Fig. 7.1
Appearance of a LASIK-treated eye 10 years post-op. Superficial punctate keratitis is clearly visible after fluorescein staining
Fig. 7.2
Eyes underwent small-incision lenticule extraction (SMILE) and LASIK 1 year post-op. The SMILE procedure has a less pronounced impact on the ocular surface compared with LASIK
7.2 Trial Evaluation
Data source articles limited to SMILE were searched in the following databases from January 2011 to December 2014: PubMed (Medline). A minimum follow-up of 3 months was required. Eyes with the mean preoperative spherical equivalent (SE) of more than −6.0 diopters (D) were excluded from this review. The data of interest for each clinical outcome were extracted as follows: (1) Efficacy: the number of eyes achieving an uncorrected distance visual acuity (UDVA) of 20/20 or better postoperatively. (2) Predictability: the number of eyes achieving a postoperative spherical equivalent (SE) within ± 0.50 diopter (D) of the intended target. (3) Safety: the number of eyes that lost two or more lines of postoperative CDVA relative to the preoperative CDVA. (4) Stability: the changes in manifest refraction from 1 week to the last follow-up.
7.3 Recent Findings
Eleven studies, mostly on SMILE for moderate myopic correction and one study on low myopia were included in this review and summarized in Table 7.1.
Table 7.1
Summary of clinical results after small-incision refractive lenticule extraction in eyes with low to moderate myopia
Studya (year) | No. of eyes | Follow-up (month) | Mean Preop SE (D) | UDVA ≥20/20 (%) | Eyes within ±0.5 D (%) | Lost ≥2 lines in CDVA (%) | Change in SE (D) |
|---|---|---|---|---|---|---|---|
Sekundo [1] (2011) | 91 | 6 | −4.75 ± 1.56 | 83.5 | 80.2 | 2.2 | 0.05 |
Shah [2] (2011) | 51 | 6 | −4.87 ± 2.16 | 62 | 91 | 0 | −0.06 ± 0.27 |
Kamiya [14] (2014) | 26 | 6 | −4.21 ± 1.63 | 96 | 100 | 0 | 0.00 ± 0.30 |
Ganesh [15] (2014) | 50 | 3 | −4.37 ± 2.21 | 96 | NA | 0 | NA |
Ang [16] (2014) | 20 | 3 | −3.23 ± 1.09 | 65.0 | 65.0 | NA | NA |
Lin [17] (2014) | 60 | 3 | −5.13 ± 1.75 | 85.0 | 98.3 | 1.7 | NA |
Xu [18] (2015) | 52 | 12 | −5.53 ± 1.70 | 83 | 90.4 | 0 | −0.06 ± 0.37 |
Sekundo [19] (2014) | 54 | 12 | −4.68 ± 1.29 | 88 | 92 | 0 | −0.19 ± 0.19 |
Agca [20] (2014) | 40 | 12 | −4.03 ± 1.61 | 65 | 95 | 0 | −0.33 ± 0.25 |
Kunert [21] (2015) | 55 | 12 | −4.66 ± 1.75 | 1.8 | −0.11 ± 0.42 | ||
Reinstein [22] (2014) | 110 | 12 | −2.61 ± 0.55 | 96 | 84 | 0 | −0.05 ± 0.36 |
SE spherical equivalent, D diopters, UDVA uncorrected distance visual acuity, CDVA corrected distance visual acuity, NA data not available
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