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

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.

scholarly journals Clinical outcomes after small incision lenticule extraction versus femtosecond laser-assisted LASIK for high myopia: a Meta-analysis.

2020 ◽  
Author(s):  
Yanyan Fu ◽  
Yewei Yin ◽  
Yang Zhao ◽  
Aiqun Xiang ◽  
Ying Lu ◽  
...  
Keyword(s):  
Femtosecond Laser ◽  
Clinical Outcomes ◽  
High Myopia ◽  
Spherical Aberration ◽  
Meta Analysis ◽  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Significant Difference ◽  
Lenticule Extraction

Abstract Background To compare postoperative clinical outcomes of high myopia after being treated by Small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK).Methods Comprehensive studies were conducted on the PubMed, MEDLINE, EMBASE, the Cochrane Library, and Chinese databases.Trials meeting the selection criteria were quality appraised, and the data were extracted by 2 independent authors, and the RevMan 5.3 version software were used in analyzing.Result Ten studies involving 637 patients (1093 eyes;575 eyes in the SMILE group and 518 eyes in the FS-LASIK group) were included in this meta-analysis. Pooled result revealed no significant differences in the following outcomes: the logMAR values of postoperative UDVA(WMD = -0.01, 95% CI: -0.02,0.00, I²=0%, P = 0.10 at postoperative 1mo; WMD =-0.01, 95% CI: -0.00 to 0.01, I²=0%,P = 0.35 at postoperative 3mo; WMD = -0.01, 95% CI:-0.02 to 0.01, I²=17%,P = 0.26 at long term), the logMAR values of postoperative CDVA(WMD = -0.02, 95% CI, -0.04 to 0.00, I²=0%, P = 0.11),and the postoperative mean refractive SE (WMD =0.02, 95% CI:0.04 to 0.08, I²=29%, P=0.60) . In the long-term observation, postoperative tHOA (WMD =-0.10, 95% CI:-0.13 to -0.07, I²=15%, P<0.00001)and postoperative spherical aberration (WMD =-0.13, 95% CI:--0.17 to -0.09, I²=38%, P<0.00001) were found to be less in the SMILE group compared with the FS-LASIK group, but no significant difference was found in postoperative coma (WMD =-0.02, 95% CI:-0.04 to 0.00, I²=98%, P=0.40).We also found greater PCE change post FS-LASIK than SMILE at long term follow-ups(WMD =-0.69, 95% CI:-1.36 to -0.01, I²=0%, P<0.05, however, there was no significant difference between the two groups at 3- or 6- months.(WMD =-0.19, 95% CI:-0.41 to 0.03, I²=31%, P=0.09;WMD =-0.20, 95% CI:-0.50 to 0.10, I²=17%, P=0.20)Conclusion For patients with high myopia, both SMILE and FS-LASIK are safe and efficacious. However, SMILE induced less tHOA and spherical aberration compared with FS-LASIK. Besides, FS-LASIK showed a greater increase in PCE than SMILE only at long term follow-ups. It remains to be seen whether the patients can get a better visual quality after SMILE and more comparative studies focused on high myopia is necessary.

scholarly journals Clinical outcomes after small-incision lenticule extraction versus femtosecond laser-assisted LASIK for high myopia: A meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0242059
Author(s):  
Yanyan Fu ◽  
Yewei Yin ◽  
Xiaoying Wu ◽  
Yuanjun Li ◽  
Aiqun Xiang ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Clinical Outcomes ◽  
High Myopia ◽  
Meta Analysis ◽  
Small Incision Lenticule Extraction ◽  
Distance Visual Acuity ◽  
Small Incision ◽  
Lenticule Extraction

Aim To compare postoperative clinical outcomes of high myopia after small-incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK). Methods From March 2018 to July 2020, PubMed, MEDLINE, Embase, the Cochrane Library, and several Chinese databases were comprehensively searched. The studies meeting the criteria were selected and included; the data were extracted by 2 independent authors. The clinical outcome parameters were analyzed with RevMan 5.3. Results This meta-analysis included twelve studies involving 766 patients (1400 eyes: 748 receiving SMILE and 652 receiving FS-LASIK). Pooled results revealed no significant differences in the following outcomes: the logarithm of the mean angle of resolution (logMAR) of postoperative uncorrected distance visual acuity (weighted mean difference (WMD) = -0.01, 95% confidence interval (CI): -0.02 to 0.00, I2 = 0%, P = 0.07 at 1 mo; WMD = -0.00, 95% CI: -0.01 to 0.01, I2 = 0%, P = 0.83 at 3 mo; WMD = -0.00, 95% CI: -0.01 to 0.00, I2 = 32%, P = 0.33 in the long term), and the postoperative mean refractive spherical equivalent (WMD = -0.03, 95% CI: -0.09 to 0.03, I2 = 13%, P = 0.30). However, the SMILE group had significantly better postoperative corrected distance visual acuity (CDVA) than the FS-LASIK group (WMD = -0.04, 95% CI, -0.05 to -0.02, I2 = 0%, P<0.00001). In the long term, postoperative total higher-order aberration (WMD = -0.09, 95% CI: -0.10 to -0.07, I2 = 7%, P<0.00001) and postoperative spherical aberration (WMD = -0.15, 95% CI: -0.19 to -0.11, I2 = 29%, P<0.00001) were lower in the SMILE group than in the FS-LASIK group; a significant difference was also found in postoperative coma (WMD = -0.05, 95% CI: -0.06 to -0.03, I2 = 30%, P<0.00001). Conclusion For patients with high myopia, both SMILE and FS-LASIK are safe, efficacious and predictable. However, the SMILE group demonstrated advantages over the FS-LASIK group in terms of postoperative CDVA, while SMILE induced less aberration than FS-LASIK. It remains to be seen whether SMILE can provide better visual quality than FS-LASIK; further comparative studies focused on high myopia are necessary.

