A Comparative Study Of Low And High Energy For Three-Month Outcomes Of Smartsight Lenticule Extraction For Correcting Myopia And Astigmatism.

To compare the outcomes of Smartsight lenticule extraction performed with low and high energy settings, focusing on efficacy, safety, and predictability. To find the optimal energy setting that will produce the best results.

First Eye Clinic, Seoul, Republic of Korea

A retrospective analysis was conducted on patients who underwent Smartsight lenticule extraction. 392 eyes of 196 patients were included. Patients were divided into two groups based on the energy settings used during the procedure: low energy group (LE) and high energy group (HE). Laser parameters of the lenticule cut in the LE group were 80nJ of energy level, 5.1㎛ of spot distance. Laser parameters in the HE group were 85nJ of energy level, 4.1㎛ of spot distance. Tract distance was the same at 2.8㎛ in both groups. Visual acuity outcomes, refractive errors, intraoperative and postoperative findings were compared between the two groups.

At postoperative day 1 (POD1), astigmatism was -0.06 ± 0.02D lower for LE group (p < .05); uncorrected visual acuities (UDVA) were -0.02 ± 0.01 logMAR better for LE group (p < .05). The differences between postop UDVA and preop corrected visual acuities (CDVA) were + 0.2 ± 0.1 lines better for LE group at POD1 (p < .05). There was no significant difference in visual acuity outcomes and refractive errors between the two groups at postoperative 3 months. In the LE group, the frequency of corneal interface haze was lower at 3 months postoperatively.

Both low and high energy Smartsight lenticule extraction offer effective, safe, and predictable options for refractive correction. However, the low energy approach may offer advantages in faster recovery and prevention of corneal interface haze.