A Comparison Of Femtosecond Assisted Lasik With Two Variants Of Keratolenticule Extraction For Correcting Of Myopia.

To compare femtosecond assisted LASIK (F-LASIK) with two methods of KLEx (SMILE and Smart Sight) in correcting myopia below 8.0 D.

Magrabi Eye Center, Jeddah, Saudi Arabia

This retrospective comparative study included 134 eyes treated with F-LASIK, 132 with SMILE, and 126 with Smart Sight. All eyes had myopia less than 8.0 D, corrected distance visual acuity of 0.0 logMAR or better, and astigmatism less than 2 D. Visual and refractive outcomes were assessed. F F-LASIK was performed using the SCHWIND ATOS femtosecond laser for flap creation and the AMARIS 500 excimer laser for ablation. SMILE procedures were performed with the VisuMax 500 (Carl Zeiss Meditec), while Smart Sight was performed using the SCHWIND ATOS femtosecond laser system.

On the first postoperative day, uncorrected visual acuity (UDVA) of 0.1 logMAR was achieved in 90% of F-LASIK, 69% of SMILE, and 67% of Smart Sight eyes. F-LASIK provided significantly better UDVA on day one and at one week (p <0.01). By one month, there was no statistically significant difference in UDVA among the groups: mean UDVA was –0.03 (F-LASIK), –0.01 (SMILE), and –0.02 logMAR (Smart Sight) (P > 0.05). At 1 month, mean manifest refraction spherical equivalent was –0.05 ± 0.31 D (F-LASIK), –0.19 ± 0.21 D (SMILE), and –0.17 ± 0.38 D (Smart Sight) (P > 0.05). No visually threatening complications were encountered in the three groups.

F-LASIK, SMILE, and Smart Sight are effective and predictable for correcting myopia below 8.0 D. Visual recovery is faster with F-LASIK and slower with KLEx. At one month, visual and refractive outcomes are similar for all three procedures.