Comparison Of The Effect Of Flat Keratometry On Visual And Refractive Outcomes After Smile Versus Fs-Lasik In Mild And Moderate Miyopia
Published 2024 - 42nd Congress of the ESCRS
Reference: FP24.07 | Type: Free paper | DOI: 10.82333/exjw-es12
Authors: Nilay Kandemir Besek 1 , Metehan Simsek* 1 , Burcu Kemer Atik 1 , Sibel Ahmet 1 , Ahmet Kırgız 1
1Cataract Refractive,University of Health Sciences, Beyoglu Eye Training and Research Hospital, Beyoglu, Istanbul, Turkey,Istanbul,Türkiye
Purpose
To investigate the effect of a flat cornea on postoperative visual and refractive outcomes of laser-assisted in-situ keratomileusis (LASIK) and Small incision lenticule extraction (SMILE) in mild and moderate myopia and to compare the results of these procedures.
Setting
University of Health Sciences, Beyoglu Eye Training and Research Hospital, Beyoglu, Istanbul, Turkey.
Methods
114 eyes of a total of 114 (59 female-55 male) patients were included in the study. Thirty-one patients underwent LASIK (group 1) and 26 patients underwent SMILE (group 2) of 60 patients with flat corneas ( K2 <42 D). Of the 57 patients in the control group (K2 between 42-46 D), 29 underwent LASIK (group 3) and 28 underwent SMILE (group 4). Pre- and postoperative 6-month values of uncorrected and best-corrected visual acuity (UCVA, BCVA), spherical and cylindrical refractive errors, spherical equivalent (SE), keratometry, and higher order aberrations (HOAs) were evaluated.
Results
The postoperative values of UCVA, refractive errors were similar in all groups (p>0.05; for each). Although BCVA of group 3 was better than that of group 1 (p= 0.033). The postoperative SE values of group 2 and group 4 were also higher than the other two groups (p<0.05;for each). While there was no statistically significant difference in Safety index (SI ) values between the groups (p=0.40), the Efficacy index (EI) of group 1 was lower than the other three groups (p<0.05;for each). The postoperative total Root mean square (RMS) values of groups 1 and 2, which had flat corneas, were higher than the other two groups (p<0.05;for each). Similarly, coma values increased postoperatively in groups 1 and 2 (p<0.05;for each).
Conclusions
Both LASIK and SMILE are safe procedures with satisfactory results for flat corneas. However, higher postoperative HOA values in flat corneas may negatively affect vision quality. In addition, SMILE surgery seems to be more favourable in terms of BCVA and EI.