Clinical Efficacy Of Fs-Lasik Combined With Smile Surgery In The Treatment Of Myopia Combined With Presbyopia

Exploring the application effect of femtosecond laser assisted laser in situ keratomileusis (FS-LASIK) combined with femtosecond laser small incision lens extraction (SMILE) in the treatment of myopia combined with presbyopia.

Presbyopia refers to symptoms such as difficulty in approaching the eyes that occur with age and decreased eye regulation ability. However, before the onset of presbyopia, although there is still some regulatory capacity, there have been varying degrees of underregulation, which also affects people's lives and work.  With normal lens structure, many patients choose laser corneal refractive surgery. 

Prospective, non-randomized clinical studies. A total of 32 patients who underwent myopia combined with presbyopia correction at Chongqing Baiji Ophthalmology Clinic from Aug. 2021 to Apr. 2023, including 9 males and 23 females, aged (45.66±5.02) years were collected. Based on the preoperative examination, SMILE surgery was performed on the dominant eye (32 eyes), while FS-LASIK surgery was performed on the non dominant eye (32 eyes) of the same patient. Collected preoperative and postoperative visual acuity, spherical equivalent, spherical aberration(SA), coma, higher order aberration (HOA), corneal epithelial thickness and postoperative satisfaction.

Starting from 1 week, the UDVA of dominant eye was better than preoperative (P<0.05). Starting from 1 month, non dominant eye UNVA was better than preoperative (P<0.05). The percentages of UDVA≥20/20 was 96.2% in dominant eye and UNVA≥20/25 was 92.3% in non dominant eye. The SA of dominant eye and non dominant eye were (0.11±0.03) and (-0.01 ± 0.04) μm (P<0.05); the coma were（0.25±0.03）and（0.25±0.15）μm (P＞0.05); the HOA were (0.22±0.04) and (0.29±0.08) μm (P<0.05).The corneal epithelial thickness of both eyes increased after surgery(P<0.05). At 1 week and 1 month, the corneal epithelial thickness in all ranges of the non dominant eye was higher than that of dominant eye (P<0.05). 96.2% of the patients were satisfied after surgery.

The corneal refractive surgery of FS-LASIK combined with SMILE is safe and effective in treating myopia combined with presbyopia, and this design takes the ocular surface effect into account, which is a new design method for presbyopia correction.