scholarly journals Dry Eye after Small Incision Lenticule Extraction (SMILE) versus Femtosecond Laser-Assisted in Situ Keratomileusis (FS-LASIK) for Myopia: A Meta-Analysis

PLoS ONE ◽  
2016 ◽  
Vol 11 (12) ◽  
pp. e0168081 ◽  
Author(s):  
Zeren Shen ◽  
Yanan Zhu ◽  
Xiaohui Song ◽  
Jie Yan ◽  
Ke Yao
2020 ◽  
Author(s):  
Yanyan Fu ◽  
Yewei Yin ◽  
Yang Zhao ◽  
Aiqun Xiang ◽  
Ying Lu ◽  
...  

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.


2020 ◽  
Vol 46 (3) ◽  
pp. 403-409 ◽  
Author(s):  
Beril Tülü Aygün ◽  
Kadir İlker Çankaya ◽  
Alper Ağca ◽  
Yusuf Yıldırım ◽  
Burçin Kepez Yıldız ◽  
...  

2018 ◽  
Vol 12 (1) ◽  
pp. 164-174 ◽  
Author(s):  
Iben Bach Damgaard ◽  
Mohamed Reffat ◽  
Jesper Hjortdal

Worldwide, femtosecond Laser AssistedIn-situKeratomileusis (LASIK) is a well known and commonly used refractive technique, although Small Incision Lenticule Extraction (SMILE) has become increasingly popular since it was introduced in 2011. In LASIK, a corneal flap is cut with a microkeratome or femtosecond laser, followed by thinning of the stromal bed with excimer laser ablation. In SMILE, a minor intrastromal lenticule is cut with a femtosecond laser and subsequently removed through a small incision, leaving the anterior and strongest part of the cornea almost intact. Both LASIK and SMILE require cutting of corneal lamellae that may reduce the biomechanical stability of the cornea, with the potential risk of corneal iatrogenic ectasia as a severe complication. However, SMILE preserves the anterior corneal integrity and may, in theory, better preserve the corneal biomechanical strength than LASIK after surgery.A review aimed to examine the current literature that describes and compares the corneal biomechanical properties after Laser AssistedIn-situKeratomileusis (LASIK) and Small Incision Lenticule Extraction (SMILE). A comprehensive search was performed in Pubmed.gov using the following search queries: Corneal biomechanical properties, corneal biomechanics, ocular response analyser, ocular response analyzer, ORA,ex vivo, in vitro, Corvis, Corvis ST, LASIK, and SMILE.


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