Five-Year Follow-Up of Visual Outcomes and Optical Quality After Small Incision Lenticule Extraction for Moderate and High Myopia

Purpose. To report long-term visual and refractive results of small-incision lenticule extraction (SMILE) in treatment of high myopia. Materials and Methods. Medical records of patients who underwent SMILE for surgical correction of myopia or myopic astigmatism were retrospectively reviewed. Only patients with a preoperative spherical equivalent of subjective manifest refraction (SE) ≥ 6 D and a postoperative follow-up of 5 years were included in the study. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and SE were analyzed preoperatively and at 1-, 3-, and 5-year postoperative periods. Results. Thirty-seven eyes of 37 patients were included in the study. The mean attempted SE was −7.47 ± 1.10 D (range −6.00 to −10.00 D). At the 5-year visit, the mean difference between achieved and attempted SE was −0.43 ± 0.47 (0.50 to −1.25 D). Mean postoperative UDVA and CDVA were 0.20 ± 0.18 and 0.06 ± 0.08 logMAR, respectively. At the 1-year visit, 70% and 97% of the eyes were within ±0.50 D and ±1.00 D of the intended correction. At the 5-year follow-up, 59% and 92% percent of the eyes were within ±0.50 D and ±1.00 D of the intended SE, respectively. At the 5-year visit, the efficacy index was 0.89 ± 0.26 and the safety index was 1.16 ± 0.20. Fifty-four percent of the eyes gained one or more lines of CDVA. Conclusion. SMILE with an intended correction of up to a spherical equivalent of 10 D is safe and effective. However, there is regression of the refractive effect over extended follow-up.

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One‐year visual outcomes and optical quality of femtosecond laser small incision lenticule extraction and Visian Implantable Collamer Lens (ICL V4c) implantation for high myopia

Acta Ophthalmologica ◽

10.1111/aos.14344 ◽

2020 ◽

Vol 98 (6) ◽

Cited By ~ 3

Author(s):

Lingling Niu ◽

Huamao Miao ◽

Mi Tian ◽

Dan Fu ◽

Xiaoying Wang ◽

...

Keyword(s):

Femtosecond Laser ◽

High Myopia ◽

Optical Quality ◽

Small Incision Lenticule Extraction ◽

Implantable Collamer Lens ◽

Small Incision ◽

Icl V4c ◽

Lenticule Extraction ◽

One Year

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Early visual outcomes and optical quality after femtosecond laser small-incision lenticule extraction for myopia and myopic astigmatism correction of over −10 dioptres

Acta Ophthalmologica ◽

10.1111/aos.13609 ◽

2017 ◽

Vol 96 (3) ◽

pp. e341-e346 ◽

Cited By ~ 10

Author(s):

Bing Qin ◽

Meiyan Li ◽

Xun Chen ◽

Walter Sekundo ◽

Xingtao Zhou

Keyword(s):

Femtosecond Laser ◽

Optical Quality ◽

Small Incision Lenticule Extraction ◽

Visual Outcomes ◽

Small Incision ◽

Astigmatism Correction ◽

Lenticule Extraction ◽

Myopic Astigmatism

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Short-Term Outcomes of Small-Incision Lenticule Extraction (SMILE) for Low, Medium, and High Myopia

European Journal of Ophthalmology ◽

10.5301/ejo.5000849 ◽

2016 ◽

Vol 27 (2) ◽

pp. 153-159 ◽

Cited By ~ 12

Author(s):

Joaquín Fernández ◽

Almudena Valero ◽

Javier Martínez ◽

David P. Piñero ◽

Manuel Rodríguez-Vallejo

Keyword(s):

