference vector of 0.09±0.24 and 0.05±0.19 (p=0.254), and correction index of 0.97±0.16 and 1.00±0.12 (p=0.090) in these two groups. Angle of error was within ±5 degrees in 94% and 93% of eyes, and within ±15 degrees in 98% and 96% of eyes, in the FS-LASIK and SMILE group.
Conclusions
Our outcomes confirm that similarly to FS-LASIK surgery, SMILE is an effective and safe method for a correction of myopia and myopic astigmatism. Despite the absence of iris registration during SMILE, correction of astigmatism was highly effective