Comparison Of Dry Eye Symptoms, Tear Film Stability, And Visual Quality In Myopic Patients Undergoing Surgery With Implantable Collamer Lens (Icl) Versus Small Incision Lenticule Extraction (Smile)
Published 2025 - 43rd Congress of the ESCRS
Reference: PO1063 | Type: Poster | DOI: 10.82333/1tkh-tb35
Authors: Ricardo Pérez Izquierdo* 1 , Blanca Poyales Villamor 1 , Elena Corral Carrasquilla 2 , Felix González López 1 , Cristina Peláez Gutiérrez 3
1Department of Cataract and Refractive Surgery,Miranza IOA,Madrid,Spain, 2Department of Optometry,Miranza IOA,Madrid,Spain, 3R&D Department,Miranza IOA,Madrid,Spain
Purpose
To compare changes in the ocular surface disease index (OSDI), non-invasive tear break-up time (NIBUT), and visual quality parameters (objective scattering index (OSI), modulation transfer function (MTF), and Strehl ratio (SR)) in patients who underwent myopic refractive surgery using the ICL or SMILE technique. Measurements were performed using the Optical Quality Analysis System (OQAS, Visiometrics, Terrassa, Spain).
Setting
Clínica Miranza IOA Madrid
Methods
A total of 62 patients (108 eyes) were studied. Dry eye symptoms were assessed using the OSDI questionnaire, and OQAS examinations were performed during the preoperative visit (preop) and at 1-month (1M), 3-month (3M), and 6-month (6M) postoperative (postop) visits. Preoperative and postoperative measurements were compared to evaluate changes in the ICL and SMILE groups.
Results
A total of 52 eyes underwent ICL surgery, and 56 eyes for SMILE surgery. The mean age was 31.5 years in the ICL group and 28.29 years in the SMILE group. The mean spherical equivalent refraction was -4.14 diopters (D) in ICL and -3.71 D in SMILE. Preoperative OSDI was higher in the ICL (9.28 ± 10.68) compared to the SMILE group (4.68 ± 3.64, p=0.04). Postoperative OSDI values at 1M, 3M, and 6M were 12.13 ± 8.07, 7.68 ± 6.93, and 6.71 ± 7.20 for ICL, and 12.94 ± 10.7, 7.34 ± 6.22, and 6.65 ± 8.75 for SMILE. Preoperative NIBUT was 11.16 ± 5.31 seconds for ICL and 13.51 ± 5.35 for SMILE. Postoperative NIBUT at 1M, 3M, and 6M were 11.50 ± 5.42, 11.57 ± 5.60, and 12.32 ± 5.17 for ICL, and 13.79 ± 4.62, 5.85 ± 6.76, and 12.23 ± 5.51 for SMILE.
Conclusions
In our study, preoperative OSDI and NIBUT values were slightly worse in the ICL group. At one month postoperatively, both groups showed a significant increase in OSDI, followed by a gradual recovery to similar levels at six months. Tear film stability initially decreased in both groups, with no significant differences observed between them. Regarding visual quality, OSI was higher in the ICL group at one month, but both groups exhibited similar values at six months. MTF and SR indicated better long-term recovery in the ICL group. While OSDI and NIBUT improved immediately in the ICL group, the SMILE group experienced a temporary decrease, followed by recovery at six months.