Visual outcomes after small incision lenticule extraction and implantable collamer lens V4c for moderate myopia: 1-year results

Objectives: To compare the efficacy of small incision lenticule extraction (SMILE) and toric implantable collamer lens (TICL) implantation for myopic astigmatism correction using vector analysis. Methods: In this retrospective study, 171 eyes of 171 patients with cylinder ⩾1.0 diopters (D) were recruited, with 97 eyes underwent SMILE and 74 eyes underwent TICL implantation. Preoperative and 3-months postoperative visual and refractive results were examined. The astigmatism correction, graded by the degree of preoperative cylinder was compared between two groups using vector analysis. Results: At 3-months postoperatively, the residual cylinder was −0.10 ± 0.21 D in the SMILE group and −0.30 ± 0.32 D in the TCL group ( p < 0.05). Furthermore, 98% and 85% of eyes had the cylinder within ±0.5 D in the SMILE and TICL group, respectively. The vector analysis revealed similar target induced astigmatism vector in two groups. However, the difference vector, magnitude of error, angle of error, and index of success were significantly higher (0.30 ± 0.32 D, −0.19 ± 0.25, −2° ± 4.35°, and 0.16 ± 0.17 D, respectively) in the TICL group than the values in the SMILE group (0.10 ± 0.21 D, −0.05 ± 0.20, −0.03° ± 2.13°, and 0.05 ± 0.12, respectively), regardless of the degree of preoperative cylinder (all p < 0.05). For preoperative cylinder < 2.0 D, surgically induced astigmatism vector and correction index in the SMILE group were higher than those in the TICL group ( p < 0.05). Conclusion: Both SMILE and TICL implantation are effective techniques for myopic astigmatism correction. However, the accuracy of correction in the magnitude and axis of astigmatism with SMILE was better than that achieved with TICL implantation.

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Control-matched comparison of refractive and visual outcomes between small incision lenticule extraction and femtosecond laser-assisted LASIK

Clinical Ophthalmology ◽

10.2147/opth.s161883 ◽

2018 ◽

Vol Volume 12 ◽

pp. 865-873 ◽

Cited By ~ 5

Author(s):

Takahiro Kataoka ◽

Tomoya Nishida ◽

Azusa Murata ◽

Mayuka Ito ◽

Naoki Isogai ◽

...

Keyword(s):

Femtosecond Laser ◽

Small Incision Lenticule Extraction ◽

Visual Outcomes ◽

Small Incision ◽

Lenticule Extraction ◽

Matched Comparison

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Implantable collamer lens versus small incision lenticule extraction for high myopia correction: A systematic review and meta-analysis

BMC Ophthalmology ◽

10.1186/s12886-021-02206-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kai Cao ◽

Jingshang Zhang ◽

Jinda Wang ◽

Mayinuer Yusufu ◽

Shanshan Jin ◽

...

Keyword(s):

Systematic Review ◽

High Myopia ◽

Meta Analysis ◽

Cochrane Central Register ◽

Safety Index ◽

Small Incision Lenticule Extraction ◽

Implantable Collamer Lens ◽

Small Incision ◽

Lenticule Extraction ◽

Efficacy Index

Abstract Purpose To compare the efficacy, safety, predictability and visual quality between implantable collamer lens (ICL) implantation and small incision lenticule extraction (SMILE) for high myopia correction in adults. Methods A systematic review and meta-analysis was conducted. A comprehensive literature search was done based on databases including PubMed, Science Direct, Embase, and the Cochrane Central Register of Controlled Trials. The efficacy index, safety index, changes in Snellen lines of corrected distance visual acuity (CDVA), predictability (difference between post-operative and attempted spherical equivalent error, SER), incidence of halos, and change in higher-order aberrations (HOAs) were compared. Mean difference (MD) and 95% confidence interval (CI) was used to estimate continuous outcomes, risk ratio (RR) and 95%CI was used to estimate categorical outcomes. Results Five observational studies involving 555 eyes were included in this review. Studies’ sample sizes (eyes) ranged from 76 to 197. Subjects’ refraction ranged from -6 diopter (D) to -12D. Study duration of most researches were 6 months or 12 months. Compared to SMILE, ICL implantation showed better efficacy index (MD=0.09, 95%CI:0.01 to 0.16) and better safety index (MD=0.08, 95%CI: 0.00 to 0.16). Compared with SMILE, more ICL-treated eyes gained one or more Snellen lines of CDVA (RR=1.54, 95%CI:1.28 to 1.86), more gained two or more lines (RR=2.09, 95%CI:1.40 to 3.13), less lost one or more lines (RR=0.17, 95%CI:0.05 to 0.63). There was no difference in predictability between two treatments, RRs of predictability of within ±0.5D and ±1D were 1.13 (95%CI: 0.94 to 1.36) and 1.00 (95%CI: 0.98 to 1.02). Compared with SMILE, ICL implantation came with a higher risk of halos [RR=1.79, 95%CI: 1.48 to 2.16] and less increase in total HOAs (MD=-0.23, 95%CI: -0.42 to -0.03). Conclusion Compared with SMILE, ICL implantation showed a higher risk of halos, but equal performance on SER control, and better performance on efficacy index, safety index, CDVA improvement and HOAs control. Overall, ICL implantation might be a better choice for high myopia correction in adults.

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