Visual Acuity ◽

High Myopia ◽

Small Incision Lenticule Extraction ◽

Distance Visual Acuity ◽

Small Incision ◽

Uncorrected Distance Visual Acuity ◽

Manifest Refraction ◽

Corrected Distance Visual Acuity ◽

Lenticule Extraction

Purpose To determine the safety, efficacy, and predictability of small-incision lenticule extraction at 6-month follow-up, depending on the level of the myopic refractive error. The surgeries were performed by a surgeon new to this technique. Methods Seventy-one subjects with a mean age of 31.86 ± 5.57 years were included in this retrospective observational study. Subjects were divided into 3 groups depending on the preoperative spherical equivalent (SE): low group from -1.00 D to -3.00 D, medium from -3.25 D to -5.00 D, and high from -5.25 D to -7.00 D. Manifest refraction, corrected distance visual acuity (CDVA), and uncorrected distance visual acuity (UDVA) were measured before surgery and at 6 months after the treatment. Results In total, 1.4% of the eyes lost 1 line of CDVA after the procedure, whereas 95.8% remained unchanged and 2.8% gained 1 line. A significant undercorrection (p = 0.031) was found in the high myopia group (median -0.50 D), whereas the low and medium groups remained near to emmetropia. In terms of efficacy, no statistically significant intergroup differences for postoperative UDVA (p = 0.282) were found. The vector analysis also showed undercorrection of the preoperative cylinder, even though the standard deviations decreased from 0.9 D in the x axis and 0.7 D in the y axis to 0.24 D and 0.27 D, respectively. Conclusions Small-incision lenticule extraction might be a safe, effective, and predictable procedure even for inexperienced surgeons. No differences in efficacy were found among myopia levels even though undercorrections were found for SE and cylinder in high myopia.

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Visual Outcomes after Small Incision Lenticule Extraction and Femtosecond Laser-Assisted LASIK for High Myopia

Ophthalmic Research ◽

10.1159/000504304 ◽

2019 ◽

Vol 63 (4) ◽

pp. 427-433

Author(s):

Weiming Yang ◽

Shengtao Liu ◽

Meiyan Li ◽

Yang Shen ◽

Xingtao Zhou

Keyword(s):

Femtosecond Laser ◽

High Myopia ◽

Small Incision Lenticule Extraction ◽

Visual Outcomes ◽

Small Incision ◽

Lenticule Extraction

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Five-years Results of Small-incision Lenticule Extraction in High Myopia

10.21203/rs.3.rs-21611/v1 ◽

2020 ◽

Author(s):

Min Lang ◽

Kaiwei Cao ◽

Ting Liu ◽

Jiao Pan ◽

Jian Ye

Keyword(s):

Visual Acuity ◽

High Myopia ◽

Control Group ◽

Small Incision Lenticule Extraction ◽

Small Incision ◽

Related Quality ◽

Lenticule Extraction

Abstract Background To investigate long-term refractive visual quality outcomes and vision-related quality of life after small-incision lenticule extraction (SMILE) in the treatment of high myopia.Methods Thirty patients (60 eyes) with high myopia who underwent SMILE more than 5 years previously were selected as the SMILE group. Another 30 high myopia patients (60 eyes) who had worn corrective spectacles for more than 5 years were selected as the control group. In the SMILE group, the postoperative follow-up times were 3 months, 6 months, 1 year and 5 years. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent (SE), and ocular axial length (AL) were analysed. The Chinese version of the National Eye Institute Visual Function Questionnaire-25 (CHI-NEI-VFQ-25) was used to evaluate the vision-related quality of life in the SMILE group and the control group.Results In the SMILE group, the mean preoperative SE was -7.29±0.87 D (range -6.00 to -9.125 D). The efficacy index and safety index of SMILE were 1.09±0.18 and 1.19±0.12, respectively. Five years postoperatively, 44 eyes (73%) obtained a visual acuity of 20/20 or better. There were no eyes with CDVA loss of one or more Snellen lines. Forty-nine eyes (82%) and 57 eyes (95%) were within ±0.50 D and ±1.00 D of attempted correction, respectively. Forty-eight eyes (80%) had astigmatism < 0.50 D. The postoperative mean SE values at 3 months, 6 months, 1 year, and 5 years were 0.11±0.44 D, 0.07±0.45 D, -0.02±0.41 D, and -0.15±0.46 D, respectively. No significant change was observed in the ocular axial length from before operation to 5 years postoperatively (26.08±0.96 mm vs 26.01±0.94 mm, p>0.05). Compared to the control group, the SMILE group showed a significantly higher total score on the CHI-NEI-VFQ-25 (90.14 vs 81.43, p < 0.001).Conclusions In the present study, in a long-term follow-up, we demonstrated that correcting high myopia with SMILE is safe, effective, and predictable. In addition, there is slight undercorrection.

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