scholarly journals Comparison of clinical outcomes of implantable collamer lens versus femtosecondlaser in situ keratomileusis and small incision lenticule extraction for moderate-to-high myopia and myopic astigmatism correction

2021 ◽  
Vol 17 (4) ◽  
pp. 400-415
Author(s):  
Yen Hai Tran ◽  
Huy Dinh Minh Tran ◽  
Ly Thi-Hai Tran ◽  
Dung Thi Mong Nguyen ◽  
Chuong Nguyen Thao Le ◽  
...  
Keyword(s):  
High Myopia ◽  
Linear Models ◽  
Laser In Situ Keratomileusis ◽  
Small Incision Lenticule Extraction ◽  
Implantable Collamer Lens ◽  
Small Incision ◽  
Lenticule Extraction ◽  
Safety Indices ◽  
Myopic Astigmatism

Purpose: To compare safety, efficacy, stability, and predictability of implantable collamer lens (ICL) with femtosecond-laser in situ keratomileusis (FS-LASIK) or small incision lenticule extraction (SMILE) for the correction of moderate-to-high myopia/myopic astigmatism. Study design: We retrospectively collected data from patients with moderate-to-high myopia/myopic astigmatism (spherical equivalent [SE] ≥ −3.00 diopters [D]) who underwent ICL (48 eyes), FS-LASIK (36 eyes), or SMILE (86 eyes) at Hai Yen Eye Center from October 2016 to February 2018. Materials and methods: The Wilcoxon Mann-Whitney U test was used to compare pre- and postoperative patients’ characteristics of ICL with SMILE or FS-LASIK. Generalized linear models with unstructured correlation matrix and robust standard errors were used to analyze efficacy and safety indices; logistic regression was used for cylinder predictability. Results: After controlling for age, preoperative SE, and preoperative corrected distance visual acuity (pCDVA), SMILE had significantly lower safety indices (Coefficient = −0.04, 95% CI = −0.07–−0.01) and efficacy indices (Coefficient = −0.10, 95% CI = −0.20–−0.01) than did ICL, while FS-LASIK was not significantly different from ICL (Coefficient = −0.02, 95% CI = −0.06–0.02 and Coefficient = −0.01, 95% CI= −0.10–0.09, respectively). ICL SEswere stable over 12 months after surgery. However, in FS-LASIK and SMILE, SEs significantly decreased at 12 months compared with 6 months after surgery. The percentage of eyes that underwent FS-LASIK and had target SEs within ±0.5 D at 12 months was significantly lower than those that underwent ICL (OR = 0.14, 95% CI = 0.02–0.85), after controlling for age, preoperative SE, and pCDVA. Conclusion: For the correction of moderate-to-high myopia/myopic astigmatism, ICL seems to perform better than SMILE and FS-LASIK.

scholarly journals Outcomes of Small Incision Lenticule Extraction for Myopic Astigmatic Treatment

2019 ◽  
Vol 7 (24) ◽  
pp. 4272-4277 ◽  
Author(s):  
Nguyen Xuan Hiep ◽  
Pham Thi Minh Khanh ◽  
Do Quyet ◽  
Than Van Thai ◽  
Vu Thi Nga ◽  
...  
Keyword(s):  
Control Function ◽  
Case Series ◽  
Safety Index ◽  
Small Incision Lenticule Extraction ◽  
Small Incision ◽  
Before And After ◽  
Lenticule Extraction ◽  
Efficacy Index ◽  
The Mean ◽  
Myopic Astigmatism

BACKGROUND: Some studies have shown that there is a certain rotation of the eye in the sitting and lying position of the patient. The Visumax system used for the Refractive Lenticule Extraction-Small Incision Lenticule Extraction (ReLEx SMILE) surgery lacks the rotation of eye control function. So, is the ReLEx SMILE surgery for patients with astigmatism safe and effective? AIM: To evaluate the outcomes of the ReLEx SMILE surgery in cases with myopic astigmatism. METHODS: The case series included 120 eyes with myopic astigmatism undergoing ReLEx SMILE surgery from January 2018 to November 2018. The distribution of patients for two subgroups based on the power of astigmatism, low astigmatic group (≤ 1.50D) and high astigmatic group (> 1.50D). All patients were measured UDVA, CDVA, refractive sphere, astigmatism and sphere equivalent before and after surgery one week, one month and three months carefully. The astigmatic correction was evaluated by the vectorial analysis Alpins. RESULTS: The mean efficacy index of the low and high astigmatic group was 1.035 and 1.082 (respectively); the mean safety index was 1.113 and 1.215 (respectively). 93% of eyes in the low astigmatic group had an angle of error (AE) within ± 15 degrees and 100% in high astigmatic group. There was an undercorrection in astigmatic treatment. No complications during and after surgery were recorded. CONCLUSION: ReLEx SMILE surgery for the myopic astigmatic treatment was safe and effective.

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